Benefit Guide - Circles

2024 BENEFITS GUIDE

“ Whenever you think you can ’ t do more, try harder. ” HARRY ADJMI, CEO

ADJFAM ACHS Management Essential Brand Fashion Footwear Kidz Concepts Lifeworks NJ Distribution

WELCOME

At One Step Up, LTD we appreciate your commitment and contributions to our company ’ s success. Each year, we strive to offer benefit plans to our employees that not only reward you for your hard work, but offer you and your family comprehensive and affordable health and wellness protection. We are confident that you will find our 2024 benefit offerings to be of excellent value to you and to your dependents. In the following pages, you will find a summary of our benefit plans for 2024. Please read this guidebook carefully as you prepare to make your elections for the upcoming Plan Year to ensure that you select the coverage that is right for you. Our benefit programs remain highly competitive for 2024. About this Guidebook This Benefits Guidebook describes the highlights of One Step Up, LTD ’ s benefits program in non - technical language. Your specific rights to benefits under the plan are governed solely, and in every respect, by the official plan documents, and not the information in this guidebook. If there is any discrepancy between the descriptions of the program ’ s elements as contained in this benefits guidebook and the official plan documents, the language in the official plan documents shall prevail as accurate. Please refer to the plan - specific documents published by each of the respective carriers for detailed plan information. You should be aware that any and all elements of One Step Up, LTD ’ s benefits program may be modified in the future, at any time, to meet Internal Revenue Service rules, or otherwise as decided by One Step Up, LTD

TABLE OF CONTENTS

Advocacy ····································· 3 Eligibility ····································· 4 Medical Glossary ························ 5 Medical Benefit ························· 6 Medical Benefit Information ······ 7 Medical Benefit Information ······ 8 Virtual Medical Care ··················· 9 Cigna Extras ························· 10 - 11 Dental Benefit Information ······ 12 Dental Benefits ························· 13 Vision Benefit Information ······· 14 Vision Benefits ·························· 15 Flexible Spending Accounts ······························ 16 - 17 Life & AD&D Benefits ·············· 18 Carrier Contacts ······················· 19 Annual Notices ···················· 20 - 21

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ADVOCACY

HELP STARTS HERE BenefitsVIP is a powerful, one - stop contact center staffed by seasoned professionals. Your dedicated team of employee benefits advocates is ready to help you and your family members resolve your benefits issues.

For service that ’ s confidential and responsive, contact:

866.286.5354 Monday - Friday 8:30am - 8:00pm (ET) Fax: 856.996.2755 Answers@benefitsvip.com

BenefitsVIP.com Request member assistance and order ID cards with a click when you visit BenefitsVIP.com .

QUESTIONS ANSWERED HERE COMPLETELY CONFIDENTIAL! Your dedicated

BenefitsVIP advocates understand your benefit plans and are able to answer benefit questions and quickly resolve claims and eligibility issues. A majority of inquiries are resolved the same day and all calls adhere to privacy best practices.

BenefitsVIP.com

HealthDiscovery.org Get vital, useful and fun health insurance and wellness facts.

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ELIGIBILITY

EMPLOYEE ELIGIBILITY All full - time employees working 30 or more hours per week are eligible for company - offered benefit plans on the first of the month following 60 days. DEPENDENT ELIGIBILITY Employees who are eligible to participate in the One Step Up, LTD benefit program may also enroll their dependents. For the purposes of our benefit plans, your dependents are defined as follows: • Your spouse • Your dependent children to age 26 CHANGING YOUR BENEFITS (QUALIFYING LIFE EVENTS) Per Internal Revenue Service (IRS) rules, employees enrolled in pre - tax benefit plans may only make elections or changes to their plans once per year with the exception of the following Qualifying Life Events: • Marriage • Birth, adoption or placement for adoption of an eligible child • Divorce, or annulment of marriage • Loss of spouse ’ s job or change in work status (when coverage is maintained through spouse ’ s plan) • A significant change in your or your spouse ’ s health coverage that is attributable to your spouse ’ s employment • Death of spouse or dependent • Loss of dependent status

• Employer - directed transfers to facilities out of the benefits network • Becoming eligible for Medicare or Medicaid during the plan year

30 DAYS Qualifying Life Events allow you to make plan changes outside of the Annual Enrollment Period. For any allowable changes, you must inform Human Resources within 30 calendar days of the qualifying event. Benefit changes that are requested due to a ‘ change of mind ’ cannot be allowed until the next Annual Enrollment Period. For additional information concerning plan changes, please contact Human Resources.

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MEDICAL GLOSSARY

CLAIM A request for payment that you or your health care provider submits to your health insurer when you get items or services you think are covered. COINSURANCE The percentage of costs of a covered health care service you pay (30%, for example) after you've A predetermined (flat) fee an individual pays for health care services, in addition to what the insurance covers. DEDUCTIBLE The amount you pay for covered health care services before your insurance plan starts to pay. Eligible expenses applied to the In - Network deductibles will not be applied to satisfy Out - of Network deductibles. In addition, check your carrier certificates to confirm how your plan satisfies the family deductible. IN - NETWORK A doctor or facility providing your care has negotiated a contract rate with your health insurance company. You may not be balanced billed for amounts over the coinsurance. OUT - OF - NETWORK A doctor or facility providing your care does not have a contract with your health insurance company. You may be balanced billed for amounts over the coinsurance. OUT - OF - POCKET MAXIMUM/LIMIT The most you have to pay for covered services in a plan year. After you spend this amount on deductibles, copayments, and coinsurance, your health plan pays 100% of the costs of covered benefits. Non - covered services or amounts over the U&C are not applied to your out - of - pocket maximum. paid your deductible. COPAYMENT/COPAY

PRE - CERTIFICATION REQUIREMENTS This only applies to non - participating providers. See requirements in the Medical Necessity and Pre - authorization Requirements section of your carrier certificates. Failure to comply will result in penalties. PRIMARY CARE PHYSICIAN (PCP) A physician who directly provides or coordinates a range of health care services for a patient. SPECIALIST A physician specialist focuses on a specific area of medicine or a group of patients to diagnose, manage, prevent or treat certain types of symptoms and conditions. A non - physician specialist is a provider who has more training in a specific area of health care. USUAL AND CUSTOMARY ALLOWANCE Usual and customary allowance is the amount of money that a particular health insurance company determines if the normal or acceptable range of payment for a specific health - related service or medical procedure. VIRTUAL VISITS A consultation between you and a provider who is performing a clinical medical or behavioral health service by two - way audiovisual or telephone calls.

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MEDICAL BENEFIT

BENEFIT

IN-NETWORK

IN-NETWORK ONLY

IN-NETWORK

OUT-OF-NETWORK

Annual Deductible (Calendar Year)

Individual:

$4,000 $8,000

Individual:

$2,000 $4,000

Individual :

$3,000 $6,000

Individual:

$3,000 $6,000

Family:

Family:

Family:

Family:

Coinsurance

Cigna 80%/EE 20%

Cigna 90%/EE 10%

Cigna 80%/EE 20%

Cigna 60%/EE 40%

Out-of-Pocket Maximum

Individual:

$5,000 $10,000

Individual:

$4,500 $9,000

Individual:

$5,000 $10,000

Individual:

$7,000 $14,000

Family:

Family:

Family:

Family:

Adult Preventive Care Adult Annual Physical Exam Well-Child Care

Covered at 100% Covered at 100% Covered at 100%

Covered at 100% Covered at 100% Covered at 100%

Covered at 100% Covered at 100% Covered at 100%

30% after deductible 30% after deductible 30% after deductible

Doctor’s Office Visits Primary Care Physician Specialist Virtual Care Outpatient Laboratory X-ray Complex Imaging (CT, PET Scans, MRI)

$40 copay $60 copay $40 copay

$30 copay $50 copay $30 copay

$30 copay $50 copay $30 copay

30% after deductible 30% after deductible In-Network Only 30% after deductible 30% after deductible 30% after deductible

20% after deductible 20% after deductible 20% after deductible

Covered at 100% Covered at 100% Covered at 100%

Covered at 100% Covered at 100% Covered at 100%

Outpatient Surgery

$750 copay per admission then 20% after deductible

$750 copay per admission then 10% after deductible

$750 copay per admission then 20% after deductible

40% after deductible

Emergency Care Ambulance Emergency Room

20% after deductible $500 copay

10% after deductible $500 copay

20% after deductible $500 copay

20% after deductible $500 copay

Urgent Care

$50 copay

$50 copay

$50 copay

30% after deductible

Inpatient Hospital Care

$750 copay per admission then 20% after deductible

$750 copay per admission then 10% after deductible

$750 copay per admission then 20% after deductible

40% after deductible

Maternity Care Hospital services for mother & child

$750 copay per admission then 20% after deductible

$750 copay per admission then 10% after deductible

$750 copay per admission then 20% after deductible

40% after deductible

PRESCRIPTION DRUG COVERAGE

Drug Deductible Waived for Tier 1

Individual:

$100 $200

Individual:

$100 $200

Individual:

$100 $200

Individual:

N/A N/A

Family:

Family:

Family:

Family:

Retail (30 day supply) Tier 1 Tier 2 Tier 3

$15 copay $35 copay $75 copay

$15 copay $35 copay $75 copay

$15 copay $30 copay $60 copay

In-Network Only

Mail Order (90 day supply) Tier 1 Tier 2 Tier 3

$38 copay $88 copay $188 copay

$38 copay $88 copay $188 copay

$38 copay $75 copay $150 copay

In-Network Only

BI -WEEKLY CONTRIBUTIONS

Employee Employee + Spouse Employee + Child(ren) Employee + Family

$187.88 $621.68 $540.33 $708.62

$220.48 $691.84 $603.12 $785.19

$273.92 $799.67 $701.56 $965.03

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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MEDICAL BENEFIT INFORMATION

MEDICAL PLAN INFORMATION One Step Up will continue to offer a choice of three medical plans through Cigna. This allows us to implement coverage that maximizes benefit and lowers the cost to both the company and its employees. Visit Cigna.com to access important information related to your health plan:

• View claims status • View deductible and out - of - pocket maximums • Obtain your ID card

• Find a doctor • Access other important benefits information

OPEN ACCESS PLUS HIGH PLAN (OAP) - IN - NETWORK & OUT - OF - NETWORK BENEFITS Under this plan, you have coverage both In - Network and Out - of - Network. You can see any doctor you choose, you do not have to select a primary care physician (PCP), and you do not need referrals to access specialists. OPEN ACCESS PLUS MIDDLE PLAN and OPEN ACCESS PLUS LOW PLAN - IN - NETWORK ONLY BENEFITS For employees that are comfortable with a lower payroll deduction, we offer the OAPIN. This plan is an In - Network only plan, which eliminates the Out - of - Network option and becomes an effective alternative to consider when choosing the right medical plan for your needs. You do not need to select a primary care physician (PCP), and you do not need referrals to access a specialist. Utilizing In - Network providers saves money. Your out - of - pocket costs are lower because you are only responsible for set copays. If you go Out - of - Network, you will pay a greater share of the cost. The plan is subject to deductibles and coinsurance, and is subject to reasonable and customary (R&C) limits.

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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Medical Benefits MEDICAL BENEFIT INFORMATION

ONE STEP UP OFFERS A CIGNA OAP PLUS PLAN TO ALL ELIGIBLE EMPLOYEES. The Cigna Medical plan allow you to receive medical services both In - Network and Out - of - Network. Limitation & Exclusion

Detail will be provided in your Cigna summary plan description booklet. The following page highlights benefit levels, copays, deductibles and any applicable out - of - pocket expenses. Reference your Cigna summary plan description booklet for further detail. Outpatient Occupational, Speech and Hearing Therapy The Plan covers prescribed occupational, speech and hearing therapy rehabilitation that is performed by an appropriate healthcare provider; and that is part of a therapy program designed to improve lost or impaired function or reduce pain resulting from Illness, injury, congenital defect or surgery; and is expected to result in significant improvement over a clearly defined period of time. Medical Benefit Questions 800.CIGNA24 www.myCIGNA.com Step 1 Go to Cigna.com , and click on “ Find a Doctor ” at the top of the screen. Then, under “ How are you Covered? ” select “ Employer or School. ” (If you ’ re already a Cigna customer, log in to myCigna.com or the myCigna ® app to search your current plan ’ s network. To search other networks, use the Cigna.com directory.) Step 2 Change the geographic location to the city/state or zip code you want to search. Select the search type and enter a name, specialty or other search term. Click on one of our suggestions or the magnifying glass icon to see your results. Step 3 Answer any clarifying questions, and then verify where you live (as that will determine the networks available). Step 4 Optional: Select one of the plans offered by your employer during open enrollment. That ’ s it! You can also refine your search results by distance, years in practice, specialty, languages spoken and more. HOW TO LOCATE A PROVIDER—MEDICAL Is your doctor or hospital in your plan ’ s Cigna network? Cigna ’ s online directory makes it easy to find who (or what) you ’ re looking for.

After you enroll, you ’ ll have access to myCigna.com – your one - stop source for managing your health plan, anytime, just about anyplace. On myCigna.com, you can estimate your health care costs, manage and track claims, learn how to live a healthier life and more.

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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VIRTUAL MEDICAL CARE

MEDICAL VIRTUAL CARE LIFE IS DEMANDING

It ’ s hard to find time to take care of yourself and your family members as it is, never mind when one of you isn ’ t feeling well. That ’ s why your health plan through Cigna includes access to medical and behavioral/ mental health virtual care. Whether it ’ s late at night and your doctor or therapist isn ’ t available, or you just don ’ t have the time or energy to leave the house, you can: • Access care from anywhere via video or phone. • Get medical virtual care 24/7/365 – even on weekends and holidays. • Schedule a behavioral/mental health virtual care appointment online in minutes. • Connect with quality board - certified doctors and pediatricians, as well as licensed counselors and psychiatrists. • Have a prescription sent directly to your local pharmacy, if appropriate.

MDLIVE Medical and behavioral/mental health virtual care. 888.726.3171

Board - certified doctors and pediatricians can diagnose, treat and prescribe most medications for minor medical conditions, such as:

Cigna Behavioral Health also provides access to video - based counseling through Cigna ’ s network of providers. To find a provider: • Visit myCigna.com , go to “ Find Care & Costs ” and enter “ Virtual counselor ” under “ Doctor by Type ”. • Call the number on the back of your • Cigna ID card 24/7.

• Acne • Allergies • Asthma • Bronchitis

• Joint aches • Nausea • Pink eye • Rashes • Respiratory infections • Shingles

• Cold and flu • Constipation

• Diarrhea • Earaches • Fever

• Sinus infections • Skin infections • Sore throats • Urinary tract infections

• Headache • Infections • Insect bites

BEHAVIORAL/MENTAL HEALTH VIRTUAL CARE Licensed counselors and psychiatrists can diagnose, treat and prescribe most medications for nonemergency behavioral/mental health conditions, such as:

CONVENIENT? YES. COSTLY? NO

• Addictions • Bipolar disorders • Child/adolescent issues • Depression • Eating disorders • Grief/loss

• Parenting issues • Postpartum depression • Relationship and marriage issues • Stress • Trauma/PTSD • Women ’ s issues

Medical virtual care for minor conditions costs less than ER or urgent care center visits, and maybe even less than an in - office primary care provider visit.

• Life changes • Men ’ s issues • Panic disorders

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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CIGNA EXTRAS

KNOW BEFORE YOU GO! Understanding the difference between routine, urgent and emergency care can help you save money .

Primary Care Doctor •

Urgent Care Facility •

Emergency Room •

General health issues. Preventive Services. Routine Checkups.

Non - Emergency Care such as minor cuts, burns, fever, flu symptoms, pink eye etc.

Uncontrolled bleeding, seizures or loss of consciousness, shortness of breath, chest pain, head injury or major trauma

• • •

Immunizations and Screenings.

Costs are lower than Emergency Room.

•

Costs may include copay or deductible. Appointments needed. Typically has little wait time.

•

No appointments necessary. Wait time are much shorter.

Costs will be higher

• •

• • •

No appo8intment required

• •

Longer wait time

HELP WITH YOUR MEDICATIONS Talk with a pharmacist from the privacy and comfort of your own home. As part of your pharmacy plan, you can talk with a licenses, specially trained pharmacist from Express Scripts. They ’ ll help you stay on track with your medication routine. • Find ways to save on your medication. • Better understand how your medication works and how it helps keep you healthy.

HELP WITH SPECIALTY MEDICATIONS Accredo, your specialty pharmacy, is focused on supporting complex medical conditions. • Easily order, manage and track your medications on your phone or online. • Fast shipping, at no extra cost. • Easy refills and fee reminders to help make sure you don ’ t miss a dose. Refill certain prescriptions by text. • 24/7 access to specialty - trained pharmacists and nursers experienced in complex medical conditions. • Personalized care services including counseling and training on how to administer your medication. • Help with applying for third - party copay assistance programs and other options.

• Learn how to work through side effects. • Get tips to help you remember to take your medication. • See how you can make refills easier.

USE THE MYCIGNA APP OR WEBSIDE— 24/7 Manage all your prescriptions on the My Medications page. • See which medications your plan covers. • Price a medication. • Search for lower - cost alternatives, if available. • View all the prescriptions you ’ ve filled in the last 18 months. • Find an In - Network pharmacy. • Switch a prescription from a retail pharmacy to our home delivery pharmacy.

For Home delivery prescriptions: • Refill and track your orders. • Pay your bill online. • Sign up for automatic refills. • Request a payment plan. • For specialty medications, connect to your Accredo account.

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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CIGNA EXTRAS

RECOVERYONE - GET BACK OUT THERE You have access to RecoveryOne for Cigna, an online physical therapy program that ’ s included in your health plan benefits. There ’ s no added cost to you or your covered dependents (ages 18+) to use it. With RecoveryOne for Cigna you get: • Online PT you can do when you want, from the comfort and safety of home. • Customized recovery plans to meet your needs.

• A multimedia app that guides you through your exercises. • Video, voice, and chat conversations with your support team. • Weekly check - ins with a certified health coach to help keep you on track.

GINGER FOR CIGNA Easy access to care—no matter where you are, when you need it, or what you ’ re going through. Visit ginger.com/cigna to learn more. Incredible mental health care for everyone.

• Real - time behavioral health coaching within 60 seconds. • Video therapy and psychiatry appointments within hours. • Personalized, clinically - validated skill - building activities. CIGNA BEHAVIORAL HEALTH NOW FEATURING ….. TALKSPACE How it works

Within days of completing registration, you can begin to exchange unlimited asynchronous messages (text, voice and video) with your dedicated therapist. Live sessions can also be schedules, depending on your plan. Therapists are encouraged to engage daily, five days per week, which often includes weekends. You will continue to work with the same therapist throughout your journey. However, you ’ re always welcome to switch providers so you can find the perfect fit. Talkspace ’ s clinical network features thousands of licensed, insured and verified clinical professionals with specialties ranging from behavioral to emotional wellness needs, including stress, anxiety and depression to name a few.

CIGNA HEALTHY REWARDS PROGRAM Start saving today with Cigna Healthy Rewards

Just use your Cigna ID wallet card when you pay and let the savings begin. Get discounts on the health products and programs you use every day for:

• Nutritional Meal Delivery Service Fitness. • Memberships and Devices Vision Care. • Lasik Surgery, Hearing Aids Alternative medicine.

• Yoga Products and Virtual Workouts. Real brands. Real Discounts. Real Easy

Log into mycigna.com and navigate to Health Rewards Discounts Program or call 800.810.3470

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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DENTAL BENEFITS INFORMATION

THE DHMO PLAN has no deductible, no annual lifetime maximums, and lower employee contributions. However, there is no Out - of - Network coverage. You are not required to choose a primary dentist. You have the freedom to choose any general dentist in the network when you make your appointment. You can change your general dentist at any time. Referrals are required for specialty care if you want to pay the cost listed on the fee schedule. It is more cost - effective to get a referral from a network dentist when specialty care is needed, but you can choose to NOT get a referral and go straight to an In - Network dental specialist and get a 25% discount on the provider ’ s rates. Look up dentists who participate in the DHMO to find one taking new patients and who you are willing to see before you elect the DHMO. THE PPO PLAN offers you the flexibility to visit any dentist, but you ’ ll save money when you visit a dentist in your plan network. After you meet the annual deductible, the plan pays a percentage of covered expenses until you reach the annual maximum benefit limit of $3,000. Oral Health Rewards Program Regular visits to the dentist can help prevent and detect the early signs of serious diseases. Guardian ’ s Maximum Rollover Oral Health Rewards Program encourages and rewards member who visit the dentist, by rolling over part of your unused annual maximum into a Maximum Rollover Account (MRA). This can be used in future years if your plan ’ s annual maximum is reached. How Maximum Rollover Works Depending on your plan ’ s annual maximum, if claims made for a certain year don ’ t reach a specified threshold, then the set maximum rollover amount can be rolled over. You can view your annual MRA Statement detailing your account and those of your dependents on www.GuardianAnytime.com . How to Look Up a Network Providers Online Guardian ’ s innovative web technology lets you look up a provider right from your computer. Our Find a Provider Search function is simple and easy - to - use. Just follow these steps: Visit Guardian ’ s web page at www.GuardianAnytime.com • Click on “ Find A Provider ” at the top of the page. • Under “ Select Your Dental Plan ” Choose Managed Dental Care DMO or PPO. • Under “ Search by ” click the circle next to “ Location & Dentist ’ s Name ” • Under “ Your Location ”, enter Zip Code or Street Address information • Under “ Distance ” select you mile radius, then “ Select your Dental Network ” Note: You also have the option to include type of Dentist, foreign language spoken, and office status in your search. • Click “ Continue ” to view the list of network providers. • Click on the box that says “ Find a Dentist ”. On the next web page, do the following:

You can also find a dentist on the go from your smart phone. Simply download our app at www.GuardianAnytime.com/ mobile .

Watch our video Learn how dental insurance

can protect your long - term health.

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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DENTAL BENEFITS

DMO PLAN

PPO PLAN

BENEFIT

IN-NETWORK ONLY

IN-NETWORK

OUT-OF-NETWORK

Annual Deductible

Individual:

N/A N/A

Individual:

$50

Individual:

$75

Family:

Family:

$150

Family:

$225

Office Copay

$5

NA

N/A

Annual Maximum

None

$3,000

$3,000

Diagnostic/Preventive Services Include Periodic Oral Evaluation Cleaning, Fluoride Treatment & Sealants X-rays Space Maintainers

See Fee Schedule

100% of PPO negotiated contracted fee deductible waived Cleanings/Exams: Once every 6 months X-Rays: Bitewings two per calendar year

100% of R&C* charge deductible waived

Cleanings/Exams: Once every 6 months X-Rays: Bitewings two per calendar year

Cleanings/Exams: Once every 6 months X-Rays: Bitewings two per calendar year

Basic Services Include Fillings Simple Extractions & Oral Surgery (Includes surgical extractions) Periodontics & Endodontics

80% of PPO negotiated contracted fee after deductible

See Fee Schedule

80% of R&C* charge after deductible

Major Services Include Bridges Dentures Implants, Veneers Inlays, Onlays & Crowns

50% of PPO negotiated contracted fee after deductible

See Fee Schedule

50% of R&C* charge after deductible

Orthodontic Service

50% of PPO negotiated contracted fee after deductible Children (to age 19)

See Fee Schedule Adults & Children

50% of R&C* charge after deductible Children (to age 19)

Orthodontic Lifetime Maximum:

See Fee Schedule

$1,500

$1,500

Dependent Cut-off Age

26 Years Old

*Out-of-Network UCR is 90%. Certain services may be covered under the Medical Plan. Contact Member Services for more details.

BI -WEEKLY CONTRIBUTIONS

Bi -Weekly Contributions Employee Only

$6.35 $12.71 $15.09 $20.42

$33.84 $64.18 $83.39 $112.35

Employee + Spouse Employee + Children Employee + Family

Allows a portion of unused benefit maximum to carry over to next years benefit maximum amount. To qualify, you must have had a dental service performed and claim submitted within the plan year. You must not exceed the paid claims threshold.

Maximum Rollover

ANNUAL BENEFIT MAXIMUM

MAXIMUM ROLLOVER AMOUNT

IN-NETWORK ONLY MAXIMUM ROLLOVER AMOUNT

MAXIMUM ROLLOVER ACCOUNT LIMIT

THRESHOLD

$3,000

$1,000

$500

$750

$1,500

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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VISION BENEFITS INFORMATION

SAVE WITH VSP THROUGH GUARDIAN •

Guardian's affiliation with Vision Service Plan (VSP), offers one of the largest vision care network in the industry with over 70,000 provider access points nationwide. It's easy to find a network provider at GuardianAnytime.com . • Choice plans offer 20% off any additional pairs of glasses purchased within 12 months of the exam. Members also receive 20% off the amount exceeding the copay and allowance on frames purchased as well as 15% off providers' professional services for prescription contact lenses. These discounts only apply to services from an In - Network provider. • With our Choice plans, members will receive significant discounts on lens options, discounts will range from 20 - 25% off the U&C. For example , standard progressive plastic lenses will cost the member $55 and scratch resistant coating will cost $17. Solid tints and dyes are covered in full.

How to Use Your Vision Benefits Please read the directions below to find an In - Network vision provider Step 1: Visit www.GuardianAnytime.com Click on ” Connect With Us ”, at the top of the web page. Step 2: Select “ Find A Provider ” and choose “ Find a Vision Provider ”. Step 3: Select VSP as your vision network. Step 4: You can search by Zip Code, Office or Doctor.

Watch our video How vision insurance can help you see clearly as you get older.

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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VISION BENEFITS

Regular eye examinations can not only determine your need for corrective eye wear but also may detect general health problems in their earliest stages. Protection for the eyes should be a major concern to everyone.

VSP CHOICE NETWORKPLAN

BENEFIT

IN-NETWORK

OUT-OF-NETWORK

Eye Exam

$10 copay

Reimbursed up to $39

Prescription Glasses

$25 copay

See below

Frequency Exam Lenses Contact Lenses Frames

Every calendar year Every calendar year Every calendar year Every other calendar year

$130 allowance 80% over $130 allowance

Frames

Reimbursed up to $46

Lenses Single Vision Lenses Bifocal Vision Lenses Trifocal Vision Lenses Lenticular Vision Lenses

Reimbursed up to $23 Reimbursed up to $37 Reimbursed up to $49 Reimbursed up to $64

Included in Prescription Glasses

Contact Lenses Elective

$130 allowance No charge 15% off UCR

Reimbursed up to $100 Reimbursed up to $210 In-Network Only

Medically Necessary Evaluation and Fitting

BI-WEEKLY CONTRIBUTIONS

Employee Employee + Spouse Employee + Child(ren) Employee + Family

$1.74 $3.49 $5.59 $6.63

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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FLEXIBLE SPENDING ACCOUNT

FSA Ac

Through a Section 125 Plan, One Step Up offers eligible employees the opportunity to open a Flexible Spending Account (FSA). WHAT IS A FLEXIBLE SPENDING ACCOUNT (FSA)? A FSA is a tax - free account, in your name, that pays or reimburses you for qualified health care or dependent care expenses. Your FSA contributions are made pretax (no employment or federal income taxes are deducted) through payroll deductions. When you receive a distribution from your FSA, the reimbursements are tax - free. Eligible expenses must be incurred from January 1, 2024 through December 31, 2024. Do you want to reduce your out - of - pocket costs and lower your taxable income at the same time? The FSA is a special savings account that enables you to lower the after - tax cost of your out - of - pocket expenditures by setting aside money from your paycheck in one or all three of these accounts, before taxes are calculated. The money can then be used to reimburse yourself for certain eligible expenses. You can set aside any amount up to $3,200 in your Health Care FSA . One Step Up is offering an Health Care Flexible Spending Account (FSA): • Health Care FSA – Can be used to reimburse yourself for medical, dental and vision expenses incurred by you and your dependents. Expenses that are eligible for reimbursement include annual deductibles and co - pays. For a list of eligible expenses please visit ParticipantServices@BenefitResource.com . Participants in Health Care FSA must utilize all available funds by March 15th and file all claims for calendar year 2024 by March 31, 2025.

ACCOUNT TYPE

EXAMPLES OF ELIGIBLE EXPENSES

CONTRIBUTION LIMITS*

ACCESS TO FUNDS

PRE TAX BENEFIT

HealthCare FSA

Maximum contribution: $3,200 per year

Allows immediate access to the entire contribution amount from the 1st day of the benefit year, before all scheduled contributions have been made

Save 20% - 40% on your health care expenses

• Medical Plan Deductibles • Insurance Co-payments • Prescription Drugs • Vision Exams/Eyeglasses/Contacts • Laser Eye Surgery • Acupuncture • Weight Loss Programs • Dental and Orthodontia (Braces) • Birth Control Pills / Devices / Procedures • Chiropractic

Save on purchases not covered by insurance

Reduce your taxable income resulting in more money in your pocket

Employees may be required to provide substantiation to complete the processing of your claim and are responsible to check their balances.

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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ELIGIBLE FSA MEDICAL EXPENSES

• Air conditioner (when necessary for relief from difficulty in breathing) • Alcoholism treatment

• FICA and FUTA tax paid for medical care service • Fluoridation unit • Guide dog • Gum treatment • Gynecologist • Healing services • Hearing aids and batteries • Hospital bills • Hydrotherapy • Insulin treatment • Lab tests • Lead paint removal • Legal fees • Lodging (away from home for outpatient care) • Metabolism tests • Neurologist • Nursing (including board and meals) • Operating room costs • Ophthalmologist • Optician • Optometrist • Oral surgery • Organ transplant (including donor ’ s expenses) • Orthopedic shoes • Orthopedist • Osteopath • Oxygen and oxygen equipment • Pediatrician • Physician • Physiotherapist

• Podiatrist • Postnatal treatments • Practical nurse for medical services • Prenatal care • Prescription medicines • Psychiatrist • Psychoanalyst • Psychologist

• Ambulance • Anesthetist

• Arch supports • Artificial limbs • Autoette (when used for relief of sickness/disability) • Birth Control Pills (by prescription) • Blood tests • Blood transfusions • Braces • Cardiographs • Chiropractor • Christian Science Practitioner • Contact Lenses • Contraceptive devices (by prescription) • Convalescent home (for medical treatment only) • Dental Treatment • Dental X - rays • Dentures • Dermatologist • Diagnostic fees • Diathermy • Drug addiction therapy • Drugs (prescription) • Elastic hosiery (prescription) • Eyeglasses • Fees paid to health institute prescribed by a doctor

• Psychotherapy • Radium Therapy • Registered nurse • Special school costs for the handicapped • Spinal fluid test • Splints • Sterilization • Surgeon • Telephone or TV equipment to assist the hard - of - hearing • Therapy equipment • Transportation expenses (relative to health care) • Ultra - violet ray treatment • Vaccines • Vasectomy • Vitamins (if prescribed) • Wheelchair • X - rays

For more information, you can contact Benefit Resource Inc. at 800.473.9595 or visit their website at BenefitResource.com.

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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LIFE INSURANCE BENEFITS

Your family depends on you in many ways and you ’ ve worked hard to ensure their financial security. But if something happened to you, would your family be protected? Would your loved ones be able to stay in their home, pay bills, and prepare for the future? Life insurance provides a financial benefit that your family can depend on.

One Step Up pays the entire cost of Basic Life Insurance and Basic AD&D for you and you are automatically enrolled upon meeting eligibility.

TYPE

AVAILABLE COVERAGE

Basic Life

1x Base salary up to $300,000

Basic AD&D

1x Base salary up to $300,000

GLOSSARY • Life Benefit: A policy that pays a beneficiary a specified death benefit amount when the insured dies. • AD&D Benefit: This is paid, in addition to the life benefit, if you die in a covered accident. It also pays if you suffer a covered dismemberment. • Conversion: All or some of your term insurance is converted into a permanent life insurance policy.

For additional information, please refer to your detailed plan summary. In the event of a discrepancy, the carrier Plan Document shall prevail.

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CARRIER CONTACT

Need additional information? Have a question about one of your benefits? Keep this brochure handy for a quick reference for all of your benefit needs. If you still have questions, please contact your Human Resources Department.

Plan

Administrator

Phone Number

Website/Email

BenefitsVIP

Corporate Synergies

866.286.5354

Answers@benefitsvip.com

Medical

Cigna

800.997.1654

www.cigna.com

Dental

Guardian

800.541.7846

www.guardiannytime.com

Vision

Guardian

800.541.7846

www.guardiannytime.com

Life Insurance

SunLife

800.247.6875

www.sunlife.com

FSA

Benefits Resource

800.473.9595

www.benefitresource.com

Human Resources

Sherline Ayuso

212.398.1110

sayuso@onestepup.com

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ANNUAL NOTICES

NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT OF 1996 (NEWBORN’S ACT) Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). THE WOMEN’S HEALTH A ND CANCER RIGHTS ACT OF 1998 (WHCRA, ALSO KNOWN A S JANET’S LAW) Under WHCRA, group health plans, insurance companies and health maintenance organizations (HMOs) offering mastectomy coverage must also provide coverage for reconstructive surgery in a manner determined in consultation with the attending physician and the patient. Coverage includes reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, and prostheses and treatment of physical complications at all stages of the mastectomy, including lymph edemas. Call your Plan Administrator for more information. QMCSO is a medical child support order issued under State law that creates or recognizes the existence of an “alternate recipient’s” right to receive benefits for which a participant or beneficiary is eligible under a group health plan. An “alternate recipient” is any child of a participant (including a child adopted by or placed for adoption with a participant in a group health plan) who is enrollment under a group health plan with respect to such participant. Upon receipt, the administrator of a group health plan is required to determine, within a reasonable period of time, whether a medical child support order is qualified, and to administer benefits in accordance with the applicable terms of each order that is qualified. In the event you are served with a notice to provide medical coverage for a dependent child as the result of a legal determination, you may obtain information from your employer on the rules for seeking to enact such coverage. These rules are provided at no cost to you and may be requested from your employer at any recognized under a medical child support order as having a right to QUALIFIED MEDICAL CHILD SUPPORT ORDER (QMCSO)

time. SPECIAL ENROLLMENT RIGHTS (HIPAA) If you have previously declined enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment within 30 days after your other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. COVERAGE EXTENSION RIGHTS UNDER THE UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT (USERRA) If you leave your job to perform military service, you have the right to elect to continue your existing employer-based health plan coverage for you and your dependents (including spouse) for up to 24 months while in the military. Even if you do not elect to continue coverage during your military service, you have the right to be reinstated in your employer’s health plan when you are reemployed, generally without any waiting periods or exclusions for pre existing conditions except for service connected injuries or illnesses. MICHELLE’S LAW Michelle’s Law permits seriously ill or injured college students to continue coverage under a group health plan when they must leave school on a full time basis due to their injury or illness and would otherwise lose coverage. The continuation of coverage applies to a dependent child’s leave of absence from (or other change in enrollment) a postsecondary educational institution (college or university) because of a serious illness or injury, while covered dependent status under the terms of the plan. Coverage will be continued until: 1. One year from the start of the medically necessary leave of absence, or 2. The date on which the coverage MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT OF 2008 This act expands the mental health parity requirements in the Employee Retirement Income Security Act, the Internal Revenue Code and the Public Health Services Act by imposing new mandates on group health plans that provide both medical and surgical benefits and mental health or substance under a health plan. This would otherwise cause the child to lose would otherwise terminate under the terms of the health plan; whichever is earlier.

abuse disorder benefits. Among the new requirements, such plans (or the health insurance coverage offered in connection with such plans) must ensure that: The financial requirements applicable to mental health or substance abuse disorder benefits are no more restrictive that the predominant financial requirements applied to substantially all medical and surgical benefits covered by the plan (or coverage), and there are no separate cost sharing requirements that are applicable only with respect to mental health or substance abuse disorder benefits. employers from discriminating against an employee, individual, or member because of the employee’s “genetic information,” which is broadly defined in GINA to mean (1) genetic tests of the individual, (2) genetic tests of family members of the individual, and (3) the manifestation of a disease or disorder in family members of such individual. GINA also prohibits employers from requesting, requiring, or purchasing an employee’s genetic information. This prohibition does not extend to information that is requested or required to comply with the certification requirements of family and medical leave laws, or to information inadvertently obtained through lawful inquiries under, for example, the Americans with Disabilities Act, provided the employer does not use the information in any discriminatory manner. In the event a covered employer lawfully (or inadvertently) acquires genetic information, the information must be kept in a separate file and treated as a confidential medical record, and may be disclosed to third parties only in very limited situations. CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA) The Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA) requires employers who provide medical coverage to their employees to offer such coverage to employees and covered family members on a temporary basis when there has been a change in circumstances that would otherwise result in a loss of such coverage [26 USC §4980B ] This benefit, known as “continuation coverage,” applies if, for example, dependent children become independent, spouses get divorced, or employees leave the employer. CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT (CHIPRA) Effective April 1, 2009 employees and dependents who are eligible for coverage, but who have not enrolled, have the right to elect coverage during the plan year under two circumstances: GENETIC INFORMATION NON DISCRIMINATION ACT (GINA) GINA broadly prohibits covered

• The employee’s or dependent’s state Medicaid or CHIP (Children's Health Insurance Program) coverage terminates because the individual cease to be eligible. • The employee or dependent becomes eligible for a CHIP premium assistance subsidy under state Medicaid or CHIP (Children's Health Insurance Program). Employees must request this special enrollment within 60 days of the loss of coverage and/or within 60 days of when eligibility is determined for the premium subsidy. PREMIUM ASSISTANCE UNDER MEDICAID AND CHILDRE N’S HEALTH INSURANCE PROGRAM (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare.gov . If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1 877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444 EBSA (3272) . If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2023. Contact your State for more information on eligibility – ALABAMA – Medicaid Website: http://myalhipp.com/ Phone: 1-855-692-5447

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QUESTIONS? Call BenefitsVIP at 866.286.5354