2026 BENEFITS GUIDE
Eligibility and Enrollment
Part-time Team Members
Part-time Team Members who work on average 20 or more hours per week over the course of a 6-month measurement period:
• Eligible to participate in the Medical/Prescription, Dental, Vision, Health Savings Account, Flexible Spending Account, EAP, Critical Illness and Accident, and Core Advocacy plans only. Coverage begins on the 1st day of the month following the 6-month measurement period.
Full-time Team Members
• Eligible to participate in the Medical/Prescription, Dental, Vision, Health Savings Account, Flexible Spending Account, EAP, Critical Illness, Accident, Core Advocacy, and Voluntary Life and AD&D Insurance plans. Coverage begins on the 1st day of the month following a 60-day waiting period.
• Eligible for company-paid Life, AD&D, Short Term Disability and Long-Term Disability insurance. Coverage begins on the 1st day of the month following a 1-year waiting period, provided you worked continuously and full-time for one year.
If you have any questions regarding your eligibility, contact the Team Member Engagement Department.
Eligible Dependents
In addition to yourself, you may also enroll your eligible dependents, including:
• Spouse to whom you are legally married.
• Dependent child(ren) under the age of 26. If a dependent child has a mental or physical disability, coverage may be extended beyond these age limits.
Are you a new Team Member?
Changes during the year
Your benefit elections cannot be changed during the year unless you, your spouse, or your dependent child(ren) have a Qualified Life Event, such as:
• Marriage, death of a spouse or divorce.
• Number of covered dependents due to birth, death, adoption, or placement for adoption.
• You, your spouse, or dependent terminate or begin employment.
• You, your spouse, or dependent experience an increase or reduction in hours of employment (including a switch between part-time and full-time employment or the beginning or ending of an unpaid leave of absence).
• Your dependent satisfies or ceases to satisfy the requirements for coverage under the Plan due to attainment of age, student status, or similar circumstance.
• You, your spouse, or dependent experience a change in residence or worksite.
• A court order requires that your child receive accident or health coverage under this plan or a former spouse’s plan.
• You, your spouse, or dependent becomes entitled to Medicare or Medicaid.
• You have a Special Enrollment Right.
You must notify the Team Member Engagement Department within 30 days of the life event in order to make a change to your benefit elections. The election change must correspond with that gain or loss of eligibility.
After you have reviewed this guide and determined which benefits to elect, complete your elections online through Paylocity. Stop by the TME offices for more details.
Any plan elections you make will apply for the entire calendar year. You cannot make changes to your elections unless you have a Qualified Life Event.
If you do not enroll during your eligibility period, you will not be able to enroll until the next open enrollment period unless you have a Qualified Life Event.
Cigna Medical Benefits
The health benefits available to you represent a meaningful component of your compensation package, and they provide important protection to keep you and your family in good health. Eligible Team Members have the choice of three medical plans through Cigna with Cigna’s Open Access Plus (OAP) National Network.
House Plan | Senate Plan | HDHP Plan
When selecting a plan, please keep in mind that the House Plan provides coverage for only in-network services. There is no outof-network coverage. The Senate Plan offers the flexibility to visit the provider of your choice, but you will pay less out-of-pocket if you stay in-network. The HDHP Plan is a qualified high-deductible health plan that offers lower per paycheck premiums in exchange for a higher deductible (the amount you pay before insurance kicks in). When enrolled in the HDHP Plan, you can contribute to a health savings account (HSA) and use the funds to pay for qualified medical, dental, and vision expenses. Referrals are never required to see a Specialist, under any plan.
Preventive Care is covered at 100% by all plans!
Preventive care* focuses on evaluating your health when you are symptom free. Routine checkups and screenings can help you avoid more serious health problems down the line. Even if you’re in the best shape of your life, a serious condition with no signs or symptoms may put your health at risk.
Preventive services are covered in full when you visit an in-network provider. These services include annual routine examinations, well-childcare visits, immunizations, routine OB/GYN visits, mammograms, PAP tests, prostate screenings, and other age and gender appropriate screenings.
*The plan pays for preventive health benefits based on recommendations of the U.S. Preventive Services Task Force (USPSTF). Any physician visits or services which are to manage a previously diagnosed condition are not considered preventive. Note: Reasonable and customary charges are determined by Cigna.
myCigna App
Cigna is completely virtual. Find nearby care options in your network, view and share your health plan ID card, see your claim details, and view progress toward your deductible with ease. Scan the QR codes below to get started.
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How do I ensure the most affordable care?
Use the Cost Estimator tool on the myCigna App. See TME for more details.
How do I know which medical plan is right for me?
The Cigna Easy Choice Tool is an easy-to-use decision tool designed to do one thing: Help team members choose the Cigna medical plan that’s right for them.
Just answer a few simple questions and Cigna will help recommend a medical plan for you and your family based on your answers.
Use the Cigna Easy Choice Tool on the myCigna App. Available in Spanish.
Medical Plan Highlights
Prescription Drug Highlights
Easily fill and save on your medications
You’ll be covered for a wide variety of medications from Cigna Best of all, we’ve made it easy for you to get your prescriptions filled and save money.
• Access thousands of retail pharmacies
• Save when you use a network pharmacy
• Get 24/7 phone support, refill reminders and more
• Take advantage of special programs for complex conditions
How we cover prescriptions
The Cigna Prescription Drug List (PDL) is the list of prescriptions that are covered by the plan and organized by cost tiers. Choosing medications in the lower tiers may save you money. This list can be found at myCigna.com
Take advantage of no-cost home delivery with Mail Order
You can get your long-term medications delivered to your door with free shipping You also get 24/7 phone support, refill reminders and more.
GetMoreatmyCigna.com
• Refill prescriptions
• Find network pharmacies
• Estimate and compare costs
Health Savings Account (HSA)
Health savings accounts (HSAs) are a great way to save money and budget for qualified healthcare expenses. HSAs are taxadvantaged savings accounts that accompany high-deductible health plans (HDHPs). HDHPs offer lower monthly premiums in exchange for a higher deductible (the amount you pay before insurance kicks in). You can use the funds in your HSA to pay for qualified medical, dental, and vision expenses. You are only eligible for an HSA if you are enrolled in the HDHP medical plan. The HSA is administered by Paylocity
Benefits of an HSA
There are many benefits of using an HSA, including the following:
• It saves you money. Save the extra money from the lower premium in your HDHP to your HSA for when you need it.
• It is portable. The money in your HSA is carried over from year to year and is yours to keep, even if you leave the company
• It is a tax-saver HSA contributions are made with pre-tax dollars. Since your taxable income is decreased by your contributions, you’ll pay less in taxes.
HSA Eligibility
• You are enrolled in an HSA-eligible high-deductible health plan, such as Congressional Country Club’s HDHP plan.
• You are not covered by your spouse’s health plan (unless it is a qualified HDHP), flexible spending account (FSA) or health reimbursement account (HRA).
• You are not eligible to be claimed as a dependent on someone else’s tax return.
• You are not enrolled in Medicare, TRICARE or TRICARE for Life.
• You have not received Veterans Administration benefits in the past three months.
Contributions to Your HSA
Any contributions that you choose to make will be pre-tax. The IRS limits the total amount that can be contributed to an HSA each year (both employer and employee contributions combined). For 2026 those limits are:
• Up to $4,400 for employee only coverage
• Up to $8,750 for employee + dependent(s) coverage
Additionally, if you are age 55 or older, you may make an additional $1,000 “catch-up” contribution to your HSA.
If you do choose to make contributions to your HSA, you can change them at any time throughout the year as long as those changes don’t cause you to exceed the IRS annual maximum. For more information about how to change your HSA contributions, please reach out to TME.
Flexible Spending Account (FSA)
Flexible Spending Accounts (FSAs) help you save money by allowing you to pay for eligible expenses tax-free. The plans are administered by Paylocity. All full-time and benefit eligible part-time team members are eligible for this benefit.
Health Care FSA
Health Care FSAs help you stretch your budget for health care expenses for you and your dependents by allowing you to pay for these expenses using tax-free dollars. You may set aside up to $3,400 annually, which is deducted out of your pay pre-tax throughout the year. Funds can be used to pay for qualified health expenses such as medical and prescription copays, dental expenses, and vision expenses. You can use the FSA for expenses for yourself, your spouse and your dependent children. When you have an eligible expense simply use your debit card to pay, or you can submit a claim online to be reimbursed.
The Health Care FSA has a carryover provision that allows you to rollover up to $680 from one year to the next. If you have any money left in your account at the end of the year, the balance (up to $680) will rollover to the next year. Any additional amount over $680 will be forfeited. Please note you cannot enroll in and contribute to the Health Care FSA if you enroll in the HDHP Plan and contribute to an HSA.
Dependent Care FSA
Contributing to a Dependent Care FSA allows you to set aside pre-tax funds to pay for dependent care expenses so that you and your spouse can work or attend school full-time. It includes daycare (center or individual daycare), before/ after school care, summer day camp and elder care. The minimum contribution for 2026 is $315, and the maximum contribution is $3,750 if single or married and filing separately; $7,500 if married and filing a joint return. Any amount left in your account at the end of the year will be forfeited.
Eligible expenses include:
• Care for your dependent child who is under the age of 13 whom you can claim as a dependent for tax purposes.
• Care for your dependent child who resides with you and who is physically or mentally incapable or caring for him/herself
• Care for your spouse who is physically or mentally incapable of caring for him/herself.
Do I need to enroll each year?
In order to participate in the FSA, you must enroll each year. Your annual contribution stays in effect during the entire year (January 1 through December 31). The only time you can change your election is during Open Enrollment or if you experience a qualified life event.
Will I lose my money if I don’t use it in a year?
Any remaining funds over $680 in a Health Care FSA and any amount left in your Dependent Care FSA at the end of the year will be forfeited. Eligible expenses must be incurred during the plan year and reimbursed within 2.5 months after the end of the plan year.
Online access to view FSA information and manage your account at paylocity.com. Download the free mobile app to access your account on the go!
Find an In-Network Provider
Is your provider in the Cigna network? Cigna’s online directory makes it easy to find who (or what) you’re looking for.
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 their 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 the “Open Access Plus, OA Plus, Choice Fund OA Plus” plan.
Step 5
Enter a name, specialty or other search word. Click SEARCH to see your results.
That’s it! You can also refine your search results by distance, years in practice, specialty, languages spoken and more.
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Cigna Virtual Care
Cigna provides access to MDLIVE telehealth services as part of your medical plan. Cigna Virtual Care lets you get the care you need – including most prescriptions – for a wide range of minor conditions. Now you can connect with a board-certified doctor via secure video chat or phone, without leaving your home or office.
The Choice is Yours
• Choose when: Day or night, weekdays, weekends and holidays.
• Choose where: Home, work or on the go.
• Choose how: Phone or video chat.
• Choose who: MDLIVE doctors.
When Should I Use this Service?
Say it’s the middle of the night and your child is sick, or you’re at work and not feeling well. If you pre-register on MDLIVE, you can speak with a doctor for help with:
• Sore throat
• Headache
• Fever
• Cold and flu
• Allergies
• Rash
• Acne
Clear Cost Savings
Virtual Care with MDLIVE can be a cost-effective alternative to a convenience care clinic, urgent care center, or emergency room. The cost of a phone or online visit is the same or less than with your primary care provider. Remember, your virtual care services are only available for minor, non-life-threatening conditions. In an emergency, dial 911 or go to the nearest hospital.
Scan to easily register your account. Just point your phone’s camera at the code to get access to myCigna.com
myCigna App Register with MDLIVE BEFORE you need it on the myCigna app today! Scan the QR codes below to get started.
All information shared with MDLIVE is strictly confidential and is not shared with Congressional Country Club.
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Cigna Resources
Cigna Lifestyle Management Programs
If weight, tobacco or stress is affecting your ability to live an active life, a health advocate can provide you with personalized support to help you.
• Weight management: Learn to manage your weight using a non-diet approach that helps you build confidence, change habits, eat healthier and become more active.
• Quit tobacco: Develop a personal quit plan to become and remain tobacco-free.
• Reduce stress: Understand the sources of your stress, and learn to use coping techniques to better manage stress both on and off the job.
Use an online or telephone coaching program – or both – for the support you need. Call the number on the back of your medical ID card to get connected.
Cigna Diabetes Prevention Program from Omada Health
Digital support focused on reducing the risk of type 2 diabetes and heart disease through healthy weight loss, nutrition, sleep and exercise. To get started, visit OmadaHealth.com/OmadaforCigna to see if you’re eligible.
Personalized tools at no extra cost to you*
• Digitally enabled scale
• Omada professional health coach
• Social support group
• Interactive online training lessons on healthy eating, physical activity, sleep and stress
* Covered plan participants must meet certain clinical criteria and be accepted into the program. This program is provided by Omada Health and not by Cigna. Contact Cigna for more information.
Build healthy habits that last
• Eat healthier – Learn the fundamentals of making smart food choices.
• Increase activity – Discover easy ways to move more and boost your energy.
• Overcome challenges and stress less – Gain skills that allow you to break barriers to change.
• Strengthen habits – Zero in on what works for you and find lasting motivation.
Cigna Resources, continued
Personify Health
With the Cigna Healthcare Wellness Experience, together with Personify Health, we’ll help make every step count.
Choose your own wellness journey.
Whether you’re motivated by reducing stress, having more energy or getting more involved in your community, you can customize your goals and find the best path to get there. It’s all included with your Cigna Healthcare plan at no extra charge to you.
Our wellness experience lets you set achievable goals, challenge friends to healthy competitions, tackle stress and enjoy a healthier lifestyle. And it’s powered by Personify Health, one of the world’s largest comprehensive digital health activation and engagement companies impacting 100+ million people with their mission to help change lives for good.
Get started with these simple steps:
1. Set up your profile today on myCigna.com or by downloading the myCigna app.
2. Select the Wellness tab, then click “Get Started” to enroll.
3. Don’t forget to turn on notifications for the app to enable helpful reminders and information about upcoming opportunities – so you get the most out of your mobile experience.
Cigna Healthcare Healthy Babies
Get help throughout your pregnancy with Cigna Healthcare Healthy Babies. To support you along your journey, you’ll get:
• A guide to help you learn about pregnancy and babies, including topics like prenatal care, exercise, stress, depression and more.
• Access to a maternity specialist to help answer your questions on everything from morning sickness to maternity benefits.
• You’ll also have access to a wealth of information on the myCigna website from trusted sources like WebMD and Healthwise.
You’ll learn how to:
• Make a plan for a healthy pregnancy
• Monitor your pregnancy week by week
• Prepare for labor and delivery
• Care for your baby
Foodsmart
Making the most of your new benefit to save money on food and feel your best.
With the Cigna Health Plan, you now have access to personal nutrition support that can help you save money on food and feel your best all for free. You can meet with a registered dietitian an expert in nutrition who will create a personalized nutrition plan for you based on your health history, preferences, and goals. You’ll get daily tips and tools that make following your plan simple including thousands of delicious recipes, grocery price comparison, food delivery, and more.
Scan the QR code or call 415.800.2311 to book your free* phone or video visit with a registered dietitian. Follow the prompts to choose a date and time that works for you and enter the Cigna member ID on the back of your ID Card when prompted.
*Cigna members are eligible for up to 3 visits at no cost/no deductible.
Active & Fit Direct
Cigna brings you flexible and affordable fitness options through Active & Fit Direct! For only $28 a month, you have access to thousands of fitness options (+12,700 standard gyms) plus 8,700+ premium exercise studios with 20%-70% discounts at most locations.
Sign up yourself and your spouse today at discoverhealthyrewards.sites.cigna.com!
Get Fit at Home for Free with 12,000+ on-demand workout videos before you enroll. Just create an account through Cigna.
Financial Tips
Prescription Drugs
• Find the complete list of covered medications at myCigna.com
• Convery your maintenance medication to mail order
Care Options
• Only use the emergency room for true emergencies
• Sign up for virtual visit provider MDLIVE
• Don’t wait: Save money by locating a convenience care clinic or urgent care facility near you, before you need it
Healthcare Professional Choice
• Use the health care professional most appropriate for your care including telemedicine
• Use Cigna Care Designation (CCD) providers to find quality, costeffective physicians. Those who meet Cigna’s requirements for both care quality and cost efficiency receive the CCD
• To Find a CCD provider:
1. Log in to myCigna.com or myCigna App and select “Find Care & Costs”
2. Enter your search information
3. Look for the CCD symbol under the provider’s name
4. Using the preferred labs, Labcorp and Quest, can save you money
Proactive Measures
• Use your preventive care benefit: annual physicals, mammograms, screenings and immunizations are covered at 100%
• Use the health improvement tools available to you
• Log in or register at myCigna.com
• Select ‘Wellness’ tab,
• Under ‘Tools’, click on Apps & Activities
• Get information on the cost of treatment to ensure there are no surprises
• Use Cigna’s One Guide concierge service to better understand and utilize your plan One Guide personal support, tools and reminders can help you stay healthy and save money Download the myCigna App or call 888-806-5042 to talk with your personal guide
Member Resources
Core Advocacy
Health Advocate’s Core Advocacy program is designed to help you navigate through the complicated healthcare system and get the most out of your healthcare experience. The Core Advocacy program is available to you, your spouse, dependent children, parents, and parents-in-law at no cost to you.
How Core Advocacy Can Help
• Find the right doctors, dentists, specialist and other providers
• Schedule appointments; arrange for treatment and tests
• Answer questions about test results, treatments and medication
• Clarify benefits; uncover billing errors
• Get to the bottom of coverage denials
• Get appropriate approvals for covered services
• Find options for non-covered services
• Negotiate payment arrangements with providers
• Provide information about generic drug options
• Find in-home care, adult day care, assisted living, and longterm care
• Clarify Medicare, Medicare Supplement plans and Medicaid
• Research transportation to appointments
Employee Assistance Program
Because everyone experiences challenges and needs supports from time to time. The Club understands the importance of balancing work and family issues and can provide an EAP benefit to help through Cigna. The EAP is available to all Team Members and their immediate family members, providing free and confidential help.
A professional counselor is available 24 hours a day, 7 days a week. Cigna allows you to have 3 visits with a counselor at no cost to you.
How EAP Can Help
• Marital or family problems
• Financial/legal difficulties
• Balancing work/life situations
• Emotional or stress related problems
• Drug or Alcohol Abuse
• Work-related issues
Call 866.695.8622, or visit online at HealthAdvocate.com/members for more information about Health Advocate’s Core Advocacy Program
Call 877.622.4327, or visit online at myCigna.com for more information on Cigna’s Employee Assistance Program
Critical Illness and Accident Insurance
Offered Through Unum
All full-time and benefit eligible part-time team members are able to elect Critical Illness and Accident insurance.
Critical Illness Insurance
Critical Illness insurance provides financial protection by paying a lump sum benefit if you are diagnosed with a covered critical illness, such as cancer or a heart attack. The benefit can help offset the out-of-pocket expenses that medical insurance does not pay, including deductibles and co-pays. You can also purchase critical illness coverage for your spouse. Dependent children are automatically covered under your election. This benefit is 100% team member paid through payroll deductions. You an elect either $10,000 or $20,000 of coverage. For more information, please refer to the Unum plan documents. Pre-existing condition limitations may apply.
Accident Insurance
Even with incredible benefits, like the ones offered by Congressional, an accident can add up with co-pays, prescriptions and physical therapy. Accident Insurance can pay you money based on the injury and the treatment you receive, whether it’s a simple sprain or something more serious like a broken bone. Your plan can pay benefits for emergency room treatment, stitches, injury-related surgery and a list of other accident-related expenses. The money is paid directly to you and you decide how to spend it. You can also purchase coverage for your spouse and dependent children. This benefit is 100% team member paid through payroll deductions.
Accident Insurance Benefit Payment Example:
Kathy’s daughter, Molly, plays soccer on the varsity high school team. During a recent game, she collided with an opposing player, was knocked unconscious and taken to the local emergency room by ambulance for treatment. The ER doctor diagnosed a concussion and a broken ankle. Molly was put into a cast and released the same day. Depending on her health insurance, Kathy’s out-of-pocket costs could run into hundreds of dollars to cover expenses like insurance co-payments and deductibles. UNUM Group Accident Insurance payments can be used to help cover these unexpected costs.
Dental Plan
Offered Through Cigna
Although you can choose any dental provider, when you use an in-network dentist, you will generally pay less for treatments because your share of the cost will be based on negotiated discount fees. With out-of-network providers, the plan will pay the same percentage, but the reimbursement will be based on out-of-network rates (you may be billed for the difference).
To view and print an ID card, register for the myCigna app You can also access Cigna’s 24/7 365 Customer service line if you need assistance finding a provider or checking on the status of your claim. Cigna’s Dental PPO Plan also includes 24/7 virtual care options with a contracted “Teledentist”.
and Preventive
Team Member Dental Payroll Contributions
For more information on your dental benefits, download the myCigna app. Simply scan the QR Code with your phone and follow the instructions to register for myCigna.
Cigna Dental PPO
Cigna Dental PPO (26 pays per period) Per Pay Rate
Vision Plan
Offered Through Cigna
Cigna’s vision care benefits include coverage for eye exams, standard lenses and frames, and contact lenses and discounts for laser surgery. Cigna Vision Network serviced by EyeMed offers one of the largest specialty routine vision networks, with optometrists and ophthalmologists, at full service locations nationwide, including private practice and national and regional retail locations. When you use an out-of-network provider, you will experience higher costs.
Team Member Vision Payroll Contributions
To find a provider, download the myCigna app. Find in-network doctors, hospitals and medical services, as well as compare quality of care information for doctors and hospitals.
Cigna Vision
Life and AD&D
Basic Life and Accidental Death & Dismemberment (AD&D) Insurance
Life and AD&D insurance helps protect your family from financial risk and sudden loss of income in the event of your death or dismemberment. Coverage is provided at no cost to you through Mutual of Omaha. Full-time team members are eligible for this benefit after one year of active employment.
Basic Life insurance provides a benefit of one times your annual salary (rounded to the next $1,000), up to a maximum benefit of $75,000. If you die as a result of an accident, your beneficiary will receive an additional benefit equal to the basic life insurance benefit. For other covered losses, such as an accidental dismemberment, the amount of the benefit is a percentage of the AD&D insurance coverage amount. Evidence of good health is not required.
Don’t forget to designate a beneficiary!
Choosing who will receive your life insurance benefits is an important decision. Please make sure your beneficiary information is up to date.
Age Reduction
The value of Mutual of Omaha’s life insurance policy decreases with age. You may be paying a higher premium for a lower value. Please see TME for more information.
Voluntary Life and AD&D Insurance
Full-time Team Members have the option to purchase Voluntary Life and AD&D insurance for yourself, your spouse, and/or your dependent children. You are eligible to elect Voluntary Life and AD&D on the first day of the month following 60 days of employment. Voluntary Life and AD&D insurance benefits are elected together, and at the same benefit level.
Team Member
Spouse*
Dependent Child(ren)*
$10,000 increments
$5,000 increments
$1,000 increments
$500,000 or 5 times salary, whichever is less
$100,000, not to exceed the Team Member’s elected amount.
$10,000 ($2,000 minimum benefit), not to exceed Team Member’s elected amount
Evidence of insurability is required if you elect a benefit greater than the guaranteed issue amount of 5 times salary or $100,000, whichever is less.
The guaranteed issue amount for your spouse is 100% of your elected amount or $35,000, whichever is less.
Evidence of insurability is not required.
* You must elect coverage for yourself in order to purchase coverage for your spouse and/or dependent children.
Monthly Rates Per $1,000 of Coverage
Team member rates are calculated based on the Team Member’s current age as of the effective date of the plan. The spouse rates are dependent upon the spouse’s age. Rates are adjusted once each year on the plan anniversary date for Team Members advancing to the next age band.
*If you are age 70 or older on the date insurance becomes effective, the amount of life and AD&D insurance will be reduced. Thereafter, the amount of life and AD&D insurance will continue to reduce in accordance with the schedule below. If you elect voluntary life and AD&D coverage for your spouse, their coverage will terminate at age 70. Please see TME for more details.
Evidence of Insurability
The insurance carrier requires you to show that you are in good health before they will agree to provide certain levels of coverage. This is called “evidence of insurability”.
You will need to provide evidence of insurability when you:
>waive coverage when you are initially eligible and enroll for the first time later.
> select coverage of any amount over the guaranteed issue amount
During annual open enrollment, Team Members can elect to increase coverage by up to two $10,000 increments without Evidence of Insurability.
Don’t forget to designate a beneficiary!
Choosing who will receive your life insurance benefits is an important decision. Please make sure your beneficiary information is up to date.
Disability
Disability insurance coverage is designed to protect your income in the event you are unable to work due to illness or non-work-related injury. Coverage is provided by Congressional Country Club, at no cost to you, through Mutual of Omaha.
Short Term Disability (STD)
Full-time Team Members after one year of active employment
Short Term Disability (STD) insurance coverage replaces a portion of your income for a short duration in case you become disabled from a non-work-related injury or sickness, including pregnancy. Contact the Team Member Engagement Department with any questions and to obtain required paperwork.
Benefit payments begin on the 1st day for accidents, on the 5th day for illnesses, and may last for up to 13 weeks. Claims are subject to review and approval by Mutual of Omaha. The benefit amount is based on years of service with the Club as follows:
Pre-Existing Condition Exclusions
A pre-existing condition is a sickness or an injury for which you received medical treatment, advice or consultation, care or services, including diagnostic measures, or took prescribed drugs or medications in the 3 months prior to your effective date of LTD coverage.
If you suffer from a disability caused by, contributed to, or resulting from a pre-existing condition, the disability may not be covered.
A condition will no longer be considered pre-existing once you have been insured under the LTD policy for at least 12 consecutive months.
Maternity Leave
Full-time team members after one year of employment may be eligible to participate in Congressional Country Club’s Maternity Leave benefit. Maternity Leave is offered to eligible new mothers, so they can have the opportunity to heal from pregnancy as well as bond with their newborn child. All eligible Team Members will be paid at 100% of salary for 12 consecutive workweeks. Team Members may only use 12 weeks of Maternity Leave during a 12-month period. This 12-month measurement period will begin on the date the Team Member begins Maternity Leave.
See TME for more details.
Long Term Disability (LTD)
Full-time Team Members after one year of active employment.
Long Term Disability (LTD) coverage is intended to protect your income for a longer duration if you have an extended disability
Benefit of 60% of monthly earnings up to a maximum benefit of $7,500 per month
Benefit payments begin on the 91st day of disability
Additional Benefits
401K and Retirement
Congressional Country Club offers a 401K and Retirement plan through Principal.
• Team Members are eligible to join the plan and begin contributing by meeting the minimum age of 21 years old and completing 60 days of service with the Club (youareabletoentertheplanon thefirstdayofthemonthafteryoumeetyoureligibility requirements)
• Congressional Country Club begins to contribute to your plan after you have completed one year of service and 1,000 hours worked
• Enrollment must be completed by each Team Member through Principal by either phone or internet
Please see a member of TME for more information!
Principal Contact Information: 800-547-7754 or Principal.com/enroll.
Legal Resources
Legal Resources is a comprehensive, voluntary employee benefit that provides integrated legal, financial, tax and insurance services to help members confidently navigate the major and daily life events that families face including marriage, home purchase, retirement, end of life planning and more!
Legal Resources covers 100% of the attorney fees for fully covered legal services, which includes the following:
• General Advice, Preparation, and Consultation Review of Routine Legal
• Family Law Documents
• Elder Law
• Real Estate
• Criminal Matters
• Consumer Relations and Credit Protection
• Wills and Estate Planning
• Identity Theft
• Traffic Violations
• Civil Actions
All members will receive a welcome letter upon enrolling in the plan, which includes instructions on signing up on the member portal, along with a unique code for registration. For any issues, please contact Member Services at info@legalresources.com
Paid Time Off
In addition to these benefits, full-time team members are eligible for vacation, holiday pay, sick & safe leave and additional PTO days. Please see a member of TME if you have questions about PTO.
Team Member Meals
Team Members are welcome to enjoy lunch and dinner in Ms. V’s cafe. Meals are provided for lunch and dinner, 7 days a week!
Team Member Golf
Congressional Team Members may have the ability to golf for free on Mondays. Please see a member of the Golf Shop for availability, details and restrictions.
Team Member Apparel Discounts
Our golf and tennis shop offer a 25% discount on all apparel. Keep an eye out for other additional sales throughout the year!
Referral Bonuses
Team Member referrals are our number one source of new Team Members! As a Team Member who refers someone, there is a referral bonus in it for you! See the Talent Acquisition Manager for more details on this perk.
Holiday Bonus
Our Members generously contribute to a holiday bonus fund for Team Members. Please see a member of Team Member Engagement for more information about our holiday bonus.
The Congo Press
Make sure to check out our Team Member Newsletter, The Congo Press! The Congo Press is sent out bi-weekly via email and can also be found on Paylocity’s Community. Here you’ll find all the information of what’s going around at the Club!
If you have any questions about these benefits, please ask a member of the Team Member Engagement Department.
Congressional Country Club HEALTH PLAN NOTICES
IMPORTANT NOTICE
This packet of notices related to our health care plan includes a notice regarding how the plan’s prescription drug coverage compares to Medicare Part D. If you or a covered family member is also enrolled in Medicare Parts A or B, but not Part D, you should read the Medicare Part D notice carefully. It is titled, “Important Notice From Congressional Country Club About Your Prescription Drug Coverage and Medicare.”
MEDICARE PART D CREDITABLE COVERAGE NOTICE
IMPORTANT NOTICE FROM CONGRESSIONAL COUNTRY CLUB ABOUT YOUR PRESCRIPTION DRUG COVERAGE AND MEDICARE
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Congressional Country Club and about your options under Medicare’s prescription drug coverage. This information can help you decide whether you want to join a Medicare drug plan. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.
If neither you nor any of your covered dependents are eligible for or have Medicare, this notice does not apply to you or your dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.
1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
2. Congressional Country Club has determined that the prescription drug coverage offered by the Congressional Country Club Employee Health Care Plan (“Plan”) is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is considered “creditable” prescription drug coverage. This is important for the reasons described below.
Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare drug plan, as long as you later enroll within specific time periods.
Enrolling in Medicare General Rules
As some background, you can join a Medicare drug plan when you first become eligible for Medicare. If you qualify for Medicare due to age, you may enroll in a Medicare drug plan during a seven-month initial enrollment period. That period begins three months prior to your 65th birthday, includes the month you turn 65, and continues for the ensuing three months. If you qualify for Medicare due to disability or endstage renal disease, your initial Medicare Part D enrollment period depends on the date your disability or treatment began. For more information you should contact Medicare at the telephone number or web address listed below.
Late Enrollment and the Late Enrollment Penalty
If you decide to wait to enroll in a Medicare drug plan you may enroll later, during Medicare Part D’s annual enrollment period, which runs each year from October 15 through December 7. But as a general rule, if you delay your enrollment in Medicare Part D, after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).
If after your initial Medicare Part D enrollment period you go 63 continuous days or longer without “creditable” prescription drug coverage (that is, prescription drug coverage that’s at least as good as Medicare’s prescription drug coverage), your monthly Part D premium may go up by at least 1 percent of
the premium you would have paid had you enrolled timely, for every month that you did not have creditable coverage.
For example, if after your Medicare Part D initial enrollment period you go 19 months without coverage, your premium may be at least 19% higher than the premium you otherwise would have paid. You may have to pay this higher premium for as long as you have Medicare prescription drug coverage. However, there are some important exceptions to the late enrollment penalty.
Special Enrollment Period Exceptions to the Late Enrollment Penalty
There are “special enrollment periods” that allow you to add Medicare Part D coverage months or even years after you first became eligible to do so, without a penalty. For example, if after your Medicare Part D initial enrollment period you lose or decide to leave employer-sponsored or union-sponsored health coverage that includes “creditable” prescription drug coverage, you will be eligible to join a Medicare drug plan at that time.
In addition, if you otherwise lose other creditable prescription drug coverage (such as under an individual policy) through no fault of your own, you will be able to join a Medicare drug plan, again without penalty. These special enrollment periods end two months after the month in which your other coverage ends.
Compare Coverage
You should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. See the Congressional Country Club Plan’s summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get one by contacting us at the telephone number or address listed below.
Coordinating Other Coverage With Medicare Part D
Generally speaking, if you decide to join a Medicare drug plan while covered under the Congressional Country Club Plan due to your employment (or someone else’s employment, such as a spouse or parent), your coverage under the Congressional Country Club Plan will not be affected. For most persons covered under the Plan, the Plan will pay prescription drug benefits first, and Medicare will determine its payments second. For more information about this issue of what program pays first and what program pays second, see the Plan’s summary plan description or contact Medicare at the telephone number or web address listed below.
If you do decide to join a Medicare drug plan and drop your Congressional Country Club prescription drug coverage, be aware that you and your dependents may not be able to get this coverage back. To regain coverage you would have to re-enroll in the Plan, pursuant to the Plan’s eligibility and enrollment rules. You should review the Plan’s summary plan description to determine if and when you are allowed to add coverage.
For More Information About This Notice or Your Current Prescription Drug Coverage…
Contact the person listed below for further information, or call (301) 469-2013 NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Congressional Country Club changes. You also may request a copy.
For More Information About Your Options Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage:
• Visit www.medicare.gov
• Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help,
• Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and whether or not you are required to pay a higher premium (a penalty).
Date: January 1, 2026
Name of Entity/Sender: Venus Alexander
Contact Position/Office: HR & Team Member Engagement Manager
Address: 8500 River Road
Bethesda, MD 20817
Phone Number: (301) 469-2013
Nothing in this notice gives you or your dependents a right to coverage under the Plan. Your (or your dependents’) right to coverage under the Plan is determined solely under the terms of the Plan.
HIPAA COMPREHENSIVE NOTICE OF PRIVACY POLICY AND PROCEDURES
CONGRESSIONAL COUNTRY CLUB
IMPORTANT NOTICE
COMPREHENSIVE NOTICE OF PRIVACY POLICY AND PROCEDURES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice is provided to you on behalf of:
CONGRESSIONAL COUNTRY CLUB HEALTH AND WELFARE PLAN*
* This notice pertains only to healthcare coverage provided under the plan.
For the remainder of this notice, Congressional Country Club is referred to as Company.
1. Introduction: This Notice is being provided to all covered participants in accordance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and is intended to apprise you of the legal duties and privacy practices of the Company’s self-insured group health plans. If you are a participant in any fully insured group health plan of the Company, then the insurance carriers with respect to those plans is required to provide you with a separate privacy notice regarding its practices.
2. General Rule: A group health plan is required by HIPAA to maintain the privacy of protected health information, to provide individuals with notices of the plan’s legal duties and privacy practices with respect to protected health information, and to notify affected individuals follow a breach of unsecured protected health information. In general, a group health plan may only disclose protected health information (i) for the purpose of carrying out treatment, payment and health care operations of the plan, (ii) pursuant to your written authorization; or (iii) for any other permitted purpose under the HIPAA regulations.
3. Protected Health Information: The term “protected health information” includes all individually identifiable health information transmitted or maintained by a group health plan, regardless of whether or not that information is maintained in an oral, written or electronic format. Protected health information does not include employment records or health information that has been stripped of all individually identifiable information and with respect to which there is no reasonable basis to believe that the health information can be used to identify any particular individual.
4. Use and Disclosure for Treatment, Payment and Health Care Operations: A group health plan may use protected health information without your authorization to carry out treatment, payment and health care operations of the group health plan.
• An example of a “treatment” activity includes consultation between the plan and
your health care provider regarding your coverage under the plan.
• Examples of “payment” activities include billing, claims management, and medical necessity reviews.
• Examples of “health care operations” include disease management and case management activities.
The group health plan may also disclose protected health information to a designated group of employees of the Company, known as the HIPAA privacy team, for the purpose of carrying out plan administrative functions, including treatment, payment and health care operations.
5. Disclosure for Underwriting Purposes. A group health plan is generally prohibited from using or disclosing protected health information that is genetic information of an individual for purposes of underwriting.
6. Uses and Disclosures Requiring Written Authorization: Subject to certain exceptions described elsewhere in this Notice or set forth in regulations of the Department of Health and Human Services, a group health plan may not disclose protected health information for reasons unrelated to treatment, payment or health care operations without your authorization. Specifically,agrouphealthplanmaynotuseyour protected health information for marketing purposes or sell your protected health information. Any use or disclosure not disclosed in this Notice will bemadeonly with your written authorization. If you authorize a disclosure of protected health information, it will be disclosed solely for the purpose of your authorization and may be revoked at anytime. Authorization forms are available from the Privacy Official identified in section 23.
7. Special Rule for Mental Health Information: Your written authorization generally will be obtained before a group health plan will use or disclose psychotherapy notes (if any) about you.
8. Uses and Disclosures for which Authorization or Opportunity to Object is not Required: A group health plan may use and disclose your
protected health information without your authorization under the following circumstances:
• When required by law;
• When permitted for purposes of public health activities;
• When authorized by law to report information about abuse, neglect or domestic violence to public authorities;
• When authorized by law to a public health oversight agency for oversight activities;
• When required for judicial or administrative proceedings;
• When required for law enforcement purposes;
• When required to be given to a coroner or medical examiner or funeral director;
• When disclosed to an organ procurement organization;
• When used for research, subject to certain conditions;
• Whennecessarytopreventorlessenaserious and imminent threat to the health or safety of a person or the public and the disclosure is to a person reasonably able to prevent or lessen the threat; and
• When authorized by and to the extent necessary to comply with workers’ compensation or other similar programs established by law.
9. Minimum Necessary Standard: When using or disclosing protected health information or when requesting protected health information from another covered entity, a group health plan must make reasonable efforts not to use, disclose or request more than the minimum amount of protected health information necessary to accomplish the intended purpose of the use, disclosure or request. The minimum necessary standard will not apply to: disclosures to or requests by a health care provider for treatment; uses or disclosures made to the individual about his or her own protected health information, as permitted or required by HIPAA; disclosures made to the Department of Health and Human Services; or uses or disclosures that are required by law.
10. Disclosures of Summary Health Information: Agrouphealthplanmayuseordisclosesummary health information to the Company for the purpose of obtaining premium bids or modifying, amending or terminating the group health plan. Summary health information summarizes the participant claims history and other information without identifying information specific to any one individual.
11. Disclosures of Enrollment Information: A group health plan may disclose to the Company information on whether an individual is enrolled in or has disenrolled in the plan.
12. Disclosure to the Department of Health and Human Services: A group health plan may use and disclose your protected health information to the Department of Health and Human Services to investigate or determine the group health plan’s compliance with the privacy regulations.
13. Disclosures to Family Members, other Relations and Close Personal Friends: A group health plan may disclose protected health information to your family members, other relatives, close personal friends and anyone else you choose, if: (i) the information is directly relevant to the person’s involvement with your care or payment for that care, and (ii) either you have agreed to the disclosure, you have been given an opportunity to object and have not objected, or it is reasonably inferred from the
circumstances, based on the plan’s common practice, that you would not object to the disclosure.
For example, if you are married, the plan will shareyourprotectedhealthinformationwithyour spouseifheorshereasonablydemonstrates tothe plananditsrepresentativesthat he orsheis acting on your behalf and with your consent. Your spouse might to do so by providing the plan with your claim number or social security number. Similarly, the plan will normally share protected health information about a dependent child (whether or not emancipated) with the child’s parents. The plan might also disclose your protected health information to your family members, other relatives, and close personal friends if you are unable to make health care decisions about yourself due to incapacity or an emergency.
14. Appointment of a Personal Representative: You may exercise your rights through a personal representative upon appropriate proof of authority (including, for example, a notarized power of attorney). The group health plan retains discretion to deny access to your protected health information to a personal representative.
15. Individual Right to Request Restrictions on Use or Disclosure of Protected Health Information: You may request the group health plan to restrict (1) uses and disclosures of your protected health information to carry out treatment, payment or health care operations, or (2) uses and disclosures to family members, relatives, friends or other persons identified by you who are involved in your care or payment for your care. However, the group health plan is not required to and normally will not agree to your request in the absence of special circumstances. A covered entity (other than a group health plan) must agree to the request of an individual to restrict disclosure of protected health information about the individual to the group health plan, if (a) the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law, and (b) the protected health information pertains solely to a health care item or service for which the individual (or person other the health plan on behalf of the individual) has paid the covered entity in full.
16. Individual Right to Request Alternative Communications: The group health plan will accommodate reasonable written requests to receive communications of protected health information by alternative means or at alternative locations (such as an alternative telephone number or mailing address) if you represent that disclosure otherwise could endanger you. The plan will not normally accommodate a request to receive communications of protected health information by alternative means or at alternative locations for reasons other than your endangerment unless special circumstances warrant an exception.
17. Individual Right to Inspect and Copy
Protected Health Information: You have a right to inspect and obtain a copy of your protected health information contained in a “designated record set,” for as long as the group health plan maintains the protected health information. A “designated record set” includes the medical records and billing records about individuals maintained by or for a covered health care provider; enrollment, payment, billing, claims adjudication and case or medical management recordsystemsmaintainedbyorforahealthplan; or other information used in whole or in part by or for the group health to make decisions about individuals.
The requested information will be provided within 30 days. A single 30-day extension is allowed if the group health plan is unable to comply with the deadline, provided that you are given a written statement of the reasons for the delay and the date by which the group health plan will complete its action on the request. If access isdenied,youoryourpersonalrepresentativewill be provided with a written denial setting forth the basis forthe denial, a description of how you may exercise those review rights and a description of how you may contact the Secretary of the U.S. Department of Health and Human Services.
18. Individual Right to Amend Protected Health Information: You have the right to request the group health plan to amend your protected health information for as long as the protected health information is maintained in the designated record set. The group health plan has 60 days after the request is made to act on the request. A single 30-day extension is allowed if the group health plan is unable to comply with the deadline. If the requestis denied in whole or part, the group health plan must provide you with a written denial that explains the basis for the denial. You may then submit a written statement disagreeing with the denial and have that statement included with any future disclosures of your protected health information.
19. Right to Receive an Accounting of Protected Health Information Disclosures: You have the right to request an accounting ofall disclosures of your protected health information by the group health plan during the six years prior to the date of your request. However, such accounting need not include disclosures made: (1) to carry out treatment, payment or health care operations; (2) to individuals about their own protected health information; (3) prior to the compliance date; or (4) pursuant to an individual’s authorization.
If the accounting cannot be provided within 60 days, an additional 30 days is allowed if the individual is given a written statement of the reasons for the delay and the date by which the accounting will be provided. If you request more
than one accounting within a 12-month period, thegrouphealthplanmaychargeareasonablefee for each subsequent accounting.
20. The Right to Receive a Paper Copy of This Notice Upon Request: If you are receiving this Notice in an electronic format, then you have the right to receive a written copy of this Notice free of charge by contacting the Privacy Official (see section 23).
21. Changes in the Privacy Practice. Each group healthplanreservestheright tochangeitsprivacy practices from time to time by action of the Privacy Official. You will be provided with an advance notice of any material change in the plan’s privacy practices.
22. Your Right to File a Complaint with the Group Health Plan or the Department of Health and Human Services: If you believe that your privacy rights have been violated, you may complain to the group health plan in care of the HIPAA Privacy Official (see section 24). You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services, Hubert H. Humphrey Building, 200 Independence Avenue S.W., Washington, D.C. 20201. The group health plan will not retaliate against you for filing a complaint.
23. Person to Contact at the Group Health Plan for More Information: If you have any questions regarding this Notice or the subjects addressed in it, you may contact the Privacy Official
Privacy Official
The Plan’s Deputy Privacy Official(s) is/are:
Venus Alexander HR & Team Member Engagement Manager (301) 469-2013
Effective Date
The effective date of this notice is: January 1, 2026.
NOTICE OF SPECIAL ENROLLMENT RIGHTS
CONGRESSIONAL COUNTRY CLUB EMPLOYEE HEALTH CARE PLAN
If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to later enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage).
Loss of eligibility includes but is not limited to:
• Loss of eligibility for coverage as a result of ceasing to meet the plan’s eligibility requirements (e.g., divorce, cessation of dependent status, death of an employee, termination of employment, reduction in the number of hours of employment);
• Loss of HMO coverage because the person no longer resides or works in the HMO service area and no other coverage option is available through the HMO plan sponsor;
• Elimination of the coverage option a person was enrolled in, and another option is not offered in its place;
• Failing to return from an FMLA leave of absence; and
• Loss of eligibility under Medicaid or the Children’s Health Insurance Program (CHIP).
Unless the event giving rise to your special enrollment right is a loss of eligibility under Medicaid or CHIP, you must request enrollment within 30 days after your or your dependent’s(s’) other coverage ends (or after the employer that sponsors that coverage stops contributing toward the coverage).
If the event giving rise to your special enrollment right is a loss of coverage under Medicaid or CHIP, you may request enrollment under this plan within 60 days of the date you or your dependent(s) lose such coverage under Medicaid or CHIP. Similarly, if you or your dependent(s) become eligible for a stategranted premium subsidy toward this plan, you may request enrollment under this plan within 60 days after the date Medicaid or CHIP determine that you or the dependent(s) qualify for the subsidy.
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. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.
To request special enrollment or obtain more information, contact:
Venus Alexander HR & Team Member Engagement Manager
(301) 469-2013
* This notice is relevant for healthcare coverages subject to the HIPAA portability rules.
Introduction
GENERAL COBRA NOTICE
You’re getting this notice because you recently gained coverage under a group health plan (the Plan). This notice has important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan. This notice explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect your right to get it. When you become eligible for COBRA, you may also become eligible for other coverage options that may cost less than COBRA continuation coverage.
The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end. For more information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator.
You may have other options available to you when you lose group health coverage. For example, you may be eligible to buy an individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-day special enrollment period for another group health plan for which you are eligible (such as a spouse’s plan), even if that plan generally doesn’t accept late enrollees.
What is COBRA continuation coverage?
COBRA continuation coverage is a continuation of Plan coverage when it would otherwise end because of a life event. This is also called a “qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage.
If you’re an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
• Your hours of employment are reduced, or
• Your employment ends for any reason other than your gross misconduct. If you’re the spouse of an employee, you’ll become a qualified beneficiary if you lose your coverage under the Plan because of the following qualifying events:
• Your spouse dies;
• Your spouse’s hours of employment are reduced;
• Your spouse’s employment ends for any reason other than his or her gross misconduct;
• Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or
• You become divorced or legally separated from your spouse. Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because of the following qualifying events:
• The parent-employee dies;
• The parent-employee’s hours of employment are reduced;
• The parent-employee’s employment ends for any reason other than his or her gross misconduct;
• The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both);
• The parents become divorced or legally separated; or
• The child stops being eligible for coverage under the Plan as a “dependent child.”
When is COBRA continuation coverage available?
The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred. The employer must notify the Plan Administrator of the following qualifying events:
• The end of employment or reduction of hours of employment;
• Death of the employee;
• The employee’s becoming entitled to Medicare benefits (under Part A, Part B, or both).
For all other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days after the qualifying event occurs. You must provide this notice in writing to the Plan Administrator. Any notice you provide must state the name of the plan or plans under which you lost or are losing coverage, the name and address of the employee covered under the plan, the name(s) and address(es) of the qualified beneficiary(ies), and the qualifying event and the date it happened. The Plan Administrator will direct you to provide the appropriate documentation to show proof of the event.
How is COBRA continuation coverage provided?
Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children.
COBRA continuation coverage is a temporary continuation of coverage that generally lasts for 18 months due to employment termination or reduction of hours of work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage.
There are also ways in which this 18-month period of COBRA continuation coverage can be extended: Disability extension of 18-month period of COBRA continuation coverage
If you or anyone in your family covered under the Plan is determined by Social Security to be disabled and you notify the Plan Administrator in a timely fashion, you and your entire family may be entitled to get up to an additional 11 months of COBRA continuation coverage, for a maximum of 29 months. The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of COBRA continuation coverage. If you believe you are eligible for this extension, contact the Plan Administrator.
Second qualifying event extension of 18-month period of continuation coverage
If your family experiences another qualifying event during the 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if the Plan is properly notified about the second qualifying event. This extension may be available to the spouse and any dependent children getting COBRA continuation coverage if the employee or former employee dies; becomes entitled to Medicare benefits (under Part A, Part B, or both); gets divorced or legally separated; or if the dependent child stops being eligible under the Plan as a dependent child. This extension is only available if the second qualifying event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred.
Are there other coverage options besides COBRA Continuation Coverage?
Yes. Instead of enrolling in COBRA continuation coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicare, Medicaid, Children’s Health Insurance Program (CHIP), or other group health plan coverage options (such as a spouse’s plan) through what is called a “special enrollment period.” Some of these options may cost less than COBRA continuation coverage. You can learn more about many of these options at www.healthcare.gov
Can I enroll in Medicare instead of COBRA continuation coverage after my group health plan coverage ends?
In general, if you don’t enroll in Medicare Part A or B when you are first eligible because you are still employed, after the Medicare initial enrollment period, you have an 8-month special enrollment period1 to sign up for Medicare Part A or B, beginning on the earlier of
• The month after your employment ends; or
• The month after group health plan coverage based on current employment ends.
If you don’t enroll in Medicare and elect COBRA continuation coverage instead, you may have to pay a Part B late enrollment penalty and you may have a gap in coverage if you decide you want Part B later. If you elect COBRA continuation coverage and later enroll in Medicare Part A or B before the COBRA continuation coverage ends, the Plan may terminate your continuation coverage. However, if Medicare Part A or B is effective on or before the date of the COBRA election, COBRA coverage may not be discontinued on account of Medicare entitlement, even if you enroll in the other part of Medicare after the date of the election of COBRA coverage.
If you are enrolled in both COBRA continuation coverage and Medicare, Medicare will generally pay first (primary payer) and COBRA continuation coverage will pay second. Certain plans may pay as if secondary to Medicare, even if you are not enrolled in Medicare. For more information visit https://www.medicare.gov/medicare-and-you.
If you have questions
Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under the Employee Retirement Income Security Act (ERISA), including COBRA, the Patient Protection and Affordable Care Act, and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security Administration (EBSA) in your area or visit www.dol.gov/ebsa. (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA’s website.) For more information about the Marketplace, visit www.HealthCare.gov. Keep your Plan informed of address changes
To protect your family’s rights, let the Plan Administrator know about any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Plan contact information
For additional information regarding your COBRA continuation coverage rights, please contact the Plan Administrator below:
Venus Alexander HR & Team Member Engagement Manager
8500 River Road, Bethesda, MD 20817
(301) 469-2013
1 https://www.medicare.gov/basics/get-started-with-medicare/sign-up/when-does-medicare-coverage-start
WOMEN’S HEALTH AND CANCER RIGHTS NOTICE
Congressional Country Club Employee Health Care Plan is required by law to provide you with the following notice:
The Women’s Health and Cancer Rights Act of 1998 (“WHCRA”) provides certain protections for individuals receiving mastectomy-related benefits. Coverage will be provided in a manner determined in consultation with the attending physician and the patient for:
• All stages of reconstruction of the breast on which the mastectomy was performed;
• Surgery and reconstruction of the other breast to produce a symmetrical appearance;
• Prostheses; and
• Treatment of physical complications of the mastectomy, including lymphedemas.
The Congressional Country Club Employee Health Care Plan provide(s) medical coverage for mastectomies and the related procedures listed above, subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. Therefore, the following deductibles and coinsurance apply:
If you would like more information on WHCRA benefits, please refer to your Policy Booklet or contact your Plan Administrator at:
Venus Alexander HR & Team Member Engagement Manager
(301) 469-2013
Contacts
Medical/RxPlans - Cigna
One Guide: 800-244-6224
Website mycigna.com
Dental - Cigna
One Guide: 800-244-6224
Website mycigna.com
Vision- Cigna
One Guide: 800-244-6224
Website mycigna.com
Health Savings Account - Paylocity
Phone 1-800-631-3539
Website paylocity.com
Flexible Spending Accounts- Paylocity
Phone 1-800-631-3539
Website paylocity.com
Life/AD&D Insurance, Short Term Disability, Long Term Disability - Mutual of Omaha
Phone Life claims: 1-800-775-8805
Disabilityclaims: 1-800-877-5176
Websitemutualofomaha.com
Employee Assistance Program - Cigna
Phone 1-877-622-4327
Website mycigna.com
Core Advocacy- Health Advocate Phone 1-866-695-8622
Website healthadvocate.com/members
CriticalIllness and Accident- UNUM
Phone Accident: 800-635-5597
Critical Illness: 800-421-0344
Website unum.com
401(k) - Principal Phone 1-800-547-7754
Website principal.com
LegalResources
Phone 1-800-728-5768
Website legalresources.com
The descriptions of the benefits are not guarantees of current or future employment or benefits. If there is any conflict between this guide and the official plan documents, the official documents will govern.
