Benefits enrollment brochure A

OPEN ENROLLMENT

Welcome to the 2023 Benefits Open Enrollment. DFA is proud to continue to provide you and your family with a wide range of resources and services to support your physical, emotional and mental health needs in these challenging times. The last few years have been rough for everyone and we have worked hard to keep these important benefits a source of stability.

During these times we have been reminded of just how important our health is and that physical health is only one piece of our overall well-being. With this in mind, we are expanding our mental health services with a new Employee Assistance Program through CuraLinc called SupportLinc. These services are provided free of charge to you and your family. See page 17 for details.

We have also been reminded just how important each of you are to DFA’s success as an organization. We want you to know we sincerely appreciate you and we hope you will educate yourself on all of the benefits and resources offered to you as we look forward to the next year.

Your benefit elections become effective Jan. 1, 2023, and can be completed online, by mobile device or by telephone. Although we have included specific instructions in this guide on how to make your elections, you may also contact your local human resources representative with questions.

During open enrollment, you can review your benefit needs and adjust your coverage for the upcoming plan year without having a qualifying life event or family status change. You are allowed to add or drop coverage for yourself and/or your dependents. At any other time during the year, you must experience a family status change (marriage, divorce, birth or adoption, death of a dependent, change in your child’s dependent status, or change in your or your spouse’s employment status) in order to make these same changes. When you experience a family status change or life event, you have 31 days from the date of the event to make the desired changes to your benefits.

2023 OPEN ENROLLMENT ANNOUNCEMENTS AND ACTION ITEMS

This is a passive open enrollment, meaning that a majority (including medical, dental, vision and voluntary benefits) of your current elections will roll over for 2023 if you take no action.

Benefits that require you to make an election for 2023 are:

• HSA

• Healthcare FSA/Limited Purpose FSA/ Dependent Care FSA

Read this brochure in its entirety before making your 2023 benefit decisions.

DFA’s contribution to your Health Savings Account will be increasing to $750 for Employee Only and $1,500 for all other coverage tiers if you are enrolled in either the HDHP Enhanced or HDHP Basic plan with a HealthEquity HSA.

The Spousal Surcharge is increasing to $1,800 annually (which equals $150 per month). As a reminder, you will be charged this additional contribution if your spouse is employed and eligible for health insurance through his or her own employer and you wish to cover him or her under a DFA medical plan.

We are excited to announce the transition of our Employee Assistance Program to SupportLinc. See additional information on page 17.

To ensure that all covered dependents meet the eligibility requirements to participate in our benefit plans we will partner with Consova to complete a Dependent Eligibility Audit in early 2023. Be on the look out for more information! Open enrollment is your opportunity to remove dependents from the plan who are no longer eligible.

You have the opportunity to elect Voluntary Life Insurance up to the guaranteed issue amount for yourself or your spouse even if you previously declined coverage, or if you are currently enrolled, you may increase your or your spouse’s current election up the guaranteed issue amount without Evidence of Insurability! You may not have this opportunity again for a few more years. See page 15 for details.

Review your 401(k) and Life Insurance beneficiary designations to confirm the information is current. If you do not have a beneficiary listed, it is important that you add one.

Make sure to complete any required health coaching calls and/or tobacco cessation program by Nov. 30, 2022 in order to achieve the incentive. Be on the look-out for more information on the 2023 Happy. Healthy. Safe. program in the coming months!

MEDICAL AND PRESCRIPTION DRUG PLANS

HEALTH INSURANCE PLAN OFFERINGS

DFA is committed to offering comprehensive health insurance to our employees. In 2023, we will continue to offer the following choices through Blue Cross Blue Shield: HDHP Enhanced

• Preferred Care Blue

BlueSelect Plus

IMPORTANT

HDHP Basic

Preferred Care Blue

BlueSelect Plus

PPO

Preferred Care Blue

BlueSelect Plus

Find a Provider | To view provider finder results for either the Preferred Care Blue or BlueSelect Plus network, first log in as a member on www.myhealthtoolkitkc.com or the My Health Toolkit mobile app. After logging in, click “Find Care” and then “Find a Doctor” to search for a provider in the BlueSelect Plus or Preferred Care Blue network.

Blue Cross Blue Shield Care Connected Concierge | Blue Cross Blue Shield’s dedicated customer service Concierge team can help guide and support both you and your family members navigate the health care system. The Concierge team is able to help connect you with a variety of your 2023 carriers including:

• FSA and HSA (HealthEquity)

• Surgery Resources (SurgeryPlus)

Diabetes Care (Livongo, Virta)

Concierge team

• Wellness Program

EAP

available

Virtual Care (Teladoc)

Medical Care (BCBS)

When

Who should enroll,

Plus is

in one of these twelve (12)

what

BLUESELECT PLUS NETWORK

You have the option to choose to participate in the BlueSelect Plus network at a lower monthly premium. You may participate in this network with the PPO, HDHP Basic or HDHP Enhanced plan. BlueSelect Plus is a network of select health care providers specially designed to provide affordable access to quality care in and around the Kansas City metro area. Since this network is smaller than the Preferred Care Blue network, members will receive deeper discounts when receiving medical treatment. Use the following guidelines to better understand the BlueSelect Plus network and your coverage.

The network includes 4,100+ providers and 13 hospitals.1

The following Kansas City area counties are in-network. Missouri: Clinton, Clay, Jackson, Johnson and Platte. Kansas: Johnson and Wyandotte.

The surrounding Kansas City counties are out-of-network. When receiving care outside the BlueSelect Plus network, but within the 32-county Blue KC service area, your out-of-network coverage means higher out-of-pocket costs will apply.2

Missouri: Clay, Jackson, Platte, Cass, Clinton, DeKalb, Johnson, Lafayette, Ray, Caldwell Kansas: Johnson, Wyandotte

Outside the local 32-county Blue KC service area and across the nation (e.g., travel or vacation), the BlueCard network is in-network.

care from any of the 4,100+ providers and 13 hospitals primarily located in these seven (7) counties: Missouri: Clinton, Clay, Jackson, Johnson, Platte Kansas: Johnson, Wyandotte

network includes these

Which hospitals are in the network?

participating hospitals:

• AdventHealth College Boulevard

• AdventHealth Shawnee Mission

• AdventHealth College Boulevard

• AdventHealth South Overland Park

AdventHealth Shawnee Mission

• Cameron Regional Medical Center

AdventHealth South Overland Park

• Children’s Mercy Hospital

Cameron Regional Medical Center

• Children’s Mercy Hospital - South

• Liberty Hospital

Children’s Mercy Hospital

• North Kansas City Hospital

Children’s Mercy Hospital — South

• Olathe Medical Center

Liberty Hospital

• University Health Truman Medical Center

North Kansas City Hospital

• University Health Lakewood Medical Center

Olathe Medical Center

• University of Kansas Health Hospital

• Western Missouri Medical Center

University Health Truman Medical Center

Over 4,100 Providers.

Top Hospitals.

All other hospitals

University Health Lakewood Medical Center

University of Kansas Health Hospital

Western Missouri Medical Center

MEDICAL PLAN OPTIONS

For 2023, you will continue to be offered the choice of two High Deductible Health Plans (HDHPs): the HDHP Enhanced and the HDHP Basic, in addition to the PPO plan. These plans have a higher deductible than the PPO plan as described in the summary below, but the HDHP plans give you lower premiums and allow you to contribute to a Health Savings Account. With these plan options, you pay the cost of all services until the deductible is met, with the exception of most preventive care services. This includes the cost of physician services, prescription drugs and all other medical services. Once you meet the applicable in-network or out-of-network deductible, you and the plan share in the cost of services, called coinsurance, until the applicable out-of-pocket maximum is met.

IMPORTANT

Enrollment in one of the HDHPs below allows you to open a Health Savings Account to save for future health care expenses as discussed in more detail on page 10, including details on the automatic one-time HSA contribution from DFA.

HDHP PLAN DESIGNS

Benefit

HDHP ENHANCED

PREFERRED CARE BLUE OR BLUESELECT PLUS

In-Network Out-of-Network1

HDHP BASIC

PREFERRED CARE BLUE OR BLUESELECT PLUS

In-Network Out-of-Network1

Lifetime Maximum Unlimited Unlimited

Annual Deductible2

Employee Only $2,500 $2,500 $3,500 $3,500

Family $5,000 $5,000 $7,000 $7,000

(If you elect coverage for more than yourself, the family deductible must be satisfied before benefits will be paid for any covered family member.)

Annual Out-of-Pocket Maximum (OOP)2

(If you elect coverage for more than yourself, the family deductible must be satisfied before benefits will be paid for any covered family member.)

Employee Only $5,000 $10,000 $7,000 $14,000

Family (An individual must meet his or her individual OOP, not the family OOP, before benefits are paid on that individual.)

$10,000 $20,000 $14,000 $28,000

Coinsurance 80% 55% 80% 55%

Routine Preventive Care 100% (not subject to deductible) 100% (not subject to deductible)

Inpatient Hospital Services/ Outpatient Surgery 80% after deductible 55% after deductible 80% after deductible 55% after deductible

Emergency Room 80% after deductible 80% after deductible

Urgent Care Facility 80% after deductible 55% after deductible 80% after deductible 55% after deductible Teladoc Telemedicine 80% after deductible N/A 80% after deductible N/A

Office Visit 80% after deductible 55% after deductible 80% after deductible 55% after deductible Outpatient Lab, Outpatient X-ray and Other Radiology Procedures 80% after deductible 55% after deductible 80% after deductible 55% after deductible

Prescription Drugs: Retail Pharmacy (31-Day Supply)

Prescription Drugs: Mail Order (90-Day Supply)

Generic: 85% after deductible Formulary: 80% after deductible (member pays $40 max.) Non-formulary: 60% after deductible (member pays $65 max.)

Generic: 85% after deductible Formulary: 80% after deductible (member pays $120 max.)

Non-formulary: 60% after deductible (member pays $195 max.)

1The plan will limit out-of-network payments

reasonable and customary

55% after deductible

Generic: 85% after deductible

Formulary: 80% after deductible (member pays $40 max.)

Non-formulary: 60% after deductible (member pays $65 max.)

Generic: 85% after deductible Formulary:

after deductible

after deductible (member pays $120 max.)

Non-formulary:

55% after deductible

after deductible

pays $195 max.)

out-of-pocket

after deductible

amounts can be substantial. You may be

billed the difference between the provider’s charge and Blue Cross Blue Shield’s allowable.

and out-of-network claims cross accumulate for both the deductible and

PPO PLAN DESIGN

Benefit

PREFERRED CARE BLUE OR BLUESELECT PLUS In-Network Out-of-Network1

Lifetime Maximum Unlimited

Annual Deductible2

Employee Only

Employee +1 (Employee + Spouse or Employee + Child)

Family (Employee + Children or Family)

$1,000 $2,000 $3,000

Annual Out-of-Pocket Maximum (OOP)2 — Includes Deductible, Coinsurance and Copays

Employee Only

Employee +1 (Employee + Spouse or Employee + Child)

Family (Employee + Children or Family)

$5,000 $10,000 $10,000

$1,000 $2,000 $3,000

$10,000 $20,000 $20,000

Coinsurance 80% 55%

Routine Preventive Care 100% (not subject to deductible)

Inpatient Hospital Services/Outpatient Surgery 80% after deductible 55% after deductible

Outpatient Lab, Outpatient X-ray and Other Radiology Procedures 80% after deductible 55% after deductible

Emergency Room 80% after deductible

Urgent Care Facility $50 copay 55% after deductible

Teladoc Telemedicine $25 copay N/A

Primary Care Office Visit $25 copay 55% after deductible Specialist Office Visit $50 copay 55% after deductible

Tier 1: $10 copay

Prescription Drugs: Retail Pharmacy (31-Day Supply)

Prescription Drugs: Mail Order (90-Day Supply)

1The plan

IMPORTANT

Tier 2: $30 copay

Tier 3: $50 copay

Tier 1: $30 copay

Tier 2: $90 copay

Tier 3: $150 copay

Tier 1: $10 copay, then plan pays 55% coinsurance

Tier 2: $30 copay, then plan pays 55% coinsurance

Tier 3: $50 copay, then plan pays 55% coinsurance

Tier 1: $30 copay, then plan pays 55% coinsurance

Tier 2: $90 copay, then plan pays 55% coinsurance

Tier 3: $150 copay, then plan pays 55% coinsurance

A plan comparison tool is available to help you compare costs and benefits between the High Deductible Health Plans and the PPO plan as well as both the Preferred Care Blue and BlueSelect Plus networks. This tool enables you to enter your anticipated medical expenses and compare the estimated costs under each plan. You can locate the tool at https://my.adp.com in Forms and Plan Documents while making your elections.

IMPORTANT

Pharmacy Plan Information

Your pharmacy administrator is CVS Caremark. Visit a pharmacy in the CVS National Network, which includes CVS retail pharmacies, Walgreens, Target, Walmart, Costco and more! Visit www.caremark.com for more information.

• DFA offers plan participants on the HDHP Basic or HDHP Enhanced plans the opportunity to have certain preventive drugs covered at 100%! If your medication falls on the CVS generic preventive drugs list, it will be covered at 100% if it is obtained through an in-network pharmacy.

• In addition to using mail order to fill maintenance medications, you can fill a 90-day maintenance medication at any retail CVS pharmacy. Maintenance medications are commonly used to treat conditions that are considered chronic or long term and usually require regular, daily use of medicines. Examples include those used to treat high blood pressure, heart disease, asthma and diabetes.

• If you request a brand when a generic is available, you may be required to pay the difference in the cost of the brand name vs. generic drug (in addition to the applicable coinsurance).

• Your specialty prescriptions will come from VIVIO Health. VIVIO may also help you manage your complex or chronic condition with one-on-one case management.

TELADOC: A CONVENIENT WAY TO AVOID WAITING ROOMS 24/7

If you can’t wait or do not have quick access to care, Teladoc can get you the care you need for common medical concerns from your phone or the web 24/7/365.

SAVE TIME AND MONEY BY USING TELADOC!

• Sinus pain

• Mild asthma

• Mild allergic reactions

Speak with a doctor in minutes.

• Minor headaches

• Burning with urination

• Cold sores

• Sprains, strains

Get the care you need — including some prescriptions.

• Pinkeye/eye irritation

• Nausea, vomiting, intestinal issues

PPO

General Medicine

Dermatology

Psychologist, Licensed Clinical Social Worker, Counselor or Therapist

Psychiatrist (Initial Visit)

Psychiatrist (Ongoing Visit)

*You pay the consult fee until the deductible is met, then coinsurance applies.

$25 copay

$50 copay

$25 copay

$25 copay

$25 copay

Pay much less than going to the emergency room.

• Bumps, cuts, scrapes

• Coughs, sore throat

• Minor fevers, colds

• Rashes, minor burns

• Behavioral health

• Dermatology

HDHP Basic and Enhanced*

$55 consult fee

$85 consult fee

$90 consult fee

$220 consult fee

$100 consult fee

Grab your insurance card and go to www.teladoc.com or call 1-800-Teladoc (835-2362) to set up your account. Once you have an account, simply log in with your username and password whenever you need to consult with a Teladoc physician. Prefer a mobile app? Check out page 18 for details!

DFA offers voluntary programs that are available to support you or a family member who is a diabetic, has chronic hypertension, or needs to have a nonemergency surgery. Details about each of these programs can be found in the ADP Document Library which can be accessed online at https://my.adp.com or through the mobile app. You can also access each company’s website by scanning the below QR code with your smartphone camera.

PREVENT DIABETES, MANAGE YOUR DIABETES OR MANAGE YOUR HYPERTENSION WITH LIVONGO

DFA offers three programs through LIVONGO which are free of charge to employees and dependents. These programs help you prevent diabetes; manage type 1, or type 2 diabetes; or manage your hypertension. Participation in the diabetes program includes a no cost blood glucose meter, testing strips and lancets. Participation in the high blood pressure program includes a no cost blood pressure monitor. Participation in the diabetes prevention program includes a no cost smart scale. No cost to members

REVERSE YOUR TYPE 2 DIABETES WITH VIRTA

DFA offers a program through Virta which is free of charge to employees, spouses and adult dependents who are between the ages of 18 and 79 and are Type 2 diabetics. The goal of the program is to reduce your blood sugar and A1c, getting you off medications and helping you to lose weight. The program is based upon nutritional ketosis, includes a physician-led care team and is personalized to the individual’s needs. No cost to members

SAVE MONEY WITH SURGERYPLUS

SurgeryPlus can be an option when you need to have a planned, non-emergent surgery. The SurgeryPlus network includes quality providers with favorable surgery outcomes. Additionally, use of one of these providers can result in significantly less out-of-pocket expense and reduced hassle. If you or a family member is seeking to have bariatric surgery, it is a requirement to utilize a SurgeryPlus provider.

HEALTH SAVINGS ACCOUNT

WHAT IS A HEALTH SAVINGS ACCOUNT?

A Health Savings Account (HSA) can help you manage your expenses today and in the future. It’s yours to:

• Own. The HSA is always yours, even if you change jobs, re-enroll in one of the traditional plans, become unemployed or retire.

• Grow. Your unused balance rolls over from year to year. No “use it or lose it.”

• Save. HSAs provide tax-free contributions, tax-free withdrawals for qualified health expenses and tax-free earnings from investment options.

• Choose. Use for current expenses, save for the future (money you save can be used for health expenses after you retire) or explore investment options.

HSA: ACCOUNT ELIGIBILITY

You must be covered by one of the Qualified High Deductible Health Plans (HDHP Basic or HDHP Enhanced). You cannot be claimed as a dependent on someone else’s tax return. It is the account holder’s responsibility to maintain compliance under these regulations. You cannot have any “other coverage” such as:

• A plan that is not an HSA-qualified HDHP.

• Spouse’s plan that is not a QHDHP (Traditional HMO or PPO).

• Medicare or Medicaid.

• TRICARE coverage (military health care).

• Health Care Flexible Spending Account.

• Not including a Dependent Care Flexible Spending Account or a Limited Purpose Flexible Spending Account.

• Health Reimbursement Arrangement (HRA).

QUALIFIED EXPENSES

IRS Publication 502 provides a

and can be found at www.irs.gov.

INVEST IN YOUR HSA

HealthEquity offers a wide range of investment and savings options to suit your individual needs and financial goals including Cash Account, Yield Plus and Varying Risk mutual funds.

TAX SAVING OPTION

The 2023 IRS annual maximum allowed contributions for these accounts are:

HSA Funding and Limits: Employees are responsible for tracking annual limits, including any employer contributions you receive.

At age 55, an additional $1,000 contribution is allowed annually.

IMPORTANT

Your Responsibilities as the HSA Account holder

Keep your itemized receipts.

• Monitored by you and the IRS

• If you are under the age of 65, non-qualified expenses subject to: 20% penalty and normal income tax

• After 65, non-qualified expenses subject to normal income tax

2023 EMPLOYER CONTRIBUTION

Any employee enrolled in either the HDHP Enhanced or HDHP Basic plan in 2023 with a HealthEquity HSA will receive an automatic one-time HSA contribution from DFA.

If you elect EmployeeOnly coverage, you will receive $750.

If you elect Family coverage, you will receive $1,500.

This contribution is in addition to the wellness incentive you may be eligible to receive. Both employer contributions count toward the annual limits, so plan carefully how much you’ll contribute annually to avoid excess contributions.

DENTAL PLANS

Dental coverage will continue to be administered by Delta Dental of Kansas with the choice between the Basic Plan or Enhanced Plan coverage. You will have access to the nationwide Delta Dental networks. You can find an in-network dentist by using the dentist search online at www.deltadentalks.com or by downloading the mobile app.

BASIC AND ENHANCED DENTAL PLAN OPTIONS

DELTA DENTAL PPO DENTIST

YOU HAVE THREE PROVIDER OPTIONS:

BENEFITS

These dentists accept payment based on a reduced fee schedule. (Your out-of-pocket expenses will be lowest when you see a Delta PPO dentist.) There is no balance billing.*

DELTA DENTAL PREMIER DENTIST

These dentists accept payment based on Delta’s contractual agreement. There is no balance billing to you.*

NONPARTICIPATING DENTIST

Benefit payments will be based on Delta’s Maximum Plan Allowance, and you will be responsible for any difference between the dentist’s charge and Delta’s Maximum Plan Allowance. Balance billing* is possible.

Nonparticipating Dentist

Annual Deductible $50 per person, up to $150 family maximum

Preventive Services Includes Routine Exams, X-rays and Cleanings

Covered at 100% (no deductible)

Covered at 100% (no deductible)

Covered at 100% (no deductible)

Basic Services Includes Periodontics and Oral Surgery Covered at 80% after deductible Covered at 80% after deductible Covered at 80% after deductible

Major Services Includes Crowns, Dentures and Bridgework

Orthodontia Applies Only to Dependent Children Under Age 19

Covered at 60% after deductible Covered at 60% after deductible Covered at 60% after deductible

Covered at 50% after deductible

DENTAL ENHANCED

Orthodontia Lifetime Maximum

Annual Maximum Delta Dental Preventive Plus Program

$2,500 per person

$2,500 per person

Routine care (exams, X-rays, perio-maintenance cleanings) will not reduce your plan year maximum benefit amount.

*Balance billing is when you are billed the difference between the dentist’s charge and Delta’s maximum allowance.

DENTAL BASIC

$1,500 per person

$1,500 per person Routine care (exams, X-rays, perio-maintenance cleanings) will not reduce your plan year maximum benefit amount.

VISION PLAN

DFA’s vision coverage through VSP includes coverage for exams, lenses and frames or contact lenses, and many cosmetic lens options. The vision plan is built around a network of eye care providers, with better benefits at a lower cost to you when you use in-network providers.

ESSENTIAL MEDICAL EYECARE PROGRAM

If you have diabetic eye disease, glaucoma or age-related macular degeneration (AMD), you can receive eye care services from your VSP doctor. You can also receive preventive retinal screenings if you have diabetes but don’t show signs of diabetic eye disease. Visit your VSP doctor whenever you need to do so. Services are covered with just a $20 copay.

IMPORTANT

TRUHEARING DISCOUNTS

TruHearing provides exclusive savings up to 60% to VSP members and their dependent and extended family members even if they are not enrolled in the plan. Contact TruHearing at www.truhearing.com/vsp or call 1-877-396-7194, and mention VSP to have your questions answered and schedule a hearing exam with a local provider.

VSP® KIDSCARE PLAN SM

This plan meets the eye care and eyewear demands of active and growing children (under age 19) by providing two comprehensive eye exams and one pair of glasses every year, plus other important benefits.

Your VSP benefit includes EyeconicTM, an online eyewear store exclusively for VSP members. You can preshop before your next doctor’s appointment or buy online. The choice is yours. Visit www.eyeconic.com.

Benefit In-Network

Eye Exam Copay $10

Prescription Glasses Copay $25

Eye Exam Every calendar year

Lenses

Every calendar year

Frames Every other calendar year

Frame Allowance $150 plus 20% off any out-of-pocket costs

Single Vision Lens Covered after copay (including polycarbonate lenses for dependent children)

Lined Bifocal Lens Covered after copay

Lined Trifocal Lens Covered after copay

Lenticular Covered after copay

Cosmetic Lens Options Covered Photochromic, standard progressive, tints, dyes and anti-reflective coating

Cosmetic Lens Options Not Covered 35%-40% average savings on all non-covered lens options

Contact Lenses (in Lieu of Glasses) $60 max. copay for fitting and $150 for materials, 15% discount on fitting evaluation fee

Additional Discounts 20% discount on additional pairs of prescription glasses and non-prescription sunglasses from VSP provider

Laser Surgery Discounts Toward PRK, LASIK and Custom LASIK (Using Wavefront Technology) Surgeries

Limited Out-of-Network reimbursements available.

Average discount savings of 15%-20%

FLEXIBLE SPENDING ACCOUNTS

Stretch your health care and dependent care dollars by using pretax dollars for qualified health care and/or dependent care costs by participating in the Flexible Spending Account (FSA) program. Participation in the FSA program must be elected each year during open enrollment for the following calendar year. The health care and limited purpose health care FSA allow for up to $570 of your unused FSA balance to be carried in to the next FSA plan year.

Employees may maximize their pretax savings by using the Health Care FSA or Limited Purpose Health Care FSA and Dependent Care FSA. Pretax means the dollars used for eligible expenses are not subject to Social Security tax, federal income tax, and in most cases, state and local income tax. If you are not eligible to open or contribute to an HSA, you may participate in the Health Care FSA. Note, if you are eligible to contribute to the HSA, you may enroll in the Limited Purpose Health Care FSA and/or the Dependent Care FSA only.

HEALTH CARE FSA LIMITED PURPOSE HEALTH CARE FSA DEPENDENT CARE FSA

Medical Plan PPO Plan HDHP Enhanced or Basic PPO, HDHP Enhanced or Basic

• Medical expenses

Eligible Expenses1

• Prescription and over-the-counter costs

• Dental expenses

• Vision expenses

• Dental expenses

• Vision expenses

• Medical expenses once the 2023 IRS annual HDHP deductibles of $1,500 employee only/$3,000 family have been reached

• Licensed adult and child day care centers

• Day camps

• Home care

• Nursery school for children not yet in first grade

Contribution Limits $2,850 $2,850 $5,0002 (or $2,500 if married and filing separate tax returns)

Balance Rollover Limits $570 $570

Deadline to Incur Expenses

Dec. 31, 2023. Receipts must be submitted by March 31, 2024.

Dec. 31, 2023. Receipts must be submitted by March 31, 2024.

No, you will lose any money you don’t use at the end of the year.

Dec. 31, 2023. Receipts must be submitted by March 31, 2024.

HSA Participation No Yes Yes

Investment Options No, your FSA funds do not earn interest and cannot be invested.

1Go to www.irs.gov for a complete list of eligible expenses.

2Highly compensated employees are not eligible to contribute to a Dependent Care FSA per IRS rules.

IMPORTANT

Important Note Applicable to All FSAs | You must keep a copy of all receipts, because IRS regulations require the plan administrator to substantiate each claim. While some transactions can be identified by provider name, dollar amount, etc., you may be required to send in additional information to substantiate the claim. Please retain all receipts for your debit card purchases.

Eligible Expenses | IRS Publication 502 provides a complete list of eligible expenses and can be found at www.irs.gov. The following list includes some of the most common eligible expenses:

• Deductibles, copayments and amounts that exceed the dollar maximum as provided for in your health care plan

• Out-of-pocket dental expenses

• Immunizations

• Hearing exams

• Glasses

• Prescription and over-the-counter drugs

LIFE INSURANCE BENEFITS

IMPORTANT

In the event of your death, Life Insurance may provide your family members or other beneficiaries with financial protection and security. DFA provides full-time employees with a Basic Life Insurance benefit and an Accidental Death and Dismemberment benefit through New York Life Group Benefit Solutions.

In addition to your Basic Life Insurance benefit, full-time employees may also elect Supplemental Life Insurance in $10,000 increments from $10,000 to $500,000. Spouses are able to elect up to the lesser of $250,000 or 100% of the employee’s supplemental coverage in $5,000 increments. A $10,000 or $20,000 dependent child option is available (the benefit is $2,500 for dependents seven days to six months of age).

For 2023 only, even if you previously declined coverage, you will be able to elect up to $250,000 of coverage without an Evidence of Insurability form.

Employees who currently have between $10,000 and $240,000 of Supplemental Life Insurance may increase their coverage to $250,000 without proof of good health during this open enrollment.

Any spouse who wishes to elect supplemental coverage if they were previously declined or who has existing Life Insurance and wishes to increase coverage up to $50,000 will not be required to submit an Evidence of Insurability form.

Any amounts elected above the guaranteed issue amount will require Evidence of Insurability. If required, an Evidence of Insurability form will be mailed to you after the open enrollment period ends. Evidence of Insurability is not needed for the dependent child option.

ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCE BENEFITS

AD&D insurance can help you pay expenses if you or an eligible family member are seriously injured or killed in a covered accident. In 2023 you may purchase additional AD&D insurance through New York Life Group Benefit Solutions:

• Yourself: AD&D coverage is available to a maximum of $500,000.

• Your Family: If you elect family coverage and no dependent children are covered, your spouse coverage amount will be 50% of your coverage amount. If one or more dependent children are insured, your spouse coverage amount will be 40% of your coverage amount. Each of your covered children’s benefit amount will be 10% of yours, subject to a maximum benefit of $20,000.

VOLUNTARY BENEFITS

DFA has partnered with Aflac to offer employees an opportunity to choose benefits that suit their personal circumstances and lifestyle by purchasing additional financial protection through these voluntary benefit offerings: Critical Illness insurance, Hospital Indemnity insurance and Accident insurance. In 2023, DFA is also partnering with Allstate Identity Protection and MetLife Legal to make sure you are able to protect your identity and be prepared for any unexpected legal matters. You are not required to be enrolled in any other company benefits to elect these coverages.

ACCIDENT INSURANCE

AFLAC | Voluntary Accident insurance provides a range of fixed, lump-sum benefits for injuries resulting from a covered accident or for accidental death and dismemberment. These benefits are paid directly to the insured and may be used for any reason, from deductibles and prescriptions to transportation and child care. Two plans are being offered, a low plan and a high plan.

CRITICAL ILLNESS INSURANCE

AFLAC | Voluntary Critical Illness insurance provides a fixed, lump-sum benefit upon diagnosis of a critical illness, which can include heart attack, stroke, paralysis and more. These benefits are paid directly to the insured and may be used for any reason, from deductibles and prescriptions to transportation and child care. This coverage also includes a $50 annual wellness (health screening) benefit. Visit www.aflacgroupinsurance.com to learn more.

HOSPITAL INDEMNITY INSURANCE

AFLAC | Voluntary Hospital Indemnity insurance provides a range of fixed, lump-sum daily benefits to help cover costs associated with a hospital admission, including room and board costs. These benefits are paid directly to the insured following a hospitalization that meets the criteria for benefit payment.

IDENTITY THEFT

ALLSTATE IDENTITY PROTECTION | Your identity is made up of more than your Social Security number and credit score. That’s why Allstate Identity Protection does more than monitor your credit reports. They help you look after your online activity, from financial transactions to what you share on social media so you can protect the trail of data you leave behind.

LEGAL PLAN

METLIFE | Legal matters, both planned and unplanned, are part of life. Enrolling in the MetLife Legal Plan gives you the financial and emotional peace of mind to know you will be covered for many expected and unexpected legal events.

The MetLife Legal Plan provides you, your spouse and dependents with fully covered legal services from attorneys experienced in estate planning documents, civil suits, adoption, identity theft issues and much more.

IMPORTANT

Details about each of these benefits can be found in the ADP Document Library which can be accessed at MyADP through the mobile app, or online.

EMPLOYEE ASSISTANCE PROGRAM

Life can be a juggling act. It takes time, and lots of it, to manage work, family and personal challenges. To help you, we are please to announce SupportLinc Employee Assistance Program, administered by Curalinc Healthcare, is being implemented.

SupportLinc offers confidential, expert guidance to help address and resolve everyday issues. Their emotional wellbeing and work-life balance resources will help keep you at your best.

IMPORTANT

Employees who use the EAP find their stress levels improve!

Call: 1-888-903-0650

Log on: www.supportlinc.com and enter group code dfa.

Check out our app. See page 18 for details.

In-The-Moment Support

Reach a licensed clinician by phone 24/7/365 for immediate assistance.

Legal Consultation

By phone or in-person with a local attorney.

Convenience Resources

Referrals for child and elder care, home repair, housing needs, education, pet care and so much more.

Short-Term Counseling (up to 6 sessions)

Access in-person or video counseling sessions to resolve concerns such as stress, anxiety, depression, relationship issues, work-related pressures, or substance abuse.

Confidentiality

Financial Expertise Planning and consultation with a licensed financial counselor.

SupportLinc ensures no one will know you have accessed the program without your written permission except as required by law.

IMPORTANT CONTACTS & MOBILE APPLICATIONS

Provider websites and mobile apps listed on this page are a great resource to view plan information, review claims and find out more general Information about each provider.

IMPORTANT

To download any of these free mobile apps, visit your smartphone’s app store. The icons and names of each app are bold and in blue. Follow the directions in the app store or app to log in/register. In most cases, you will use your online login for that carrier for their mobile application. If you have never logged in before, you will need to register.

DFA Benefit Solution Center Online and telephonic enrollment services https://my.adp.com 1-800-422-6109

Blue Cross Blue Shield Medical Plan www.myhealthtoolkitkc.com 1-833-644-1302

CVS Caremark Prescription Drug Plan www.caremark.com

VIVIO Specialty Prescriptions www.myvivio.com/dfa 1-800-470-4034

SurgeryPlus Surgery Assistance dfa.surgeryplus.com 1-855-713-1576

HealthEquity HSA and FSA www.healthequity.com HSA: 1-866-346-5800 FSA: 1-877-924-3967

Delta Dental Dental Plan www.deltadentalks.com 1-800-234-3375

VSP Vision Plan http://dairyfarmersofamerica.vspforme.com 1-800-877-7195

New York Life Life and AD&D and Disability www.newyorklife.com 1-888-842-4462

Aflac Accident, Critical Illness and Hospital Indemnity www.aflacgroupinsurance.com 1-800-433-3036

Allstate Identity Protection www.myaip.com 1-800-789-2720

MetLife Legal Services www.legalplans.com 1-800-821-6400

SupportLinc eConnect Mobile — Employee Assistance Program www.supportlinc.com (Group code is dfa) 1-888-903-0650

Additional helpful mobile applications: ADP Mobile Solutions Teladoc Virta Health Livongo

The 2023 employee benefits Open Enrollment is Tuesday, Oct. 25—Tuesday, Nov. 15, 2022. Your benefit elections become effective Sunday, Jan. 1, 2023.

HOW TO ENROLL

ADP Mobile makes it easy to access and elect your 2023 benefits during open enrollment.

Download the free ADP Mobile Solutions app by scanning the QR code to the right with your mobile phone’s camera, or log in from your mobile browser: www.mobile.adp.com.

The Summaries of Benefits and Coverage (SBCs) for DFA medical plans can be found in Forms and Plan Documents on the open enrollment website at https://my.adp.com through the Benefits tab and then Health & Welfare.