Benefits enrollment brochure J

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 an active open enrollment, meaning that your current elections will not roll over for 2023. There will be no coverage if you do not enroll.

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

During this open enrollment you will complete your enrollment through the ADP self-service portal or the ADP Mobile Solutions app or by calling the DFA Benefit Solution Center by Nov. 15, 2022. Your current elections will not be loaded in to ADP so if you would like to check what you are enrolled in today, you will need to review the flyer that was mailed to your home or log in to or call LifeWorks and view your current elections. See page 20 for more details.

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.

Watch your mail for information on the 2023 Happy. Healthy. Safe. program requirements in the coming months.

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

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.

MEDICAL AND PRESCRIPTION DRUG PLANS

DFA is

to

insurance

through the Blue Cross Blue Shield Blue Care Network of

primary care physician or health plan.

Benefit

Annual Deductible

Employee Only Family

+ Spouse,

Allergy Injections

Visits

Referral Physician Visits

Urgent Care Facility

Room Visit

Preventive Care

arranged

waived

after deductible High Technology Radiology Imaging (MRI, MRA, CAT, PET)

Diagnostic Tests and X-rays:

copay after deductible

Out-of-Pocket Maximum (Applies to deductibles, copays and coinsurance amounts for all covered services. Includes pharmacy cost-sharing.)

Employee Only Family (Employee + Spouse, Employee + Children or Family)

Prescription Drugs: Retail Pharmacy (30-Day Supply)

Prescription Drugs: Mail Order (90-Day Supply)

BCN

the number

back of

ID card.

a.m. to 5:30 p.m.

$16,300

Tier 1 (Generic): $10 copay

(Preferred): $40 copay

(Non-preferred): $80 copay

Tier 1 (Generic): $20 copay

(Preferred): $80 copay

(Non-preferred): $160 copay

COVERAGE THAT TRAVELS

As a Blue Care Network member with BlueCard coverage, you can receive benefits when you’re away from home. So can your dependents. Just show your member ID card.

Physicians and hospitals that contract with Blue plans nationwide participate in BlueCard.

You can locate BlueCard providers at www.bcbsm.com. Select Find a doctor from the home page. In search options, select Traveling? Find out how to get care. You can also call BlueCard at 1-800-810-2583.

PHARMACY COVERAGE

Your BCN ID card is accepted at thousandsof pharmacies nationwide, including most major chains, that participate with Blue plans.

BLUE CROSS MEMBER ONLINE ACCOUNT

HOW TO REGISTER

Online:

Go to www.bcbsm.com/register and select Register Now. Once your account is activated, you can set up one for each of your dependents.

Text

Text REGISTER to 222764.

Use the app

• Download the app by searching BCBSM on the App store or on Google Play.

• Tap the app icon and then Register.

• Use the app to snap a photo of your ID card. Your enrollee ID number will be entered for you.

Using an online account allows you to easily:

• Check your balances and coverage.

• Monitor claims and explanation of benefits statements.

• Search for doctors, hospitals and specialists.

• Compare costs for health care services.

• Find peace of mind with quality hospital care.

• Carry your ID card safely.

• Stay healthy, store your health records and track your goals in one location.

• See the status of authorizations and referrals.

• Use your member discounts.

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 FSA allows 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 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.

HEALTH CARE FSA DEPENDENT CARE FSA

• Medical expenses

Eligible Expenses1

• Prescription and over-the-counter costs

• Dental expenses

• Vision expenses

• Licensed adult and child day care centers

• Day camps

• Home care

• Nursery school for children not yet in first grade

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

Balance Rollover Limits $570 No, you will lose any money you don’t use at the end of the year.

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.

HSA Participation No 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 14 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 Care Network of Michigan Medical/Rx Plan www.bcbsm.com 1-800-662-6667 (TTY users: 711)

HealthEquity FSA www.healthequity.com 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

Additional helpful mobile application: ADP Mobile Solutions

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

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.