2026-2027
Employee Benefits Guide A guide to understanding your employee benefits program
CONTENTS 3
Important Contacts
4
Eligibility
5
How to Enroll
6
Medical Coverage
7
Prescription Coverage
8
UHC Resources
9
Primary Care and Urgent Care
10
Imaging Services
11
Health Care Options
12
Telemedicine
13
Medicare Assistance
14
VSP Optional Voluntary Vision Coverage
15
Dental Coverage
16
Life and AD&D Insurance
17
Disability Insurance
18
Optional Voluntary Supplemental Insurance
21
Additional Benefits
22
Optional Voluntary Benefit - LifeLock
23
Employee Contributions
24
Glossary of Terms
25
Important Notices
If you and/or your dependents have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. Please see Important Notices for more details.
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JOHNSON SUPPLY & EQUIPMENT
WELCOME We are pleased to offer a full benefits package to help protect your well-being and financial health. Read this guide to learn about the benefits available to you and your eligible dependents starting May 1, 2026. Each year during Open Enrollment (OE), you may make changes to your benefit plans. The benefit choices you make this year will remain in effect through December 31, 2026. Take time to review these benefit options and select the plans that best meet your needs. After OE, you may only make changes to your benefit elections if you have a Qualifying Life Event (QLE).
AVAILABILITY OF SUMMARY HEALTH INFORMATION Your benefits program offers a medical plan, as well as dental, vision, and other benefits options. To help you make an informed decision, a Summary of Benefits and Coverage for each plan is available in BenefitsInHand at www.benefitsinhand.com.
NEED PLAN INFORMATION? Scan this QR code to get all your benefits links and information in one place, which may include videos, employee benefits portal, current benefits guide, medical plan summaries, and more.
IMPORTANT CONTACTS Coverage
Carrier
Group #
Phone
Website/Email
Medical
UnitedHealthcare
944526
888-332-8885
www.myuhc.com
Pharmacy
CANARX ElectRx
N/A
866-893-6337 855-353-2879
www.canarx.com info@electrx.com
Primary Care and Urgent Care
Next Level PRIME
N/A
832-957-6200
navigators@nextlevelurgentcare.com
Imaging Services
Green Imaging
N/A
844-968-4647
www.greenimaging.com
Telemedicine
UnitedHealthcare
N/A
888-332-8885
www.myuhc.com
SmartConnect
N/A
844-784-5160
www.smartmatch.com/connect/ johnsonsupply
Vision
VSP
30048074
800-877-7195
www.vsp.com
Dental
UnitedHealthcare
944526
888-332-8885
www.myuhc.com
Basic Life and AD&D Voluntary Life and AD&D
Lincoln Financial
000010282148 000400282150
800-487-1485
www.lfg.com
Short Term Disability Long Term Disability
Lincoln Financial
000490282329 000010282149
800-487-1485
www.lfg.com
Accident Critical Illness Hospital Indemnity
Lincoln Financial
0000997058 0000997056 0000997057
800-487-1485
www.lfg.com
Employee Assistance Program
Lincoln Financial GuidanceResources
N/A
888-628-4824
www.lfg.com www.guidanceresources.com
Emergency Travel Assistance
Lincoln Financial/ TravelConnect
N/A
U.S. and Canada: 866-525-1955 Other Locations: 603-328-1955
mail@oncallinternational.com
Identity Theft
Norton LifeLock
1362437
800-607-9174
www.lifelock.com
Human Resources
Lucinda Ackley Rudy Carlin
N/A
713-830-2357 713-830-2373
lmackley@johnsonsupply.com rcarlin@johnsonsupply.com
Medicare Assistance
Employee Response Center Employee benefits can be complicated. The Higginbotham Employee Response Center can assist you with the following:
Enrollment
Claims and billing questions
Benefit information
Eligibility issues
Call or text 833-354-5678 (JOSU) to speak with a bilingual representative Monday through Friday from 7:00 a.m. to 6:00 p.m. CT. If you leave a message after 3:00 p.m. CT, your call or text will be returned the next business day. You can also email questions or requests to johnsonsupply@higginbotham.net.
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ELIGIBILITY You are eligible for benefits if you are a regular, full-time employee working 30 hours per week or more. Short Term Disability and Long Term Disability coverage are effective the first of the month following 12 months of employment. All other coverage is effective the first of the month after you have completed 30 days of continuous employment. You may also enroll eligible dependents for benefits coverage. The cost for coverage depends on the number of dependents you enroll and the benefits you choose. When covering dependents, you must select and be on the same plans.
Eligible Dependents
Qualifying Life Events Once you elect your benefit options, they remain in effect for the entire plan year until the following OE. You may only change coverage during the plan year if you have a QLE, some of which include:
Marriage, divorce, legal separation, or annulment
Birth, adoption, or placement for adoption of an eligible child
Death of your spouse or child
Change in your spouse’s employment status that affects benefits eligibility
Change in your child’s eligibility for benefits
FMLA leave, COBRA event, judgment, or decree
Your legal spouse
Children under the age of 26 regardless of student, dependency, or marital status
Becoming eligible for Medicare, Medicaid, or TRICARE
Receiving a Qualified Medical Child Support Order
Children over the age of 26 who are fully dependent on you for support due to a mental or physical disability and who are indicated as such on your federal tax return
Important If you have a QLE and want to change your elections, you may process that event in BenefitsInHand. You must do this within 30 days of the event (60 days for a newborn). You may be asked to provide documentation to support the change. Contact Human Resources for details.
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JOHNSON SUPPLY & EQUIPMENT
HOW TO ENROLL To begin the enrollment process, go to www.benefitsinhand.com. First-time users, follow steps 1-4. Returning users, log in and start at step 5.
1
If this is your first time to log in, click on the New User Registration link. Once you register, you will use your username and password to log in.
2
Enter your personal information and company identifier of Johnson Supply and click Next.
3
Create a username (work email address recommended) and password, then check the I agree to terms and conditions box before you click Finish.
4
If you used an email address as your username, you will receive a validation email to that address. You may now log in to the system.
5
Click the Start Enrollment button to begin the enrollment process.
6
Confirm or update your personal information and click Save & Continue.
7
Edit or add dependents who need to be covered on your benefits. Once all dependents are listed, click Save & Continue.
8
Follow the steps on the screen for each benefit to make your election. Please notice there is an option to decline coverage. If you wish to decline, click the Don’t want this benefit? button and select the reason for declining.
9
Once you have elected or declined all benefits, you will see a summary of your elections. Click the Click to Sign button. Your enrollment will not be complete until you click the Click to Sign button.
Have questions or need help enrolling? Contact the Employee Response Center:
Call or Text – 833-354-5678
Email – johnsonsupply@higginbotham.net
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MEDICAL COVERAGE The medical plan through UnitedHealthcare (UHC) protects you and your family from major financial hardship in the event of illness or injury.
Preferred Provider Organization (PPO) A PPO plan allows you to see any provider when you need care. When you see in-network providers in the UnitedHealthcare Choice Plus PPO network for care, you will pay less and get the highest level of benefits. You will pay more for care if you use out-of-network providers. When you see in-network providers, your office visits, urgent care visits, and prescription drugs are covered with a copay, and most other network services are covered at the deductible and coinsurance level. The PPO plan includes a $1,500 individual and a $4,500 family in-network deductible.
Medical
PPO Plan
Network
UHC PPO In-Network
Out-of-Network
Calendar Year Deductible Individual Family
$1,500 $4,500
$3,000 $9,000
Calendar Year Out-of-Pocket Maximum Includes deductible and copays Individual Family
$5,000 $10,000
$5,000 $10,000
Coinsurance
80%
60% You Pay
Preventive Care
$0
40%1
Telemedicine
$0
Not covered
Primary Care Physician
$30 copay
40%1
Specialist
$50 copay
40%1
Urgent Care
$30 copay
40%1
Diagnostics X-ray and Lab
$0
40%1
Complex Imaging (MRI, CT scan, ultrasound, etc.)
20%1
40%1
Emergency Room
$150 copay + 20%1
Inpatient Hospital Services
20%1
40%1
Outpatient Hospital Services
20%
40%1
Retail Pharmacy Up to 30-day supply Tier 1 Tier 2 Tier 3 Tier 4
$15 copay $40 copay $75 copay 20% up to $250
20% + copay 20% + copay 20% + copay Not covered
Mail Order Pharmacy Up to 90-day supply Tier 1 Tier 2 Tier 3
$30 copay $80 copay $150 copay
Not covered
1
1
The amount you will pay after your deductible has been met.
Find an In-Network Medical Provider
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JOHNSON SUPPLY & EQUIPMENT
Visit – www.myuhc.com
Call – 888-332-8885
Download – Get the UnitedHealthcare app.
PRESCRIPTION COVERAGE International Mail Order Prescription Program If you enroll in one of the medical plans, CANARX provides you and your eligible dependents access to an affordable international mail order program for select brand name prescriptions. This program is voluntary and offered in addition to the prescription benefits available with the BCBSTX medical coverage.
CANARX HIGHLIGHTS
$0 copay
Three-month supply with three refills
Free shipping directly to your home or location that you designate
No out-of-pocket expenses
Covered brand name drugs include Jardiance, Xeljanz, Farxiga, and Eliquis. Visit www.canarx.com for a complete list of covered medications.
ElectRx International If you enroll in one of the medical plans, ElectRx International mail order program offers savings on certain specialty prescription drugs such as Humira, Stelara, Trulicity, Nuvaring, Ozempic, and others. You pay $0 on all specialty drugs on the ElectRx formulary. Here is how you can begin using the program:
Call 855-353-2879 to enroll. A customer service representative will complete the enrollment process, and order for you. You will be asked several questions related to your medical condition, including any known allergies and a list of the prescription drugs you are currently taking. You should have those prescription drugs with you when you make the call.
Have your physician prepare a prescription with three refills and fax it to 833-353-2879. You will receive an automated reminder notification when you need a refill. Shipping takes five to 15 business days from the date of completed requirements.
HOW CANARX WORKS If your prescription is available through the CANARX formulary of more than 400 brand name drugs, and you have taken the medication for at least 30 days without complications, you can send your prescription to CANARX for filling. Your physician can fax the prescription to CANARX, or you can download an enrollment form online and mail the completed form with your original prescription to CANARX. Allow up to four weeks for delivery when ordering new medications. CANARX will call you prior to each refill to ensure you have a continuous supply of medication.
For more information or to find out if your prescription is on the ElectRx formulary, call 855-353-2879 or email info@electrx.com.
Enroll in CANARX
Visit – www.canarx.com (Web ID: JSEC)
Call – 866-893-6337
Mail – CANARX, P.O. Box 3009, Windsor ON, Canada N8N 2M3
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UHC RESOURCES The following programs are included in your UHC medical coverage.
myUHC Member Portal Access your plan details at www.myuhc.com, your personalized member website. Once you register for an account, you can:
Find care and compare costs for in-network providers and services
Check your plan balances, view your claims, and access your ID card
Access wellness programs and view clinical recommendations
Get 24/7 access to board-certified doctors via virtual visits
MOBILE APP Download the UnitedHealthcare app for easy access to your benefit plan information and virtual care.
Health Care Advocacy Get personalized support whenever you need it. The Advocate4Me program helps you make sense of your benefits and get the most from your plan.
Understand your benefits and claims
Get answers about bills or payments
Find doctors and compare care options
Learn about your prescriptions
Access support for complex health needs
Make the most of your health and well-being benefits
Call the number on your ID card, chat on www.myuhc.com, or use the UnitedHealthcare app.
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JOHNSON SUPPLY & EQUIPMENT
Fitness Program Stay active your way with One Pass Select – a flexible fitness program that gives you access to a nationwide network of gyms and local studios, plus online workouts you can do at home. Choose a membership tier that fits your lifestyle and switch up your routine anytime. You can also access digital tools to build personalized workouts based on your fitness level and goals. Enroll through your UnitedHealthcare app or member website to get started.
Mental Health App Build healthier habits with the Calm Health app – a personalized experience designed by psychologists to support your mental well-being. Get tailored content and tools to help you manage stress, improve focus, and feel more balanced. Move at your own pace and track your progress along the way. Download the app after signing in at www.myuhc.com or through the UnitedHealthcare app.
PRIMARY CARE AND URGENT CARE Next Level PRIME offers no-cost health care services for:
Primary and chronic care management
24/7 telemedicine virtual visits
Preventive care
Care navigation
Urgent care
Health and wellness coaching , including weight management
Next Level PRIME takes a more in-depth and personal approach to healing and wellness, starting with your annual exam. Plus, it offers more convenience with virtual visits, multiple locations, and extended business hours.
Primary Care
Urgent Care
Annual physicals Well-woman exams Well-child exams Vaccinations Diabetes Hypertension Thyroid conditions Depression and anxiety Chronic diseases Preventive screenings Blood draws Specialist referrals
Upper respiratory Infections Urinary tract Infections X-rays for acute injuries Sprains, strains, splints, and casts Gastroenteritis Stitches for lacerations Abscesses Pink eye Rashes Headaches and ear infections IV fluids for dehydration Back pain
Next Level PRIME Locations*
Annual Checkup Procedures Step 1 – Meet virtually with a PRIME provider to discuss your medical history, health challenges, and concerns. Step 2 – Go to any Next Level location for an in-person exam and labs. Schedule this through PRIME’s Care Navigator any day of the week from 9:00 a.m. to 9:00 p.m. CT. Step 3 – Meet virtually with your PRIME provider to review results, discuss any risk factors, and create a wellness plan.
Prepare for PRIME
*
Austin and San Antonio locations are also available.
Contact Next Level PRIME
Call 832-957-6200.
Email navigators@nextlevelurgentcare.com.
Download the Next Level Urgent Care app from the Apple Store or Google Play Store.
Your Next Level PRIME membership gives you unlimited access to medical care at any Next Level location, seven days a week, 9:00 a.m. - 9:00 p.m.
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IMAGING SERVICES How Green Imaging Works $0 X-ray and Imaging Services Green Imaging provides diagnostic imaging services to you for FREE. If your physician prescribes a diagnostic imaging service (e.g., X-ray, CT scan, MRI, etc.), contact Green Imaging to schedule the procedure. This service is only available if you enroll in one of the medical plans.
When your doctor prescribes a diagnostic imaging service, ask her/him to fax the order to 866-653-0882 then:
Text – 713-524-9190 Chat – www.greenimaging.com Call – 844-968-4647
PROVIDED SERVICES
MRI
CT scan
PET
Ultrasound
Nuclear medicine
Mammography
DXA
X-ray
Arthrogram
Echocardiogram
Contact Green Imaging to schedule an appointment and request a voucher:
You will need your name, ZIP code, physician order (a photo of it if texting), and your group name.
Green Imaging will schedule your appointment and send you a voucher.
Show your voucher at your appointment.
Your exam report will be sent to your Green Imaging account and your doctor.
Find a Location
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JOHNSON SUPPLY & EQUIPMENT
Visit – www.greenimaging.com
HEALTH CARE OPTIONS Becoming familiar with your options for medical care can save you time and money.
Health Care Provider
Symptoms
Average Cost
Average Wait
Non-Emergency Care
TELEMEDICINE
DOCTOR’S OFFICE
RETAIL CLINIC
Access to care via phone, online video, or mobile app whether you are home, work, or traveling; medications can be prescribed 24 hours a day, 7 days a week
Allergies Cough/cold/flu Rash Stomachache
$
2-5 minutes
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history Office hours vary
Infections Sore and strep throat Vaccinations Minor injuries/sprains/ strains
$
15-20 minutes
Usually lower out-of-pocket cost than urgent care; when you can’t see your doctor; located in stores, and pharmacies Hours vary based on store hours
Common infections Minor injuries Pregnancy tests Vaccinations
$
15 minutes
When you need immediate attention; walk-in basis is usually accepted Generally includes evening, weekend, and holiday hours
Sprains and strains Minor broken bones Small cuts that may require stitches Minor burns and infections
$$
15-30 minutes
Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility 24 hours a day, 7 days a week
Chest pain Difficulty breathing Severe bleeding Blurred or sudden loss of vision Major broken bones
$$$$
4+ hours
Services do not include trauma care; can look similar to an urgent care center, but medical bills may be 10 times higher 24 hours a day, 7 days a week
Most major injuries except trauma Severe pain
$$$$$$
Minimal
URGENT CARE Emergency Care
HOSPITAL ER
FREESTANDING ER
Note: Examples of symptoms are not inclusive of all health issues. Wait times described are only estimates. This information is not intended as medical advice. If you have questions, please call the phone number on the back of your medical ID card.
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TELEMEDICINE Your medical coverage offers telemedicine services through UHC 24/7 Virtual Visits. Connect anytime day or night with a boardcertified doctor via your mobile device or computer. UHC partners with Amwell, Doctor on Demand, and Teladoc Health to deliver these virtual visits.
When to Use UHC 24/7 Virtual Visits While telemedicine does not replace your primary care physician, it is a convenient and cost-effective option when you need care and:
Have a non-emergency issue and are considering an after-hours health care clinic, urgent care clinic, or emergency room for treatment
Are on a business trip, vacation, or away from home
Are unable to see your primary care physician
Use telemedicine services for minor conditions such as:
Sore throat
Mental health issues
Headache
Allergies
Stomachache
Fever
Cold/Flu
Urinary tract infections
Do not use telemedicine for serious or life-threatening emergencies.
Registration is Easy Register with UHC 24/7 Virtual Visits so you are ready to use this valuable service when and where you need it.
Call – 888-332-8885
Visit – www.myuhc.com
Download – Get the UnitedHealthcare app
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JOHNSON SUPPLY & EQUIPMENT
MEDICARE ASSISTANCE SmartConnect is a specialized program designed for working or retiring adults, as well as their family members, who are eligible for Medicare and may not have fully explored the advantages of Medicare coverage. As an independent Medicare agency, Johnson Supply & Equipment has partnered with SmartConnect to help you research, compare, and purchase Medicare insurance plans – and SmartConnect does the work for you.
Learn More or Schedule a Consultation Visit www.smartconnectplan.com to learn more or www.smartconnectplan.com/schedule or https://smartmatch.com/connect/johnsonsupply to schedule a consultation. Call 844-784-5160 Monday through Friday, 7:30 a.m. – 5:00 p.m. CT.
Key points to consider when deciding whether to choose a Medicare Advantage plan or Medicare Supplement insurance policy:
Existing Conditions and Treatments – Medicare covers most pre-existing conditions, but exceptions apply, and an advisor can help.
Prescriptions – Multiple Medicare options provide prescription coverage.
Location – Plan networks and availability depend on your region.
Travel – Travel frequency and type affect out-ofpocket costs.
Cost Structure – Some plans have monthly premiums, while others charge only when used.
This valuable service is available to anyone 64½ or older, or otherwise eligible for Medicare, including your family members. Get an unfiltered view of the entire range of options and prices available to you when you call or visit online.
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VSP OPTIONAL VOLUNTARY VISION COVERAGE Our vision plan offers quality care to help preserve your health and eyesight. Regular exams can detect certain medical issues such as diabetes and high blood pressure, in addition to vision and eye problems. You may seek care from any vision provider, but the plan will pay the highest level of benefits when you see an in-network provider. Coverage is provided through VSP using the VSP Choice Vision Care network. The cost of this benefit is paid 100% by the employee through payroll deductions.
Find an In-Network Provider
Visit – www.vsp.com/eye-doctor
Call – 800-877-7195
Group Number – 30048074
you can use your frame and lens benefit to obtain nonprescription UV or blue light eyewear from your VSP network doctor.
Even if you don’t wear prescription glasses, an annual eye exam is an easy and cost-effective way to take care of your eyes and overall health. With VSP LightCare,
Vision Benefits Summary VSP Vision Plan In-Network
Out-of-Network
VSP Choice Vision Care Network
You Pay
Reimbursement
Exam (Once every 12 months)
$10 copay
Up to $45
$25 copay $25 copay $25 copay $25 copay
Up to $30 Up to $50 Up to $60 Up to $75
Standard – $0 copay Premium – $95-$105 copay Custom – $150-$175 copay
Up to $50 N/A N/A
$130 allowance + 20% discount on amount over allowance
Up to $50
Up to $60 $130 allowance $0
N/A Up to $100 Up to $210
Lenses (Once every 12 months) Single Vision Bifocals Trifocals Lenticular Progressive Lenses Frames (Once every 24 months) Contacts (In lieu of frames and lenses) (Once every 12 months) Fitting and Evaluation Elective Medically Necessary
Extra Savings and Discounts Glasses and Prescription Sunglasses – 20% off additional glasses and sunglasses, including lens options, from any VSP provider within 12 months of your last WellVision exam. Non-Prescription Sunglasses – $130 allowance for ready-made non-prescription sunglasses, or ready-made non-prescription blue light filtering glasses instead of prescription glasses or contacts. A $25 copay will apply. Laser Vision Correction – Average 15% off the regular price or 5% off the promotional price; discounts only available through contracted facilities.
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JOHNSON SUPPLY & EQUIPMENT
DENTAL COVERAGE
Dental Benefits Summary
Our dental plan helps you maintain good oral health through affordable options for preventive care, including regular checkups and other dental work. Coverage is provided through UHC using the UnitedHealthcare Dental National Network.
Dental
DPPO Plan Two levels of benefits are available with the DPPO plan: in-network and out-of-network. You may see any dental provider for care, but you will pay less and get the highest level of benefits with in-network providers. You could pay more if you use an out-of-network provider. Note: The medical and dental benefits are packaged together. If you enroll in medical, you will automatically be enrolled in the dental plan on the same coverage tier as medical.
$
PLAN AHEAD For procedures over $500, ask your dentist to request a pre-treatment estimate so you know your expected costs in advance.
DPPO Plan In-Network 1
Calendar Year Deductible Individual Family
$50 $150
Calendar Year Maximum Benefit Per covered person
$2,000
Orthodontia Lifetime Maximum
$2,000 You Pay
Preventive Care Oral examinations, X-rays, cleanings
$0; Deductible waived
Basic Restorative Care Fillings, extractions, oral surgery, root canals
20% after deductible
Major Restorative Care Inlays, onlays, crowns, bridgework, implants
50% after deductible
Orthodontia Adults and eligible child(ren)
50%; No deductible
See your plan for details about out-of-network coverage. If no in-network dentist is available nearby, you may be approved to see an out-of-network provider at in-network rates. 1
MAXIMUM ROLLOVER PROGRAM When you enroll in the dental plan, you are automatically enrolled in the UHC Consumer MaxMultiplier program. This program rewards preventive dental care by allowing you to carry forward a portion of your unused annual maximum. If you receive dental services during the benefit year and total paid claims do not exceed $1,000, up to $600 of your unused $2,000 annual maximum will roll over into a Maximum Rollover Account (MRA). These rollover funds can be used in future years if you reach your plan’s annual maximum. For more information visit www. myuhc.com, or call the number on your member ID card.
Member Website and App Visit www.myuhc.com or use the UnitedHealthcare app to manage your dental plan anytime:
Find an In-Network Dentist
Find in-network dentists near you
Visit – www.myuhc.com
Estimate costs before care
Call – 888-332-8885
Access your ID card on the go
Download the UnitedHealthcare app
Track claims and review coverage in one place
Group Number – 944526
Still need help? Call the number on your ID card.
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LIFE AND AD&D INSURANCE
Available Coverage
Life and Accidental Death and Dismemberment (AD&D) insurance through Lincoln Financial are important to financial security, especially if others depend on you for support.
Benefit Amount All employees
Basic Life and AD&D Maximum Benefit Amount All employees
$500,000
Guaranteed Issue Amount
$500,000
Age Reduction Schedule
50% at age 70
Voluntary Life
Basic Life and AD&D Basic Life and AD&D insurance are provided at no cost to you. With Life insurance, you or your beneficiary(ies) can use the coverage to pay off debts such as credit cards, loans, and bills. AD&D coverage provides specific benefits if an accident causes bodily harm or loss (e.g., the loss of a hand, foot, or eye). If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies).
Three times basic annual earnings
Employee Increments of $10,000 up to $100,0001 Age 70 or older maximum is $50,000 Guaranteed Issue – new hire $100,000; age 70 or older $50,000 Spouse $5,000 up to $50,000, not to exceed 50% of employee coverage2 Guaranteed Issue – $50,000 Child(ren) Birth to age 26 – $10,0003 Existing employees may increase coverage by two increments of $10,000 up to the Guaranteed Issue amount without having to provide EOI. Late entrants must provide EOI for all amounts. 1
Existing spouse coverage may be increased by two increments of $5,000 up to the Guaranteed Issue amount without having to provide EOI. Late entrants must provide EOI for all amounts. Spouse coverage terminates at age 70. 2
Voluntary Life Insurance You may buy more Life insurance for you and your eligible dependents. If you do not elect Voluntary Life insurance when first eligible or if you want to increase your benefit amount at a later date, you may need to show proof of good health, also known as Evidence of Insurability (EOI). You must elect Voluntary Life coverage for yourself before you may elect coverage for your spouse or children. If you leave the company, you may be able to take the insurance with you.
Conversion – Portability – Waiver of Premium Upon termination of employment, you have the option to continue your company-paid Life and AD&D insurance and pay premiums directly to Lincoln Financial. Your company-paid Life and AD&D insurance may be converted to an individual policy. Portability is available for Life coverage if you are enrolled in additional Life coverage. Portability is not available for AD&D. If you are disabled at the time your employment is terminated, you may be eligible for a Waiver of Premium while you are disabled. Contact Human Resources for a Conversion, Portability, or Waiver of Premium application.
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3
No EOI is required for child(ren) coverage.
Designating a Beneficiary A beneficiary is the person or entity you elect to receive the death benefits of your Life and AD&D insurance policies. You can name more than one beneficiary, and you can change beneficiaries at anytime. If you name more than one beneficiary, you must identify how much each beneficiary will receive (e.g., 50% or 25%).
DISABILITY INSURANCE Disability insurance provides partial income protection if you are unable to work due to a covered accident or illness. We provide Short Term Disability (STD) and Long Term Disability (LTD) insurance at no cost to you through Lincoln Financial. You are eligible for disability benefits after you have completed one year of full-time employment.
Short Term Disability
Long Term Disability
STD coverage pays a percentage of your weekly salary if you are temporarily disabled and unable to work due to an illness, pregnancy, or non-work-related injury. STD benefits are not payable if the disability is due to a job-related injury or illness. If a medical condition is job related, it is considered workers’ compensation, not STD.
LTD insurance pays a percentage of your monthly salary for a covered disability or injury that prevents you from working for more than 180 days. Benefits begin at the end of an elimination period and continue while you are disabled up to age 65 or Social Security Normal Retirement Age (SSNRA).
Short Term Disability
Long Term Disability
Benefits Begin
15th day
Benefits Begin
181st day
Percentage of Earnings You Receive
662/3% of your basic weekly earnings
Percentage of Earnings You Receive
60% of your total monthly earnings
Maximum Weekly Benefit
$3,500
Maximum Monthly Benefit
$10,000
Maximum Benefit Period
Up to 24 weeks
Maximum Benefit Period
To age 65 or SSNRA
Pre-existing Condition Exclusion
3/121
Benefits may not be paid for any condition treated within three months prior to your effective date until you have been covered under this plan for 12 months. 1
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OPTIONAL VOLUNTARY SUPPLEMENTAL INSURANCE You and your eligible family members have the opportunity to enroll in additional voluntary coverage that complements our traditional health care programs. Health insurance covers medical bills, but if you have an emergency, you may face unexpected out-of-pocket costs such as deductibles, coinsurance, travel expenses, and non-medical expenses.
Accident Insurance Accident insurance, offered through Lincoln Financial, provides affordable protection against a sudden, unforeseen accident. The Accident plan helps offset the direct and indirect expenses resulting from an on or off-the-job accident such as copayments, deductibles, ambulance, physical therapy, and other costs. The cost of this benefit is paid 100% by the employee through payroll deductions.
ACCIDENT INSURANCE BENEFITS SUMMARY
Service Emergency Room Ambulance – Ground/Air
Benefit $250 $425/$1,750
Initial Hospitalization
$1,000 per incident
Hospital Confinement
$200 per day, up to 365 days
Intensive Care Unit Admission
$2,000
Intensive Care Unit Confinement
$400 per day, up to 15 days
Specific Sum Injuries Dislocations, ruptured discs, eye injuries, fractures, lacerations, concussions, etc. Health Screening Benefit One per covered person per calendar year
$150-$6,250
$50
Monthly Rates Employee Employee + Spouse Employee + Child(ren) Employee + Family
BEWELL BENEFIT Covered members can also receive $50 per year for completing a wellness screening with their doctor.
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$9.32 $15.70 $17.45 $23.65
OPTIONAL VOLUNTARY SUPPLEMENTAL INSURANCE Critical Illness Insurance Critical Illness insurance helps pay the cost of nonmedical expenses related to a covered critical illness or cancer. The plan provides a lump-sum benefit payment to you upon first and second diagnosis of any covered critical illness or cancer. The benefit can help cover expenses such as lost income, out-of-town treatments, special diets, daily living, and household upkeep costs.
The cost of this benefit is paid 100% by the employee through payroll deductions, and there is no Evidence of Insurability (EOI) required. With your coverage election, your dependent children automatically receive 50% of your coverage amount at no extra cost.
CRITICAL ILLNESS INSURANCE BENEFITS SUMMARY
Coverage
Benefit Amounts Available
Employee Spouse Child
$10,000-$30,000 $10,000-$30,000 50% of employee amount
Condition
First Occurrence Benefit
Full Coverage Heart attack, sudden cardiac arrest resulting in death, stroke, invasive cancer, renal failure, major organ failure, advanced Huntington’s disease, advanced COPD, AIDS, advanced ALS, advanced Alzheimer’s disease, advanced Parkinson’s disease, advanced multiple sclerosis, benign brain tumor, loss of sight/hearing/speech, severe burns, permanent paralysis, traumatic brain injuries
100% of benefit amount
Partial Coverage Arterial/Vascular disease, mitral or aortic valve disease, noninvasive cancer (in situ)
25% of benefit amount
Employee Monthly Premium1 For $1,000 of Coverage Attained Age
Rate
Attained Age
Rate
Attained Age
Rate
<25
$0.301
40-44
$1.060
60-64
$4.094
25-29
$0.387
45-49
$1.521
65-69
$5.793
30-34
$0.508
50-54
$2.158
70+
$10.109
$0.726
55-59
$2.878
35-39
Spouse Monthly Premium For $1,000 of Coverage 1
Attained Age
Rate
Attained Age
Rate
Attained Age
Rate
<25
$0.222
40-44
$0.980
60-64
$4.015
25-29
$0.308
45-49
$1.442
65-69
$5.713
30-34
$0.429
50-54
$2.078
70+
$10.030
35-39
$0.646
55-59
$2.797
1
Rates will change as you change age brackets.
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OPTIONAL VOLUNTARY SUPPLEMENTAL INSURANCE Hospital Indemnity Insurance The Hospital Indemnity plan helps you with the high cost of medical care by paying you a set amount when you have an inpatient hospital stay. Unlike traditional insurance that pays a benefit to the hospital or doctor, this plan pays you directly based on the care or treatment that you receive. These costs may include meals and transportation, childcare, or time away from work due to a medical issue that requires hospitalization. The cost of this benefit is paid 100% by the employee through payroll deductions.
HOSPITAL INDEMNITY INSURANCE BENEFITS SUMMARY
Service
Benefit
Hospital Admission
$1,000 (once per calendar year)
Hospital Confinement
$200 per day, up to 30 days
Intensive Care Unit Admission
$2,000 (once per calendar year)
Intensive Care Unit Confinement
$400 per day, up to 30 days
Monthly Rates Employee Employee + Spouse Employee + Child(ren) Employee + Family
$19.20 $41.23 $29.16 $53.32
Contact Lincoln Financial
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Visit – www.lfg.com
Call – 800-487-1485
ADDITIONAL BENEFITS Included with your Basic Life insurance are three additional benefits through Lincoln Financial that are available to you at no additional cost.
Employee Assistance Program
LifeKeys
EmployeeConnect offers 24/7 counseling and support to help you and your family members cope with personal issues.
LifeKeys offers free services and support to help prepare for or deal with the loss of a loved one.
Prepare a will
PERSONAL MATTERS
Get help (now and for your beneficiaries later)
Protect your identity
Get in-person help for short-term issues (up to five sessions per person, per issue, per year).
Relationships
Work-life balance
Childcare and eldercare resources Addiction And more
Stress
Grief and loss
LEGAL OR FINANCIAL MATTERS Get one free 30-minute meeting per legal issue and 25% off follow-up meetings.
College planning
Financial help
Estate planning
Home or car buying
Wills
Moving
Legal counsel
Budgeting
CONTACT LIFEKEYS
Call – 855-891-3684
Visit – www.guideanceresources.com (web ID: LifeKeys)
TravelConnect On Call International offers TravelConnect services to give you timely help and support when you travel. These benefits are available 24/7 and apply if you are 100 or more miles from home.
EMERGENCY SUPPORT
Arrange travel if you are injured and need to be taken for help
RESOURCES
Get a wide range of information, tools, and resources.
Plan and pay for evacuations due to natural disasters or threats
Board or return pets and transport the dead
Articles and courses
TRAVEL SUPPORT
Videos
Online tools
GET HELP NOW
Call – 888-628-4824
Visit – http://guidanceresources.com (username: LFGSupport, password: LFGSupport1)
Get the GuidanceNow app
Recover lost or stolen items
Replace medical devices or eyewear
Translation
Deliver medicine
Call – In the U.S. or Canada: 866-525-1955 Other locations, collect: +1-603-328-1955
Email – mail@oncallinternational.com
Note: On Call International must manage all the planning. Add them as a contact so you have ready support when you need it.
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OPTIONAL VOLUNTARY BENEFIT - LIFELOCK
Other services include:
Home title monitoring
Social media monitoring
Credit, bank, and utility account freezes
LifeLock identity alert system
Mobile app
Dark web monitoring
USPS address change verification
Stolen wallet protection
Identity Theft Protection – LifeLock monitors for fraudulent use of personal information and sends alerts when a potential threat is detected.
Reduced pre-approved credit card offers
Fictitious identity monitoring
Device Security – Antivirus software and multilayered, advanced security helps protect devices against existing and emerging threats, including malware and ransomware.
Data breach notifications
Bank and credit card activity alerts
Checking/Savings application alerts
Home and Family Parental – Take action to monitor your child’s online activity with easy-to-use tools to set screen time limits, block unsuitable sites, and monitor search terms and activity history.
401(k) account activity alerts
File sharing network searches
Sex offender registry reports
Online Privacy – Norton Secure VPN protects devices and helps keep online activity and browsing history private. Privacy Monitor scans common public people-search websites to help you out. In addition, SafeCam alerts you and blocks attempts to access your webcam.
Prior identity theft remediation
Million Dollar Protection Package – This package provides up to $1 million of coverage for lawyers and experts, reimbursement of stolen funds, and personal expenses.
No one intends to be unsafe online. Help protect your identity and devices with the voluntary Norton LifeLock Benefit Plan. Identity restoration specialists are all U.S.based and available 24/7. This benefit is paid 100% by the employee through payroll deductions.
Plan Overview
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Services
JOHNSON SUPPLY & EQUIPMENT
For More Information or to Enroll
Call – 800-607-9174 Monday through Friday from 9:00 a.m. to 7:00 p.m. CT
EMPLOYEE CONTRIBUTIONS Your Monthly Contributions Medical/Dental Coverage PPO Plan Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
$60.00 $294.00 $244.00 $411.00
Vision Coverage Employee Only Employee + Spouse Employee + Child(ren) Employee + Family
$7.37 $11.80 $12.04 $19.42
Life and AD&D Basic Life and AD&D
Voluntary Life
Paid by Johnson Supply
See BenefitsInHand for rates
Short Term
Long Term
Paid by Johnson Supply
Paid by Johnson Supply
Disability
Optional Voluntary Supplemental Insurance Premiums Paid 100% by the Employee
Accident
Critical Illness
Hospital Indemnity
See page 18 for rates
See page 19 for rates
See page 20 for rates
LifeLock Employee Only Employee + Family
$11.24 $22.49
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GLOSSARY OF TERMS Beneficiary – Who will receive a benefit in the event of the insured’s death. A policy may have more than one beneficiary. Coinsurance – Your share of the cost of a covered health care service, calculated as a percent (for example, 20%) of the allowed amount for the service, typically after you meet your deductible. Copay – Copays are fixed amounts with the deductible waived. Deductible – The amount you owe for health care services before your health insurance begins to pay its portion. For example, if your deductible is $1,000, your plan does not pay anything until you meet your $1,000 deductible for covered health care services. The deductible may not apply to all services, including preventive care. Embedded Deductible – Once a family member meets the individual deductible amount, the plan will begin paying benefits for that family member. The entire family deductible does not have to be met first before this family member will begin receiving benefits. The individual deductible is embedded in the family deductible. Employee Contribution – The amount you pay for your insurance coverage. Employer Contribution – The amount Johnson Supply & Equipment contributes to the cost of your benefits. Explanation of Benefits (EOB) – A statement sent by your insurance carrier that explains which procedures and services were provided, how much they cost, what portion of the claim was paid by the plan, what portion of the claim is your responsibility, and information on how you can appeal the insurer’s decision. These statements are also posted on the carrier’s website for your review. In-Network – Doctors, hospitals, and other providers that contract with your insurance company to provide health care services at discounted rates. Out-of-Network – Doctors, hospitals, and other providers that are not contracted with your insurance company. If you choose an out-of-network provider,
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JOHNSON SUPPLY & EQUIPMENT
you may be responsible for costs over the amount allowed by your insurance carrier. Out-of-Pocket Maximum – Also known as an out-of-pocket limit. The most you pay during a policy period (usually a 12-month period) before your health insurance or plan begins to pay 100% of the allowed amount. The limit does not include your premium, charges beyond the Reasonable & Customary Allowance (R&C), or health care your plan does not cover. Check with your health insurance carrier to confirm what payments apply to the out-of-pocket maximum. Over-the-Counter (OTC) Medications – Medications typically made available without a prescription. Prescription Medications – Medications prescribed by a doctor. Cost of these medications is determined by their assigned tier: Generic, Preferred Brand Name, Non-Preferred Brand Name, or Specialty.
Generic Drugs – Drugs approved by the U.S. Food and Drug Administration (FDA) to be chemically identical to corresponding brand name versions. The color or flavor of a generic medicine may be different, but the active ingredient is the same. Generic drugs are usually the most cost-effective version of any medication.
Preferred Brand Name Drugs – Brand name drugs on your provider’s list of approved drugs. You can check online with your provider to see this list.
Non-Preferred Brand Name Drugs – Brand name drugs not on your provider’s list of approved drugs. These drugs are typically newer and have higher copayments.
Preventive Care – The care you receive to prevent illness or disease. It also includes counseling to prevent health problems. Reasonable and Customary Allowance (R&C) – Also known as an eligible expense or the Usual and Customary (U&C). The amount your insurance company will pay for a medical service in a geographic region based on what providers in the area usually charge for the same or similar medical service. SSNRA – Social Security Normal Retirement Age.
IMPORTANT NOTICES Women’s Health and Cancer Rights Act of 1998 In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some important provisions of the Act. Please review this information carefully. As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruction in connection with a mastectomy is also entitled to the following benefits: •
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; and
•
Prostheses and treatment of physical complications of the mastectomy, including lymphedema.
Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Coverage for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are consistent with those that apply to other benefits under the plan.
Special Enrollment Rights This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time. Loss of Other Coverage or Becoming Eligible for Medicaid or a state Children’s Health Insurance Program (CHIP) If you are declining coverage for yourself or your dependents 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). However, you must enroll within 31 days after your or your dependents’ other coverage ends (or after the employer that sponsors that coverage stops contributing toward the other coverage).
If you or your dependents lose eligibility under a Medicaid plan or CHIP, or if you or your dependents become eligible for a subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents in this plan. You must provide notification within 60 days after you or your dependent is terminated from, or determined to be eligible for, such assistance. Marriage, Birth or Adoption If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 31 days after the marriage, birth, or placement for adoption. For More Information or Assistance To request special enrollment or obtain more information, contact: Johnson Supply & Equipment Corporation 10151 Stella Link Road Houston, TX 77025 713-830-2357
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 Johnson Supply & Equipment Corporation and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to enroll in 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 the 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.
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IMPORTANT NOTICES 1.
Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage through a Medicare Prescription Drug Plan or a Medicare Advantage Plan that offers prescription drug coverage. All Medicare prescription 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.
Johnson Supply & Equipment Corporation has determined that the prescription drug coverage offered by the Johnson Supply & Equipment Corporation medical plan is, on average for all plan participants, expected to pay out as much as the standard Medicare prescription drug coverage pays and is considered Creditable Coverage.
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 prescription drug plan, as long as you later enroll within specific time periods.
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If you choose to enroll in a Medicare prescription drug plan and cancel your current Johnson Supply & Equipment Corporation 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. If you cancel or lose your current coverage and do not have prescription drug coverage for 63 days or longer prior to enrolling in the Medicare prescription drug coverage, your monthly premium will be at least 1% per month greater for every month that you did not have coverage for as long as you have Medicare prescription drug coverage. For example, if nineteen months lapse without coverage, your premium will always be at least 19% higher than it would have been without the lapse in coverage. For more information about this notice or your current prescription drug coverage:
You can enroll in a Medicare prescription drug plan when you first become eligible for Medicare. If you decide to wait to enroll in a Medicare prescription 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).
Contact the Human Resources Department at 713-8302357.
You should compare your current coverage, including which drugs are covered at what cost, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. See the 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 Johnson Supply & Equipment Corporation at the phone number or address listed at the end of this section.
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You will get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare prescription drug plans. For more information about Medicare prescription drug coverage:
JOHNSON SUPPLY & EQUIPMENT
NOTE: You will receive this notice annually and at other times in the future, such as before the next period you can enroll in Medicare prescription drug coverage and if this coverage changes. You may also request a copy. For more information about your options under 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 877-486-2048.
IMPORTANT NOTICES If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. Information about this extra help is available from the Social Security Administration (SSA) online at www. socialsecurity.gov, or you can call them at 800-772-1213. TTY users should call 800-325-0778. Remember: Keep this Creditable Coverage notice. If you enroll in one of the new plans approved by Medicare which offer prescription drug coverage, 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). May 1, 2026 Johnson Supply & Equipment Corporation 10151 Stella Link Road Houston, TX 77025 713-830-2357
Notice of HIPAA Privacy Practices This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on employer health plans concerning the use and disclosure of individual health information. This information known as protected health information (PHI), includes virtually all individually identifiable health information held by a health plan – whether received in writing, in an electronic medium or as oral communication. This notice describes the privacy practices of the Employee Benefits Plan (referred to in this notice as the Plan), sponsored by Johnson Supply & Equipment Corporation, hereinafter referred to as the plan sponsor. The Plan is required by law to maintain the privacy of your health information and to provide you with this notice of the Plan’s legal duties and privacy practices with respect to your health information. It is important to note that these rules apply to the Plan, not the plan sponsor as an employer. You have the right to inspect and copy protected health information which is maintained by and for the Plan for enrollment, payment, claims and case management.
If you feel that protected health information about you is incorrect or incomplete, you may ask the Human Resources Department to amend the information. For a full copy of the Notice of Privacy Practices describing how protected health information about you may be used and disclosed and how you can get access to the information, contact the Human Resources Department. Complaints: If you believe your privacy rights have been violated, you may complain to the Plan and to the Secretary of Health and Human Services. You will not be retaliated against for filing a complaint. To file a complaint, please contact the Privacy Officer. Johnson Supply & Equipment Corporation Human Resources 10151 Stella Link Road Houston, TX 77025 713-830-2357 Conclusion PHI use and disclosure by the Plan is regulated by a federal law known as HIPAA (the Health Insurance Portability and Accountability Act). You may find these rules at 45 Code of Federal Regulations Parts 160 and 164. The Plan intends to comply with these regulations. This Notice attempts to summarize the regulations. The regulations will supersede any discrepancy between the information in this Notice and the regulations.
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www.healthcare. gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.
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IMPORTANT NOTICES If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employersponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272). If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of January 31, 2026. Contact your State for more information on eligibility. Louisiana – Medicaid Louisiana Medicaid Website: https://www.ldh.la.gov/healthy-louisiana Medicaid Customer Service Line: 1-888-342-6207 Louisiana Medicaid email: healthy@la.gov Louisiana Health Insurance Premium Program (LaHIPP) Website: https:// www.ldh.la.gov/lahipp LaHIPP phone: 1-877-697-6703 LaHIPP email: La.HIPP@la.gov LaHIPP fax: 1-888-716-9787 LaHIPP mailing address: 100 Crescent Centre Parkway, Suite 1000 Tucker, GA 30084
Texas – Medicaid Website: https://www.hhs.texas.gov/services/financial/healthinsurance-premium-payment-hipp-program Phone: 1-800-440-0493
To see if any other States have added a premium assistance program since January 31, 2026, or for more information on special enrollment rights, can contact either:
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JOHNSON SUPPLY & EQUIPMENT
U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa 1-866-444-EBSA (3272) U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565
Continuation of Coverage Rights Under COBRA Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the Johnson Supply & Equipment Corporation group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the Johnson Supply & Equipment Corporation plan after you have left employment with the company. If you wish to elect COBRA coverage, contact your Human Resources Department for the applicable deadlines to elect coverage and pay the initial premium. Plan Contact Information Johnson Supply & Equipment Corporation Human Resources / Higginbotham is the COBRA administrator 10151 Stella Link Road Houston, TX 77025 713-830-2357
Your Rights and Protections Against Surprise Medical Bills When you get emergency care or get treated by an out-ofnetwork provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing. What is “balance billing” (sometimes called “surprise billing”)? When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
IMPORTANT NOTICES “Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-ofnetwork providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit. “Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
When balance billing is not allowed, you also have the following protections: •
You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay outof-network providers and facilities directly.
•
Your health plan generally must: •
Cover emergency services without requiring you to get approval for services in advance (prior authorization).
•
Cover emergency services by out-of-network providers.
•
Base what you owe the provider or facility (costsharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
•
Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.
You are protected from balance billing for: •
•
Emergency services – If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s innetwork cost-sharing amount (such as copayments and coinsurance). You cannot be balance billed for these emergency services. This includes services you may get after you are in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services. Certain services at an in-network hospital or ambulatory surgical center – When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist services. These providers cannot balance bill you and may not ask you to give up your protections not to be balance billed.
If you get other services at these in-network facilities, outof-network providers cannot balance bill you, unless you give written consent and give up your protections. You are never required to give up your protections from balance billing. You also are not required to get care outof-network. You can choose a provider or facility in your plan’s network.
If you believe you have been wrongly billed, you may contact your insurance provider. Visit www.cms.gov/ nosurprises for more information about your rights under federal law.
New Health Insurance Marketplace Coverage Options and Your Health Coverage PART A: General Information Even if you are offered health coverage through your employment, you may have other coverage options through the Health Insurance Marketplace (“Marketplace”). To assist you as you evaluate options for you and your family, this notice provides some basic information about the Health Insurance Marketplace. What is the Health Insurance Marketplace? The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers “one-stop shopping” to find and compare private health insurance options in your geographic area.
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IMPORTANT NOTICES Can I Save Money on my Health Insurance Premiums in the Marketplace? You may qualify to save money and lower your monthly premium and other out-of-pocket costs, but only if your employer does not offer coverage, or offers coverage that is not considered affordable for you and doesn’t meet certain minimum value standards (discussed below). The savings on your premium that you’re eligible for depends on your household income. You may also be eligible for a tax credit that lowers your costs. Does Employment-Based Health Coverage Affect Eligibility for Premium Savings through the Marketplace? Yes. If you have an offer of health coverage from your employer that is considered affordable for you and meets certain minimum value standards, you will not be eligible for a tax credit, or advance payment of the tax credit, for your Marketplace coverage and may wish to enroll in your employment-based health plan. However, you may be eligible for a tax credit, and advance payments of the credit that lowers your monthly premium, or a reduction in certain cost-sharing, if your employer does not offer coverage to you at all or does not offer coverage that is considered affordable for you or meet minimum value standards. If your share of the premium cost of all plans offered to you through your employment is more than 9.12%1 of your annual household income, or if the coverage through your employment does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit, and advance payment of the credit, if you do not enroll in the employment-based health coverage. For family members of the employee, coverage is considered affordable if the employee’s cost of premiums for the lowest-cost plan that would cover all family members does not exceed 9.12% of the employee’s household income.1, 2
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JOHNSON SUPPLY & EQUIPMENT
Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered through your employment, then you may lose access to whatever the employer contributes to the employment-based coverage. Also, this employer contribution -as well as your employee contribution to employment-based coverage- is generally excluded from income for federal and state income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. In addition, note that if the health coverage offered through your employment does not meet the affordability or minimum value standards, but you accept that coverage anyway, you will not be eligible for a tax credit. You should consider all of these factors in determining whether to purchase a health plan through the Marketplace. When Can I Enroll in Health Insurance Coverage through the Marketplace? You can enroll in a Marketplace health insurance plan during the annual Marketplace Open Enrollment Period. Open Enrollment varies by state but generally starts November 1 and continues through at least December 15. Outside the annual Open Enrollment Period, you can sign up for health insurance if you qualify for a Special Enrollment Period. In general, you qualify for a Special Enrollment Period if you’ve had certain qualifying life events, such as getting married, having a baby, adopting a child, or losing eligibility for other health coverage. Depending on your Special Enrollment Period type, you may have 60 days before or 60 days following the qualifying life event to enroll in a Marketplace plan. There is also a Marketplace Special Enrollment Period for individuals and their families who lose eligibility for Medicaid or Children’s Health Insurance Program (CHIP) coverage on or after March 31, 2023, through July 31, 2024. Since the onset of the nationwide COVID-19 public health emergency, state Medicaid and CHIP agencies generally have not terminated the enrollment of any Medicaid or CHIP beneficiary who was enrolled on or after March 18, 2020, through March 31, 2023. As state Medicaid and CHIP agencies resume regular eligibility and enrollment practices, many individuals may no longer be eligible for Medicaid or CHIP coverage starting as early as March 31, 2023. The U.S. Department of Health and Human Services is offering a temporary Marketplace Special Enrollment period to allow these individuals to enroll in Marketplace coverage.
IMPORTANT NOTICES Marketplace-eligible individuals who live in states served by HealthCare.gov and either- submit a new application or update an existing application on HealthCare.gov between March 31, 2023 and July 31, 2024, and attest to a termination date of Medicaid or CHIP coverage within the same time period, are eligible for a 60-day Special Enrollment Period. That means that if you lose Medicaid or CHIP coverage between March 31, 2023, and July 31, 2024, you may be able to enroll in Marketplace coverage within 60 days of when you lost Medicaid or CHIP coverage. In addition, if you or your family members are enrolled in Medicaid or CHIP coverage, it is important to make sure that your contact information is up to date to make sure you get any information about changes to your eligibility. To learn more, visit www.HealthCare.gov or call the Marketplace Call Center at 1-800-318-2596. TTY users can call 1-855-889-4325.
How Can I Get More Information? The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area. PART B: Information About Health Coverage Offered by Your Employer This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.
What about Alternatives to Marketplace Health Insurance Coverage? If you or your family are eligible for coverage in an employment-based health plan (such as an employersponsored health plan), you or your family may also be eligible for a Special Enrollment Period to enroll in that health plan in certain circumstances, including if you or your dependents were enrolled in Medicaid or CHIP coverage and lost that coverage. Generally, you have 60 days after the loss of Medicaid or CHIP coverage to enroll in an employment-based health plan, but if you and your family lost eligibility for Medicaid or CHIP coverage between March 31, 2023 and July 10, 2023, you can request this special enrollment in the employment-based health plan through September 8, 2023. Confirm the deadline with your employer or your employment-based health plan. Alternatively, you can enroll in Medicaid or CHIP coverage at any time by filling out an application through the Marketplace or applying directly through your state Medicaid agency. Visit https://www.healthcare.gov/ medicaid-chip/getting-medicaid-chip/ for more details.
3. Employer Name: Johnson Supply & Equipment Corporation
4. Employer Identification Number (EIN): 74-1989212
5. Employer Address: 10151 Stella Link Road,
6. Employer Phone Number: 713-830-2357
7. City: Houston
8. State: TX
9. ZIP Code: 77025
10. Who can we contact at this job?: Human Resources 11. Phone Number (if different from above): 713-830-2357
12. E-Mail Address: lmackley@johnsonsupply.com
You are not eligible for health insurance coverage through this employer. You and your family may be able to obtain health coverage through the Marketplace, with a new kind of tax credit that lowers your monthly premiums and with assistance for out-of-pocket costs. 1
Indexed annually; see https://www.irs.gov/pub/irs-drop/rp-22-34.pdf for 2023.
An employer-sponsored or other employment-based health plan meets the “minimum value standard” if the plan’s share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. For purposes of eligibility for the premium tax credit, to meet the “minimum value standard,” the health plan must also provide substantial coverage of both inpatient hospital services and physician services. 2
2026/2027 EMPLOYEE BENEFITS
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This brochure highlights the main features of the Johnson Supply & Equipment Corporation employee benefits program. It does not include all plan rules, details, limitations, and exclusions. The terms of your benefit plans are governed by legal documents, including insurance contracts. Should there be an inconsistency between this brochure and the legal plan documents, the plan documents are the final authority. Johnson Supply & Equipment Corporation reserves the right to change or discontinue its employee benefits plans at anytime.