2026 United Vision Logistics Employee Benefits Guide
Each year during Open Enrollment, 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 Open Enrollment, you may only make changes to your benefit elections if you have a Qualifying Life Event.
Your plan offers medical
options. To help you make an informed choice, review each plan’s Summary of Benefits and Coverage (SBC) available from Human Resources.
We at United Vision Logistics appreciate the hard work and dedication you bring to our team every day. To do our part, we are committed to keeping your benefits affordable and worthwhile for you and your eligible family members.
United Vision Logistics strives to provide benefits that:
Meet your needs
Are easy to understand and use Provide excellent value for affordable costs
To save money and stay healthy, be sure to take advantage of free preventive care and our wellness programs.
Take Time to review your benefit options and select the plans that best meet your needs.
If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, federal law gives you more choices for your prescription drug coverage. Please see page 35 for more details.
Important Contacts
When your Coverage Ends
When you leave employment at United Vision Logistics, some of your coverage will end immediately and some will last until the last day of the month in which your employment ends – or after another qualifying event.
When your coverage ends, you may be eligible to continue your medical, dental, vision, and Flexible Spending Account coverage using COBRA. Voluntary Life and AD&D, Accident, and Critical Illness coverage are portable, and if you want to continue them, you can call the carrier directly.
Eligibility
Who is Eligible for Benefits
Eligibility
Enrollment
Coverage Begins
• Regular, full-time employee
• Working an average of 30 or more hours per week
• Enroll by the deadline given by Human Resources
• First of the month following 30 days of employment
• Regular, full-time employee
• Working an average of 30 or more hours per week
• Enroll during Open Enrollment (OE) or when you have a Qualifying Life Event (QLE)
• OE: Start of the plan year
• QLE: Ask Human Resources
*Verification of dependent eligibility may be required upon enrollment.
Qualifying Life Events
DEPENDENT(S)
• Your legal spouse (or common law spouse where recognized)
• Child(ren) under age 26, including birth children, stepchildren, legally adopted children, children placed for adoption, foster children, and children for whom you or your legal spouse have legal guardianship
• Child(ren) age 26 or more years old 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
• You must enroll the dependent(s) at OE or for a QLE
• When covering dependents, you must enroll for and be on the same plans
• Based on OE or QLE effective dates*
You may only change coverage during the plan year if you have a Qualifying Life Event, such as:
Undergoing FMLA, COBRA event, court judgment or decree
Becoming eligible for Medicare, Medicaid, or TRICARE
Receiving a Qualified Medical Child Support Order (QMCSO)
Gain or loss of benefits coverage
Change in employment status affecting benefits
Significant change in cost of spouse’s coverage
If you have a Qualifying Life Event and want to change your elections, you must notify Human Resources and complete your changes within 30 days of the event
How to Enroll
Are you ready for Open Enrollment?
Here are some things to keep in mind as you look over this booklet and sign up for benefits.
1. Make sure your personal information is up to date.
2. Have your dependent information ready.
3. Compare the two medical plans and decide which is right for you.
4. Consider how much you want to contribute to your HSA or FSA.
5. You are automatically covered for Basic Life and AD&D, Short Term Disability, and Base Long Term Disability. Sign up for additional LTD, Life and AD&D coverage by enrolling in the voluntary Buy-Up LTD and Supplemental Life and AD&D plans.
6. Check that your providers are in-network.
Medical Coverage
The medical plan options protect you and your family from major financial hardship in the event of illness or injury.
Medical Provider: Blue Cross Blue Shield of Texas Network: Blue Choice PPO Network
About This Coverage
You have a choice of two medical plans:
PPO Medical Plan* – This plan is a PPO Copay Plan
HDHP Medical Plan – This plan is a High Deductible Health Plan (HDHP) that uses a PPO network
Preferred Provider Organization (PPO)
A PPO allows you to see any provider when you need care. When you see in-network providers for care, you will pay less and get the highest level of benefits. You will pay more for care if you use non-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.
High Deductible Health Plan (HDHP)
An HDHP allows you to see any provider when you need care, and you will pay less for care when you go to innetwork providers. In exchange for a lower per-paycheck cost for medical benefits, you must satisfy a higher plan deductible that applies to almost all health care expenses, including prescription drugs. If you enroll in the HDHP, you will be automatically enrolled in a Health Savings Account (see page 19).
Find an In-Network Provider
Call 800-521-2227 or visit www.bcbstx.com to find an in-network medical provider.
Spousal Surcharge
If your spouse has access to health care coverage through his or her employer, there is a $100 monthly surcharge if your spouse chooses United Vision Logistics coverage. If your spouse does not work, works part time, is not eligible for coverage, has lost coverage as an active employee but has been offered COBRA or is covered by Medicare, then the surcharge does not apply.
* 2026 will be the final year that the PPO Medical Plan is offered.
Medical Coverage
Medical Benefits Summary
•
•
1 The individual deductible amount must be met by each member enrolled under your medical coverage. If you have several covered dependents, all charges used to apply toward a “per individual” deductible amount will also be applied toward the “per family” deductible amount. When the family deductible amount is reached, no further individual deductibles will have to be met for the remainder of that plan year. No member may contribute more than the individual deductible amount to the “per family” deductible amount. The same applies for the out-of-pocket maximum.
2 Each covered individual is not required to meet the individual deductible. The HDHP has an aggregate deductible, meaning the family deductible amount will include all combined eligible expenses that you and your covered dependents incur. The family deductible amount may be satisfied by one member or a combination of two or more members covered under your medical plan. The same applies for the out-of-pocket maximum.
3 After deductible.
1 Employees who are tobacco/nicotine users will pay an additional $46.15 per pay period in surcharges if the Nicotine Cessation Program is not completed.
2 If your spouse already has access to health care coverage through his or her employer, there is a $100 monthly surcharge ($46.15 per pay period) if your spouse chooses United Vision Logistics coverage.
PPO vs. HDHP
Need help choosing between an HDHP Medical Plan and a PPO Medical Plan? This page breaks down what each plan means for your health – and your wallet.
See How Each Plan Stacks Up
Costs Higher premiums but copays for office visits and prescription drugs.
Coverage Includes copays for services such as doctor visits, urgent care, and prescriptions, helping manage out-of-pocket costs.
Lower premiums but no copays for office visits and prescription drugs.
Requires meeting the deductible before plan coverage starts. BCBSTX in-network provider discounts apply.
Network Both plans have exactly the same type of network. Both allow you to choose a health care provider without requiring a referral for a specialist, ensuring the flexibility in managing your health needs.
Tax Benefits Premiums are taken out through payroll deductions on a pretax basis.
Your HSA contributions are tax advantaged. You can use your HSA to pay for qualified health care expenses tax free. Your premiums and contributions get taken out through payroll deductions on a pretax basis.
Evaluate the Best and Worst Financial Scenarios
Which health plan is right for you?
Both plans allow the freedom to choose your health care providers without requiring a referral for specialists, ensuring flexibility in managing your health needs. But which plan you choose depends on your needs.
PPO
If you expect more frequent medical care and prefer lower charges per service.
EXAMPLE
Mark prefers a PPO to reduce the costs of his regular specialist visits.
HDHP
If you are in good health, anticipate few medical expenses, and prefer the ability to contribute to an HSA.
EXAMPLE
Mary would rather take the money she saves from the lower premiums associated with the HDHP plan and redirect that money to her HSA account through her pretax contributions each pay period. Mary also enjoys the benefit of employer contributions to her HSA.
Preventive Care
You take your car in for maintenance, so why not do the same for yourself? Annual preventive checkups can help you and your doctor identify your baseline level of health and detect issues before they become serious.
What is Preventive Care?
Health insurers are required by law to cover a set of preventive services from an in-network BCBSTX provider at no cost to you, even if you have not met your yearly deductible. The preventive care services you will need to stay healthy vary by age, sex, and medical history. Visit www.cdc.gov for recommended guidelines.
Typical Screening for Adults
Blood pressure
Cholesterol
Diabetes
Colorectal cancer
Depression
Prostate cancer
Testicular exam
Mammograms
OB/GYN screening
Preventive Care Coverage
Preventive care is covered in full only when obtained from an IN-NETWORK BCBSTX provider. Exams performed by specialists are generally not considered preventive and may not be covered at 100%. Additionally, certain screenings may be considered diagnostic, not preventive, based on your current medical condition. You may be responsible for paying all or a share of the cost for those screening services. If you have a question about whether a service will be covered as preventive care, contact your medical plan.
Medical Cost Saving Strategies
Our medical plans are self-funded. This means that United Vision Logistics does not pay fixed premiums to Blue Cross Blue Shield of Texas but instead pays fixed administrative fees to use BCBSTX’s network and then we pay our employees’ claims as necessary from our own general assets.
This gives United Vision Logistics more control over the plan we select for our employees. Together, United Vision Logistics and you share the cost of health care. We are presenting several cost saving strategies to help keep medical and pharmacy costs as low as possible.
Benefits Value Advisor
Before you schedule your next medical procedure, consider calling a Benefits Value Advisor. The same procedure performed in the same area by different providers can vary greatly in cost. You can potentially save a lot of money by evaluating the costs beforehand. A Benefits Value Advisor can:
Help compare costs at different providers near you
Help you schedule your appointment
Help with pre-certification
Tell you about online educational tools
CONTACT A BENEFITS VALUE ADVISOR
Call 800-810-2583 to speak with a Benefits Value Advisor.
Use the BCBSTX website or app to compare costs
You can use the BCBSTX member website to compare costs of medical services, from prescriptions to major surgeries to ensure you do not pay more than you have to. Visit www.bcbstx.com or download the BCBSTX mobile app and use the information on your BCBSTX ID card to register and get started.
Pharmacy Cost Saving Strategies
Generic Drugs
Generic drugs are just as effective as brand-name drugs, but they cost 80% to 85% less on average than the brandname equivalent. To find out if there is a generic equivalent for your brand-name drug, visit www.fda.gov
Prior Authorization
Prior authorization (PA) requires your doctor to explain why you are taking a medication to determine if it will be covered under your BCBSTX pharmacy benefit. Some medications must be reviewed because they may:
Only be approved or effective for safely treating specific conditions
Cost more than other medications used to treat the same or similar conditions
When you fill a new prescription, your pharmacist will tell you if a PA is required. You can also see a list of prescriptions requiring PA at www.bcbstx.com. Your doctor can find PA forms online at www.bcbstx.com
Doctors may also call 800-289-1525 with questions, or to get a form. Have your doctor submit the PA electronically for the fastest response.
Step Therapy
The step therapy program through BCBSTX encourages you to try a proven, cost-effective prescription drug first before stepping up to a less tested, more expensive medication. If your doctor determines that a first-line drug is not appropriate or effective for you, your doctor can then recommend a second-line medication. Your pharmacist will tell you if your prescription must go through the step therapy program. You can also go to www.bcbstx.com to see which drugs are in this program.
Save on High Cost Medications
FlexAccess is a cost assistance program designed to help lower your out-of-pocket expense for certain high-cost medications. A FlexAccess team member will contact you if your prescription is eligible for the program. Your savings could be as low as $0 cost! Participation is voluntary.
For more information, call 888-302-3618 or send an email to member.services@flexaccessrx.com
Prescription Drug Discount Programs
Prescription drug prices are not regulated and can vary greatly between pharmacies. Pharmacy discount programs can help you find the best price. Note that you cannot use both the discount program and your insurance discount, so you will need to compare and go with the most cost-effective option. The cash amount you pay for the prescription may not count toward your deductible or out-of-pocket maximum under the benefit plan.
GOODRX
GoodRX allows you to view prices and find coupons, discounts, and savings tips. Visit www.goodrx.com to print coupons or get the GoodRX app to display the coupon on your phone. GoodRX is a free service, so you do not have to create an account to search for prices and receive discounts. If you do create an account, you can store your prescription list for ease of use in the future.
OPTUM PERKS
Use Optum Perks to get discounts on prescription drugs so you do not overpay for medication. This service is free and does not require a membership. Visit https://perks.optum.com or download the free Optum Perks app to get discounts.
Search. Type in your drug name(s).
Find the best price. See prices from pharmacies near you to get the best discount.
Get your coupons. Print, email, or text the coupon.
Show the coupon to your pharmacist.
AMAZON PRIME RX SAVINGS DISCOUNT CARD
If you have Amazon Prime, you have the option to use the Amazon Prime Rx Savings discount card, administered by InsideRx. It provides discounts of up to 80% for generics and up to 40% for brand-name medication at participating pharmacies.
COST PLUS DRUG COMPANY
Cost Plus Drug Company is a web-based pharmacy that claims to keep costs low by buying directly from the manufacturer. It currently offers a very limited selection of medications and accepts only a handful of prescription insurance providers.
International Pharmacy Savings
CANARx
CANARx is a voluntary international mail order prescription program that is available to you and your family.
Brand name medications, in the original factory-sealed manufacturer’s packaging, are delivered directly to your door from certified pharmacies in Canada, The United Kingdom, and Australia. You pay nothing out of pocket.
GET STARTED
1. Check to see if a medication is offered by calling CANARx at 866-893-6337
2. Ask your doctor for a prescription for a 3-month supply, or three refills.
3. Submit documentation (completed enrollment form, prescription, and photo ID).
$0 copay
450+ brand name medications
Easy, convenient refills
Refills only, no “new to you” medications
No additional costs
ElectRx
Save big and stay healthy while paying no cost for injectable and refrigerated medications, including those for diabetes. ElectRx lets you access eligible medications at no cost through safe, licensed pharmacies in Canada, Australia, Great Britain, and New Zealand at no cost.
GET STARTED
1. Call ElectRx at 855-353-2879 to enroll in the program. Have your current medication list and any medical or allergy questions ready.
2. Have your doctor fax your prescription(s) to:
ElectRx 833-353-2879, or EScribe 313-875-2869
3. Once your prescription is received, your medication(s) will be mailed directly to your home at no cost to you. First-time delivery takes 10-15 business days. You will receive an email notification with tracking information.
Telemedicine
Allows 24/7/365 access to board-certified doctors from your mobile phone or computer.
Virtual care from MDLIVE is available if you are enrolled in our medical plan. It is a convenient way to obtain care if you are traveling, away from home, or are unable to see your regular doctor. Connect anytime day or night with a board-certified doctor via your mobile device or computer for $40 (PPO Medical Plan) or $48 (HDHP Medical Plan) per visit.
Skip The Hassle
Skip the hassle, travel, and waiting room with virtual care! Register for an account with MDLIVE so you can speak to a doctor in a few minutes or schedule a virtual appointment that is most convenient for you. Doctors will diagnose non-emergency medical issues and prescribe medication, if needed.
Minor Conditions Treated
PRIMARY CARE
• Preventive care
• Wellness screenings
• Chronic condition management
BEHAVIORAL/MENTAL HEALTH
• Addictions
• Bipolar disorders
• Depression
• Eating disorders
URGENT CARE
• Sore throat
• Headache
• Earache
• Fever
• Grief/loss
• Panic disorders
• Parenting issues
• Cold/Flu
• Bronchitis
• Allergies
• Stomachache
• Lab work
• Diagnostic tests
• Postpartum depression
• Stress
• Trauma/PTSD
• Urinary tract infection
• Pink eye
• Rashes
Do not use telemedicine for serious or life-threatening emergencies.
Registration is Easy
Register with MDLIVE so you are ready to use this valuable service when and where you need it. Visit www.mdlive.com, call 888-680-8646, or download the MDLIVE app.
Did You Know?
Your regular provider may offer telemedicine services, so it is best to ask now and know what your options are before you need care. Costs may differ from MDLIVE services.
Health Care Options
Becoming familiar with your options for medical care can save you time and money.
Non-Emergency Care
Access to care via phone, online video or mobile app whether you are home, work or traveling; medications can be prescribed
Telemedicine
24 hours a day, 7 days a week
Generally, the best place for routine preventive care; established relationship; able to treat based on medical history
Doctor’s Office
Office hours vary
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
When you need immediate attention; walk-in basis is usually accepted
Generally includes evening, weekend and holiday hours
Urgent Care
Life-threatening or critical conditions; trauma treatment; multiple bills for doctor and facility
24 hours a day, 7 days a week
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
• Allergies
• Cough/cold/flu
• Rash
• Stomachache
• Infections
• Sore and strep throat
• Vaccinations
• Minor injuries, sprains and strains
• Common infections
• Minor injuries
• Pregnancy tests
• Vaccinations
• Sprains and strains
• Minor broken bones
• Small cuts that may require stitches
• Minor burns and infections
• Chest pain
• Difficulty breathing
• Severe bleeding
• Blurred or sudden loss of vision
• Major broken bones
• Most major injuries except trauma
• Severe pain
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.
Retail Clinic
Wellness Program
Helps you begin or keep Working
Towards Wellness through WellRight by completing challenges, meeting goals, and avoiding the $1,200 wellness noncompliance surcharge!
Your path to wellbeing is unique to your personal goals and situation, so the WellRight program takes a holistic approach in the activities and challenges it offers you. To help you form healthy habits, the program’s dimensions of wellbeing include physical, financial, purpose, social, occupational, and emotional services.
Select from more than 100 activities and track your progress toward goals online or through the WellRight app. The program consists of a health assessment, company and personal challenges, and incentives.
Get Your Rewards
Complete the following mandatory/required activities to avoid monthly penalties/surcharges:
Complete a mandatory/required biometric screening by November 30, 2026 – and earn 50 more points! – to avoid the $100 monthly insurance premium surcharge for the upcoming plan year.
If you use nicotine products, complete the nicotine cessation program to avoid a $100 monthly surcharge.
Complete the nicotine cessation program by February 28, 2026 to be reimbursed the monthly surcharge for January and February, and avoid any further nicotine surcharge in 2026.
Complete the nicotine cessation program after February 28, 2026 and the monthly nicotine surcharge will stop, but you will not be reimbursed for any surcharges.
WELLRIGHT ACTIVITIES EARNED POINTS
Biometric Screening
Nicotine Cessation Program
Required + 50 points must be earned from other activities on the portal to avoid $100 monthly surcharge
If you use nicotine, you must complete the tobacco and vaping free university courses to avoid the $100 per month nicotine surcharge
Welcome Activities Complete activities in this section to earn five points
Company-Wide Challenges
20 points each (up to five)
Annual Physical 25 points
Preventative Exam 25 points each (up to two)
Vaccinations 10 points each (up to two)
Health Assessment 10 points
Healthy U: University Courses One point each (up to 10)
Coach Connect 20 points each (up to four)
Athletic Event
10 points each (up to two)
Top Chef 10 points
Personal and Peer to Peer Challenges 20 points each (up to five)
Nicotine Cessation Program
United Vision Logistics provides nicotine cessation support through WellRight. If you use nicotine and want to stop, you can avoid a $100 monthly surcharge on your health insurance by enrolling in and completing the online course.
Avoid the Nicotine Surcharge
United Vision Logistics has a nicotine user surcharge to help control employee medical premium costs. This surcharge applies to you or your spouse if you are enrolled in the medical plan and acknowledge being a nicotine user. If you or your spouse do not confirm your nicotine status, you will automatically receive the nicotine user surcharge of $100 per month.
To avoid the nicotine surcharge, you and/or your spouse must complete the smoking cessation course.
HOW TO ENROLL
Visit https://uvlogistics.wellright.com to enroll.
Once you have successfully completed the program, the monthly surcharge of $100 will be removed, and you will receive credit for any surcharge paid before February 28, 2026. If you complete the course after the February 28 deadline, we will only stop the surcharge going forward. There is no refund of the surcharge.
Employee Assistance Program
The Employee Assistance Program (EAP) from Symetra helps you and your family cope with a variety of personal or workrelated issues.
This program provides confidential counseling and support services at little or no cost to you to help with:
Relationships
Work/life balance
Stress and anxiety
Will preparation and estate resolution
Grief and loss
Child and eldercare resources
Substance abuse
Contact the EAP Call 888-327-9573 or visit www.guidanceresources.com (web ID: Symetra) for support at any hour of the day or night.
Additional Benefit
Included with your Symetra coverage is three face-to-face sessions with a certified therapist. These sessions can be used for you or any of your eligible dependents. Additional sessions can be purchased at a discounted rate. Visit www.guidanceresources.com for more details.
Health Savings Account
Offsets your medical costs, reduces your taxes, and offers a long-term tax-advantaged savings account.
A Health Savings Account (HSA) is a tax-deductible savings plan that allows you to put aside pre-tax dollars to use for current or future health care expenses. It is also a tax-exempt tool to supplement your retirement savings. It is always yours to keep, even if you change health plans or jobs.
Triple Tax Savings
HSA Eligibility
You are eligible to open and contribute to an HSA if you are:
Enrolled in an HSA-eligible HDHP Medical Plan
Not covered by another plan that is not a qualified HDHP, such as your spouse’s health plan
Not enrolled in a Health Care Flexible Spending Account
Not eligible to be claimed as a dependent on someone else’s tax return
Not enrolled in Medicare, Medicaid, or TRICARE
Not receiving Veterans Administration
3. Withdrawals for qualifying medical expenses are
HSA Contributions
United Vision Logistics provides an HSA employer contribution that will be deposited in early January. New hires will be on a prorated basis 60 days after effective date.
Important HSA Information
Ask your in-network doctor to file claims with your medical, dental, or vision carrier. Pay the doctor with your HSA debit card for any balance due.
Keep ALL records and receipts for HSA reimbursements in the event of an IRS audit.
You may open an HSA at the financial institution of your choice, but only accounts opened through HSA Bank are eligible for automatic payroll deduction.
Open an HSA
If you meet the eligibility requirements, we will open an HSA administered by HSA Bank
Flexible Spending Accounts
Allow you to set aside pretax dollars from each paycheck to pay for certain IRS-approved health and dependent care expenses. We offer three Flexible Spending Accounts, administered by HSA Bank.
Health Care FSA
The Health Care FSA covers qualified medical, dental, and vision expenses for you or your eligible dependents. You may contribute up to $3,400 annually to a Health Care FSA and you are entitled to the full election from day one of your plan year. Eligible expenses include:
Dental and vision expenses
Medical deductibles and coinsurance
Prescription copays
Hearing aids and batteries
You may not contribute to a Health Care FSA if you enrolled in a High Deductible Health Plan (HDHP) and contribute to a Health Savings Account (HSA).
Limited Purpose FSA
A Limited Purpose Health Care FSA is available if you enrolled in the HDHP medical plan and contribute to an HSA. You can use a Limited Purpose Health Care FSA to pay for eligible out-of-pocket dental and vision expenses only, such as:
Dental and orthodontia care (e.g., fillings, X-rays, and braces)
Vision care (e.g., eyeglasses, contact lenses, and LASIK surgery)
Refer to page 23 for a list of qualified FSA expenses
How the Health Care and Limited Purpose FSAs Work
You can access the funds in your Health Care or Limited Purpose FSA two different ways:
Use your FSA debit card to pay for qualified expenses, doctor visits, and prescription copays.
Pay out-of-pocket and submit receipts for reimbursement.
Important FSA Rules
The maximum per plan year you can contribute to a Health Care or Limited Purpose FSA is $3,400. The maximum per plan year you can contribute to a Dependent Care FSA is $7,500 when filing jointly or head of household and $3,750 when married filing separately.
You cannot change your election during the year unless you experience a Qualifying Life Event.
You can continue to file claims incurred during the plan year for another 30 days (up until January 31, 2027).
Your Health Care or Limited Purpose FSA debit card can be used for health care expenses only. It cannot be used to pay for dependent care expenses.
The IRS has amended the “use it or lose it” rule to allow you to carry over up to $680 in your Health Care FSA into the next plan year. The carry-over rule does not apply to your Dependent Care FSA.
Flexible Spending Accounts
Dependent Care FSA
The Dependent Care FSA helps pay for expenses associated with caring for elder or child dependents so you or your spouse can work or attend school full time. Use the account to pay for daycare or baby sitter expenses for your children under age 13 and qualifying older dependents, such as dependent parents. Reimbursement from your Dependent Care FSA is limited to the total amount deposited in your account at that time. To be eligible, you (and your spouse, if married) must be gainfully employed, looking for work, a full-time student, or incapable of self-care.
THINGS TO CONSIDER REGARDING THE DEPENDENT CARE FSA
Overnight camps are not eligible for reimbursement (only day camps can be considered).
You may not request reimbursement for children age 13 and older; you may only request reimbursement for the part of the year when the child was under age 13.
You may request reimbursement for care of a spouse or dependent of any age who spends at least eight hours a day in your home and is mentally or physically incapable of self-care.
The dependent care provider cannot be your child under age 19 or anyone claimed as a dependent on your income taxes.
Plan Comparison
Most medical, dental, and vision care expenses that are not covered by your health plan, such as:
• Copayments
• Coinsurance
• Deductibles
• Glasses
• Doctor-prescribed over-the-counter medications Most dental and vision care expenses that are not covered by your health plan, such as:
• Eyeglasses
• Contacts
• LASIK eye surgery
• Fillings
• X-rays
• Braces
$3,400 per year
• Saves on eligible expenses not covered by insurance
• Reduces your taxable income
• Saves on eligible expenses not covered by insurance
• Reduces your taxable income
Dependent care expenses so you and your spouse can work or attend school full-time, such as:
• Daycare
• After-school programs
• Eldercare programs
and
• Reduces your taxable income
FSA vs. HSA
Who is eligible?
Contribution limits
Who owns the account?
Contributions subject to income tax?
Employees not eligible or participating in an HSA
$3,400
Does interest accrue? No
Contributions
Disbursement of funds
Catch-up contribution for older workers
Money is deducted pretax from the employee’s salary every pay period. Additional individual contributions are NOT allowed.
The entire annual contribution amount is available from the beginning of the year, even if the account is not yet fully funded.
No
Portability and forfeiture Not portable. Unspent money in an FSA is lost when employment is terminated.
Must be enrolled in a High Deductible Health Plan (HDHP), have no other non-HDHP health plan, including coverage under Medicare, a spouse’s health plan, or FSA.
Money is deducted pretax from the employee’s salary every pay period. Additional individual contributions ARE allowed.
Only funds paid in by the employee and/or company are available for health care expenses.
Yes. Employees aged 55 and older may contribute up to $1,000 more to their account per year.
Yes. HSA balance is not forfeited when the employee changes employers or health plans.
Expiration All money in an FSA expires and is lost at the end of the grace period. Never expires or is lost.
Balance carryover (or rollover)
Subject to IRS limits.
Yes. Unused funds are carried over to the following year.
Changes to contributions Only for Qualified Life Events, such as a marriage, divorce, birth, or during Open Enrollment. On a pay period basis.
Eligible health care expenses
Qualified medical expenses are those specified in the plan that would generally qualify for the medical and dental expenses deduction (e.g., copays, coinsurance, deductible, prescription drugs, braces, dental, and eye care expenses).
Non-health care expenses FSA funds cannot be used for non-medical expenses.
Proof of expenses required?
Yes
Qualified medical expenses defined under IRC 213(d). HSAs can be used to pay premiums for Temporary Continuation of Coverage, Long Term Care, and health insurance for retirees.
HSA funds can be used for non-health care distributions but are included in gross income and subject to a 10% penalty if under age 65.
No. However, the employee should be prepared to substantiate to the IRS that the expense has been incurred, the amount of the expense, and its eligibility.
Qualified HSA + FSA Expenses
The products and services listed below are examples of medical expenses eligible for payment under your Health Care FSA or HSA.
Abdominal supports
Acupuncture
Air conditioner (when necessary for relief from difficulty in breathing)
Alcoholism treatment
Ambulance
Anesthetist
Arch supports
Artificial limbs
Autoette (when used for relief of sickness/disability)
Blood tests
Blood transfusions
Braces
Cardiographs
Chiropractor
Contact lenses
Convalescent home (for medical treatment only)
Crutches
Dental treatment
Dental X-rays
Dentures
Dermatologist
Diagnostic fees
Diathermy
Drug addiction therapy
Drugs (prescription)
Elastic hosiery (prescription)
Eyeglasses
Fees paid to health institute prescribed by a doctor
FICA and FUTA tax paid for medical care service
Fluoridation unit
Guide dog
Gum treatment
Gynecologist
Healing services
Hearing aids and batteries
Hospital bills
Hydrotherapy
Insulin treatment
Lab tests
Lead paint removal
Legal fees
Lodging (away from home for outpatient care)
This list is not all-inclusive; additional expenses may qualify and the items listed may change in accordance with IRS regulations. Refer to IRS Publication 502 Medical and Dental Expenses at www.irs.gov for complete details.
Metabolism tests
Neurologist
Nursing (including board and meals)
Obstetrician
Operating room costs
Ophthalmologist
Optician
Optometrist
Oral surgery
Organ transplant (including donor’s expenses)
Orthopedic shoes
Orthopedist
Osteopath
Oxygen and oxygen equipment
Pediatrician
Physician
Physiotherapist
Podiatrist
Postnatal treatments
Practical nurse for medical services
Prenatal care
Prescription medicines
Psychiatrist
Psychoanalyst
Psychologist
Psychotherapy
Radium therapy
Registered nurse
Special school costs for the handicapped
Spinal fluid test
Splints
Surgeon
Telephone or TV equipment to assist the hard-of-hearing
Therapy equipment
Transportation expenses (relative to health care)
Ultra-violet ray treatment
Vaccines
Vitamins (if prescribed)
Wheelchair
X-rays
Dental Coverage
About This Plan
See any dental provider for care.
Pay less and get the highest level of benefits by seeing in-network providers.
Pay more for care if you go to out-of-network providers.
Implant Services, Denture Adjustments and Repairs, Crowns, Dentures, Bridges
Note: Refer to the MetLife Patient Charge schedule for full details and explanation of benefits.
Vision Coverage
Helps detect certain medical issues, prolong your eyesight, and correct vision or eye problems.
About This Plan
See any vision provider for care.
Pay less and get the highest level of benefits by seeing in-network providers.
Pay more for care if you go to out-of-network providers.
Vision Benefits
•
•
• Elective
Life and AD&D Insurance
Provides your loved ones with a monetary safety net after your death and/or after an accident that causes loss of life, limb, or function.
Basic Life and Accidental Death and Dismemberment (AD&D) insurance through Symetra are important to your financial security, especially if others depend on you for support.
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 of a limb or function. If death occurs from an accident, 100% of the AD&D benefit would be paid to you or your beneficiary(ies).
Life and AD&D coverage amounts reduce to 67% at age 70.
Basic Life and AD&D
Basic Life and AD&D insurance are provided at no cost to you. You are automatically covered at $50,000 for each benefit.
Voluntary Life and AD&D
If you need more coverage than Basic Life and AD&D, you may buy Voluntary Life and AD&D for yourself and your dependent(s). If you do not elect Voluntary Life and AD&D 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. You must elect Voluntary Life and AD&D coverage for yourself before covering your spouse and/or child(ren).
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.
Life and AD&D Insurance
VOLUNTARY LIFE AND AD&D
• Increments of $10,000 up to the lesser of 5x annual base salary or $250,000.
Employee
Spouse
Child(ren)
• EOI is required at time of request for increase and new coverage. No EOI required at hire only.
• Increments of $5,000 up to $50,000 not to exceed 100% of your election.
• EOI is required at time of request for increase and new coverage. No EOI required at hire only.
• Flat $10,000 benefit.
• No evidence of insurability (EOI) required.
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 Symetra. 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 the Human Resources Department for a Conversion, Portability, or Waiver of Premium application.
1 Spouse rate is
CALCULATE YOUR BIWEEKLY COST
Coverage amount ÷1,000 × rate = biweekly cost
Example
Ariel is 44 years old and wants to elect $20,000 in employee only coverage.
$20,000 ÷ 1,000 × $0.071 = $1.42 biweekly cost
Disability Insurance
Provides partial income protection if you are unable to work due to a
or illness.
Short Term Disability
We provide Short Term Disability (STD) insurance at no cost to you through Symetra
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.
Long Term Disability
We provide Long Term Disability (LTD) insurance at no cost to you through Symetra
BASIC LTD
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.
BUY-UP LTD
We also offer Buy-Up LTD insurance for you to purchase through Symetra.
Supplemental Coverage
Complements our traditional health care programs and pays you directly for unexpected health care costs.
Accident Insurance
Accident insurance through MetLife provides affordable protection against a sudden, unforeseen accident. The Accident plan helps offset the direct and indirect expenses resulting from an accident, such as copayments, deductible, ambulance, physical therapy, and other costs not covered by traditional health plans.
Important
This benefits package includes a fixed indemnity policy, which is not health insurance.
This fixed indemnity policy may pay you a limited dollar amount if you are sick or hospitalized. You are still responsible for paying the cost of your care.
The payment you get is not based on the size of your medical bill.
There might be a limit on how much this policy will pay each year.
This policy is not a substitute for comprehensive health insurance.
Since this policy is not health insurance, it does not have to include most Federal consumer protections that apply to health insurance.
•
Looking for comprehensive health insurance?
Visit www.healthcare.gov or call 1-800-318-2596 (TTY: 1-855-889-4325) to find health coverage options.
To find out if you can get health insurance through your job, or a family member’s job, contact the employer.
QUESTIONS ABOUT THIS POLICY?
For questions or complaints about this policy, contact your State Department of Insurance. Find their number on the National Association of Insurance Commissioners’ website (www.naic.org) under Insurance Departments.
If you have this policy through your job, or a family member’s job, contact the employer.
Supplemental Coverage
Critical Illness Insurance
Critical Illness insurance through MetLife helps pay the cost of non-medical 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.
CRITICAL ILLNESS
Benign brain tumor, invasive cancer, coma, blindness, deafness, loss of speech, heart attack, kidney failure, major organ transplant, ALS, Alzheimer's disease, multiple sclerosis, muscular dystrophy, advanced Parkinson's disease, severe burn, stroke
Cerebral palsy, cleft lip or palate, cystic fibrosis, Type 1 diabetes, Down syndrome, sickle cell anemia, spina bifida
Pre-existing Condition Limitation
CALCULATE YOUR BIWEEKLY COST
Coverage amount ÷1,000 × rate = biweekly cost
Example
Daniel is 35 years old and wants to elect $20,000 in employee only coverage.
$20,000 ÷ 1,000 × $0.25 = $5.00 biweekly cost
will not pay a benefit for a Covered Condition that is diagnosed prior to the coverage effective date.
Supplemental Coverage
LifeLock Identity Protection and Support
You have two identity theft protection and support plans to choose through LifeLock
Ultimate Plus – Offers comprehensive identity theft protection. You will get alerts for new bank account applications and attempts to take over existing accounts. This plan offers annual online credit reports and scores from three bureaus; monthly credit score tracking from one bureau; and priority access to live U.S.-based Member Support.
LifeLock Benefit Elite – Helps protect your identity and your nest eggs, including investment accounts, from fraudulent withdrawals and balance transfers.
HOW LIFELOCK WORKS
LifeLock monitors your identity and when activity occurs involving your information, you are alerted by email, text, or a phone call. You can respond to confirm whether the activity is legitimate, and if it is not, a U.S.-based LifeLock Identity Restoration Specialist will help you resolve the issue. If you are a victim of identity theft, LifeLock Benefit Elite helps protect you with a Million Dollar Protection Package. This includes reimbursement for stolen funds and coverage for personal expenses.
NORTON LIFELOCK BENEFIT PLAN
Help protect your identity and devices with the Norton LifeLock Benefit Plan. The plan includes:
Device Security – Anti-virus software and multi-layered, advanced security help protect devices against existing and emerging threats, including malware and ransomware.
Online Privacy – Norton Secure VPN protects devices and helps keep online activity and browsing history private.
Identity – LifeLock monitors for fraudulent use of personal information and sends alerts when a potential threat is detected.
Home and Family – 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.
LIFELOCK BY NORTON
401(k) Retirement Program
A 401(k) plan can be a powerful tool to help you be financially secure in retirement. Our 401(k) plan through Fidelity can help you reach your investment goals.
How the Retirement Plan Works*
You are eligible to participate in the Plan if you are 18 years of age and have 30 days of service with the company. You may contribute up to the 2026 IRS limit. If you are over the age of 50, you can contribute an additional catch-up amount of $8,000.
You decide how much you want to contribute and can change your contribution amount anytime. All changes are effective as soon as administratively feasible and remain in effect until you update or stop your contributions. You also decide how to invest the assets in your account and may change your investment choices anytime. For more details, refer to your 401(k) Enrollment Guide or contact Fidelity
Vesting
You are always 100% vested in your own contributions. You are 100% vested in matching Company contributions after three years of service.
Automatic Enrollment
United Vision Logistics will automatically withhold 3% of your pay and invest it in a default conservative investment fund. The funds will be withdrawn starting 30 days after your date of hire. If you want to cancel your automatic enrollment or change your contributions through Fidelity, visit https://netbenefits.fidelity.com or call 800-835-5097
Rollover Options
If you have a Retirement Plan with a previous employer, you are eligible to roll that plan into the 401(k) plan.
Investment Options
You may direct your contributions to any of the investments offered within the company 401(k) plan. You can make changes to your investments by calling 800-835-5097 or visiting https://netbenefits.fidelity.com
401(k) Automatic Increase
*At the time of this publication's release, the 2026 IRS 401(k) limits were not yet available.
As part of our ongoing effort to help our team members save for retirement, we will be implementing an automatic 1% increase to 401(k) contributions effective January 1, 2026. Your contribution rate will automatically increase by 1% on the first payroll of 2026 if it is less than 10%. You do not need to take any action—this adjustment will occur automatically. This small increase is designed to help you steadily build your retirement savings over time.
Additional Benefits
Paid Time Off
United Vision Logistics knows the importance of work/ life balance. Our Paid Time Off (PTO) policy provides you with flexible time off that you can use for vacation, personal, or family illness, doctor appointments, school, and volunteering. Our goal is to reduce unscheduled absences and the need for supervisory oversight.
PTO Guidelines
Full-time employees accrue PTO in hourly increments based on length of service.
PTO accrues as you complete each full pay period.
Accrued PTO is added to your PTO bank when your paycheck is issued.
You cannot earn PTO in pay periods during which you take unpaid leave, disability leave, or workers’ compensation.
You must use your PTO in one-hour increments.
Part-time employees, temporary employees, contract employees, and interns are not eligible to accrue PTO.
PerkSpot Discount Program
The PerkSpot Discount Program makes it easy for you to find exclusive discounts on your favorite brands. Items are curated based on your interests so you can stay healthy and save on items, activities, and places that are most meaningful to you. Explore 30,000 national and local offers that include travel, hobbies, health and fitness, beauty, toys, pets, jewelry, services, education, entertainment, apparel, and more.
1. Visit https://pslogin.perkspot.com
2. Click Register to create your account.
3. Select your interests from the My Interests feature and click on Got it!
4. Log in or read weekly emails to get ongoing and featured discounts.
Access the program at home, work, or on the go to save money and splurge on happiness.
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 – The fixed amount you pay for health care services received.
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.
Employee Contribution – The amount you pay for your insurance coverage.
Employer Contribution – The amount United Vision Logistics 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.
Flexible Spending Account (FSA) – An option that allows participants to set aside pretax dollars to pay for certain qualified expenses during a specific time period (usually a 12-month period).
Health Savings Account (HSA) – A personal savings account that allows you to pay for qualified medical expenses with pretax dollars.
High Deductible Health Plan (HDHP) – A medical plan with a higher deductible in exchange for a lower monthly premium. You must meet the annual deductible before any benefits are paid by the plan.
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, you may be responsible for costs over the amount allowed by your insurance carrier.
Out-of-Pocket Maximum – Also known as an out-ofpocket 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 (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.
Brand Name Drugs (Formulary) – Brand name drugs on your provider’s list of approved drugs. You can check online with your provider to see this list.
Brand Name Drugs (Non-Formulary) – Brand name drugs not on your provider’s list of approved drugs. These drugs are typically newer and have higher copayments.
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.
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 30 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 30 days after the marriage, birth, or placement for adoption.
For More Information or Assistance
To request special enrollment or obtain more information, contact:
United Vision Logistics
Human Resources
400 East Kaliste Saloom Rd. Ste. 3500
Lafayette, LA 70508
337-291-6802 or 337-291-6804
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 United Vision Logistics 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.
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. United Vision Logistics has determined that the prescription drug coverage offered by the United Vision Logistics 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.
Important Notices
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.
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).
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 United Vision Logistics at the phone number or address listed at the end of this section.
If you choose to enroll in a Medicare prescription drug plan and cancel your current United Vision Logistics 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:
Contact the Human Resources Department at 337-291-6802 or 337291-6804
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:
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:
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
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).
January 1, 2026
United Vision Logistics Human Resources 400 East Kaliste Saloom Rd. Ste. 3500 Lafayette, LA 70508 337-291-6802 or 337-291-6804
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 United Vision Logistics, hereinafter referred to as the plan sponsor.
Important Notices
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.
United Vision Logistics Human Resources
400 East Kaliste Saloom Rd. Ste. 3500 Lafayette, LA 70508 337-291-6802 or 337-291-6804
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.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272)
If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. The following list of States is current as of July 31, 2025. Contact your State for more information on eligibility.
Website: www.medicaid.la.gov or www.ldh.la.gov/lahipp Phone: 1-888-342-6207 (Medicaid hotline) or 1-855-618-5488 (LaHIPP)
To see if any other States have added a premium assistance program since July 31, 2025, or for more information on special enrollment rights, you can contact either:
Centers for Medicare & Medicaid Services www.cms.hhs.gov
1-877-267-2323, Menu Option 4, Ext. 61565
Important Notices
Continuation of Coverage Rights Under COBRA
Under the Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), if you are covered under the United Vision Logistics group health plan you and your eligible dependents may be entitled to continue your group health benefits coverage under the United Vision Logistics 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
United Vision Logistics Human Resources
400 East Kaliste Saloom Rd. Ste. 3500 Lafayette, LA 70508 337-291-6802 or 337-291-6804
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network 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.
“Out-of-network” describes providers and facilities that have not signed a contract with your health plan. Out-of-network 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-ofpocket 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.
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 in- network 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 outof-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, out-of-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 out-of-network. You can choose a provider or facility in your plan’s network.
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 out-of-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 (cost-sharing) 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-ofnetwork services toward your deductible and out-of-pocket limit.
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.
Important Notices
Notice Regarding Wellness Program
The employee wellness program is a voluntary program administered according to federal rules permitting employer-sponsored wellness programs that seek to improve employee health or prevent disease, including the Americans with Disabilities Act of 1990, the Genetic Information Nondiscrimination Act of 2008, and the Health Insurance Portability and Accountability Act, as applicable, among others. If you choose to participate in the wellness program you may be asked to complete a voluntary health risk assessment or “HRA” that asks a series of questions about your health-related activities and behaviors and whether you have or had certain medical conditions (e.g., cancer, diabetes, or heart disease). You may also be asked to complete a biometric screening, which could include a blood test for certain medical conditions such as diabetes, heart disease, etc. You are not required to complete the HRA or to participate in the blood test or other medical examinations.
However, employees who choose to participate in the wellness program may qualify for an incentive. Although you are not required to complete a HRA or biometric screening, the wellness program may specify that only employees who do so will qualify for the incentive. Additional incentives may be available for employees who participate in certain health-related activities or achieve certain health outcomes.
If you are unable to participate in any of the health-related activities or achieve any of the health outcomes required to earn an incentive, you may be entitled to a reasonable accommodation or an alternative standard. You may request a reasonable accommodation or an alternative standard by contacting Human Resources.
If you choose to participate in a HRA and/or biometric screening, information from your HRA and results from your biometric screening will be used to provide you with information to help you understand your current health and potential risks and may also be used to offer you services through the wellness program. You also are encouraged to share your results or concerns with your own doctor.
Protections from Disclosure of Medical Information
We are required by law to maintain the privacy and security of your personally identifiable health information. Although the wellness program may use aggregate information it collects to design a program based on identified health risks in the workplace, the wellness program will never disclose any of your personal information either publicly or to the employer, except as necessary to respond to a request from you for a reasonable accommodation needed to participate in the wellness program, or as expressly permitted by law. Medical information that personally identifies you that is provided in connection with the wellness program will not be provided to your supervisors or managers and may never be used to make decisions regarding your employment.
Your health information will not be sold, exchanged, transferred, or otherwise disclosed except to the extent permitted by law to carry out specific activities related to the wellness program, and you will not be asked or required to waive the confidentiality of your health information as a condition of participating in the wellness program or receiving an incentive. Anyone who receives your information for purposes of providing you services as part of the wellness program will abide by the same confidentiality requirements.
In addition, all medical information obtained through the wellness program will be maintained separate from your personnel records, information stored electronically will be encrypted, and no information you provide as part of the wellness program will be used in making any employment decision. Appropriate precautions will be taken to avoid any data breach, and in the event a data breach occurs involving information you provide in connection with the wellness program, we will notify you immediately.
You may not be discriminated against in employment because of the medical information you provide as part of participating in the wellness program, nor may you be subjected to retaliation if you choose not to participate.
If you have questions or concerns regarding this notice, or about protections against discrimination and retaliation, please contact Human Resources.
This brochure highlights the main features of the United Vision Logistics 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. United Vision Logistics reserves the right to change or discontinue its employee benefits plans at anytime.
