Edited 9.2026
TABLE OF CONTENTS Page 2
A Smarter Way to Better Health
Page 3
Eligibility & Enrollment
Page 4-5
Medical Plans
Page 6
United Healthcare Mobile App
Page 7-12
United Healthcare Value Added Programs
At OneStreet Residential, we know that our
associates are crucial to our success. That’s why we provide you with an excellent, diverse benefits package that helps protect you and your family, now and into the future. This Benefit Guide outlines the health and welfare plans offered to you and your family. It contains general information and is meant to provide a brief overview. For complete details regarding each benefit plan offered, please refer to the individual plan documents as the information contained herein is for illustrative purposes. Details can be found in the plan specific Summary of Benefits & Coverage located in Employee Navigator. In the case of a discrepancy, the plan specific documents will prevail.
Page 13
United Healthcare - Find Care
Page 14
Medical Plan – Important Notes
Page 15
RelyMD - Telemedicine
Page 16
MedCom Flexible Spending Accounts
Page 17
United Healthcare Dental Plans
Page 18-19
Dental Extra Benefits
Page 20
United Healthcare Vision Plan
Page 21-25
Vision Extra Benefits
Page 26
Lincoln Basic Life/AD&D and Voluntary Life/AD&D Insurance
Page 27-29
Lincoln Value Added Services
Page 30
Lincoln Disability Insurance and MetLife’s Legal Plan
Page 31
Allstate Accident, Critical Illness and
Identity Theft Page 32-33
ADP Benefits Enrollment via Employee Navigator
Page 34
401(k)
Page 35-37
EAP Work/Life—HealthAdvocate
Page 38
Medicare Assistance & Education
Page 39
Associate Payroll Deductions
Page 40
Key Contacts & Resources
Page 41-47
Important Notices
Page 48-49
Flexible Spending Election Worksheet
OneStreet Residential Benefit Guide | 1
A SMARTER WAY TO BETTER HEALTH It’s Your Health. Get Involved.
Your health is a work in progress that needs your consistent attention and support. Each choice you make for yourself, and your family, is part of an ever-changing picture. Taking steps to improve your health such as going for annual physicals and living a healthy lifestyle can make a positive impact on your well-being. It’s up to you to take responsibility and get involved, and we are pleased to offer programs that will support your efforts and help you reach goals.
Preventive Health Care Services
Preventive care includes services like checkups, screenings and immunizations that can help you stay healthy and may help you avoid or delay health problems. Many serious conditions such as heart disease, cancer, and diabetes are preventable and treatable if caught early. It’s important for everyone to get the preventive care they need. Some examples of preventive care services are: ▪ ▪ ▪ ▪
Blood pressure, diabetes, and cholesterol tests Certain cancer screenings, such as mammograms, colonoscopies Counseling, screenings and vaccines to help ensure healthy pregnancies Regular well-baby and well-child visits
Immunizations
Some immunizations and vaccinations are also considered preventive care services. Standard immunizations recommended by the Centers for Disease Control (CDC) Include: hepatitis A and B, diphtheria, polio, pneumonia, measles, mumps, rubella, tetanus and influenza although these may be subject to age and/or frequency restrictions.
Understanding What’s Covered
Generally speaking, if a service is considered preventive care, it will be covered at 100%. If it’s not, it may still be covered subject to a copay, deductible or coinsurance. The Affordable Care Act (ACA) requires that services considered preventive care be covered by your health plan at 100% in-network, without a copay, deductible or coinsurance. To get specifics about your plan’s preventive care coverage, call the customer service number on your member ID card. You may want to ask your doctor if the services you’re receiving at a preventive care visit (such as an annual checkup) are all considered standard preventive care. If any service performed at an annual checkup is as a result of a prior diagnosed condition, the office visit may not be processed as preventive, and you may be responsible for a copay, coinsurance or deductible. To learn more about the ACA or preventive care and coverage, visit www.healthcare.gov.
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ELIGIBILITY & ENROLLMENT Who is Eligible to Join the Benefit Plan?
Qualifying Event Changes
You and your dependents are eligible to join OneStreet Residential’s health and welfare benefit plans if you are a full-time associate who works an average of at least 30 hours per week. You must be enrolled in the plan to add dependent coverage.
You are allowed to make changes to your current benefit elections during the plan year if you experience an IRS-approved qualifying change in life status. If you have a status change, you must notify Human Resources within 30 days of the event. If you do not notify Human Resources during that time, you and/or your dependents must wait until the next open enrollment to change your coverage.
Who is an Eligible Dependent? •
Your spouse to whom you are legally married
•
Your dependent child under the maximum age specified in the Carriers’ plan documents including: o Natural child o Adopted child o Stepchild o Child for whom you have been appointed as the legal guardian
IRS-approved qualifying life status changes include: •
Marriage, divorce or legal separation
•
Birth or adoption of a child or placement of a child for adoption
•
Death of a dependent
•
Child no longer eligible due to reaching age limit
*Your child’s spouse and a child for whom you are not the legal guardian are not eligible.
•
Change in employment status, including loss or gain of employment, for your spouse or a dependent
The Dependent Maximum Age Limits is up to age 26. The dependent does not need to be a full-time student; does not need to be an eligible dependent on parent’s tax return; is not required to live with you; and may be unmarried or married.
•
Change in work schedule, including switching between full-time and part-time status, by you, your spouse or a dependent
•
Change in residence or work site for you, your spouse, or a dependent that results in a change of eligibility
•
If you or your dependents lose eligibility for Medicaid or the Children’s Health Insurance Program (CHIP) coverage or become eligible for a state’s premium assistance subsidy under Medicaid or CHIP, then you have 60 days from the date of the Medicaid/eligibility change to request enrollment in OneStreet Residential’s plans.
Once the dependent reaches age 26, coverage will terminate on the last day of the birth month. A totally disabled child who is physically or mentally disabled prior to age 26 may remain on the plan if the child is primarily dependent on the enrolled member for support and maintenance.
When Do Benefits Become Effective? Your benefits become effective on the first day of the month following 60 days as a full-time associate with OneStreet Residential. All associates (full-time and parttime) are eligible for the Employee Assistance Program (EAP) through HealthAdvocate upon date of hire. Annual Open Enrollment Each year during the annual open enrollment period, you are given the opportunity to make changes to your current benefit elections. Annual open enrollment is the only time during the year you can make changes to your benefits unless you experience a qualified life status change (qualifying event). The annual enrollment period occurs each year during the month of September.
!
This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. A special enrollment period is a time outside of the annual open enrollment period during which you and your family have a right to sign up for health coverage. In the Marketplace, you qualify for a special enrollment period 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage. Job-based plans must provide a special enrollment period of 30 days. Some events will require additional documentation to be submitted with the application at the time of enrollment. Find more information on page 30. You should read this notice even if you plan to waive coverage at this time.
Please note, loss of coverage due to non-payment or voluntary termination of other coverage outside a spouse’s or parent’s open enrollment is not an IRS-approved qualifying life event and you do not qualify for a special enrollment period.
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MEDICAL OneStreet Residential offers you two medical plan choices through United Healthcare. Please refer to the following charts for a list of the major features for each plan. As a plan member, you have access to many consumer education tools and valueadded programs designed to help you manage you and your dependents’ medical care. Visit www.myUHC.com and register as a member. You can estimate your medical costs, view your Explanation of Benefits (EOB), and more. The national network for both United Healthcare plans is the Choice Plus Network. You can search for an in-network doctor, hospital or other providers by following the step-by-step instructions on page 6 of this guide. The prescription drug coverage provided by the medical plans are expected to pay out as much as standard Medicare prescription drug coverage pays. This is important because members who enroll in a Medicare prescription drug plan after their initial eligibility period, may pay a higher premium (a penalty) if they were enrolled in a group health plan with noncreditable prescription drug coverage.
MEDICAL PLAN OPTION #1 $2500 DEDUCTIBLE United Healthcare P2500i100LX21B RX4_ADVB | Network: Choice Plus Plan Highlights
In Network – You Pay
Out-of-Network – You Pay
Deductible
$2,500 Individual | $5,000 Family
$5,000 Individual | $10,000 Family
Coinsurance
You Pay 0%
You Pay 50%
Annual Out-of-Pocket Maximum
$5,000 Individual | $10,000 Family
$10,000 Individual | $20,000 Family
Primary Care Physician Office Visit or Mental Health Visit
$25 copay
Deductible, then 50%
Telemedicine Visit via UHC’s App
$25 for PCP and Mental Health $75 Specialist
Deductible, then 50%
Chiropractic Care
$25 copay (20 visits per calendar year)
Deductible, then 50%
Rehab ( PT, OT, etc.)
Deductible then 0% (30 visits combined per calendar year)
Deductible then 50%
Specialist Office Visit
$75 copay
Deductible then 50%
Preventive Care Services
Plan pays 100%
Deductible then 50%
Lab and Xray Services
Deductible then 0%
Deductible then 50%
Major Imaging Hospital or Free Standing Center
Deductible then 0%
Deductible then 50%
Hospital Inpatient Care
Deductible then 0%
Deductible then 50%
Outpatient Surgery at Hospital or Free Standing Center
Deductible then 0%
Deductible then 50%
Emergency Room Convenience Care or Urgent Care
$300 copay + Deductible $25 - $50 copay
Rx Calendar Year Deductible
Deductible then 50% None
Tier 1
$10 copay | $10 copay Specialty Medication
Tier 2
$35 copay | $150 copay Specialty Medication
Tier 3
$75 copay | $350 copay Specialty Medication
Tier 4
$250 copay | $500 copay Specialty Medication
90 Day Mail Order (excludes specialty)
!
$25 / $87.50 / $187.50 / $625
This chart is a summary of your benefits. If there is a discrepancy between the chart and official documents, the documents will prevail.
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MEDICAL MEDICAL PLAN OPTION #2 $5000 DEDUCTIBLE P5000i100LX21B RX4_ADVB | Network: Choice Plus Plan Highlights
In Network – You Pay
Out-of-Network – You Pay
Deductible
$5,000 Individual | $10,000 Family
$10,000 Individual | $20,000 Family
Coinsurance
You Pay 0%
You Pay 50%
Annual Out-of-Pocket Maximum
$8,150 Individual | $16,300 Family
$16,300 Individual | $32,600 Family
Primary Care Physician Office Visit Mental Health Visit
$25 copay
Deductible then 50%
Telemedicine Visit via UHC’s App
$25 for PCP and Mental Health $75 Specialist
Deductible then 50%
Chiropractic Care
$25 copay (20 visits per calendar year)
Deductible, then 50%
Rehab ( PT, OT, etc.)
Deductible then 0% (30 visits combined per calendar year)
Deductible then 50%
Specialist Office Visit
$75 copay
Deductible then 50%
Preventive Care Services
Plan pays 100%
Deductible then 50%
Lab and Xray Services
Deductible then 0%
Deductible then 50%
Major Imaging Hospital or Free Standing Center
Deductible then 0%
Deductible then 50%
Hospital Inpatient Care
Deductible then 0%
Deductible then 50%
Outpatient Surgery at Hospital or Free Standing Center
Deductible then 0%
Deductible then 50%
Emergency Room Convenience Care or Urgent Care
$300 copay + Deductible $25 - $50 copay
Rx Calendar Year Deductible
Deductible then 50% None
Tier 1
$10 copay | $10 copay Specialty Medication
Tier 2
$35 copay | $150 copay Specialty Medication
Tier 3
$75 copay | $350 copay Specialty Medication
Tier 4
$250 copay | $500 copay Specialty Medication
90 Day Mail Order (excludes specialty)
!
$25 / $87.50 / $187.50 / $625
This chart is a summary of your benefits. If there is a discrepancy between the chart and official documents, the documents will prevail.
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Find a doctor, hospital, or other care provider by following the steps below at www.myUHC.com: 1. 2. 3. 4. 5.
Click on Find a Provider or Find a Pharmacy Select your Provider Select ‘Employer and Individual Plans’ Select the ‘Choice Plus’ Network Select your Care Category
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UHC VALUE ADDED PROGRAMS Health Care Programs
Whether you're already a member with a UnitedHealthcare plan or considering UnitedHealthcare, understanding what's available to members can help you be sure you're getting the most out of your benefits. These resources are plan specific, please login to www.myUHC.com for further guidance on the offerings below:
Wellness and rewards programs • Rewards programs Get support and motivation to keep your body and mind healthy — and with some programs, earn rewards for reaching activity and health goals. • Real Appeal® Lose weight with a personal coach and a program designed just for you. • Quit For Life® Get tools and one-on-one support to help you quit smoking or using tobacco.
Mental health and emotional support programs • Mental health programs and services Learn how to access mental health programs and resources for mental health support. • Substance Use Helpline Get confidential alcohol and drug addiction help whenever you need it.
Health support programs • Clinical support programs Learn how our clinical support programs offer help with managing ongoing health conditions, like diabetes, heart disease and more. • LGBTQ+ resources Explore benefits and resources included in some UnitedHealthcare plans offering support for members and allies of the LGBTQ+ community. • Maternity support Get maternity support resources to help you throughout your pregnancy. • Member support and advocacy services Learn how health care advocates may help members connect with resources and support.
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UHC VALUE ADDED PROGRAMS
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UHC VALUE ADDED PROGRAMS
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UHC VALUE ADDED PROGRAMS
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UHC VALUE ADDED PROGRAMS
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UHC VALUE ADDED PROGRAMS
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MANAGE YOUR IN-NETWORK HEALTHCARE NEEDS Where to Receive Care
Type of Provider
Estimated Average Cost Company Paid Benefit Standalone Telemedicine Benefit See Page 15 of Guide
RelyMD Telehealth
Board Certified Doctors
• • • • • •
Minor allergic reactions Minor headache Nausea or diarrhea Cold, cough, and sore throat Minor sinus pain and fever Eye or ear pain or irritation
$25 copay PCP $75 copay Specialist
• • • • • •
Minor allergic reactions Minor headache Nausea or diarrhea Cold, cough, and sore throat Minor sinus pain and fever Eye or ear pain or irritation
$25 - $50 copay
• • • • • • •
Minor allergic reactions Bumps, cuts, scrapes, or rashes Burning with urination Minor burns Cold, cough, and sore throat Minor sinus pain and fever Eye or ear pain or irritation; Shots
$25 copay
• • • • •
Same as retail health clinic, plus: Mild asthma Back pain Nausea or diarrhea Minor headache
$50 copay
• • • • •
Same as walk-in doctor's office, plus: Animal bites Sprains and strains Stitches X-rays
During the hours of 6am-10pm M-F, $0 cost to you During the hours of 10pm-6am M-F and all hours Saturday & Sunday, there is a $5 after-hours visit fee
United Healthcare Telehealth
Board Certified Doctors
Convenience Care Clinic
Physician Assistants or Nurse Practitioners
Walk-in Doctor's Office
Family Practice Doctors or Primary Care Physician
Urgent Care Center
Family Practice and Emergency Medicine Doctors
Emergency Room
Doctors trained in Emergency Medicine
Symptoms
$300 copay + In Network Deductible
Digital tools to keep you connected
Once you’re a member, you can access your personalized digital tools – the UnitedHealthcare app and www.MyUHC.com – these tools give you quick access to resources designed to help you. OneStreet Residential Benefit Guide | 13
• Coughing up or vomiting blood • Symptoms feel life-threatening or disabling • Chest pain or severe shortness of breath • Major injury or broken bones • Sudden or unexplained loss of consciousness • Severe pain that cannot be controlled • Labor pains when pregnant
Get Connected
MEDICAL PLANS – IMPORTANT NOTES BOTH MEDICAL PLANS • Receive services from a national network of providers and facilities – Choice Plus POS network in all states. Receive the best rates by staying in network; reserve the Emergency Room for life threatening situations. • “Open Access”- you may choose any provider without having a Primary Care Physician (PCP) identified or requiring a referral from a PCP to see a specialist. • You pay copays for day-to-day services such as doctor visits, urgent care & prescriptions. • Preventive Care is covered at no cost in-network • All deductible, coinsurance and copay expenses accrue toward the out-of-pocket maximum. • Chiropractic visits limited to 20 per calendar year. • Physical therapy, occupational therapy, speech therapy, cardiac therapy, post cochlear therapy, cognitive therapy and pulmonary therapy limited to 30 combined visits per calendar year. • The plans offer Mail Order Pharmacy at a reduced cost for tiers 2, 3, and 4. Receive a 90-day supply of medication for 2.5 copays. • Specialty pharmacy offered in-network only, for a 31-day supply, and at a different copay than the standard pharmacy: • Tier 1 - $10 copay | Tier 2 - $150 copay | Tier 3 - $350 copay | Tier 4 - $500
MEDICAL THINGS TO CONSIDER • Since your medical plans run on a calendar year basis, all deductible and out of pocket amounts will reset to $0 on January 1st. • Members and new covered associates will receive ID cards 7-10 business days after United Healthcare concludes entering enrollment in their system. Please do not schedule appointments at the start of your new coverage unless it is unavoidable. Providers cannot always immediately find your information in the system. • Members can view/print a copy of their ID cards and search for care via the United Healthcare member website www.myUHC.com or the United Healthcare Mobile App.
Make sure your doctors, facilities, and pharmacies are contracted (in-network) with United Healthcare’s Choice Plus Network. To locate participating providers, please visit www.myUHC.com: Click on Find a Provider or Find a Pharmacy • Select your Provider • Select ‘Employer and Individual Plans’ • Select the ‘Choice Plus’ Network • Select your Care Category To locate a participating Dental provider, click here and choose the National Options PPO 30 Network : Dental Provider Search To locate a participating Vision provider, click here using the United Healthcare Vision Network: Vision Provider Search Check the Prescription Drug tier your medications are assigned to under the United Healthcare Plans. Pharmacy Formulary: Advantage 4-Tier Drug List
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• • Company Paid Benefit Standalone Telemedicine Benefit
•
During the hours of 6am-10pm M-F, $0 cost to you. During the hours of 10pm-6am M-F and all hours Saturday & Sunday, there is a $5 after-hours visit fee. This service also covers your spouse and dependents to age 26.
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FLEXIBLE SPENDING ACCOUNT What is a Flexible Spending Account?
An FSA is a plan allowing you to use before-tax dollars to pay for eligible out-of-pocket medical, dental, vision and child care expenses. The maximum amounts that can be used on your FSA plans are $3,400 for the Medical FSA and $7,500 for the Dependent Care FSA. The money you set aside for your annual elections cannot be seen as gross taxable wages by the IRS and will be divided up equally over your payroll periods as a deduction to be set aside. Access to your funds is quick with the prepaid benefits card allowing you to pay for your eligible expenses at point of sale to your providers. Filing claims and submitting documentation on your account is easy with access to your mobile application and online portal 24/7/365.
What is my plan year?
Your FSA Plan runs on a plan year of 10/01/2026 to 9/30/2027.
Healthcare Flexible Spending Account (FSA)
You may defer up to $3,400 to your Healthcare FSA to fund eligible out-of-pocket healthcare expenses. The following list provides examples of expenses eligible for reimbursement under the IRS guidelines: • Non-covered medical expenses that quality under Section 217 of the IRS code • Deductibles See Pages 48-49 for • Office visit copays • Prescription medication Flexible Spending • Over-the-counter medications (require physician prescription) Election Worksheet • Hearing and dental expenses not covered by insurance • The IRS 2026 rollover max is $680 • Great Resource: The FSA Store - https://fsastore.com/
Dependent Care FSA
You may defer up to $7,500 to your Dependent Care FSA to fund eligible out-of-pocket expenses for childcare and eldercare. To be eligible for reimbursement, expenses must meet the following criteria established by the IRS: • The person cared for must be under age 13, or if older, physically or mentally incapable of self-care. • Day care must be necessary in order for you and your spouse to work. • The person cared for must be claimed as a dependent on your federal tax return and must reside in your home at least eight hours per day. • Payment for care cannot be made to anyone you claim as a dependent on your income tax return, to your spouse or to a child under age 19. • If care is provided by a center that cares for more than six individuals, it must be licensed.
Mobile App:
For a life that is on-the-go, download our mobile application here. Check your balance, view account activity, and reach out to customer service all through our FREE mobile app for iPhone and Android!
Medcom Links:
• FSA/DCFSA Link - https://medcombenefits.com/resources/for-employees • Employee Login - https://medcom.wealthcareportal.com/Authentication/Handshake • Mobile App Guide - https://medcombenefits.com/images/uploads/documents/Medcom_Mobile_Guide.pdf OneStreet Residential Benefit Guide | 16
DENTAL Our Dental benefits, administered by United Healthcare, provide a wide range of dental services including preventive care, fillings, and x-rays. You have the freedom of choice to utilize in-network or out-of-network providers. For a list of innetwork providers, visit www.myUHC.com. - The network for our plan is the National Options PPO 30 Network When you visit an in-network dentist, your out-of-pocket expenses are lower. In-network dentists will file the claim for you and services are paid at the negotiated rate. Eligible employees may elect coverage for themselves and eligible dependents. Dependent children are covered up to age 26, regardless of student status.
United Healthcare LOW (Base) Plan 1
In-Network
Out of Network
Your Deductible
$50 Individual / $150 Family
$50 Individual / $150 Family
Calendar Year Maximum Applies to preventive, basic, and major services
$1,000
Preventive & Diagnostic Services Exams, Cleanings & Bitewing X-Rays, Fluoride, Sealants and Space Maintainers
100% (Deductible waived)
Basic Services Filings, Extractions, Endodontics (root canal), Periodontics (gum surgery), Oral Surgery
80% (After deductible)
Major Services Crowns, Inlays/Onlays, Dentures, Implants
50% (After deductible)
Orthodontics
Not Covered
United Healthcare HIGH (Buy-Up) Plan 2
In-Network
Out of Network
Your Deductible
$50 Individual / $150 Family
$50 Individual / $150 Family
Calendar Year Maximum Applies to preventive, basic, and major services
$2,000
Preventive & Diagnostic Services Exams, Cleanings & Bitewing X-Rays, Fluoride, Sealants and Space Maintainers
100% (Deductible waived)
Basic Services Filings, Extractions, Endodontics (root canal), Periodontics (gum surgery), Oral Surgery
80% (After deductible)
Major Services Crowns, Inlays/Onlays, Dentures, Implants
50% (After deductible)
Orthodontics (Adult & Children)
50%
Lifetime Orthodontia Maximum
$1,500 lifetime maximum
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DENTAL EXTRA BENEFITS United Healthcare is focused on helping you save money and keeping your teeth and gums healthy. Giving you freedom and choice.
You can see any dentist you want, anywhere across the country. When you choose a dentist who is part of the plan’s large national network, you may receive discounted rates only available to members. There’s no need to get referrals to see a specialist. Preventive care is covered 100% in our network. Get coverage on hundreds of services. Visit www.welcometouhc.com/dentalppo30 to find network providers and learn more.
Helping you stay healthier.
Oral cancer screenings - With our dental plan, adults (age 18 and older) get oral cancer screenings as part of your preventive care benefit. There are over 49,000 new cases of oral cancer detected1 and a little over 60% survive more than five years. Extra care during pregnancy - We cover extra dental visits during pregnancy and the first three months after birth. Pregnant women are at higher risk of dental disease. During pregnancy, a woman is more likely to have gum disease. And gum disease is associated with pregnancy complications. Once a woman gives birth, she can pass oral bacteria on to her baby through kisses and sharing spoons. That’s why it’s so important to treat and detect oral diseases during pregnancy. And it’s good to know that seeing a dentist when you’re pregnant is safe. Dental Consumer Multiplier UHC’s Consumer MaxMultiplier program rewards you for keeping up with your dental care by adding dollars to next year’s annual maximum. It’s included as part of your dental plan. How the program works: 1) Earn award dollars for visiting your dentist once a year • If you’re dental claims are under the assigned threshold, you get a reward o $250 for the Base Plan o $500 for the Buy-Up Plan 2) Your award dollars can be used for claims that go beyond your annual maximum (does not apply to orthodontia) o $1,000 annual maximum for the Base Plan o $2,000 annual maximum for the Buy-Up Plan 3) Your unused award dollars roll over year after year • The maximum award dollars you can accumulate are o $1,000 for the Base Plan o $2,000 for the Buy-Up Plan
United Healthcare LOW (Base) Plan 1
This year’s Dental Annual Maximum: $1,000
If your total claims are less than: $500
United Healthcare HIGH (Buy-Up) Plan 2
This year’s Dental Annual Maximum: $2,000
If your total claims are less than: $1,000
Award you’ll Earn: $250
Bonus! If all claims are with an In Network Dentist: $100 Bonus
Award you’ll Earn: $500
Bonus! If all claims are with an In Network Dentist: $100 Bonus
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Total Award Dollars available next year: Up to $350
Total Award Dollars available next year: Up to $600
DENTAL
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VISION United Healthcare Vision offers easy access to thousands of conveniently located vision care providers. Unlike other programs that may restrict provider options, the United Healthcare Vision Network offers a nationwide network of convenient, accessible options for eye care including optometrists, ophthalmologists, opticians and many leading optical retailers, such as Private Practitioners, Costco, Target Optical, and other Retail locations. VISION Services
In-Network
Out-of-Network
$10 Copay
Up to $40 allowance
Eye Exam: Routine Exam
Frames: Frames
$150 allowance (30% discount on balance over $150)
Up to $45 allowance
Standard Plastic Lenses: Single
$25 Copay
up to $40 allowance
Bifocal
$25 Copay
up to $60 allowance
Trifocal
$25 Copay
up to $80 allowance
Contact Lenses: (Material Only) Elective contacts
$150 allowance
Up to $125 allowance
Contact lens fitting
$40
n/a
Frequency: Examination
Once every 12 months Twice every 12 months for persons with Diabetes
Frames
Once every 24 months
Eyeglass Lenses
Once every 12 months
Contact Lenses
Once every 12 months
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VISION EXTRA BENEFITS
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VISION EXTRA BENEFITS
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VISION EXTRA BENEFITS
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VISION EXTRA BENEFITS
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VISION EXTRA BENEFITS
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LIFE AND AD&D Basic Life/AD&D Insurance provided by OneStreet Residential Life Insurance is a key element of proper financial planning and helps provide financial stability and protection for families in case of an untimely death. If you are an eligible full-time associate, OneStreet Residential provides $25,000 of basic group term Life insurance and an additional matching amount of Accident Death and Dismemberment (AD&D) insurance through Lincoln Financial. This coverage is guarantee issue, which means there are no health questions. There is a reduction in benefit by 35% ($16,250) at age 65, and again by 50% ($12,500) at age 70. This is a company paid benefit.
Supplemental Term Life Insurance And Accidental Death & Dismemberment (AD&D) Associates have the option of purchasing Supplemental Term Life and AD&D Insurance through Lincoln Financial, in addition to their employer-paid life insurance. Supplemental Term Life Insurance and Accidental Death and Dismemberment (AD&D) are intended to provide additional protection to full-time associates. AD&D provides double the benefit in the event of accidental death. It also provides a partial benefit for loss of limb or eye due to an accident. Those interested can elect the amount that suits their needs at an affordable rate. Rates are based on age and when you enroll for this benefit, it will illustrate the cost in Employee Navigator. Supplemental Term Life Insurance and AD&D coverage is portable (you may take it with you when you leave OneStreet Residential by contacting Lincoln Financial within 30 days). Associate: Increments of $10,000 up to the lesser of 5 times base annual earnings or a maximum of $500,000. The guarantee issue amount at your initial offering of this plan is $100,000. Associates wishing to apply for coverage above $100,000 will need to seek approval for this coverage by completing an Evidence of Insurability (EOI) form, where they will answer a series of simple health questions for Lincoln Financial underwriting to review. If electing coverage for yourself, you may also elect coverage for your spouse, and/or children. Spouse: Increments of $5,000 up to the lesser of 50% of your Supplemental amount or $100,000 maximum. The guarantee issue amount is $25,000. Spouse rates are based on the associate’s age. Child (age 6 months – 26): $10,000. All child life is guarantee issue. One monthly premium covers all dependent children.
Choose Your Beneficiary: Make sure your life and accidental death benefits will be paid as you intend. Be sure you name a beneficiary when you enroll in Life and AD&D benefits. If you do not enroll in supplemental associate or spouse life when you are first eligible (within 30 days of your eligibility), you will be subject to Evidence of Insurability (EOI) when you apply for coverage at a later date. You will also be subject to EOI when requesting an increase to your coverage outside of your initial eligibility date. OneStreet Residential Benefit Guide | 26
LINCOLN VALUE ADDED SERVICES Lincoln LifeKeys Life insurance helps your employees plan for their families’ future and offers financial security at a difficult time. Through Lincoln’s trusted partnership with ComPsych, all term life and accidental death and dismemberment policies include access to LifeKeys, a program that provides services to support your employee’s current and future needs: • EstateGuidance will preparation - Employees and family members can create their wills online easily and economically. A step-by-step guide takes users through the entire process, and online instructions help them execute their wills.
•
•
GuidanceResources Online - This resource is the place to go for articles, tutorials, streaming videos, and “Ask the Expert” information about: o Law and regulations o Money and investments o Family and relationships o Health and wellness o Work and education o Leisure and home Identity theft Identity theft is one of the fastest growing crimes in the U.S. We help ensure your employees have the information they need to recognize and prevent it.
GuidanceResources.com | New users click Register (web ID: LifeKeys)
Travel Assistance through Lincoln TravelConnect services offer security and reassurance — helping make travel less stressful. If you’re enrolled in life and/or accidental death and dismemberment insurance, TravelConnect services are available to you and your loved ones 24 hours a day, seven days a week. •
Visit www.MyOnCallPortal.com and enter Group ID LFGTravel123 to access plan documents, international calling instructions, and destination information.
Make financial wellness happen with Lincoln’s WellnessPATH!
When employees improve their financial wellness, they’re better able to manage everyday expenses, reduce financial stress, save for retirement and emergencies, and pay off debt. Lincoln offers three paths to financial wellness, including actionable web content, on-site personal support, and an interactive financial wellness tool. Register at www.lincolnfinancial.com OneStreet Residential Benefit Guide | 27
LINCOLN VALUE ADDED SERVICES
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LINCOLN VALUE ADDED SERVICES
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DISABILITY Disability coverage provides the financial security of knowing that you will continue to receive income if you are unable to work due to illness or injury. Rates are based on age and basic earnings. You will be able to determine the cost in Employee Navigator.
Voluntary Short-Term Disability OneStreet Residential offers all full-time associates the opportunity to purchase short-term disability coverage through Lincoln Financial. This coverage pays up to a weekly benefit of 60% of the associate’s pre-disability income (up to a maximum of $3,000 per week) during periods of disability resulting from injury, sickness, or pregnancy. STD benefits begin on the 8th day after an accident, sickness, or pregnancy. STD benefits pay weekly for a duration of up to 12 weeks. *There is a 3/12 pre-existing condition limitation which means the plan will not pay a claim anytime in the first 12 months of coverage due to a condition for which a member received medical care anytime in the 3 months prior to the effective date.
Voluntary Long-Term Disability OneStreet Residential offers all full-time associates the opportunity to purchase longterm disability coverage through Lincoln Financial. Long-term disability pays 60% of monthly earnings to a maximum of $15,000. Benefits begin after 90 days of being disabled and can last up to Social Security Normal Retirement Age. *There is a 3/12 pre-existing condition limitation which means the plan will not pay a claim anytime in the first 12 months of coverage due to a condition for which a member received medical care anytime in the 3 months prior to the effective date. *The pre-existing condition limitation does apply to pregnancy (i.e. if you are already pregnant when you elect STD, you cannot make a claim when you deliver. The plan will only pay if you become pregnant AFTER the effective date of your STD coverage). If you do not enroll in the Disability plans when you are first eligible (within 30 days of your eligibility), you will be subject to Evidence of Insurability (EOI) when you apply for coverage at a later date.
LEGAL PLAN OneStreet Residential offers all full-time associates the opportunity to enroll in MetLife’s Legal Plan, MetLaw. Many people will need an attorney at some point in their lives. Associates who enrolled in ’s Legal Plan will have unlimited access to professional attorneys who can help navigate through life’s major milestones. You can meet an attorney in person, or contact them over the phone, or online using our Law Firm E-Panel®. And MetLaw has a range of self-service tools to give associates and their family members a helping hand and a little guidance. For some legal matters, the attorneys may even be able to appear on your behalf in court, so you don’t have to take time away from work or your families to attend a court hearing.
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ACCIDENT & CRITICAL ILLNESS Accident Insurance OneStreet Residential offers an Accident plan through Allstate. Benefits are paid directly to you based on a flat schedule when an accident occurs. Some examples of when the plan would pay a benefit are the following: fracture, dislocation, burn, concussion, coma, torn cartilage in knee, laceration, broken tooth, eye injury, ambulance, emergency room, hospital admission, paralysis and more. The plan has a $25 annual benefit (reward; 2 per covered member, per calendar year payable up to FOUR times a year) for preventive screenings. If enrolling, you may also cover a spouse and/or children. Rates are based on who you cover on the plan and can be found in Employee Navigator. This plan is portable at the same rate should you leave the company.
Critical Illness Insurance
OneStreet Residential offers a Critical Illness plan through Allstate. A lump sum benefit is paid out when diagnosed with a critical illness. Consider this plan as a way to help with your medical plan expenses and other daily living expenses if you were to be diagnosed with a critical illness. The plan pays $10,000 for diagnosis of Heart Attack, Stroke, Major Organ Transplant, End-Stage Renal Failure & Invasive Cancer. The plan pays $2,500 for diagnosis of Coronary Artery Bypass and Carcinoma in situ. The plan has a $5,000 specified illness rider if the insured is certified by a physician as having one of the additional chronic illnesses listed in the policy and is unable to perform at least two activities of daily living for 90 days. The plan has a $50 annual benefit (reward; 1 per covered member, per calendar year) for preventive screenings. If enrolling, you may also cover a spouse and/or children, and they are eligible for 50% of the associate’s benefit amount. Rates are based on age and can be found in Employee Navigator. This plan is portable at the same rate should you leave the company.
MyBenefits: 24/7 Access An easy-to-use website that offers 24/7 access to important information about your benefits. Plus, you can submit and check your claims (including claim history), request your cash benefit to be direct deposited, make changes to personal information, and more. Please register at www.standard.com/ahl/mybenefits
IDENTITY THEFT PROTECTION Identity Protection Select offered through Allstate and The Standard provides comprehensive financial and identity monitoring to help associates protect themselves against the impact of identity theft. OneStreet Residential offers all full-time associates the opportunity to enroll in the Identity Protection Select plan. With this plan, associates can:
• Check their identity health score • Get comprehensive identity and financial monitoring • View and manage alerts in real time • Receive high-risk financial transaction alerts • Depend on in-house customer care specialists 24/7 • Rely on $1 million identity theft expense coverage • Protect themselves and their family (everyone that’s “under the member’s roof and wallet”)
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ADP BENEFITS ENROLLMENT EMPLOYEE NAVIGATOR NOTE:
• You must login and submit your elections or actively WAIVE the benefits. • Please make sure to designate a beneficiary for your life insurance benefits. • Have your dependent’s information readily available when enrolling in the benefits, such as date of birth and social security numbers.
Step 1: Access Your Benefits Portal in ADP:
In ADP WorkForce Now, navigate to the Benefits tile.
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401(k) Savings for retirement can seem overwhelming. Looking out, a retirement date seems so far into the future and something to think about at a later time. But in reality, retirement is sometimes closer than you think. Will you be ready? One way to start saving for retirement is with the company’s 401(k) Plan. Enrollment Associates who are age 18+, have completed at least 1,000 hours of service and have been employed for a minimum of 6 months of service are eligible to enroll the first of the month following the 6-month waiting period. Contributions An associate can make contributions on a pre-tax basis as a Traditional 401(k) deferral or an after-tax basis as a Roth 401(k) deferral. All contributions and rollovers are 100% vested. Company Match Additionally, the company matches 100% up to 1% of your contributions. Matching contributions are made during the first quarter of the following year and an associate must be employed on 12/31 of the current year unless the associate retired at age 65, deceased or became disabled. Matching contributions follow the vesting schedule below:
Years of Service
Vesting Percentage
Less than 1
0%
1
20%
2
40%
3
60%
4
80%
5
100%
6 or more
100%
For more information, visit www.trpc401k.com
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EMPLOYEE ASSISTANCE PROGRAM
Help, when you need it most. With your Employee Assistance Program and Work/Life Balance services, confidential assistance is as close as your phone or computer. When you experience life’s challenges, the Employee Assistance Program (EAP) through HealthAdvocate is available to help 24/7/365. This free, confidential program is available to you and members of your household. You do not need to be enrolled in one of OneStreet Residential’s medical plans in order to take advantage of this valuable benefit. The program is designed to offer short-term counseling and support for a range of personal, family, financial and work/life issues. This service is available to you and your dependents, including your spouse, children, parents and parent-in-laws. All associates (full-time and part-time) are eligible for the Employee Assistance Program (EAP) upon date of hire. Clinical Support: Confidential Short-term Counseling • 24-hour Emergency Hotline answered by a Licensed Master’s-level Counselor • Professional telephone evaluation for the nature/scope of the issue and referral (if needed) to appropriate professional counseling or other necessary care • Up to 5 In-person counseling sessions, per person per issue per year • Video Counseling available for face-to-face sessions only Work/Life Support: Telephonic, Online and Mobile Associates have unlimited 24/7 access to call, go online or use the app for help locating resources to better balance your work and life responsibilities, such as:
• Financial: online Financial Wellness portal and Financial Fitness Center for help with debt management, budgeting, college funding, retirement strategies and other issues; free 30-minute consultation with a financial specialist
• Employee Discount Center: online savings program with 25% discounts on name-brand items
• Childcare: childcare centers, family childcare homes, nanny agencies, summer camps, babysitter tips, community resources
• Eldercare: nursing homes, assisted-living facilities, independent living facilities, home healthcare, hospice, respite care, geriatric Care Managers, senior centers, adult day care, community services and resources
• Legal: family law, real estate, estate planning, motor vehicle, elder law, criminal matters; free 30-minute consultation with a legal specialist; access to discounted legal services
Visit Health Advocate at www.healthadvocate.com/members or call 877-240-6863. OneStreet Residential Benefit Guide | 35
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MEDICARE ASSISTANCE & EDUCATION
Take the Uncertainty Out of Medicare! As we begin the journey to retirement, planning for and understanding the intricacies of Medicare can be difficult. Our Benefits Broker, Sterling Seacrest Pritchard, has endorsed John Mudrock at Medicare Plan Pro to aid you in navigating your options as you approach Medicare eligibility. John Mudrock As Co-Founder of Medicare Plan Pros John brings 13 years of Medicare industry experience with him. His first 10 years in the industry were spent with Humana before venturing out in 2015 to start what is now Medicare Plan Pros. He likes to take a consultative approach with his clients educating them on all of their options so that they may make the best decision for themselves Discover What We Do Best Find expert Medicare advise with Medicare Plan Pros! Let us take the worry and stress out of your future. We know picking a Medicare plan can be an overwhelming process. That’s why we are here. Contact us and let an independent agent do the work for you today to insure your tomorrow. • Medicare Advantage: Also known as Medicare Part C. These plans allow for a private insurance company to provide your Medicare benefits. These plans cover all the benefits of Original Medicare and can include Medicare Part D prescription coverage as well as vision, dental, and hearing. • Medicare Supplements: These plans help cover Medicare Part A and Part B deductibles, as well as Medicare coinsurance. Each policy is standardized and must offer you the same basic benefits no matter which company sells it to you. Costs are typically more predictable and not limited to the use of specific networks. • Medicare Part D: Medicare Part D coverage can come in the form of a standalone Prescription Drug Plan (PDP). Someone might combine this coverage with Original Medicare. Also, in some cases, Part D may come included with a Medicare Advantage Plan.
For more detailed information visit www.medicareplanpros.com Or call John Mudrock, (404) 376-3449
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ASSOCIATE PAYROLL DEDUCTIONS Your Bi-Weekly Payroll Deductions Benefit Plans
Associate Only
Associate + Spouse
Associate + Child(ren)
Associate + Family
Medical Option 1 - $2500
$146.75
$651.31
$582.51
$1,087.08
Medical Option 2 - $5000
$92.85
$538.13
$477.42
$922.70
RelyMD Telemedicine
Employer paid benefit
Dental Low Option
Employer paid benefit
$17.69
$22.23
$42.89
Dental High Option
$5.16
$28.02
$36.01
$62.98
Vision
$3.08
$6.25
$7.08
$10.65
Basic Life/AD&D
Employer paid benefit
Supplemental Life/AD&D
Employee Navigator will calculate deductions based on election and age.
Short-Term Disability
Employee Navigator will calculate deductions based on age and annual salary.
Long-Term Disability
Employee Navigator will calculate deductions based on age and annual salary.
MetLaw Legal Plan
$11.08 covers all tiers
Accident
$4.68
Critical Illness
$8.08
$10.30
$13.56
Employee Navigator will calculate deductions based on elections and age.
Identity Theft
$2.75
Employee Assistance Program
$5.52
$5.52
Employer paid benefit
For all eligible associates, OneStreet Residential shares in your benefit cost by contributing up to $9,260 annually to your health and welfare benefits.
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$5.52
KEYYourCONTACTS Broker Support Contacts & RESOURCES JEN RAKESTRAW Client Service Executive 678-553-8293 jrakestraw@sspins.com ABIGAIL (ABBY) RIVES Client Service Assistant 404-698-4419 arives@sspins.com
KEY CONTACTS & RESOURCES Benefit
Company
Phone
Website
Medical & Pharmacy Coverage
United Healthcare
800-291-2634
www.MyUHC.com
Dental
United Healthcare
800-291-2634
www.MyUHC.com
Vision
United Healthcare
800-291-2634
www.MyUHC.com
Medical FSA and Dependent Care FSA
MedCom
800-523-7542 Opt 1
https://medcom.wealthcareportal.com /Authentication/Handshake
Basic Life/AD&D and Voluntary Life/AD&D
Lincoln Financial Group
877-275-5462
www.LincolnFinancial.com
Voluntary Short and Long Term Disabilty
Lincoln Financial Group
877-275-5462
www.LincolnFinancial.com
Accident & Critical Illness
Allstate
877-810-2920
www.standard.com/ahl/mybenefits
Identity Theft
Allstate | The Standard
800-789-2720
www.MyAIP.com
Telemedicine
RelyMD
855-879-4332
www.Relymd.com email: support@relymd.com
EAP + Work/Life Program
HealthAdvocate
877-240-6863
www.healthadvocate.com/members
Legal Plan - MetLaw
MetLife
800-821-6400
clientservice@legalplans.com www.members.legalplans.com
401(k)
TRPC
888-673-5440
www.trpc401k.com
John Mudrock, Co-Founder Medicare Assistance and Education
Medicare Plan Pros
404-376-3449
www.medicareplanpros.com
OSR Human Resources
Angel Gravley Karen Thompson
678-460-2864 404-974-4691
Angel@onestreetres.com Karen@onestreetres.com
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IMPORTANT NOTICES COBRA Continuation of Coverage
The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end. For more information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator. For additional information regarding COBRA qualifying events, how coverage is provided and actions required to participate in COBRA coverage, please see your Human Resources department.
Newborns’ and Mothers’ Health Protection Act The group health coverage provided complies with the Newborns’ and Mothers’ Health Protection Act of 1996. Under this law group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable.) In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).
Premium Assistance under Medical and CHIP
If you or your children are eligible for Medicaid or CHIP (Children’s Health Insurance Program) and you are eligible for health coverage from your employer, your State may have a premium assistance program that can help you pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employersponsored health coverage but need assistance in paying their health premiums. If you or your dependents are already enrolled in Medicaid or CHIP you can 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, you can contact your State Medicaid or CHIP office or dial 1877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Please see Human Resources for a list of state Medicaid or CHIP offices to find out more about premium assistance.
Special Enrollment Events An Eligible Person and/or Dependent may also be able to enroll during a special enrollment period. A special enrollment period is not available to an Eligible Person and his or her dependents if coverage under the prior plan was terminated for cause, or because premiums were not paid on a timely basis. An Eligible Person and/or Dependent does not need to elect COBRA continuation coverage to preserve special enrollment rights. Special enrollment is available to an Eligible Person and/or Dependent even if COBRA is elected. Please be aware that most special enrollment events require action within 30 days of the event. Please see Human Resources for a list of special enrollment opportunities and procedures.
Women’s Health and Cancer Rights Act If you have had or are going to have a mastectomy , you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: All stages of reconstruction of the breast on which the mastectomy has been performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; and Prostheses and treatment of physical complications of the mastectomy, including lymphedemas. These benefits will be provided subject to deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. If you would like more information on WHCRA benefits, call your plan administrator.
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IMPORTANT NOTICES GINA
The Genetic Information Nondiscrimination Act (GINA) prohibits health benefit plans from discriminating on the basis of genetic information in regard to eligibility, premium and contributions. This generally also means that private employers with more than 15 employees, its health plan or “business associate” of the employer, cannot collect or use genetic information, (including family medical history information). The once exception would be that a minimum amount of genetic testing results make be used to make a determination regarding a claim. You should know that GINA is treated as protected health information (PHI) under HIPAA. The plan must provide that an employer cannot request or require that you reveal whether or not you have had genetic testing; nor can your employer require that you participate in a genetic test. An employer cannot use any genetic information to set contribution rates or premiums.
PPACA Compliant Plan Notice
Since key parts of the health care law took effect in 2014, there is a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment-based health coverage offered by your employer. If your employer offers health coverage that meets the “minimum value” plan standard, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan. The “minimum value” plan standard is set by the Affordable Care Act. Your health plans offered by [Company] are ACA compliant plans (surpassing the “minimum value” standard), thus you would not be eligible for the tax credit offered to those who do not have access to such a plan. NOTE: If you purchase a health plan through the marketplace instead of accepting health coverage offered by your employer, then you will lose the employer contribution to the employer offered coverage. Also, this employer contribution, as well as your employee contribution to employer offered coverage, is excluded from income for Federal and State income tax purposes.
USERRA Notice The Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) established requirements that employers must meet for certain employees who are involved in the uniformed services. In addition to the rights that you have under COBRA, you (the employee) are entitled under USERRA lo continue the coverage that you (and your covered dependents, if any) had under the [Company] plan. You Have Rights Under Both COBRA and USERRA. Your rights under COBRA and USERRA are similar but not identical. Any election that you make pursuant to COBRA will also be an election under USERRA, and COBRA and USERRA will both apply with respect to the continuation coverage elected. If COBRA and USERRA give you different rights or protections, the law that provides the greater benefit will apply. The administrative policies and procedures described in the attached COBRA Election Notice also apply to USERRA coverage, unless compliance with the procedures is precluded by military necessity or is otherwise impossible or unreasonable under the circumstances.
Definitions "Uniformed services" means the Armed Forces, the Army National Guard, and the Air National Guard when an individual is engaged in active duty for training, inactive duty training, or full-time National Guard duty (i.e., pursuant to orders issued under federal law), the commissioned corps of the Public Health Service, and any other category of persons designated by the President in time of war or national emergency. "Service in the uniformed services" or "service" means the performance of duty on a voluntary or involuntary basis in the uniformed services under competent authority, including active duty, active and inactive duty for training, National Guard duty under federal statute, a period for which a person is absent from employment for an examination to determine his or her fitness to perform any of these duties, and a period for which a person is absent from employment to perform certain funeral honors duty. It also includes certain service by intermittent disaster response appointees of the National Disaster Medical System. OneStreet Residential Benefit Guide | 42
IMPORTANT NOTICES Duration of USERRA Coverage General Rule: 24-Month Maximum. When a covered employee takes a leave for service in the uniformed services, USERRA coverage for the employee (and covered dependents for whom coverage is elected) can continue until up to 24 months from the date on which the employee's leave for uniformed service began. However, USERRA coverage will end earlier if one of the following events takes place: A premium payment is not made within the required time; You fail to return to work or to apply for reemployment within the time required under USERRA (see below) following the completion of your service in the uniformed services; You lose your rights under USERRA as a result of a dishonorable discharge or other conduct specified in USERRA.
Notice of Privacy Provision This Notice of Privacy Practices (the "Notice") describes the legal obligations of [Company] (the "Plan") and your legal rights regarding your protected health information held by the Plan under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Among other things, this Notice describes how your protected health information may be used or disclosed to carry out treatment, payment, or health care operations, or for any other purposes that are permitted or required by law. We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA. The HIPAA Privacy Rule protects only certain medical information known as "protected health information." Generally, protected health information is health information, including demographic information, collected from you or created or received by a health care provider, a health care clearinghouse, a health plan, or your employer on behalf of a group health plan, from which it is possible to individually identify you and that relates to:
• Your past, present, or future physical or mental health or condition; • The provision of health care to you; or • The past, present, or future payment for the provision of health care to you. If you have any questions about this Notice or about our privacy practices, please contact your Human Resources department. The full privacy notice is available with your Human Resources Department.
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IMPORTANT NOTICES This guide provides a summary of you employee benefits rights and regulations as determined by Federal and State Laws. Information included in this guide includes the following: Special Open Enrollment Rights Children’s Health Insurance Program (CHIP) Premium Assistance
General Notice of the Cobra Continuations Rights Affordable Care Act (ACA) – Insurance Mandate
Health Insurance Marketplace Coverage Options and Your Group Health Coverage
Affordable Care Act (ACA) – Preventive Services for Non-grandfathered Plans Newborns’ and Mothers’ Health Protection Act of 1996 Break Time for Nursing Mothers Under the Fair Labor Standards Acts (FLSA) Women’s Health & Cancer Rights Act
The Generic Information Nondiscrimination Act of 2008 (GINA) HIPAA Privacy Rules
SPECIAL OPEN ENROLLMENT RIGHTS This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. A special enrollment period is a time outside of the annual open enrollment period during which you and your family have a right to sign up for health coverage. In the Marketplace, you qualify for a special enrollment period 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage. Job-based plans must provide a special enrollment period of 30 days. Some events will require additional documentation to be submitted with the application at the time of enrollment. You should read this notice even if you plan to waive coverage at this time.
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 request enrollment within 30 days after the marriage, birth, or placement for adoption.
Loss of Other Coverage
If you are declining coverage for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to 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 request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).
Medicaid or CHIP
If you or your dependents lose eligibility for coverage under Medicaid or the Children’s Health Insurance Program (CHIP) or become eligible for a premium assistance subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents. You must request enrollment within 60 days of the loss of Medicaid or CHIP coverage or the determination of eligibility for a premium assistance subsidy. To request special enrollment or obtain more information, please contact HR. OneStreet Residential Benefit Guide | 44
HEALTH INSURANCE MARKETPLACE PART A: GENERAL INFORMATION To assist you as you evaluate options for you and your family, this notice provides some basic information about the Marketplace and employment-based health coverage offered by your employer.
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. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Open enrollment for health insurance coverage through the Marketplace runs from November 1, 2026, through December 15, 2026, for coverage starting as early as January 1, 2027.
Can I Save Money on my Health Insurance Premiums in the Marketplace? You may quality to save money and lower your monthly premium, but only if our employer does not offer coverage, or offers coverage that doesn’t meet certain standards. The savings on your premium that you’re eligible for depends on your household income.
Does Employer Health Coverage Affect Eligibility for Premium Savings Through the Marketplace? Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan. However, you may be eligible for a tax 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 meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit.
!
If you purchase a health plan through the Marketplace instead of accepting health coverage by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution – as well as your employee contribution to employer-offered coverage – is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an alter-tax basis.
How Can I Get More Information? For more information about your coverage offered by your employer, please check your summary plan description or contact Human Resources.
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.
OneStreet Residential Benefit Guide | 45
HEALTH INSURANCE MARKETPLACE 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. 3. Employer Name OneStreet Residential, LLC
4. Employer Identification Number (EIN) 81-4913089
5. Employer Address 104 Interstate N Pkwy E SE
6. Employer Phone Number 404-974-4691
7. City Atlanta
8. State GA
9. Zip Code 30339
10. Who can we contact about health coverage at this job? Karen Thompson 11. Phone Number (if different from above)
12. Email Address Karen@onestreetres.com
Here is some basic information about health coverage offered by this employer: As your employer, we offer a health plan to: All employees. Eligible employees are:
X
Active full-time employees working 30 or more hours a week.
Some employees. Eligible employees are:
With respect to dependents: We do offer coverage. Eligible dependents are:
X
Spouses and children up to age 26.
We do not offer coverage. If checked, this coverage meets the minimum value standard and the cost of this coverage to you is intended to be affordable, based on employee wages. ** Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount through Marketplace. The Marketplace will use your household income, along with other factors, to determine whether you may be eligible for a premium discount. If for example, your wages vary from week to week (perhaps you are an hourly employee or you work on a commission basis), if you are newly employed mid-year, or if you have other income losses, you may still qualify for a premium discount.
If you decide to shop for coverage in the Marketplace, Healthcare.gov will guide you through the process. Here’s the employer information you’ll enter when you visit to find out if you can get a tax credit to lower your monthly premiums. OneStreet Residential Benefit Guide | 46
IMPORTANT NOTICE ABOUT PRESCRIPTION DRUG COVERAGE & MEDICARE CREDITABLE Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with OneStreet and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: •
Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.
•
OneStreet Residential has determined that all of the prescription drug coverage offered by the United Healthcare plans in this Benefit Guide are, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.
When Can You Join a Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.
What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current OneStreet Residential coverage will not be affected. Please review prescription drug coverage plan provisions/options under the certificate booklet provided by United Healthcare. See pages 7- 9 of the CMS Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance which outlines the prescription drug plan provisions/ options that Medicare eligible individuals may have available to them when they become eligible for Medicare Part D. If you do decide to join a Medicare drug plan and drop your current OneStreet Residential coverage, be aware that you and your dependents may not be able to get this coverage back.
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with OneStreet Residential and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.
For more information about this notice or your current prescription drug coverage, contact your carrier. NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through OneStreet Residential changes. You also may request a copy of this notice at any time. More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage Visit www.medicare.gov. Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help Call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486- 2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-7721213 (TTY 1-800-325-0778). Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).
OneStreet Residential Benefit Guide | 47
FLEXIBLE SPENDING ELECTION WORKSHEET The Health FSA and Dependent Care FSA Election Worksheets can help you determine how much to set aside in your Flexible Spending Accounts. Important: Make a conservative election, only considering expenses that are expected to be incurred by you and your FSA eligible dependents while you are enrolled during the FSA plan year. Up to $680 of your FSA funds will rollover to next year (10/1/2027-9/30/2028), so you will have to spend your remaining election amount by the end of this planyear (9/30/2027). Reference the MedCom’s FSA eligible expense list (www.fsastore.com/fsa-eligibility-list) to see what type of expenses and services are eligible. Please note, some expenses and services are eligible for a reimbursement with a prescription from a qualified healthcare professional and/or a Letter of Medical Necessity signed by your doctor.
Health FSA Worksheet
For Your Spouse
For You
For Your Dependent s to age 26
Dental deductible
$
$
$
Dental work (estimated)
$
$
$
Orthodontia
$
$
$
Eye exam, LASIK surgery
$
$
$
Prescription glasses, reading glasses, contact lenses
$
$
$
Vision solution and supplies
$
$
$
Medical deductibles
$
$
$
Medical copays
$
$
$
Prescription drugs
$
$
$
Over-the-counter (OTC) products, including medicines and drugs
$
$
$
Medical Supplies
$
$
$
Chiropractic care and/or acupuncture
$
$
$
Other eligible expenses
$
$
$
Total per family member
$
$
$
Total for family
$
Maximum election for 2026-2027 plan year
$3,400
Election amount (can be no more than plan year maximum above)
$
Number of pay periods per year
26
Payroll deduction amount per pay period (divide election amount by 26)
$
OneStreet Residential Benefit Guide | 48
FLEXIBLE SPENDING ELECTION WORKSHEET The Health FSA and Dependent Care FSA Election Worksheets can help you determine how much to set aside in your Flexible Spending Accounts. Important: Important: Make a conservative election, only considering expenses that are expected to be incurred for dependent care expenses for the plan year. Dependent Care FSA funds do not rollover year to year, so you will have to spend your election amount by the end of the year. Reference the Dependent care eligible expense (www.fsastore.com/fsa-eligibility-list toggle to Dependent Care) list to see what type of expense are eligible. Dependent Care Worksheet Eligible weekly dependent care costs (A)
$
Weeks of dependent care you will have in the plan year (B)
$
Total anticipated cost of dependent care for the plan year (A x B)
$
Maximum election for 2026-2027 plan year
$7,500
Election amount (can be no more than plan year maximum above)
$
Number of pay periods per year
26
Payroll deduction amount per pay period (divide election amount by 26)
$
OneStreet Residential Benefit Guide | 49