NVA Medical & Ancillary Benefits Guide 2021

2021 Guide To Your Benefits Understanding Your Benefits Program

MEDICAL/ANCILLARY GUIDE

Let’s Get Started!

Table of Contents How and When to Enroll. . . . . . . . . . 3

Income Protection. . . . . . . . . . . . . 14

Medical. . . . . . . . . . . . . . . . . . . . . . . . 4

Dependent Care FSA. . . . . . . . . . . 15

UnitedHealthcare Has You

WeeCare. . . . . . . . . . . . . . . . . . . . . 15

Covered. . . . . . . . . . . . . . . . . . . . . . . 5

MetLaw/Hyatt Legal & Identity

Traditional PPO Plans. . . . . . . . . . . . . 6

Theft Protection. . . . . . . . . . . . . . . 15

High-Deductible Health Plans. . . . . . 7

Pet Insurance. . . . . . . . . . . . . . . . . 15

Kaiser Permanente HMO Plan . . . . . 8

401(k) Plan. . . . . . . . . . . . . . . . . . . 16

Health Savings Account (HSA). . . . . . 9

Student Debt Refinancing. . . . . . . 16

Wellness Programs . . . . . . . . . . . . 10

Veterinary Technician Education

Dental. . . . . . . . . . . . . . . . . . . . . . . 11

Discount Program . . . . . . . . . . . . . 16

Vision . . . . . . . . . . . . . . . . . . . . . . . 12

Rates. . . . . . . . . . . . . . . . . . . . . . . . 17

Life and AD&D. . . . . . . . . . . . . . . . 13

Directory of Benefit Providers . . . 20

Critical Illness and Accident Plan . 13

Important Medical Plan Terms. . . 20

National Veterinary Associates is pleased to present this overview of your team member benefits. We offer a variety of benefits to support your physical, financial, and mental wellness. This year’s new and enhanced programs make it easier than ever to get the care and services you and your family need.

Your benefits are a valuable part of your Total Rewards package.

Please take the time to review this information carefully, along with the resources available through the insurance carriers and the bswift Benefits Portal. This guide will walk you through what you need to know about your 2021 benefits and empower you to: • Understand your benefits package • Learn how to make cost effective choices when it comes to your health care needs • Choose the right options for you and your family’s needs

WHO IS ELIGIBLE?

What’s New for 2021?

You are eligible to participate in the National Veterinary Associates benefits program if you are an active full-time team member working at least 30 hours each week. If eligible, you may enroll yourself in the medical, dental, vision, life/AD&D, disability, accident, and critical illness plans. You may enroll eligible dependents in all plans except disability.

• • • • • • • • •

WHEN COVERAGE STARTS Newly benefit eligible team members, and their dependents, are eligible for coverage on the first of the month following 60 days of your full-time (30 hours per week) start date.

Enhanced and Streamlined Medical Plans Kaiser Permanente Medical Program (in select states) Vision Provider with EyeMed Dependent Care FSA Provider with Discovery WeeCare ClassPass Talkspace Pet Insurance 401(k) Match

ACTION REQUIRED! You must enroll in Medical during Open Enrollment to have coverage as of January 1, 2021. If you don’t enroll, your medical coverage will end December 31, 2020. All nonmedical benefit elections will continue through 2021 if no action is taken.

Team members who join NVA as part of an acquisition will have a special enrollment period following the date that the work location joined the NVA Community.

This guide is only a summary. Please visit the library in bswift for full plan details.

This brochure summarizes the key features of your benefit plans. It is only intended to provide the highlights of your benefits; see your plan document for full details. If any conflict ever arises between this brochure and the actual plan document, the terms of the plan document will govern in all cases. National Veterinary Associates reserves the right to change, modify, or terminate the benefit plans at any time. This brochure is not a contract for purposes of employment or payment of benefits.

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When to Enroll

How to Enroll

WHEN FIRST ELIGIBLE – Team members must make elections within 30 days of their full-time start date (whether you are a new hire or moved from part-time to full-time). The choices you make when you first become eligible will remain in effect through the plan year, which ends on December 31, 2021. If you don’t enroll within 30 days, you won’t be able to enroll for benefits until the next annual Open Enrollment period unless you have a Qualifying Life Event.

NVA team members will enroll using bswift, the online benefits portal that gives you 24/7 access to your benefits information from any computer. Just log on to http://nva.bswift.com.

Username: The first initial of your first name plus your last name (e.g. John Smith = JSmith) Before logging into bswift, please verify with your site leader what your username is as you may have a numeric value added to your username.

All eligible team members must log on to bswift and formally elect or decline coverage for themselves and their eligible dependents.

Password: The last four digits of your Social Security number

MAKING CHANGES DURING THE YEAR • Open Enrollment is your annual opportunity to update or choose benefits that best meet your needs. Decisions made during Open Enrollment are generally in effect for the entire plan year. You may not make changes to your benefits until next year’s Open Enrollment period unless you have a Qualifying Life Event.

• If you experience a Qualifying Life Event, you must update your coverage on the bswift Benefits Portal within 30 days of the life event date. Documentation may be required.

WHAT’S A QUALIFYING EVENT? Examples of qualifying events include, but are not limited to:

WHO CAN I COVER?

• • • • •

Full-time team members may cover: • • • •

Your legal spouse Registered Domestic Partners Your children up to age 26 Your mentally or physically disabled children over age 26, if they depend on you for financial support – You will be required to provide documentation of your child’s disability.

Marriage Divorce Birth or adoption of a child Death of a dependent Loss or gain of dependent coverage

You have 30 days from your life event date to log into bswift, create your life event and make changes to your benefits coverage.

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Medical Our 2021 medical plans have been redesigned with you in mind! Our partnership with UnitedHealthcare continues to provide an outstanding experience for members. An additional partnership has been established with Kaiser Permanente for team members in CA, CO, DC, GA, MD, OR, VA, and WA. Here’s what you need to know about our new plans.

Base PPO Plan

HSA Plan

• $4,000 deductible for individual and $12,000 in total for families

• $2,000 Deductible for Individual and $4,000 in total for Families

• $0 copay for outpatient mental health visits

• High deductible

• Copays for doctor visits and pharmacy

• Must meet the deductible before the plan begins to pay for services other than preventive care and generic diabetic pharmacy – After you’ve met the deductible, you’ll pay 20% for most covered services until you reach the out-of-pocket maximum

• Telemedicine doctor visit through Virtual Visits with a $0 copay

Buy-Up PPO Plan

• Telemedicine doctor visit through Virtual Visits will have a charge of up to $50 for services

• $1,000 deductible for individual and $3,000 in total for families

• NVA will make contributions into your HSA up to $25 per month for employee only coverage and $50 per month for employee + dependent(s)

• $0 copay for outpatient mental health visits • Copays for doctor visits, emergency room, urgent care and pharmacy

Note: While the HSA plan may be a good choice for someone who is a low utilizer of health care and has predictable expenses, it might not be the right plan for everyone. Please utilize the Ask Emma decision support tool for assistance evaluating the medical plans available to make the best choice for you.

• Telemedicine doctor visit through Virtual Visits with a $0 copay

Finding the Right Plan

How to Find Network Providers

Which plan is best for you depends on your health care needs and your budget? Please see the medical charts for a comparison of the key benefits under each plan or utilize the Ask Emma decision support tool in bswift.

1. Log in to www.myuhc.com.

2. Click on Find a Doctor.

3. Choose either Medical or Behavioral Health providers.

ASK EMMA: YOUR PERSONALIZED ENROLLMENT TOOL

4. Under “Choose a Type of Plan” select “All UnitedHealthcare plans”.

Get help choosing the right plan with “Ask Emma,” bswift’s interactive decision-support tool. Just answer a few simple questions, and Ask Emma will show personalized cost comparisons based on your family’s health needs and preferred doctors, then suggest the plans that fit your individual needs.

It’s easy to understand and fun to use.

5. From the network listing, select “Choice Plus”.

6. Search for providers by physician specialty, type of facility, or conditions treated .

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UnitedHealthcare Has You Covered UNITEDHEALTHCARE GIVES TEAM MEMBERS WHO ENROLL IN THE PPO OR HDHP MEDICAL PLANS ACCESS TO PROGRAMS TO PROMOTE HEALTH AND WELLBEING.

MYHEALTH COST ESTIMATOR When you’re deciding where to go for care, take a look at cost as well as quality and convenience. Often you can get the care you need — and save money at the same time. Just go to www.myuhc.com to find and compare costs and get personalized estimates before your visit.

REGISTER/LOGIN TO MYUHC.COM OR UHC APP The UnitedHealthcare website and mobile app provides instant access to your family’s health information, anytime and anywhere. Whether you want to find a physician near you, check the status of a claim, or speak directly with a health care professional, the UnitedHealthcare App is available for both Apple and Android devices. Access them today to get instant access to your health plan details.

VIRTUAL VISITS If you need medical care for a nonemergency condition, a virtual visit lets you see and talk to a doctor from your mobile device or computer without an appointment. A virtual visit is a good option for health issues like colds and flus, bronchitis, migraines, pink eye, sore throats, and stomach aches. Most visits take about 10 to 15 minutes, and in many states, doctors can even write a prescription that you can pick up at your local pharmacy. Virtual visits are available to you and your covered dependents.

Just log in to www.myuhc.com and register for a virtual visit. During your visit, you will be able to talk to a doctor about your health concerns, symptoms, and treatment options.

PREMIUM DESIGNATED PROVIDER PROGRAM Choosing a doctor is one of the most important health decisions you will make.

The UnitedHealth Premium® program can help you find doctors who are right for you and your family. Providers who have earned the Premium® designation have demonstrated excellence in their areas of specialization. When you visit, those on the PPO plan can enjoy lower copays than you otherwise would!

It’s easy to find a UnitedHealth Premium Care Physician. Just go to www.myuhc.com and click on “Find a Doctor.” Choose smart.

Look for blue hearts.

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CONCIERGE SERVICE WITH ADVOCATE4ME Advocate4Me is designed to help members successfully navigate the health care system by matching you with expert advocates who guide you when you have questions. Members can use this resource as their single point of contact, giving you a clear way to get support to make more informed health care choices and get the most out of your benefits. Contact them today at (866) 844-4864 (PPO’s) and (866) 734-7670 (HSA’s).

MATERNITY SUPPORT PROGRAM If you’re thinking about having a baby or have one on the way, the Maternity Support Program is here to provide information and support – throughout your pregnancy and after giving birth.

When you enroll in the program, you’ll be able to work with a maternity nurse who is available to answer your questions and help you with things like: • Choosing a doctor or nurse midwife and finding a pediatrician or other specialist • Learning how to take care of yourself and the health of your baby – even if your pregnancy is considered high-risk • Managing your health – physically and emotionally – before and after your baby is born

Traditional PPO Plans MEDICAL PLAN BENEFITS

BASE PPO PLAN

BUY-UP PPO PLAN

In-Network

Out-of-Network

In-Network

Out-of-Network

$4,000 $12,000

$8,000 $24,000

$1,000 $3,000

$2,000 $6,000

25%

50%

20%

50%

$8,000 $16,000

$16,000 $32,000

$3,500 $7,000

$7,000 $14,000

• Primary Physician Visit

$30 copay

50% after deductible

$30 copay

50% after deductible

• Specialist Visit

$100 copay

50% after deductible

$100 copay

50% after deductible

• Premium Designated Providers

$30 copay

50% after deductible

$30 copay

50% after deductible

• Virtual Visit

$0 copay

Not covered

$0 copay

Not covered

• Preventive Care

$0 copay

Not covered

$0 copay

Not covered

• Outpatient Mental Health Visit

$0 copay

50% after deductible

$0 copay

50% after deductible

Deductible (does not include copays) • Individual • Family Coinsurance (you pay) Out-of-Pocket Maximum (includes deductible and copays) • Individual • Family Physician Services

Inpatient Hospital Care

25% after deductible

50% after deductible

20% after deductible

50% after deductible

Outpatient Surgery

25% after deductible

50% after deductible

20% after deductible

50% after deductible

Emergency Room Care Urgent Care Center

25% after deductible 25% after deductible

Prescription Drugs – Retail Pharmacy (up to a 31-day supply) • Generic Diabetic • Tier 1 – Your Lowest Cost Option • Tier 2 – Your Mid-Range Cost Option • Tier 3 – Your Highest Cost Option

No charge $20 copay $50 copay $75 copay

50% after deductible You pay the in-network copay plus all charges above UHC’s allowed amount

$200 copay per visit $100 copay

No charge $10 copay $40 copay $60 copay

50% after deductible You pay the in-network copay plus all charges above UHC’s allowed amount.

Prescription Drugs – Mail-Order (up to a 90-day supply) • Tier 1 – Your Lowest Cost Option • Tier 2 – Your Mid-Range Cost Option • Tier 3 – Your Highest Cost Option

Not covered

$50 copay $125 copay $187.50 copay

$25 copay $100 copay $150 copay

Not covered

All prescription drugs on OptumRx’s Prescription drug list are assigned to Tier 1, Tier 2, or Tier 3. Find individualized information on your benefits coverage, determine tier status, check the status of claims, and search for network pharmacies by logging on to www.optumrx.com or calling the Customer Care number on your ID card.

ACCESSING MEDICAL CARE The Emergency Room (ER) is a costly experience if you’re seeking care for an issue that is not a true emergency or a medical issue that could cause death or permanent injury if not treated quickly. There are alternatives to the ER that can offer you quick care at a more affordable cost. The key is finding these alternatives today when you’re happy and healthy. Where you go for care matters.

• Primary Care Physician (PCP): care from the doctor who knows you best. For symptoms that aren’t extreme, call and let them know your symptoms require immediate attention.

• Virtual Visits: available 24/7 for some health concerns like cough, fever, sinus problems, pink eye, minor rashes and more. You can virtually visit a board-certified doctor from the comfort of your home.

• Convenient Care Clinics: when you do not have a primary doctor or cannot get an appointment. Useful for fever, sore throat/strep, coughs/congestion, sports physicals, etc.

• Urgent Care (UC): less costly than the ER; can treat sprains, minor breaks, mild asthma, minor infections, rashes, small cuts, burns, etc.

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High-Deductible Health Plans MEDICAL PLAN BENEFITS

HSA PLAN

In-Network

Out-of-Network

$2,000 $4,000

$4,000 $8,000

20% after deductible

50% after deductible

$4,000 $8,000

$8,000 $16,000

Physician Services • Primary Physician Visit • Specialist Visit • Virtual Visit • Preventive Care

20% after deductible 20% after deductible Up to $50 No charge

50% after deductible 50% after deductible Not covered Not covered

Inpatient Hospital Care

20% after deductible

50% after deductible

Outpatient Surgery

20% after deductible

50% after deductible

Emergency Room Care

20% after deductible

50% after deductible

Urgent Care Center

20% after deductible

50% after deductible

Deductible • Individual • Family Coinsurance (you pay) Out-of-Pocket Maximum (includes deductible) • Individual • Family

Prescription Drugs – Retail Pharmacy (up to a 31-day supply) • Preventive Medications • Tier 1 – Your Lowest Cost Option • Tier 2 – Your Mid-Range Cost Option • Tier 3 – Your Highest Cost Option Prescription Drugs – Mail-Order (up to a 90-day supply) • Preventive Medications • Tier 1 – Your Lowest Cost Option • Tier 2 – Your Mid-Range Cost Option • Tier 3 – Your Highest Cost Option

Once you meet the deductible, the copays below apply: No charge $10 copay $50 copay $75 copay

You pay the in-network copay plus all charges above UHC’s allowed amount.

Once you meet the deductible, the copays below apply Not covered

No charge $25 copay $125 copay $187.50 copay

You must pay the full cost of your medical and non-preventive prescription drug expenses until you meet the annual deductible.

The coinsurance and prescription drug copays shown apply only after the deductible has been paid.

Tips to Save Money PREVENTIVE/WELLNESS EXAMS ARE COVERED AT 100% • In-network preventive care is equal to one physical exam per year per enrolled member.

PRESCRIPTION DRUGS • Ask your doctor if there is a generic version of the medication you’re taking.

• Take advantage of the Generic Prescription Savings Programs at major retailers.

• Ask about free samples from your doctor and/or manufacturer rebates.

HIGH COST SCANS, X-RAYS & TESTS • MRI, PET scans, CT scans, etc. are nearly 2/3 less costly at free-standing, in-network imaging centers than at hospitals.

• Finding an in-network, free-standing imaging center can save you money.

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Kaiser Permanente HMO Plan Kaiser Permanente provides medical care through its own hospitals and health care facilities. All Kaiser Permanente HMO members are encouraged to select a personal care physician (PCP) for preventive care, treatment of illness, and referral to a specialist when needed. You may change or choose your personal care physician (PCP) at any time.

You must live in a Kaiser Permanente service area in CA, CO, DC, GA, MD, OR, VA or WA to enroll in the plan.

All medical care is provided by Kaiser Permanente providers at Kaiser Permanente facilities. Out-of-network care is not covered unless referred by a Kaiser Permanente provider or in the case of an emergency. Emergency care is covered 24/7, worldwide, no referral needed.

MEDICAL PLAN BENEFITS

CALIFORNIA ONLY

CO, DC, GA, MD, OR, VA OR WA

$1,000 $2,000

$1,000 $2,000

20%

20%

$2,000 $4,000

$2,000 $4,000

$20 copay $30 copay No charge

$20 copay $30 copay No charge

Inpatient Hospital Care

20% after deductible

20% after deductible

Outpatient Surgery

20% after deductible

20% after deductible

Emergency Room Care

20% after deductible

20% after deductible

Deductible • Individual • Family

Coinsurance (you pay) Out-of-Pocket Maximum • Individual • Family Physician Services • Primary Physician Visit • Specialist Visit • Preventive Care

Urgent Care

$20 copay

$30 copay

Prescription Drugs – Kaiser Permanente Pharmacy (up to a 30-day supply) • Generic • Brand • Non-Preferred • Specialty

$15 $30 N/A 20% up to $150

$15 $30 $60 20% up to $150

Prescription Drugs – Mail Order (up to a 100-day supply) • Generic • Brand • Non-Preferred • Specialty

$30 $60 N/A 20% up to $150

$30 $60 $120 20% up to $150

My Health Manager My Health Manager is a secure, one-stop resource that helps you stay connected to your health care team from the convenience of your computer, 24 hours a day. You can use My Health Manager mobile to email your doctor’s office, view most test results, schedule or cancel routine appointments, refill most prescriptions, and view your past visits. You can also download a free app to use My Health Manager on your Apple or Android device.

Your Care, Your Way, Connect to Care Get the care you need the way you want it. No matter which option you choose, your providers can see your health history, update your medical record, and give you personalized care that fits your life.

CHOOSE WHERE, WHEN, AND HOW YOU GET CARE 24/7 CARE ADVICE: Get medical advice and care guidance in the moment from a Kaiser Permanente provider.

IN-PERSON VISIT: Same-day appointments are often available.

Sign in to kp.org anytime or call us to schedule a visit.

EMAIL: Message your doctor’s office with nonurgent questions anytime. Sign in to kp.org or use our mobile app.

PHONE APPOINTMENT: Save yourself a trip to the doctor’s office for minor conditions by scheduling a call with a clinician.

Kaiser Permanente Maternity Support Program

VIDEO VISIT: Meet face-to-face online with a clinician on your computer, smartphone, or tablet for minor conditions or follow-up care.

E-VISIT: Get quick online care for minor health problems. Fill out a short questionnaire about your symptoms, and a clinician will get back to you with a care plan — usually within 2 hours.

You’re at the beginning of an incredible journey — and you’ll get an amazing reward at the end. As you prepare to welcome your new baby, we’re here to give you the care and support you need for a happy, healthy pregnancy. You’re bound to have lots of questions, and we have answers, articles, videos, checklists, and resources to guide you through every stage — from a positive pregnancy test, to delivery day, to life with your little one. Get ready for an action-packed 9 months!

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Health Savings Account (HSA) NVA’S HSA PROVIDER IS OPTUM BANK A Health Savings Account (HSA) is an individually-owned, tax-advantaged account that you can use to pay for current or future qualified medical, prescription, dental and vision expenses. You must be enrolled in the UHC HSA plan in order to have an HSA opened on your behalf with Optum Bank. With an HSA, you’ll have the potential to build more savings for health care expenses or additional retirement savings through self-directed investment options.

NVA provides an employer contribution to your HSA, regardless of the amount you contribute. NVA’s contributions are funded to your HSA account following each pay period (based on 26 pay periods). You are not taxed on these contributions, and you may also contribute tax-free dollars to your HSA account. NVA will contribute the following amounts directly into your account: NVA’s Contribution per Month

2021 IRS Contribution Limits (Total Contributions from You and NVA)

Employee Only

$25 ($11.54 per pay period)

$3,600

Employee + Dependent(s)

$50 ($23.08 per pay period)

$7,200

HOW IT WORKS: You may only access up to the balance in your HSA at the time the expense is incurred. For example, you may elect to contribute $500 to your HSA during 2021. If you only have $125 in your account in March and you have a $200 expense, you can only pay $125 of the expense from your HSA.

NEED TO CATCH-UP? Accountholders that are age 55 or older (regardless of when in the year an accountholder turns 55) are eligible to make an HSA catchup contribution of $1,000. (Cannot be enrolled in Medicare. If an accountholder enrolls in Medicare mid-year, catch-up contributions should be prorated.)

ELIGIBILITY You must not be covered by any other medical plan, unless it is also an HSA-eligible HDHP. • • • •

You must not be enrolled in Medicare.

You must not receive health benefits under TRICARE. You must not have received VA benefits within the last three months.

You cannot be claimed as a dependent on another person’s tax return, except as a spouse.

• Neither you nor your covered spouse may participate in a health care flexible spending account, unless it is a “limited FSA” used for dental and vision services only.

LOOK AT THESE ADVANTAGES! If you pay out-of-pocket, you can reimburse yourself!

You can pay for qualified medical, prescription, dental and vision expenses with your HSA Card directly to your provider.

Check out this list of eligible expenses: https://www.optumbank.com/ resources/medical-expenses.html Unused funds will roll over year to year.

Save for retirement! After age 65, funds can be withdrawn for any purpose without penalty (subject to ordinary income taxes).

HSA funds earn interest and investment earnings are tax free.

Check balances and account information via Optum Bank’s Member Website at www.optumbank.com.

You can change your pre-tax contribution during the year by contacting benefits@nva.com.

You can contribute to your HSA via payroll deduction, online banking transfer, or by sending a personal check to Optum.

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Wellness Programs HELP WHEN YOU NEED IT MOST

Talkspace If you are enrolled in NVA’s National UnitedHealthcare or Kaiser Permanente plans, you have free access to Talkspace. Talkspace is an online therapy service that connects you to a dedicated, licensed therapist via private messaging and live video from a secure digital platform. Talkspace works with everyday emotional wellness needs like relationship issues and workplace stress, as well as diagnoses such as depression, anxiety, PTSD, substance use disorders, and most other behavioral health conditions. To enroll in Talkspace go to www.talkspace.com/NVA. Your Talkspace membership includes: • Unlimited text, voice or video messages • Four live video 30-minute sessions per month • Therapists engage with users daily, 5 days per week (or during scheduled live video sessions).

Employee Assistance Program (EAP) With your Employee Assistance Program, confidential assistance is as close as your phone, mobile app or computer. We all need help with life’s challenges now and then. Whether it’s a difficult situation affecting your home life or stress interfering with your work, the EAP is there 24 hours a day, 7 days a week. EAP services are available to all eligible team members and their immediate family members at no cost.

24/7 A LICENSED PROFESSIONAL COUNSELOR CAN HELP YOU WITH: Stress, depression, anxiety, relationship issues, divorce, job stress, work conflicts, family and parenting problems, anger, grief and loss, and more.

ASK OUR WORK/LIFE SPECIALISTS ABOUT:

HELP IS EASY TO ACCESS:

TOLL-FREE 24/7 ACCESS:

Childcare • Elder care Legal questions • Pet care Moving • Buying a car College planning • Financial services Debt Management • And more

Online/phone support: Unlimited, confidential, 24/7

(866) 628-4824 www.GuidanceResources.com Username: LFGSUPPORT Password: LFGSUPPORT1

In-person: You can get up to 5 visits available at no additional cost to you with a Licensed Professional Counselor. Your counselor may refer you to resources in your community for ongoing support.

ClassPass ClassPass is a discounted monthly subscription service that provides you with access to tens of thousands of different studios, gyms, and wellness offerings in over 2,500 cities worldwide. Their digital and in-person classes provide you with options to support your physical and mental health.

Upon signing up for a ClassPass membership on their website, you can purchase credits each month that you use to book classes ranging from yoga to barre to cycling to martial arts – the options are endless! For more information and to sign up go to: https://classpass.com/corporate/nva-8b13 and use code NVA1CP.

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Dental SMILE! QUALITY CARE YOU CAN COUNT ON FROM ROUTINE CHECKUPS TO MAJOR SERVICES You have your choice of two PPO dental plans. Both plans give you the option of going to any dentist you choose, but if you go to a dentist who is a member of the UnitedHealthcare Dental PPO network, you can take advantage of the PPO’s discounted rates and reduce your outof-pocket costs.

The main differences between the High and Low Plans are a higher calendar year maximum ($1,000 vs. $2,000), the amount you pay for services following the deducible, and orthodontia coverage for children is only available with the High Dental Plan. If you are a team member in Texas, Louisiana, Michigan or Montana, you only have the High Plan available.

HIGH PLAN OPTION

In-Network

LOW PLAN OPTION

Out-of-Network

In-Network

Out-of-Network

Calendar Year Deductible

$50 / person $150 / family

$50 / person $150 / family

Calendar Year Maximum Benefit

$2,000 / person

$1,000 / person

Preventive Services • Oral exams • Cleanings • X-rays and lab tests

Plan pays 100%; deductible waived

Plan pays 100% of U&C charge; deductible waived

Plan pays 100%

Plan pays 50% of U&C charge; deductible waived

Basic Services • Fillings • Simple extractions • Oral surgery

Plan pays 80%

Plan pays 80% of U&C charge

Plan pays 90%

Plan pays 50% of U&C charge

Root Canals & Periodontics

Plan pays 80%

Plan pays 80% of U&C charge

Plan pays 60%

Plan pays 50% of U&C charge

Major Services • Crowns • Dentures • Bridges • Implants - High Plan Only

Plan pays 50%

Plan pays 50% of U&C charge

Plan pays 60%

Plan pays 50% of U&C charge

Orthodontic Services

Plan pays 50% Covered only for dependent children to age 19, up to maximum lifetime benefit of $1,000/person

Not covered

HOW TO FIND A NETWORK DENTIST To find a network provider, log in to www.myuhc.com, click on Find a Dentist, and then select the National Options PPO 30 network.

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Vision SEE YOUR WAY TO SAVINGS ON EYE CARE, LENSES, FRAMES AND CONTACTS WITH THE EYEMED VISION PLAN

EYEMED Insight Network

FRAMES Once every other plan year. $130 allowance, 20% off balance.

Extra $25 allowance with Plus Provider

STANDARD PLASTIC LENSES $25 copay

EYE EXAMS, LENSES & CONTACT LENSES

CONTACT LENSES

$130 allowance (Conventional: 15% off balance)

EYE EXAM $10 Copay $0 Copay with Plus Provider

Once every plan year

BENEFITS AVAILABLE

ROUTINE RETINAL SCREENING

(When an in-network provider is utilized)

$39 copay

EYE360 SAVINGS

VISION CARE IS HEALTH CARE

Eye360 provides enhanced benefits when members visit a PLUS Provider—a select group of providers in the EyeMed network.

Eye360 focuses on health, simplicity and savings. Best of all, the perks are built into the vision plan. That means no promo codes or paperwork required.

An annual eye exam not only helps uncover vision correction needs, it can sometimes be the first to detect signs of serious health conditions, such as diabetes, high blood pressure, high cholesterol and eye diseases like glaucoma and cataracts.

Members can also take advantage of special offers and exclusive discounts on glasses, sunglasses, contact lenses and more!

SEEING SAVINGS

• Frames: 20% discount on balance over allowance • Contacts: 15% discount on balance over allowance for conventional contacts • Lasik or PRK from US Laser Network: 15% off retail or 5% off promo price

With Eye360, members receive $0 copay eye exams and additional frame allowances at PLUS Providers—on top of their base plan’s benefits. When combined with other offers and discounts, it adds up to truly eye-opening savings.

Visit www.eyemed.com to locate a provider or to access innetwork online providers (LensCrafters, Target Optical, Ray-Ban, Glasses.com and ContactsDirect).

CHOICE OF PROVIDERS With PLUS Providers nationwide, including independent, retail and online options, members will find plenty of locations nearby.

Out-of-Network benefits are available. Please see EyeMed Summary of Benefits in the bswift library.

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Extra Protection OPTIONS TO HELP COVER YOU AND YOUR DEPENDENTS FOR THE UNKNOWN

Life and AD&D eligible family members when you are first eligible for coverage, you will have to give Lincoln Financial satisfactory evidence of good health before coverage is approved.

Your life and AD&D insurance benefits are some of the most valuable benefits available to you. They are often referred to as “survivor” benefits because they provide financial security to your loved ones if you die or are disabled by an accident or illness. You may purchase coverage in the amounts shown below. If you purchase coverage for yourself, you may also purchase coverage for your family members.

Peace of Mind: If you are already enrolled in NVA’s Life/AD&D Insurance, you may increase your coverage by two increments (up to the Guaranteed Issue amount) during annual Open Enrollment without providing evidence of good health.

When you first become eligible for benefits, you may purchase coverage up to the “Guaranteed Issue” amounts shown below without providing evidence of good health. If you don’t enroll yourself or your

EMPLOYEE LIFE INSURANCE You are able to buy up to $200,000 of voluntary life insurance in increments of $10,000. You cannot buy more than 5x your annual earnings.

The guaranteed issue amount is $200,000 when you are first eligible for coverage.

SPOUSE / DOMESTIC PARTNER LIFE INSURANCE If you purchase coverage for yourself, you are able to cover your spouse/domestic partner with up to 50% of your voluntary life insurance amount, in increments of $5,000. The guaranteed issue is $30,000 when they are first eligible for coverage.

CHILD LIFE INSURANCE You are able to cover your child(ren) with up to $10,000 of voluntary life insurance, in increments of $2,000 as long as you purchase life insurance for yourself.

AD&D INSURANCE AD&D provides an additional benefit if you die or become dismembered due to a specifically covered accident.

If you enroll yourself, spouse/ domestic partner or children in life, you will be enrolled in the equal amount of AD&D.

Critical Illness Plan

Accident Plan

Voluntary critical illness insurance, offered through UnitedHealthcare, is designed to help you offset the costs of certain covered critical illnesses, including cancer, heart attack, major organ failure, and stroke. If diagnosed, you will receive a lump-sum cash benefit that you can use for any expense, including deductibles, copays, transportation, or medical supplies. The plan also provides a $100 wellness benefit. If you purchase coverage for yourself, you may also purchase coverage for your spouse or domestic partner and dependent children. The cost of your coverage will be based on your age and whether or not you use tobacco.

The voluntary accident plan, offered through UnitedHealthcare, pays cash benefits if you suffer an accidental injury. Benefits are payable for ambulance service, hospital care, and both surgical and non-surgical treatment of various injuries. The plan also provides a $100 wellness benefit. If you purchase coverage for yourself, you may also purchase coverage for your spouse or domestic partner and dependent children.

Examples of the lump-sum cash benefits payable: • Emergency Room: $100 • Hospital Care Daily Benefit: $160 • Hospital Admission: $800 • Broken Arm or Wrist: $240 (non-surgical) or $480 (surgical)

• Team Member: May purchase coverage in $5,000 increments, up to a maximum benefit of $25,000 • Spouse/Domestic Partner: May purchase $5,000, $10,000, or $15,000 of coverage • Children: May purchase $2,500 or $5,000 of coverage

The plan also pays a benefit if a covered accident results in death: • Team Member, Spouse/Domestic Partner: $20,000 • Child: $10,000

Portability: These coverages are portable; you can take your policy with you if you change jobs or retire. If you would like to utilize the portability option, you will need to complete the portability forms and return them to NVA’s Benefits Team within 30 days of your separation date. Please contact Benefits@nva.com for applicable forms or visit the library in bswift.

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Income Protection DISABILITY INSURANCE CAN HELP! If sickness or injury prevents you from working for an extended period, you may be eligible for disability benefits.

SHORT-TERM DISABILITY PLAN

LONG-TERM DISABILITY PLAN

Short Term Disability (STD) benefits take away the worry of not being able to work and bring home a paycheck if a non-job-related disability prevents you from working.

The financial consequences of a lengthy disability can be very serious. The LTD plan provides monthly income protection if you become unable to work due to a disabling condition that lasts beyond 90 days.

Elimination Period: 7 days for disability due to an injury or sickness

Elimination Period: 90 days

Benefits begin the 8th day after the elimination period is completed Length of Payment Period: Up to 12 weeks

Length of Payment Period: For as long as you remain disabled or until you reach SSNRA whichever is sooner

60% OF WEEKLY EARNINGS TO A MAXIMUM BENEFIT OF $1,000 PER WEEK

60% OF MONTHLY EARNINGS TO A MAXIMUM BENEFIT OF $10,000 PER MONTH

PRE-EXISTING CONDITION LIMITATION Any injury or sickness for which you received medical treatment or advice (including diagnostic measures) or had drugs or medicines prescribed in the three months prior to the day your STD coverage began. Benefits will not be paid for any disability that begins in the first six months you are covered by the STD plan, if that disability is due to or results from a pre-existing condition.

PRE-EXISTING CONDITION LIMITATION Any injury or sickness for which you received medical treatment or advice (including diagnostic measures) or had drugs or medicines prescribed in the three months prior to the day your LTD coverage began. Benefits will not be paid for any disability that begins in the first 12 months you are covered by the LTD plan, if that disability is due to or results from a pre-existing condition.

Benefits may be reduced by other disability income benefits, such as state disability insurance, sick leave, or unemployment insurance.

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Supporting Your Family Wellness DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT A Dependent Care FSA lets you save money by paying certain dependent care expenses on a pre-tax basis. You may put up to $5,000 per calendar year in the FSA (if your tax filing status is married filing jointly” or “head of household”). You can use the money in this FSA to pay for child day care (for your children age 12 or younger) or care for an adult dependent who is incapable of self-care, so that you—and your spouse, if you are married—can work. If your spouse contributes to a dependent care FSA through his or her employer, your combined contributions may not exceed $5,000. To enroll make your selection in nva.bswift.com.

WEECARE WeeCare provides you access to 24/7 concierge care specialists who will help with your childcare needs. WeeCare will match, setup tours, place and manage your childcare experience so you don’t have to be stressed or worried. Services are available for full-time, back-up, flexi, school aged, and learning pods arrangements. WeeCare will only match you with licensed, verified, experienced daycare providers who will provide a safe home to take care of your children. Children are always placed in a small setting and each provider is required to follow COVID protocols. Go to www.weecare.co/nva for more information.

MetLaw/Hyatt Legal & Identity Theft Protection The MetLaw voluntary legal plan, administered by Hyatt Legal Plans, provides you and your dependents with easy access to a nationwide network of more than 13,000 qualified attorneys. The plan covers a range of legal services, including document review and preparation, estate planning, immigration assistance, family law, debt collection defense, real estate transactions, the preparation of wills and estates, and representation at civil court proceedings. Trials are covered from beginning to end, regardless of length, when using a network attorney.

Additional services, such as representation for personal injury, probate, and estate administration matters, are available at reduced fees. To enroll make your selection in nva.bswift.com.

Pet Insurance PUMPKIN Pumpkin is pet health insurance focused on providing dogs and cats with extensive accident & illness coverage and essential preventive care throughout their lives. If you’d like to insure your pet with Pumpkin, you can receive 10% off the monthly insurance premium for your first pet and 20% off for any additional pets you enroll after that! Please visit pumpkin.care/teams and use code: NVA

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401(k) Plan enhanced NVA encourages team members to save toward their retirement and has established the National Veterinary Associates, Inc. 401(k) Plan to help them do so. The plan offers both a pre-tax 401(k) and an after-tax Roth provision.

Effective, January 1, 2021, NVA will match 25% of the first 4% that you contribute. Match is on pre-tax contributions only. Take a look at the following examples: SALARY

YOUR CONTRIBUTION %

YOUR CONTRIBUTION (IN $)

NVA’S MATCHING CONTRIBUTION

$1,000

1%

$10.00

$2.50

$1,000

2%

$20.00

$5.00

$1,000

3%

$30.00

$7.50

$1,000

4%

$40.00

$10.00

$1,000

5%

$80.00

$10.00

Tip: To ensure you maximize your employer contribution and receive the full match of 1% of your compensation, set your pre-tax employee contribution to 4%. Match is not included on Roth contributions.

You are vested in NVA’s matching contribution at three years of service. You are always 100% vested in your own contributions.

Full-time and Part-time team members of NVA are eligible to participate in the plan. There are no age requirements. You become eligible to enroll in the plan according to the chart below. You can also rollover funds from a previous employer.

NEW HIRE DATE

ELIGIBILITY DATE

9/1 – 11/30

January 1st

12/1 – 2/28

April 1st

3/1 – 5/31

July 1st

6/1 – 8/31

October 1st

Please email 401k@nva.com with any questions. Start saving for your retirement today!

To Enroll: Go to www.retiresmart.com or call Empower Retirement at (800) 743-5274 (M-F, 8am to 8pm ET).

Student Debt Refinancing NVA recognizes that many of our team members may have student debt. To help you pay off your debt as quickly as possible, we have partnered with CommonBond. Refinance your student debt and receive an exclusive $500 bonus just for NVA team members. If you’re interested in refinancing your student debt, please contact CommonBond.

Veterinary Technician Education Discount Program NVA has partnered with a number of veterinary technician schools to offer discounts, so you can grow your career through continuing education. Discounts are offered through Penn Foster College, Colby Community College, and Cedar Valley College. All NVA team members are eligible for discounts at these schools regardless of their hospital’s availability to provide financial sponsorship.

For Penn Foster, you can apply through a link provided by our Learning & Development Team. Colby Community College will give a discount to anyone with an NVA email address.

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Rates (all rates are bi-weekly) MEDICAL

DENTAL

BENEFIT PLAN NAME

COVERAGE TIER

COVERAGE TIER

BI-WEEKLY

Buy-Up PPO

Employee

$135.42

Buy-Up PPO

Employee + Spouse/Domestic Partner

$485.75

Buy-Up PPO

Employee + Child(ren)

$338.41

Buy-Up PPO

Employee + Family

$737.94

Base PPO

Employee

$32.82

Base PPO

Employee + Spouse/Domestic Partner

$356.49

Base PPO

Employee + Child(ren)

$237.84

Base PPO

Employee + Family

$559.59

HSA Plan

Employee

$53.08

HSA Plan

Employee + Spouse/Domestic Partner

$399.36

HSA Plan

Employee + Child(ren)

$271.20

HSA Plan

Employee + Family

$618.75

Dental “High Plan”

Employee

$151.09

HMO

Employee + Spouse/Domestic Partner

$546.19

HMO

Employee + Child(ren)

$414.49

HMO

Employee + Family

$842.52

Employee

$18.54

Employee + Child(ren)

$42.92

Employee + Family

$67.16

Employee + Spouse/Domestic Partner

$36.66

Employee

$11.49

Employee + Child(ren)

$26.60

Employee + Family

$41.63

Employee + Spouse/Domestic Partner

$22.73

VISION Vision Employee

$2.84

Employee + Child(ren)

$5.23

Employee + Family

$8.21

Employee + Spouse/Domestic Partner

$5.47

ACCIDENT Accident

KAISER PERMANENTE CO, DC, GA, MD, OR, VA OR WA HMO

Employee

Dental “Low Plan”

KAISER PERMANENTE CALIFORNIA HMO

BI-WEEKLY

$82.59

Employee

$6.57 $8.71

HMO

Employee + Spouse/Domestic Partner

$395.48

Employee + Child(ren)

HMO

Employee + Child(ren)

$291.18

Employee + Family

$12.52

$630.14

Employee + Spouse/Domestic Partner

$10.38

HMO

Employee + Family

METLAW Legal ID Flat rate

$9.69

WEECARE Concierge Childcare Support Flat rate

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$0.92

Rates CRITICAL ILLNESS BI-WEEKLY- EMPLOYEE

BI-WEEKLY - SPOUSE

UHC

UHC

NON-SMOKER

$5,000

$10,000

$15,000

$20,000

$25,000

$5,000

$10,000

$15,000

Age 24 & Under

$0.76

$1.52

$2.28

$3.05

$3.81

$0.76

$1.52

$2.28

25 - 29

$1.25

$2.49

$3.74

$4.98

$6.23

$1.25

$2.49

$3.74

30 - 34

$1.50

$3.00

$4.50

$6.00

$7.50

$1.50

$3.00

$4.50

35 - 39

$1.87

$3.74

$5.61

$7.48

$9.35

$1.87

$3.74

$5.61

40 - 44

$2.52

$5.03

$7.55

$10.06

$12.58

$2.52

$5.03

$7.55

45 - 49

$3.42

$6.83

$10.25

$13.66

$17.08

$3.42

$6.83

$10.25

50 - 54

$4.57

$9.14

$13.71

$18.28

$22.85

$4.57

$9.14

$13.71

55 - 59

$6.18

$12.37

$18.55

$24.74

$30.92

$6.18

$12.37

$18.55

60 - 64

$8.72

$17.45

$26.17

$34.89

$43.62

$8.72

$17.45

$26.17

65 - 69

$12.65

$25.29

$37.94

$50.58

$63.23

$12.65

$25.29

$37.94

70 - 74

$19.13

$38.26

$57.39

$76.52

$95.65

$19.13

$38.26

$57.39

75 and over

$22.50

$45.00

$67.50

$90.00

$112.50

$22.50

$45.00

$67.50

SMOKER RATES

$5,000

$10,000

$15,000

$20,000

$25,000

$5,000

$10,000

$15,000

Age 24 & Under

$0.78

$1.57

$2.35

$3.14

$3.92

$0.78

$1.57

$2.35

25 - 29

$1.29

$2.58

$3.88

$5.17

$6.46

$1.29

$2.58

$3.88

30 - 34

$1.59

$3.18

$4.78

$6.37

$7.96

$1.59

$3.18

$4.78

35 - 39

$2.10

$4.20

$6.30

$8.40

$10.50

$2.10

$4.20

$6.30

40 - 44

$3.05

$6.09

$9.14

$12.18

$15.23

$3.05

$6.09

$9.14

45 - 49

$4.62

$9.23

$13.85

$18.46

$23.08

$4.62

$9.23

$13.85

50 - 54

$7.02

$14.03

$21.05

$28.06

$35.08

$7.02

$14.03

$21.05

55 - 59

$10.64

$21.28

$31.92

$42.55

$53.19

$10.64

$21.28

$31.92

60 - 64

$16.85

$33.69

$50.54

$67.38

$84.23

$16.85

$33.69

$50.54

65 - 69

$26.65

$53.31

$79.96

$106.62

$133.27

$26.65

$53.31

$79.96

70 - 74

$40.36

$80.72

$121.08

$161.45

$201.81

$40.36

$80.72

$121.08

75 and over

$39.85

$79.71

$119.56

$159.42

$199.27

$39.85

$79.71

$119.56

CHILD RATE

Child-$2,500

Child-$5,000

All eligible ages

$0.219

$0.438

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Rates SHORT-TERM DISABILITY Step 1: Calculate your weekly benefit by dividing your annual earnings by 52. This amount is your weekly earnings. Multiply the weekly earnings by 60% to get your weekly benefit amount.

VOLUNTARY LONG-TERM DISABILITY TABLE AGE RANGE

PREMIUM RATE

0 - 29

$0.152

30 - 34

$0.251

35 - 39

$0.403

40 - 44

$0.632

45 - 49

$0.882

50 - 54

$1.144

55 - 59

$1.459

60 - 64

$1.220

65 - 99

$0.958

70 - 99

$0.828

EMPLOYEE AGE RANGE

LIFE & AD&D PREMIUM RATE

0 - 34

$0.08

35 - 39

$0.12

40 - 44

$0.17

SPOUSE LIFE AND AD&D

45 - 49

$0.24

The estimated monthly premium for life and AD&D insurance is determined by taking the desired amount of coverage (purchased in increments of $5,000) divide by 1,000 then multiplying by the team members age-range premium rate.

50 - 54

$0.41

55 - 59

$0.62

60 - 64

$0.64

Step 2: To get the monthly cost, divide the weekly benefit by 10, and then multiply the amount by $0.629. Bswift will also calculate your costs for you when you are in your enrollment. The bswift calculation is based off your earnings as listed in payroll.

Note: If your annual earnings exceed $86,667, use $86,667 as your earnings in the calculation. Monthly premium costs may be slightly off due to rounding.

LONG-TERM DISABILITY Step 1: To calculate your monthly benefit, divide your annual earnings by 12. This amount is your monthly earnings. Multiply the monthly earnings by 60% to get your monthly benefit amount.

Step 2: To get the monthly cost, divide the monthly earnings by 100, and then multiply the amount by your age-range premium. Bswift will also calculate your costs for you when you are in your enrollment. The bswift calculation is based off your earnings as listed in payroll.

Note: If your annual earnings exceed $200,000, use $200,000 as your annual earnings in the calculation. Monthly premium costs may be slightly off due to rounding.

EMPLOYEE LIFE AND AD&D The estimated monthly premium for life and AD&D insurance is determined by taking the desired amount of coverage (purchased in increments of $10,000) divide by 1,000 then multiplying by your age-range premium rate.

Coverage Amount

CHILD VOLUNTARY LIFE

65 - 69

$1.16

Bi-Weekly Pay Period Cost

Monthly Cost

70 - 74

$2.43

$2,000

$0.18

$0.39

75 - 79

$7.24

$4,000

$0.37

$0.80

80 - 99

$15.60

$6,000

$0.55

$1.19

$8,000

$0.74

$1.60

$10,000

$0.92

$1.99

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Directory of Benefit Providers GET ANSWERS FROM THE EXPERTS BENEFIT

CARRIER

CONTACT

WEBSITE

Medical UnitedHealthcare Plans

Advocate4Me

www.myuhc.com

Maternity Support Program Pharmacy - OptumRX

(866) 844-4864 (PPO’s) (866) 734-7670 (HSA’s) (877) 201-5326 (844) 720-0032

www.myuhc.com www.optumrx.com

California Colorado (Denver/Boulder) Colorado (Northern) Colorado (Southern) MAS (DC Metro) MAS (DC Outside Metro) Georgia Oregon/SW Washington Washington

(800) 464-4000 (303) 338-3800 (844) 201-5824 (888) 681-7878 (301) 468-6000 (800) 777-7902 (888) 865-5813 (800) 813-2000 (206) 630-4636

www.kp.org www.kp.org www.kp.org www.kp.org www.kp.org www.kp.org www.kp.org www.kp.org www.kp.org

Optum Bank

(800) 791-9361

www.optumbank.com

Talkspace EAP - ComPsych

partners-support@talkspace.com (866) 859-4956

www.talkspace.com/NVA www.GuidanceResources.com

Medical Kaiser Permanente Plan

Health Savings Account (HSA) Wellness Programs ClassPass Dental Plans Vision Plan

ClassPass

https://classpass.com/corporate/nva-8b13

www.classpass.com

UnitedHealthcare

(877) 816-3596

www.myuhc.com

EyeMed

(866) 800-5457

www.eyemed.com/member

Life/AD&D and Disability

Lincoln Financial

(800) 423-2765

www.lfg.com

Critical Illness and Accident

UnitedHealthcare

(888) 299-2070

www.uhc.com

FSA - Discovery Benefits WeeCare

(866) 451-3399 (213) 401-4964 Email: benefits+NVA@weecare.co

www.discoverybenefits.com Website: www.weecare.co/nva

MetLife Hyatt Legal

(800) 821 -6400

www.legalplans.com

Pumpkin

(866) ARF-MEOW

pumpkin.care/teams Use Code: NVA

Empower Retirement

(800) 743-5274 Email: rsicmailpic@MassMutual.com

www.RetireSmart.com

CommonBond

(800) 975-7812 Email: nva@commonbond.co/nva

www.cbpartner.co/nva

Family Wellness

Metlaw/Hyatt Legal & Identity Theft Protection Pet Insurance 401(k) Plan Student Debt Refinancing Veterinary Technician Education Discount Program

Email: LD@nva.com

Important Medical Plan Terms Preferred Provider Organization (PPO) – A network of doctors and health care facilities that have agreed to provide services to plan members at discounted rates. You are free to go to any doctor or health care facility you choose, but your out-of-pocket costs will be much lower if you go to a provider in the PPO network.

Deductible – The dollar amount you pay for some services each calendar year before the plan will pay benefits. Copays do not count toward the deductible.

Coinsurance – The percentage of medical costs you pay for some covered services. You will begin paying your share of the coinsurance after you have met your deductible.

Copay – The dollar amount you pay for certain services, such as office visits and prescription drugs, when you go to a network provider.

Out-of-Pocket Maximum – The maximum amount of covered expenses (coinsurance and deductible) you have to pay each calendar year.

Medical and pharmacy copays count toward the out-of-pocket maximum.

Payment of Out-of-Network Benefits – If you go to an out-of-network provider, the plan will pay benefits based on the “reasonable and customary” (R&C) amount—that is, what UHC has determined is an appropriate charge for a particular medical service in your geographic area. That means the plan might pay less than what the out-of-network provider charges. If this happens, the provider will most likely make you pay the difference between the provider’s original bill and the R&C amount covered by the plan. This is called “balance billing.”

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