Benefits Presentation

July 1, 2025

Who is Eligible for Benefits?

Full-time active employees working 30 hours or more per week

• Benefits are effective first of the month following 60 days of employment

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Eligible Dependents

• Spouse
• Legal Spouse
• Children
• Children up to age 26
• Natural children, stepchildren, foster and legally adopted children
• Children under your legal guardianship

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Qualifying Life Events�Changing Benefit Elections

Qualifying life events include but are not limited to:

• Birth or adoption of a child
• Marriage or divorce
• Death of a dependent
• Dependent’s loss of eligibility
• Change in spouse employment
• Loss or gain of other health coverage

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You have 31 days to contact HR and submit required documentation

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Enrollment

• This year’s enrollment will be passive, meaning that you will be auto enrolled in the same benefits you currently have
• If you wish to be enrolled in the Health Savings Account (HSA) or the Flexible Spending Account (FSA), you MUST go into MyEnroll and complete the enrollment process
• Benefits will also remain bundled for health benefits effective July 1, 2025
• Medical, Dental, Vision & Basic Life/AD&D

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BAS Enrollment Platform

Enrollment will be handled online via myenroll.com. Please see your local HR representative for additional details if you need assistance to login.

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Open Enrollment: May 15, 2025 – May 30, 2025

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PPO Plan 1 Medical / Rx Plan Options

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Annual Deductible

• $1,000 Individual / $2,000 Family (In-Network)
• $2,000 Individual / $4,000 Family (Out-of-Network)

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Out-of-Pocket Maximum

• $3,000 Individual / $6,000 Family (In-Network)
• $5,100 Individual / $15,250 Family (Out-of-Network)

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Plan Coinsurance

• 20% Member responsibility In-Network
• 40% Member responsibility Out-of-Network

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In-Network Copays

• $25 Office Visit
• $25 Specialist
• $25 Urgent Care
• $100 + 20% Coinsurance Emergency Room

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Preventive Care

• 0% Member responsibility In-Network
• 40% Out-of-Network

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Prescription Drugs

30-Day Retail Copays:

• $4 Generic
• $34 Formulary Brand
• $64 Non-Formulary Brand

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Mail Order / 90-Day Retail Copays:

• 2x Retail

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PPO Plan 2 Medical / Rx Plan Options

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Annual Deductible

• $1,500 Individual / $3,000 Family (In-Network)
• $3,000 Individual / $6,000 Family (Out-of-Network)

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Out-of-Pocket Maximum

• $4,500 Individual / $9,000 Family (In-Network)
• Unlimited Out-of-Network

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Plan Coinsurance

• 30% Member responsibility In-Network
• 60% Member responsibility Out-of-Network

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In-Network Copays

• $30 Office Visit
• $45 Specialist
• $300 + 30% Coinsurance Emergency Room

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Preventive Care

• 0% Member responsibility In-Network
• 60% Member responsibility Out-of-Network

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Prescription Drugs

30-Day Retail Copays:

• $10 Generic
• $45 Formulary Brand
• $85 Non-Formulary Brand

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Mail Order / 90-Day Retail Copays:

• 2.5 Retail

HDHP Plan 3 Medical / Rx Plan Options

Annual Deductible

• $5,000 Individual / $10,000 Family (In-Network)
• $10,000 Individual / $20,000 Family (Out-of-Network)

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Out-of-Pocket Maximum

• $6,850 Individual / $13,700 Family (In-Network)
• $13,700 Individual / $27,400 Family (Out-of-Network)

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Plan Coinsurance

• 30% Member responsibility In-Network
• 60% Member responsibility Out-of-Network

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Preventive Care

• 0% Member responsibility In-Network
• 60% Member responsibility Out-of-Network

Prescription Drugs

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HDHP Copay / Coinsurance (30 day Retail):

• 30% Coinsurance Generic
• 30% Coinsurance Formulary Brand
• 30% Coinsurance Non-Formulary Brand

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HDHP Copay / Coinsurance (Mail Order/Retail 90)

• 30% Coinsurance

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Health Savings Account (HSA)�Offered with HDHP Plan 3

• An HSA account helps pay for qualified medical expenses or invest for future healthcare expenses through pre-tax contributions and/or company contributions to fund the account.
• You must be enrolled in the CEBG HDHP Medical Plan.
• You are eligible to enroll and/or contribute to an HSA if:
• You elect the CEBG qualified high-deductible health plan (HDHP)
• Your only coverage is an HDHP
• If you are covered under your spouse’s plan and that plan is not a qualified HDHP, you are not eligible to contribute to an HSA.
• You are not covered by a traditional Healthcare FSA through your spouse.
• You are not covered by Medicare (part A & B), Tricare, or VA benefits
• You cannot be claimed as a dependent on another person’s tax return (unless it’s your spouse).

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Health Savings Account (HSA)�Contributions

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CEBG Annual Contributions

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Employee Only: $1560

Employee + Spouse: $1560

Employee + Child(ren): $1560

Family: $1560

IRS Maximum Contributions for 2025

(Includes employee and employer contributions)

Individual: $4,300

Family: $8,550

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Those employees who are or will be age 55 in 2025 can contribute an additional $1,000.

The IRS limits the maximum contribution of employee and employer contributions each year.

Reminder: Enrollment does not carry forward year-to-year. You MUST make an election each year during Open Enrollment.

Flexible Spending Account (FSA)�Offered with PPO Plan 1 & PPO Plan 2

• Set pre-tax money aside to pay for healthcare-related expenses on a pretax basis
• The flexible spending account can be used for Medical, Prescription, Dental & Vision expenses you incur throughout the year
• When are my funds available?
• Your total contribution amount will be front loaded into your account by your Diocese and immediately available for use. However, your contributions are deducted in equal installments from each paycheck throughout the year.
• What happens if I don’t use the money during the year?
• The FSA will allow you to automatically carry over up to $660 of any balance at the end of your plan year to utilize during the July 1, 2026 plan year.

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Contributions for 2025

Minimum: $120

Maximum:$3,300

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Reminder: Enrollment does not carry forward year-to-year. You MUST make an election each year during Open Enrollment.

Pharmacy Benefits

When you enroll into the medical plan you will be automatically enrolled into the pharmacy coverage as well

• You will pay the applicable co-pay for your drug depending on what tier your prescription falls into (generic, preferred brand, non-preferred brand, or specialty)
• NetResults is your formulary/pharmacy network. List can be found online at www.primetherapeutics.com/member/documents
• Prime Therapeutics Pharmacy has a national pharmacy network including most large retail chains as well as Walgreens and CVS
• To check if your prescription is covered under the pharmacy plan, check your formulary or contact Prime Therapeutics Pharmacy at the number on the back of your ID card

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Pharmacy Benefits

Specialty Pharmacy through Prime Therapeutics Pharmacy provides specialty medications and some clinical support for complex conditions, including cancer, arthritis, and others.

How to get started:

1. Enroll online! Visit www.primetherapeutics.com/specialtypharmacy for the Specialty Patient Enrollment Form.
2. Ask your doctor to send your prescription to Prime Therapeutics Specialty Pharmacy.
3. Prime Therapeutics will call you to help schedule your first delivery.

Alternatively, you can call Prime Therapeutics Specialty Pharmacy at the number below and they will coordinate with your doctor to get a new prescription.

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Prime Therapeutics Specialty Pharmacy: 866.554.2673

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Pharmacy Benefits

You could save time and money by getting maintenance medications by mail through Prime Therapeutics Home Delivery Pharmacy. Enroll in Prime Therapeutics Home Delivery Pharmacy to get up to a three-month supply of the medications you take regularly.

How to fill your first prescriptions –

If you already have a 90-day prescription:

Mail your 90-day prescription and home delivery order form with payment information to Prime Therapeutics Pharmacy, P.O. Box 620968, Orlando, FL 32862, or call 800.424.8274

Home delivery order forms are available at www.primetherapeutics.com/homedelivery

If you need a new prescription:

First, ask your prescriber to send your prescription to Prime Therapeutics Pharmacy. Prescribers can submit new prescriptions through one of three ways:

1. ePrescribe to Prime Therapeutics Pharmacy LLC.

2. Fax the prescription to 888.282.1349.

3. Call the prescription in to 800.424.8274.

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Prime Therapeutics Home Delivery Pharmacy: 800.424.8274 (TTY 711)

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Virtual Visits - MDLive

MDLive can be used in urgent, non-emergent situations like:

• Allergies
• Cold/Flu
• Nausea
• Headaches
• Sinus Infection

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HOW TO ENROLL

There are several ways to activate your account and set up a consultation:

• Visit Blue access for members or www.MDLIVE.com/bcbstx
• Download the MDLIVE app from Apple’s App Store or Google Play for Android
• Call MD Live at 888.680.8646
• Text BCBSTX to 635.483

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Convenient way for employees and their dependents to interact with a doctor via live, two-way video on their computer or mobile device.

COST

• PPO Plan 1: $25 Copay
• PPO Plan 2: $30 Copay
• HDHP Plan: Deductible/Coinsurance

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BCBSTX Additional Programs

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Dental Insurance�Administered by Guardian

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Annual Deductible

• $25 per person; max of 3 per family

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Annual Maximum

• $1,500 per person

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Preventive (Type A)

• 100% Negotiated Rate

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Basic (Type B)

• 80% Negotiated Rate

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Major (Type C)

• 50% Negotiated Rate

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Orthodontia

• Dependents Under Age 19 Only
• $1,500 Lifetime Maximum

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Exams, Cleanings, Periodontal Surgery

• 2 Per Calendar Year

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Fluoride Treatment (to age 19)

• 2 Per Calendar Year

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Periodontal Maintenance

• 4 Per Calendar Year

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Full Mouth X-Ray

• 1 in 5 Calendar Years

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Sealants (to age 16)

• 1 per tooth in 3 Calendar Years

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Inlay/Onlay, Crowns, Dentures, Bridges

• 1 in 5 Calendar Years

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Preventive (Type A) services do not apply to your Annual Maximum benefit.

Vision Insurance�Administered by VSP

Exam

• $10 (In-Network)
• Up to $45 (Out-of-Network)

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Frames

• $130 Allowance (In-Network)
• Up to $50 (Out-of-Network)

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Single / Bifocal / Trifocal

• $15 Copay (In-Network)
• Up to $30 / $50 / $60 (Out-of-Network)

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Conventional Contact Lenses

• $130 Allowance (In-Network)
• Up to $100 (Out-of-Network)

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Exam and Lens Frequency

• Every 12 months

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Frames Frequency

• Every 12 months

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Life Insurance�Administered by Guardian

Employee Basic Life and Accidental Death and Dismemberment (AD&D)

• Catholic Employee Benefit Group pays for Basic Life and AD&D coverage of $25,000 at no cost to you

Optional Life Coverage

• Optional Life for employees is available in $10,000 increments up to $250,000
• Optional Spouse Life insurance is available in $10,000 increments up to $130,000, not to exceed 50% of employee amount
• Dependent Child Life insurance available
• Infant (birth to 14 days) - $1,000
• Children (14 days to 26) - $10,000

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Employee Assistance Program (EAP)

An EAP is one of the most effective ways to identity and address personal problems. Through the EAP, you can access convenient and confidential services at no cost to help you and your family reach your personal and professional goals. Your EAP can assist with many common concerns such as:

• Stress management
• Legal consultations
• Financial management
• Depression/anxiety
• Relationships and communication
• Grief/loss
• Substance use
• Career development
• Life phase adjustments
• Child/elder care
• Healthy living

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Call: 800.324.2490 for additional information/assistance

Open Enrollment Action Items

Log into BAS via MyEnroll

• Check your legal address confirming it is correct
• Designate your beneficiary information for your Life Insurance Plan(s) if you have not already done so
• Review your plan elections and make changes if necessary

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Open Enrollment: May 15, 2025 – May 30, 2025

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