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BENEFIT GUIDEHomeFrontPartners for a Better Billings2021-2022 BENEFIT GUIDEWelcome to Housing Authority of Billings Employee BenefitsDuring your initial enrollment, all eligible employees have the opportunity to enroll in the following benefits:» Medical» Dental» Vision» Voluntary Life and AD&D» Accident» Cancer» Voluntary Long and ShortTerm Disability*All employees will also receive an employer paid Life and AD&D policy.Enrollment/Change Process» All employees must complete the election form.» All employees must complete a BCBS enrollment form.» All employees must complete the Guardian enrollment form.» All employees who are electing the voluntary life amounts which exceed the guaranteed issue willneed to complete the Evidence of Insurability.» All employees are encouraged to select both a primary and secondary beneficiary info for both basicand voluntary life.Please return all forms to Human Resources

Medical Benefit SummaryInsured by: Blue Cross and Blue Shield of MontanaBenefitsGoldSilver TraditionalSilver HDHPDeductible(plan year) 2,000 Individual 4,000 Family 4,750 Individual 9,500 Family 4,400 Individual 8,800 FamilyCoinsurance80/20%70/30%100/0%Out of Pocket Maximum(includes deductible) 6,000 Individual 12,000 Family 8,400 Individual 16,800 Family 4,400 Individual 8,800 FamilyPrimary Care Office Visit 35 Copay 40 CopaySpecialist Office Visit 65 Copay 65 CopayUrgent Care 50 Copay 50 CopayEmergency Room 350 ParticipatingPreferred Generic 0 Copay 10 Copay 10 Copay 20 CopayGeneric 10 Copay 20 Copay 20 Copay 30 CopayPreferred BrandNon-Preferred BrandSpecialtyDeductible/CoinsuranceCovered 100%; Deductible waivedPreventive CarePrescription BenefitsMedical Deductible AppliesMedical Deductible Applies(Some Preventive Generic 50 Copay 70 Copay 50 Copay 70 Copayprescriptions are available 100 Copay 120 Copay 100 Copay 120 Copaywith no cost sharing) 250/ 350 Copayfor 30-day supply 150/ 250 Copayfor 30-day supply3x Retail Copay for 90-day supplyMail OrderMedical PremiumsGoldSilver TraditionalSilver HDHP 797.70 666.40 710.43Employee Spouse 1,595.40 1,332.80 1,420.86Employee Child(ren) 1,675.17 1,399.44 1,491.90Employee Family 2,472.87 2,065.84 2,202.33Employee OnlyMDLIVEGetting sick is never convenient, and finding time to get to the doctor can be hard. Blue Cross and Blue Shield ofMontana (BCBSMT) provides you and your covered dependents access to care for non emergency medical issuesand behavioral health needs through MDLIVE.Whether you’re at home or traveling, access to a board-certified doctor is available 24 hours a day, seven days aweek. You can speak to a doctor immediately or schedule an appointment based on your availability. Virtual visitscan also be a better alternative than going to the emergency room or urgent care center.Page 2

Dental Benefit SummaryInsured by: GuardianBenefitsIn-Network Coverage 50 Individual 150 FamilyDeductible(calendar year) 1,500Maximum Annual BenefitPreventive100%Basic80%(oral exams, routine cleanings, x-rays, fluoride, sealants)(fillings, simple extractions, x-rays other than bitewings)Major50%(bridges, dentures, crowns, inlays, onlays, anesthesia,endodontics, periodontics, oral surgery)Dental PremiumsTotal PremiumEmployee Only 34.56Employee Spouse 61.42Employee Child(ren) 73.06 111.02Employee FamilyVision Benefit SummaryInsured by: Guardian Network: VSP ChoiceIn-Network CoverageFrequency ofServiceEye Exam 10 Copay12 monthsMaterials 25 CopayBenefitLenses12 months(single, bifocal, trifocal)Covered in fullafter 25 CopayFrames 150 allowance12 monthsContact Lenses 150 allowance12 months(in lieu of glasses)(elective only)Vision PremiumsTotal Premium 9.28Employee OnlyEmployee Spouse 18.57Employee Child(ren) 19.88Employee Family 31.76Page 3

Group Life and AD&D Benefit SummaryInsured by: GuardianHomeFront provides a 20,000 Life and AD&D benefit through Guardian Life Insurance Company to alleligible employees. Spouses are eligible for a 5,000 benefit and children are eligible for a 1,000 benefit.This benefit is at no cost to the employee and provides protection to our valued staff and their employees. Ifyou have any questions on this coverage, please reach out to your HR team.Voluntary Life and AD&D Benefit SummaryInsured by: GuardianBenefit DescriptionEmployeeSpouseDependentLife BenefitUp to 300,000Up to 250,000 notto exceed 100% ofemployee coverageUp to 10,000 not to exceed100% of employee coverageIncrements 10,000 5,000 1,000 25,000 to age 65 10,000 age 65-70 0 age 70 Age 65: 35%Age 70: 60%Age 75: 75%Age 80: 85% 50,000 to age 65,then 10,000Guarantee IssueReduction ScheduleMatches LifeAD&D Benefit*Employee must elect coverage for spouse and dependents to be eligible.Voluntary Life Rates 30Rate per 1,000 coverage(including AD&D) 0.09630-34 0.10535-39 0.13040-44 0.17445-49 0.26350-54 0.41455-59 0.58260-64 0.73765-69 1.30770 2.437Children 0.176AgePage 4N/AN/A

Voluntary Short & Long Term Disability Benefit OverviewInsured by: GuardianBenefit DescriptionBenefit MaximumElimination PeriodDuration of BenefitsMinimum BenefitPre Existing LimitationDisability DefinitionShort TermLong Term60% to 1,200 weekly7 days12 weeksNone3/1260% to 5,000 monthly90 daysSSNRA 503/122 year own occupation,then any occupationown occupationVoluntary STD & LTD RatesAge 2525-2930-3435-3940-4445-4950-5455-5960 STD Premium per 10weekly coverage 0.560 0.560 0.790 0.790 1.190 1.190 0.910 1.020 0.580LTD premium per 100covered payroll 0.160 0.200 0.400 0.660 0.970 1.360 1.860 2.090 1.820On/Off Job Accident CoverageInsured by: GuardianAccident insurance provides coverage for the unexpected. This coverage can be elected for employees, their spouses,and eligible dependents. There are 3 tiers of accident coverage and each one pays out a different amount dependingupon the situation.This coverage is not tied to your medical insurance in any way and proceeds from an accident may be used in anyway you see fit. You can use the money to pay for deductibles and coinsurance amounts or you can use the funds topay bills or any other item you may need to pay.The Accident plan also has a 50 Wellness Benefit.Employee OnlyEmployee SpouseEmployee Child(ren)Employee FamilyValue PlanAdvantage PlanPremier Plan 12.18 19.79 20.14 27.75 15.88 25.44 25.59 35.15 19.67 31.21 30.94 42.48Worksite Cancer Benefit SummaryInsured by: USAble LifeCancerCare Elite provides supplemental coverage when certain losses occur as a result of cancer or a coveredspecified disease, and is available to you and your eligible family members with a choice of three plans. Benefitsare paid directly to you regardless of other insurance coverage. The choice of three plans provides different levels ofcoverage for hospital confinement, radiation/chemotherapy/blood transfusions, and surgery/anesthesia.Page 5

Flexible Spending Account (FSA)Insured by: Allegiance Benefit Plan ManagementHomeFront offers both a Heath Flexible Spending Account and a Dependent Care Flexible Spending Account.The Health Flexible Spending Account (FSA) allows you to pay for eligible medical expenses on a pre-tax basis.You elect to have a specified amount deducted from your paycheck each pay period to pay for these expenses. Themaximum Health FSA annual contribution is 2,750.The Dependent Care Flexible Spending Account allows you to pay for out-of-pocket, work-related dependent careexpenses with pre-tax dollars. The maximum dependent care limit is 5,000 ( 2,500 if married filing separately).Health FSA allows a 550 carryover, however for dependent care, any unused funds will be forfeited at the end ofthe year. Your FSA runs on a plan year and elections must be made in December for January 1.Health Savings Account (HSA)A Health Savings Account (HSA) is an account funded by pre-tax contributions which can be used for eligiblemedical, dental and vision expenses. Unlike the Health FSA, funds roll over from year to year and remain with theemployee if they leave Housing Authority. HSA’s are individually owned accounts and Housing Authority will nothave an employer sponsored HSA, however there are several local banks that offer them.An HSA can ONLY be used if you are enrolled in the Silver 4,200 HDHP Plan.There are some exclusions. You cannot have an HSA if:» You are on a non-qualified, non-HDHP health plan, even if you are also covered on an HSA-qualified plan.» You or your spouse have a Health Flexible Spending Account (FSA).» You are enrolled in Medicare (including Part A).» You have used VA benefits in the past 3 months.» You can be claimed on someone else’s tax return.If you have a question as to whether or not you qualify for an HSA, please contact your PayneWest representative.HSA Contribution Limits20212022Employee Only 3,600 3,650Employee 1 or more 7,200 7,300Age 55 Catch-up Contribution 1,000 1,000Employee Assistance Program (EAP) Benefit OverviewAdministered by: IBH WorkLifeMattersYou and your family members have free, 24/7 access to licensed professionals for personal, relationship, familyand professional concerns. If needed, you are also eligible for up to three face-to-face sessions per member, peryear. Other available services include: Three (3) face-to-face consultations. Legal consultation. Unlimited telephone counseling Childcare, elder care, and family planning resourcesPage 6

Pre-Tax Savings OptionsHomeFront offers ways to help you and your family save money by offering various pre-tax savings optionsto help pay for future qualified expenses. What are the differences between a Medical Flex, Dependent CareFlex, and a Health Savings Account?What is it?Who is eligible?Who owns the account?What are the 2021annual contributionlimits?Who funds the account?Can unused funds berolled over from year toyear?Can I take my accountbalance with me if Ileave the company?Health FlexibleSpending Account (FSA)Dependent Care FlexibleSpending Account (FSA)Health Savings Account(HSA)Use pre-tax dollarsto pay for qualifiedmedical, Rx, dental, andvision expenses for youand your dependents.Use pre-tax dollars topay for eligible expensesrelated to care for yourchild, disabled spouse,elderly parent or otherdependent so you (andyour spouse) can work.Use pre-tax dollars topay for qualified medical,Rx, dental and visionexpenses for you andyour dependents.All employees unlessenrolled in the HDHP.Dependent care flex isavailable to all employeeswhether on the plan ornot.Employees enrolledin the HDHP.Your employer,but it's your moneyYour employer,but it's your moneyIndividualEmployee 2,750 5,000( 2,500 if filingseparately) 3,600 Individual 7,200 Family 1,000 Catch UpContribution (Age 55 )Employees can contribute pre-tax dollars through payroll deductions. 550 may be carriedover from the prior year.No. Subject to"Use it or Lose it" rule.YesNoNoYesCan I pay for nonqualified expenses?NoN/AYes, but the amount istaxed as income andincurs a 20% penalty (nopenalty if distributed afterdeath, disability, or age65)Do I get a debit card touse for expenses?YesNoYesHow do I manage myaccounts?Manage your account(s), submit claims, uploadreceipts and set up reimbursement all on theAllegiance websitewww.askallegiance.comThen select the “Submit a Claim” optionPage 7Manage account at abank of your choice.