2026-2027_employee_benefits_guide.pdf

Document Date unknown · 53 page(s) in the original

This is the document's text, extracted automatically. Headings and paragraphs are inferred from the original's layout, so the arrangement may differ from the published version — the words do not. Where it matters legally, the original governs.

Original document ↗

Town of Centreville Employee Benefits Guide Plan Year: July 1, 2026 - June 30, 2027 Human Resources Department Email: hr@townofcentreville.org Table of Contents Welcome Message 2 Eligibility 3 Key Dates & Reminders 4 Provider Directory 5 New This Year 6 Employee Per Pay Cost 7 Benecon Cost Containment (ConnectCare 3) 9 Medical & Prescription Plan Highlights 10 Medical Coverage Overview 12 Cigna Membership Information 13

Employee Assistance Program (EAP) 15 Dental Plan Benefits 17 Vision Plan Benefits 18 Flexible Spending Accounts (FSA) 19 Life & AD&D Insurance 23 Short Term & Long Term Disability Benefits 24 Holidays and Leave 26 Maryland State Retirement and Pension System 27 Deferred Compensation 29 Retiree Health Reimbursement Arrangement Stipend 30 YMCA Gym Membership 32 Important Notice About Your Prescription Drug Coverage & Medicare 33

Required Federal Notices 37 Disclaimer 46 How to Enroll 47 Employee Portal (CHR) 52 Benefits Summary 2026 - 2027 1 Welcome Message The Town of Centreville (“Town”) takes pride in offering a comprehensive and competitive benefits package to our employees. The Town, through all our benefits partners, offers you a benefits program that allows choice and flexibility.

Through this guide, you can select benefits that work best for you and your family.

2026-2027 Plan Year Benefits will be effective for the July 1, 2026 – June 30, 2027, plan year.

The Town continues to evaluate ways to improve the quality of your healthcare and keep our health plans competitively priced, while controlling costs for you and the Town. We encourage staff to become and remain engaged in these efforts by being educated on the plans and using them wisely. Be sure to participate in Employee Wellness programs and activities, and partner with your physician to get appropriate preventive screenings.

Also, consider programs like mail order pharmacy and generic prescriptions to lower your copays and overall plan costs.

When reviewing your benefits, please be aware of the difference between the following terms:

Calendar Year – runs from January 1 to December 31 and resets each January 1.

Plan Year – Town benefit plan year, which runs from July 1 to June 30.

Every 12 months – a rolling 12 months that begins on the date of your most recent service.

Take time to review available plan options before selecting. Consider the benefits and costs carefully to choose a package that meets your and your family's needs throughout the year.

For specific plan details, check the guide sections or the Provider Directory section. You can also email Human Resources at hr@townofcentreville.org to request the specific plan document.

Benefits Summary 2026 - 2027 2

ELIGIBILITY

Employees Making Changes All Town employees, as defined by the The benefits plan year runs July 1 through Town of Centreville, are benefits eligible June 30. You will not be able to make (full-time and permanent part-time changes to your elections during the plan employees who normally work 20 or more year unless you or one of your dependents hours a week). Please check each benefit experience a qualified change-in-status

for details.

event. If you do not experience a qualified change-in-status event, the elections you Dependents make and their related payroll deductions will remain in effect through June 30, In addition to enrolling yourself, you may 2026.

also enroll any eligible dependents. Eligible dependents are defined below:

You must notify the Human Resources Department within 30 days of the qualified Spouse: a person to whom you are legally married by ceremony. change-in-status event in order to make a change to your benefit elections.

Dependent Children: your biological, Documentation supporting the change will adopted, or legal dependents up to age 26 be required.

regardless of student, financial, and marital status.

What is a qualified change-in-status event?

Marriage or Divorce Change in employment status for you, your spouse, or your dependent child Birth, Adoption, or Death Eligibility for or loss of other coverage due to your spouse's Open Enrollment period, or loss or gain of benefit eligibility ➡ It is important to take time to review the plan options available to you prior to making your selections. Consider each benefit and the associated costs

carefully and choose the benefits package that will meet your and your family's needs throughout the year.

Benefits Summary 2026 - 2027 3 Key Dates Important Reminders Open Enrollment - May 13 - May 27 Qualifying Life Events Open enrollment is held annually in May. Supporting documentation may Benefit elections become effective July 1. be required and changes must typically be submitted within 30 days of the event.

New Hire Deadline Dependent Verification Newly eligible employees must enroll within 30 Employees may be required to days of becoming eligible. provide documentation verifying dependent eligibility.

Payroll Deduction Start Preventive Care Benefit deductions begin on the first payroll In-network preventive care following coverage effective dates. services are generally covered MD FAMLI payroll contributions beginning at 100% under the medical January 1, 2027. (More info to come) plan.

Benefits Summary 2026 - 2027 4 Provider Directory Benefit Provider Phone Number Website/Email Medical and Cigna 1-800-244-6224 www.mycigna.com Prescription Dental United Concordia 1-800-332-0366 www.unitedconcordia.com NVA (National Vision Vision 1-800-672-7723 www.e-nva.com Administrators, LLC) Flexible Spending CareFlex 1-888-577-2762 mycareflex.wealthcareportal.com Account (FSA/DCA) Life and Disability OneAmerica Financial 1-800-553-5318 www.oneamerica.com

Cigna 877-622-4327 www.mycigna.com Employee Assistance Program (EAP) OneAmerica 855-387-9727 guidanceresources.com Accident, Cancer, AFLAC 410-463-4162 matthew_pastva@aflac.com Hospital, Critical Care Maryland State Retirement Retirement 410-625-5555 sra.maryland.gov (mySRPS) and Pension System CBIZ 610-891-1677 rory.glackin@CBIZ.com Deferred Corebridge Financial 410-859-2164 adam.grace@corebridgefinancial.com

Compensation MissionSquare 202-962-3495 csorokos@missionsq.org Questions?

You can obtain information by contacting the Human Resources Department or our benefit providers directly.

Benefits Summary 2026 - 2027 5 New This Year You can now use your NVA vision benefits online with UVP and purchase premium eyewear from the comfort of your home! (See Vision Benefits for more info) OneAmerica is our new Life Insurance Carrier. Life benefits have not changed and new this year, OneAmerica offers EAP and Travel Assistance. (See Life Benefits for more info) Health Holidays are coming! - The Town received over $60k in health surplus

because of lower claim costs! (Great job in maintaining preventive care and continuing to strive for a healthy lifestyle!). The Council approved to give those funds back to employees by paying for their health insurance premiums as described below:

Hourly and Salary employees will not pay their health insurance premiums on the following check dates:

12/04/2026 12/18/2026 Upcoming benefit: Maryland Paid Family and Medical Leave Insurance (FAMLI) Program (Effective January 1, 2028) More information will be emailed.

Benefits Summary 2026 - 2027 6 Employee Per Pay Cost (24 Pays) Medical Rates FY27 Plan Monthly Contract Town Pays for Eligible Employee Bi-Weekly Cost Eligible Employees Pays Deduction OAP Gold Plan 85% 15% Employee $1,277.51 $1,085.88 $191.63 $95.81 Employee + $2,938.83 $2,498.01 $440.82 $220.41 Spouse Employee + $2,363.17 $2,008.69 $354.48 $177.24 Child(ren) Family $3,577.56 $3,040.93 $536.63 $268.32

Deductible - Up to $1,300 $0 $0 Employee Deductible - Up to $2,600 $0 $0 Family OAP Silver Plan 85% 15% Employee $1,132.14 $962.32 $169.82 $84.91 Employee + $2,604.48 $2,213.81 $390.67 $195.34 Spouse Employee + $2,094.25 $1,780.11 $314.14 $157.07 Child(ren) Family $3,170.49 $2,694.92 $475.57 $237.79 Deductible - Up to $2,000 $0 $0 Employee Deductible - Up to $4,000 Family The Town established a Health Reimbursement Account (HRA) and contributes up to 100% to

pay for your eligible out-of-pocket expenses during the plan year.

Benefits Summary 2026 - 2027 7 Dental Rates FY27 Plan Monthly Cost Town Pays for Eligible Employee Bi-Weekly Eligible Employees Pays Deduction United Concordia - Medium 85% 15% Employee $29.90 $23.75 $6.15 $3.08 Family $94.34 $74.94 $19.40 $9.70 Vision Rates FY27 Plan Monthly Cost Town Pays for Eligible Employee Bi-Weekly Eligible Employees Pays Deduction NVA - Vision 85% 15% Employee $4.70 $4.00 $0.70 $0.35

Family $11.73 $9.97 $1.76 $0.88 Benefits Summary 2026 - 2027 8 The ConnectCare3 Benefit What is ConnectCare3?

ConnectCare3 is a confidential benefit provided to employees and their dependents covered under the health plan at no additional cost. ConnectCare3 has no affiliation with any insurance carrier or hospital system. We aim to provide callers with positive health outcomes on their health and wellness journey.

Available Services Patient Advocacy The patient advocates are the first line of contact when reaching out to ConnectCare3. They also assist our clinical team with conducting research.

Nurse Navigation The nurse navigators are available to work with patients who have received a medical diagnosis that requires a specialist. Our nurses can provide education on a diagnosis and treatments, physician options, and can help patients prepare for physician appointments.

Chronic Disease Management & Prevention The Chronic Disease Management & Prevention team consists of registered nurses, certified health coaches, and registered dietitians. Our team approach to preventing and managing chronic conditions provides you with access to resources and expertise all in one place.

Nutrition Education Our registered dietitians will help patients to understand the connection between diet and health by completing a thorough nutritional assessment and providing healthy meal plans and alternatives.

Tobacco Cessation Work one-on-one with our Tobacco Cessation coaches to achieve and maintain a tobacco-free life.

How to Enroll Contact us at 877-223-2350 or info@connectcare3.com to enroll in our services today.

For more information, visit connectcare3.com ©2023 ConnectCare3,LLC - AllRightsReserved Benefits Summary 2026 - 2027 9 Medical & Prescription Plan Highlights The chart below highlights your costs for some of the services available to you under the medical plan. For full plan details, please refer to your Cigna plan summaries.

Silver Plan Gold Plan Plan Features In-Network ONLY YOU PAY In-Network ONLY YOU PAY Plan Network Open Access Plus Open Access Plus Referrals for Specialist No No Primary Care Physician Required No No Annual Deductible $2,000 Individual $1,300 Individual Amount covered by the Town per $4,000 Family $2,500 Family plan year before the plan begins to (Employee pays $0) (Employee pays $0) pay benefits for certain services.

Annual Out-of-Pocket Maximum $6,000 Individual $2,600 Individual $6,850 Individual-In a Family $5,200 Family $12,000 Family Preventive Care Services $0 $0 Office Visits, Labs, and Testing Primary Care Physician Office Visits 10% coinsurance $0 Specialist Office Visits 10% coinsurance $0 Diagnostic X-Rays 10% coinsurance $0 Mental Health/Substance Abuse 10% coinsurance $0 Office Visits Emergency Care, Urgent Care, and

Hospitalization Emergency Room 10% coinsurance $0 Urgent Care 10% coinsurance $0 Inpatient Hospitalization 10% coinsurance $0 Outpatient Surgical Facilities 10% coinsurance $0 Prescription Drugs - In-Network Only Annual Deductible None Benefits Summary 2026 - 2027 10 Retail 30-Day Supply $10 copay $10 copay Tier 1: Generic $40 copay $40 copay Tier 2: Preferred Brand $75 copay $75 copay Tier 3: Non-Preferred Brand

Retail 90-Day Supply $25 copay $25 copay Tier 1: Generic $100 copay $100 copay Tier 2: Preferred Brand $188 copay $188 copay Tier 3: Non-Preferred Brand Home Delivery (per 90-day supply) $25 copay $25 copay Tier 1: Generic $100 copay $100 copay Tier 2: Preferred Brand $188 copay $188 copay Tier 3: Non-Preferred Brand This chart is intended for comparison purposes only. If there are any discrepancies, the plan

document will govern.

Summary of Benefits and Coverage (SBC) Choosing a health coverage option is an important decision. To help you make an informed choice, a Summary of Benefits and Coverage (SBC), which summarizes important information in a standard format, is available for review. If you are currently enrolled, you will be provided with a copy of the SBC for the plan in which you are currently enrolled in connection with Open Enrollment. If you are a new hire and

enrolling for the first time, you will be provided with a copy of the SBC for each medical plan option with your benefits enrollment materials.

Benefits Summary 2026 - 2027 11 Medical Coverage Overview Keeping you and your family in good health The Town of Centreville cares about your health and wellbeing. The health benefits available to you represent a significant component of your compensation package, and they provide important protection to keep you and your family in good health. Employees have the option to enroll in either the HRA OAPIN Silver or the HRA OAPIN Gold Plan Need to locate a participating

through Cigna. provider?

None of the plans require you to choose a Primary Care Physician (PCP) Go to www.cigna.com and select or obtain a referral to see a specialist. The Silver and Gold plans require “Find a Doctor.” Choose your that you see an in-network provider in order to receive benefits. search location and select your medical plan option to search for a participating provider near you.

Choosing the right type of care Your doctor knows best Your personal physician best understands your health.

Having a personal physician can result in overall better care.

Save money with generic drugs But what if you get sick or injured when your doctor’s office is closed?

Ask your doctor if it’s Cigna Members: 24/7 medical advice appropriate to use a generic Health Information Line: get advice on a diagnosis or where to receive drug rather than a brand drug.

care (1-800-244-6224). Generic drugs contain the same Cigna Telehealth Connection: access virtual doctor visits for common, active ingredients and are uncomplicated, non-emergency health issues. Refer to the next page identical in dose, form and for more details. administrative method as a brand name, but cost less.

Urgent Care Centers Urgent care centers are usually open after normal business hours, including evenings and weekends.

Many urgent care centers offer on-site diagnostic tests.

In most situations, you’ll find that you save time and money by going to urgent care instead of the Emergency Room. Make sure that the urgent care center you select is in the network!

Emergency Room (ER) ERs are the best place for treating severe/life-threatening conditions.

ERs provide the most expensive type of care.

Benefits Summary 2026 - 2027 12 Cigna Membership Information myCigna.com Cigna Mobile App When you’re better informed, you make better choices. The myCigna mobile app gives you Cigna’s personalized website, www.mycigna.com, provides an easy way to organize and access to your plan information, as well as many online access your important health tools with information to help you make more informed information - anytime, anywhere.

health decisions. Want to find out how to improve your Download the free app and gain fitness or eat better? Cigna’s online tools can help you stay instant access to multiple active and take care of your health. services.

24/7 Medical Advice Cigna Telehealth Good news! Your Cigna medical plans provide you with access to two telehealth services: American Well (AmWell) and MDLive. This service is called Cigna Telehealth Connection: telehealth services designed to offer you greater control when you need to see a doctor.

With Cigna Telehealth Connection, you can get the care you need - including most prescriptions - for a wide range of minor conditions. You can connect with a board-certified doctor when, where, and how it works best for you - via video or phone - without having to leave home or work.

AmWell and MDLive televisits can be a cost-effective alternative to a convenience care clinic or urgent care center, and cost less than going to the emergency room. Costs are the same as a visit with a primary care provider.

Choose when: Day or night, weekdays, weekends, and holidays Choose where: Home, work, or on the go Choose how: Phone or video chat Choose who: AmWell or MDLive doctors You are encouraged to register for one or both services, so you’re ready when and if you need care. Signing up is easy. Set up and create an account with one or both AmWell (AmWellforCigna.com) and MDlive (MDLiveforCigna.com) complete a medical history using their “virtual clipboard,” and download AmWell

Benefits Summary 2026 - 2027 13 for Cigna App and MDLive for Cigna App to your smartphone/mobile device.

24-Hour Health Information Line The 24-Hour Health Information Line (HIL) assists individuals in understanding the right level of treatment at the right time. Trained nurses are available 24 hours a day, seven days a week, 365 days a year to provide health and medical information and direction to the most appropriate resource. To speak with a nurse, call 1-800-244-6224.

Preventive care covered at 100% Prevention is the best medicine, and your Cigna medical plans cover a wide range of preventive services to help you and your family lead healthy, productive lives. These services include annual routine examinations, well-childcare visits, immunizations, routine OB/GYN visits, mammograms, PAP tests, prostate screenings, and other services as required by the Affordable Care Act. These preventive services are covered in

full in-network.

Benefits Summary 2026 - 2027 14 Benefits Summary 2026 - 2027 15 ® Your Life. Your Work. Your Best.

Your GuidanceResources® Program Services:

Sometimes life can feel overwhelming.

Confidential Emotional Support It doesn’t have to. Your ComPsych® GuidanceResources® program provides • Anxiety,d epression,stress confidential counseling, expert • Grief, loss and life adjustments

• Relationship/marital conflicts

guidance and valuable resources to help you handle any of life’s Work and Lifestyle Support challenges, big or small.

• Child, elder and pet care

Life is challenging. • Moving and relocation

• Shelter and government assistance

We can help.

Legal Guidance Confidential 24/7 support. • Divorce,a doption and family law

• Wills, trusts and estate planning

• Free consultation and discounted local

representation Financial Resources

• Retirement planning,taxes

• Relocation, mortgages, insurance

• Budgeting, debt, bankruptcy and more

Digital Support

• Connect to counseling, work-life support or other

services

• Tap into an array of articles, podcasts, videos,

slideshows

• Improve yourskills withOn-Demand trainings

Online Will Preparation

• Quickly andeasily complete a will on your

computer with EstateGuidance® Specify guardians, trustees and property division • OneAmerica Financial® is the marketing name of the companies of OneAmerica • Provide funeral and burial instructions Financial. OneAmerica Financial markets ComPsych® services. ComPsych® is not an affiliate of the companies of OneAmerica Financial.

24/7 Live Assistance: Online: guidanceresources.com Call: 855.387.9727 App: GuidanceNowSM TRS: Dial 711 Web ID: ONEAMERICA3 Benefits Summary 2026 - 2027 16 Copyright © 2024 ComPsych Corporation. All rights reserved. To view the ComPsych HIPAA privacy notice, please go to www.guidanceresources.com/privacy.

Dental Plan Benefits United Concordia - Medium Plan Plan Features In-Network* YOU Out-of-Network* YOU

PAY PAY

Annual Program Deductible (per person/per family) $0/$0 $0/$0 Annual Program Maximum (per person) $1,500 Excludes Orthodontics Preventive Care Exams, cleanings, flouride, x-rays, sealants, space $0 $0 maintainers, palliative treatment Basic Care Basic restorative fillings, simple extractions, repairs of $0 $0 crowns, inlays, onlays, bridges & dentures, endodontics, complex oral surgery, general anesthesia

Major Care Nonsurgical periodontics, surgical periodontics, inlays, 50% 50% onlays, crowns, prosthetics (bridges, dentures), implants Orthodontics for dependent children to age 19 50% 50% Diagnostic, active, retention treatment This chart is intended for comparison purposes only. If there are any discrepancies, the plan document will govern. Out-of-Network dentists may balance bill up to their usual fees. To locate

an in-network provider for the United Concordia plan, visit www.UnitedConcordia.com.

Benefits Summary 2026 - 2027 17 Vision Plan Benefits National Vision Administrators, L.L.C.

Basic Benefit In-Network YOU PAY Out-of-Network Plan Reimbursement Exam $0 Up to $32 Once every 12 months Lenses Once every 12 months Standard glass or plastic Up to $26 Single Vision $0 Up to $36 Bifocal Up to $46 Trifocal Up to $72 Lenticular Frames Retail Allowance Once every 24 months Up to $60 Up to $30 (20% discount off balance)* Contacts (Instead of glasses) Up to $85 Once every 12 months Up to $85 retail

15% discount (conventional) or 10% discount (disposable) Up to $225 Medically necessary (pre-approval required) $0 This chart is intended for comparison purposes only. If there are any discrepancies, the plan document will govern. To locate a participating provider, visit www.e-nva.com.

Benefits Summary 2026 - 2027 18 Flexible Spending Accounts (FSA) Flexible Spending Accounts (FSAs) allow you to set aside pre-tax dollars to pay yourself back for eligible health care and dependent care expenses. There are two types of FSAs:

Health Care FSA and Dependent Care FSAs. The FSAs are administered by CareFlex.

In order to participate in the FSA, you must enroll each year. Your annual contribution stays in effect during the entire year (July 1 through June 30). The only time you can change your election is during Open Enrollment or if you experience a qualified changein-status event.

All employees who participate in a Flexible Spending Account Plan will receive an FSA debit card as a way to pay up front for qualified expenses. The FSA debit card will be mailed to your home. If you already have a card, keep it! You will not receive a new one until it expires.

Health Care FSA The Health Care FSA helps you stretch your budget for health care expenses for you and your dependents by allowing you to pay for these expenses using tax-free dollars. You may set aside up to $3,200 annually in pre-tax dollars, which is deducted out of your pay throughout the year.

Funds can be used to pay for qualified health care expenses such as deductibles, medical and prescription copays, dental expenses, and vision expenses. You can use the FSA for expenses for yourself, your spouse, and your dependent children. Your annual contribution amount is deposited into your account and is available to you at the beginning of the plan year. As you incur expenses, use your debit card to pay for your

expenses or submit a claim to be reimbursed.

The Health Care FSA allows you to rollover up to $640 in your account at the end of the plan year. You will have 90 days after the end of the plan year to submit claims incurred during the plan year.

Benefits Summary 2026 - 2027 19 Carryover Provision When you choose how much to contribute to an FSA, be sure to estimate your expenses carefully. The Health Care FSA allows you to rollover up to $640 in your account at the end of the plan year. Any funds exceeding $640 in your Health Care FSA and ANY fund remaining in your Dependent Care FSA at the end of the plan year will be forfeited.

You will have 90 days after the end of the plan year to submit claims incurred during that plan year.

Dependent Care FSA The Dependent Care FSA allows you to pay for eligible dependent care expenses with tax-free dollars. You may set aside up to $5,000 annually in pre-tax dollars, or $2,500 if you are married and file taxes separately from your spouse.

Contributing to a Dependent Care FSA allows you to pay dependent care expenses so that you and your spouse can work, look for work, or attend school full-time. It includes daycare (center or individual daycare), before and after school care, summer day camp, and elder care.

Eligible expenses include the below:

Care for your dependent child thru age 12 whom you can claim as a dependent for tax purposes Care for your dependent child who resides with you and who is physically or mentally incapable of caring for him/herself Care for your spouse or parent who is physically or mentally incapable of caring for him/herself Benefits Summary 2026 - 2027 20 Town of Centreville Plan Year: July 1, 2026 to June 30, 2027

The Health Care Spending Account (FSA) and Dependent Care Account (DCA) allow employees the ability to set aside pretax dollars to pay for out-of-pocket medical and dependent care (day care) expenses incurred by both the employee and their qualified dependents.

Employee Eligibility: All full-time employees working 30 or more hours per week or 130 hours per month are eligible for the FSA benefit. Employees are not required to be enrolled in the company sponsored health plan to participate in the FSA benefit. New hire waiting period is the first day of the next month following date of hire.

Health Care Spending Account (FSA) Maximum Election ................ $3,200.00 [Employee Funded] Health Care FSA Carryover Provision – Up to $640.00 of unused Health Care Spending Account (FSA) funds will roll-over to the next plan year after the conclusion of the run-out period. [Note: The Carryover Provision does not apply to terminated employees and does not apply to the Dependent Care Account (DCA).]

Health Care Spending Account (FSA) – Coverage includes all qualified dependents, including spouse. Dependent children are covered up to the end of the calendar year in which dependent turns 26. Eligible expenses include qualified medical expenses not reimbursed by other insurance, including vision expenses, non-cosmetic dental expenses, over-the-counter (OTC) medicines, menstrual care products (tampons and pads), PPE personal protective equipment (face masks, hand

sanitizer, and sanitizing wipes), and medical supplies. To help determine what expenses qualify for payment / reimbursement, please view the CareFlex Eligible Expense Guide on the CareFlex Participant Portal. Expenses paid out of pocket may also be submitted for manual claim reimbursement.

Dependent Care Account (DCA) Maximum Election........................$5,000.00 [Employee Funded] If you are married and file a separate return, the maximum DCA election amount is $2,500.00 Dependent Care Account (DCA) – Coverage includes dependents thru age 12; disabled/elder dependents (regardless of age). Eligible day care expenses include adult/child day care centers, providers of day care outside of the home, provider of

day care who comes to your home, before/after school care, and summer day camps. Expenses for a child in nursery school, pre-school, or similar programs for children below the level of kindergarten are eligible. Expenses to attend kindergarten or a higher grade, summer school, overnight camps, and tutoring are not eligible expenses. To help determine what expenses qualify for payment / reimbursement from the DCA plan please view the CareFlex Eligible Expense Guide on the CareFlex

Participant Portal. Enrolling in the Dependent Care Account will require you to complete IRS Form 2441 as part of your annual income tax return filing process.

Benefit Changes – Election remains in effect until the end of the plan year. An election change is only permitted if you experience a qualifying event (i.e., birth, adoption or death of a dependent; marriage or divorce; or if you or your spouse experience a change in employment or medical insurance coverage). Additional changes for a DCA include a significant increase or decrease in the cost of day care services. A qualifying event may allow for an increase or decrease of your

benefit amount consistent with the event. Changes to benefits must be made within 30 days of the date of the qualifying event.

Run-Out Period:......................................................................................... 60-Days from Last Day of Plan Year Allows time after the last day of the plan year to submit manual claims for dates of services incurred during the plan year – expenses are eligible based on the date of service, not the payment date.

Reimbursement Method ..................... Benefit Card and Manual Claim (refunded via Direct Deposit or Check) Termed Employees – Coverage Ceases ................................................................................................................. Date of Term Benefit Card Deactivated .................................................................................................................................. Date of Term

Term Run-Out Period .................................................................................................................. 60 Days from Date of Term For more information, call 888-577-2762 205 W. Dares Beach Road (cid:0) Prince Frederick, MD 20678 (cid:0) https://mycareflex.wealthcareportal.com Benefits Summary 2026 - 2027 21 Flexible Spending Accounts (FSA & DCA) Important Plan Information

FSA Health Care Carryover Provision – To help eliminate the effect of the “use it or lose it” rule, your employer has adopted the FSA Health Care Carryover Provision. The Carryover Provision allows a certain amount of unused FSA Health Care and funds to be rolled over to the next plan year after the conclusion of the run-out period. The allowed amount to be carried over is determined by your employer; see FSA Health Care Carryover Provision amount noted on reverse side. [Note: The FSA

Carryover Provision does not apply to the DCA Dependent Care plan and does not apply to terminated employees.] What to Expect When You Use Your Benefit Card – Documentation will be required to be submitted for review for all card transactions except pharmacy expenses approved at the point of sale. CareFlex has made improvements by utilizing technology to manage the communication process with members. It is a thorough process as CareFlex can review

transactions with certainty that the funds were appropriately used. We provide various methods of communicating information with us. For example, the CareFlex Participant Portal identifies and lists on the homepage transactions under review allowing members to attach the requested documentation directly to the transaction. We also offer a convenient CareFlex Mobile App with the same key features that also allows participants to snap a picture of their documentation and

upload the picture to the transaction.

Online Account Access – CareFlex provides electronic access to your plan information, plan design, account balance, transactions history, online claim filing, and more through the CareFlex Participant Portal and CareFlex Mobile App.

Once you register, the same Username and Password is used to access your account through both the portal and the mobile app.

CareFlex Participant Portal – to access the portal, go to the Portal web page: https://mycareflex.wealthcareportal.com.

CareFlex Mobile App – CareFlex offers a free mobile app for ultimate “on the go” convenience. Simply search for CareFlex Mobile App in the Apple App Store or Google Play.

Do not use your CareFlex Benefits Card to pay for previous plan year expenses. Your benefit card only recognizes current plan year funds. Once a new plan year begins, do not use your benefit card to pay for dates of services in the previous plan year. Expenses are eligible based on the date of service, not the date of payment. If you receive an invoice during the new plan year for dates of service in the previous plan year, pay with another form of payment and submit a manual claim to

CareFlex for reimbursement from previous plan year funds. All reimbursement requests received after the plan year run out period will be denied.

Reimbursements – Participants have two options to submit eligible expenses for reimbursement:

Online Claim Filing (https://mycareflex.wealthcareportal.com): Log on to the CareFlex Participant Portal to file a manual claim. Attach appropriate documentation to your online claim; or email, fax, or mail the documentation to CareFlex.

Paper Claim Submission: Email, fax, or mail a manual reimbursement request to CareFlex. Reimbursement forms can be downloaded from the CareFlex Participant Portal FSA Resources section. Reimbursement request forms must be completed and signed and include appropriate documentation to process the claim.

Appropriate proof of service/purchase documentation includes: an itemized prescription label (containing the pharmacy name, patient name, prescription number, and prescription amount), an itemized provider statement [must include the provider name, patient name, date of service, description of service, charges, medical insurance adjustment/payment (if applicable), and patient responsibility], or an Explanation of Benefits (EOB) obtained from the insurance carrier.

Important Notes: (1) cancelled checks, credit card receipts, and/or non-itemized receipts or statements are not acceptable proof of services, and (2) remember to send copies of documentation and keep the originals for your records.

Benefits Summary 2026 - 2027 22 Life & AD&D Insurance Basic Life and AD&D Insurance Life insurance helps protect your family from financial risk and sudden loss of income in the event of your death. Accidental Death and Dismemberment (AD&D) insurance provides an additional benefit if you lose your life, sight, hearing, speech, or limbs in an accident.

The Town of Centreville provides you with a basic life insurance benefit at no cost to you through OneAmerica Financial in the amounts below:

Class One - All Full-time permanent employees authorized to work and reside in the United States. Eligible employees must work 40 or more hours per week and cannot be considered a part-time, temporary or seasonal employee. - $50,000 Benefits will reduce by 35% at age 65 and at age 70, benefits will reduce an additional 25% of the original amount.

Don’t forget to designate a life insurance beneficiary and keep it up-to-date as your life status changes.

Benefits Summary 2026 - 2027 23 Disability Benefits 🩺 Short-Term Disability (STD) 🏥 Long-Term Disability (LTD) Temporary income protection while you Income protection for extended recover disabilities Eligibility Eligibility 👥 Full-time permanent employees 👤 Full-time permanent employees 📅 12 continuous months of service 🕒 40+ hours/week ⏱ 1,250 hours worked in prior 12 months 🇺🇸 Authorized to work in the U.S.

✔ Must be actively at work Benefit Amount Benefit Amount 💵 60% of weekly earnings ⬆ Max: $1,500/week 💰 60% of monthly earnings ⬇ Min: $25/week ⬆ Max: $5,000/month Waiting Period Waiting Period ⏳ 7-day elimination period ⏳ 90-days of Total Disability (Injury or sickness) Benefit Duration Benefit Duration SSNRA - Social Security Normal Retirement 📆 Up to 12 weeks Age (if continuously disabled) Cost Cost

🏛 100% paid by the Town 🏛 100% paid by the Town Benefits Summary 2026 - 2027 24 Important Coverage Information Maternity Coverage - Covered the same as any qualifying disability Other Income Benefits - Benefits may be reduced by other eligible income sources Continuation of Coverage - Coverage may continue during:

Approved Leave of Absence Temporary Layoff Military Leave This chart is intended for comparison purposes only. If there are any discrepancies, the plan document will govern.

Benefits Summary 2026 - 2027 25 Holidays and Leave Paid Holidays Sick Leave* Fourteen paid holidays per year Accrue 4 hours every pay Unlimited accrual New Year’s Day Birthday of Dr. Martin Luther King, Jr. Personal Days President’s Day Good Friday Twenty-four hours beginning Memorial Day the first pay period in the Juneteenth calendar year Independence Day Labor Day Columbus Day *For temporary and permanent part-

Veterans Day time employees, please refer to the Thanksgiving Day Sick and Safe Leave policy in the Day after Thanksgiving Town’s Personnel Manual for Christmas Eve eligibility requirements.

Christmas Day Annual Leave 0 - 4 years of service = 4 hours per pay 5 - 9 years of service = 6 hours per pay 10 + years of service = 8 hours per pay Benefits Summary 2026 - 2027 26 Maryland State Retirement and Pension System The Town of Centreville became a member of the Maryland State Retirement and Pension System (MSRP) Employees Pension on July 1, 2013 and a member of the Maryland State Law Enforcement Officers Pension System (LEOPS) on July 1,

2021.

Enrollment into the Employees’ Pension or LEOPS is mandatory for any employee employed after these dates. Employees are required to contribute 7% of their annual compensation into this plan. The contributions are made with pre-tax dollars, thereby; reducing the employee’s taxable income for the year.

Employees Pension In order for any employee to receive benefits from this plan, they have to participate for at least 10 years. Normal retirement is at least 90 years of combined age and years of eligibility service. For example:

Age 57 with 33 years of service, Age 60 with 30 years of service, or Age 63 with 27 years of service

LEOPS

In order for sworn personnel to receive benefits from this plan, depends on their service credit or their age:

Age 50 or 25 years of eligibility service at any age Benefits Summary 2026 - 2027 27 Deferred Retirement Option Program (DROP) DROP is available to eligible members of LEOPS. This is a voluntary program, you can “retire” and begin accumulating your retirement benefits in a DROP account while you continue to work and draw a paycheck.

The Maryland State Retirement Agency has a new secure website, mySRPS.com where Employees can access info related to their retirement account.

By simply logging into your mySRPS account, you will be able to view Personal Statements of Benefits, update beneficiaries, create estimates and more. If you do not have a mySRPS account, go to sra.maryland.gov, click mySRPS Login, click Register, and then follow the instructions.

Benefits Summary 2026 - 2027 28 Deferred Compensation To enhance retirement savings, employees have the option of participating in a deferred compensation program, also called a 457b plan. A 457b plan allows employees to set aside funds on a pre-tax basis for retirement.

The Town of Centreville offers opportunities for tax-deferred retirement savings and the ability to select from the agencies listed below you would like to work with:

Provider Contact Person Contact Info CBIZ Rory Glackin 610-891-1677 Corebridge Financial Adam Grace 410-859-2164 MissionSquare Caroline Sorokos 202-962-3495 What is a 457(b) plan?

A 457(b) deferred compensation plan lets you save and invest for the future with tax advantages you can’t get from regular savings and investment accounts. It works most like a 401(k) plan, but it is tailored to government employees and certain nonprofit workers.

These options are available for any employee who wants to make investments to save for retirement. Please refer to your financial advisor for what plan works best for your situation.

Benefits Summary 2026 - 2027 29 Town of Centreville Plan Year: July 1, 2026 to June 30, 2027 Your former employer has established a Retiree Health Reimbursement Arrangement (HRA) plan to assist you in paying for out-of-pocket medical expenses and qualified individual health insurance premiums.

HRA Election – Retiree Only ....................................................... $2,400.00 [Employer Funded] HRA Benefit Pro-rated: Mid-year enrollees will have their HRA benefit pro-rated to reflect the number of months remaining in the plan.

Run Out Period: ........................................................................................ 60-Days from Last Day of Plan Year Allows time after the last day of the plan year to submit manual claims for dates of services incurred during the plan year – expenses are eligible based on the date of service, not the payment date.

Reimbursement Method ................................................................................ Benefit Card and Manual Claim Employee Eligibility: Retired employees who have at least 10 years of service with the Town of Centreville.

Termed Retirees – Coverage Ceases .......................................................................................... Last Day of Month Benefit Card Deactivated ....................................................................................................... Last Day of Month Term Run-Out Period ............................................................................................... 60 Days from Date of Term

Benefit Changes – Benefit changes do not apply to this plan.

Qualified Dependents – Dependents are not covered under this plan.

Eligible Expenses – Eligible expenses include all qualified medical expenses not reimbursed by other insurance, including vision expenses, non-cosmetic dental expenses, over-the-counter (OTC) medicines, menstrual care products (tampons and pads), PPE personal protective equipment (face masks, hand sanitizer, and sanitizing wipes), and medical supplies. Expenses paid out of pocket may also be submitted for manual claim

reimbursement.

What to Expect When You Use Your Benefit Card – Documentation will be required to be submitted for review for all card transactions except pharmacy expenses approved at the point of sale. CareFlex provides various methods of communicating information with us. For example, the CareFlex Participant Portal identifies and lists on the homepage transactions under review allowing members to attach the requested documentation directly to

the transaction. CareFlex also offers a convenient CareFlex Mobile App with the same key features allowing participants to snap a picture of their documentation and upload the picture to the transaction.

For more information, call 888-577-2762 205 W. Dares Beach Road (cid:0) Prince Frederick, MD 20678 (cid:0) https://mycareflex.wealthcareportal.com Benefits Summary 2026 - 2027 30 Health Reimbursement Arrangement (HRA) Important Plan Information Online Account Access – CareFlex provides electronic access to your plan enrollment guide, plan design, account balance, transactions history, online claim filing, and more through the CareFlex Participant Portal and CareFlex

Mobile App. Once you register, the same Username and Password is used to access your account through both the portal and the mobile app.

CareFlex Participant Portal – to access the portal, go to: https://mycareflex.wealthcareportal.com.

CareFlex Mobile App – CareFlex offers a free mobile app for ultimate “on the go” convenience. Simply search for CareFlex Mobile App in the Apple App Store or Google Play.

payment and submit a manual claim to CareFlex for reimbursement from previous plan year funds. All reimbursement requests received after the plan year run out period will be denied.

Reimbursements – Participants have two options to submit eligible expenses for reimbursement:

Paper Claim Submission: Email, fax, or mail a manual reimbursement request to CareFlex. Reimbursement forms can be downloaded from the CareFlex Participant Portal HRA Resources section. Reimbursement request forms must be completed and signed and include appropriate documentation to process the claim.

the insurance carrier.

For more information, call 888-577-2762 205 W. Dares Beach Road (cid:0) Prince Frederick, MD 20678 (cid:0) https://mycareflex.wealthcareportal.com Benefits Summary 2026 - 2027 31 YMCA Membership Benefit 🏋 Healthy Employees, Healthy Community The Town of Centreville provides a complimentary YMCA membership to all fulltime and permanent part-time employees. This benefit is offered at no cost to the employee and includes membership coverage for eligible household family

members.

Benefit Includes ✔ Access to YMCA fitness facilities ✔ Group exercise classes ✔ Wellness and recreational programs ✔ Household family membership coverage Eligibility 👥 Full-time employees 👥 Permanent part-time employees How to Enroll 📞 Contact Human Resources to enroll or for additional information.

Benefits Summary 2026 - 2027 32 Important Notice About Your Prescription Drug Coverage & Medicare If you and your covered dependents are not currently covered by Medicare and will not become covered by Medicare within the next 12 months, this Notice is for informational purposes only.

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the Town of Centreville 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:

1. 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.

2. Town of Centreville has determined that the prescription drug coverage

offered by Cigna Gold or Silver Plan is, 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 Benefits Summary 2026 - 2027 33 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 Town of Centreville coverage will not be affected.

Gold Plan The prescription drug coverage that is offered through Town of Centreville has an annual deductible, employer contribution of $1,300 for individual and $2,600 for family. Participants are responsible for co-payments that vary by the drug type and whether the prescription is filled at a retail pharmacy or through mail order. For prescriptions obtained at a participating retail pharmacy (up to a 30-

day supply) the co-payments are: $10 for Generic Drugs, $40 for Brand-Name Formulary Drugs, and $75 for Brand-Name Non-Formulary Drugs. For prescriptions obtained at a participating retail pharmacy (up to a 90 day supply) the co-payments are: $25 for Generic Drugs, $100 for Brand-Name Formulary Drugs, and $188 for Non-preferred brand Drugs. For prescriptions obtained through mail order (up to a 90 day supply) the co-payments are: $25 for Generic

Drugs, $100 for Brand-Name Formulary Drugs, and $188 for Brand-Name Non- Formulary Drugs.

Silver Plan The prescription drug coverage that is offered through Town of Centreville has an annual deductible, employer contribution of $2,000 for individual and $4,000 for family. Participants are responsible for co-payments that vary by the drug type and whether the prescription is filled at a retail pharmacy or through mail order. For prescriptions obtained at a participating retail pharmacy (up to a 30

Benefits Summary 2026 - 2027 34 day supply) the co-payments are: $10 for Generic Drugs, $40 for Brand-Name Formulary Drugs, and $75 for Brand-Name Non-Formulary Drugs. For prescriptions obtained at a participating retail pharmacy (up to a 90 day supply) the co-payments are: $25 for Generic Drugs, $100 for Brand-Name Formulary Drugs, and $188 for Non-preferred brand Drugs. For prescriptions obtained

through mail order (up to a 90 day supply) the co-payments are: $25 for Generic Drugs, $100 for Brand-Name Formulary Drugs, and $188 for Brand-Name Non- Formulary Drugs.

If you do decide to join a Medicare drug plan and drop your current Town of Centreville Gold or Silver Cigna Plan coverage, be aware that you and your dependents will 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 Town of Centreville 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 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 the person listed below for further information. 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 Town of Centreville changes.

You also may request a copy of this notice at any time.

For More Information about Your Options under Medicare Prescription Drug Coverage… Benefits Summary 2026 - 2027 35 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- 772-1213 (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 not required to pay a higher premium (a penalty).

Date: July 1, 2026 Name of Entity/Sender: Town of Centreville Contact--Position/Office: Krystel Ebaugh- Human Resources Manager/Wharf Building Address: 101 Water Way, Centreville, MD 21617 Phone Number: 410-758-1180 Ext. 12 Benefits Summary 2026 - 2027 36 2026 Annual Notices Inside this issue: Introduction Summary of 1 Benefits and This brochure includes the annual notices that should be distributed to all covered employees

Coverage (SBC) and dependents. This newsletter contains important information so we encourage you to read all sections.

Special Enrollment 1 If you have questions regarding any items contained in this newsletter, please contact your Hu- Rights Notice man Resources office or plan administrator for more information.

WHCRA 2

Enrollment Notice We hope you find this information helpful and informative.

Patient Protections 2 Notice Summary of Benefits and Coverage Notice of 2 The Health Care Reform law states that all groups must implement the Availability of requirement that health plans and health insurers provide consumers Notice of Privacy with a Summary of Benefits and Coverage (SBC). The stated purpose Practices of the SBC is to “accurately describe the benefits and coverage under the applicable plan or coverage,” which will allow participants to better

Premium 3 compare plan terms and benefits.

Assistance under Medicaid and CHIP In addition, all group health plans will have to distribute a brief standard summary of benefits and must use and distribute a uniform Your Rights 4 glossary containing definitions for common terms (e.g. “copay”, Against Surprise 5 “deductible”, etc.).

Medical Bills This should be distributed annually, no later than December 1st and Dependent 6 within seven days per any employee request. The medical SBC will be Enrollment created by the insurance carrier and provided to each group for Limitations distribution.

In addition, if your group has a stand-alone HRA or FSA that covers Newborns’ Act 6 expenses beyond excepted benefits, then the plan sponsor, not the Disclosure insurance carrier, will create and distribute that SBC.

Special Enrollment Rights Notice If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment within 30 days after your coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.

Benefits Summary 2026 - 2027 37 2026 Annual Notices Page 2 WHCRA Enrollment Notice 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 mastectomyrelated 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 was performed;

• surgery and reconstruction of the other breast to produce a symmetrical appearance;

• prostheses and treatment of physical complications of the mastectomy, including lymphedema.

These benefits will be provided subject to the same 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 at the phone number on the back of your carrier ID card.

Patient Protections Disclosure Notice You do not need prior authorization from the carrieror from any other person (including a primary care provider) in order to obtain access to obstetrical or gynecological care from a health care professional in network who specializes in obstetrics or gynecology.

The health care professional, however, may be required to comply with certain procedures, including obtaining prior authorization for certain services, following a pre-approved treatment plan, or procedures for making referrals. For a list of participating health care professionals who specialize in obstetrics or gynecology, contact your insurance carrier by calling the number on the back of your ID

card.

FOR GROUPS WITH HMO PLANS:

The employer’s group health plan generally requires or allows the designation of a primary care provider. You have the right to designate any primary care provider who participates in the network and who is available to accept you or your family members. For children, you may designate a pediatrician as the primary care provider. For information on how to select a primary care provider, and for a list of the participating primary care providers, contact your insurance carrier by calling the number on the back of your ID

card.

Notice of Availability of Notice of Privacy Practices Your group health plan (the Plan) is required by the Health Insurance Portabilityand Accountability Act of 1996 (HIPAA) and its regulations to maintain the privacy of your protected health information (PHI) and to provide plan participants with notice of its legal duties and privacy practices with respect to PHI. PHI is any individually identifiable information that is received or maintained by the Plan in electronic, written, or

oral form that pertains to your past, present or future mental or physical condition, the provision of health care services for that condition, and the payment for those services.

The Plan is required by law to tell you:

The Plan’s uses and disclosures of your PHI;

The Plan’s duties with respect to your PHI;

Your right to file a complaint with the Plan and with the Secretary of the U.S. Department of Health and Human Services; and The person to contact for further information about the Plan’s privacy practices.

A copy of the Notice of Privacy Practices is available to all individuals whose PHI will be used or maintained by the Plan. If you would like a copy of the Plan’s Notice of Privacy Practices, please contact your Human Resources office or plan administrator.

Benefits Summary 2026 - 2027 38 2026 Annual Notices Page 3 Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or

your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit https://pennie.com (in Pennsylvania) or www.healthcare.gov.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a state listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDSNOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-

444-EBSA (3272).

If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2024. Contact your state for more information on eligibility - Maryland – Medicaid and MCHP Medicaid Website:

health.maryland.gov/mmcp/pages/home/ aspx Medicaid Phone: 855-642-8571 To see if any other states have added a premium assis- CHP Website:

tance program since July 31, 2023 or for more inforttps://www.marylandhealthconnection.g mation on special enrollment rights, contact either:

ov CHIP Phone: 855-642-8572:

U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/agencies/ebsa

1-866-444-EBSA (3272)

Delaware – Medicaid and CHIP Website:

U.S. Department of Health and Human Services https://medicaid.dhss.delaware.gov Centers for Medicare & Medicaid Services Phone: 1-800-372-2022 www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565 PENNSYLVANIA – Medicaid OMB Control Number 1210-0137 (expires 01/31/2026) Website:

http://www.dhs.pa.gov/Services/Assistance/Pages/HIPP- Program.aspx Phone: 1-800-692-7462 Benefits Summary 2026 - 2027 39 2026 Annual Notices Page 4 Your Rights and Protections Against Surprise Medical Bills When you get emergency care or get treated by an out-of-network provider at an innetwork hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency services If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced

billed for these post-stabilization services.

Certain services at an in-network hospital or ambulatory surgical center When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist, or intensivist

services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network. Contact the Maryland Insurance Administration Department at

www.insurance.maryland.gov or by phone at 1-800-492-6116 or if you have difficulty finding a provider or facility in your plan’s network.

Benefits Summary 2026 - 2027 40 2026 Annual Notices Page 5 When balance billing isn’t allowed, you also have the following protections:

• You are only responsible for paying your share of the cost (like the copayments,

coinsurance, and deductibles that you would pay if the provider or facility was in-network).

Your health plan will pay out-of-network providers and facilities directly.

• Your health plan generally must:

* Cover emergency services without requiring you to get approval for services in

advance (prior authorization).

* Cover emergency services by out-of-network providers.

* Base what you owe the provider or facility (cost-sharing) on what it would pay an

in-network provider or facility and show that amount in your explanation of benefits.

* Count any amount you pay for emergency services or out-of-network services

toward your deductible and out-of-pocket limit.

If you believe you’ve been wrongly billed, you may contact the Maryland Insurance Department at www.insurance.maryland.gov or by phone at 1-800-492-6116.

Visit www.insurance.maryland.gov for more information about your rights under federal and state law. You may also visit https://www.cms.gov/nosurprises for information from the federal government.

Benefits Summary 2026 - 2027 41 2026 Annual Notices Page 6 Notice of Dependent Enrollment Limitations Newborns: Must be enrolled within 30 days of birth. If they are not enrolled within this time frame, they are not eligible until the next open enrollment period. If no open enrollment period exists, they are not eligible until a 30 Life Status Event occurs (which may not occur in many instances).

Adoption/Judgments/Decrees/Etc.: Must be enrolled as of effective date listed on legal documentation. Refer to Plan Document on day limitation (i.e.

30 or 60 days to enroll).

Newborns’ Act Disclosure Group health plans and health insurance issuers offering group health insurance coverage generally may not restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a delivery by cesarean section.

However, the plan or issuer may pay for a shorter stay if the attending provider (e.g., physician, nurse midwife, or physician assistant), after consultation with the mother, discharges the mother or newborn earlier.

Benefits Summary 2026 - 2027 42 New Health Insurance Marketplace Coverage Form Approved Options and Your Health Coverage OMB No. 1210-0149 (expires 12-31-2026)

PART A: General Information

When key parts of the healthcare law take effect in 2014, there will be 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.

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 begins in October 2013 for coverage starting as early as January 1,

2014.

Can I Save Money on my Health Insurance Premiums in the Marketplace?

You may qualify to save money and lower your monthly premium, but only if your 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.1 Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered 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 after-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 Department at hr@townofcentreville.org or 410-758-1180 Ext. 12 .

The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.

1 An employer-sponsored health plan meets the "minimum value standard" if the plan's share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs.

Benefits Summary 2026 - 2027 43

PART B: Information About Health Coverage

Offered by Your Employer Thissection containsinformation aboutany health coverage offeredby your employer.If you decidetocompletean 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 4.Employer Identification Number (EIN) Town of Centreville 52-6000782 5.Employer address 6.Employer phone number 101 Lawyers Row 410-758-1180 7.City 8.State 9.ZIP code Centreville Maryland 21617 10.Who can we contact about employee health coverage at this job?

Human Resources Department 410-758-1180 Ext. 12 11.Phone number (if different from above) 12.Email address 410-758-1180 Ext. 31 hr@townofcentreville.org 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

Some employees. Eligible employees are:

Regular Full-time employees and permanent part-time employees working at least 20 or more hours a week.

• With respect to dependents:

X We do offer coverage. Eligible dependents are:

Spouse: a person to whom you are legally married by ceremony.

Dependent Children: your biological, adopted, or legal dependents up to age 26 regardless of student, financial, and marital status We do not offer coverage.

X

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 the 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 HealthCare.gov to find out if you can get a tax credit to lower your monthly premiums.

Benefits Summary 2026 - 2027 44 The information below corresponds to the Marketplace Employer Coverage Tool. Completing this section is optional for employers, but will help ensure employees understand their coverage choices.

13. Is the employee currently eligible for coverage offered by this employer, or will the employee be eligible in

the next 3 months?

Yes (Continue) 13a. If the employee is not eligible today, including as a result of a waiting or probationary period, when is the employee eligible for coverage? (mm/dd/yyyy) (Continue) No (STOP and return this form to employee)

14. Does the employer offer a health plan that meets the minimum value standard*?

XYes (Go to question 15) No (STOP and return form to employee)

15. For the lowest-cost plan that meets the minimum value standard* offered only to the employee (don't include

family plans): If the employer has wellness programs, provide the premium that the employee would pay if he/ she received the maximum discount for any tobacco cessation programs, and didn't receive any other discounts based on wellness programs.

a. How much would the employee have to pay in premiums for this plan? $ 8 4 . 9 1 XTwice a month b. How often? Weekly Every 2 weeks Monthly Quarterly Yearly If the plan year will end soon and you know that the health plans offered will change, go to question 16. If you don't know, STOP and return form to employee.

16. What change will the employer make for the new plan year?

Employer won't offer health coverage Employer will start offering health coverage to employees or change the premium for the lowest-cost plan available only to the employee that meets the minimum value standard.* (Premium should reflect the discount for wellness programs. See question 15.) a. How much would the employee have to pay in premiums for this plan? $ b. How often? Weekly Every 2 weeks Twice a month Monthly Quarterly Yearly

• An employer-sponsored health plan meets the "minimum value standard" if the plan's share of the total allowed benefit costs covered by the

plan is no less than 60 percent of such costs (Section 36B(c)(2)(C)(ii) of the Internal Revenue Code of 1986) Benefits Summary 2026 - 2027 45 Disclaimer

THIS GUIDE IS NOT A CONTRACT

This guide is a summary of the general benefits available to Town of Centreville employees and eligible retirees and describes the highlights of our benefits in non-technical language. Our specific rights to benefits under the plan are governed solely, and in every respect, by the official documents and not the information in this summary. If there is any discrepancy between the descriptions of the programs as contained in this guide and the official plan

documents, the language of the official document shall prevail as accurate.

Please refer to the plan-specific documents for detailed plan information. Any plan benefits may be modified in the future to meet Internal Revenue Service rules as decided by the Town.

Benefits Summary 2026 - 2027 46 Centrally HR CBIZ Human Capital Management Benefit Enrollment Steps Updated: 10/1/2024 Benefit Enrollment Steps Start Enrollment Open Enrollment

1. Navigate to the My Benefits card on the homepage and click “Start open enrollment” to begin the event.

If you do not see a My benefits card, navigate to My Info > My Benefits > Enrollment to begin the enrollment event.

2. You will be directed to the Enrollment Event. Please read the Instructions and begin the event. Click the blue

“Continue” button at the top right to advance to the next page in the event.

Benefits Summary 2026 - 2027 47 Centrally HR CBIZ Human Capital Management Benefit Enrollment Steps Updated: 10/1/2024 You and Your Family If you have added family members previously, they will be visible on the “You and your family” section.

ADDING FAMILY MEMBERS (DEPENDENTS, SPOUSE OR BENEFICIARIES)

1. To add existing contacts to the “You and your family” list, click the “Add family member” button.

2. A new window will open.

Select the appropriate family member to add to your benefits and click ‘Apply’.

Benefits Summary 2026 - 2027 48 Centrally HR CBIZ Human Capital Management Benefit Enrollment Steps Updated: 10/1/2024 The family member will now be visible on the You and your family page.

Select a Plan Plan Highlights and the cost per pay period for the coverage level selected will show on the benefit enrollment page

1. Change the coverage level on the benefit plan to see the cost per pay period.

2. To see additional details about a specific benefit plan, click “Show More.”

3. To enroll in a benefit plan, click “Select” on that benefit plan card.

After you select the desired coverage, a new window will open.

1. Review and confirm the level of coverage desired and add/update as needed.

2. Click Save and Select.

3. Confirm that the benefit is selected

4. Click “Continue” to proceed.

Benefits Summary 2026 - 2027 49 Centrally HR CBIZ Human Capital Management Benefit Enrollment Steps Updated: 10/1/2024 Beneficiaries If your employer offers plans requiring a Beneficiary, you may be reminded to fill in the required information.

ADD A NEW BENEFICIARY

1. Click “Add New” to enter a new beneficiary not listed in your existing contacts.

2. Enter the new beneficiary on the Account Contacts page and click Continue.

3. Click “OK” to confirm the contact was successfully added.

4. Assign the desired percentage to the new beneficiary and click “Save”.

5. Review your beneficiaries and click “Save and Select” to continue.

Benefits Summary 2026 - 2027 50 Centrally HR CBIZ Human Capital Management Benefit Enrollment Steps Updated: 10/1/2024

FINISH UP

Once all benefits have been selected, advance to the “Finish Up” section.

The page will list your selections.

1. To edit a selection, click the Edit Pencil next to the plan.

2. Click , save the document on your computer, and print a confirmation page of your elections.

3. Click Submit to request approval of your enrollment.

You may be required to electronically sign your benefit enrollment.

1. Follow the steps if prompted for a password or wet signature. Below is an example of a wet signature.

Benefits Summary 2026 - 2027 51 Employee Portal – Centrally HR (CHR)

INSTRUCTIONS:

• Your username is your first initial and last name (i.e. – John Smith = JSmith). Usernames are NOT case

sensitive.

• First time users must type in their username and click forgot password to reset their password. A

temporary password will be emailed to your primary work email address (@qac.org for CPD employees, @townofcentreville.org for all other employees).

CHR is accessible via mobile app, Town website (found under Human Resources, Employee Portal), or • via CHR URL logon page https://secure5.entertimeonline.com/ta/CBIZ20602.login?rnd=CPW&%40rtm=1 Benefits Summary 2026 - 2027 52