Benefits Guide. 2022 Please read thoroughly.

Benefits Guide. 2022 Please read thoroughly.

This publication contains important information
about your employee benefit program.

Please read thoroughly.
Benefits Guide. 2022 Please read thoroughly.
At HALO, we are committed to a comprehensive
employee benefit program to help our employees
stay healthy, feel secure, and maintain
a work/life balance.

This guide offers information on each benefit
available to you through HALO, contact information
for the providers, and instructions on how to enroll.
Please read through it carefully and keep it for
reference when enrolling in and utilizing your
benefits in the future.

Benefits Guide. 2022 Please read thoroughly.
Benefits Guide • 2022

Table of contents
Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   4       • Life and Disability Benefits . . . . . . . . . . . . . . . . . . . . . . . . . . .               22

Enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 	     8       • Short Term Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .        24

                                                                                                                            • Long Term Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .         24
Staying Healthy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 
                                                                                                                            • Voluntary Critical Illness . . . . . . . . . . . . . . . . . . . . . . . . . . . . .             25
    • Medical Highlights—CDHP . . . . . . . . . . . . . . . . . . . . . . . . . . . .                              11
                                                                                                                            • Voluntary Hospital Indemnity . . . . . . . . . . . . . . . . . . . . . . . .                     27
    • Medical Highlights—PPO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                           12
                                                                                                                            • Voluntary Group Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . .                 27
    • Tools and Resources with BCBSIL . . . . . . . . . . . . . . . . . . . . .                                    15
                                                                                                                            • 401(k) Savings Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      28
    • Dental Plan Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                         16
                                                                                                                            • Work/Life Balance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .      32
    • Vision Plan Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .                     17
                                                                                                                            • Access Your Maternity and Family Benefits—BCBSIL .                                               33
Feeling Secure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .           18
                                                                                                                         HALO Benefits Information Contact . . . . . . . . . . . . . . . . . .                                 34
    • Health Savings Account (HSA) . . . . . . . . . . . . . . . . . . . . . . . .                                 19
    • Flexible Spending Accounts (FSA) . . . . . . . . . . . . . . . . . . . . .                                   20   Important Notices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   37

Benefits Guide. 2022 Please read thoroughly.
Benefits Guide. 2022 Please read thoroughly.
Benefits Guide • 2022

Who is Eligible?
Employee Eligibility
• Actively employed administrative
  employees scheduled to work a minimum
  of 30 hours per week.

• Actively employed (commissions only)
  account executives booking a minimum
  of $40,000 in commissions in the prior
  calendar year (amount will be estimated
  or prorated for new hires with mid-year
  enrollments). The minimum booking
  threshold is subject to change at the
  company’s discretion every calendar year.

Dependent Eligibility
Legal spouses, civil union, or domestic
partners of eligible employees are ineligible
for coverage in our plans if they are eligible
for coverage through their employer and
their employer pays at least 50% of the cost.
Legal certification of marriage/civil union/
domestic partnership must be provided
if covering a spouse, civil union,
or domestic partner.

Children of eligible employees are eligible
for coverage in the health/dental/vision
plans up to the age 26, regardless of student,
marital, or employment status. Coverage
will automatically terminate at the end
of the month of the dependent’s 26th
birthday. Supplemental child life coverage
terminates at the end of the month
of the dependent child’s 19th birthday.

Benefits Guide. 2022 Please read thoroughly.
Benefits Guide • 2022

When Are
You Eligible?
Newly Eligible Employees
Your benefits become effective the first of the
month coincident with or following 30 days
of employment in an eligible classification.
NOTE: You have 30 days from your date
of hire or change to eligible status to enroll
in or waive coverage.

Annual Open Enrollment
You may make changes to your benefit
elections during your open enrollment
period for a September 1st effective date.

Qualified Change
in Status
Your benefit elections will remain in effect
for the entire year unless you experience
a qualifying life event. You may make benefit
changes within 30 days of a qualified event.
Examples of qualifying life events include:
marriage, civil union, divorce, birth, adoption,
death of a dependent, or loss of other
coverage, such as spouse/partner losing
coverage as a result of a job loss or change.
Note: This is only a summary of the
benefit plans; refer to the Summary Plan
Descriptions or Certificates for each benefit
to view full details on coverage, maximums,
limitations, and exclusions. If there is any
conflict between this document and the
official plan documents, the official plan
documents govern the plan.

Benefits Guide. 2022 Please read thoroughly.
Benefits Guide • 2022

What Benefits
Are Available?                                             Your basic life and AD&D, short term disability,
                                                           and long term disability insurance will only be
As you consider your plans for the year,
                                                           provided by HALO if you elect medical coverage.
refer to this chart of coverage and enrollment
information for the various benefit programs
offered through HALO.
                                                           • If you do not enroll in medical coverage,
                                                              but to enroll in these benefits, you will pay 100% of the cost.
                                                           • Basic life and AD&D, short term disability, and long term
Reminder: Coverage begins the first of the                   disability must be elected all together. You cannot elect only
month coincident with or following 30 days                   1 or 2 of these benefits separately.

of employment in an eligible classification.

 Benefit Plan                              Vendor                                         Do I Need to Enroll?

 Health Plans
 Medical                                   Blue Cross Blue Shield of Illionnis            Yes

 Dental                                    Delta Dental of Illinois                       Yes

 Vision                                    BCBSIL + EyeMed                                Yes

 Health Savings Account                    5th/3rd Bank                                   Yes

 Flexible Spending Accounts                Discovery Benefits                             Yes

 Life and AD&D Insurance
                                                                                          Enrolled in medical: No
 Basic Life and AD&D Insurance             New York Life
                                                                                          Not enrolled in medical: Yes
 Voluntary Life
                                           New York Life                                  Yes
 (for you and your dependents)

 Disability Insurance
                                                                                          Enrolled in medical: No
 Short Term Disability                     New York Life
                                                                                          Not enrolled in medical: Yes
                                                                                          Enrolled in medical: No
 Long Term Disability                      New York Life
                                                                                          Not enrolled in medical: Yes

 Voluntary Options
 Critical Illness                          Cigna                                          Yes

 Hospital Indemnity                        Cigna                                          Yes

 Accident                                  Cigna                                          Yes

 Additional Programs
 401(k) Savings Plans                      Bank of Oklahoma                               No

Benefits Guide. 2022 Please read thoroughly.
Benefits Guide. 2022 Please read thoroughly.
Benefits Guide • 2022

Ready to Enroll?
Follow These Steps
01 Write down big things happening
    next year for your family, do any
    of these things relate to your benefits?
       • Planning to bring home a new baby?

       • Anyone have a big expense coming
          (orthodontia, major surgery, etc.)?

       • If something happened to you,
          does your life insurance provide
          enough money to your family?

    ould you benefit from any of
02 W
     the voluntary products we offer?
       • C
          ritical illness, accident,
         hospital indemnity

     id you know you can access your
03 D
    ID cards, find network providers
     and more via mobile apps?
     Download them today!
       • Blue Access for Members

       • Delta Dental’s mobile app

       • EyeMed Members

How to Enroll:
Enroll on

Instructions on how to enroll can be found

Benefits Guide. 2022 Please read thoroughly.
Benefits Guide • 2022

Staying Healthy
Medical                                        Plan                                 CDHP Plan
                                               Features          In-Network                   Out-of-Network
Highlights—CDHP                                Coinsurance                 80%                          60%

HALO offers two medical plans plan with        Deductible
access to a comprehensive national network
                                               Individual                 $2,000                       $6,000
(Blue Edge) to cover your medical needs from
preventive care to emergency situations.       Family                     $4,000                       $12,000

                                               Account Funding (HSA)
You must meet your deductible below
before coinsurance begins. If you meet your    Individual                                $500

out-of-pocket maximum, you will not pay
                                               Family                                    $1,000
any more for the cost of your care for the
rest of the year. Note that your deductible    Out-of-Pocket Max (includes deductible)
and out-of-pocket maximum renew on
                                               Individual                 $4,000                       $12,000
a calendar year basis.
                                               Family                     $6,850                       $24,000

How the Family Deductible                      Covered Services
and Out-of-Pocket                              Preventive Care             100%               Deductible and coinsurance
Maximums Work
                                               Office visit      Deductible and coinsurance   Deductible and coinsurance
•   The plan will not begin cost sharing
                                               Specialist        Deductible and coinsurance   Deductible and coinsurance
    for any family member until the family
    deductible is met
                                               Urgent Care       Deductible and coinsurance   Deductible and coinsurance
• Any combination of one or more family       Emergency Room    Deductible and coinsurance       Same as in-network
    members can incur expenses to meet
    the family deductible                      Prescription Drug
• All family members’ out-of-pocket           Generic           Deductible and coinsurance
    expenses count towards the
                                                                                                   You pay 25%
    family deductible                          Preferred         Deductible and coinsurance
                                                                                                   of the eligible

• The family out-of-pocket maximum must       Non-Preferred     Deductible and coinsurance
                                                                                                   amount after
                                                                                                   20% coinsurance
    be met by any combination of one or more
    family members before plan will begin to   Speciality        Deductible and coinsurance

    cover in-network expenses at 100%

Benefits Guide • 2022

Staying Healthy
Medical Highlights—PPO
Diagnostic visits are covered at 100% after a copay of $30 or $50 at
the time of service at network facilities. All other in-network services
are covered at 80% after you meet an annual deductible of $1,000
if you are single, or $2,000 if you have more than one person on the
plan. Once you reach your out-of-pocket maximum of $2,000 if you
are single, or $4,000 if you have more than one person on the plan, all
eligible expenses are covered at 100%. Prescriptions are covered at
100% after a copay of $15, $30, or $50 (depending on the tier).

How the Family Deductible                             Plan                                 PPO Plan
and Out-of-Pocket                                     Features             In-Network           Out-of-Network
Maximums Work                                         Coinsurance                 80%                         60%

• A single member of a family does not have          Deductible
  to meet the full family deductible before
                                                      Individual                  $1,000                     $4,000
  the after-deductible benefits kick in

• Individual family members only need                Family                     $2,000                      $8,000
  to meet the individual deductible for
                                                      Out-of-Pocket Max (includes deductible)
  the after-deductible benefits to kick in

• The money that is paid toward the
                                                      Individual                 $2,000                      $8,000

  individual deductible and out-of-pocket             Family                     $4,000                     $16,000
  maximums is also credited toward
                                                      Covered Services
  the family deductible and
  out-of-pocket maximums                              Preventive Care             100%           Deductible and coinsurance

• Once several different family members              Office visit                 $30           Deductible and coinsurance
  have each paid enough in individual
  deductibles that meet the family                    Specialist                   $50           Deductible and coinsurance

  deductible in total, benefits will begin
                                                      Urgent Care                  $50           Deductible and coinsurance
  to be paid for the entire covered family

• When family members have paid enough               Emergency Room                          $150

  in out-of-pocket maximums to complete               Prescription Drug
  the family out-of-pocket maximum,
                                                      Generic                      $15
  the plan will begin covering in-network
  expenses at 100%                                                                                    You pay 25% of
                                                      Preferred                    $30
                                                                                                      the eligible amount
                                                                                                      minus the in-network
                                                      Non-Preferred                $50
                                                                                                      copay amount

                                                      Speciality                   $50

Benefits Guide • 2022

Staying Healthy
Cost for Medical                                Medical Plan Contributions

Coverage                                                          CDHP Bi-Weekly Contributions
                                                                                 Tobacco User/Smoker Rates
You have the opportunity to engage in HALO’s
                                                                                  1 smoker           2 smokers
wellness initiative to take advantage of
lower per-pay period medical costs. See next    Compliant
page for information on how to participate      Single                 $57.92       $75.23                 -
and receive the lower medical premiums.         EE + Spouse            $184.62      $201.93             $219.24

                                                EE + Child(ren)        $144.69      $162.00                -
If you and/or your spouse or domestic partner
are a tobacco user, you will be required to     Family                 $260.23      $277.54             $294.85

pay a surcharge on your medical premiums.       Non-Compliant
While making your elections within the
                                                Single                 $83.58       $100.89                -
Paylocity portal, you will be asked to
                                                EE + Spouse            $239.89      $257.20             $274.51
complete an affidavit for tobacco use.
                                                EE + Child(ren)        $177.38      $194.69                -

                                                Family                 $323.15      $340.46             $357.77

                                                                  PPO Bi-Weekly Contributions
                                                                                 Tobacco User/Smoker Rates
                                                                                  1 smoker           2 smokers
                                                Single                 $78.56       $95.87                 -

                                                EE + Spouse            $224.10      $241.40             $258.71

                                                EE + Child(ren)        $181.02      $198.33                -

                                                Family                 $334.99      $352.30             $369.61

                                                Single                 $104.23      $121.54                -

                                                EE + Spouse            $279.36      $296.67             $313.98

                                                EE + Child(ren)        $213.71      $231.02                -

                                                Family                 $397.90      $415.21             $432.52

                                                                  Bi-Weekly Smoker Surcharge
                                                1 Smoker                             $17.31

                                                2 Smokers                           $34.62

Benefits Guide • 2022

Staying Healthy
How to Engage                                        Well onTarget
in Wellness with HALO                                Access the Well onTarget Member Wellness
If you want to pay the lower compliant               portal at In the
rates on the medical plan, you will need             Wellness portal, you will have access to a
to take action. Tasks completed from                 wide array of wellness resources, including:
9/1/2021 – 8/31/2022 will apply towards              • Challenges that occur year-round on
your Wellness Compliance status for                    a variety of topics like managing money,
the plan year starting 9/1/2022.:                      sleep, healthy eating, etc.

Complete one task from each of
                                                     • Coaching will provide you access to
                                                       a credentialed expert to support you
the three categories shown below:                      in your unique wellness journey

                                                     • Digital self-management programs
01 V isit your physician for a physical,              on a wide range of topics like tobacco
     or any of the following screenings:               use, weight management, stress, sleep,
     Biometric, Cervical Cancer,                       and more

                                                     • Blue Points Rewards – Get rewarded
     Mammogram, or Colon Cancer
       • If getting a physical or biometric
                                                       for completing healthy activities! Use
          screening, you should tell your provider
          this a routine service to ensure             your Blue Points in an online marketplace
          it is covered at 100%                        through your Well onTarget account.

                                                     • Get rewarded for completing Health
02 C omplete a Health Risk Assessment                 Assessments, Self-Management Program,
     on the Well onTarget portal                       Fitness Programs, connecting a compatible
                                                       fitness device or app to the portal,
03    omplete a Corporate Challenge or
     C                                                 and much more!
     Coaching program within the Well
     onTarget portal or provide
     with COVID vaccination documentation

Benefits Guide • 2022

Staying Healthy
Tools and resources
Virtual Visits with MDLIVE!
Speak With a Physician or                              No copay on the PPO plan and no cost
                                                       for CDHP participants after deductible
Therapist—Anytime, Anywhere
                                                       is met for MDLIVE medical and
MDLIVE allows you to access board-certified            behavioral health visits.
physicians or therapists 24/7/365 from any
location, whether you are on the road, at
work or in the comfort of your own home. This
service is available for both physical and
behavioral health visits. You may access
MDLIVE by mobile app, online video or over
                                                   Blue Access for
the phone. Getting sick after hours or on the
weekends used to mean a long, costly trip to
                                                   Members (BAM)
the emergency room or urgent care center.          Healthcare at Your Fingertips
But with your virtual visits benefit provided      With BAM, you can:

                                                   • Use the Provider Finder tool to search for a
by Blue Cross Blue Shield of Illinois and
powered by MDLIVE, you may access care at
                                                     healthcare provider, hospital, or pharmacy
a location convenient to you. Virtual visits are
for non-emergency situations such as:              • Request or print your ID card
• Allergies               • Ear infections         • Check the status or history of a claim
• Anxiety                 • Pink eye               • View or print Explanation
• Asthma                  • Rashes                   of Benefits statements

• Cold/flu                • Stress                • Use the Cost Estimator tool to find
• Depression
                                                     the price of hundreds of tests,
                                                     treatments, and procedures

If needed, through MDLIVE, you can get a           To get started, visit
prescription called into your local pharmacy.      and use the information on your ID card to
                                                   create an account.
To set up an account, you may:

• Call MDLIVE at 866.676.4204
• Go to                          BCBSIL App
• Text BCBSIL to 635.483                               Stay connected with BCBSIL and access

• Download the MDLIVE app                              important health benefit information
                                                       wherever you are by using the BCBSIL app.
                                                       Text BCBSILAPP to 33633 to get the app.

Benefits Guide • 2022

Staying Healthy
Dental Plan                                     Dental Coverage
Highlights                                      Reminders
There are two dental plans available for you    • Two routine dental cleanings
to choose from, the Low Plan and the High         per benefit year
Plan. As a reminder, getting care from
an in-network provider will be lower cost
                                                • Annual maximum is the most your plan
                                                  will pay towards your dental services
for you than if you were to visit an
                                                  in the benefit year
out-of-network provider. For more details,
                                                       • A
                                                          pplies to each covered
see the dental plan summaries.
                                                         person on the plan

 Plan Design         High Plan Low Plan
                                                • Orthodontia limit of $2,000 on the
                                                  High Plan is a lifetime maximum
                         $50             $100          • T
                                                          his is the most your plan will
                                                         pay for orthodontia services
 Family Deductible       $150            $300            per member per lifetime

 Maximum                $1,000         $1,000          • D
                                                          oes not “reset” each year
                                                         like your annual maximum
 Preventive             100%             90%

 Basic                   80%             70%
                                                Dental Plan
 Major                   50%             50%
 Orthodontia             50%             N/A

 Orthodontia           Children
                                         N/A                Delta Dental of
 Eligibility           under 19
                                                      IL—Bi-Weekly Contributions
                        $2,000           N/A
 Lifetime Maximum                                                    High Plan Low Plan
                                                 Single                   $11.56            $9.95

    Pay Less by Using an                         EE + Spouse             $20.81             $17.91
    In-Network Provider
                                                 EE + Child(ren)         $33.63             $24.56
    Click here to find an in-network
    provider near you.                           Family                  $45.19             $34.52

Benefits Guide • 2022

Staying Healthy
Vision Plan Highlights
Your vision coverage is offered through BCBSIL. BCBSIL provides you
with affordable care options and gives you access to a range of
discounts on glasses, frames, lenses, and laser vision correction.
BCBSIL vision partners with EyeMed to provide you with an extensive
network of optometrists, ophthalmologists and opticians in private
practices and at optical retailers including Walmart, Bard Optical,
All About Eyes, Target, LensCrafters, and more! For more details
on your vision coverage and exclusive savings and promotions,
visit or download
the EyeMed Members Mobile App.

To locate an in-network provider, visit eyedoclocator.

                                                                          Visit to access a huge selection
                         BCBSIL Vision Plan                               of frames and lenses with your benefits using
                                                                          3-D virtual try-on technology!
                                                       Reimbursement      Vision Plan Contributions
 (Exams/Lens/Frames)                                                                BCBSIL Vision—Bi-Weekly
 Exam                               $10 copay                Up to $45                   Contributions
                                                                           Single                              $2.76
 Spectacle Lens

    • Single Vision                 $25 copay                Up to $30
                                                                           EE + 1                              $4.35

    • Bifocal
                                                                           EE + 2 or more                      $7.80
                                    $25 copay                Up to $50

    • Trifocal                      $25 copay                Up to $65

    • Lenticular                    $25 copay                Up to $100

                                                                               You do not need ID cards to receive services.
 Standard Progressive Lens          $25 copay                Up to $50
                                                                               BCBSIL will send you two ID cards showing
                               $140 with 20% off for                           only the employee’s name, no matter who
 Allowance                                                   Up to $70
                                balances over $140                             is covered. To download additional ID
 Elective Contact                                                              cards visit
                                  $40 max copay
 Lens—Fitting and Evaluation                                                   bcbsilhalo or the EyeMed app.
                                                             Up to $105
 Elective Contact Lens            $140 allowance

Benefits Guide • 2022

Feeling Secure
Health Savings
Account (HSA)
An HSA is an individually owned savings
account that accompanies a qualified high
deductible health, and the funds may be
used towards future eligible medical
expenses or retirement. Your HSA funds
may be rolled over from year to year.
HSAs offer a triple tax advantage:

• Contributions are pre-tax or tax-deductible
• Earnings on the balance
  and investments are not taxed

• Funds withdrawn for qualified
  medical expenses are not taxed

The IRS has a limit on how much you can
contribute to your HSA on an annual
basis, these limits are outlined below.
Employees age 55 and older may contribute
an additional $1,000 annually in catch-
up contributions. The maximum HSA
contributions are:

• Single: $3,600
• Non-single: $7,200
You have the option to invest your HSA funds
up to $2,000 annually. For more information,

HALO contributes to your HSA, employees
with single coverage receive $500/year and
employees with all other coverage receive
$1,000/year. This is free money and the
funds are yours to keep. You must open your
account in order for HALO to be able to make
these contributions.

Benefits Guide • 2022

Feeling Secure
                 Flexible Spending
                 Accounts (FSA)
                 These are administered through Discovery
                 Benefits. The FSA allows you to contribute
                 pre-tax funds from each paycheck to
                 be used towards eligible healthcare
                 and/or dependent care expenses.
                 You may also contribute to a commuter FSA,
                 for eligible transit/parking expenses
                 for your work commute.

                 IRS rules state you cannot contribute
                 more than the following amounts:

                 • Healthcare FSA: $2,750 annually
                 • Dependent care FSA: $5,000 annually
                 • Commuter FSA: $270 monthly
                 At the end of the year, remaining money up
                 to $500 will be rolled over to the following
                 year for you to continue using. If you have
                 a balance above $500, that money will be
                 forfeited, so choose your FSA election
                 amount wisely.

Benefits Guide • 2022

Feeling Secure
Healthcare Flexible                              The dependent care FSA should be used
                                                 on expenses incurred to work, seek work,
Spending Account
                                                 or attend school. Dependent must be
NOTE: You are ineligible to contribute to the    under age 13 or incapable of self-care.
medical FSA if you are enrolled in the medical
HDHP with HSA plan.                              The dependent care FSA includes
                                                 a grace period and run-out period,
The healthcare FSA can be utilized for any       here’s how they work:
of the following types of expenses incurred
by you and your family:
                                                 • Grace period—This allows you to continue
                                                   to incur claims through March 15 following
• Copays                                           the close of the plan year
• Coinsurance                                    • Run-out period—Claims for the prior year
• Some services not covered by medical            and incurred during the grace period can
  or dental insurance, vision care,                be filed through March 31
  and prescription copays
                                                 Commuter FSA
Dependent Care FSA                               Commuter FSAs pre-tax funds can be used
The dependent care FSA allows you                towards expenses related to commuting to
to use pre-tax funds towards eligible            and from work for mass transit, vanpooling,
expenses such as:                                and work-related parking costs.

• Daycare                                        This includes:

• Preschool                                      • Transit passes, tokens
• Babysitting                                    • Fare cards, vouchers
• Summer day camp                                • Parking passes
• Dependent adult daycare                        Reminder: Unused funds over $500
                                                 at the end of the plan year will not be
                                                 refunded. There are no exceptions to this;
                                                 it is an IRS regulation.

Benefits Guide • 2022

Feeling Secure
Life and
Disability Benefits
Our life and accident insurance plans provide
financial protection in the event of the death
of a covered person or upon certain other
losses suffered as the result of an accident.

Life and Disability Reminders
• If you are enrolled in medical,
  the company will provide your basic
  life and AD&D coverage

• If you are not enrolled in medical,
  you must purchase the basic life and AD&D

• Basic life and AD&D, short term disability,
  and long term disability must
  be purchased all together and enrollment
  in one or two plans is not permitted

Your basic life and AD&D coverage is two
times your annual salary up to a maximum
of $250,000. Employee benefits are reduced
by 50% at age 70.

  Plan Design

 Benefit                   2x annual salary

                          Lesser of 2x annual
 Maximum Benefit
                          salary or $250,000

Benefits Guide • 2022

Feeling Secure
Supplemental Life                             Supplemental Life
You have the option to purchase additional
Life coverage for yourself, your spouse and   and Spouse
your dependent children. Premiums for
                                                     Bi-Weekly Contributions
employee and spouse/partner vary based
                                                     (based on units of $1,000)
on your age and will increase according
to the age ranges below and your age on        Under Age 29                     $0.037
September 1 of every calendar year.

• Employee coverage is available
                                               Age 30–34                        $0.051

  in $10,000 increments up to $400,000         Age 35–39                        $0.055

• Employee benefits reduce                    Age 40–44                        $0.069
  by 50% at age 70

• Spouse/partner coverage is available        Age 45–49                        $0.106

  in $5,000 increments up to $50,000           Age 50–54                        $0.175
      • S
         pouse/partner coverage cannot
        exceed 50% of employee coverage        Age 55–59                        $0.309

      • S
         pouse/partner supplemental           Age 60–64                        $0.485
        life coverage terminates at age 70

      • S
         pouse/partner rates are              Age 65–69                        $0.637
        based upon employee age

• Child coverage of $10,000 is available
                                               Age 70+                          $1.431

  for children over 6 months

• The guaranteed issue amounts
                                              To calculate bi-weekly cost—($ amount of
                                              requested additional insurance/$1,000) × rate
  are $200,000 for employee and
                                              (table above) = bi-weekly cost.
  $30,000 for spouse/partner

• To purchase coverage over these            Dependent Child Life
  amounts or after initial eligibility,
  you will be required to submit an
                                              Insurance Contribution
  evidence of insurability (EOI) form
  which will be reviewed and                         Bi-Weekly Contributions
  approved/rejected by New York Life

                                                              $0.0508 per $1,000

Benefits Guide • 2022

Feeling Secure
Short Term                                       Long Term
Disability                                       Disability
Short term disability (STD) replaces             Long term disability (LTD) protects your
your weekly income while you are out             income by providing you with a percentage
of work following a non-work-related             of your income while you are disabled.
accident or illness.                             Benefits begin after 90 days of a qualified

• Benefits go into effect on the                disability until age 65.

  8th day of a qualified disability

• Maximum of 11 weeks with                                     New York Life
  doctor certification
                                                            LTD                 Benefits
• If you are enrolled in the medical plan,
  short term disability will be provided
                                                  Benefit Percentage               60%
  by the company

• If you are not enrolled in the medical plan    Monthly Benefit Maximum         $10,000

  and wish to be covered you must purchase
                                                  Benefits Waiting Period         90 days
  the plan along with long term disability
  and basic life and disability insurance

                  New York Life

          STD                   Benefits

 Benefit Percentage                 66.67%

 Weekly Benefit Maximum             $1,500

                              8th day accident
 Benefits Begin
                              8th day sickness

 Benefits Duration                  11 weeks

Benefits Guide • 2022

Feeling Secure
Voluntary Critical                               You may choose group critical
                                                 illness insurance as follows:

Illness, Hospital                                • Employee coverage can be elected
                                                   in increments of $10,000 up to $30,000
Indemnity, and                                   • Spouse coverage can be elected in
Group Accident
                                                   increments of $5,000 up to $15,000,
                                                   election cannot exceed 50% of the
                                                   employee coverage amount
If you’re concerned about the financial
impact large medical expenses can have on
                                                 • Child coverage can be elected in
                                                   increments of $5,000 up to $15,000
you and your family or they are diagnosed
with a serious illness or sustain a serious
injury resulting in a hospital visit, consider   Guaranteed Issue
enrolling for critical illness, group hospital   If you are a new hire, you are not required
indemnity, or group accident insurance           to provide proof of good health if you enroll
coverage through Cigna.                          during your employer’s eligibility waiting
                                                 period and you choose an amount of
Voluntary Critical Illness                       coverage up to and including the guaranteed
                                                 issue amount. If you apply for an amount
The critical illness group plan pays a lump-
                                                 of coverage greater than the guaranteed
sum benefit if a covered person is diagnosed
                                                 issue amount, coverage in excess of the
with a heart attack, stroke, cancer or many
                                                 guaranteed issue amount will not be issued
other conditions. It can help cover out-of-
                                                 until the insurance company approves
pocket medical expenses for treatments that
                                                 acceptable proof of good health.
aren’t covered by your medical plan, such as
deductibles and coinsurance.

Benefits Guide • 2022

Feeling Secure
Critical Illness Contributions
           Age Band              $10,000       $20,000       $30,000
Employee (EE)—Bi-Weekly Contributions
Benefits Guide • 2022

Feeling Secure
Voluntary          Voluntary
Hospital Indemnity Group Accident
The hospital indemnity insurance program          The group accident insurance plan helps
pays a cash benefit to you for covered            offset your out-of-pocket expenses in the
hospital stays, outpatient surgery costs,         event of an accident, such as copays,
intensive care stays, and post hospital skilled   coinsurance, and other medical expenses.
nursing facility care. This cash payment can      This plan covers accidents that occur off
be used however you choose.                       the job and includes a range of incidents
                                                  from common injuries to more serious events.
Hospital Indemnity                                You may elect the following group
                                                  accident insurance:

          Bi-Weekly Contributions                 Group Accident
 Single                           $9.21

 EE + Spouse                     $18.37
                                                            Bi-Weekly Contributions
 EE + Child(ren)                 $16.52
                                                   Single                          $5.58
 Family                          $25.16
                                                   EE + Spouse                     $8.65

                                                   EE + Child(ren)                 $10.97

                                                   Family                          $14.04

Benefits Guide • 2022

Feeling Secure
401(k) Savings Plan
Bank of Oklahoma (BOK Financial)
administers our 401(k) plan. This benefit
allows you to save money for your retirement.
Contributing is a convenient way to invest
in your future by building a source of income
for your retirement.

You must be 18 years of age and are eligible
the first of the month following 30 days of
employment to contribute to the 401(k).

An automatic deferral amount of 3% of your
compensation will be withheld from each
of your paychecks. The automatic deferral
amount will be contributed as a pre-tax
elective deferral to the plan.

You can choose to contribute a percentage of your income
(1%-100% in whole percentages only) or a specified dollar amount
to the plan biweekly on either a pre-tax or an after-tax (Roth) basis.
Contributions are deducted from each biweekly pay check. You are
allowed to change, stop, or restart the amount of your contribution
at the next reasonable pay period.

Company Match
The company may offer an annual match of 50% on the first $1,000
of your contributions (maximum match of $500 annually). The match
is made in January for the previous year’s contributions. You must work
at least 1,000 hours and be employed on the last day of the calendar
year to be eligible for the match.

Benefits Guide • 2022

Feeling Secure
The eligible automatic contribution              If automatic deferrals are
arrangement (EACA) provisions apply to
                                                 withheld from my paycheck
the Plan. This type of automatic enrollment
allows the plan administrator to enroll
                                                 can I take that money out of
employees in the Plan.                           the Plan right away?
                                                 Yes, you may request that your automatic
What happens when I                              deferrals and any earnings on those

become eligible for the Plan?                    deferrals be distributed to you as long as you
                                                 make the request in writing within 90 days
If you are eligible to make elective deferrals
                                                 of when the automatic deferrals were first
and meet the requirements below and you
                                                 withheld from your paycheck. Any matching
do not make a deferral election by your
                                                 contributions associated with the automatic
entry date, the plan administrator will begin
                                                 deferrals that you take from the Plan by the
deducting automatic deferrals from each
                                                 deadline will be forfeited. After that deadline
of your paychecks and will submit those
                                                 has passed you will only be able to take the
amounts to the Plan (automatic deferrals)
                                                 automatic deferrals out of the Plan when
on your behalf.
                                                 elective deferrals can be distributed.

An automatic deferral amount of 3% of your
compensation will be withheld from each
                                                 Do the Plan’s automatic
of your paychecks. The automatic deferral        enrollment features apply
amount will be contributed as a pre-tax          to me if I have already
elective deferral to the Plan.                   made a deferral election?
                                                 No, if you have already made a deferral
If you do not wish to have automatic
                                                 election that amount will continue to be
deferrals withheld from each of your
                                                 withheld from each of your paychecks until
paychecks or if you want to change the
                                                 you make a new election.
amount withheld, you must make a deferral
election. If automatic deferrals have already
started, you may make a deferral election to
change the amount being withheld or to stop
the deferrals entirely.

Benefits Guide • 2022

Feeling Secure
Elective Deferrals
Your elective deferrals are amounts that
you chose to (or are assumed to have chosen
to) have withheld from your paycheck and
contributed to the Plan in your name. Please
see the section of your SPD titled “Eligibility
for Participation” to determine if you are
eligible to make elective deferrals and
“Contributions to the Plan” for the type of
compensation you may defer into the Plan.

How do I make or change
my deferral election?
You may make or change your deferral
election by going to the following web site
or calling the voice response unit at the
following number:
or calling 800.876.9557.

Once I make a deferral
election, how often can
I change, stop, or re-start
the election?
You may change or re-start your deferral
election as of the next reasonable pay
period. You may stop your deferrals
at any time.

Benefits Guide • 2022

Feeling Secure
Elective Deferrals
If I make a deferral election
is the amount withheld from
my paychecks taxed?
You will have the option to decide if the         The plan administrator may establish
amount you elect to defer into the Plan           additional rules you will need to follow when
is taxed or not. If you chose to have your        making your deferral election. Your deferral
elective deferrals go into the Plan as pre-tax    election is only effective for compensation
elective deferrals, you will not be taxed until   you have not received yet. The plan
you take the money out of the Plan. If you        administrator may also reduce or totally
chose to have your elective deferrals go into     suspend your election if they determine that
the Plan as Roth elective deferrals, you will     your election may cause the Plan to fail
be taxed on that money when it is taken out       to satisfy any of the requirements of the
of your paycheck, but it will not be taxed        Internal Revenue Code.
again when you take it out of the Plan. The
earnings on those Roth elective deferrals may     How will my account
be taken out tax-free if certain conditions are
                                                  balances be invested
met. Please see the SPD for more information
on Roth elective deferrals.
                                                  if I do not make an
                                                  investment election?
Are there any limits                              The Plan’s default investments are
to how much I can defer                           intended to meet the requirements to be a
                                                  qualified default investment alternative
into the Plan?
                                                  (QDIA). If you do not make an investment
Your elective deferrals are subject               election your account balances will be
to the following limits:                          placed in investments selected by the plan
• Your total amount of deferrals                 administrator. See the attached Qualified
  cannot be more than $19,500                     Default Investment Alternative information

• If you are age 50 or over, you may             which provides information on the default
                                                  fund you will be invested in if you fail to
  defer an additional amount, called a
                                                  make an investment election.
  “catchup contribution,” of up to $6,500

Benefits Guide • 2022

Feeling Secure
Work/Life Balance
Assistance Program                               Achieve Work/Life Balance
Whether your needs are big or small, your life   For help handling life’s challenges go on line
assistance and work/life support program is      for articles and resources including on family,
there for you. It can help you and your family   care giving, pet care, aging, grief, balancing,
finds solutions and restore your peace of        working smarter, and more.
mind. You and your family may access the life
assistance program 24/7 on the phone at no       Legal Consultation
extra cost to you. An advocate can help you
                                                 and Referrals*
assess your needs and develop a solution.
                                                 Receive a free 30-minute consultation with a
He or she can also direct you to community
                                                 network attorney. And up to a 25% discount
resources and online tools.
                                                 on select fees.

Visit a Specialist
You have three face-to-face sessions with a      Financial Consultations
behavioral counselor available to you—and        Receive a free 30-minute consultation
your household members. Call New York Life       and 25% discount on tax planning and
to request a referral.                           preparation.

Monthly Webinars                                 The life assistance program is available

Educational seminars on a variety of             to you at no additional cost. For more

relevant topics such as managing your life,      information on 24/7 support, call

work, money and health are available in a        800.538.3543 or visit

quarterly calendar of monthly webcasts
distributed to your employer.

Benefits Guide • 2022

Feeling Secure
Access Your Maternity
and Family Benefits—BCBSIL
Ovia Health provides maternity and family apps to support enrolled members through
your entire parenthood journey. These apps are included in your health plan benefits,
offered through Blue Cross and Blue Shield of Illinois (BCBSIL).

Follow These Easy Steps to                          With Ovia Health, You’ll
Download Ovia and Launch                            Have Access to Enhanced,
Your Account:                                       Personalized Health and
01 Download the app that’s right for you            Wellness Features:
      • Ovia Fertility—Health & Fertility           Health Assessment
      • Ovia Pregnancy—Pregnancy & Postpartum      and Symptom Tracking
      • Ovia Parenting—Family & Working Parents    Receive alerts and predictive, personal
                                                    coaching when Ovia detects a potential
02 When signing up, choose “I have Ovia            medical issue.
    Health as a benefit” before tapping “Sign
    up” and make sure to select BCBSIL as           Over Fifty Physician-Developed
    your health plan and enter your employer        Clinical Programs to Help You
    name (optional).
                                                    be as Healthy As Possible
                                                    Engage with personalized health and
03 Already have an Ovia app on your phone?
                                                    wellness programs to help you navigate
      • O
         pen your app and tap “Health” to take
                                                    infertility, sexual health, birth planning,
        the Ovia Health Assessment.
                                                    preterm delivery, mental health,
      • T
         ap “Update my healthcare information”
                                                    breastfeeding, and more.
        and select BCBSIL as your health plan and
        enter your employer name (optional).
                                                    Unlimited 1-on-1 Coaching
If You Do Not Indicate BCBSIL                       Message instantly with Registered Nurse
As Your Health Plan, You’ll Only                    health coaches to ask all your questions.

Be Able To Access Some Of The
                                                    Career and
Features Available To You:                          Return-to-Work Programs
• Health and menstrual cycle tracker                Find coaching and career advice for

• Pregnancy calendar & daily baby updates           preparing for maternity leave, returning

• Child’s development checklist                     to work, and being a working parent.

• Daily health and wellness content
• Data & symptom feedback
Benefits Guide • 2022

HALO Benefits
Contact Information
General Benefits                     Life and Disability
Questions                            New York Life (formerly Cigna)
Matt Barbian                         800.362.4462                
                                     Group #s:
Medical and Pharmacy                 Basic Life: FLX966896
                                     Basic AD&D: OK968384
Blue Cross Blue Shield of Illinois
                                     Supplemental Voluntary Life: FLX966876
800.676.BLUE (2583)
                                     LTD: LK964719
HDHP Group #PI3985
PPO Group #PI4019
                                     Life Assistance Program
MDLIVE Virtual Visits                Cigna

Health Savings
Account (HSA)                        Bank of Oklahoma
Fifth Third Bank           
Code: FTB- 149704
Flexible Spending                    800.351.9214
Account (FSA)              
                                     Group #AI961176P
Wex (formerly Discovery Benefits)
                                     Critical Illness
Dental                               800.351.9214
Delta Dental of Illinois             Group #CI96113P
                                     Hospital Indemnity
Group #20210
Vision                               800.351.9214
Blue Cross Blue Shield of Illinois   Group #HC960527P
Group #281298

HALO Branded Solutions, Inc.
                                 HEALTH PLAN NOTICES
                                              TABLE OF CONTENTS

1.      Medicare Part D Creditable Coverage Notice
2.      HIPAA Comprehensive Notice of Privacy Policy and Procedures
3.      Notice of Special Enrollment Rights
4.      General COBRA Notice
5.      Women’s Health and Cancer Rights Notice

                            IMPORTANT NOTICE
     This packet of notices related to our health care plan includes a notice
      regarding how the plan’s prescription drug coverage compares to
     Medicare Part D. If you or a covered family member is also enrolled in
     Medicare Parts A or B, but not Part D, you should read the Medicare
      Part D notice carefully. It is titled, “Important Notice From HALO
     Branded Solutions, Inc. About Your Prescription Drug Coverage and

                                COVERAGE AND MEDICARE

    Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription
    drug coverage with HALO Branded Solutions, Inc. and about your options under Medicare’s prescription drug coverage. This
    information can help you decide whether you want to join a Medicare drug plan. Information about where you can get help to
    make decisions about your prescription drug coverage is at the end of this notice.

    If neither you nor any of your covered dependents are eligible for or have Medicare, this notice does not apply to you or your
    dependents, as the case may be. However, you should still keep a copy of this notice in the event you or a dependent should
    qualify for coverage under Medicare in the future. Please note, however, that later notices might supersede this notice.

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. HALO Branded Solutions, Inc. has determined that the prescription drug coverage offered by the HALO Branded Solutions,
   Inc. Employee Health Care Plan (“Plan”) is, on average for all plan participants, expected to pay out as much as standard
   Medicare prescription drug coverage pays and is considered “creditable” prescription drug coverage. This is important for the
   reasons described below. ____________________________________________________________

    Because your existing coverage is, on average, at least as good as standard Medicare prescription drug coverage, you can keep
    this coverage and not pay a higher premium (a penalty) if you later decide to enroll in a Medicare drug plan, as long as you later
    enroll within specific time periods.

    Enrolling in Medicare—General Rules
    As some background, you can join a Medicare drug plan when you first become eligible for Medicare. If you qualify for
    Medicare due to age, you may enroll in a Medicare drug plan during a seven-month initial enrollment period. That period begins
    three months prior to your 65th birthday, includes the month you turn 65, and continues for the ensuing three months. If you
    qualify for Medicare due to disability or end-stage renal disease, your initial Medicare Part D enrollment period depends on the
    date your disability or treatment began. For more information you should contact Medicare at the telephone number or web
    address listed below.

    Late Enrollment and the Late Enrollment Penalty

    If you decide to wait to enroll in a Medicare drug plan you may enroll later, during Medicare Part D’s annual enrollment
    period, which runs each year from October 15 through December 7. But as a general rule, if you delay your enrollment in
    Medicare Part D, after first becoming eligible to enroll, you may have to pay a higher premium (a penalty).

    If after your initial Medicare Part D enrollment period you go 63 continuous days or longer without “creditable”
    prescription drug coverage (that is, prescription drug coverage that’s at least as good as Medicare’s prescription drug
    coverage), your monthly Part D premium may go up by at least 1 percent of the premium you would have paid had you
    enrolled timely, for every month that you did not have creditable coverage.

    For example, if after your Medicare Part D initial enrollment period you go 19 months without coverage, your premium
    may be at least 19% higher than the premium you otherwise would have paid. You may have to pay this higher premium
    for as long as you have Medicare prescription drug coverage. However, there are some important exceptions to the late
    enrollment penalty.
Special Enrollment Period Exceptions to the Late Enrollment Penalty
There are “special enrollment periods” that allow you to add Medicare Part D coverage months or even years after you
first became eligible to do so, without a penalty. For example, if after your Medicare Part D initial enrollment period you
lose or decide to leave employer-sponsored or union-sponsored health coverage that includes “creditable” prescription
drug coverage, you will be eligible to join a Medicare drug plan at that time.

In addition, if you otherwise lose other creditable prescription drug coverage (such as under an individual policy) through
no fault of your own, you will be able to join a Medicare drug plan, again without penalty. These special enrollment
periods end two months after the month in which your other coverage ends.

Compare Coverage
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. See the HALO Branded Solutions, Inc. Plan’s
summary plan description for a summary of the Plan’s prescription drug coverage. If you don’t have a copy, you can get
one by contacting us at the telephone number or address listed below.

Coordinating Other Coverage With Medicare Part D
Generally speaking, if you decide to join a Medicare drug plan while covered under the HALO Branded Solutions, Inc.
Plan due to your employment (or someone else’s employment, such as a spouse or parent), your coverage under the
HALO Branded Solutions, Inc. Plan will not be affected. For most persons covered under the Plan, the Plan will pay
prescription drug benefits first, and Medicare will determine its payments second. For more information about this issue
of what program pays first and what program pays second, see the Plan’s summary plan description or contact Medicare
at the telephone number or web address listed below.

If you do decide to join a Medicare drug plan and drop your HALO Branded Solutions, Inc. prescription drug coverage,
be aware that you and your dependents may not be able to get this coverage back. To regain coverage you would have to
re-enroll in the Plan, pursuant to the Plan’s eligibility and enrollment rules. You should review the Plan’s summary plan
description to determine if and when you are allowed to add coverage.

For More Information About This Notice or Your Current Prescription Drug Coverage…
Contact the person listed below for further information, or call 815-548-9101. 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 HALO Branded
Solutions, Inc. changes. You also may request a copy.

For More Information About Your Options Under Medicare Prescription Drug Coverage…
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
• 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, 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 whether or not you are required to pay a higher premium (a penalty).

                         Date:          September 1, 2021
        Name of Entity/Sender:          Matt Barbian
      Contact—Position/Office:          Benefits Specialist
                      Address:          1500 HALO Way
                                        Sterling, IL 61081
               Phone Number:            815-548-9101

Nothing in this notice gives you or your dependents a right to coverage under the Plan. Your (or your dependents’)
right to coverage under the Plan is determined solely under the terms of the Plan.
                                         AND PROCEDURES

                                HALO BRANDED SOLUTIONS, INC.
                                     IMPORTANT NOTICE


This notice is provided to you on behalf of:

                                 HALO Branded Solutions, Inc. Welfare Benefit Plan*

* This notice pertains only to healthcare coverage provided under the plan.

The Plan’s Duty to Safeguard Your Protected Health Information
Individually identifiable information about your past, present, or future health or condition, the provision of health care to
you, or payment for the health care is considered “Protected Health Information” (“PHI”). The Plan is required to extend
certain protections to your PHI, and to give you this notice about its privacy practices that explains how, when, and why
the Plan may use or disclose your PHI. Except in specified circumstances, the Plan may use or disclose only the minimum
necessary PHI to accomplish the purpose of the use or disclosure.

The Plan is required to follow the privacy practices described in this notice, though it reserves the right to change those
practices and the terms of this notice at any time. If it does so, and the change is material, you will receive a revised
version of this Notice either by hand delivery, mail delivery to your last known address, or some other fashion. This
notice, and any material revisions of it, will also be provided to you in writing upon your request (ask your Human
Resources representative, or contact the Plan’s Privacy Official, described below), and will be posted on any website
maintained by HALO Branded Solutions, Inc. that describes benefits available to employees and dependents.

You may also receive one or more other privacy notices from insurance companies that provide benefits under the Plan.
Those notices will describe how the insurance companies use and disclose PHI and your rights with respect to the PHI
they maintain.

How the Plan May Use and Disclose Your Protected Health Information
The Plan uses and discloses PHI for a variety of reasons. For its routine uses and disclosures it does not require your
authorization, but for other uses and disclosures, your authorization (or the authorization of your personal representative
(e.g., a person who is your custodian, guardian, or has your power-of-attorney) may be required. The following offers
more description and examples of the Plan’s uses and disclosures of your PHI.

•   Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations.
    • Treatment: Generally, and as you would expect, the Plan is permitted to disclose your PHI for purposes of your
       medical treatment. Thus, it may disclose your PHI to doctors, nurses, hospitals, emergency medical technicians,
       pharmacists, and other health care professionals where the disclosure is for your medical treatment. For example,
       if you are injured in an accident, and it’s important for your treatment team to know your blood type, the Plan
       could disclose that PHI to the team in order to allow it to more effectively provide treatment to you.
    • Payment: Of course, the Plan’s most important function, as far as you are concerned, is that it pays for all or
       some of the medical care you receive (provided the care is covered by the Plan). In the course of its payment
       operations, the Plan receives a substantial amount of PHI about you. For example, doctors, hospitals, and
       pharmacies that provide you care send the Plan detailed information about the care they provided, so that they can
       be paid for their services. The Plan may also share your PHI with other plans in certain cases. For example, if you
       are covered by more than one health care plan (e.g., covered by this Plan and your spouse’s plan or covered by the
plans covering your father and mother), we may share your PHI with the other plans to coordinate payment of
          your claims.
    • Health care Operations: The Plan may use and disclose your PHI in the course of its “health care operations.”
          For example, it may use your PHI in evaluating the quality of services you received or disclose your PHI to an
          accountant or attorney for audit purposes. In some cases, the Plan may disclose your PHI to insurance companies
          for purposes of obtaining various insurance coverages. However, the Plan will not disclose, for underwriting
          purposes, PHI that is genetic information.
•   Other Uses and Disclosures of Your PHI Not Requiring Authorization. The law provides that the Plan may use
    and disclose your PHI without authorization in the following circumstances:
    • To the Plan Sponsor: The Plan may disclose PHI to the employers (such as HALO Branded Solutions, Inc.) who
          sponsor or maintain the Plan for the benefit of employees and dependents. However, the PHI may only be used
          for limited purposes, and may not be used for purposes of employment-related actions or decisions or in
          connection with any other benefit or employee benefit plan of the employers. PHI may be disclosed to: the human
          resources or employee benefits department for purposes of enrollments and disenrollments, census, claim
          resolutions, and other matters related to Plan administration; payroll department for purposes of ensuring
          appropriate payroll deductions and other payments by covered persons for their coverage; information technology
          department, as needed for preparation of data compilations and reports related to Plan administration; finance
          department for purposes of reconciling appropriate payments of premium to and benefits from the Plan, and other
          matters related to Plan administration; internal legal counsel to assist with resolution of claim, coverage, and other
          disputes related to the Plan’s provision of benefits.
    • To the Plan’s Service Providers: The Plan may disclose PHI to its service providers (“business associates”) who
          perform claim payment and plan management services. The Plan requires a written contract that obligates the
          business associate to safeguard and limit the use of PHI.
    • Required by Law: The Plan may disclose PHI when a law requires that it report information about suspected
          abuse, neglect, or domestic violence, or relating to suspected criminal activity, or in response to a court order. It
          must also disclose PHI to authorities that monitor compliance with these privacy requirements.
    • For Public Health Activities: The Plan may disclose PHI when required to collect information about disease or
          injury, or to report vital statistics to the public health authority.
    • For Health Oversight Activities: The Plan may disclose PHI to agencies or departments responsible for
          monitoring the health care system for such purposes as reporting or investigation of unusual incidents.
    • Relating to Decedents: The Plan may disclose PHI relating to an individual’s death to coroners, medical
          examiners, or funeral directors, and to organ procurement organizations relating to organ, eye, or tissue donations
          or transplants.
    • For Research Purposes: In certain circumstances, and under strict supervision of a privacy board, the Plan may
          disclose PHI to assist medical and psychiatric research.
    • To Avert Threat to Health or Safety: In order to avoid a serious threat to health or safety, the Plan may disclose
          PHI as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of harm.
    • For Specific Government Functions: The Plan may disclose PHI of military personnel and veterans in certain
          situations, to correctional facilities in certain situations, to government programs relating to eligibility and
          enrollment, and for national security reasons.
•   Uses and Disclosures Requiring Authorization: For uses and disclosures beyond treatment, payment, and
    operations purposes, and for reasons not included in one of the exceptions described above, the Plan is required to
    have your written authorization. For example, uses and disclosures of psychotherapy notes, uses and disclosures of
    PHI for marketing purposes, and disclosures that constitute a sale of PHI would require your authorization. Your
    authorization can be revoked at any time to stop future uses and disclosures, except to the extent that the Plan has
    already undertaken an action in reliance upon your authorization.
•   Uses and Disclosures Requiring You to Have an Opportunity to Object: The Plan may share PHI with your
    family, friend, or other person involved in your care, or payment for your care. We may also share PHI with these
    people to notify them about your location, general condition, or death. However, the Plan may disclose your PHI only
    if it informs you about the disclosure in advance and you do not object (but if there is an emergency situation and you
    cannot be given your opportunity to object, disclosure may be made if it is consistent with any prior expressed wishes
    and disclosure is determined to be in your best interests; you must be informed and given an opportunity to object to
    further disclosure as soon as you are able to do so).
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