2026 AtlantiCare Benefits Booklet

MEDICAL (CONT.)

WELCOME....................................2 WHAT’S NEW..............................3 HOW TO ENROLL......................4 HEALTHCARE TRANSFORMATION CONSORTIUM (HTC)...............6 GETTING TO KNOW YOUR PLAN.................................7 MEDICAL......................................8 PRESCRIPTION DRUG.......... 17 FQHC........................................... 19 ADDITIONAL MEDICAL PLAN RESOURCES................. 20 WELLNESS PROGRAM......... 21 DENTAL...................................... 23 VISION........................................ 25 LIFE INSURANCE.................... 28 DISABILITY............................... 30 VOLUNTARY OFFERINGS... 31 EDUCATIONAL SUPPORT & CAREER DEVELOPMENT...................... 31 FINANCIAL WELL-BEING.... 32 HEALTH &WELLNESS.......... 33 SAVINGS.................................... 34 VOLUNTARY BENEFITS....... 35 SPENDING ACCOUNTS............................... 38 RETIREMENT BENEFITS................................... 39 CONTACTS................................ 41 LEGAL NOTICES....................... 43 WELLNESS CHECKLIST........ 45

Make The Most Of Your Medical Benefits • Consider the Aetna Select Plan – The contributions are low cost, and unless you have many physicians who are out of network, the Aetna Select Plan’s network should meet your needs. • Preventive Care at No Cost – Preventive care is comprised of a variety of clinical services and programs, including annual doctor’s checkups, annual immunizations and screenings. Make sure your provider codes all eligible claims as preventive care in order to be eligible for 100% coverage. • Out-of-Pocket Maximums – You are protected from catastrophic medical expenses by the annual out-of-pocket maximum. When your out-of-pocket expenses (deductibles, copays and coinsurances) reach the out-of-pocket maximum, the plan pays the full cost for any covered care you receive for the rest of the year.

• Contact Aetna before a procedure to determine what you can expect to pay and to ensure any pre-authorizations have been completed. • Consider participating in Flexible Spending Accounts to supplement your out-of-pocket expenses. • Complete wellness activities to earn wellness credits which would be applied to a Health Reimbursement Spending Account.

WAIVING BENEFITS If you waive your medical benefits, $12.50 per pay* will be deposited into a Healthcare Reimbursement Account (HRA). You can use the HRA to be reimbursed for eligible expenses. The HRA is administered by Baker Tilly. For a list of eligible expenses, log in to your account at www.MyFlexDollars.com . More information on Spending Accounts on page 38. In addition, your earned wellness credits from 2025 of up to $250 will also be deposited into this account that will be applied the following year . For more information, refer to theWellness Program portion of this book on page 21. Please visit https://myatlanticare.org to view your online wellness activity checklist or call Health Engagement at 1-609-677-7507 if you have questions about your wellness activities. *If you are covered by another AtlantiCare employee and you waive medical coverage, you will not be eligible for the waiver benefit.

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