2026 AtlantiCare Benefits Booklet

VOLUNTARYBENEFITS (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

Critical Illness Insurance* The Critical Illness benefit from Allstate helps provide financial assistance should you or a covered family member be diagnosed with a covered illness such as a heart attack, stroke or cancer. For these types of illnesses, your cash needs are significant, and could include medical expenses like deductibles, copays and coinsurance costs, as well as non-medical expenses such as transportation, childcare, lost time fromwork and home maintenance. The plan is easy to use. Simply provide proof of your covered condition once and the plan pays a lump-sum benefit directly to you in addition to any other insurance benefits you may receive. You may purchase up to $30,000 of coverage. Spousal coverage is available up to 50% of your elected amount and dependent children are covered at 50% of your coverage amount at no additional cost. This is not a once-and-done benefit. Benefits are payable for each covered condition if the diagnosis is separated by at least 90 days. If a serious illness happens to you or a loved one, Allstate Critical Illness coverage provides you with a lump-sum payment that can be used for expenses not usually covered by medical or disability income plans. Coverage is available for you, your spouse and dependent children. During your initial opportunity to enroll, you may elect coverage without having to answer health questions. The plan will not pay a benefit during the first 12 months for a condition that you were being treated for or sought medical advice for during the 90 days prior to your enrollment in this plan. 1-855-799-5400 customercare@corestream.com *Subject to Open Enrollment and Plan guidelines.

Group Universal Life Insurance* Allstate Group Universal Life provides a lump-sum cash benefit upon death – plus a long-term care feature. Life insurance coverage is for the living; those left behind must deal with final expenses, bills, mortgage and expenses associated with day-to-day life. It can also help provide financial security during life-changing events that occur as you age and your needs change. Plus, fund value accumulation allows for loans and withdrawals when needed. Group Universal Life Insurance is flexible and can provide living or death benefits that adjust based on changing lifetime needs. It includes: • Cash Value – for loans and withdrawals, when needed • Living Benefits – in the event of a Terminal Illness • Long-Term Care Benefits – for qualified Long-Term Care expenses It is permanent as opposed to term insurance – as long as you pay the required premiums, the policy will provide a death benefit. It is portable – you can take it with you, regardless of employment or retirement, without a change in premium because you have aged. Upon your election of Universal Life Insurance, you have the option to elect additional coverage for your dependents: • Spouse Universal Life includes the same flexible provisions such as living or death benefits. • Children Term Life Insurance 1-855-799-5400 customercare@corestream.com

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