2026 CODAC Benefit Summaries and Carrier Flyers

Covered Expense means those Medically Necessary services, supplies and/or treatment that are covered under this Plan. Covered Expense does not necessarily mean the actual charge made nor the specific service or supply furnished to a Covered Person by a Provider. Charges for services, supplies, and/or treatments meant to treat or correct a preventable condition or cost which arises solely due to a Provider’s medical error are not considered Covered Expenses. A finding of Provider negligence and/or malpractice is not required for service(s) and/or fee(s) to be considered not Reasonable and Allowed or not a Covered Expense. Details regarding Covered Expenses that are health care services subject to the federal No Surprises Act protections are provided in the Protection from Balance Billing section of this SPD. Custodial Care means non-medical care given to a Covered Person, such as administering medication and assisting with personal hygiene or other Activities of Daily Living, rather than providing therapeutic treatment and services. Custodial Care services can be safely and adequately provided by persons who do not have the technical skills of a covered health care Provider. Custodial Care also includes care when active medical treatment cannot be reasonably expected to reduce a disability or improve the condition of a Covered Person. Deductible means an amount of money paid once per Plan Year by the Covered Person (up to a family limit, if applicable) before any Covered Expenses are paid by the Plan. The Schedule of Benefits shows the amount of the applicable Deductible (if any) and the health care benefits to which it applies. Covered Person means an Employee or Dependent who is enrolled under this Plan at the time the services are rendered.

Dependent – see the Eligibility and Enrollment section of this SPD.

Developmental Delays means conditions that are characterized by impairment in various areas of development, such as social interaction skills, adaptive behavior, and communication skills.

Domestic Partner / Domestic Partnership means a relationship between an Employee and one other person of the same or opposite sex. All of the following requirements apply to both persons:

• They must not be related by blood or a degree of closeness that would prohibit marriage in the law of the state in which they reside; • They must not be currently married to, or a Domestic Partner of, another person under with statutory or common law; • They must be at least 18 years old; • They must share the same permanent residence and the common necessities of life; • They must be mentally competent to enter into a contract; • They must be financially interdependent;

The Employee and Domestic Partner must jointly sign an affidavit of domestic partnership provide by Human Resources upon our request.

Durable Medical Equipment means equipment that meets all of the following criteria:

It can withstand repeated use.

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• It is primarily used to serve a medical purpose with respect to an Illness or Injury. • It is generally not useful to a person in the absence of an Illness or Injury. • It i s appropriate for use in the Covered Person’s home.

A cochlear implant is not considered Durable Medical Equipment.

Effective Date means the first day of coverage under this Plan as defined in this SPD. The Covered Person’s Effective Date may or may not be the same as his or her Enrollment Date, as Enrollment Date is defined by the Plan.

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