NCBA Health Benefit Trust Program Overview

NCBA Health Benefit Trust (NCBAHBT) is a program established to provide medical benefits to member banks through a community rating model. It offers a pooled approach through MEWA, ensuring lower costs, rate stability, and innovative risk management. The trust is regulated by the NC Department of Insurance and administered by Community Bank Services, offering flexible plan options, compliance resources, and dedicated customer service.

• Health Benefits
• Trust Program
• MEWA
• Community Rating
• Compliance

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1. 1 NCBA Group Benefit Program Renewal Lauren R. Perry Sheraton Imperial, Durham, NC March 29, 2022

2. 2 Agenda NCBAHBT Overview I. II. MEWA Update III. Medical Trend IV. Medical Renewal Rating & Benefit Changes V. Health Savings Account Considerations VI. Dental Renewal VII. Vision Renewal VIII.Life Renewal IX. Open Enrollment Instructions

3. 3 NCBA Health Benefit Trust Overview Established in 1999 as a Voluntary Employees Beneficiary Association plan (VEBA): 501(c)(9) tax-exempt trust Regulated by the NC DOI as a Multiple Employer Welfare Arrangement (MEWA) sponsored by the NCBA to provide medical benefits to member banks with a community rating model. NC DOI reviews and approves the rates and plan designs annually. Plan is administered by Community Bank Services and governed by a board of Trustees who are participating members. Funded by the participating members through premium contributions based on the plan elected by each institution. NCBAHBT contracts with providers on behalf of the membership to manage eligibility, billing, COBRA administration, network access, claim processing, medical utilization and wellness.

4. NCBAHBT Pooled approach of MEWA means: Lower fixed costs through large purchasing pool 13% of premium Safety for individual employers as risk is spread amongst larger population Rate stability over time 5.8% average increase over past 10 years compared to 8.0% national trend Mitigating large claim exposure for individual employers 100% return of pharmacy rebates 100% return of investment credit Plan surplus returned to participants when reserves exceed 35% of expected premium Flexible plan design options and eligibility provisions at the bank level Innovative risk management and wellness programs Compliance resource (5500, ACA reporting, SAR, SPDs, SBCs, Form 1095 prep) Dedicated customer service Consolidated online enrollment, billing and COBRA platform

5. 5 MEWA Update 23rd Year 36 participating member institutions Covering 3,900 lives 2,250 employees 1,650 dependents Financials as of 2/28/22: Paid Claims: $21,345,000 Premium Collected: $20,353,000 (+ $1.2M holiday issued in Aug 2021) Stop loss reimbursements: $200,000 (+$250,000 receivable) Pharmacy Rebates Received: $1,284,000 Reserves: $10,450,000

6. 6 MEDICAL TREND

7. 7 Medical Trend 6.8% Healthcare trend, or medical inflation, is used in the development of medical plan rates. The NCBAHBT is advised by BCBSNC and Express Scripts, on the medical and pharmacy trends to project future cost. Factors Included in Trend * Medical/Pharmacy Trends: 2016 10.1% 2017 8.2% 2018 7.6% 2019 9.4% 2020 7.9% 2021 8.17% 2022 6.8% Price Inflation Utilization Demographics Contracts with NC providers Mandated Benefits * New Treatments Therapies Technology *

8. 8 2020/2021 Drivers of Health Plan Cost COVID-19 High Cost Claimants / Specialty Rx Testing/Screening = $252,888 16 claimants exceeding $225,000 stop loss vs. 6 average claimants/year Diagnosis/Treatment = $758,552 $7,213,000 paid, $3,600,000 reimbursed from stop loss carrier Vaccines = $38,815* TOTAL SPEND = $1,050,255 High-cost brand Rx and speciality medications driving 55% of pharmacy spend *Vaccine expense is understated. Does not include vaccines obtained from providers who did not file with BCBSNC.

9. 9 COVID-19 Claims & Utilization Report

10. 10 1% of claims account for nearly half of Rx expenses! Pharmacy Utilization by Tier

11. 11 RENEWAL RATING & BENEFIT CHANGES Medical Plan Year June 1, 2022 May 31, 2023

12. 12 Medical Plan Renewal Projection *Current claims with a 6.8% trend adjustment Projected Incurred Claims* + Stop Loss Coverage + Fixed Costs & Admin Expense - Investment Credit - Drug Rebates = Net Projected Cost $26,279,313 2,055,986 2,893,858 (60,534) (1,303,908)_____ $29,864,714 $2,193,727 Total premium at current rates $27,670,987 Proposed Rate Increase = 7.9%

13. 13 Rate History 2012 Rate History 2012 - - 2022 2022 NCBAHBT Medical Plan vs. National Trend 12.00% 10.00% 8.0% 8.00% 6.00% Increase 5.8% 4.00% 2.00% 0.00% Year (*Premium Holiday Issued) NCBAHBT Medical Increase National Medical Trend Linear (NCBAHBT Medical Increase) Linear (National Medical Trend)

14. 14 Net Premium Per Employee Per Year 25000 20000 15000 10000 5000 0 2011* 2012 2013* 2014* 2015* 2016 2017* 2018* 2019* 2020* 2021* 2022 NCBAHBT Cost PEPY NCBAHBT Cost PEPY with Holiday National Plan Cost PEPY Total Cost Per Employee 2011 - 2022 165137.21 National Plan Total Cost 21.9% Savings for NCBAHBT Participating Banks 129010.90 NCBAHBT Total Cost with Holiday 135309.57 NCBAHBT Total Cost

15. 15 $250 increase to deductibles and coinsurance in the PPO plans ($500 net increase in the out-of-pocket maximum). Deductibles have not been adjusted since 2014. Medical Plan Highlights and Changes BlueConnect Members who register for BlueConnect will receive $25 in BlueRewards! $5 in BlueRewards for members who watch Learn More about Your Plan and $5 for members who update their contact preferences. Effective June 1, 2022 Case Management - $200 incentive will continue to be provided to members who engage in Case Management. Prenatal Program - $100 participation incentive will continue for members who register for the BCBSNC MyPregnancy App. Cancellation of GoPivot program effective May 31st. Low participation (41 unique users in 2021). REDEEM ALL GO PIVOT POINTS BY MAY 31, 2022!! New NCBAHBT wellness program through Wellview!

16. 16 TeleDocTelehealth Benefit Interactive audio and video consultation with doctor who can diagnose and prescribe medication. Office visit copay applies and accumulates towards OOP max. TeleDoc welcome kit will arrive in May. $10 Copay per TeleDoc Visit Medical Plan Highlights and Changes Effective June 1, 2022 Vitals SmartShopper Incentive and engagement program which empowers employees to better understand cost and take control of their health care options. Participants receive rewards by shopping for certain services/procedures and selecting the provider with better value and outcomes. MRI - $100 Mammogram - $50 Knee Replacement - $500 Colonoscopy - $150

17. 17

18. 18 Pharmacy Changes Express Scripts will remain the pharmacy benefit manager (PBM) for the upcoming plan year. Pharmacy copayments accumulate towards the global out of pocket maximum Tier 1 (generic) - $9 Tier 2 (preferred brand) - $35 Tier 3 (non-preferred brand) - $65 (increase from $55), first time since 2017. Tier 4 (specialty) 25% to $150 max

19. 19 PPO 100 and PPO 90 Plans PPO 100 PPO 90 Primary Care Office Visit / MD Live $25 Copay ($10 MD Live) Specialist Office Visit $45 Copay Urgent Care $45 Copay Emergency Room $250 Copay Inpatient/Outpatient $300, then 0%* 10%* Deductible* $750 individual $1,500 family $1,000 individual $2,000 family Coinsurance % 0%* 10%* Out of Pocket Maximum $1,500 individual $3,000 family $3,750 individual $7,500 family

20. 20 PPO 80, PPO 70, PPO 3250 Plans PPO 80 PPO 70 $30 Copay ($10 MD Live) PPO 3500 Primary Care Office Visit / MD Live Specialist Office Visit Urgent Care Emergency Room Inpatient/Outpatient $50 Copay $50 Copay $250 Copay 30%* 20%* 20%* Deductible* $1,500 individual $3,000 family 20%* $4,250 individual $8,500 family $2,000 individual $4,000 family 30%* $5,250 individual $10,500 family $3,500 individual $7,000 family 20%* $6,850 individual $13,700 family Coinsurance % Out of Pocket Maximum

21. 21 PPO 4500 & PPO 1-2-3 Plans PPO 4750 PPO 1-2-3 Primary Care Office Visit / MD Live $30 Copay ($10 MD Live) $25 Copay ($10 MD Live) Specialist Office Visit $75 Copay 40%* Urgent Care $75 Copay 40%* Emergency Room $250 Copay 40%* Inpatient/Outpatient 30%* $250, then 20%* Deductible* $4,750 individual $9,500 family $2,750 individual $5,500 family Coinsurance % 30%* 40%*, 20%* Out of Pocket Maximum $7,350 individual $14,700 family $6,850 individual $13,700 family

22. 22 High Deductible Health Plans (HDHP) Qualified HD Plans: With the exception of preventative care, the plans must not provide benefits for any medical or pharmacy expenses before the deductible is satisfied. The entire family contributes towards the aggregate deductible. Coverage is not provided for a participant in a family plan until the family deductible has been satisfied or one member satisfies $7,150. All expenses covered at 100% after deductible & out of pocket maximum is satisfied. HD 1750 Plan: Individual OOP $5,250 / Family $10,500 / Family member $7,150 HD 3250 Plan: Individual Deductible $3,250 / Family $6,500 HD 5250 Plan: Individual Deductible $5,250 / Family $10,500 / Family member $7,150

23. 23 High Deductible Plans HD 1750 HD 3250 HD 5250 Primary Care Office Visit / MD Live Specialist Office Visit 20%* 0%* 0%* 20%* 0%* 0%* Urgent Care Emergency Room Inpatient/Outpatient 20%* 20%* 20%* 0%* 0%* 0%* 0%* 0%* 0%* Deductible* $1,750 individual $3,500 family 20%* $5,250 individual $10,500 family $7,150 $3,250 individual $6,500 family 0%* $3,250 individual $6,500 family $6,500 $5,250 individual $10,500 family 0%* $5,250 individual $10,500 family $7,150 Coinsurance % Out of Pocket Maximum Max OOP Per Family Member

24. WHAT ARE THE BENEFITS OF AN HSA? Tax-Free Savings Account for Qualified Medical Expenses Balance rolls from year to year no use it or lose it Contribute money tax-free rules Account is owned by employee and unused funds may be withdrawn at age 65 without penalty. Use money for medical expenses tax-free Distributions after age 65 do not have to be for eligible medical expenses. Earn interest over time tax-free HEALTH SAVINGS ACCOUNT

25. HDHP & HSA ANNUAL HSA CONTRIBUTION LIMITS ANNUAL CONTRIBUTION LIMITS ADDITIONAL FUNDING AMOUNT OF FUNDING 2022 Catch-up Contributions above the annual limit are subject to income taxes and a 20% penalty $3,650 Individual $7,300 Family Contribution (for age 55 and over) $1,000/year

26. HDHP & HSA AM I ELIGIBLE TO CONTRIBUTE TO HSA? You are ELIGIBLE to contribute to an HSA if you COVERED ARE covered under a qualified HDHP MEDICARE ARE NOT enrolled in Medicare TRICARE DO NOT receive health benefits under TRICARE FSA NOT COVERED ARE NOT covered by any other non-HDHP You or your spouse DO NOT participate in general purpose FSA* *If you are currently participating in a general purpose FSA that offers a rollover feature, you must roll your funds to a limited purpose FSA, waive your rollover funds, or spend down your balance prior to the 1st day of the new plan year

27. FSA HSA & FSA CONSIDERATIONS If you have carryover funds from the prior year s general purpose FSA, you are INELIGIBLE to make or receive HSA contributions Convert carryover funds to limited purpose FSA (a limited purpose FSA allows you to spend the FSA dollars on dental and vision expenses only. You may not use your HSA and your limited FSA funds for the same expenses) 01 Decline or waive carryover amounts 02 03 Spend down general purpose FSA prior to end of plan year

28. 28 Member Cost Share by Plan Members Satisfying < 25% of OOP Max Members Satisfying > 75% of OOP Max Individual Family Individual Family PPO 100 71% 78% 11% 4% PPO 90 68% 69% 9% 0% PPO 80 87% 71% 5% 1% PPO 70 89% 81% 4% 1% PPO 3250 86% 80% 6% 2% PPO 4500 100% 100% 0% 0% PPO 123 85% 93% 7% 0% HD 1750 74% 54% 4% 5% HD 3250 73% 56% 12% 21% HD 5250 78% 77% 8% 5%

29. DENTAL PLAN Delta Dental of NC

30. 4.26% Rate Increase Delta Dental PPO plus Premier is Delta Dental s national preferred provider organization program that gives you access to two of the nation s largest networks of participating dentists. 5 plan designs offered and all employers can select dual option.

31. 31 Delta Dental Complete Plan $1,000 Delta Dental Complete Plan $1,500 Delta Dental Enhanced Plan $1,000 Delta Dental Enhanced Plan $1,500 Delta Dental Enhanced Plan $2,000 with Ortho with Ortho with Ortho with Ortho with Ortho Annual Maximum Per Person $1,000 $1,500 $1,000 $1,500 $2,000 Type A: Diagnostic & Preventive Exams & Cleanings Exams & Cleanings Exams & Cleanings Exams & Cleanings Exams & Cleanings 100% after Deductible x-rays (bitewing & full mouth) x-rays (bitewing & full mouth) x-rays (bitewing & full mouth) x-rays (bitewing & full mouth) x-rays (bitewing & full mouth) Emergency Pain Flouride to age 16 Sealants to age 16 Emergency Pain Flouride to age 16 Sealants to age 16 Emergency Pain Flouride to age 16 Sealants to age 16 Emergency Pain Flouride to age 16 Sealants to age 16 Emergency Pain Flouride to age 16 Sealants to age 16 Space maintainers to age 16 Space maintainers to age 16 Space maintainers to age 16 Space maintainers to age 16 Space maintainers to age 16 Oral Cancer Screening Oral Cancer Screening Oral Cancer Screening Oral Cancer Screening Oral Cancer Screening Type B: Basic Services Fillings Fillings Fillings Fillings Fillings 80% after Deductible Simple Extractions Simple Extractions Simple Extractions Simple Extractions Simple Extractions Periodontics Endodontics Periodontics Endodontics Periodontics Endodontics Type C: Major Services Anesthesia Anesthesia Anesthesia Anesthesia Anesthesia 50% after Deductible Oral Surgery Oral Surgery Oral Surgery Oral Surgery Oral Surgery (12 mo. Waiting period)* Periodontics Periodontics Endodontics Inlays and Onlays Endodontics Inlays and Onlays Inlays and Onlays Inlays and Onlays Inlays and Onlays Crowns, Bridges, Dentures Crowns, Bridges, Dentures Crowns, Bridges, Dentures Crowns, Bridges, Dentures Crowns, Bridges, Dentures Implants Implants Implants Implants Implants Type D: Orthodontics Under age 19 Under age 19 Under age 19 Under age 19 Under age 19 50% (no deducitble) $1,000 lifetime limit $1,500 lifetime limit $1,000 lifetime limit $1,500 lifetime limit $2,000 lifetime limit

32. 32 VISION PLAN Superior Vision

33. Superior Vision Plan 0% Rate Increase IN-NETWORK LOW PLAN IN-NETWORK HIGH PLAN Exam Frequency Lenses & Contacts Frequency Frames Frequency 12 months 12 months 24 months $10 Copay Exam Lenses: Standard lenses covered in full, 20% discount on any amount over covered in full standard Frames: $130 allowance after $25 Copay, 20% discount on amount over $130 Lenses: Standard lenses covered in full, 20% discount on any amount over covered in full standard. Frames: $175 allowance after $10 Copay, 20% discount on amount over $175 Frames & Lenses Elective Contact Lenses in lieu of Lenses & Frames Up to $120 Allowance Up to $200 Allowance

34. 34 GROUP LIFE PLAN The Standard

35. Basic Life/AD&D (Employer Paid) 1 times annual earnings 2 times annual earnings 3 times annual earnings 4 times annual earnings 5 times annual earnings $10,000 increments to $100,000 max Maximum volume: $900,000 Guaranteed Issue: $500,000 Rates: $0.17 per $1,000 Retiree rates remain $0.16 per $1,000.

36. Dependent Life (Employer paid or voluntary) Additional Life (Employer paid or voluntary) Option I: $2,000 spouse / $2,000 child(ren) $0.42 per month 1 times annual earnings 2 times annual earnings 3 times annual earnings 4 times annual earnings $100,000 Option II: $10,000 spouse / $5,000 child(ren) $2.50 per month Employee: Maximum volume: $400,000 (cannot exceed $900,000 of 5x salary combined with Basic Life) Guaranteed Issue: $100,000 Option III: $25,000 spouse / $10,000 child(ren) $6.00 per month Spouse: Increments of $25,000 to $200,000 Guaranteed Issue $50,000 Rates: Age-banded rates (based upon employee s age as of each June 1st )

37. 37 Voluntary AD&D & Travel Assistance Eligibility Employees elect a principal sum in increments of $50,000 to $500,000 Single or Family coverage available Spouse is insured for 50% of principal sum Child(ren) under 26 are insured for 15% of principal sum (not to exceed $25,000) Single Rate = 0.02 per $1,000 Family Rate = 0.035 per $1,000 Eligibility mirrors that of your current medical, dental, vision, and/or life plans. Coverage terms on date of termination Volume reduces on 65th birthday (to 65%) and 70th birthday (to 50%) Premium will be included on the group s monthly billing statement Employee self-service in Benefitsolver! $100,000 Family Policy as low as $3.50 per month!

38. 38 OPEN ENROLLMENT INSTRUCTIONS 2022 - 2023

39. 39 Open Enrollment Instructions 1. Complete Employer Election Form and return to CBS by April 6, 2022. 2. Communicate renewal rates and coverage options to employees. 3. Enter any changes to be effective on June 1st in Benefitsolver during the open enrollment period (April 18 May 6, 2022). This is a PASSIVE open enrollment. 4. Distribute the Uniform Summary of Benefits & Coverage (SBCs): SBCs must be provided to all plan participants 60 days in advance of any material modifications to benefits. Employers should provide the SBC to employees during the open enrollment period as there are no material changes (electronic copies are permitted). New hires and those who are enrolling mid-year due to a qualifying event should also be provided a copy of the SBC. ***SBCs are posted on the NCBA website for your convenience www.ncbankers.org Services Employee Benefits Administration Password: directed

40. 40 Questions?