2026 ORI Results Benefits Enrollment Guide
Benefits Enrollment Guide ORI Results Plan Year: January 1st, 202 6 —December 31st, 202 6
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Pick the best benefits for you and your family.
WO O p i r d e p e r . y oovui d' ree ygoeut t ai nngd tyhoeu mr foasmt iol yu twoi ft ho ua rc ob me nperfei thse—n st hi vaet ' as nwd hvya lwu ae b' vl ee bp eunt et foi tgse tphaecrk at hg ies. oOuptel inn ee narl ol lol mf t eh ne tdi isf fae rs eh no tr tb pe en reifoi tds eOaRc hI Ryeesaur l wt s hoef nf e yr so, us oc ayno mu ca akne icdheanntgi feys wt oh yi cohu or fbf ee rni enfgi tss a. rTeh bi se gs tu ifdoer wy oi ul l aEnledctyioounrsfyaomuilym. ake during open enrollment will become effective on January 1st 202 6 . If you have questions about any of the benefits mentioned in this guide, please don't hesitate to reach out to HR. Table of Contents Health Insurance ............................................................................................................................ 4 Dental Insurance ............................................................................................................................ 5 Vision Insurance............................................................................................................................. 6 Life and Disability Income Benefits ......................................................................................... 7 Contact Information ...................................................................................................................... 9 R e e I n w R e a E s n n u t r l o t t o s ll m s m t e r a i n k v t e e G s s u t u o
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Who is eligible? Iefnyrooul l' ri ne tahfeu bl l e- tni me f ei t se mo uptlloi nyeede iant tOhRi sI gRuei sduel. tFs ,uyl lo- tui 'mr ee eelmi g pi bl ol ey teoe s are those who work 30 or more hours per week. How to enroll Ab er ne eyf oi tus . rDe iadd yy ot ou emnor ov lel ? r Te cheen ft il rys to rs t eg pe t i smtaor rrieevdi?e wV eyroi fuyr aclul ryroeunrt pOenrcseo na al ll yi nofuorr mi naftoi or mn aa tni do nmiask ue pa nt yo ndeactees, siat r iys cthi ma neg et os . m a k e y o u r bc aenn ehf iat veel eac t si oi gnnsi. f Ti chaen td ei mc i ps iaocnt s oyno uy omuark lei f de uarni ndg foi npaennceens ,r oslol mi te ni st important to weigh your options carefully. When to enroll Open enrollment begins on December 2nd, 202 5 and runs through December 12th, 202 5 . The benefits you choose during open enrollment will become effective on January 1st, 202 6 . How to make changes Umnalkees sc hy oa nu geexsp teor iyeonuc re ba el inf ee f- icths aunngtiinl gt hqeuna el i xf yt ionpgeenv ee nn rt ,oyl lomu ecna tn n o t period. Qualifying events include things like: MBiartrhriaogr ea,ddoivpotirocne oorf alecghaillsdeparation CDheaanthgeofina csphoiluds'sed, cehpieldndoernotthsteartquus alified dependent CChhaannggee iinn ermespidloeynmceent status or a change in coverage under another employer-sponsored plan
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Choice Plus ELTU /P30 Health Insurance Benefits TUhneitfeodlHloewailnthgccahraerftobretlhoewJahniguhalriygh1ts some of the details included in the medical plan offered through st , 202 6 – December 31 st , 202 6 plan year.
In-Network ( AI nndni vu iadl uDa el /dFuacmt i ibl yl e) Coinsurance (carrier/member) O u(tI-nodf -ipv oi dcukaelt/MF aamx iiml yu) m Physician Visit Copay (Primary Care Provider Specialist) Urgent Care Emergency Room Copay (waived if admitted) Inpatient Hospitalization Outpatient Surgery Out of Network* Annual Deductible (Individual/Family) Coinsurance (carrier/member) O u(tI-nodf -ipv oi dcukaelt/MF aamx iiml yu) m Pharmacy Prescription Drugs Tier 1/ Tier 2/ Tier 3/ Tier 4
$2,700/$5,400
100% / 0%
$7,500 / $15,000
$40 (designated network) / $75 (Network) $60 (designated network) / $120 (Network)
$60 Copay
Deductible, then $500
Deductible, then $500 per admission
Deductible, then $60
$5,000 / $10,000
80% / 20%
$10,000 - $20,000
$20/ $50/ 20% w $150/ 30% w $300
Provider Directory Yproouvcidanerlso.gin to your UHC account or use the link below to search UHC's directory of In-Network · https://connect.werally.com/plans/uhc · Select Medical Directory -> Employer and Individual Plans -> · Under " What plan are you looking for? " select " Choice Plus "
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Dental Insurance Benefits Irne gaudl adri t ci ohne ctkou pp rs o, ct el ecat inni gn gysoaunr ds Xm- irlae y, sd. eSnetvael rianl ssut ruadni ec es shuegl pg es spt at hy aftoor rda el nd ti sa el acsaerse, sauncdh uassupa el l ryi oi nd colnutdi tei ss (cgaunmp rdoitseecatsyeo) ,ucaannda fyfoeuc tr of at hmeirl ya rf reoams otfhyeohuirg hb ocdoys t—oifndcel undt ai nl gd iysoeua sr ehaena dr t .s Ru regceeri vyi. n g r e g u l a r d e n t a l c a r e TUhHeCffoolrlotwheinJgancuhaarryt 1below highlights some of the details included in the dental plan offered through st , 202 6 – December 31 st , 202 6 plan year.
Out-of-Network (MAC*) You Pay
In-Network You Pay
Type of service
$50/$150 $50/$150 $1,500 $1,500 20% 20% 50% 50% 0% 0% $ 51 0, 5%0 0 $ 51 0, 5%0 0
Deductible: Applies to basic and major services only (individual/family)
Annual Maximum (per person)
Basic Services: Space Maintainers, Fillings, Extractions, Endodontics, Periodontics, Oral Surgery, Anesthesia Major Services: Inlays, Inlays, Crowns, Bridges, Implants Preventive Services: Oral Exams, Cleanings, Fluoride, Sealants, X-rays
Orthodontia Coverage: Child and Adult (% and Lifetime max per person)
MAC stands for Maximum Allowable Charge (and can sometimes be called a PPO Fee plan) refers tAol l tohwe arbe li emCbhuarrsgeem( eMnAt Cf o) r. Fs oe rr veixc ae ms pp rl eo ,vi ifdyeodu bvyi sai nt aonu ot -uotf--onf e- nt we towr ko rdke dn et ins tt i si st cwahpop ec hd aartgtehse$M1 5a 0x i fmo ru am crelesapnoinnsgib(cleovfoerrethdearte1m00ai%ni)n, gbu$t5t0h.e MAC is set at $100, insurance will cover $100 and you will be Dental Provider Directory Yproouvcidanerlsogin to your UHC account or use the link below to search UHC's directory of In-Network · https://connect.werally.com/plans/uhc · Select Dental Directory - > Employer and Individual Plans -> · Enter your search criteria
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Vision Insurance Benefits DY or iuvri na gb itloi t ywtoor kd ,or ae lal doifntgh ae sneeawc st i va irttiiecsl e, t ahnodu gwha, tdcehpi ne ng dTsVoanr ye oaul lr avci tsiivoint i ea sn dy oeuy el i hk ee layl tphe. rVfiosri omn ei nv es ur yr adnacye. cOaRnI hReel ps uyl tosu' vmi saiionnt aiinnsyuorua nr cvei sei onnt i talse swyeol lua st odes pt eeccti fviac rei oyue schaer ea lbt he nperfoibt sl.e mO usr. p o l i c y c o v e r s r o u t i n e e y e eexyaemglassasneds aontdhecronptraoccteldeunrseess,. and provides specified dollar amounts or discounts for the purchase of TfohrethfoellJoawnuinagrych1art below highlights some of the details included in the vision plan offered through UHC st , 202 6 – December 31 st , 202 6 plan year.
In-Network You pay
Out-of-Network Reimbursement
Type of service
Annual Eye Exam Lenses – Single Vision Lenses – Bifocal Vision Lenses – Trifocal Vision
$15 copay
Up to $40
Up to $80
$30 copay
Up to $80
$30 copay
$30 copay
Up to $80
$130 Frame Allowance
Frames
Up to $45
Elective Contact Lenses Benefit Frequency Exam
Up to $105
$105 Allowance
1 x per 12 months 1 x per 12 months 1 x per 12 months
Lenses Frames
Vision Provider Directory Yproouvcidanerlsogin to your UHC account or use the link below to search UHC's directory of In-Network · https://www.myuhcvision.com/Public/AdvancedProviderSearch?CustomSearch=true#/search · Enter your search criteria
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Life and Disability Income Benefits Ob eRnI eRf iet ss uwl tist hp rGouvai rddeisa nf u. l Wl - tiitmh oe uetmdpi sl oa by ei lei tsy wc oi tvhe rLai fgee ,aynoduAaDn&d Dy, oSuhrofratmainl yd mL oany gs-ttreur gmg lDe i tsoa bgiel itt yb yi nicf oymo ue mAtisOsRwIoRrkesduuletst,owaen iwnajunrtytoor dilloneesvse.rything we can to protect you and your family. That's why ORI Results pouayt soffoprotchkeetf.ull cost of life and AD&D, short- and long-term disability insurance—meaning that you owe nothing Iwni ltl hpe r eovvei dnet tah apta yr toi ua l breecpolma cee md iesna tb l oe fd lforsotmi nac onmo ne -. wPol er ak s- ree lnaot et ed, itnhj ou ur yg ho, r t hs iactk ny eosus , adr ies anboi lti teyl i igni bc ol emteo breenceefi ivt es short-term disability benefits if you are receiving Workers' Compensation benefits.
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Your disability coverage
Short-Term Disability
Long-Term Disability
60% of salary to maximum $6000/month Social Security Normal Retirement Age
60% of salary to maximum $600/week
Coverage amount
Maximum payment period: Maximum length of time you can receive disability benefits. Accident benefits begin: The length of time you must be disabled before benefits begin. Illness benefits begin: The length of time you must be disabled before benefits begin. Evidence of Insurability: A health statement requiring you to answer a few medical history questions. Guarantee Issue: The ‘guarantee’ means you are not required to answer health questions to qualify for coverage up to and including the specified amount, when applicant signs up for coverage during the initial enrollment period. Minimum work hours/week: Minimum number of hours you must regularly work each week to be eligible for coverage. Pre-existing conditions: A pre-existing condition includes any condition/symptom for which you, in the specified time period prior to coverage in this plan, consulted with a physician, received treatment, or took prescribed drugs. Survivor benefit: Additional benefit payable to your family if you die while disabled.
12 weeks
Day 8
Day 91
Day 8
Day 91
Health Statement may be required
Health Statement may be required
We Guarantee Issue $600 in coverage
We Guarantee Issue $6000 in coverage
Plan holder Determines
Plan holder Determines
3 months look back; 12 months after exclusion
Not Applicable
No
3 months
UNDERSTANDING YOUR BENEFITS—DISABILITY (Some information may vary by state) • Disability (long-term): For first two years of disability, you will receive benefit payments while you are unable to work in your own occupation. After two years, you will continue to receive benefits if you cannot work in any occupation based on training, experience and education. • Earnings definition: Your covered salary is based on your previous year’s W2 statement. • Special limitations: Provides a 24-month benefit limit for specific conditions including mental health and substance abuse. Other conditions such as chronic fatigue are also included in this limitation. Refer to contract for details. • Work incentive: Plan benefit will not be reduced for a specified number of months so that you have part-time earnings while you remain disabled, unless the combined benefit and earnings exceed 100% of your previous earnings.
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Contact Information
Member Services: 1-866-414-1959 Check for a provider, claim status and more www.myuhc.com
Medical, Dental and Vision
UnitedHealthcare
Customer Service: 1-888-482 7342 Check for a provider, submit a claim and more www.guardianlife.com
Life and AD&D, STD & LTD Benefits
Guardian
Susan Lynd Human Resources Phone: 703-478-0910 Email: suel@oriresults.com
Human Resources
ORI Results
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