2022 HEALTH AND WELFARE BENEFITS GUIDE

PROFESSIONAL STAFF

YOUR HEALTH CARE BENEFITS AT A GLANCE ............................................................................................ 1

WHO IS ELIGIBLE........................................................................................................................................... 2

HOW TO ENROLL ........................................................................................................................................... 2

MAKING CHANGES DURING THE YEAR........................................................................................................ 2

MEDICAL BENEFITS....................................................................................................................................... 3

BLUE CROSS BLUE SHIELD GLOBAL CORE ................................................................................................. 7

HEALTH SAVINGS ACCOUNT ...................................................................................................................... 11

FLEXIBLE SPENDING ACCOUNTS............................................................................................................... 12

DENTAL BENEFITS ...................................................................................................................................... 14

VISION BENEFITS ........................................................................................................................................ 15

MANAGING YOUR HEALTH CARE ............................................................................................................... 16

BEYOND MEDICARE .................................................................................................................................... 17

CARE@WORK/BRIGHT HORIZONS ............................................................................................................. 17

RETHINK DEVELOPMENTAL CHALLENGES ............................................................................................... 17

AFLAC .......................................................................................................................................................... 18

CONTACT INFORMATION ............................................................................................................................ 19

TABLE OF CONTENTS

YOUR HEALTH CARE BENEFITS AT A GLANCE

Benefit Options Who Pays

Medical and Prescription Drugs Enroll or waive coverage in:

• BCBS PPO Base Plan

• BCBS PPO Buy-up Plan

• BCBS HDHP w/ HSA Base Plan

• BCBS HDHP w/ HSA Buy-up Plan

Coverage includes Blue Cross Blue Shield

Global Core when you are traveling.

Dental Enroll or waive coverage in the Delta Dental

PPO. You pay the cost of this coverage.

Vision Enroll or waive coverage in the VSP Vision

Care Plan. You pay the cost of this coverage.

Flexible Spending Accounts (FSAs) Enroll or waive coverage each year in:

• Health Care FSA

• Limited Purpose Health Care

FSA (for HDHP participants only)

• Dependent Care FSA • Commuter FSA (transit and parking) –

only FSA for which your prior year elections

carry forward.

You make pre-tax contributions to your

account(s).

Teladoc You pay a copay at the time of service.

Health Advocate + Employee

Assistance Program (EAP)

Holland & Knight pays the full cost for

this benefit.

Beyond Medicare Holland & Knight pays the full cost for

this benefit.

AFLAC

Available 24/7; automatic enrollment with

medical plan participation. Register for

the service on the Teladoc website.

Available 24/7; no enrollment required.

No enrollment required. Medicare advice available to individuals who are age 60 or older.

Enroll or waive coverage in:

• Cancer Insurance

• Accident Insurance

• Hospital Insurance

You pay the cost of this coverage.

You and Holland & Knight share

in the cost of coverage.

WHO IS ELIGIBLE If you are a full-time employee or part-time employee who is expected to work 30 hours or more each week, you, your spouse/domestic

partner and your dependents are eligible to participate in Holland & Knight’s health and welfare benefit plans. Eligible dependents for medical,

dental and vision coverage include:

• Spouse

• Domestic partner

• Biological children, stepchildren, adopted children, your domestic partner’s children and children for whom you are the legal guardian,

in each case up to age 26. Dependents are no longer eligible at the end of the calendar year in which they turn 26.

HOW TO ENROLL New hires will have 30 days from their date of hire to enroll, with coverage retroactive to their hire date. Access Workday to enroll in benefits for the

first time as a new hire, request changes due to a qualified life event during the year or to make changes to your benefit elections during the firm’s

annual open enrollment. Instructions on the enrollment process in Workday can be found on the firm’s intranet under Human Resources.

MAKING CHANGES DURING THE YEAR The benefits you elect during your enrollment period remain in effect for the entire calendar year. No changes can be made un til the next open enrollment period unless you experience a qualifying change in status such as:

• marriage, divorce or legal separation

• birth or adoption (or placement for adoption) of a child

• involuntary loss of other group health insurance

• death of a dependent, or

• a dependent becomes covered under another policy

If you have a qualifying change in status, you must provide written notification, which includes date of qualifying event and benefits affected, to the

firm’s Human Resources Department within 30 days of the event and make your benefit election changes in Workday. You are required to inform

the firm if you were covering a spouse at the time of your divorce and anytime your covered dependent loses eligibility. The election changes you

make must be consistent with the event. For example, if you have a new child, you may add your child but you may not drop your spouse from

coverage. If you do not report your qualifying change in status within 30 days, no benefit changes will be allowed until the next open enrollment

period.

2

YOUR MEDICAL BENEFITS You may choose the medical plan that is right for you from among four plans:

1. PPO Base Plan

2. PPO Buy-up Plan

3. HDHP with HSA Base Plan (High Deductible Health Plan)

4. HDHP with HSA Buy-up Plan (High Deductible Health Plan)

All four medical plans:

• Are administered by Blue Cross Blue Shield (BCBS) and use the BCBS PPO network of providers.

• Offer 100% coverage for preventive care services when using in-network providers.

• Cover expenses from providers both in and out of network, although you can expect to pay more when you use an out-of-network provider.

• Feature deductibles and coinsurance for medical care.

• Protect from catastrophic medical claims through an out-of-pocket maximum.

Importance of Using In-Network Providers

Utilizing medical service providers who are in-network is more cost-effective for you. In-network providers have agreed to provide eligible services at

a discounted rate. That means when you visit an in-network provider, you will not be billed for an amount over the agreed-upon discounted rate. The

plan also pays a higher percentage of coinsurance when you use an in-network provider.

If you use a provider who is outside the network, it is likely you will pay more for care. Out-of-network providers have not agreed to a set rate with

BCBS and are permitted to bill you for the difference between the amount allowed for a service by BCBS and the amount

the out-of-network provider decides to charge. This is sometimes referred to as “balance billing.” Additionally, the

plan requires you to pay a higher percentage of coinsurance for services provided by out-of-network.

Check the Network

Whenever you need medical care, check to see if your provider is in the BCBS network.

You can call 1.833.466.0177 or visit www.MyHealthToolkitFL.com.

Out-of-Network

In-Network

3

The PPO Plans with Flexible Spending Account If you want a traditional medical plan in which you pay copays for doctor visits and prescription drugs and have the option to pay medical expenses

from a flexible spending account, you have two PPO Plan options to choose from:

1. PPO Base Plan. Your premiums for this plan are lower, but you will have higher deductibles and higher copays.

2. PPO Buy-up Plan. Your premiums for this plan are higher, but you will have lower deductibles to satisfy and lower copays to pay.

Consider whether you want to pay more for coverage throughout the year and less when you actually see a medical provider or whether you want to

pay more for coverage only if you need to see a medical professional.

How a PPO Plan Works

For in-network health care expenses, you will pay a copay for a doctor’s visit or for prescription drugs. Preventive services will be covered 100%.

The plan deductible and a coinsurance percentage will apply to all other services. After satisfying your deductible, the plan will pay 75% and you will

pay 25% for in-network services until the expenses you pay total the out-of-pocket maximum. Then, the plan pays 100% of your eligible in-network

services for the rest of the plan year.

4

The High Deductible Health Plans with Health Savings

If you prefer an HDHP with an HSA in which you pay the full cost of

your health care and prescription drugs until you satisfy your annual

deductible and have the option to pay medical expenses from, or save

for future health care expenses in, a Health Savings Account, you have

two HDHP with HSA options to choose from:

1. HDHP with HSA Base Plan. Your premiums for this plan are

lower, but you will have higher deductibles to satisfy and a

higher coinsurance percentage.

2. HDHP with HSA Buy Up. Your premiums for this plan are higher, but

you will have lower deductibles to satisfy and a lower coinsurance

percentage.

How a High Deductible Health Plan Works

• You pay the full cost of your health care and prescription drugs

(except for preventive services) until your annual deductible is met.

The amount you pay for in-network services is the pre-negotiated

BCBS cost, not a copay. Preventive services are covered at 100% by

the plan.

• After satisfying your deductible, the plan will pay a percentage of your

eligible health care expenses (either 75% or 85% depending on which

HDHP you select) and you pay the rest until your out-of-pocket costs

satisfy the out-of-pocket maximum. Then, the plan pays 100% of your

eligible in-network expenses for the rest of the year.

• If you are enrolled in an HDHP with more than employee-only

coverage, the full family deductible must be met before coinsurance

will apply to any eligible expenses for any family member.

Choosing the Right Plan

The primary differences between PPO plans and HDHPs:

• Health Savings Account: Only HDHPs include an HSA that you can

use to pay eligible expenses or to save for future eligible expenses.

• Prescription Drugs: If you elect a PPO plan, you will pay a copay

for prescriptions. If you elect an HDHP, you will pay the full discounted

cost of your prescriptions until you meet your deductible, after which

you will pay a percentage of the cost called coinsurance.

• Medical Services: If you elect an HDHP, you will pay the full

discounted cost of medical services until you meet your deductible,

after which you will pay a percentage of the cost called coinsurance.

Now that you understand how the plans work, you can match the right

plan to your medical needs.

5

High Deductible

Health Plan

Health Savings

Account

HDHP/HSA Options

Miranda Saves for the Future

Miranda doesn’t expect many health care expenses. She

plans to enroll in the Base HDHP and to add the money

she saves in payroll deductions to her HSA, which she

contributes to on a pre-tax basis.

“I’m enrolling in the Base HDHP because it costs less per

paycheck, has a Health Savings Account, and it offers

quality care if I need it.”

Brian Wants to Save on Taxes

Brian and his wife expect about $2,000 in out-of-pocket

medical expenses next year, as they are expecting a baby.

He plans on enrolling in the Buy-up HDHP and adding

$1,000 on a pre-tax basis to his HSA account.

“All it takes is a little planning to satisfy a higher deductible

and save on paycheck contributions.”

Mark Wants to Pay Less for Services

Mark and his wife Sandy are both fairly healthy and have

some but not many medical expenses each year.

“We prefer to keep our costs low for doctors’ visits and

prescriptions so we elected the PPO plan. Although we pay

a higher monthly premium we will pay less when we use the

plan.”

Preventive Care All four medical plans cover 100% of the cost of preventive care

services provided by in-network doctors and facilities, which means

you do not have to pay any copays or deductibles. Regular preventive

care visits and age-appropriate health screenings can help your doctor

identify potential health risks and may help you avoid a serious – and

costly – health issue down the road. These services include yearly

screenings and immunizations, including flu shots, as well as basic

family health needs. Skin cancer screenings will be covered under

preventive care. Take advantage of this valuable benefit. You can find

a schedule of covered preventive services on the intranet under

Human Resources.

Teladoc Health (Your anytime, anywhere doctor!)

Whether you are at home, at the office or on the road, you can access

quality health care conveniently and affordably through phone or video

appointments with board-certified physicians. You can seek medical

advice 24 hours a day, 7 days a week. Regardless of which medical

plan you choose, the cost for an appointment is $55 and will count

toward your maximum out-of-pocket amount.

Use your smartphone, tablet or computer to get a diagnosis and

treatment plan for nonemergency conditions such as:

• Cold or flu

• Bronchitis

• Ear infection

• Sore throat

• Poison ivy

• Insect bites

• And more!

If you are enrolled in a Holland & Knight medical plan, you can call

1.866.789.8155 or visit www.teladoc.com to register at no cost to you.

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In-Network Doctors/Facilities

No copays or deductibles for preventive care

services. All medical plans cover 100% of

in-network preventive care costs.

Use This Valuable Benefit

Preventive care/screenings help identify

potential health risks and future issues.

Learn More

The preventive schedule can be found on the

HR intranet page under Health & Welfare

Benefits > General Information.

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Blue Cross Blue Shield Global Core Health care coverage when you are traveling or living abroad

As a Blue Cross and Blue Shield member, you take your health care

benefits with you when you are abroad. Through the Blue Cross Blue

Shield Global Core program, you have access to doctors and hospitals

around the world. To take advantage of the program:

• Always carry your current member ID card

• Before you travel, contact your Blue Cross and Blue Shield (BCBS)

company for coverage details. Coverage outside the United States

may be different.

• If you need to locate a doctor or hospital, call the Service Center for

Blue Cross Blue Shield Global Core (1.800.810.2583). An

assistance coordinator, in conjunction with a medical professional,

will arrange a physician appointment or hospitalization if necessary.

• If you need inpatient care, call the Service Center (1.800.810.2583)

to arrange direct billing. In most cases, you should not need to pay

upfront for inpatient care except for the out-of-pocket expenses

(non-covered services, deductible, copayment and coinsurance)

you normally pay. The hospital should submit the claim to BCBS on

your behalf.

• In addition to contacting the Service Center, call your BCBS company

for precertification or preauthorization. Refer to the phone number on

the back of your member ID card (1.833.466.0177).

• For outpatient and doctor care or inpatient care not arranged through

the Service Center, you may need to pay upfront. Complete a Blue

Cross Blue Shield Global Core International claim form and send it with

the bill(s) to the Service Center (the address is on the form). You can

also submit your claim online or through the Blue Cross Blue Shield

Global Core mobile app. The claim form is available from your BCBS

company or online at www.bcbsglobalcore.com

Blue Cross Blue Shield Global Core To locate doctors and hospitals, or obtain medical assistance services

when outside the United States, call 1.800.810.2583 or call collect at

1.804.673.1177 or visit www.bcbsglobalcore.com.

Personal Care Connection Your health, your call. We’ll connect you with the solutions you need.

Serious illnesses, traumatic injuries or chronic conditions can be

overwhelming. When you feel your worst, you need the best care.

Personal Care Connection, offered through Blue Cross Blue Shield, is

a comprehensive clinical care management program aimed at

improving the quality of care across a broad range of conditions.

Through the Personal Care Connection program, you and your

dependents will have access to a registered nurse as a single point of

contact. This dedicated nurse works with you, your family members

and your doctors to coordinate your health care and help you make

informed decisions related to your medical condition. Your dedicated

nurse will remain with you throughout your treatment and has access to

medical directors, social workers, behavioral health clinicians,

registered dieticians and pharmacists to provide you with relevant

guidance and advice. If you are diagnosed with a serious illness or

chronic condition or suffer a traumatic injury, a nurse will reach out to

you to provide assistance. Alternatively, you can call a nurse directly at

1.833.466.0177 to request assistance. The firm covers the cost of this

service, which is available to all Holland & Knight employees and

dependents who are enrolled in the firm’s medical plan.

COMPARING YOUR 2022 MEDICAL PLAN OPTIONS

1 When enrolled in a family HDHP, the full family deductible must be met before coinsurance applies to eligible expenses.

Additional details are available in each plan’s Summary of Benefits and Coverage (SBC), which are posted on the intranet unde r Human Resources.

8

CHOOSING THE RIGHT PLAN: Side-by-Side Comparison of What You Pay for Services

Feature

HDHP w/HSA

Base Plan

HDHP w/HSA

Buy-up Plan

PPO

Base Plan

PPO

Buy-up Plan

In-network Out-of-

Network

In-network Out-of-

Network

In-network Out-of-

Network

In-network Out-of-

Network

Plan Year Deductible

Individual:

Family: $2,750

$5,5001

$5,500

$11,0001

$1,800

$3,6001

$3,600

$7,2001

$1,200

$2,400

$4,800

$9,600

$ 900

$1,700

$2,500

$5,000

Coinsurance

You Pay:

Plan Pays:

25%

75%

35%

65%

15%

85%

35%

65%

25%

75%

50%

50%

25%

75%

35%

65%

Plan Year Out-of- Pocket Maximum

(includes Plan Year Deductible)

Individual:

Family:

$5,850

$11,700

$11,700

$29,250

$4,500

$9,000

$9,000

$18,000

$5,000

$10,000

$15,000

$30,000

$4,000

$8,000

$8,000

$16,000

Physician Services

Preventive Services $0

You pay

35% after

deductible

$0

You pay

35% after

deductible

$0

You pay

50% after

deductible

$0

You pay

35% after

deductible

Primary Care Physician Office Visit You pay

25% after

deductible

You pay

15% after

deductible

$50 $40

Specialist Physician Office Visit $60 $50

Behavioral Health

Inpatient Hospital Services

Outpatient Hospital Services

You pay

25% after

deductible

You pay

35% after

deductible

You pay

15% after

deductible

You pay

35% after

deductible

You pay

25% after

deductible

You pay

50% after

deductible

You pay

25% after

deductible

You pay

35% after

deductible

Emergency Room You pay 25% after

in-network deductible

You pay 15% after

in-network deductible

You pay $300 copay You pay $300 copay

Urgent Care Facility You pay

25% after

deductible

You pay

35% after

deductible

You pay 15% after

deductible

You pay 35% after

deductible

$60 copay You pay

50% after

deductible

$50 copay You pay

35% after

deductible

X-Ray and Lab Services You pay 25% after

deductible

You pay 35% after

deductible

You pay 15% after

deductible

You pay 35% after

deductible

You pay 25% after

deductible

You pay 50% after

deductible

You pay 25% after

deductible

You pay 35% after

deductible

Advanced Radiology Imaging

(MRI, MRA, PET, CT screenings)

You pay

25% after

deductible

You pay

35% after

deductible

You pay

15% after

deductible

You pay

35% after

deductible

You pay

25% after

deductible

You pay

50% after

deductible

You pay

25% after

deductible

You pay

35% after

deductible

Behavioral Health Inpatient Mental Health and

Substance Abuse

You pay

25% after

deductible You pay

35% after

deductible

You pay

15% after

deductible You pay

35% after

deductible

You pay

25% after

deductible You pay

50% after

deductible

You pay

25% after

deductible

You pay

35% after

deductible

Outpatient Mental Health and

Substance Abuse

You pay

25% after

deductible

You pay

15% after

deductible

$60 copay $50 copay

Provider Choice Use the provider of your choice.

Search for network providers in the BCBS network at www.MyHealthToolkitFL.com.

HSA Funding

(Holland & Knight Annual Contributions)

Individual:

Family:

Not available Not available $500

$1,000

$500

$1,000

Facility Services

Prescription Drug Benefits

Retail Pharmacy HDHP w/HSA

Base Plan

HDHP w/HSA

Buy-up Plan

PPO

Base Plan

PPO

Buy-up Plan

Up to 34-day supply Up to 34-day supply

Generic

Brand-name formulary

Non-formulary

Specialty drugs

All specialty medications (e.g.,

injectables) must be obtained

through ESI/Accredo

Specialty Pharmacy. .

Mail Order Pharmacy

Up to 90-day supply Up to 90-day supply

Generic $50 copay $30 copay

Brand-name formulary You pay 25% after

deductible

You pay 15% after

deductible

$90 copay $90 copay

Non-formulary $140 copay $130 copay

PRESCRIPTION DRUG BENEFITS When you enroll in a Holland & Knight medical plan, you automatically receive prescription drug coverage through Express Scripts (ESI). The

prescription drug plan has both retail and mail order features. If you take a maintenance drug (e.g., for blood pressure or high cholesterol) you can fill

your prescriptions through the mail order service at a lower cost.

Please note: Express Scripts will issue a separate member ID card for prescription drug coverage.

$25 copay $15 copay

$45 copay $45 copay

You pay 25% after

deductible

You pay 15% after

deductible

$70 copay $65 copay

25% up to

$125

25% up to

$125

HDHP w/HSA HDHP w/HSA PPO PPO

Base Plan Buy-up Plan Base Plan Buy-up Plan

Coverage Management Programs

Holland & Knight leverages coverage management programs offered by ESI that help to ensure that

prescription medications are being used safely and in accordance with the latest evidence-based guidelines

and are available at a reasonable cost. The programs include prior authorization, step therapy and drug

quantity limits, and are administered by ESI. The programs are common among prescription plans and are

familiar to physicians and pharmacists.

Prior authorization: some prescription medications will require preapproval before the prescription will

be covered by the plan.

Step therapy: some prescription medications will be covered by the plan only after the physician has tried

other recommended prescription medications or treatment options.

Drug quantity limits: the plan may cover a lesser quantity of some prescription medications than what the physician has prescribed.

9

2022 EMPLOYEE COST TO PARTICIPATE IN MEDICAL AND RX PLANS Your cost to participate in a Holland & Knight medical plan is shown below. Contributions are made on a pre-tax basis unless you are covering

a domestic partner or a domestic partner’s children. Contributions for domestic partners and their children are made on an after-tax basis.

Please be advised that your compensation as of January 1, 2022, will determine your contribution for the entire year.

(*Note: If you are paid biweekly, deductions will now be taken from all 26 paychecks you receive in a calendar year.)

Salary: Under $75,000

Employee Only

Per biweekly pay period*

Monthly

HDHP Base HDHP Buy-up PPO Base PPO Buy-up

$10.15

$22.00

$35.08

$76.00

$35.08

$76.00

$62.31

$135.00

Employee + Spouse

Per biweekly pay period*

Monthly

$204.92 $276.00 $276.00 $345.69

$444.00 $598.00 $598.00 $749.00

Employee + Child (1-2)

Per biweekly pay period*

Monthly

$179.54 $240.46 $241.38 $301.85

$389.00 $521.00 $523.00 $654.00

Employee + Family or

Employee + 3 or more children

Per biweekly pay period*

Monthly

$280.62 $378.00 $378.00 $475.38

$608.00 $819.00 $819.00 $1,030.00

Salary: $75,000 - $149,999

Employee Only

Per biweekly pay period*

Monthly

HDHP Base HDHP Buy-up PPO Base PPO Buy-up

$36.00 $63.23 $63.23 $96.92

$78.00 $137.00 $137.00 $210.00

Employee + Spouse

Per biweekly pay period*

Monthly

$263.54 $349.38 $349.38 $426.46

$571.00 $757.00 $757.00 $924.00

Employee + Child (1-2)

Per biweekly pay period*

Monthly

$204.92 $269.08 $269.08 $337.38

$444.00 $583.00 $583.00 $731.00

Employee + Family or

Employee + 3 or more children

Per biweekly pay period*

Monthly

$340.15 $452.31 $452.31 $556.15

$737.00 $980.00 $980.00 $1,205.00

Salary: $150,000 and over

Employee Only

Per biweekly pay period*

Monthly

HDHP Base HDHP Buy-up PPO Base PPO Buy-up

$74.77 $102.92 $102.46 $136.15

$162.00 $223.00 $222.00 $295.00

Employee + Spouse Per biweekly pay period*

Monthly $331.38 $417.23 $417.23 $494.77

$718.00 $904.00 $904.00 $1,072.00

Employee + Child (1-2) Per biweekly pay period*

Monthly $243.69 $308.77 $307.85 $375.69

$528.00 $669.00 $667.00 $814.00

Employee + Family or

Employee + 3 or more children

Per biweekly pay period*

Monthly $408.46 $521.08 $521.08 $624.92 $885.00 $1,129.00 $1,129.00 $1,354.00

10

HEALTH SAVINGS ACCOUNT How a Health Savings Account Works

Eligibility: To be eligible for an HSA, you must:

• Be enrolled in an HDHP

• Not be enrolled in Medicare

• Not be a dependent on another’s tax return

The contributions you make to an HSA are tax-free and are deducted

from your paycheck. You can use your HSA funds to pay for medical,

dental or vision expenses. You can also save the funds in your HSA

and carry them over from year to year to save for future health care

expenses. You will receive a debit card to pay eligible expenses. If you

do not have sufficient funds in your HSA to cover your expenses, you

will pay out-of-pocket and reimburse yourself when funds are available.

The account is yours to keep and control, even if you change plans,

leave the firm or retire. And you can designate a beneficiary for your

account. HSA Bank provides unique opportunities to invest HSA funds

in self-directed investment options, more information can be found by

visiting myaccounts.hsabank.com.

The Triple Tax Advantage of HSAs • Your contributions are tax-free, deducted from your paychecks

before taxes are withheld.

• You may invest the funds in your HSA and those earnings accumulate

tax-free.

• When you withdraw money from your HSA, it remains tax-free as

long as you are using the funds for eligible heath care expenses.

Holland & Knight Contributions: You are automatically enrolled in an

HSA when you elect coverage in an HDHP. HSA Bank will administer

your HSA. If you are enrolled in an HDHP for January 1, 2022, Holland

& Knight will contribute to your HSA:

• $500 contribution for employee-only coverage

• $1,000 contribution for family coverage

If you enroll during the calendar year, Holland & Knight will pro-rate the

firm’s contribution amount to your HSA based on the number of months

left in the calendar year.

Your Contributions: You can also contribute to your HSA up to the IRS

limit (which includes both your and Holland & Knight’s contributions):

• $3,650 for employee-only coverage

• $7,300 for family coverage

If you are age 55 or older in 2022, you may contribute an extra $1,000,

defined as Catch-Up Contribution. You can change how much you

contribute to your HSA account throughout the year during the first

week of any calendar quarter (January, April, July or October) by

contacting hr-benefits@hklaw.com.

You will only have access to your HSA directly through HSA Bank’s

Member Website by visiting myaccounts.hsabank.com. This site

includes decision support tools, including an HSA savings calculator,

plan comparison tool, contribution calculator and more.

Important Information About HSAs and FSAs If you are currently enrolled in a PPO Plan and participate in a Health

Care FSA and move to an HDHP with an HSA, you must use the

balance in your FSA before December 31, 2021, or your FSA funds will

be forfeited. The grace period, as referenced on the next page for FSAs

does not apply in this instance. If you expect to have dental and vision

care expenses that you do not want to pay for from your HSA, you

may participate in a Limited Purpose Health Care FSA for only these

expenses. Please refer to page 12 for more information on Flexible

Spending Accounts.

11

Health Care Flexible Spending Accounts You do not have to enroll in a Holland & Knight medical plan to participate in a Health Care FSA. If you choose to participate in a Health Care FSA,

see below for the type of Heath Care FSA that is right for you.

Health Care FSA

Which Health Care FSA Is Right for You?

Use for most medical, dental and vision

(only for participants in a PPO plan or care expenses (copays, deductibles,

participants enrolled in Medicare that have eyeglasses, prescriptions).

elected an HDHP) Up to $2,850

maximum annual

contribution Limited Purpose Use for most dental and vision care

Health Care FSA expenses (copays, deductibles,

(only for participants in an HDHP w/HSA) orthodontia) but not medical expenses.

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FLEXIBLE SPENDING ACCOUNTS Flexible spending accounts (FSAs) offer you a way to save money on your health care, dependent care, and transit and parking expenses. The

money you contribute to your FSAs is deducted pre-tax from your paycheck, lowering your taxable income. FSAs are easy to use and can help you

budget for expenses while saving money. You can choose to enroll in a Health Care FSA, a Limited Purpose Health Care FSA, Dependent Care

FSA and/or Commuter FSA (transit and parking). The FSAs are administered by Health Equity/WageWorks. The Health Care, Limited Purpose

Health Care and Dependent Care FSA contributions do not roll over from year-to-year and you must re-enroll online each year through

Workday in order to participate. No changes can be made until the next open enrollment period for the Health Care, Limited Purpose

Health Care and Dependent Care FSAs unless you experience a qualifying change in status. The Commuter FSA (transit and parking) does

not require you to re-enroll each year. Participation and contributions can be modified at any time during the calendar year as of the beginning of any

calendar month.

Dependent Care Flexible Spending Account Pay eligible day care expenses for your dependent child under age 13 or a disabled or senior dependent such as a parent who l ives with you and

needs care while you and your spouse are working or your spouse is in school. Eligible expenses include those for before- and after-school care, day

care and nursery schools, preschool programs and elder care. You can contribute up to $5,000 a year or $2,500 if you and your spouse file separate

tax returns.

Note: Please be aware in recent years that Holland & Knight has not passed the Non-Discrimination 55% Average Benefits Test on the Dependent

Care portion. Therefore, those electing Dependent Care and who are considered Highly Compensated Employees under the IRS rule s may have

adjustments to their Dependent Care elections.

Commuter (Transit and Parking) Flexible Spending Account The Commuter (transit and parking) FSA Program allows you to set aside pre-tax dollars to help defray some of your employment-related

transportation costs. You can set aside up to $280 a month ($3,360 a year) for reimbursement of transit expenses and up to $280 a month ($3,360

a year) for reimbursement of parking expenses. Elections are deducted on a monthly basis from your paycheck. You must make your election or

any changes to your election by the 10th of the previous month on the Health Equity/WageWorks website: www.wageworks.com (i.e., if you

are making an election for the month of March, you must submit your election by February 10).

Plan Carefully

Before making your FSA elections, estimate your expenses carefully. Any money remaining in your account after the cut-off date will be forfeited.

Holland & Knight offers a grace period to allow you more time to incur expenses against your FSA. You can continue to spend your 2022 FSA funds

after the end of calendar year 2022, until March 15, 2023. You have until March 31, 2023, to submit those expenses from your 2022 FSA funds.

If you are currently enrolled in a PPO plan with a Health Care FSA and move to a HDHP with an HSA, you must use the balance in your FSA before

December 31, 2021, or your FSA funds will be forfeited. The grace period for FSAs does not apply in this instance.

Money in the FSAs cannot be transferred from one account to the other, nor can funds from one account be used to cover expenses for another

account.

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DENTAL BENEFITS Dental benefits are provided through Delta Dental. With Delta Dental, you have

the choice of using either in-network or out-of-network providers. However, you will

save with lower out-of-pocket costs if you use a dentist in the Delta Dental PPO

network. In addition to you, your spouse (including domestic partner) and your

eligible dependent children to age 26 are all able to receive Dental benefits.

Dental Plan — Delta Dental

Annual Deductible Single: $50

Family: $100

Diagnostic and Preventive Care (oral exams, two cleanings a year, x-rays, biopsy/tissue exams, fluoride treatments, space maintainer)

Plan pays 100%; no deductible

(expenses do not count against the $1,500 calendar year maximum)

Basic Care (simple extractions, fillings, simple restorations, sealants, endodontics) Plan pays 80% after deductible

Major Care (crowns, jackets, cast restorations, bridges, partials and full dentures, denture repairs)

Plan pays 50% after deductible

Orthodontia (children and adults; up to $1,500 lifetime maximum)

Plan pays 50% after deductible

Annual Maximum Benefit (not including Diagnostic, Preventive and Orthodontia costs)

$1,500 per person

Dental Plan Contributions Your cost for the dental plan is shown below. Contributions are made on a pre-tax basis unless you are covering a domestic partner and/or their

children. Those coverage costs are made on an after-tax basis.

Per Biweekly Pay Period* Monthly

Employee Only $24.00 $52.00

Employee + Spouse $46.15 $100.00

Employee + Child (1-2) $43.85 $95.00

Employee + Family or

Employee + 3 or more Children $72.46 $157.00

* Note: If you are paid biweekly, deductions will now be taken from all 26 paychecks you receive in a calendar year.

Delta Dental To review covered benefits or locate a dentist near you who participates in the Delta Dental Network, call 1.800.521.2651 or visit www.deltadental.com.

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VISION BENEFITS Vision care benefits are provided through the VSP Choice network of providers. While you can see any eye doctor you wish, you ’ll pay more if you

use a provider outside the VSP Choice network. In addition to you, your spouse/domestic partner and/or your eligible dependent children to age 26

may be enrolled in Vision benefits.

Plan Feature VSP Provider Non-VSP Provider

Eye Exam

(every calendar year)

You pay $10 copay,

then plan pays 100% Reimbursed up to $40

Lenses

(every calendar year) single vision, bifocal,

trifocal, lenticular

You pay $25 copay, then plan pays 100%,

excluding out-of-pocket expenses

Reimbursed up to:

Single vision –$30

Bifocal – $40

Trifocal – $50

Frames

(every other calendar year)

You pay $25 copay, and plan pays 100%

up to $150, then you receive 20% off the

amount over the allowance

Reimbursed up to $50

Contact Lenses

(in lieu of lenses and frames, every calendar year)

Plan pays 100% up to $120; no copay

You pay $60 copay for contact lens

fitting and evaluation

Reimbursed up to $50

Laser Eye Surgery Laser VisionCare Preferred Program: Discounts available only from VSP contracted

facilities. $1,000 lifetime maximum for laser vision correction.

Vision Plan Contributions Your cost for vision coverage is shown below. Contributions are made on a pre-tax basis unless you are covering a domestic partner and/or their

children. Those coverage costs are made on an after-tax basis.

Per Biweekly Pay Period* Monthly

Employee Only $3.23 $7.00

Employee + Spouse $6.46 $14.00

Employee + Child (1-2) $6.46 $14.00

Employee + Family or

Employee + 3 or more Children $11.08 $24.00

*Note: If you are paid biweekly, deductions will now be taken from all 26 paychecks you receive in a calendar year.

Find a VSP Provider To locate a VSP provider near you, call 1.800.877.7195

or visit www.vsp.com (Group #30017442).

Please note: VSP does not issue ID cards. Your

vision provider should be able to verify your

coverage with VSP directly.

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MANAGING YOUR HEALTH CARE Health Advocate – Health Advocacy With the Health Advocacy Services you have unlimited, confidential

access to a Personal Health Advocate, who can get to the bottom of a

wide variety of health care and insurance-related issues.

Health Advocate – Employee Assistance Program If you find yourself in need of some professional support to deal

with personal, work, financial or family issues, the firm’s Employee

Assistance Program (EAP) through Health Advocate can help. You and

your immediate family (spouse or domestic partner, dependent children,

parents and parents-in-law) can use the EAP for help with:

Assistance through the EAP is confidential and provided by licensed

professional counselors and work/life specialists. Through the EAP, you

have access to up to three in-person, telephone or video confidential

counseling sessions, per issue.

Health Advocate is available to assist you 24 hours a day, 7 days a

week with Health Advocacy and EAP Services. To access

either the Health Advocacy Services or the EAP Services,

contact Health Advocate by phone at 1.866.799.2728, visit the website

at https://members.healthadvocate.com or email

answers@HealthAdvocate.com. For free, convenient and on-the-go

help, you can download Health Advocate’s Smartphone App.

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Employee Assistance Program (EAP)

Support with Personal, Work or Family

Issues: 24 Hours a Day, 7 Days a Week

Marriage and family problems

Job-related issues

Stress, anxiety and depression

Grief and loss

Parent and child relationships

Elder care and child care

Legal and financial counseling – free 30-minute telephonic

consultation with an attorney

with a financial specialist

You can use 3 in-person sessions per year/per issue

Health Advocate Services

Helping You Navigate the Health Care System:

24/7 Availability

Find network doctors, dentists, hospitals, other health care

providers and expedite appointments

Help you understand complex medical conditions,

research and locate the latest treatments, and facilitate

second opinions

Coordinate care and schedule follow-up visits

Arrange specialized treatments and tests; answer

questions about test results, treatments and

prescribed medications

Personal contact with a nurse and web-based

information to support treatment decisions

Clarify your benefits

Help resolve insurance claims and negotiate billing

Provide valuable information about the transition to

Medicare

Assist with elder care – from finding adult day care

or assisted living and other issues facing your elderly

relatives

Work with insurance providers to obtain prior approval for

services

Assist with the transfer of medical records, lab results

or X-rays

BEYOND MEDICARE Given the complexity of Medicare, it can be difficult to make an

informed decision about when and how to participate in Medicare

benefits. Beyond Medicare specialists can help you understand your

Medicare options and answer questions about eligibility, benefits, timing

of enrollment, Medicare Supplements, Medicare Cost Plans, Medicare

Advantage plans and plan costs. Beyond Medicare will work with you

to find the best coverage options available to you by comparing your

current medical benefits to those available through Medicare. Education

and one-on-one consultation are available, at no cost, to Holland &

Knight partners and employees who are age 60 or older.

To schedule an individual consultation with a Beyond Medicare

specialist, contact Beyond Medicare at 1.866.906.7346 or

ClientService@BeyondMedicare.com. Additional information about

Medicare and Medicare supplements can be found in the Beyond

Medicare booklet located on the intranet under Human Resources.

If, after reviewing your Medicare options, you decide to move from the

Holland & Knight medical plan to Medicare coverage, your dependents

may remain on the firm’s medical plan if they are not yet Medicare

eligible. You and your dependents can continue to participate in

the Dental and Vision benefits as well. For additional information,

please contact the Holland & Knight Benefits team at

hr-benefits@hklaw.com.

BRIGHT HORIZONS (Legacy TK employees through 6/30/2022)

Bright Horizons offers quality backup child, adult and elder care when

your regular care is unavailable. You are eligible for up to 15 days of

back-up care (subject to applicable copays). You must register online

or by phone to use this service. Once you have completed the

registration process, you can make reservations whenever the need

for care arises. In addition, Bright Horizons also offers free access to a

database of nannies and sitters for evening and weekend care, elder

care resources, housekeepers and pet sitters. Other options include

preferred enrollment access and discounts for regular center-based

childcare. Test prep and tutoring for the SAT and ACT, standardized

tests, Common Core subjects and general help for your student is also

available.

CARE@WORK As a part of the Care@Work Program, Holland & Knight pays for you to

have a Care.com Membership at no cost to you. Backup Care is also

available for in-home or in-center help, whether you have an emergency

and need someone within the next 24 hours (they can locate help in as

little as 2 hours) or you need to schedule care in advance for holidays,

breaks or any other time you need a caregiver. Care@Work is not

just for children. It offers care for all ages, whether for children, teens,

adults or seniors. Backup Care for adults is available to your family and

your extended family. Holland & Knight covers up to 15 days of Backup

Care a year, and new parents can request an additional 5 days. Backup

Care’s subsidized rates are $8.00/hour for in-home or adult care, or

$15.00 per child per day at a child care center.

RETHINK DEVELOPMENTAL CHALLENGES Caring for a child with developmental challenges can be stressful; and

balancing a busy work schedule with finding treatment options can be

overwhelming. To help address these challenges, Holland & Knight

offers you support through Rethink, a web-based program and personal

coaching service that will help your child reach his or her fullest

potential. The Rethink program includes a comprehensive treatment

curriculum with over 1,500 video-based teaching steps, automated

progress tracking, printable lesson plans and teaching materials, peer

support and a platform that facilitates collaboration between you and

your health care team. You can register at

www.rethinkbenefit.com/hollandknight, complete an online

assessment and follow the customized learning plan. You can then

schedule a coaching session with an experienced clinician at no cost to

you.

Voluntary Benefits

You have the option of purchasing voluntary cancer, personal accident indemnity and/or personal hospital indemnity insurance through AFLAC.

• Cancer: Provides substantial cash for all types of cancer treatment and also provides a wellness benefit for early detection treatment

• Personal Accident Indemnity Plan: Benefits are payable for a covered person’s death, dismemberment or injury caused by a covered accident

that occurs on or off the job

• Personal Hospital Indemnity Plan: Provides cash for hospital confinement for sickness or injury

You pay for the cost of coverage on a pre-tax basis through payroll deduction. If you are interested in any of these coverages, contact the Holland & Knight Benefits team at hr-benefits@hklaw.com to be put in touch with the AFLAC representative for your location.

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AFLAC

For Questions About… Contact… Contact Information

CONTACT INFORMATION

0

Refer to this chart for additional contact information about your Holland & Knight benefits. If you don’t know whom to call, contact

your local Office Manager or the Human Resources Benefits team at hr-benefits@hklaw.com.

Cancer, Accident, Hospital Protection Insurance

Contact Jillian DeNisco at Jillian.DeNisco@hklaw.com or email: HR-Benefits@hklaw.com

1.877.242.2732 https://clients.brighthorizons.com/hklaw

Care@Work 1.855.781.1303 https://hklaw.care.com

Dental Plan 1.800.521.2651 (Group #3847)

https://deltadentalins.com

Flexie Spending Accounts 1.877.924.3967 https://wageworks.com

Health Advocacy + Employee Assistance Program (EAP)

1.866.799.2728 https://members.healthadvocate.com email: answers@HealthAdvocate.com

HSA Bank 1.866.471.5946 https://myaccounts.hsabank.com/

Medical Benefits 1.833.466.0177 https://member.myhealthtoolkitfl.com

Medicare Information (available at no cost to Holland & Knight partners and employees age 60 or over)

1.866.906.7346

ClientService@BeyondMedicare.com

Teladoc Health 1.866.789.8155 https://www.teladoc.com

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Personal Care Connection 1.833.466.0177 https://member.myhealthtoolkitfl.com

Prescription Drug Benefits 1.855.785.6497 https://www.Express-Scripts.com

Rethink 1.877.988.8871 info@rethinkbenefits.com www.rethinkbenefits.com/hollandknight

Vision Plan 1.800.877.7195 (Group #30017442) https://www.vsp.com

Bright Horizons (Legacy TK only)