Page 5 - 2021 Mid Year Open Enrollment Guide

Welcome to Your 2021 Mid-Year Open If You are a Legacy BMC Team Member

CURRENT ENROLLMENT
MAPPED ENROLLMENT AS OF 6/1
Enrollment Benefits Guide! UMR Core Plan (UHC/CVS) Core HDHP (BCBS/CVS)
Have a Smartphone? UMR Buy-Up Plan (UHC/CVS) Buy-Up HDHP (BCBS/CVS)
This Benefit Guide is equipped with mobile-friendly barcodes commonly referred to as “Quick Dental HMO (Cigna) Dental Basic (MetLife)
Response” or QR codes. Scanning these codes will take you to a new place on your phone. They
might show you a website, video, or article. They can take you anywhere, you just have to scan them. Dental PPO (Cigna) Dental Enhanced (MetLife)

So How Do I Scan Them? Vision (Cigna) Vision Enhanced (EyeMed)
Your phone may be able to read them from within its camera app - try taking a picture of one and Critical Illness, Hospital Indemnity or Accident (Cigna) Critical Illness, Hospital Indemnity or Accident (Voya)
see what happens. If it doesn’t pop up a link, then you’ll need one of the many free QR Reader apps
available for smartphones or tablets. After the download, just open the app and follow the directions Basic & Supplemental Life (Securian) Basic & Supplemental Life (Voya)
to scan the QR code. The app will read it and immediately take you to that code’s content.
Short and Long-Term Disability (Cigna) Short and Long-Term Disability (Sun Life)
About the 2021 Mid-Year Open Enrollment MetLaw Legal Plan MetLaw Legal Plan
This mid-year Open Enrollment has been designed to allow for a PASSIVE experience. Where
possible, your current coverage has been mapped to similar or like coverage. However, you are
encouraged to log into Dayforce and view for yourself how your coverage has mapped and how the If You are a Legacy BFS Team Member
cost of your coverage may have changed and make any desired adjustments. You will also find some CURRENT ENROLLMENT MAPPED ENROLLMENT AS OF 6/1
NEW coverage options not previously offered that may be of interest to you. Here are examples of
how current coverage elections have mapped. Keep in mind that many of the existing carriers have Consumer HDHP (BCBS/CVS) Core HDHP (BCBS/CVS)
changed. Additonal details are provided in each section.
Standard PPO (BCBS/CVS) Standard PPO (BCBS/CVS)

Dental Basic (MetLife) Dental Basic (MetLife)
Dental Enhanced (MetLife) Dental Enhanced (MetLife)
Vision Basic (EyeMed) Vision Basic (EyeMed)

Vision Enhanced (EyeMed) Vision Enhanced (EyeMed)
Plan is discontinued. Consider new Critical Illness,
Medical Gap (Sun Life/Assurant)
Hospital Indemnity or Accident coverage through Voya.
Basic & Supplemental Life (Sun Life) Basic & Supplemental Life (Sun Life)
Short and Long-Term Disability (Sun Life) Short and Long-Term Disability (Sun Life)

This document is intended to serve as a Summary of Material Modification (SMM) for the specific benefits outlined in this
document. Eligibility and benefit determinations will be governed by the official plan documents and SPD. Please remember
that the SPD, this SMM, and any other summaries of material modifications are only summaries of the official plan document
and in the case of any conflicts between the summaries and the official plan document, the terms of the official plan
document will govern. Your eligibility for Plan benefits does not guarantee continued employment with Builders FirstSource,
Inc. or any of its subsidiaries or affiliates.

2 • 2021 BUILDERS FIRSTSOURCE MID-YEAR BENEFITS GUIDE 2021 BUILDERS FIRSTSOURCE MID-YEAR BENEFITS GUIDE • 3