Your Plan: Huntington County Community School Corporation Employee Benefit Trust: Anthem POS 3 Tier Your Network: HealthSync This summary of benefits is intended to be a brief outline of coverage. The entire provisions of benefits and exclusions are contained in the Group Contract, Certificate, and Schedule of Benefits. In the event of a conflict between the Group Contract and this description, the terms of the Group Contract will prevail. By signing this Summary of Benefits, I agree to the benefits for the product selected as of the effective date indicated. Authorized group signature (if applicable) Date Underwriting signature (if applicable) Date IN/LG/Anthem POS 3 Tier/8X5X/01-01-2025 Page 8 of 10