What Are My Benefits? Property of Bind Benefits, Inc., d/b/a Surest. All rights reserved © 2026. 11 Expenses are the Claim Administrator’s contracted fee(s) with that Provider. • When Covered Health Services are received from an out-of-network Provider as arranged by the Claims Administrator, Eligible Expenses are an amount negotiated by the Claims Administrator or an amount permitted by law. Please contact the Claims Administrator if you are billed for amounts in excess of your applicable copayment. Surest will not pay excessive charges or amounts you are not legally obligated to pay. Out-of-Network Benefits The Surest Plan generally provides Benefits for medical Claims incurred with an out-of-network Provider at a lower level. As a result, if you choose to seek Covered Health Services out-of- network, except as described below, you will be responsible for the difference between the amount billed by the out-of-network Provider or facility and the amount Surest determines to be the Eligible Expense for reimbursement (plus any applicable copayments). The amount in excess of the Eligible Expense could be significant, and this amount will NOT apply to the out- of-network out-of-pocket maximum. You may want to ask the out-of-network Provider about their billing practices before you receive care. • For Covered Health Services that are Ancillary Services received at certain in- network facilities on a non-Emergency basis from out-of-network Providers, you are not responsible (and the out-of-network Provider may not bill you) for amounts in excess of your copayment which is based on the Recognized Amount as defined in Section 12 (Glossary). • For Covered Health Services that are non-Ancillary Services received at certain in- network facilities on a non-Emergency basis from out-of-network Providers who have not satisfied the notice and consent criteria as described below, you are not responsible (and the out-of-network Provider may not bill you) for amounts in excess of your copayment which is based on the Recognized Amount as defined in Section 12 (Glossary). • For Covered Health Services that are Emergency Health Services provided by an out-of-network Provider, you are not responsible (and the out-of-network Provider may not bill you) for amounts in excess of your applicable copayment which is based on the Recognized Amount as defined in Section 12 (Glossary). • For Covered Health Services that are air ambulance services provided by an out-of- network Provider, you are not responsible (and the out-of-network Provider may not bill you) for amounts in excess of your applicable copayment which is based on the rates that would apply if the service was provided by an in-network Provider. Eligible Expenses are determined solely in accordance with the Claims Administrator’s reimbursement policy guidelines or as required by law. The Claims Administrator develops the reimbursement policy guidelines, in the Claims Administrator’s discretion, following evaluation and validation of all Provider billings in accordance with one or more of the following methodologies: