What Are My Benefits? Property of Bind Benefits, Inc., d/b/a Surest. All rights reserved © 2026. 29 • Refer to the Surest mobile app for additional coverage information. • Skilled Nursing Facility stays are limited to 60 days per Participant per Plan Year for in-network and out-of- network Providers combined. • Routine diagnostic services, including diagnostic lab, x-ray, and ultrasound are included in the Skilled Nursing Facility Services copayment. When the routine diagnostic service is prescribed by a doctor and received on a different date of service and location, the service is $0 copayment. • An Inpatient Rehabilitation Facility, such as a long-term acute rehabilitation center, a hospital, or a special unit of a hospital designated as an inpatient rehabilitation facility, that provides occupational therapy, physical therapy, and/or speech therapy as authorized by law. • Benefits include: − Facility services for an inpatient stay in a Skilled Nursing Facility or inpatient rehabilitation facility. − Supplies and non-Physician services received during the inpatient stay. − Room and board in a semi-private room (a room with two or more beds). − Physician services for anesthesiologists, pathologists, and radiologists. − Benefits are available when skilled nursing and/or inpatient rehabilitation facility services are needed on a daily basis. Benefits are also available in a Skilled Nursing Facility or inpatient rehabilitation facility for treatment of an illness or injury that would have otherwise required an inpatient stay in a hospital. • Benefits are available only if both of the following are true: − The initial confinement in a Skilled Nursing Facility or inpatient rehabilitation facility was or will be a cost- effective alternative to an inpatient stay in a hospital. − You will receive skilled care services that are not primarily Custodial Care. • Skilled care is skilled nursing, skilled teaching, and skilled rehabilitation services when all of the following are true: − Services must be delivered or supervised by licensed technical or professional medical personnel in order to obtain the specified medical outcome and provide for the safety of the patient. − Services are ordered by a Physician. − Services are not delivered for the purpose of assisting with activities of daily living, including dressing, feeding, bathing, or transferring from a bed to a chair. − Services require clinical training in order to be delivered safely and effectively. • You are expected to improve to a predictable level of recovery. Benefits can be denied or shortened for Participants who are not progressing in goal-directed rehabilitation services or if discharge rehabilitation goals have previously been met. • The Surest Plan does not provide Benefits for Custodial Care or Domiciliary Care, even if ordered by a Physician, as defined in Section 12 (Glossary). • Returning home from a Skilled Nursing Facility or Inpatient Rehabilitation Facility stay with durable medical equipment, such as a walker, may result in an additional copayment. • All Skilled Nursing Facility and Inpatient Rehabilitation Facility admissions require Prior Authorization and Medical Necessity review. • See Hospital Services for other coverage notes. Transplant Services In-Network Out-of-Network Bone Marrow and Solid Organ Transplant $1,700 copayment / visit Not Covered Corneal Transplant $1,600 copayment / visit Not Covered CAR T and Non-Genetic Cellular Therapy $1,700 copayment / visit Not Covered Cellular and Gene Therapy $1,700 copayment / visit Not Covered Notes: • Refer to the Surest mobile app for additional coverage information. • Copayments for outpatient hospital visits may vary based on Provider and location. • Routine diagnostic services, including diagnostic lab, x-ray, and ultrasound are included in the Transplant Services copayment. When the routine diagnostic service is prescribed by a doctor and received on a different date of service and location, the service is $0 copayment. • Transplants for which Benefits are available include bone marrow (including CAR T-cell therapy for malignancies), heart, heart/lung, lung, kidney, kidney/pancreas, pancreas, liver, liver/intestine, intestine, and cornea. • Benefits are available for CAR T and non-genetic cellular therapy received on an inpatient or outpatient basis at a hospital or on an outpatient basis at an alternate facility. Note this Benefit excludes the gene therapies as