AMENDMENT #1

TO THE

PLAN DOCUMENT AND SUMMARY PLAN DESCRIPTION

FOR

DELAWARE COUNTY EMPLOYEE HEALTH PLAN

COST PLUS HSA-IH PLAN

Effective Date: March 1, 2026
  1. 1. DELETE the “Recuro Health Telehealth” table in the SCHEDULE OF BENEFITS.
  2. 2. DELETE the “Recuro Health Telehealth” benefit from the MAJOR MEDICAL EXPENSE BENEFITS section.
  3. 3. DELETE the “Consultations (Online/Telephone)” benefit from the MAJOR MEDICAL PLAN EXCLUSIONS AND LIMITATIONS section.
I, Josh Jarvis Name , certify that I am the Human Resources Title of the Plan Administrator for the above named Plan, and further certify that I am authorized to sign this Amendment. I have read and agree with the above change to the Plan and am hereby authorizing its implementation as of the effective date stated above.
Signature:
Signature of Josh Jarvis
Print Name:
Josh Jarvis
Date:
4/20/26