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2018 Benefits Guide

Medical

The medical plans offered by the Company are designed to help protect you and your covered dependents against financial loss by paying for a substantial portion of eligible expenses incurred for medically necessary care and treatment. The medical plans are insured by UnitedHealthcare.

For the 2018 benefit plan year, you will be able to select from two HMO plans, two PPO plans and two HSA plans as follows:

• Option 1 - PPO Plan 494 ($500 deductible)
• Option 2 - PPO Plan 521 ($1,000 deductible)
• Option 3 - HDHP HSA Plan 557 ($2,700 deductible)
• Option 4 - HDHP HSA Plan 552 ($3,000 deductible)
• Option 5 - HMO Value Network Plan UM4/3IF ($0 deductible)
• Option 6 - HMO Full Network Plan U90/3IF ($0 deductible)

If you enroll for coverage within your initial eligibility period, your coverage will be effective on the first of the month following 30 days of employment.

If you do not enroll for coverage within your initial eligibility period, you may enroll for coverage during the next annual enrollment period or in accordance with the section entitled Making Changes During the Year.

High Deductible Health Plans (HDHPs) and Health Savings Accounts (HSAs)

If you enroll in one of the HDHPs (Option 3 or Option 4), you will be given the opportunity to establish an HSA.

An HSA is an account that allows you to contribute and set aside pretax dollars to pay for eligible health care expenses either in the current year or at a later date, such as during retirement.

In 2018, the maximum amount you can contribute to your HSA cannot exceed:

• $3,450 for individual coverage
• $6,850 for 2-party or more coverage

If you are age 55 or older you can also make catch-up contributions of $1,000 per year, in accordance with federal regulations.

Click here to watch a quick 2 minute video on the many benefits that come with having an HSA account. Learn about the three ways you can save on taxes and tips on HSA rules based on where you live.

In deciding your HSA contribution amount, be sure to keep in mind your medical plan’s premium, deductible and out-of-pocket maximum. For example, you may be able to afford to contribute more to your HSA than under one of other medical plans because of the difference in premiums. The HSA plan may work for you if you can afford the higher out-of-pocket maximum. No matter what plan you choose, you can start, stop or change your contribution amount at any time. Changes are applied to your remaining pay periods in the current year.

When you sign up for your HSA, UnitedHealthcare will send you a packet of information on how to use your account. You will also receive an HSA debit card. Once your account is open and funded, you can use your new card to access your HSA funds. You will be permitted to use your account dollars now or in retirement to pay for eligible medical, prescription drug, dental and vision expenses, including those not normally covered by your medial plan.

HSAs are fully portable. This means that if you terminate employment, the money is yours and stays in your account until you use it, become deceased or close the account. Money in the HSA can be carried over to help save for medical expenses in subsequent years (such as retirement) and you can continue to contribute up to the maximum amount each year, as long as you remain eligible and enrolled in a qualified HDHP. In subsequent years, if you decide not to enroll in a qualified HDHP, you can continue to use your HSA for qualified medical expenses, but you will no longer be able to contribute to the HSA.

Your Cost

The Company and you share the cost of medical coverage. Your cost is generally deducted from your pay on a pretax basis. (Note: Coverage for domestic partners is generally deducted on an after-tax basis, unless otherwise permitted by state or federal law.) Refer to Employee Contributions for the applicable cost.

Summary of Benefits and Coverage

The Patient Protection and Affordable Care Act (also known as Health Care Reform) requires that you receive a Summary of Benefits and Coverage (SBC). The SBC is designed to help you understand and evaluate your health plan choices. To obtain a copy of the SBC for any of the Company-sponsored medical plans, please call the medical plan's member services department or contact HR/Benefits.

Medical Plan Key Features

The medical plans provide substantial benefit levels to protect you from catastrophic loss in the event of illness or injury. The following table summarizes the key features of the plans available to you and your dependents. To receive the highest level of benefits, you should use in-network providers and fully understand what is expected of you.

Medical Plans (UnitedHealthcare)
Key Features	Option 1		Option 2		Option 3		Option 4		Option 5		Option 6
	PPO (Plan 494)		PPO (Plan 521)		HDHP HSA (Plan 557)		HDHP HSA (Plan 552)		HMO Value Network Plan		HMO Full Network Plan
	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network
	You pay		You pay		You pay		You pay		You pay		You pay
Annual Deductible
Individual	$500	$1,000	$1,000	$2,000	$2,700	$5,200	$3,000	$5,000	$0	Not covered	$0	Not covered
Family	$1,000	$2,000	$2,000	$4,000	$5,400	$10,400	$6,000	$10,000	$0	Not covered	$0	Not covered
Annual Out-of-Pocket Maximum
Individual	$2,500	$5,000	$3,000	$6,000	$3,900	$10,400	$4,000	$6,000	$1,500	Not covered	$1,500	Not covered
Family	$5,000	$10,000	$6,000	$12,000	$7,800	$20,800	$8,000	$12,000	$3,000	Not covered	$3,000	Not covered
Physician Services
Office visits	$20 copay	40% after ded	$15 copay	30% after ded	0% after ded	20% after ded	0% after ded	20% after ded	$20 copay	Not covered	$20 copay	Not covered
Specialist visits	$20 copay	40% after ded	$15 copay	30% after ded	0% after ded	20% after ded	0% after ded	20% after ded	$20 copay	Not covered	$20 copay	Not covered
Urgent Care	$50 copay	40% after ded	$50 copay	30% after ded	0% after ded	20% after ded	0% after ded	20% after ded	$75 copay	$75 copay	$75 copay	$75 copay
Preventive Care
Routine physical   exams	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered
Immunizations	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered
Well-woman   exams	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered	No copay	Not covered
Hospital
Inpatient hospital   services	20% after ded	40% after ded	10% after ded	30% after ded	0% after ded	20% after ded	0% after ded	20% after ded	No copay	Not covered	No copay	Not covered
Emergency
Hospital   emergency room	$100 copay	$100 copay	$100 copay	$100 copay	0% after ded	0% after ded	0% after ded	0% after ded	$150 copay	$150 copay	$150 copay	$150 copay
Other Medical Services
Laboratory and   x-ray services	No copay	40% after ded	10% after ded	30% after ded	0% after ded	20% after ded	0% after ded	20% after ded	No copay	Not covered	No copay	Not covered
Imaging (MRI,   CAT, PET scans)	20% after ded	40% after ded	10% after ded	30% after ded	0% after ded	20% after ded	0% after ded	20% after ded	$100 copay	Not covered	$100 copay	Not covered
Prescription Drugs (Retail)
Tier 1	$10 copay	$10 copay	$10 copay	$10 copay	$10 copay after ded	$10 copay after ded	$10 copay after ded	$10 copay after ded	$10 copay	Not covered	$10 copay	Not covered
Tier 2	$30 copay	$30 copay	$30 copay	$30 copay	$30 copay after ded	$30 copay after ded	$30 copay after ded	$30 copay after ded	$25 copay	Not covered	$25 copay	Not covered
Tier 3	$50 copay	$50 copay	$50 copay	$50 copay	$50 copay after ded	$50 copay after ded	$50 copay after ded	$50 copay after ded	$50 copay	Not covered	$50 copay	Not covered
Prescription Drugs (Mail Order)
Tier 1	$25 copay	Not covered	$25 copay	Not covered	$25 after ded	Not covered	$25 after ded	Not covered	$20 copay	Not covered	$20 copay	Not covered
Tier 2	$75 copay	Not covered	$75 copay	Not covered	$75 after ded	Not covered	$75 after ded	Not covered	$50 copay	Not covered	$50 copay	Not covered
Tier 3	$125 copay	Not covered	$125 copay	Not covered	$125 after ded	Not covered	$125 after ded	Not covered	$100 copay	Not covered	$100 copay	Not covered

This summary is provided for general information only. Refer to the specific plan documents available on the Forms and Downloads page for detailed information and complete plan provisions, exclusions and limitations.