HEALTH CARE BENEFIT SUMMARY DESCRIPTIONS

PREPARED FOR THE WORKSITE:

EFFECTIVE: October 1, 2017

10.01.2017

TABLE OF CONTENTS BENEFIT SUMMARIES

PRIORITY HEALTH

HMO 100% Coverage, $500 Deductible

DENTAL

DELTA DENTAL PLAN: PPO STANDARD

VSP VISION

VISION PLAN: VSP SIGNATURE PLAN 1

VISION PLAN: VSP SIGNATURE PLAN 2

INFORMATION ON SUPPLEMENTAL BENEFITS

COBRA INFORMATION

ADMINISTRATIVE INFORMATION

Midwest Management Group, Inc. for MM1, Inc. at the worksite: Charlton Heston Academy Ralph Cunningham – Plan Administrator 3170 Old Farm Lane Commerce Township, MI 48390 248-313-2000

Priority Health Vision coverage (in all plans)

A national network of eye care providers With PriorityVision you have access to thousands of eye care providers and flexible appointment times on weekdays, evenings and weekends. See an eye care professional at a private practice by going to our Find a Doctor online directory and search PriorityVision, or call one of these chain stores:

• LensCrafters®

• Pearle Vision®

• Sears OpticalSM

• Target Optical®

• JCPenney Optical®

Hassle-free service You'll find your vision claims and other information in your online MyHealth account.

Have questions about your plan?

Call PriorityVision customer service at 877.572.4001.

Phone hours

• Monday - Saturday, 7:30 a.m. to 11 p.m. Eastern Time

• Sundays, 11 a.m. to 8 p.m.

Customer Service Toll-Free Number: 800-524-0149 www.deltadentalmi.com

July 21, 2017

Delta Dental PPO (Standard) Summary of Dental Plan Benefits

For Group# 0007474-0001 MidWest Management Group, Inc.

This Summary of Dental Plan Benefits should be read in conjunction with your Dental Care Certificate. Your Dental Care Certificate will provide you with additional information about your Delta Dental plan, including information about plan exclusions and limitations. The percentages below will be applied to the lesser of the dentist's submitted fee and Delta Dental's allowance for each service. Delta Dental's allowance may vary by the dentist's network participation. PLEASE NOTE - If you choose a Nonparticipating Dentist, you will be responsible for any difference between the amount Delta Dental allows and the amount the Nonparticipating Dentist charges, in addition to any Copayment or Deductible. Control Plan – Delta Dental of Michigan Benefit Year – April 1 through March 31 Covered Services - Plan Pays* You Pay

Class I Diagnostic and Preventive Services - includes exams, cleanings, fluoride, and space maintainers 100% 0%

Emergency Palliative Treatment - to temporarily relieve pain 100% 0% Brush Biopsy - to detect oral cancer 100% 0% Radiographs - X-rays 100% 0%

Class II Minor Restorative Services - includes fillings 80% 20% Periodontic Services - to treat gum disease 80% 20% Endodontic Services - includes root canals 80% 20% Oral Surgery Services - extractions and dental surgery 80% 20% Relines and Repairs - to bridges and dentures 80% 20% Other Basic Services - misc. services 80% 20%

Class III Major Restorative Services - includes crowns 50% 50% Prosthodontic Services - includes bridges, implants, and dentures 50% 50%

Class IV Orthodontic Services - includes braces 50% 50% Orthodontic Age Limit - To age 19 *When you receive services from a Nonparticipating Dentist, the percentages in this column indicate the portion of Delta Dental's Nonparticipating Dentist Fee that will be paid for those services. This Nonparticipating Dentist Fee may be less than what your dentist charges, which means that you will be responsible for the difference. Oral exams are payable twice per calendar year. Prophylaxes (cleanings) are payable twice per calendar year. Fluoride treatments are payable twice per calendar year for people up to age 19. Bitewing X-rays are payable once per calendar year and full mouth X-rays (which include bitewing X-rays) are

payable once in any five-year period. Composite resin (white) restorations are Covered Services on posterior teeth. Porcelain crowns are optional treatment on posterior teeth. Implants and implant related services are payable once per tooth in any five-year period. People with certain high-risk medical conditions may be eligible for additional prophylaxes (cleanings) or

fluoride treatment. The patient should talk with his or her dentist about treatment.

Customer Service Toll-Free Number: 800-524-0149 www.deltadentalmi.com

July 21, 2017

Having Delta Dental coverage makes it easy for our enrollees to get dental care almost everywhere in the world! You can now receive expert dental care when you are outside of the United States through our Passport Dental program. This program gives you access to a worldwide network of dentists and dental clinics. English-speaking operators are available around the clock to answer questions and help you schedule care. For more information, check our Web site or contact your benefits representative to get a copy of our Passport Dental information sheet. Maximum Payment – $1,000 per person total per benefit year on all services except Orthodontics. $1,000 per person total per lifetime on Orthodontic Services. Deductible – $50 deductible per person total per benefit year limited to a maximum deductible of $150 per family per benefit year. The deductible does not apply to diagnostic and preventive services, emergency palliative treatment, brush biopsy, X-rays, and orthodontic services. Waiting Period – Employees who are eligible for dental benefits are covered on the first day of the month following 90 days of employment. Eligible People – All full-time employees of the Contractor who choose the dental plan and COBRA (Consolidated Omnibus Budget Reconciliation Act of 1985) enrollees, if applicable. The Contractor and Subscriber share the cost of this plan. Also eligible at your option are your legal spouse, your dependent children to the end of the calendar year in which they turn 19, and your dependent unmarried children who are eligible to be claimed by you as a dependent under the U.S. Internal Revenue code during the current calendar year. You and your eligible dependents must enroll for a minimum of 12 months. If coverage is terminated after 12 months, you may not re-enroll prior to the open enrollment that occurs at least 12 months from the date of termination. Your dependents may only enroll if you are enrolled (except under COBRA) and must be enrolled in the same plan as you. Plan changes are only allowed during open enrollment periods, except that an election may be revoked or changed at any time if the change is the result of a qualifying event as defined under Internal Revenue Code Section 125. If you and your spouse are both eligible under this Contract, you may be enrolled as both a Subscriber on your own application card and as a dependent on your spouse's application card. Your dependent children may be enrolled on both application cards as well. Delta Dental will coordinate benefits. Benefits will cease on the last day of the month in which the employee is terminated.

MIDWEST MANAGEMENT GROUP and VSP provide you an affordable eyecare plan.

Doctor Network VSP Signature Plan 1

WellVision Exam® focuses on your eye health and

overall wellness

$10 copay .............................. every 12 months

Prescription Glasses

$ 2 5 c o p a y Lenses ........... every 12 months

Single vision, lined bifocal, and lined trifocal lenses.

Polycarbonate lenses for dependent children. Frame .............................................. every 12 months

$130 allowance for a wide selection of frames

20% off the amount over your allowance. ~OR~

Contact Lens Care

No copay .............................. every 12 months $130 allowance for contacts and the contact lens exam (fitting and evaluation). Current soft contact lens wearers may qualify for a special program that includes a contact lens exam and initial supply of lenses.

Extra Discounts and Savings

Glasses and Sunglasses

Average 35 - 40% savings on all non-covered lens options

30% off additional glasses and sunglasses, including lens options, from the same VSP doctor on the same day as your Well Vision Exam. Or get 20% off from any VSP doctor within 12 months of your last Well Vision Exam

Contacts 15% off cost of contact lens exam (fitting and

evaluation) Laser Vision Correction

Average 15% off the regular price or 5% off the promotional price. Discounts only available from contracted facilities.

After surgery, use your frame allowance (if eligible)

for sunglasses from any VSP doctor

Your Coverage with Other Providers

Visit vsp.com for details, if you plan to see a provider other than a VSP doctor.

Exam ...................................................................... Up to $35 Single vision lenses .............................................. Up to $25 Lined bifocal lenses .............................................. Up to $40

Lined trifocal lenses .............................................. Up to $55 Frame ................................................................ Up to $45 Contacts .......................................................... Up to $120

VSP guarantees service from VSP doctors only. In the event of a conflict between this information and your organization's contract with VSP, the terms of the contract will prevail

VSP® Member Services

At VSP Vision Care, we’re dedicated to offering a benefit that’s simple to use and worry free. Here are answers to questions we’re asked most about our services for members.

Frequently Asked QuestionsVSP® Member Services

QuestionsWhat’s the best way tocommunicate and promotethe VSP benefit to members?

AnswersWe have a variety of member communication tools designed toincrease awareness and understanding of the VSP benefit. They’reeasy to read and provide all the benefit information members need. Please review the enclosed Member Communications Overview, and then contact the Client Support Team at 800.216.6248 for more information or to order the tools you need.

An ID Card, or Member Vision Card, isn’t required for members to receive services or care. Members simply call a VSP provider to schedule an appointment, and tell them that they’re a VSP member. The provider and VSP handle the rest. If a member wishes to have an ID Card, they can register and log on to vsp.com to print one.

They simply go to vsp.com or contact VSP at 800.877.7195. Clientsregistered for the Manage Your Plan section at vsp.com can download customized VSP provider lists as PDF or Excel files.

Members and dependents have instant access through vsp.com tocheck coverage and eligibility, find a VSP provider, and learn moreabout eye care wellness.

Members can also call VSP Member Services any time at 800.877.7195 or access our automated benefits information system to check eligibility or find a provider. VSP Member Services is available Monday – Friday, from 5:00 a.m. to 8:00 p.m.; Saturday, 7:00 a.m. to 8:00 p.m.; and Sunday, 7:00 a.m. to 7:00 pm. (Pacific Time).

Yes. To make it easy for members to find vsp.com, add the followingcode to your website: <a href=http://www.vsp.com>VSP</a>.

Do members need an ID Card?

How do members obtain a list of VSP Providers?

If members have questions about plan coverage, eligibility, or eye care wellness information, where should I direct them?

Can we link our intranet or website to the VSP website?

Frequently Asked Questions

JOB#21561CL 8/15

QuestionsWhat is my client ID number to register for the Manage Your Plan section?

AnswersYou’ll receive your client ID number with your welcome call or e-mail. Each month’s bill contains your client ID number, along with the active division and class number(s). Or, contact the Client Support Team at 800.216.6248 for your client ID number.

Our Member Promise Program guarantees complete member satisfaction with services received at a VSP provider. If a member isn’t happy with the services or products from a VSP provider when using their VSP benefit, please have them contact Member Services at 800.877.7195.

Yes. If VSP out-of-network coverage is included in your plan, members can obtain services from any provider they choose, including national or retail chains. Reimbursement for out-of-network services is according to a schedule with the same copays and limitations as services through VSP Providers. However, VSP can’t guarantee satisfaction or extend discounts when using an out-of-network provider.

When services and/or materials are obtained from an out-of-networkprovider, members have two reimbursement choices:1. Most out-of-network providers will submit a request for

reimbursement on behalf of VSP members. This means members won’t need to pay their entire bill up front and will only be responsible for paying applicable copays and any balance above their out-of-network schedule.

2. Members can pay the provider directly and submit a claim to VSP for reimbursement, using the following procedure:

A. Visit the Benefits & Claims section of vsp.com to begin your claim.

B. Complete the claim form. Make sure you have a copy of your itemized receipt or statement that includes: • Doctor name or office name• Name of Patient• Date of Service• Each service received and the amount paid

C. After completing the claim form, you may attach your receipt(s) or print and mail copies of your claim form and receipt(s) to: VSP P.O. Box 385018 Birmingham, AL 35238-5018

Please note that claims for reimbursement must be filed within 12 months of the date of service. Members will be reimbursed according to the out-of-network reimbursement schedule.

©2015 Vision Service Plan. All rights reserved.VSP is a registered trademark of Vision Service Plan.

Can members choose anyeye care provider?

How do members collectreimbursement after visiting an out-of-network provider?

What if a member is dissatisfied with a VSP provider, or the materials received through theVSP benefit?

JOB#21421CM 06/15

You’re unique—and so are your VSP® Vision Care benefits. As a member, you’ll experience personalized attention, patient-centered care, and innovative solutions to keep you healthy. We’re committed to keeping you in control of your eye health.

Personalized care and coverage for you.

See your vision benefits. Create an account at vsp.com to access your plan details, so you can make the best choices about your eye health.

Find superior eye care near you. The decision is yours—choose a conveniently located VSP provider or any out-of-network provider. Find the best doctor for you at vsp.com.

Get member-exclusive savings and more choices. Visit a VSP provider and save more than if you see an out-of-network provider. Take advantage of Exclusive Member Extras, like member-only offers and rebates. You’ll get even more benefits and a larger selection of featured frame brands when you choose a VSP doctor who participates in the Premier Program. Find more savings at vsp.com/specialoffers.

Print a Member Vision Card—if you’d like one. There’s no ID card necessary—just tell your provider you have VSP. If your employer provided you with an ID number, share that too.

Eye Care Made Easy

©2015 Vision Service Plan. All rights reserved. VSP and VSP Vision care for life are registered trademarks of Vision Service Plan.

Questions? vsp.com | 800.877.7195

YOUR VISION& HEALTHCOME FIRSTWITH VSP

Register, find your local VSP provider, and

see your benefits at vsp.com today!

For more about your coverage, visit vsp.com or call 800.877.7195.

Using your VSP® benefit is easy.• Find the eye care provider who’s right for you. To find a VSP provider, visit vsp.com or call 800.877.7195.• Review your benefit information at vsp.com before your appointment.• At your appointment, tell them you have VSP.

My eye care provider:_____________________

Phone:_____________________________This card isn’t required for service and doesn’t guarantee benefit eligibility. It’s for use by VSP members. In the event of a conflict between this information and your organization’s contract with VSP, the terms of the contract will prevail. Utah members, your VSP coverage is provided by Vision Service Insurance Plan Company and is regulated by the State of Utah Insurance Division.

©2015 Vision Service Plan. All rights reserved.VSP is a registered trademark of Vision Service Plan.

Member NameCoverage TypeDoctor NetworkCopays

month/day/yearJOB#1006-15-VCCM 10/15

Supplemental Benefits

Policies offered through Aflac: Short-term Disability Cancer Hospital Protection Life Insurance

Policies offered through Allstate

Accident Critical Illness

Legal Shield and Identity Theft Shield

For further information or to elect and/or make changes to your current supplemental benefits, please contact: Brian A. Graef | Benefits Specialist BOST Workplace Benefits Phone: 734.476.1999 | Fax: 734.316.2781 bgraef@bostbenefits.com www.bostbenefits.com

** CONTINUATION COVERAGE RIGHTS UNDER COBRA**

Introduction You are receiving this notice because you have recently become covered under a group health plan. This notice contains important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan. This notice generally explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the right to receive it. The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you when you would otherwise lose your group health coverage. It can also become available to other members of your family who are covered under the Plan when they would otherwise lose their group health coverage. For additional information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator. What is COBRA Continuation Coverage? COBRA continuation coverage is a continuation of Plan coverage when coverage would otherwise end because of a life event known as a “qualifying event.” Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a “qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage. If you are an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because either one of the following qualifying events happens:

• Your hours of employment are reduced, or • Your employment ends for any reason other than your gross misconduct.

If you are the spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because of any of the following qualifying events happens:

• Your spouse dies; • Your spouse’s hours of employment are reduced; • Your spouse’s employment ends for any reason other than his or her gross

misconduct;

• Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or

• You become divorced or legally separated from your spouse. Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because any of the following qualifying events happens:

• The parent-employee dies; • The parent-employee’s hours of employment are reduced; • The parent-employee’s employment ends for any reason other than his or her

gross misconduct; • The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or

both); • The parents become divorced or legally separated; or • The child stops being eligible for coverage under the plan as a “dependent child.”

When is COBRA Coverage Available? The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred. When the qualifying event is the end of employment or reduction of hours of employment, death of the employee or the employee’s becoming entitled to Medicare benefits (under Part A, Part B, or both), the employer must notify the Plan Administrator of the qualifying event. You Must Give Notice of Some Qualifying Events For the other qualifying events (divorce or legal separation of the employee and spouse or a dependent child’s losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days after the qualifying event occurs. You must provide this notice to MM1, Inc.. If loss of coverage is due to divorce or legal separation, you must provide MM1, Inc. a copy of your divorce decree or legal separation paperwork. In the event of a child losing dependency status please contact MM1, Inc. for specifics. How is COBRA Coverage Provided? One the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children. COBRA continuation coverage is a temporary continuation of coverage. When the qualifying event is the death of the employee, the employee’s becoming entitled to Medicare benefits (under Part A, Part B, or both), your divorce or legal separation, or a

dependent child losing eligibility as a dependent child, COBRA continuation coverage lasts for up to a total of 36 months. When the qualifying event is the end of employment or reduction of the employee’s hours of employment, and the employee became entitled to Medicare benefits less than 18 months before the qualifying event, COBRA continuation coverage for qualified beneficiaries other than the employee lasts until 36 months after the date of Medicare entitlement. For example, if a covered employee becomes entitled to Medicare 8 months before the date on which his or her employment terminates, COBRA continuation coverage for his or her spouse and children can last up to 36 months after the date of Medicare entitlement, which is equal to 28 months after the date of the qualifying event (36 months minus 8 months). Otherwise, when the qualifying event is the end of employment or reduction of the employee’s hours of employment, COBRA continuation coverage generally lasts for only up to a total of 18 months. There are two ways in which this 18-month period of COBRA continuation coverage can be extended. Disability extension of 18-month period of continuation coverage If you or anyone in your family covered under the Plan is determined by the Social Security Administration to be disabled and you notify the Plan Administrator in a timely fashion, you and your entire family may be entitled to receive up to an additional 11 months of COBRA continuation coverage, for a total maximum 29 months. The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of continuation coverage. If you feel you may qualify for this extension, please call MM1, Inc. upon receipt of this notice or your Social Security Disability Award Letter Second qualifying event extension for 18-month period of continuation coverage If your family experiences another qualifying event while receiving 18 months of COBRA continuation coverage, the spouse and the dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum 36 months, if notice of the second qualifying event is properly given to the Plan. This extension may be available to the spouse and dependent children receiving continuation coverage if the employee or former employee dies, becomes entitled to Medicare (under Part A, Part B, or both), gets divorced or legally separated, or if the dependent child stops being eligible under the Plan as a dependent child, but only if the event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred. If You Have Questions Questions concerning your Plan and your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under ERISA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits

Security Administration (EBSA) in your area or visit the EBSA website at www.dol.gov/ebsa. (Addresses and phone numbers of Regional and District EBSA offices are available through EBSA’s website. Keep Your Plan Informed of Address Changes In order to protect your family’s rights, you should keep the Plan Administrator informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Plan Contact Information Ralph Cunningham (248)313-2000 ext. 106 MM1, Inc. 3170 Old Farm Ln. Commerce Township, MI 48390 LALIB:128577.1\099999-90030

NOTES