THAT BENEFIT YOU · which case coverage will extend to the end of the month in which the child a ©ains age 19, 25 or is no longer a full‐me student). Your unmarried dependent children

BENEFITS THAT BENEFIT YOU

OUR COMMITMENT TO YOU: A plan designed for your needs Excellence and integrity define our approach to the rela onships we build and to the professionals who are among the UNIS team. UNIS is pleased to offer a comprehensive benefits program to its valued employees.

Here is a summary of the changes for the 2016‐2017 benefit plan year, effec ve April 1, 2016:

We have changed our medical carrier to Aetna. You now have the choice between an Open Access Managed Choice POS and an Open Access Elect Choice EPO. Both medical plan op ons do not require a referral for a specialist visit. See page 5 for more informa on.

We have decided to renew Aetna as our dental carrier. The Indemnity plan has been replaced with a Preferred Provider Organiza on (PPO). You will now have the op on between a PPO or a DMO. See page 6 for more informa on.

BENEFIT BASICS As a new hire, now is your opportunity to review your benefits and make your enrollment elec ons. Once you elect your benefits op ons your elec ons remain in effect un l the next open enrollment period which will be held in advance of April 1, 2017. Outside of the annual open enrollment period, you may only change coverage due to a Qualifying Life Event and must do so within 30 days of the event. UNIS encourages you to review all of your benefits and choose the plans that best meet the needs of you and your family.

2016-2017

Employee Benefits Guide

What’s New for 2016?

2

2016 BENEFITS

UNIS | TABLE OF CONTENTS

APRIL 1, 2016 ‐ MARCH 31, 2017 PLAN YEAR

Benefit Information 3 Know Before You Go 4 Medical Plan Options 5 Dental Plan Options 6 Vision Plan 7 Flexible Spending Accounts (FSA) 8 Qualified Transit Benefit 9 Long Term Disability 10 Ability Assist EAP 11 Life and AD&D Insurance 12 Voluntary Life Insurance 12 BenefitsVIP® 13 2016 Annual Notices 14 - 15

3

ELIGIBILITY All regular part‐ me (working 17.5 hours per week) and full‐ me (working 35 hours per week) employee are eligible to enroll in the UNIS benefits program. Employees are eligible for benefits on their date of hire. Benefits include:

BENEFIT INFORMATION | UNIS

DEPENDENT ELIGIBILITY:

Your Spouse or Domes c partner. Your spouse is a person to whom you are legally married under the laws of the state in which you live. Your domes c partner is a person with whom you have executed and filed a Declara on of Domes c Partnership with the Secretary of the State, or has registered as a domes c partner under the local law.

Your Dependent Children including: natural born children, legally adopted children (or children who have been placed with you for adop on), stepchildren for whom you have been appointed legal guardian or foster parent, children of whom you are required to cover under a Qualified Child Support Order.

Medical & Vision: Your dependent children under age 26, regardless of student or marital status.

Dental: Your dependent child up to age 19 or un l age 25 years if a full‐ me student in an ins tute of higher educa on (in which case coverage will extend to the end of the month in which the child a ains age 19, 25 or is no longer a full‐ me student).

Your unmarried dependent children who are totally and permanently disabled, incapable of self‐support because of a mental or physical disability, and financially supported by the employee. Required proof of disability must be provided.

QUALIFYING LIFE EVENT (QLE) The plan elec ons you make are effec ve for the 2016‐2017 plan year (April 1, 2016 ‐ March 31, 2017). You may not make changes to your benefits unless you experience a life event. Qualifying life event changes include: marriage, divorce, birth or adop on, death of dependent, and change in employment status of a spouse. Please contact your Human Resources department within 30 days of the qualifying life status change if you wish to make changes to your plan elec ons. WHEN BENEFITS END Health Insurance coverage will end on the earliest of these dates:

The last day of the month when employment is terminated

When eligibility requirements are not longer met

If any required contribu on is not made

The day UNIS no longer offers the coverage or the policy terminates

Upon the death of an enrolled employee * See CBA Ar cle 12.2.02 (C) If you or your dependent loses coverage, a COBRA elec on form will be sent to you from Infinisource, or COBRA administrator, which will give you the op on of con nuing our group medical, dental, vision coverage and your Healthcare FSA for a designated period, as required by COBRA law. COBRA provides former employees, spouses and dependent children the right to temporary con nua on of health coverage at a group rate. For more informa on on COBRA, please contact your Human Resources department.

Medical

Dental

Vision

Flexible Spending Accounts

Qualified Transit Benefit

Long‐Term Disability

Employee Assistance Program (EAP)

Basic Life and AD&D (Accidental Death and Dismemberment) Insurance

Voluntary Life and AD&D Insurance

Voluntary Supplemental Insurance through Aflac (Please see Human Resources for more informa on)

4

2016 BENEFITS

UNIS | KNOW BEFORE YOU GO

UNDERSTANDING YOUR MEDICAL BENEFITS

Glossary of Terms

Copayment (copay) A predetermined (flat) fee an individual pays for health care services, in addi on to what

the insurance covers.

Covered Services The health care services your insurance company will pay

for under your plan.

Deduc ble The amount you must pay

before the plan pays any benefits.

Denial of Claim Refusal by an insurance company to honor a

request by an individual (or his or her provider) to pay for health care services obtained

from a health care professional.

Dependents Spouse, domes c partner, and/or children

(whether natural, adopted , step, or partner’s children) of an insured.

Effec ve Date

The date your insurance is to actually begin. You are

not covered un l the policy’s effec ve date.

Exclusions

Medical services that are not covered by an individual's insurance policy.

CONDITIONS TREATED

YOUR COST & TIME

Emergency Room (ER) Sudden numbness, weakness

Uncontrolled bleeding Seizure or loss of

consciousness

Shortness of breath Chest pain Head injury/major trauma

Blurry or loss of vision Severe cuts or burns Overdose

Costs are highest No appointment needed

Wait mes may be long, averaging over 4 hours

For the immediate treatment of cri cal injuries or illness. If a situa on seems life‐threatening, call 911 or go to the nearest emergency room. Open 24/7.

Urgent Care Center Minor cuts, sprains, burns, rashes

Fever and flu symptoms

Headaches Chronic lower back pain Joint pain Minor respiratory

symptoms

Urinary tract infec on

Costs are lower than an ER visit

No appointment needed

Wait mes vary For condi ons that are not life threatening. Urgent Care Centers are staffed by nurses and doctors and usually have extended hours.

Doctor’s Office General health issues Preven ve services

Rou ne checkups

Immuniza ons and screenings

May include a copay/coinsurance and/or deduc ble

Appointment usually needed

May have li le wait me

The best place to receive rou ne or preven ve care, track medica ons, or get a referral to see a specialist.

Convenience Care Clinic Common cold/flu

Rashes or skin condi ons

Sore throat, earache, sinus pain

Minor cuts or burns

Pregnancy tes ng

Vaccina ons

Costs are same or lower than office visit

No appointment needed

Wait mes typically 15 minutes or less

Staffed by nurse prac oners and physician assistants. Treat minor medical concerns that are not life threatening. Located in retail stores and pharmacies, they’re o en open nights and weekends.

KNOW BEFORE YOU GO

Member Services: 1.800.962.6842 www.aetna.com

5

MEDICAL AND PRESCRIPTION PLANS

MEDICAL AND PRESCRIPTION PLANS | UNIS

HIGH POS PLAN EPO PLAN

Medical Benefits In‐Network Out‐of‐Network In‐Network Only

Referrals Required for Specialist

No No No

Deduc ble (Calendar Year)

None Individual: $500 Family: $1,000

None

Coinsurance None Plan Pays: 80% You Pay: 20%

None

Calendar Year Out‐of‐Pocket Maximum1

Individual $2,500 Family: $5,000

Individual: $2,500 Family: $5,000

Individual: $2,500 Family: $5,000

Preven ve Care No Charge 20% a er deduc ble No Charge

PCP Office Visit Specialist Office Visit

$25 copay $40 copay

20% a er deduc ble 20% a er deduc ble

$30 copay $50 copay

Outpa ent Surgery Lab and X‐ray

No Charge No Charge

20% a er deduc ble 20% a er deduc ble

No Charge No Charge

Hospital Care No Charge 20% a er deduc ble No Charge

Emergency Room $200 copay,

waived if admi ed $200 copay,

waived if admi ed

Urgent Care $40 copay 20% a er deduc ble $50 copay

Prescrip on Drugs

Retail Tier 1 Tier 2 Tier 3

$15 copay $35 copay $75 copay

Covered in‐network only

$15 copay $35 copay $75 copay

Mail Order Tier 1 Tier 2 Tier 3

$37.50 copay $87.50 copay $187.50 copay

Covered in‐network only

$37.50 copay $87.50 copay $187.50 copay

MONTHLY EMPLOYEE CONTRIBUTIONS

Aetna POS High Plan Aetna EPO Plan

Employee $303.82 $274.95

Employee + 1 Dependent

$589.41 $533.41

Employee + Family $917.53 $830.36

1. All Copayments, Deduc bles, and Coinsurance (medical and prescrip on) paid for In‐Network Covered Services contribute to the In‐Network, Out‐of‐Pocket Maximum


How to Locate a Network Provider Step 1: Go to www.aetna.com ‐ click on Employers & Organiza ons then click on Menu Step 2: Under “Quick Links” click on “Find a Doctor or Hospital” Step 3: Under “Thinking of ge ng an Aetna Plan” click on “Find doctors, den sts and hospitals in our plans” Step 4: Under “What type of plan are you considering choose the third op on i.e. “A plan offered by my employer or organiza on” Step 5: Under “Provider Types” select the Healthcare professional you wish to search Step 6: Enter your search criteria ‐ Zip code or city, state then click search Step 7: Under “Select a Plan” ‐ scroll down to “Aetna Open Access Plans” and select either “Elect Choice EPO (Open Access)” or “Managed Choice POS (Open Access)” and click con nue You may also call Aetna directly at 800.962.6842

For additional plan information, please refer to your detailed plan design provided by the carrier. In the event of a discrepancy, the carrier Plan Document shall prevail.

6

DENTAL PLAN OPTIONS

2016 BENEFITS

PPO OPTION #1

DMO

OPTION #2

BENEFIT IN‐NETWORK IN‐NETWORK ONLY

Office Visit Copay $0 $0

Annual Deduc ble (Waived for Preventa ve)

$50 Individual $150 Family

None

Calendar Year Maximum $1,500 Per Person

None

Preven ve Services Covered 100% Covered 100%

Basic Services Covered 85% a er deduc ble

Covered 100%

Major Services Covered 70% a er deduc ble

Covered 60%

Orthodon c Services* (Children only)

Covered 50% deduc ble waived

Covered 50%

Orthodon c Deduc ble None None

Orthodon c Life me Maximum

$1,000 N/A

OUT‐OF‐NETWORK

$0

$50 Individual $150 Family

$1,500 Per Person

Covered 100%

Covered 85% a er deduc ble

Covered 70% a er deduc ble

Covered 50% deduc ble waived

None

$1,000

The Aetna Dual Op on Dental plans allow you to make an annual elec on into either the PPO or DMO. Each plan gives you and your family the op on for dental coverage that works best for you. It’s your choice!

PPO VS. DMO

PREFERRED PROVIDER ORGANIZATION (PPO) Our dental PPO plan gives you the freedom to visit any licensed den st for covered expenses. You do not need a referral, or an ID card.

The deduc ble is the set amount you pay for dental care before your dental plan starts to pay.

In network PPO den sts agree to accept Aetna nego ated fees as payment in full. You can also select an out of network den st and receive similar benefits but are subject to higher out of pocket costs. Reimbursements for out of network services are based off Aetna’s reasonable & customary (R&C) fee amounts or maximum allowable charges.

DENTAL MAINTENANCE ORGANIZATION (DMO) Requires you to choose a primary care den st (PCD) from Aetna’s network. There are no deduc bles. As well as, no claim forms. When you visit the den st’s office, show your ID card. You may be asked to pay a copay (a flat dollar amount or percentage of the covered expenses). But with this plan there are no other bills to pay. You can change your PCP as o en as once a month! To find a den st that par cipates in either

network, go to www.aetna.com and search the DMO Network or the PPO II Network.

UNIS | DENTAL PLANS

*Orthodon a is covered only for children (appliance must be placed prior to age 20) **24 months of comprehensive orthodon c treatment plus 24 months of reten on



DUAL OPTION PPO

Employee $17.99

Employee + Family $49.17

DUAL OPTION DMO

$3.80

$12.09

Employee + 1 Dependent $40.64 $9.99


7 VISION PLAN | UNIS

You have the op on to purchase Vision benefits for yourself and or your dependents through Empire Blue Cross Blue Shield. With Blue View Vision, you have access to one of the na on’s largest vision networks. You can call or click online at 1‐800 CONTACTS, visit a private prac ce eye doctor, or go in‐store to LensCra ers®, Pearle Vision®, Sears Op calSM, Target Op cal®, JCPenney® Op cal, Davis Vision and Empire Vision Centers. Just remember, you’ll save me and money by using an eye doctor

or retail store that’s in the network.

IN‐NETWORK PROVIDERS When you use an in‐network provider, All you have to do is:

Find an in‐network provider at empireblue.com.

Make an appointment.

Show the staff your member ID card. If you don’t have it, don’t worry. They can look up your ID number online if they’re part of the Blue View Vision network.

Pay your copay or any remaining balance if you have one.

OUT‐OF NETWORK PROVIDER When you use an out‐of‐network provider you’re s ll covered. But here’s how it works:

Pay the full cost of the services you receive at your visit.

Get a claim form at empireblue.com.

Mail your receipt and your claim form to us and we’ll pay you back the amount your plan covers.

BENEFIT IN‐NETWORK OUT‐OF NETWORK

Comprehensive Exam (every 12 months)

$10 copay Up to $40 allowance

Eyeglass Lens $20 copay Varies

Frames (every 24 months) $130 allowance, then 20% off remaining balance

Up to $45

Basic Lenses (Pair) (every 24 months) Single Vision Bifocal Trifocal

Covered in full a er $20 copay Covered in full a er $20 copay Covered in full a er $20 copay

Up to $25 Up to $40 Up to $55

Lens Op ons (every 24 months) UV Coa ng Ting (Solid Gradient) Standard Polycarbonate Transi on Lenses (Adults)

$15 $15 $40 $75

N/A N/A N/A N/A

Progressive Lenses Standard Progressive Premium Tier 1 Premium Tier 2 Premium Tier 3

$65 $91 $97 $103

N/A N/A N/A N/A

An ‐Reflec ve Coa ng Standard An ‐Reflec ve Coa ng Premium Tier 1 An ‐Reflec ve Coa ng Premium Tier 2 An ‐Reflec ve Coa ng Other

$45 $57 $68

20% discount off retail pricing

N/A N/A N/A N/A

Contacts (in lieu of glasses) (every 24 months) Elec ve Conven onal Elec ve Disposable Non‐Elec ve Contact Lenses

$130 allowance, then 15% off remaining balance

$130 allowance (no addi onal discount)

Covered in full

Up to $105

Up to $105

Up to $210

BLUE VIEW VISION


Empire Blue View Vision

Employee $1.30

Employee + 1 Dependent $2.54

Employee + Family $3.78

Member Services: 1.866.723.0515 www.empireblue.com

VISION BENEFIT


8

2016 BENEFITS

UNIS | FLEXIBLE SPENDING ACCOUNTS

FLEXIBLE SPENDING ACCOUNTS (FSA)

Fitzharris & Company

Member Services: 1.516.944.2823

www.fitzharrisinsurance.com

A Flexible Spending Account, or FSA, is an important part of your overall benefit package. Through the plan, you can set aside a por on of your earnings, tax‐free, for everyday expenses you may have with:

Dependent day care expenses Out‐of‐pocket medical expenses including medical, dental, vision, and prescrip on drug expenses

When you enroll in the FSA plan, the amount you elect is automa cally deducted from your paycheck on a pre‐tax basis. Once you have a qualified expense, you can submit a completed claim form along with the suppor ng documenta on such as pharmacy receipts, detailed bills or the Explana on of Benefits (EOB).

FSA’s are “use it or lose it” type programs meaning if you do not use all of the funds you elect to contribute to your FSA during the calendar year, you will lose those remaining funds. This is why it is important for you to budget appropriately and use all of the funds within the FSA plan year. The only me you may make a change to your contribu on rate is during open enrollment or if you experience an IRS qualified status change such as marriage, birth of a child, adop on of a child, divorce, widowed, etc. In accordance with IRS regula ons, if you leave UNIS, any amount not used for claims on or before the termina on date is forfeited, unless COBRA is elected. REMINDER: FSA plan par cipants will be allowed to roll over up to $500 of unused funds at the end of the plan year. The rollover amount of $500 does not impact the maximum elec on for the following plan year (e.g. if you have a maximum elec on limit of $2,500 and a maximum rollover of $500, you could have access to up to $3,000 for the next plan year.)

ACCOUNT TYPE EXAMPLES OF

ELIGIBLE EXPENSES MONTHLY

CONTRIBUTION LIMITS ACCESS TO FUNDS PRE TAX BENEFIT

Health Care FSA Medical Plan Deduc bles Most Insurance Co‐payments Prescrip on Drugs Some OTC medicines Vision Exams/Eyeglasses/Contacts

Laser Eye Surgery Dental and Orthodon a (Braces)

Contraceptives

There is no minimum contribu on per year. Maximum contribu on is $2,550 per employee per year

Allows immediate access to the en re contribu on amount from the 1st day of the benefit year, before all scheduled contribu ons have been made

Save 20% ‐ 40% on avg. on your health care expenses Save on purchases not covered by insurance Reduce your taxable income

Dependent Care FSA

Daycare Day Camp Eldercare Before and A er School Care

There is no minimum contribu on per year. Maximum contribu on is $5,000 per year ($2,500 if married and file separate tax returns)

You will be able to submit claims up to your year‐to‐date accumulated amount in your account (You will only be reimbursed based on your accumulated contribu on amounts)

Save 20% ‐ 40% on avg. on your dependent care expenses Reduce your taxable income


9 QUALIFIED TRANSIT PROGRAM | UNIS

TRANSITCHEK® COMMUTER CHECK PROGRAM TransitChek® allows you to use pre‐tax dollars to pay for your commute and save on taxes. TransitChek commuter benefits cover all types of commu ng ‐ subway, bus, train, ferry, vanpool, bicycle and parking. Use TransitChek benefits to save money.

The IRS allows employees to set aside money for their commute ‐tax‐free.

With commu ng and gasoline costs con nuing to rise, TransitChek commuter

benefits program can significantly reduce the burden of these increased costs.

The IRS sets a monthly maximum amount that you can deduct pre‐tax:

2016 Monthly Maximums:

$255 for transit

$255 for qualified parking.

Tax savings on your commute means more of your money in your pocket.

Member Services: 1.866.410.2435 www.transitchek.com

QUALIFIED TRANSIT PROGRAM

*Employee savings are for informa onal purposes only and are based upon an overall marginal tax rate of 40%, monthly pretax deduc ons of $255 for a transit benefit and $255 for a parking benefit. Individual savings may vary based upon income, individual tax rates, state of residence and other factors. Please consult your tax advisor.


10 UNIS | LONG TERM DISABILITY INSURANCE

2016 BENEFITS Member Services: 1.877.778.1383

www.thehar ordatwork.com

LONG‐TERM DISABILITY BENEFIT HARTFORD

Elimina on Period 180 days

Defini on of Disability Own Occupa on to Age 65 or SSNRA

Benefit Percentage 66.23%

Minimum Monthly Benefit $100

Maximum Monthly Benefit $10,000

Maximum Dura on Social Security Normal Re rement Age

Pre‐exis ng Condi on Limita on 12 Months for condi ons treated within the 3 months prior to effec ve date of coverage

Long Term Disability (LTD) provides income replacement if you become disabled and are unable to work

The LTD plan works together with other sources of disability income (for example, Social Security) to replace a por on of your earnings

UNIS provides this benefit to all employees at no cost. Accordingly, any benefits received will be considered taxable income to you.

DISABILITY BENEFITS


11 EMPLOYEE ASSISTANCE PROGRAM | UNIS

Emo onal or work‐life counseling

Helps address stress, rela onship or other personal issues you or your family members may face. It’s staffed by GuidanceExperts℠ – highly trained master’s and doctoral level clinicians – who listen to concerns and quickly make referrals to in‐person counseling or other valuable resources. Situa ons may include:

Job pressures Stress, anxiety and depression Substance abuse

Rela onship/marital conflicts

Work/School disagreements

Child and elder care referral services

Financial informa on and resources

Provides support for the complicated financial decisions you or your family members may face. Speak by phone with a Cer fied Public Accountant and Cer fied Financial Planners on a wide range of financial issues. Topics may include:

Manage a budget

Ge ng out of debt

Re rement

Tax ques ons

Saving for college

Legal support and resources

Offers assistance if legal uncertain es arise. Talk to an a orney by phone about the issues that are important to you or your family members. If you require representa on, you’ll be referred to a qualified a orney in

Debt and bankruptcy Buying a home

Guardianship

Power of a orney

Divorce

Employee Assistance Plan

ABILITY ASSIST COUNSELING SERVICES

24 / 7 access to GuidanceResources® Online (offered by ComPsych).

Chat sessions with professional moderators.

Access to hundreds of personal health topics and resources for child care, elder care, a orneys or financial planners.

Visit www.guidanceresources.com to create your own personal username and password. If you’re a first‐ me user, you’ll be asked to provide the following informa on on the profile page: 1. In the Company/Organiza on field, use: HLF902 2. Then, create your own confiden al user name and password. 3. Finally, in the Company Name field at the bo om of personaliza on page, use: abili

As part of your Long Term Disability benefit with Har ord you and your family, including spouse and dependents, can access to Har ord’s Ability Assist Counseling Services, offered by ComPsych®, at any me.

Ability Assist can help provide simple solu ons to help you cope with the stress and life changes that may result from the everyday issues like job pressures, rela onships, re rement planning or personal impact of grief, loss, or a disability.

Service features: The service includes up to three face‐to‐face emo onal or work‐life counseling sessions per occurrence per year. This means you and your family members won’t have to share visits. Each individual can get counseling help for his/her own unique needs. Legal and financial counseling are also available by telephone during business hours.

Ge ng in touch is easy.

Just one simple call.

1‐800‐96‐HELPS (1‐800‐964‐3577)


12 UNIS | LIFE AND AD&D INSURANCE

LIFE AND AD&D INSURANCE

BASIC LIFE AND AD&D Basic life insurance coverage provides important financial protec on in the event of your death. AD&D insurance coverage provides protec on in the event of accidental death, loss of hands, feet and/or vision. UNIS provides eligible employees with coverage through Mutual of Omaha at no cost to you.

Member Services: 1.800.775.8805 www.mutualofomaha.com

VOLUNTARY LIFE INSURANCE You have the op on to purchase addi onal Life Insurance for yourself and or your dependents through Mutual of Omaha

Please see Human Resources for more informa on on Voluntary

Life and AD&D rates

BENEFIT

Life Benefit Amount 1 X annual earnings to a maximum benefit of $225,000

AD&D Benefit Amount 1 X annual earnings to a maximum benefit of $225,000

Guarantee Issue Amount All Amounts

Waiver of Premium If you become disabled prior to age 60 (as defined by your

plan) and are no longer able to work, your premium payments will be waived during this period of disability, up to age 65.

Waiver of Premium Elimina on Period

180 days

Reduc on of Benefits Schedule

67% at age 70 50% at age 75

Accelerated Life Benefit 100% of Life Insurance amount up to $225,000

Portability If you re re, reduce your hours or leave UNIS, you can take this coverage with you according to the terms of the contract

BASIC LIFE AD&D INSURANCE

VOLUNTARY LIFE INSURANCE BENEFIT EMPLOYEE SPOUSE* CHILD(REN)*

Benefit Amount Up to 5 mes salary in increments of

$10,000

Up to 100% of employee amount in increments of

$5,000

Up to 50% of employee coverage

amount in increments of $2,000

Maximum Benefit $500,000 $500,000 $10,000

Guarantee Issue Amount

$130,000 $25,000

$10,000 (birth ‐ 6 months:

$1,000 )

Reduc on of Benefits Schedule

65% at age 70 50% at age 75

65% at age 70 50% at age 75

**

2016 BENEFITS

*Dependent Spouse and/or Child coverage is only available if the Employee has coverage under this plan. **Children covered up to age 19, or to 26 if they are full‐ me students covered. Disabled children over the maximum child age may be eligible for benefits, please see your plan administer for more details.


13 BENEFITSVIP | UNIS

Completely confiden al! A majority of issues are resolved the same day; and all calls adhere to privacy best prac ces.

THE INSURANCE BEHIND YOUR INSURANCE

All rights reserved. Corporate Synergies Group LLC TM

For personal service that’s confiden al and responsive, contact:

1.866.293.9736

Monday ‐ Friday, 8:30am ‐ 8:00pm (EST)

Fax: 1.856.996.2735

solu [email protected]

Benefits ques ons ID card issues Billing issues and claims resolu on Prescrip on issues Provider network ques ons ...and much more!

BenefitsVIP®

ONE CALL DOES IT ALL!

BenefitsVIP is a powerful, one‐stop contact center staffed by seasoned professionals. Your dedicated team of employee benefits advocates is ready to help you and your family members with:

BenefitsVIP can resolve claims issues through carriers and

service providers 3-4 times faster than employees.

- Corporate Synergies BenefitsVIP

Client Utilization Report

14 UNIS | ANNUAL NOTICES

ANNUAL EMPLOYER HEALTH BENEFITS NOTICES

Health Protec on Act of 1996 (Newborn's Act)

Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connec on with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean sec on. However, federal law generally does not prohibit the mother's or newborn's a ending provider, a er consul ng with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable).

In any case, plans and issuers may not, under federal law, require that a provider obtain authoriza on from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

The Women’s Health and Cancer Rights Act of 1998 (WHCRA, also known as Janet’s Law)

Under WHCRA, group health plans, insurance companies and health maintenance organiza ons (HMOs) offering mastectomy coverage must also provide coverage for reconstruc ve surgery in a manner determined in consulta on with the a ending physician and the pa ent. Coverage includes reconstruc on of the breast on which the mastectomy was performed, surgery and reconstruc on of the other breast to produce a symmetrical appearance, and prostheses and treatment of physical complica ons at all stages of the mastectomy, including lymph edemas. Call your Plan Administrator for more informa on.

Qualified Medical Child Support Order (QMCSO)

QMCSO is a medical child support order issued under State law that creates or recognizes the existence of an “alternate recipient's” right to receive benefits for which a par cipant or beneficiary is eligible under a group health plan. An “alternate recipient” is any child of a par cipant (including a child adopted by or placed for adop on with a par cipant in a group health plan) who is recognized under a medical child support order as having a right to enrollment under a group health plan with respect to such par cipant. Upon receipt, the administrator of a group health plan is required to determine, within a reasonable period of me, whether a medical child support order is qualified, and to administer benefits in accordance with the applicable terms of each order that is qualified. In the event you are served with a no ce to provide medical coverage for a dependent child as the result of a legal determina on, you may obtain informa on from your employer on the rules for seeking to enact such coverage. These rules are provided at no cost to you and may be requested from your employer at any me.

No ce of Privacy Prac ces (HIPAA)

In compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA), your employer recognizes your right to privacy in ma ers related to the disclosure of health‐related informa on. The No ce of Privacy Prac ces (provided to you upon your enrollment in the health plan) details the steps your employer has taken to assure your privacy is protected. The No ce also explains your rights under HIPAA. A copy of this No ce is available to

you at any me, free of charge, by request through your employer.

Special Enrollment Rights (HIPAA)

If you have previously declined enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment within 30 days a er your other coverage ends. In addi on, if you have a new dependent as a result of marriage, birth, adop on, or placement for adop on, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days a er the marriage, birth, adop on, or placement for adop on.

Coverage Extension Rights under the Uniformed Services Employment and Reemployment Rights Act (USERRA)

If you leave your job to perform military

service, you have the right to elect to

con nue your exis ng employer‐based

health plan coverage for you and your

dependents (including spouse) for up to 24

months while in the military. Even if you do

not elect to con nue coverage during your

military service, you have the right to be

reinstated in your employer’s health plan

when you are reemployed, generally

without any wai ng periods or exclusions

for pre‐exis ng condi ons except for

service‐connected injuries or illnesses.

15 ANNUAL NOTICES | UNIS

Coverage Extension Rights under the Uniformed Services Employment and Reemployment Rights Act (USERRA)

If you leave your job to perform military service, you have the right to elect to con nue your exis ng employer‐based health plan coverage for you and your dependents (including spouse) for up to 24 months while in the military. Even if you do not elect to con nue coverage during your military service, you have the right to be reinstated in your employer’s health plan when you are reemployed, generally without any wai ng periods or exclusions for pre‐exis ng condi ons except for service‐connected injuries or illnesses.

Special Enrollment Rights CHIPRA – Children’s Health Insurance Plan

Effec ve April 1, 2009 you and your dependents who are eligible for coverage, but who have not enrolled, have the right to elect coverage during the plan year under two circumstances:

You or your dependent’s state Medicaid or CHIP (Children’s Health Insurance Program) coverage terminated because you ceased to be eligible.

You become eligible for a CHIP premium assistant subsidy under state Medicaid or CHIP (Children’s Health Insurance Program).

You must request special enrollment within 60 days of the loss of coverage and/or within 60 days of when eligibility is determined for the premium.

Michelle’s Law

Michelle’s Law permits seriously ill or injured college students to con nue coverage under a group health plan when they must leave school on a full‐ me basis due to their injury or illness and would otherwise lose coverage. The con nua on of coverage applies to a dependent child’s leave of absence from (or other change in enrollment) a postsecondary educa onal ins tu on (college or university) because of a serious illness or injury, while covered under a health plan. This would otherwise cause the child to lose dependent status under the terms of the plan.

Coverage will be con nued un l:

1. One year from the start of the medically necessary leave of absence, or

2. The date on which the coverage would otherwise terminate under the terms of the health plan; whichever is earlier.

Mental Health Parity and Addic on Equity Act of 2008

This act expands the mental health parity requirements in the Employee Re rement Income Security Act, the Internal Revenue Code and the Public Health Services Act by imposing new mandates on group health plans that provide both medical and surgical benefits and mental health or substance abuse disorder benefits. Among the new requirements, such plans (or the health insurance coverage offered in connec on with such plans) must ensure that the financial requirements applicable to mental health or substance abuse disorder benefits are no more restric ve than the predominant financial

requirements applied to substan ally all medical and surgical benefits covered by the plan (or coverage), and there are no separate cost sharing requirements that are applicable only with respect to mental health or substance abuse disorder benefits.

Gene c Informa on Non‐Discrimina on Act ‐ GINA

GINA broadly prohibits covered employers from discrimina ng against an employee, individual, or member because of the employee’s “gene c informa on,” which is broadly defined in GINA to mean (1) gene c tests of the individual, (2) gene c tests of family members of the individual, and (3) the manifesta on of a disease or disorder in family members of such individual.

GINA also prohibits employers from reques ng, requiring, or purchasing an employee’s gene c informa on. This prohibi on does not extend to informa on that is requested or required to comply with the cer fica on requirements of family and medical leave laws, or to informa on inadvertently obtained through lawful inquiries under, for example, the Americans with Disabili es Act, provided the employer does not use the informa on in any discriminatory manner. In the event a covered employer lawfully (or inadvertently) acquires gene c informa on, the informa on must be kept in a separate file and treated as a confiden al medical record, and may be disclosed to third par es only in very limited circumstances.

disclosed to third par es only in very limited circumstances.

This benefit summary provides selected highlights of the employee benefits program at UNIS. It is not a legal document and shall not be construed as a guarantee of benefits nor of con nued employment at UNIS. All benefit plans are governed by master policies, contracts and plan documents. Any discrepancies between any informa on provided through this summary and the actual terms of such policies, contracts and plan documents shall be governed by the terms of such policies, contracts and plan documents. UNIS reserves the right to amend, suspend or terminate any benefit plan, in whole or in part, at any me. The authority to make such changes rests with the Plan Administrator.

2016‐2017 EMPLOYEE BENEFITS GUIDE

Documents

THAT BENEFIT YOU · which case coverage will extend to the end of the month in which the child a ©ains age 19, 25 or is no longer a full‐me student). Your unmarried dependent children