OE Summary Ben School PY 2017 Flipbook

Benefits



























EMPLOYEE ENROLLMENT GUIDE
































NOVEMBER 1, 2017 - OCTOBER 31, 2018

Benefits Eligibility & Medical Coverage




ELIGIBILITY PRESCRIPTION COVERAGE
Employees working a minimum of 30 hours per week are Under the HMO HRA plan, medications may be purchased
eligible to participate in the Benefits Program on the first for a copay, without the need to meet the deductible.
of the month following 30 days of employment. Children Under the HMO Bronze plan, members pay a discounted
are eligible for medical, dental and vision coverage until the cost until meeting the plan deductible, then prescriptions
end of the month in which the child reaches age 26. are covered at 70%.
Step Therapy is a component of the prescription drug
PLAN YEAR HIGHLIGHTS & CHANGES program to help employees save on prescription drug
Medical Plan WHAT’S costs. It requires that a generic medication is prescribed
NEW?
• Decrease in plan costs! to treat common medical conditions such as asthma,
high cholesterol and other ongoing conditions before a
• Slight change in deductible and plan design more expensive medication is approved. If a different
• Increase in Benedictine School funding to the Health medication is necessary, your doctor can contact Cigna for
Reimbursement Arrangement to offset increase in authorization. Medications in the Step Therapy program
deductible. are noted with an “ST” in the Prescription Drug list.
Life and Disability
• Lincoln Financial Group will be our new life and disability LOCATING NETWORK PROVIDERS
carrier. Participating providers may be located online by visiting
• There are no benefit changes; current coverage will www.cigna.com and selecting the “Find a Doctor” link on
transition at the same levels. the right side of the page. Members may also register for a
• Rates under the Voluntary Life and Disability plans have myCigna.com account from the Cigna homepage to access
decreased. to a variety of resources including:
• Open Enrollment Opportunity: Employees may enroll • Physician and facility locations and information
without providing medical evidence of insurability • Claims and deductible status or additional ID cards
(proof of good health). • Medical services or prescription drug costs and lower
Employee Assistance Program cost options
• Through Lincoln Financial, employees and family • Discounts on health and wellness services
members have free access to a new Employee CIGNA HEALTH IMPROVEMENT
Assistance Program. Cigna offers many wellness opportunities to help you get
healthy and stay healthy. A few of the free tools and services
MEDICAL COVERAGE available to help you achieve your health and fitness goals
Medical coverage is provided through Cigna, a national include Biometric Screenings, Health Assessments and
healthcare company. Members have access to a nationwide Seminars. Log into mycigna.com for additional information.
network of providers in addition to health discounts and a
variety of wellness services by visiting www.mycigna.com. HEALTH ADVOCACY SERVICES
Benedictine School offers the following two HMO network Health Advocacy services are offered to all eligible
only plans. employees. Personal Health Coaches will assist members
in coordinating their medical care and treatment, locating
• Option I HMO HRA $1,500: Lower deductible plan providers, explaining benefits and resolving claim issues.
recommended for employees who have a frequent They also can help members identify wellness services and
need for medical services and care.
alternative medicine as well as locate appropriate senior
• Option II: HMO HRA $4,000: Higher deductible plan care or special needs services.
recommended for employees who are generally Members have access to these free, confidential services by
healthy with the need for less frequent medical care. calling toll-free: 866-799-2725.


2

Medical Plan Comparison




Cigna Open Access Medical Plans HMO HRA Open Access Plan HMO Bronze Open Access Plan

Services Per Benefit Period Network Only - No Referrals Network Only - No Referrals
Health Reimbursement Arrangement Eligible YES NO
Lifetime Maximum Benefit Unlimited Unlimited
Plan Year Deductible: Individual, Family $750 / $1,500 $4,000 / $10,000
Plan Year Out-of-Pocket Limit: Individual, Family $6,600 / $13,200 $6,350 / $12,700

Preventive Services Not Subject to Deductible Not Subject to Deductible
Routine Preventive Care - All Ages 100% 100%
Mammogram, PAP, PSA Tests 100% 100%
Immunizations - All Ages 100% 100%
Hospitalization Deductible Applies Deductible Applies
Room & Board - Semi Private 80% 70%
Ancillaries & Surgery 80% 70%
Physicians Visits 80% 70%
Skilled Nursing Facility - 60 Days 80% 70%

Outpatient Services Deductible Applies Deductible Applies
Physicians Visits - PCP/Specialist 80% 70%
Diagnostic/Xray/Lab 80% 70%
Outpatient Surgery 80% 70%
Emergency Room 80% 70%
Mental Health/Substance Abuse Visits 80% 70%
Prescription Drug Copays Not Subject to Deductible Deductible Applies

Tier 1 / Tier 2 / Tier 3: 30-Day Supply $10 / $50 / $75 70%
Tier 1 / Tier 2 / Tier 3: 90-Day Supply $30 / $150 / $225 70%

Please Note: If a medical diagnosis is indicated during a Preventive Care visit, the deductible may apply.


Medical Plan Per Pay Costs
Individual $113.47 $48.84
Individual/Child(ren) $217.15 $92.79
Individual/Spouse $240.18 $102.56

Family $343.79 $146.51




MOBILE ACCESS TO YOUR MEDICAL PLAN
The MyCigna Mobile App gives you an easy way to access your health information.
Anytime. Anywhere. Download it today from the App Store or Google Play .
TM
SM
• Find a doctor or health care facility
• View ID cards for the entire family
• Review deductibles, account balances and claims



3

Health Reimbursement Arrangement




EMPLOYER DEDUCTIBLE CONTRIBUTION

Benedictine School provides a Health Reimbursement Arrangement (HRA) to employees enrolling in medical coverage.
The HRA is set up through Cigna and will pay for eligible deductible-related expenses under the medical plan.


How the HRA works: HRA TIPS & TOOLS
•
• At the beginning of the plan year, employees enrolling in individual, self-only
coverage will receive $750 and employees enrolled in any other coverage • Stay on top of your HRA
level will receive $1,500. Examples of qualified medical plan expenses balance
include office visits, X-rays, lab tests, prescriptions and hospital care. - Visit: www.mycigna.com
• After an employee has exhausted the HRA funds provided by the • Be sure to use your HRA only
Benedictine School, the remaining deductible expenses are the employee’s for expenses that apply to the
responsibility.
medical plan deductible
• HRA funds will pay for eligible medical plan expenses and the amount will - Expenses that do not apply
be applied to your deductible (the amount you pay out-of-pocket before will not be covered
your plan starts to pay).
• If you anticipate that you will
• Providers will be directly reimbursed through Cigna, without the need to
pay up-front and submit claim forms. incur expenses during the plan
year which are not covered
• Employees should review their benefit statements or visit mycigna.com to under the medical plan or
track their deductible, HRA balance and claims status. reimbursed through the HRA...
- Open an FSA and use pre-
tax money to pay for these
expenses.





Employee Benefit Center (EBC)
Benedictine School EBC
Employees are encouraged to log into the Benedictine School
Website: http://benedictine.ubaebc.com Employee Benefit Center (EBC) to access plan benefits, forms
Username: Benedictine and other benefit resources. The EBC offers:
Password: benefits • Benefits information 24-hours a day, 7 days a
week

• Quick access to plans, provider directories, SPDs,
forms, and other content

• Online Health and Wellness Resources that
provides information to help you and your family
manage lifestyle issues
• Financial Planning Calculators to assist you with
managing your finances







4

Flexible Spending Accounts





The Flexible Spending Account Program (FSA) is administered through CareFlex. FSAs allow you to reduce your taxable
income by setting aside pre-tax dollars to pay for qualified medical and dependent care expenses. You may use the CareFlex
Benefits Card to pay for eligible expenses. Be sure to keep your itemized receipts and statements as documentation. You do
not need to enroll in the medical plan to participate in a FSA.

HEALTH AND DEPENDENT CARE FSA CLAIMS AND REIMBURSEMENT

FSAs allow you to save money on health care and dependent Employees have online access to account information
care expenses by using pre-tax dollars to pay for the following through the CareFlex Participant Portal. To register for an
types of expenses: account, visit www.mywealthcareonline.com/careflex/ and

• Health Care: Out-of-pocket health care expenses for select “Register for an Account”. If the Benefits Card is not
medical, dental and vision care (such as deductible and used, there are two reimbursement options:
copayments, glasses, orthodontia or prescription drugs). • Enter claims online through the Participant Portal; or,
• Dependent Care: Child care for children under the age of • Fax, email or mail a reimbursement request with
13 (such as day care centers, or in-home day care for an supporting documentation
incapacitated spouse or elderly parent). School tuition Email: [email protected]
(kindergarten and higher) and overnight camps are not Mail: 205 W. Dares Beach Road
eligible expenses. Prince Frederick, MD 20678


FSA CONTRIBUTIONS Fax: (410) 414-8432
Contributions are pre-tax through payroll deductions. The For questions, CareFlex can be reached toll-free by calling
maximum you may contribute for the plan year is: (888) 577-2762.
• Health Care FSA: $2,600
• Dependent Care FSA: $5,000 ($2,500 if you are married CAREFLEX MOBILE APP
and file a separate tax return) The Mobile App is a convenient way for you to view your
account balance and details. In addition, you can also:
BENEFITS CARD • File claims and take a picture of a receipt
Employees will receive the CareFlex Benefits Card that • Upload receipts and other documentation
provides convenient access to FSA funds. It is important • Receive notifications
to save all your receipts in the event you are required to The app may be downloaded by visiting www.careflex.com.
document the eligibility of an expense.
To access your account via your mobile device, enter your
CareFlex Portal account username and password.


FSA PLAN YEAR
CareFlex Benefits Card
Expenses must be incurred during the November 1, 2017 -
USING YOUR FSA October 31, 2018 Plan Year. Contributions cannot be carried
You can use your funds for yourself as well as any of your over; remaining funds will be forfeited. Changes to your
dependents, regardless of whether they are covered by contribution elections are not permitted unless you have a
your medical, dental or vision plan. For a listing of eligible qualified life status change. Be sure to carefully review your
expenses, please review the FSA Eligible Expense Guide annual Health Care and Dependent Care expenses prior to
available online at www.careflex.com. making your contribution elections.



Re-Enroll Reminder
A new election is required each Plan Year to participate in an FSA, even if you are
keeping the same election. You are not required to be enrolled in a medical plan to enroll in an FSA.



5

Employee Assistance Program




RESOURCES YOU NEED TO MEET LIFE’S CHALLENGES
An Employee Assistance Program (EAP) is available at no cost to all employees. EmployeeConnect services are provided
SM
through Lincoln Financial Group. The EAP provides counseling and assistance for a wide array of personal challenges, family
difficulties, stress and other life issues.

Unlimited 24/7 Assistance
You can access the following services anytime, online or
with a toll-free call:
• Information, resources, and referrals on family matters,
such as child and elder care; kennels and pet care; event
and vacation planning; moving and relocation;
car buying; college planning; and more
• Legal information and referrals for situations requiring
expertise in family law, estate planning, landlord/tenant
relations, consumer and civil law, and more EmployeeConnect counselors are experienced and
SM
• Guidance with financial matters, including household credentialed
budgeting, and short- and long-term planning When you call our toll-free line, you’ll talk to an
In-person Guidance experienced professional who will provide counseling,
Some matters are best resolved by meeting with a worklife advice, and referrals. All counselors hold master’s
professional in person. With EmployeeConnect , you’ll get: degrees, with broad-based clinical skills and at least three
SM
• In-person help for short-term issues (up to four* sessions years of experience in counseling on a variety of issues.
with a counselor per person, per issue, per year) For face-to-face meetings, you will be referred to a fully
• In-person consultations with network lawyers, including credentialed, state-licensed clinician.
one free 30-minute in-person consultation per legal You’ll receive a customized information packet for
issue, and subsequent meetings at a reduced fee each of the work-life services you use.
Online resources To take advantage of the EmployeeConnectSM program,
EmployeeConnect offers a wide range of information and or for more information:
SM
resources that you can research and access on your own Visit www.GuidanceResources.com
just by visiting GuidanceResources.com. You’ll find: or call 888-628-4824.
• Articles and tutorials
• Streaming videos
• Interactive tools — including financial calculators,
budgeting spreadsheets, and a language translator




















6

Dental Coverage



DENTAL PLAN

The Cigna PPO Dental plan covers services in or out-of- The plan includes the Dental Wellness Plus feature that
network. The plan year maximum benefit and deductible offers members the opportunity to increase their benefit
is based on a calendar year. the following year. Members must receive an exam and
Cigna PPO dental providers have agreed to accept the cleaning during the year to be eligible. Please refer to
contracted fee as payment in full for covered services. your plan materials for additional information on this
Services received through non-network providers are feature.
reimbursed based on Usual, Customary and Reasonable Cigna PPO network providers and further plan information
(UCR) charges at the 80th percentile. Members are can be can be accessed online by visiting www.cigna.com.
responsible for costs that exceed these charges.



Cigna Dental PPO In Network Out-of-Network
Year 1: $1,000, Year 2: $1,100
Calendar Year Benefit Per Person *
Year 3: $1,200, Year 4: $1,300

Calendar Year Individual Deductible $25 $25
Calendar Year Family Deductible $75 $75

Class I Expenses - Preventive Care (Deductible Waived) 100% 100% of UCR **
Oral Exams, Cleanings, X-rays, Fluoride Application, Sealants, Space
Maintainers

Class II Expenses - Basic Restorative Care 80% 80% of UCR **
Fillings, Emergency Care, Root Canal Therapy/Endodontics, Osseous Surgery,
Periodontal Scaling and Root Planing, Oral Surgery, Extractions of Impacted
Teeth, Repairs to Bridges, Crowns, Inlays

Class III Expenses - Major Restorative 80% 80% of UCR **
Crowns, Dentures, Bridges, Inlays/Onlays, Prosthesis Over Implant,
Stainless Steel/Resin Crowns
Class IV Expenses - Child Orthodontia, Deductible Waived 50% - $1,500 Lifetime Maximum
Dependent children to age 19

* Your yearly benefit increases to the next level if Class 1 services are utilized in the prior year

** Services received out-of-network are reimbursed based on Usual, Customary and Reasonable charges (UCR) at the 80th percentile.



Dental Plan Per Pay Costs
Individual $5.90
Individual/Child(ren) $12.18

Individual/Spouse $9.81
Family $16.78







7

Vision Coverage




VISION PLAN
The Cigna PPO Vision plan covers services in and out- Services received out-of-network are reimbursed
of-network. The Cigna network includes independent based on a schedule as outlined below. Members
optometrists and ophthalmologists as well as retail will need to pay for services at the time of the visit
providers such as Pearle Vision, Sears Optical and JCPenney and submit a claim form to Cigna for reimbursement.
Optical. Savings are maximized when receiving care from Members may visit www.cigna.com for provider
participating providers. information and further details.



Out-of-Network Locating Network Providers
Cigna Vision PPO In Network •
Reimbursement
• Log in to myCigna.com and
Service Frequency Once per Plan Year click on the “Cigna Vision
Eye Exams 100% Up to $45 coverage” page
Lenses • Select “View Details”, then
Single Vision 100% Up to $32 “Find a Cigna Vision Network
Bifocal 100% Up to $55 Eye Care Professional” to
Trifocal 100% Up to $65 search the Cigna Vision
Lenticular 100% Up to $80
Directory.
Frames Benefit up to $130 Up to $71 • If you don’t have access to

Contact Lenses (in lieu of eyeglasses) myCigna.com, visit www.
cigna.com and click on the
Elective Benefit up to $130 Up to $105
Therapeutic 100% Up to $210 orange “Find a Doctor” tab
at the top. Select the “Cigna
Vision Directory” and enter
your city, state and zip code.
Vision Plan Per Pay Costs
• Questions? Call the toll-free
Individual $2.27 number found on your Cigna
Individual/Child(ren) $3.36 ID Card to speak with a Cigna

Individual/Spouse $4.48 Vision customer service
Family $5.81 representative.
























8

Life & Voluntary Supplemental Life




GROUP LIFE AND SUPPLEMENTAL/DEPENDENT LIFE

Benedictine School provides Basic Life and Accidental Death and Dismemberment Insurance (AD&D) at no cost to eligible
employees. Employees may purchase Voluntary Life and Disability Insurance through Lincoln Financial Group. Voluntary Life
benefits may be purchased for a spouse and/or child(ren) provided the employee purchases coverage.



BASIC LIFE AND AD&D VOLUNTARY LIFE RATES
• Life Insurance Benefit of $15,000
Voluntary Life Monthly Rates Per $1,000
• AD&D Benefit of $15,000 Age Employee Spouse
• Benefits are issued without evidence of good <24 $0.05 $0.05
health 25-29 $0.06 $0.06
30-34 $0.08 $0.08
VOLUNTARY LIFE BENEFIT OPTIONS 35-39 $0.09 $0.09

• Employee: Increments of $10,000 up to a 40-44 $0.13 $0.13
maximum of $150,000, not to 45-49 $0.20 $0.20
exceed five times annual salary 50-54 $0.30 $0.30
Guarantee Issue: $150,000 55-59 $0.46 $0.46
60-64 $0.66 $0.66
• Spouse: Increments of $5,000 up to
$50,000, not to exceed 2 1/2 times 65-69 $1.27 $1.27
the employee’s salary 70-74 $2.06 N/A
Guarantee Issue: $30,000 75+ $4.21 N/A
All Children $0.112/$1,000
• Children: To age 19 (or to age 26
if a full-time student): Note: Spouse coverage ends at age 70
Increments of $2,000 up to $10,000
14 days to 6 months: $250. 6 month EVIDENCE OF INSURABILITY
to age 19 (26 if a full-time student): Employees applying for this coverage 31 days after
option of $2,500, $5,000, or $10,000 becoming eligible will need to complete a form attesting
Guarantee Issue: $10,000 to good health and may be subject to a health exam.








OPEN ENROLLMENT for Voluntary Life

Lincoln Financial Group is offering employees the opportunity to elect benefits on a guaranteed acceptance
basis without requiring evidence of good health (subject to guarantee issue limits). This opportunity is only
available during this Open Enrollment period. Employees applying for coverage at a later date will be subject
to medical evidence of insurability for all amounts.








9

Voluntary Disability




VOLUNTARY DISABILITY

Disability Insurance helps to supplement an employee’s income in the event of a non-work related accident or illness. These
plans are available to employees through Lincoln Financial Group (LFG) at discounted group rates. Employees who apply for
this coverage after their initial eligibility period will be subject to medical evidence of insurability.

VOLUNTARY SHORT TERM DISABILITY VOLUNTARY LONG TERM DISABILITY

Employees may purchase Voluntary Short Term Disability Employees may purchase Voluntary Long Term Disability
coverage which pays benefits for up to 11 weeks. coverage which pays benefits for an extensive disability.
• The policy pays 60% of your weekly salary, to a • The policy pays 60% of your monthly salary, to a
maximum of $1,000 per week. maximum of $5,000 per month.

• Benefits begin on the 15th day of a disability due to • Benefits begin after 90 days of a disability and are
an accident or an illness. payable for 2 years if you are disabled from your
own occupation, then to Social Security Normal
• Employees receiving care, treatment or medication Retirement Age (SSNRA) if you are disabled from
for a condition during the 3 months prior to the any occupation.
coverage date must remain treatment-free for 6 • Employees receiving care, treatment or medication
months to be covered for the condition. Conditions for a condition during the 3 months prior to the
occurring within 12 months after the coverage coverage date must remain treatment free for
effective date will be subject to pre-existing condition 6 months to be covered for that condition. Any
reviews.
condition that occurs within 12 month after the
• Current coverage will transition with credit applied effective date is subject to pre-existing condition
toward the pre-existing condition time period. limitations.

• The cost of this plan is $0.39 per $10 of benefit. • The cost of this plan is $0.48 per $100 of monthly
covered salary.
Sample Cost Calculation - Salary of $30,000
Sample Cost Calculation - Salary of $30,000
$30k divided by 52 weeks = $577 x 60% (.6) = $346
$30k divided by 12 months = $2,500 x .48 = $1,200
$346 x 0.39 = $134.94 divided by $10 = $13.49
$1,200 divided by $100 = $12.00
$13.49 per month x 12 divided by 26 pays = $6.23 per pay
$12.00 per month x 12 divided by 26 pays = $5.54 per pay








OPEN ENROLLMENT for Voluntary Disability
Lincoln Financial Group is offering employees the opportunity to elect benefits on a guaranteed acceptance
basis without requiring proof of good health. This opporuntinty is only available during this Open Enrollment
period. Employees applying for coverage at a later date will be subject to medical evidence of insurability for
proof of good health.







10

Additional Voluntary Plans





VOLUNTARY ACCIDENT AND CRITICAL ILLNESS
Employees have the opportunity to purchase voluntary accident and critical illness coverage through Cigna. Each plan pays
benefits directly to the employee, and coverage may also be purchased for a spouse and eligible dependents. Both plans are
portable and may be continued in the event of an employee’s termination of employment.

Employees may elect one or both plans:
Accident Insurance: Helps to offset the cost of deductible Critical Illness Insurance: Supplements health coverage for
expenses, copays or fees incurred from accidental expenses associated with a critical illness. The plan pays
injuries. The plan pays a lump sum cash benefit for a a cash benefit when diagnosed with a covered condition.
broad range of accident treatments and conditions. Employees may purchase a benefit amount of $5,000,
Examples of covered injuries include burns, dislocations, $10,000 or $20,000. Spousal benefits are available for up
fractures, lacerations. Services covered under this plan to 50% of the employee amount and 25% of the employee
include: amount may be purchased for child(ren). Examples of
covered conditions include:
• Emergency Care Treatment • Cancer
• Intensive Care Stay or Hospital Admission • Heart Attack or Stroke
• Ambulance Services • Renal (Kidney) Failure
• Office visits, • Major Organ Transplant
• Paralysis
• Diagnostics
• Amyotrophic Lateral Sclerosis (Lou Gehrig’s disease)
• Follow-up Care • Blindness

This plan also includes a yearly benefit of $50 per • Coronary Artery Disease (surgery)
person for Wellness Visits, Health Screening Tests and Covered members are also provided with a $50 benefit
Preventive Care services for each covered member. amount for annual Health Screening Tests.
Non-Smoker Per Pay Cost - Benefit Amount of $10,000 *
Accident Plan - Per Pay Costs
Age Employee Employee + Spouse Family
Individual $4.18 <25 $1.78 $3.15 $3.30
Individual/Child(ren) $7.73 25-29 $2.05 $3.50 $3.66
Individual/Spouse $7.37 30-34 $2.68 $4.34 $4.49
Family $10.61 35-39 $3.58 $5.71 $5.86
40-44 $4.67 $7.20 $7.36
45-49 $6.56 $10.07 $10.22
50-54 $8.62 $13.88 $14.03
55-59 $11.49 $18.84 $19.00
60-64 $14.66 $24.47 $24.62
65-69 $18.43 $30.09 $30.24
70-74 $25.22 $41.61 $41.76
75 - 79 $33.27 $54.83 $54.99
* Rates illustrated reflect an employee benefit amount of $10,000, a
benefit amount of 50% of the employee amount for a spouse and 25% of
the employee amount for child(ren). Please refer to the plan document
for complete cost details.



Please refer to the Cigna plan documents for additional information.


11

retirement plan & benefit changes




403(b) RETIREMENT PLAN CHANGING Your Benefits

Benedictine School offers employees the opportunity to Employee medical, dental, vision and FSA contributions
participate in a comprehensive retirement plan through are payroll deducted on a pre-tax basis before State,
Principal Financial Group. The tax deferred income plan Federal and Social Security taxes are withheld.
allows employees to save money on a pre-tax basis. • Benefits you elect are in effect through the
Employees may invest up to a maximum set by law entire Plan Year and cannot be changed unless
of $18,000 in calendar year 2017. Employees age 50 you have a qualified life status change.
or older may defer an additional $6,000 as a catch-up • If you have a qualified benefits change and wish
contribution. For plan eligibility and details, please to change your benefits accordingly, you must
contact the Human Resources Department.
contact the Human Resources Department and
complete the necessary paperwork within 30
days of the qualified change.






Benefit Contacts Directory

Medical, Dental, Vision Plan and Cigna (800) 244-6224 www.mycigna.com
Health Reimbursement Arrangment


Flexible Spending Accounts CareFlex (888) 577-2762 www. careflex.com


Basic Life, Voluntary Life, Lincoln Financial Group (800) 423-2765 www.lfg.com
Voluntary Disability



Critical IIlness and Accident Plans Cigna (800) 754-3207 www.mycigna.com



Retirement Plan Principal Financial Group (800) 547-7754 www.principal.com



Insurance Broker Jennifer Shipp, Vice President (443) 837-0662 [email protected]
Insurance Solutions Megan Ross, Account Coordinator (443) 837-0667 [email protected]





This summary provides an overview of your health and welfare benefits. It does not include all of the terms, coverages, exclusions,
limitations and conditions of the actual contract language. The descriptions within this summary do not guarantee coverage or
benefits. If a discrepancy exists between the benefits and descriptions within this summary and the legal documents governing each
benefit, the legal documents will prevail. For more detailed information on the plans and your legal rights under each plan, please refer
to the summary plan descriptions or request a copy of the applicable plan documents.


Summary provided courtesy of Insurance Solutions www.insursol.com
12