Mary Washington Healthcare 2011 Benefits Guide by M.K.

BeneďŹ ts Guide 2011

Your MWHC Health System Beneﬁts Guide for 2011 4HIS GUIDE IS DESIGNED FOR ACTIVE -7(# !SSOCIATES WHO ARE ELIGIBLE TO ENROLL IN THE -7(# BENEÚTS PLAN /UR BENEÚTS PACKAGE INCLUDES A WIDE VARIETY OF BENEÚTS TO CHOOSE FROM AND IS A VALUABLE PART OF THE TOTAL COMPENSATION YOU RECEIVE AS AN !SSOCIATE )NCLUDED IN THE GUIDE THIS YEAR ARE MANDATED (EALTHCARE 2EFORM CHANGES TO THE HEALTH PLANS ENROLLMENT AND ÛEXIBLE SPENDING ACCOUNTS

Your Beneﬁts Choices are Important 4HIS GUIDE WILL HELP YOU UNDERSTAND THE OPTIONS AVAILABLE TO YOU AS AN -7(# !SSOCIATE 5NDERSTANDING YOUR OPTIONS AND HOW YOUR BENEÚTS WORK HELPS MAXIMIZE THE VALUE OF YOUR BENEÚTS PACKAGE

Your Beneﬁts at a Glance 4HIS CHART SUMMARIZES THE BENEÚTS OPTIONS AVAILABLE TO YOU 3OME BENEÚTS ARE FULLY PAID BY -7(# SOME REQUIRE CONTRIBUTIONS FROM YOU !LL OF THE BENEÚTS AND HOW YOU ELECT THEM EACH YEAR ARE EXPLAINED IN GREATER DETAIL ON THE FOLLOWING PAGES 7HO 0AYS FOR #OVERAGE

We’re Here to Help!

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9OUR "ENEÚTS 4EAM IS AVAILABLE TO ANSWER ANY QUESTIONS YOU MAY HAVE 9OU MAY ALSO ACCESS THE 3ELF %VIDENT !PPLICATION 3%! AT ANY TIME FROM ANY COMPUTER WITH )NTERNET ACCESS &ROM 3%! YOU CAN REVIEW PLAN SUMMARIES FREQUENTLY ASKED QUESTIONS AND PLAN WEBSITES !LSO INSIDE THE BACK COVER OF THIS GUIDE IS A LISTING OF IMPORTANT TELEPHONE NUMBERS OF OUR "ENEÚTS 4EAM WHO ARE AVAILABLE TO FURTHER ASSIST YOU )N THE MEANTIME IF YOU D LIKE TO CONTACT US CALL OR E MAIL !SK"ENEÚTS MWHC COM 7E LOOK FORWARD TO SERVING YOU 9OUR "ENEÚTS 4EAM

-EDICAL 0RESCRIPTION $RUG 7ELLNESS 0ROGRAM

-7(#

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&LEXIBLE 3PENDING !CCOUNTS &3!S

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3HORT TERM $ISABILITY ,ONG TERM $ISABILITY

8 8 8

6OLUNTARY "ENEÚTS (OMEOWNERS !UTO ETC %MPLOYEE !SSISTANCE 0ROGRAM !33)34

2ETIREMENT 3AVINGS 0LAN 9OU FUND #OMPANY MATCHES A PERCENTAGE

9OU

0AID !NNUAL ,EAVE 0!,

%DUCATION !SSISTANCE

#HILD #ARE

0LEASE KEEP IN MIND 4HIS GUIDE PROVIDES ONLY AN OVERVIEW OF YOUR OPTIONS )F YOU NEED SPECIÚC PLAN DETAILS SEE YOUR SUMMARY PLAN DESCRIPTION OR CONTACT A MEMBER OF THE "ENEÚTS 4EAM 7HILE WE HAVE DONE OUR BEST TO PROVIDE AN ACCURATE SUMMARY PLEASE BE AWARE THAT IF THERE IS ANY DISCREPANCY BETWEEN THE INFORMATION IN THIS GUIDE AND THE OFÚCIAL BENEÚTS PLAN DOCUMENTS THE OFÚCIAL PLAN DOCUMENTS WILL PREVAIL

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Eligibility & Enrollment -7(# S BENEÚTS PACKAGE PROVIDES A WIDE RANGE OF BENEÚTS 3OME BENEÚTS YOU NEED TO ELECT EACH YEAR OTHERS ARE AUTOMATICALLY PROVIDED TO SUPPORT YOU AND YOUR FAMILY 4HE FOLLOWING PAGES OUTLINE WHAT YOU NEED TO DO AS A NEW HIRE AND THEN EACH YEAR AS AN ACTIVE !SSOCIATE

Who’s Eligible to Enroll

%LIGIBILITY "ENEFITS

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7HEN YOU ENROLL YOUR SPOUSE OR DEPENDENT CHILDREN YOU LL NEED TO PROVIDE THE FOLLOWING DOCUMENTATION TO COMPLETE ENROLLMENT p &OR A SPOUSE A STATE ISSUED MARRIAGE LICENSE p &OR DEPENDENT CHILDREN A STATE ISSUED BIRTH CERTIÚCATE AND IF LEGAL WARD PROOF OF CUSTODY OR GUARDIANSHIP

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&AMILY -EMBERS &OR MANY OF THE -7(# BENEÚTS OPTIONS YOU MAY ENROLL THE FOLLOWING FAMILY MEMBERS p 3POUSE

(EALTHCARE 2EFORM 5PDATE &OR DEPENDENT CHILDREN UP TO AGE A STATE ISSUED BIRTH CERTIÚCATE AND 3OCIAL 3ECURITY NUMBER

#OVERAGE ,EVELS !VAILABLE TO 9OU -7(# WANTS TO ENSURE YOU GET THE COVERAGE RIGHT FOR YOUR FAMILY SITUATION AND BUDGET 3O WHEN YOU ENROLL IN MEDICAL DENTAL AND VISION YOU HAVE FOUR OPTIONS FOR YOUR COVERAGE LEVEL 9OU MAY CHOOSE DIFFERENT LEVELS FOR EACH PLAN 4HE ENCLOSED COST SHEET SHOWS THE RATES FOR EACH #OVERAGE LEVELS AVAILABLE p !SSOCIATE /NLY p !SSOCIATE AND 3POUSE p !SSOCIATE 0LUS /NE #HILD p &AMILY

3TATUS

$ESCRIPTION

)F BENEÚTS ELIGIBLE WHEN ACTIVE

)-0/24!.4 .%7 2%15)2%-%.4 4HE -EDICARE -EDICAID AND 3#()0 %XTENSION !CT OF IMPOSED NEW MANDATORY QUARTERLY REPORTING REQUIREMENTS ON GROUP HEALTH PLANS 4HESE AMENDMENTS STATE THAT WE MUST PROVIDE 3OCIAL 3ECURITY NUMBERS FOR ALL DEPENDENTS 9OU WILL NEED TO ACCESS THE 3%! DEPENDENT SCREEN TO ENTER 3OCIAL 3ECURITY NUMBERS FOR YOUR DEPENDENTS OR YOU MAY CALL "ROOKE 0ERRY AT

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Eligibility & Enrollment “What If I Don’t Enroll?”

How to Enroll

)F YOU DON T ENROLL AS A NEW HIRE OR DURING THE /PEN %NROLLMENT YOU LL HAVE LIMITED BENEÚTS COVERAGE !S A NEW HIRE p 9OU MUST COMPLETE ONLINE ENROLLMENT WITHIN DAYS OF YOUR HIRE DATE IF YOU WOULD LIKE MEDICAL DENTAL VISION &3! SHORT TERM DISABILITY FULL TIME ONLY OR ANY ADDITIONAL LIFE COVERAGE p )F YOU ARE A NEW HIRE AND DO NOTHING 9OU WILL ./4 HAVE DENTAL VISION OR SHORT TERM DISABILITY INSURANCE COVERAGE 9OU WILL BE ENROLLED IN STANDARD !SSOCIATE /NLY MEDICAL COVERAGE 9OU WILL BE ENROLLED IN BASIC LIFE INSURANCE AND THE 2ETIREMENT 3AVINGS 0LAN

/NLINE 5SING THE ,AWSON 3YSTEM S 3ELF %VIDENT !PPLICATION 3%! 9OU CAN ACCESS THE ONLINE ENROLLMENT SYSTEM FROM ANY COMPUTER WITH )NTERNET ACCESS )F YOU DON T HAVE ACCESS TO A COMPUTER COMPUTERS ARE AVAILABLE IN THE (UMAN 2ESOURCES OFÚCES AT -ARY 7ASHINGTON (OSPITAL -7( 3TAFFORD (OSPITAL 3( AND &ALL (ILL AS WELL AS IN THE 7EST #OMMUTER 2OOM AT -7(

$URING /PEN %NROLLMENT p 9OU MUST ENROLL DURING /CTOBER IF YOU WANT COVERAGE FOR p )F YOU DO NOTHING 9OU WILL ./4 HAVE DENTAL VISION OR SHORT TERM DISABILITY INSURANCE COVERAGE 9OU WILL BE ENROLLED IN STANDARD !SSOCIATE /NLY MEDICAL COVERAGE p 9OU MUST RE ENROLL EACH YEAR TO CONTINUE YOUR MEDICAL OR DEPENDENT &LEXIBLE 3PENDING !CCOUNT p )F ALREADY ENROLLED YOUR COVERAGE IN OPTIONAL SPOUSE CHILD AND SUPPLEMENTAL LIFE WILL CONTINUE (EALTHCARE 2EFORM 5PDATE p 9OU MAY ENROLL DEPENDENTS UP TO AGE IN THE -7(# MEDICAL BENEÚT PLAN DURING /CTOBER

6 Easy Steps

'O TO THE 3ELF %VIDENT !PPLICATION 3%! p &ROM ANY COMPUTER WITH )NTERNET ACCESS GO TO WWW -ARY7ASHINGTON(EALTHCARE COM p 3ELECT g!SSOCIATE AND 0HYSICIAN 2ESOURCESs AT THE BOTTOM OF THE HOMEPAGE ON THE NEXT PAGE CLICK g3%! FROM WORKs OR g3%! FROM HOMEs

%NTER YOUR 5SER )$ AND PASSWORD p &ORGOT YOUR PASSWORD )F YOU FORGET YOUR PASSWORD FOR 3%! CALL THE )NFORMATION 3ERVICE )3 (ELP $ESK AT 4HEY WILL IMMEDIATELY RESET IT TO A TEMPORARY PASSWORD 9OU LL BE PROMPTED TO CHANGE IT WHEN YOU LOG IN p &IRST TIME USERS 9OUR 5SER )$ IS YOUR SIX DIGIT EMPLOYEE NUMBER p 9OUR INITIAL PASSWORD IS THE ÚRST THREE LETTERS OF YOUR BIRTH MONTH LOWERCASE AND YOUR FOUR DIGIT BIRTH YEAR &OR EXAMPLE IF YOU WERE BORN ON *ANUARY YOUR PASSWORD WOULD BE JAN p 9OU LL BE PROMPTED TO CREATE YOUR OWN UNIQUE PASSWORD AFTER YOUR INITIAL LOGIN

#ONÚRM AND UPDATE YOUR PERSONAL DATA 3ELECT g-Y 0ERSONAL $ATAs p #LICK ON (OME !DDRESS TO CONÚRM YOUR ADDRESS p #LICK ON "ENEÚCIARY TO ENTER THE QUALIFYING PERSON OR PEOPLE WHO WILL RECEIVE FUNDS OR OTHER BENEÚTS FROM AN INSURANCE POLICY p #LICK ON $EPENDENTS TO ENTER ANY QUALIFYING FAMILY MEMBERS WHO DEPEND ON YOU AS A PRIMARY SOURCE OF INCOME AND ARE COVERED BY YOUR INSURANCE BENEÚTS 9OU ARE REQUIRED TO PROVIDE 3OCIAL 3ECURITY NUMBERS FOR ALL COVERED DEPENDENTS

IMPORTANT! )F YOU ARE A NEW HIRE OR MAKING BENEÚT CHANGES DUE TO A QUALIFYING LIFE EVENT p 9OU HAVE DAYS FROM YOUR HIRE DATE OR QUALIFYING LIFE EVENT TO ENROLL OR MAKE CHANGES 9OUR BENEÚTS WILL BECOME EFFECTIVE THE ÚRST DAY OF THE MONTH FOLLOWING YOUR DATE OF HIRE OR LIFE EVENT DATE p )F YOU FAIL TO ENROLL OR CHANGE BENEÚTS WITHIN DAYS YOU WILL MAINTAIN THE BENEÚTS IN EFFECT OR IF A NEW HIRE YOU WILL RECEIVE LIMITED BENEÚTS COVERAGE 9OUR NEXT OPPORTUNITY TO ENROLL OR MAKE CHANGES IS DURING THE /PEN %NROLLMENT PERIOD OR WHEN YOU HAVE ANOTHER QUALIFYING EVENT &OR MORE INFORMATION SEE g7HEN TO %NROLL OR -AKE #HANGESs ON PAGE

3ELECT YOUR BENEÚTS 'O TO g-Y "ENEÚTSs p )F A NEW HIRE CLICK ON .EW (IRE %NROLLMENT p )F ENROLLING AT /PEN %NROLLMENT CLICK ON "ENEÚTS %NROLLMENT p &ROM THERE YOU LL CHOOSE YOUR BENEÚTS OPTIONS FOR THE PLAN YEAR p #ONTINUE UNTIL YOU HAVE ENTERED ALL BENEÚTS SELECTIONS p 4HE LAST SCREEN WILL BE A REVIEW OF YOUR NEW BENEÚTS p )MPORTANT .OTE /NLINE ENROLLMENT IS NOT AVAILABLE FOR SPOUSE TERM LIFE OR SUPPLEMENTAL LIFE BENEÚTS 4O PURCHASE OR CHANGE SPOUSE TERM LIFE OR SUPPLEMENTAL LIFE REQUEST A FORM FROM A MEMBER OF THE "ENEÚTS 4EAM

#ONÚRM YOUR BENEÚTS SELECTIONS p #LICK ON +EEP 4HESE "ENEÚTS p )F YOU HAVE CORRECTIONS OR MORE CHANGES CLICK ON -AKE #HANGES

#OMPLETE ENROLLMENT p 4HE ÚNAL SCREEN WILL SAY g#ONGRATULATIONSs p %NROLLMENT IS COMPLETE ONCE YOU CLICK #ONTINUE p 2EMEMBER TO LOG OUT OF 3%! BY CLICKING ON THE g,OG /UTs BUTTON ON THE SCREEN • If you experience technical problems with the application, please call the IS Help Desk at 540.741.1122. -ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

When to Enroll or Make Changes As a New Hire 9OU HAVE DAYS FROM YOUR DATE OF HIRE TO ENROLL IN YOUR BENEÚTS 4HE BENEÚTS YOU ELECT WILL BECOME EFFECTIVE THE ÚRST DAY OF THE MONTH FOLLOWING YOUR DATE OF HIRE &OR EXAMPLE IF YOUR DATE OF HIRE IS -ARCH AND YOU ENROLL WITHIN DAYS BY !PRIL YOUR BENEÚTS WILL BE EFFECTIVE !PRIL 2EMEMBER IF YOU DO NOTHING AS A NEW HIRE YOU WILL BE AUTOMATICALLY ENROLLED IN THE STANDARD HEALTH PLAN !SSOCIATE /NLY OPTION 4O OPT OUT OF THE HEALTH PLAN YOU WILL NEED TO OPT OUT ON THE 3%!

During Open Enrollment (October) 9OU GENERALLY HAVE ONE OPPORTUNITY EACH YEAR TO MAKE CHANGES TO YOUR BENEÚTS 4HE /PEN %NROLLMENT PERIOD AT -7(# OCCURS EACH /CTOBER !NY CHANGES OR ENROLLMENTS MADE DURING /PEN %NROLLMENT WILL TAKE EFFECT *ANUARY OF THE FOLLOWING YEAR

Healthcare Reform Update $URING OPEN ENROLLMENT IN /CTOBER YOU MAY ADD YOUR ELIGIBLE DEPENDENTS UP TO AGE TO THE MEDICAL PLAN

If a Qualifying Life Event 9OU CAN CHANGE YOUR BENEÚTS OUTSIDE OF THE /PEN %NROLLMENT PERIOD IF YOU HAVE A QUALIFYING LIFE EVENT

Qualifying life Events include: • "IRTH LEGAL ADOPTION OR PLACEMENT FOR ADOPTION • -ARRIAGE DIVORCE OR ANNULMENT • $EPENDENT CHILD REACHES AGE • 3POUSE GAINS OR LOSES EMPLOYMENT OR ELIGIBILITY WITH CURRENT EMPLOYER • $EATH OF SPOUSE OR DEPENDENT CHILD • 3POUSE OR DEPENDENT BECOMES -EDICARE -EDICAID OR 3#()0 ELIGIBLE OR INELIGIBLE • #HANGE IN RESIDENCE CHANGES ELIGIBILITY FOR COVERAGE • #OURT ORDERED CHANGE 4O MAKE CHANGES CONTACT A MEMBER OF THE "ENEÚTS 4EAM TO COMPLETE THE NECESSARY FORMS !NY CHANGES YOU MAKE FOR YOURSELF AND YOUR DEPENDENTS MUST BE CONSISTENT WITH AND AS A RESULT OF YOUR LIFE EVENT $OCUMENTATION OF THE QUALIFYING LIFE EVENT IS REQUIRED

When Coverage Ends 4HE CHOICES YOU MAKE WILL REMAIN IN EFFECT UNTIL THE END OF THE CALENDAR YEAR UNLESS YOU HAVE A QUALIFYING LIFE EVENT THAT CHANGES YOUR ELIGIBILITY OR THAT OF FAMILY MEMBERS OR YOU TERMINATE EMPLOYMENT OR RETIRE 5PON YOUR TERMINATION OR TRANSFER TO A NO BENEÚT STATUS YOUR MEDICAL DENTAL AND VISION WILL END THE LAST DAY OF THE MONTH IN WHICH YOU TERMINATE OR TRANSFER ,IFE INSURANCE AND DISABILITY COVERAGE END ON YOUR LAST DAY OF ACTIVE WORK OR ELIGIBLE STATUS 9OU MAY BE ELIGIBLE FOR CONTINUATION UNDER THE #/"2! PROVISIONS OF THE PLAN 2EFER TO YOUR SUMMARY PLAN DESCRIPTION FOR SPECIÚCS OR CONTACT A MEMBER OF THE "ENEÚTS 4EAM

Paying for Beneﬁts &OR MEDICAL AND DENTAL YOU AND -7(# SHARE THE COST OF COVERAGE -7(# PAYS A MAJOR SHARE OF THE COST AND YOU PAY THE REMAINDER 9OUR BENEÚTS COSTS WILL BE TAKEN FROM YOUR PAYCHECK THROUGHOUT THE YEAR ON A PRE TAX OR AFTER TAX BASIS AS FOLLOWS 0RE TAX CONTRIBUTIONS WILL BE TAKEN FROM YOUR PAYCHECK FOR MEDICAL DENTAL VISION THE ÛEXIBLE SPENDING ACCOUNTS SHORT TERM DISABILITY AND THE RETIREMENT SAVINGS PLAN 9OU DO NOT PAY FEDERAL OR 3OCIAL 3ECURITY TAXES ON YOUR CONTRIBUTIONS 4HEY MAY ALSO BE EXEMPT FROM STATE TAXES DEPENDING ON WHERE YOU LIVE &OR MORE INFORMATION ABOUT PRE TAX CONTRIBUTIONS CONSULT A TAX ADVISOR !FTER TAX CONTRIBUTIONS WILL BE TAKEN FROM YOUR PAYCHECK FOR OPTIONAL LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT !$ $ INSURANCE AND VOLUNTARY BENEÚTS

9OU MUST MAKE ANY CHANGES OR NEW ELECTIONS WITHIN DAYS OF THE EFFECTIVE DATE OF THE LIFE EVENT )F YOU FAIL TO MAKE CHANGES WITHIN DAYS OF THE EVENT YOU WILL HAVE TO WAIT UNTIL THE /PEN %NROLLMENT PERIOD TO MAKE CHANGES !NY CHANGES MADE WILL TAKE EFFECT THE ÚRST OF THE MONTH FOLLOWING THE LIFE EVENT DATE

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Medical & Prescription Plan -7(# S MEDICAL AND PRESCRIPTION DRUG PLAN IS DESIGNED SPECIÚCALLY FOR -7(# !SSOCIATES )T S SELF FUNDED SO INSTEAD OF AN INSURANCE COMPANY -7(# PAYS THE CLAIMS COVERED BY THE PLAN 4HE PLAN IS MANAGED BY !ETNA WHO HAS A LARGE NATIONAL NETWORK OF PROVIDERS HELPING YOU TO BETTER MANAGE YOUR COSTS !ETNA S NETWORK IS PARTICULARLY STRONG IN &REDERICKSBURG 2ICHMOND AND .ORTHERN 6IRGINIA

Your 2011 Options 9OU HAVE A VARIETY OF OPTIONS TO CHOOSE FROM • 3TANDARD • %NHANCED • 0REMIER • (IGH $EDUCTIBLE (EALTH 0LAN ($(0 • 0REMIUM 7AIVER 9OU MAY OPT OUT OF MEDICAL COVERAGE AND STILL SELECT OTHER BENEÚTS !LL MEDICAL OPTIONS COVER RELATIVELY THE SAME SERVICES INCLUDING PRESCRIPTION DRUGS 4HE OPTIONS DIFFER BASED ON COST THE AMOUNT YOU PAY OUT OF EACH PAYCHECK AND WHAT YOU PAY AS YOU USE SERVICES THROUGH THE DEDUCTIBLE CO PAYS OR COINSURANCE AMOUNTS 3EE PAGES AND FOR A CHART COMPARING THE COSTS OF USING THE PLAN OPTIONS 3EE THE TABLES ON PAGE FOR THE PAYCHECK DEDUCTIONS 5NDER ALL OPTIONS YOU MAY SEE ANY PROVIDER AN -7(# FACILITY WHEN AVAILABLE AN !ETNA PROVIDER OR AN OUT OF NETWORK PROVIDER 9OU PAY LESS FOR SERVICES WHEN YOU USE AN -7(# FACILITY OR !ETNA PROVIDER BUT THE CHOICE IS STILL YOURS .O REFERRALS ARE NECESSARY TO SEE ANY PROVIDER YOU CHOOSE 3EE PAGES FOR MORE ABOUT USING NETWORK PROVIDERS 0LEASE REVIEW EACH OF YOUR OPTIONS CAREFULLY WHEN YOU ENROLL TO ENSURE YOU SELECT THE RIGHT ONE FOR YOU AND YOUR FAMILY

Aetna Can Help You Pick !ETNA HAS ONLINE TOOLS THROUGH !ETNA .AVIGATOR TO HELP YOU ÚND INFORMATION ABOUT ALL THE OPTIONS AND LOCATE NETWORK PROVIDERS ,OG ON TO WWW AETNA COM TO • 4AKE ADVANTAGE OF HEALTH EDUCATION AND SERVICES • &IND A PROVIDER • 2EVIEW YOUR CLAIMS PAYMENTS AND HISTORY

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

High-Deductible Health Plan with Health Savings Account 9OU HAVE THE OPTION OF A (IGH $EDUCTIBLE (EALTH 0LAN ($(0 WITH A (EALTH 3AVINGS !CCOUNT (3! 4HE ($(0 IS A HEALTH INSURANCE PLAN WITH HIGHER DEDUCTIBLES AND LOWER PREMIUMS THAN OUR OTHER HEALTH PLANS ! DEDUCTIBLE IS THE AMOUNT OF MONEY YOU PAY EACH YEAR TOWARD COVERED HEALTHCARE EXPENSES BEFORE THE BENEÚT PLAN BEGINS TO PAY FOR COVERED MEDICAL SERVICES

Includes Four Components

1. 2. 3.

Preventive care covered 100 percent — without the deductible needing to be satisﬁed High annual deductible for all other services, including prescriptions Plan coverage (in- and out-of-network)

4. A Health Savings Account (HSA) - MWHC will make a $250 contribution to your HSA Overview of the Plan Features

Health Savings Account (HSA)

0REVENTIVE #ARE 0REVENTIVE CARE SERVICES AND WELLNESS SCREENINGS ARE COVERED IN FULL FROM DAY ONE .O NEED TO MEET THE DEDUCTIBLE ÚRST

)F YOU ELECT THE ($(0 YOU HAVE THE OPTION OF OPENING AN (3! WITH YOUR OWN PRE TAX CONTRIBUTIONS 9OU CAN USE YOUR (3! TO PAY YOUR OUT OF POCKET HEALTHCARE EXPENSES OR LET YOUR MONEY GROW FOR FUTURE USE

$EDUCTIBLE 9OU MUST MEET THE ANNUAL DEDUCTIBLE BEFORE THE PLAN PAYS FOR MOST SERVICES SUCH AS OFÚCE VISITS HOSPITAL STAYS AND PRESCRIPTION DRUGS 4HE DEDUCTIBLE IS SIGNIÚCANTLY HIGHER THAN THE DEDUCTIBLE FOR OUR OTHER HEALTH PLAN OPTIONS 9OU CAN PAY YOUR DEDUCTIBLE FROM YOUR OWN POCKET OR YOU CAN DECIDE TO USE FUNDS FROM YOUR (3!

0RESCRIPTION DRUGS ARE NOT COVERED UNTIL YOU MEET THE ANNUAL DEDUCTIBLE 0LAN #OVERAGE /NCE YOU MEET YOUR DEDUCTIBLE YOU ARE RESPONSIBLE FOR YOUR COINSURANCE PORTION OF THE CHARGES #OINSURANCE IS THE PERCENTAGE OF THE SERVICE COST YOU MUST PAY

(OW THE (3! 7ORKS )T IS A TYPE OF SAVINGS ACCOUNT PERMITTED UNDER CURRENT TAX LAW -ONEY YOU CONTRIBUTE TO THIS ACCOUNT IS AUTOMATICALLY DEDUCTED FROM YOUR PAY ON A PRE TAX BASIS EACH PAY PERIOD 4HE MONEY IN YOUR ACCOUNT CAN GROW WITH INVESTMENT EARNINGS ON A TAX FREE BASIS 5NLIKE THE ÛEXIBLE SPENDING ACCOUNTS ANY MONEY YOU HAVE LEFT IN THE ACCOUNT AT THE END OF THE YEAR WILL BE ROLLED OVER TO THE NEXT YEAR 9OU CAN USE THE MONEY YOU HAVE SAVED OVER TIME TO HELP PAY FOR ANY HEALTHCARE EXPENSES WHENEVER YOU NEED IT 9OU WON T HAVE TO PAY TAXES ON ANY OF THE MONEY YOU WITHDRAW IF YOU USE IT FOR HEALTHCARE EXPENSES )F YOU SELECT AN (3! YOU ARE INELIGIBLE TO OPEN A HEALTHCARE ÛEXIBLE SPENDING ACCOUNT )F YOU LEAVE THE ORGANIZATION YOU CAN TAKE YOUR (3! WITH YOU AND ROLL IT OVER TO A NEW (EALTH 3AVINGS !CCOUNT

#ONTRIBUTING TO THE (3! 7HEN YOU ENROLL IN THE ($(0 YOU CAN ELECT THE (3! AND THE AMOUNT YOU WANT TO CONTRIBUTE 9OUR CONTRIBUTIONS WILL BE DEDUCTED FROM YOUR PAY IN EQUAL INSTALLMENTS OVER THE COURSE OF THE YEAR TAX FREE

4HE )23 MAXIMUM (3! CONTRIBUTIONS ARE !SSOCIATE /NLY COVERAGE &AMILY COVERAGE !DDITIONAL CATCH UP CONTRIBUTIONS FOR PARTICIPANTS AGE OR OLDER

)S THE (IGH $EDUCTIBLE (EALTH 0LAN 2IGHT FOR 9OU )F YOU RARELY USE HEATHCARE SERVICES AND ARE LOOKING FOR A PLAN WITH THE LOWEST PAYCHECK DEDUCTION THE (IGH $EDUCTIBLE (EALTH 0LAN MAY BE THE RIGHT CHOICE FOR YOU )F YOU HAVE AN ONGOING MEDICAL CONDITION OR ARE ANTICIPATING A MAJOR MEDICAL EVENT THE (IGH $EDUCTIBLE (EALTH 0LAN MAY NOT BE YOUR BEST OPTION 'O TO WWW AETNA COM HSA VIDEOPRE FOR USEFUL INFORMATION IN DETERMINING IF THIS OPTION IS RIGHT FOR YOU

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

2011 MEDICAL, DENTAL AND VISION COSTS 9OUÂ&#x;ANDÂ&#x;-ARYÂ&#x;7ASHINGTONÂ&#x;(EALTHCAREÂ&#x;SHAREÂ&#x;RESPONSIBILITYÂ&#x;FORÂ&#x;THEÂ&#x;COSTÂ&#x;OFÂ&#x;YOURÂ&#x;MEDICAL Â&#x;DENTAL Â&#x;ANDÂ&#x;VISIONÂ&#x;COVERAGE Â&#x;9OURÂ&#x; SHAREÂ&#x;OFÂ&#x;THEÂ&#x;COSTÂ&#x;DEPENDSÂ&#x;UPONÂ&#x;WHETHERÂ&#x;YOUÂ&#x;AREÂ&#x;AÂ&#x;FULL TIMEÂ&#x;ORÂ&#x;PART TIMEÂ&#x;!SSOCIATEÂ&#x;ANDÂ&#x;THEÂ&#x;LEVELÂ&#x;OFÂ&#x;COVERAGEÂ&#x;YOUÂ&#x;CHOOSE Â&#x;

Full-Time Associates: Medical, Dental and Vision Costs (Per Pay Period) ASSOCIATE ONLY

ASSOCIATE + 1 CHILD

ASSOCIATE + SPOUSE

FAMILY

MEDICAL

Part-Time Associates: Medical, Dental and Vision Costs (Per Pay Period) ASSOCIATE ONLY

ASSOCIATE + 1 CHILD

ASSOCIATE + SPOUSE

FAMILY

MEDICAL

Standard

$23.66

$38.44

$71.55

$112.37

Standard

$29.66

$48.75

$81.18

$131.40

Enhanced

$43.93

$83.43

$145.70

$194.25

Enhanced

$51.86

$96.32

$156.63

$219.31

Premier High Deductible-HSA DENTAL Standard Enhanced VISION Standard Enhanced

$80.91

$152.39

$246.36

$305.55

$92.19

$170.51

$261.11

$343.45

$20.90

$33.96

$63.22

$99.28

$25.37

$41.70

$69.44

$112.39

$4.85 $9.50

$6.74 $11.07

$8.40 $15.58

$13.67 $19.57

$8.52 $21.88

$11.84 $25.48

$14.75 $35.86

$24.01 $45.05

$6.42 $7.60

$9.99 $11.79

$10.70 $12.63

$17.08 $20.19

Premier High Deductible-HSA DENTAL Standard Enhanced VISION Standard Enhanced

$6.42 $7.60

$9.99 $11.79

$10.70 $12.63

$17.08 $20.19

-ARYÂ&#x;7ASHINGTONÂ&#x;(EALTHCAREÂ&#x;"ENEĂ&#x161;TSÂ&#x;'UIDE

BeneďŹ ts Summary: Whatâ&#x20AC;&#x2122;s Covered 4HEÂ&#x;FOLLOWINGÂ&#x;TABLEÂ&#x;SHOWSÂ&#x;HOWÂ&#x;BENEĂ&#x161;TSÂ&#x;AREÂ&#x;PAIDÂ&#x;UNDERÂ&#x;THEÂ&#x;-7(#Â&#x;MEDICALÂ&#x;OPTIONS Â&#x;&ORÂ&#x;COINSURANCEÂ&#x; AMOUNTS Â&#x;THEÂ&#x;PERCENTAGEÂ&#x;SHOWNÂ&#x;ISÂ&#x;THEÂ&#x;AMOUNTÂ&#x;YOUÂ&#x;PAYÂ&#x;AFTERÂ&#x;YOU VEÂ&#x;METÂ&#x;YOURÂ&#x;DEDUCTIBLE Â&#x;#AREFULLYÂ&#x; REVIEWÂ&#x;THEÂ&#x;PLANÂ&#x;FORÂ&#x;CHANGESÂ&#x;INÂ&#x;CO PAYÂ&#x;ANDÂ&#x;COINSURANCEÂ&#x;AMOUNTS Standard

Enhanced

MWHC Facility Annual Deductible Out-of-Pocket Maximum

Aetna Provider

$400 Individual / $800 Family $2,500 Individual / $5,000 Family

Lifetime Maximum BeneďŹ t

$5,000 Individual / $6,000 Family

MWHC Facility

Aetna Provider

$300 Individual / $600 Family $2,000 Individual / $4,000 Family

$4,000 Individual / $5,000 Family

No limit

Well-Baby/Well-Adult Care

$0 Co-pay

Annual Gynecological Visit

$0 Co-pay

Covered 100%

PCP OfďŹ ce Visits

$30 Co-pay

$25 Co-pay

Specialist OfďŹ ce Visits

$60 Co-pay

$50 Co-pay

Urgent Care Center

$35 Co-pay

NextCare Urgent Care Center

$25 Co-pay

Chiropractic Care (20-visit limit)

$60 Co-pay

$50 Co-pay

PREVENTIVE CARE

Routine Screenings(Mammogram, PAP, PSA, Colonoscopy) PHYSICIAN SERVICES

Physical, Speech, and Occupational Therapy (Combined total of 60 visits per year)

$30 Co-pay

$75 Co-pay

$25 Co-pay

$60 Co-pay

Inpatient

25% Coinsurance

$500 Co-pay plus 25% Coinsurance

20% Coinsurance

$500 Co-pay plus 20% Coinsurance

Outpatient Surgery

25% Coinsurance

$150 Co-pay plus 25% Coinsurance

20% Coinsurance

$150 Co-pay plus 20% Coinsurance

HOSPITAL SERVICES

Emergency Room (Co-pay waived if admitted) Outpatient X-ray & Lab (x-ray, MRI, PET, CAT)

$200 Co-pay plus 25% Coinsurance

$175 Co-pay plus 20% Coinsurance

$30 Co-pay

$30 Co-pay plus25% Coinsurance

$25 Co-pay

$25 Co-pay plus 20% Coinsurance

25% Coinsurance

$500 Co-pay plus25% Coinsurance

20% Coinsurance

$500 Co-pay plus 20% Coinsurance

MENTAL HEALTH/SUBSTANCE ABUSE Inpatient Outpatient

$30 Co-pay

$25 Co-pay

Home Health Care (90-visit limit per plan year)

25% Coinsurance

20% Coinsurance

Skilled Nursing Facility (100-day limit per plan year)

25% Coinsurance

20% Coinsurance

Durable Medical Equipment (Must be reviewed for medical necessity if over $500)

25% Coinsurance

20% Coinsurance

Allergy Care

$30 Co-pay for testing; Injections covered 100% (if no ofďŹ ce visit); Serum covered 100%

$25 Co-pay for testing; Injections covered 100% (if no ofďŹ ce visit); Serum covered 100%

Infertility Treatment (Testing and diagnosis only; treatment not covered)

$50 ofďŹ ce visit Co-pay; 25% Coinsurance for tests

$50 ofďŹ ce visit Co-pay; 20% Coinsurance for tests

Annual Deductible

$1,500 Individual / $3,000 Family

Out-of-Pocket Maximum

$3,000 Individual / $6,000 Family

50% of reasonable and customary charges

OTHER

OUT-OF-NETWORK

Coinsurance

.OTE Â&#x;Â&#x; Â&#x;/UT OF NETWORKÂ&#x;CAREÂ&#x;RECEIVEDÂ&#x;FROMÂ&#x;PROVIDERSÂ&#x;THATÂ&#x;AREÂ&#x;NEITHERÂ&#x;ANÂ&#x;-(3Â&#x;PROVIDERÂ&#x;NORÂ&#x;PARTICIPATINGÂ&#x;PROVIDERSÂ&#x;INÂ&#x;!ETNA SÂ&#x;NETWORKÂ&#x;ISÂ&#x;INÂ&#x;ADDITIONÂ&#x;TOÂ&#x;ABOVEÂ&#x;DEDUCTIBLEÂ&#x;ANDÂ&#x;OUT OF POCKET Â&#x;

-ARYÂ&#x;7ASHINGTONÂ&#x;(EALTHCAREÂ&#x;"ENEĂ&#x161;TSÂ&#x;'UIDE

Premier

High Deductible

MWHC Facility

Aetna Provider

$200 Individual / $400 Family $1,500 Individual / $3,000 Family

$2,000 Individual / $4,000 Family

MWHC Facility

Aetna Provider

$1,200 Individual / $2,400 Family $5,000 Individual / $10,000 Family

No limit

$0 Co-pay

0% Coinsurance

$0 Co-pay

0% Coinsurance

Covered 100%

$20 Co-pay

20% Coinsurance

30% Coinsurance

$40 Co-pay

20% Coinsurance

30% Coinsurance

$35 Co-pay

20% Coinsurance

30% Coinsurance

$25 Co-pay

20% Coinsurance

30% Coinsurance

$40 Co-pay

20% Coinsurance

30% Coinsurance

$15 Co-pay

$45 Co-pay

20% Coinsurance

30% Coinsurance

15% Coinsurance

$500 Co-pay plus 15% Coinsurance

20% Coinsurance

30% Coinsurance

15% Coinsurance

$150 Co-pay plus 15% Coinsurance

20% Coinsurance

30% Coinsurance

20% Coinsurance

30% Coinsurance

$150 Co-pay plus 15% Coinsurance $15 Co-pay

$15 Co-pay plus 15% Coinsurance

20% Coinsurance

30% Coinsurance

15% Coinsurance

$500 Co-pay plus 15% Coinsurance

20% Coinsurance

30% Coinsurance

$20 Co-pay

20% Coinsurance

30% Coinsurance

15% Coinsurance

20% Coinsurance

30% Coinsurance

15% Coinsurance

20% Coinsurance

30% Coinsurance

15% Coinsurance

20% Coinsurance

30% Coinsurance

$15 Co-pay for testing; Injections covered 100% (if no ofďŹ ce visit); Serum covered 100%

20% Coinsurance

30% Coinsurance

$50 ofďŹ ce visit Co-pay; 15% Coinsurance for tests

20% Coinsurance

30% Coinsurance

$1,500 Individual / $3,000 Family

$3,600 Individual / $7,200 Family

$3,000 Individual / $6,000 Family

$5,800 Individual / $11,600 Family

50% of reasonable and customary charges

Terms to Know $EDUCTIBLE Â&#x;!Â&#x;FIXEDÂ&#x;DOLLARÂ&#x; AMOUNTÂ&#x;YOUÂ&#x;PAYÂ&#x;BEFOREÂ&#x;THEÂ&#x; PLANÂ&#x;WILLÂ&#x;BEGINÂ&#x;PAYINGÂ&#x;FORÂ&#x; MOSTÂ&#x;SERVICES #O PAY Â&#x;!Â&#x;FIXEDÂ&#x;DOLLARÂ&#x; AMOUNTÂ&#x;YOUÂ&#x;PAYÂ&#x;FORÂ&#x;CERTAINÂ&#x; MEDICALÂ&#x;SERVICES Â&#x;SUCHÂ&#x;ASÂ&#x;AÂ&#x; DOCTORÂ&#x;VISIT #OINSURANCE Â&#x;!Â&#x;PERCENTAGEÂ&#x; OFÂ&#x;THEÂ&#x;SERVICEÂ&#x;COSTÂ&#x;YOUÂ&#x; PAYÂ&#x;AFTERÂ&#x;THEÂ&#x;DEDUCTIBLEÂ&#x; ISÂ&#x;MET Â&#x;4HEÂ&#x;PLANÂ&#x;PAYSÂ&#x;THEÂ&#x; REMAINDERÂ&#x;OFÂ&#x;THEÂ&#x;COST )N NETWORK Â&#x;$OCTORS Â&#x; HOSPITALS Â&#x;ANDÂ&#x;OTHERÂ&#x; PROVIDERSÂ&#x;WITHÂ&#x;WHOMÂ&#x; THEÂ&#x;MEDICALÂ&#x;PLANÂ&#x;HASÂ&#x;ANÂ&#x; AGREEMENTÂ&#x;TOÂ&#x;CAREÂ&#x;FORÂ&#x;ITSÂ&#x; COVEREDÂ&#x;!SSOCIATESÂ&#x;ANDÂ&#x; DEPENDENTS Â&#x;9OUÂ&#x;HAVEÂ&#x; LOWERÂ&#x;COSTSÂ&#x;WHENÂ&#x;USINGÂ&#x; IN NETWORKÂ&#x;PROVIDERS /UT OFÂ&#x;NETWORK Â&#x;#AREÂ&#x; RECEIVEDÂ&#x;FROMÂ&#x;AÂ&#x;DOCTOR Â&#x; HOSPITAL Â&#x;ORÂ&#x;OTHERÂ&#x;PROVIDERSÂ&#x; WITHÂ&#x;WHOMÂ&#x;THEÂ&#x;MEDICALÂ&#x; PLANÂ&#x;DOESÂ&#x;NOTÂ&#x;HAVEÂ&#x;ANÂ&#x; AGREEMENT Â&#x;9OUÂ&#x;PAYÂ&#x;MOREÂ&#x; TOÂ&#x;USEÂ&#x;THESEÂ&#x;PROVIDERS

For a beneďŹ ts summary of the Premium Waiver Plan and family income eligibility requirements, see page 13.

-ARYÂ&#x;7ASHINGTONÂ&#x;(EALTHCAREÂ&#x;"ENEĂ&#x161;TSÂ&#x;'UIDE

Using MWHC Health System Facilities 7HEN SEEKING MEDICAL CARE YOU ARE FREE TO USE ANY DOCTOR OR HOSPITAL OF YOUR CHOICE 9OU WILL TYPICALLY PAY LESS FOR SERVICES AND THE MEDICAL PLAN COVERS MORE IF YOU USE AN -7(# (EALTH 3YSTEM FACILITY WHEN AVAILABLE -7(# EXISTS TO IMPROVE THE HEALTH STATUS OF ALL PEOPLE WITHIN OUR COMMUNITIES 4HE WELL BEING OF -7(# !SSOCIATES IS ALSO OF UTMOST IMPORTANCE 7HERE YOU GO FOR MEDICAL CARE IS ENTIRELY YOUR CHOICE HOWEVER CONSIDER USING -7(# FACILITIES FOR TWO VERY IMPORTANT REASONS 9OUR OUT OF POCKET EXPENSES MAY BE REDUCED FOR SOME SERVICES 3EE CHART ON PAGES AND

You receive continuity of care. &OR EXAMPLE WHEN YOUR ANNUAL PHYSICAL INCLUDES LABORATORY TESTS OR IMAGING PERFORMED AT ONE OF -7(# S FACILITIES THE TEST RESULTS ARE SENT TO YOUR PHYSICIAN AND BECOME PART OF YOUR CONÚDENTIAL PATIENT RECORD )F YOU SHOULD EVER NEED THE SERVICES OF -7( %MERGENCY $EPARTMENT THOSE TEST RESULTS WILL BE IMMEDIATELY ACCESSIBLE WITHIN THE HEALTH SYSTEM -7(# HEALTHCARE PROVIDERS WILL ACCEPT ALL PROPERLY WRITTEN ORDERS FOR TESTS AND PROCEDURES EVEN IF ANOTHER PROVIDER IS SPECIÚED

MWHC Health System Facilities: • -ARY 7ASHINGTON (OSPITAL INPATIENT OUTPATIENT LAB RADIOLOGY EMERGENCY SERVICES 04 /4 AND SPEECH • 3TAFFORD (OSPITAL INPATIENT OUTPATIENT LAB RADIOLOGY EMERGENCY SERVICES 04 /4 AND SPEECH • &REDERICKSBURG !MBULATORY 3URGERY #ENTER • -EDICAL )MAGING OF &REDERICKSBURG -EDICAL )MAGING AT ,EE S (ILL AND )MAGING #ENTER FOR 7OMEN • -7( (OME (EALTH • #ANCER #ENTER OF 6IRGINIA • -7( (OSPICE • 3NOWDEN AT &REDERICKSBURG

Outreach Patient Service Centers (Lab Draw Centers) -7(# -EDICAL #ENTER 0RINCESS !NNE 3TREET 3UITE &REDERICKSBURG 6! -ONDAY k &RIDAY A M k P M 3ATURDAY A M k P M

4OMPKINS -ARTIN -EDICAL 0LAZA 3AM 0ERRY "OULEVARD 3UITE &REDERICKSBURG 6! -ONDAY k &RIDAY A M k P M

0ROFESSIONAL 0LAZA AT ,EE S (ILL 3POTSYLVANIA !VENUE 3UITE &REDERICKSBURG 6! -ONDAY k &RIDAY A M k P M

-ARY 7ASHINGTON %YE #ARE #ENTER 3POTSYLVANIA 0ARKWAY 3UITE &REDERICKSBURG 6! -ONDAY k &RIDAY A M k P M

-ASSAPONAX -EDICAL 0ARK #OSNER $RIVE 3UITE &REDERICKSBURG 6! -ONDAY k &RIDAY A M k P M

3TAFFORD (OSPITAL #ENTER (OSPITAL #ENTER "OULEVARD 3TAFFORD 6! -ONDAY k &RIDAY A M k P M

'ATEWAY -EDICAL 5RGENT #ARE *OURNAL 0ARKWAY +ING 'EORGE 6! -ONDAY k &RIDAY A M k P M 3ATURDAY A M k P M

&OR MORE ON THE LAB DRAW CENTERS CALL OPTION 0LEASE NOTE 4IMED STUDIES NEED TO BE SCHEDULED #ALL FOR ASSISTANCE !LL OTHER PROCEDURES ARE PERFORMED ON A WALK IN BASIS 0ATIENT 3ERVICE #ENTERS ARE CLOSED ON MAJOR HOLIDAYS .EW 9EAR S $AY -EMORIAL $AY )NDEPENDENCE $AY ,ABOR $AY 4HANKSGIVING $AY AND #HRISTMAS $AY

Mary Washington Eye Care Center 3POTSYLVANIA 0ARKWAY 3UITE #OSNER S #ORNER -EDICAL 0AVILION &REDERICKSBURG 6! p /PHTHALMIC AND OPTOMETRIC SERVICES INCLUDING p 2OUTINE AND ANNUAL EYE EXAMS p -EDICAL EXAMS FOR CORNEAL DISEASE CATARACTS GLAUCOMA AND MACULAR DEGENERATION p #ONTACT LENS AND EYEWEAR SERVICES p ,!3)+ SURGERY

Remember! It is your right as the patient to determine where you want to receive care. You may contact a Beneﬁts Team member if you have any questions.

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

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Breast Reconstruction Following Mastectomy

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-ARY┬Я7ASHINGTON┬Я(EALTHCARE┬Я"ENE├ЪTS┬Я'UIDE

Prescription Drug Beneﬁts 0RESCRIPTION DRUG COVERAGE IS PROVIDED AUTOMATICALLY WITH ALL MEDICAL OPTIONS 0RESCRIPTION COVERAGE IS NOT AVAILABLE BY ITSELF ,IKE MEDICAL OUR PRESCRIPTION DRUG BENEÚTS ARE SELF FUNDED AND MANAGED BY !ETNA #O PAYMENTS FOR PRESCRIPTION DRUGS UNDER THE OPTIONS ARE BASED ON A FORMULARY AN APPROVED LIST OF DRUGS

How the Formulary Works ! FORMULARY IS A LIST OF DRUGS APPROVED BY THE PLAN 9OUR PLAN OFFERS THREE LEVELS OF BENEÚTS DEPENDING ON THE DRUG PRESCRIBED

•Tier 1 (common generics) 4HEY CONTAIN THE SAME ACTIVE INGREDIENTS AS BRAND NAME EQUIVALENTS AND ARE USUALLY AS EFFECTIVE 9OUR COST WILL BE LOWEST WITH A PRESCRIPTION FOR A GENERIC DRUG • Tier 2 (generics or brand names) 4HEY ARE GENERALLY HIGHER COST DRUGS THAN THOSE IN 4IER THEREFORE THEY HAVE A HIGHER CO PAY • Tier 3 (brand names) 4HESE ARE GENERALLY NEW DRUGS "ECAUSE THESE DRUGS ARE NOT FOUND IN !ETNA S FORMULARY THEY CAN BE THE MOST EXPENSIVE &OR PRESCRIPTIONS OF UP TO A DAY SUPPLY ÚLL YOUR PRESCRIPTION AT THE -7(# -EDICAL !RTS 0HARMACY FOR THE LOWEST COST OR AT AN !ETNA PARTICIPATING PHARMACY &OR A LIST OF !ETNA PARTICIPATING RETAIL PHARMACIES VISIT WWW AETNA COM OR CALL

Beneﬁts Summary: What’s Covered 4HIS TABLE SHOWS HOW PRESCRIPTION DRUG BENEÚTS ARE PAID &OR COINSURANCE AMOUNTS THE PERCENTAGES SHOWN ARE THE AMOUNTS YOU PAY 4HERE IS NO DEDUCTIBLE TO SATISFY 3TANDARD %NHANCED AND 0REMIER 0LANS

(IGH $EDUCTIBLE (EALTH 0LAN

-7(# &ACILITY

!ETNA 0ROVIDER

4IER &ORMULARY

#O PAY

4IER &ORMULARY

#O PAY

4IER &ORMULARY

#O PAY

2%4!), $!9 3500,9

-7(# &ACILITY #OINSURANCE PLUS

!ETNA 0ROVIDER #OINSURANCE PLUS #O PAY

-!), /2$%2 $!9 3500,9 4IER &ORMULARY

#O PAY

4IER &ORMULARY

#O PAY

#O PAY #O PAY

4IER &ORMULARY

#O PAY

0RESCRIPTION DRUG COVERAGE UNDER THE (IGH $EDUCTIBLE (EALTH 0LAN WILL APPLY AFTER YOU MEET THE ANNUAL DEDUCTIBLE

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Prescription: Quality Convenient Service /RDERING IS EASY AND !ETNA 0HARMACISTS ARE AVAILABLE HOURS A DAY SEVEN DAYS A WEEK

Mandatory Mail-Order OR -EDICAL !RTS 0HARMACY )F YOU HAVE A CHRONIC CONDITION LIKE ARTHRITIS ASTHMA DIABETES HIGH BLOOD PRESSURE OR HIGH CHOLESTEROL !ETNA 28 (OME $ELIVERY CAN ÚLL AND REÚLL THE MAINTENANCE PRESCRIPTION MEDICATIONS YOU MUST TAKE REGULARLY "EGINNING *ANUARY IF YOU TAKE A MAINTENANCE MEDICATION YOU WILL BE REQUIRED TO ÚLL YOUR PRESCRIPTION USING !ETNA 28 (OME $ELIVERY OR -EDICAL !RTS 0HARMACY p )F YOU DO NOT USE THE !ETNA 28 (OME $ELIVERY OR -EDICAL !RTS 0HARMACY TO OBTAIN YOUR MEDICATIONS YOU WILL BE RESPONSIBLE FOR OF THE RETAIL PHARMACY S COST !ETNA CAN HELP YOU DETERMINE IF YOUR PRESCRIPTION IS CONSIDERED MAINTENANCE

New in 2011 Mandatory Generic Prescriptions p 2EQUIRED MANDATORY GENERIC DRUGS WHEN AVAILABLE "EGINNING *ANUARY IF YOU TAKE A BRAND NAME MEDICATION THAT HAS A GENERIC EQUIVALENT YOU WILL BE REQUIRED TO ÚLL THE PRESCRIPTION WITH THE GENERIC DRUG 9OU WILL PAY MORE OUT OF POCKET FOR BRAND NAME DRUGS WHEN A GENERIC IS AVAILABLE

Aetna RX Home Delivery p 'REATER SUPPLIES p ,OWER #OPAYMENTS p 3AVES YOU MONEY YOU PAY TWO CO PAYS FOR A THREE MONTH SUPPLY AND YOUR MEDICATION IS DELIVERED TO YOUR HOME WITH FREE STANDARD SHIPPING

Placing Your First Order with Aetna RX Home Delivery Step 1 !SK YOUR DOCTOR TO WRITE 47/ PRESCRIPTIONS

0RESCRIPTION ! ONE MONTH SUPPLY &ILL IT AT A LOCAL RETAIL PHARMACY 7ITH THIS SHORT TERM SUPPLY YOU WILL HAVE ENOUGH OF YOUR MEDICATION ON HAND TO SEE YOU THROUGH UNTIL YOUR ÚRST !ETNA 2X (OME $ELIVERY ORDER ARRIVES

0RESCRIPTION 4YPICALLY A DAY SUPPLY WITH THREE REÚLLS 3END THIS ONE TO !ETNA 2X (OME $ELIVERY

Step 2: p &ILL OUT THE /RDER &ORM 0ATIENT 2EGISTRATION &ORM &IND FORM IN THE .OTES FORMS DATABASE ON THE 3%! OR FROM A MEMBER OF THE -7(# "ENEÚT 4EAM p-AIL IT WITH YOUR PRESCRIPTIONS AND PAYMENT TO !ETNA 2X (OME $ELIVERY 0 / "OX +ANAS #ITY -/ p (AVE YOUR DOCTOR FAX YOUR PRESCRIPTIONS AND COMPLETED /RDER &ORM TO .OTE 7RITE YOUR DATE OF BIRTH AND !ETNA MEMBER )$ ON ALL DOCUMENTS INCLUDING YOUR PRESCRIPTIONS -AKE SURE THAT YOU COMPLETE THE METHOD OF PAYMENT SECTION ON THE /RDER &ORM !ETNA NEEDS TO KNOW WHAT CREDIT CARD TO CHARGE OR DEBIT CARD TO DEDUCT FROM 9OU CAN ALSO USE YOUR (EALTH 3AVINGS !CCOUNT OR &LEXIBLE 3PENDING !CCOUNT AS A FORM OF PAYMENT

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

NextCare Urgent Care Centers

NextCare Urgent Care Centers /NLY COSTS TO USE A .EXT#ARE 5RGENT #ARE #ENTER 4HESE CENTERS OFFER WALK IN CARE WITH QUALIFIED "OARD CERTIFIED PHYSICIANS AVAILABLE -ONDAY THROUGH &RIDAY A M TO P M 3ATURDAY AND 3UNDAY A M TO P M 7ALK IN CARE IS EVEN MORE ACCESSIBLE WITH ONLINE REGISTRATION AND CHECK IN BEFORE ARRIVAL &OR MORE INFORMATION VISIT WWW NEXTCARE COM OR CALL .%84#!2%

NextCare Locations !LL .EXT#ARE SITES HAVE -7( /UTREACH ,ABORATORY DRAW SITE SERVICES AVAILABLE ON A WALK IN BASIS -ONDAY k &RIDAY

A M k P M p (ARRISON #ROSSING 3HOPPING #ENTER 0LANK 2OAD 3UITE &REDERICKSBURG 6! p 4OWN #OUNTRY 3HOPPING #ENTER 7HITE /AK 2OAD &REDERICKSBURG 6!

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

p #ARTER S #ROSSING 3HOPPING #ENTER 3OUTH 'ATEWAY $RIVE &REDERICKSBURG 6! p 7OODBRIDGE -ANASSAS -ILSTEAD 7AY 3UITE 7OODBRIDGE 6! p $UMFRIES &ETTLER 0ARK $RIVE 3UITE " $UMFRIES 6! p 'ARRISONVILLE 'ARRISONVILLE 2OAD 3UITE 3TAFFORD 6! #HECK IN USING ONE OF THE TWO EASY OPTIONS IN PERSON OR OVER THE PHONE AND THE REPRESENTATIVE WILL LET YOU KNOW WHEN YOUR EXAM ROOM IS READY /R CALL TO ÚND OUT ABOUT WAITING TIMES

4O ÚND OUT MORE PLEASE VISIT WWW OUTPATIENT -ARY7ASHINGTON(EALTHCARE COM OR WWW NEXTCARE COM HEALTHLINK

Premium Waiver Plan -7(# BELIEVES IT IS IMPORTANT TO OFFER ALL !SSOCIATES THE CHANCE TO HAVE HEALTHCARE COVERAGE 4HE PURPOSE OF Family Income THIS PLAN IS TO ENSURE OUR !SSOCIATES AND THEIR ELIGIBLE FAMILY MEMBERS RECEIVE QUALITY AFFORDABLE HEALTH CARE Guidelines 4HE PLAN WAS DESIGNED TO ASSIST !SSOCIATES WHO MAY NOT BE ABLE TO AFFORD HEALTHCARE COVERAGE &AMILY !MOUNT OF

Who’s Eligible?

3IZE

)NCOME

&ULL TIME !SSOCIATES AND ELIGIBLE DEPENDENTS MAY ENROLL IN THE 0REMIUM 7AIVER MEDICAL AND STANDARD DENTAL PLANS WITHOUT PAYING PREMIUMS 4O BE ELIGIBLE YOUR TOTAL GROSS COMBINED FAMILY INCOME MUST NOT HAVE EXCEEDED THE &AMILY )NCOME 'UIDELINES SEE CHART 4O APPLY CONTACT THE "ENEÚTS 3ECTION OF (UMAN 2ESOURCES -7(# WILL PAY YOUR MEDICAL AND DENTAL PREMIUMS IF YOU MEET ALL OF THE FOLLOWING p 9OUR INCOME DOES NOT EXCEED THE FAMILY INCOME REQUIREMENTS p 9OU ARE A FULL TIME !SSOCIATE p 9OU MEET THESE REQUIREMENTS BY -AY OF EACH YEAR .EW !SSOCIATES MUST MEET ELIGIBILITY REQUIREMENTS ON HIRE DATE

Beneﬁts Summary: What’s Covered 4HIS TABLE SHOWS HOW THE BENEÚTS ARE PAID UNDER THE 0REMIUM 7AIVER 0LAN &OR COINSURANCE AMOUNTS THE PERCENTAGES SHOWN ARE THE AMOUNTS YOU PAY 4HERE IS NO 0REMIUM 7AIVER 0LAN DEDUCTIBLE TO SATISFY -7(# &ACILITY

!ETNA 0ROVIDER

!NNUAL $EDUCTIBLE /UT OF 0OCKET -AXIMUM

.ONE )NDIVIDUAL &AMILY

,IFETIME -AXIMUM "ENEÚT

)NDIVIDUAL &AMILY .O LIMIT

02%6%.4)6% #!2% 7ELL "ABY 7ELL !DULT #ARE

#OVERED

!NNUAL 'YNECOLOGICAL 6ISIT

#O PAY

2OUTINE 3CREENINGS -AMMOGRAM 0!0 03! #OLONOSCOPY

#O PAY

0(93)#)!. 3%26)#%3 0#0 /FÚCE 6ISITS

#O PAY

3PECIALIST /FÚCE 6ISITS

#O PAY

5RGENT #ARE #ENTER

#O PAY

.EXT#ARE 5RGENT #ARE #ENTER

#O PAY

#HIROPRACTIC #ARE VISIT LIMIT

#O PAY

0HYSICAL 3PEECH AND /CCUPATIONAL 4HERAPY #OMBINED TOTAL OF VISITS PER YEAR

#O PAY

)NPATIENT

#OVERED

#O PAY PLUS #OINSURANCE

/UTPATIENT 3URGERY

#OVERED

(/30)4!, 3%26)#%3

%MERGENCY 2OOM #O PAY WAIVED IF ADMITTED /UTPATIENT X RAY ,AB X RAY -2) 0%4 #!4

#O PAY PLUS #OINSURANCE #O PAY

#OVERED

#O PAY PLUS #OINSURANCE

-%.4!, (%!,4( 35"34!.#% !"53% )NPATIENT

#OVERED

/UTPATIENT

#O PAY PLUS #OINSURANCE #O PAY

/4(%2 (OME (EALTH #ARE VISIT LIMIT PER PLAN YEAR

#O PAY

COINSURANCE #OINSURANCE

3KILLED .URSING &ACILITY DAY LIMIT PER PLAN YEAR 3KILLED .URSING &ACILITY DAY LIMIT PER PLAN YEAR

#OINSURANCE

$URABLE -EDICAL %QUIPMENT

#OINSURANCE

!LLERGY #ARE

#O PAY FOR TESTING )NJECTIONS COVERED IF NO OFÚCE VISIT 3ERUM COVERED

)NFERTILITY 4REATMENT

OFÚCE VISIT #O PAY #OINSURANCE FOR TESTS

-UST BE REVIEWED FOR MEDICAL NECESSITY IF OVER

4ESTING AND DIAGNOSIS ONLY TREATMENT NOT COVERED

/54 /& .%47/2+ !NNUAL $EDUCTIBLE /UT OF 0OCKET -AXIMUM

02%3#2)04)/. $25'3 4IER &ORMULARY 4IER &ORMULARY 4IER &ORMULARY

)NDIVIDUAL &AMILY )NDIVIDUAL &AMILY

2ETAIL DAY -7(# &ACILITY #O PAY #O PAY #O PAY

-AIL /RDER DAY

!ETNA 0HARMACY #O PAY #O PAY #O PAY

!ETNA #O PAY #O PAY #O PAY

.OTES /UT OF NETWORK CARE RECEIVED FROM PROVIDERS THAT ARE NEITHER AN -(3 PROVIDER NOR IN !ETNA S NETWORK IS IN ADDITION TO DEDUCTIBLE AND OUT OF POCKET 0RESCRIPTION DRUGS ONLY COVERED AT -EDICAL !RTS !ETNA PARTICIPATING RETAIL PHARMACIES OR THROUGH MAIL ORDER .O OUT OF NETWORK COVERAGE -ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Dental Plan -7(# S DENTAL PLAN IS SELF FUNDED AND MANAGED BY $ELTA $ENTAL 9OU MAY SEE ANY DENTIST YOU PREFER 7HEN YOU USE A $ELTA $ENTAL 0REMIER NETWORK DENTIST YOU PAY LESS AND HAVE NO CLAIM FORMS TO ÚLE

Two Dental Options 3TANDARD #OSTS LESS EACH PAYCHECK BUT YOU LL PAY MORE AS YOU USE MOST SERVICES 3OME SERVICES INCLUDING ORTHODONTIA ARE NOT COVERED

%NHANCED #OSTS A BIT MORE OUT OF YOUR PAYCHECK BUT YOU PAY LESS AS YOU USE SERVICES 4HIS OPTION INCLUDES ORTHODONTIA COVERAGE WITH NO AGE RESTRICTION BOTH CHILDREN AND ADULTS CAN TAKE ADVANTAGE OF IT

Using Network Dentists 9OU MAY USE ANY DENTIST YOU PREFER 9OU WILL TYPICALLY PAY LESS WHEN YOU USE A NETWORK DENTIST BECAUSE THEY HAVE AGREED TO ACCEPT REDUCED FEES FOR THEIR SERVICES 4O ÚND A $ELTA $ENTAL DENTIST p 'O TO WWW DELTADENTALVA COM OR p #ALL $ELTA $ENTAL AT

Beneﬁts Summary: What’s Covered 4HIS TABLE SHOWS HOW BENEÚTS ARE PAID UNDER THE -7(# DENTAL OPTIONS &OR COINSURANCE AMOUNTS THE PERCENTAGE SHOWN IS WHAT YOU PAY AFTER MEETING THE DEDUCTIBLE

!NNUAL $EDUCTIBLE !NNUAL "ENEÚT -AXIMUM PER COVERED INDIVIDUAL

3TANDARD

%NHANCED

0REVENTIVE $IAGNOSTIC /RAL EXAMS PROPHYLAXIS CLEANING ÛUORIDE TREATMENTS SPACE MAINTAINERS PALLIATIVE CARE X RAYS FULL MOUTH PANOREX BITEWINGS SEALANTS

#OINSURANCE

"ASIC #ARE &ILLINGS ENDODONTICS ROOT CANALS GENERAL ANESTHESIA SIMPLE EXTRACTIONS SURGICAL EXTRACTIONS ORAL SURGERY CONSULTATIONS

#OINSURANCE

0ERIODONTICS

#OINSURANCE

.OT COVERED

#OINSURANCE

.OT COVERED

#OINSURANCE

,IFETIME 0ERIODONTAL -AXIMUM

,IFETIME /RTHODONTIC -AXIMUM

.OT COVERED

-AJOR 2ESTORATIVE 0ROSTHODONTICS $ENTURES BRIDGES HARMFUL HABIT APPLIANCE IMPLANTS INLAYS ONLAYS CROWNS CROWN BUILDUPS RECOMMENDATIONS AND REPAIRS REBASES RELINES

/RTHODONTICS $IAGNOSTICS TREATMENT INSTALLATION AND ADJUSTMENTS

Have your beneﬁts predetermined &OR ANY SERVICE OVER WE STRONGLY RECOMMEND YOU ASK $ELTA $ENTAL FOR A PREDETERMINATION OF BENEÚTS 4HIS WILL HELP YOU TO UNDERSTAND YOUR POTENTIAL COST BEFORE YOU UNDERGO ANY TREATMENT

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Terms to Know p $EDUCTIBLE %XCEPT WITH RESPECT TO PREVENTIVE AND ORTHODONTIC SERVICES EACH COVERED INDIVIDUAL MUST MEET THE ANNUAL DEDUCTIBLE BEFORE THE PLAN BEGINS TO PAY BENEÚTS p #OINSURANCE !FTER YOU SATISFY THE ANNUAL DEDUCTIBLE THE PLAN PAYS ITS SHARE OF COINSURANCE AND YOU PAY YOUR SHARE OF COINSURANCE p !NNUAL "ENEÚT -AXIMUM 4HE MAXIMUM AMOUNT THE PLAN WILL PAY IN A CALENDAR YEAR FOR EACH COVERED INDIVIDUAL /NCE THE ANNUAL BENEÚT MAXIMUM AMOUNT HAS BEEN REACHED YOU BECOME RESPONSIBLE FOR ALL CHARGES OVER THAT AMOUNT p ,IFETIME 0ERIODONTAL /RTHODONTIC "ENEÚT 4HE MAXIMUM AMOUNT THE PLAN WILL EVER PAY FOR EACH COVERED INDIVIDUAL FOR PERIODONTAL AND ORTHODONTIA SERVICES /NCE THE LIFETIME BENEÚT HAS BEEN REACHED YOU BECOME RESPONSIBLE FOR ALL CHARGES OVER THAT AMOUNT .OTE /RTHODONTIA IS ONLY COVERED UNDER THE %NHANCED OPTION

Routine Checkups Can Lead to Additional Coverage 4HE MAXIMUM AMOUNT ANY DENTAL PLAN COVERS IN A YEAR IS CALLED THE ANNUAL BENEÚT MAXIMUM &OR THE 3TANDARD OPTION THE MAXIMUM IS PER COVERED PERSON THE %NHANCED /PTION IS PER PERSON 4YPICALLY ANY UNUSED AMOUNTS ARE LOST AT THE END OF EACH YEAR .OT SO WITH OUR PLANS

The MaxOver Feature )F YOU KEEP UP WITH YOUR PREVENTIVE CARE $ELTA $ENTAL WILL ROLL OVER A PORTION OF YOUR REMAINING ANNUAL MAXIMUM TO A -AX/VER ACCOUNT FOR USE IN FUTURE YEARS )T S YOUR REWARD FOR TAKING CARE OF YOUR TEETH

'ENERALLY YOU LL BE ELIGIBLE FOR -AX/VER IF p 9OU HAVE AT LEAST ONE PREVENTIVE EXAM AND CLEANING DURING THE CALENDAR YEAR p 9OUR CLAIMS FOR THE YEAR ARE LESS THAN THE -AX/VER CLAIMS THRESHOLD SEE CHART BELOW p 4HE WAITING PERIOD ON MAJOR SERVICES HAS BEEN MET 34!.$!2$ /04)/.

%.(!.#%$ /04)/.

#LAIMS 4HRESHOLD

!NNUAL -AX/VER !MOUNT

!NNUAL "ENEÚT -AXIMUM

-AX/VER !CCOUNT ,IMIT

.OTE 9OUR TOTAL -AX/VER ACCOUNT CANNOT EXCEED THE OPTION S ANNUAL BENEÚT MAXIMUM

How MaxOver Works *UDY IS ENROLLED IN THE %NHANCED OPTION /VER THE YEAR SHE SUBMITS WORTH OF CLAIMS INCLUDING ONE CLAIM FOR A ROUTINE EXAM AND CLEANING (ER CLAIMS ARE LESS THAN THE -AX/VER THRESHOLD SO THE PLAN ROLLS OF HER REMAINING !NNUAL "ENEÚT -AXIMUM INTO HER -AX/VER ACCOUNT .OW *UDY HAS TO SPEND ON DENTAL CLAIMS BENEÚT MAXIMUM )F *UDY CONTINUES TO MEET THE ELIGIBILITY REQUIREMENTS SHE CAN CONTINUE TO ADD TO HER -AX/VER !CCOUNT UP TO A MAXIMUM OF

Things to Know -AX/VER BENEÚTS ARE DETERMINED THREE MONTHS AFTER THE END OF THE PLAN YEAR -EMBERS WHO QUALIFY FOR A DEPOSIT INTO THEIR -AX/VER ACCOUNT WILL RECEIVE A REPORT SHOWING DETAILS /RTHODONTIA SERVICES ARE EXCLUDED FROM THE -AX/VER PROGRAM

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Vision Plan 6ISION CARE BENEÚTS ARE PROVIDED THROUGH THE 6ISION 3ERVICE 0LAN BETTER KNOWN AS 630 7ITH OVER MILLION MEMBERS NATIONWIDE 630 PROVIDES EYE CARE COVERAGE TO ONE IN EIGHT PEOPLE 9OU MAY SEE ANY LICENSED VISION CARE PROVIDER AND RECEIVE BENEÚTS 7HEN YOU USE A 630 PARTICIPATING PROVIDER YOU PAY LESS AND HAVE NO CLAIM FORMS TO ÚLE

Using VSP Providers 4HERE IS NO )$ CARD FOR VISION 9OU SIMPLY TELL YOUR PROVIDER YOU ARE COVERED BY 630 )F YOUR EYE CARE PROFESSIONAL IS A 630 PROVIDER THE OFÚCE STAFF WILL BE ABLE TO VERIFY YOUR BENEÚTS COVERAGE AND TAKE CARE OF THE REST FOR YOU 9OU JUST NEED TO PAY YOUR CO PAY )F YOU SEE A NON 630 EYE DOCTOR YOU LL NEED TO PAY FOR THE SERVICES UP FRONT AND REQUEST REIMBURSEMENT FROM 630 4O ÚND A 630 PROVIDER NEAR YOU p 'O TO WWW VSP COM OR p #ALL

Beneﬁts Summary: What’s Covered 4HIS TABLE SHOWS HOW BENEÚTS ARE PAID UNDER THE -7(# VISION PLAN

630 0ROVIDER

.ON 630 0ROVIDER

%XAM ONE PER YEAR

COVERED

2EIMBURSED UP TO

0RESCRIPTION 'LASSES ,ENSES ONE PAIR PER YEAR 3INGLE 6ISION

COVERED

2EIMBURSED UP TO

,INED BIFOCAL

COVERED

2EIMBURSED UP TO

,INED TRIFOCAL

COVERED

2EIMBURSED UP TO

&RAMES

5P TO #O PAY /VER DISCOUNT

2EIMBURSED UP TO

#ONTACT ,ENSES ONE PAIR PER YEAR

5P TO ALLOWANCE FOR CONTACTS ÚTTING AND EVALUATION EXAM .O CO PAY APPLIES

2EIMBURSED UP TO

9OU MAY CHOOSE EITHER PRESCRIPTION GLASSES OR CONTACT LENSES FOR REIMBURSEMENT

Need a Second Pair? Buy up to the Enhanced Option )F YOU TYPICALLY PURCHASE TWO PAIRS OF PRESCRIPTION GLASSES OR AN EXTRA PAIR OF PRESCRIPTION SUNGLASSES YOU MAY WANT TO CONSIDER BUYING UP TO THE %NHANCED OPTION 9OUR SECOND PAIR OF GLASSES OR CONTACTS WILL ONLY COST YOU A CO PAY

3ECOND 0AIR OF 'LASSES OR #ONTACT ,ENSES

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

3TANDARD

%NHANCED

$ISCOUNT ONLY

#O PAY

Flexible Spending Accounts -7(# OFFERS TWO ÛEXIBLE SPENDING ACCOUNTS &3!S A HEALTHCARE &3! AND A DEPENDENT CARE &3! 4HESE ACCOUNTS ARE ADMINISTERED BY !ETNA AND THEY ALLOW YOU TO SET ASIDE PRE TAX MONEY FOR CERTAIN HEALTH AND DEPENDENT CARE EXPENSES 4HIS IS A GREAT WAY TO PAY FOR HEALTHCARE OR DEPENDENT CARE EXPENSES

Tax-Free Savings

Should You Enroll in an FSA?

&3!S ARE LIKE GETTING A DISCOUNT ON CERTAIN HEALTH AND DEPENDENT CARE EXPENSES .OT BECAUSE THE EXPENSES ARE LESS BUT BECAUSE YOU ARE PAYING THEM WITH MONEY THAT HAS NOT BEEN SUBJECT TO FEDERAL OR 3OCIAL 3ECURITY TAX

9OU SHOULD CONSIDER ENROLLING IN ONE OR BOTH OF THE &3! ACCOUNTS IF YOU

(OW )T 7ORKS

p %XPECT DENTAL AND ORTHODONTIA EXPENSES TO EXCEED YOUR DENTAL PLAN

*IM S ANNUAL TAXABLE INCOME IS (E TYPICALLY INCURS IN HEALTHCARE EXPENSES EACH YEAR )NSTEAD OF PAYING FOR THAT IN EXPENSES OUT OF HIS WALLET THROUGHOUT THE YEAR *IM FUNDS A HEALTHCARE &3! 4HEN HE USES THE &3! THROUGHOUT THE YEAR TO PAY HIS HEALTHCARE EXPENSES 0UTTING MONEY INTO THE &3! REDUCES *IM S TAXABLE INCOME TO .ORMALLY HE WOULD PAY IN INCOME TAXES "Y LOWERING HIS TAXABLE INCOME TO *IM PAYS ONLY IN TAXES THAT S IN EXTRA INCOME *IM WILL RECEIVE THROUGHOUT THE YEAR

Find Out What You Could Save 5SE !ETNA S &3! 3AVINGS #ALCULATOR TO ESTIMATE YOUR ANNUAL TAX SAVINGS BASED ON YOUR INCOME AND QUALIÚED EXPENSES 'O TO WWW AETNA COM FSA #LICK ON #ALCULATE 3AVINGS ON THE TOP NAVIGATION BAR

p 0AY DEDUCTIBLES CO PAYS OR COINSURANCE INCLUDING PRESCRIPTIONS AS PART OF YOUR MEDICAL PLAN

p "UY PRESCRIPTION GLASSES CONTACT LENSES OR SALINE SOLUTION p 0LAN TO HAVE ,!3)+ VISION CORRECTION p 0AY A DAY CARE CENTER TO CARE FOR YOUR DEPENDENT CHILDREN OR ELDERLY PARENTS 4HE ITEMS DESCRIBED ABOVE ARE SOME OF THE MANY EXPENSES THAT ARE ELIGIBLE FOR REIMBURSEMENT THROUGH AN &3! &OR A COMPLETE LISTING GO TO WWW AETNA COM FSA

( (EALTHCARE 2EFORM 5PDATE 7ITH THE ENACTMENT OF (EALTHCARE 2EFORM E OVER THE COUNTER MEDICATIONS WITHOUT PRESCRIPTIONS WILL NO LONGER BE ELIGIBLE FOR REIMBURSEMENT FROM YOUR &3! OR (3!

The typical Associate saves 35% on eligible expenses through the FSA plan.

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Flexible Spending Accounts Healthcare FSA

No Claim Forms to File

#OVERS ELIGIBLE HEALTHCARE EXPENSES NOT REIMBURSED BY YOUR MEDICAL DENTAL AND VISION PLANS 4HE HEALTHCARE &3! CAN BE USED FOR YOU YOUR SPOUSE OR ANYONE YOU CLAIM ON YOUR FEDERAL TAX RETURN

!ETNA MAKES IT EASY TO ACCESS THE MONEY IN YOUR SPENDING ACCOUNT WITHOUT EVER ÚLING A CLAIM

Contribution Amount 9OU MAY CONTRIBUTE UP TO PER PAY PERIOD PER YEAR AND YOUR ENTIRE CONTRIBUTION IS AVAILABLE *ANUARY 4HAT WAY YOU DON T HAVE TO PUT OFF NECESSARY MEDICAL PROCEDURES WAITING FOR YOUR ACCOUNT TO BUILD UP

More Time to Use It 4HE PLAN YEAR FOR THE HEALTHCARE &3! IS LONGER THAN THE CALENDAR YEAR IT S MONTHS LONG 9OU HAVE UNTIL -ARCH OF THE FOLLOWING YEAR TO SPEND THE CONTRIBUTIONS YOU MAKE TO YOUR ACCOUNT

Plan Wisely !CCORDING TO )23 LAW YOU WILL FORFEIT ANY MONEY LEFT IN YOUR ACCOUNT AT THE END OF THE &3! PLAN YEAR "E SURE TO PLAN ACCORDINGLY

• 3TREAMLINE 7HEN YOU VISIT AN !ETNA PHYSICIAN YOU PAY YOUR CO PAY UP FRONT 4HE CO PAY AMOUNT IS THEN AUTOMATICALLY DEDUCTED FROM YOUR &3! AND MAILED TO YOUR HOME OR DEPOSITED DIRECTLY INTO YOUR CHECKING OR SAVINGS ACCOUNT • !UTO$EBIT 7HEN YOU USE AN !ETNA PARTICIPATING PHARMACY YOUR PRESCRIPTION DRUG CO PAY IS PAID DIRECTLY TO THE PHARMACY .O NEED TO PAY YOUR CO PAY UP FRONT • $IRECT $EPOSIT $ON T WAIT FOR YOUR REIMBURSEMENT CHECKS TO BE MAILED TO YOU OR SPEND TIME DRIVING TO THE BANK 9OU CAN REQUEST THAT ALL YOUR SPENDING ACCOUNT REIMBURSEMENTS BE DEPOSITED DIRECTLY INTO YOUR CHECKING OR SAVINGS ACCOUNT 9OU WILL BE AUTOMATICALLY ENROLLED IN THE 3TREAMLINE AND !UTO$EBIT FEATURES 4O TURN THESE OFF CONTACT !ETNA AT OR LOG INTO YOUR ACCOUNT AT WWW AETNA COM

If you enroll in the high-deductible health plan, you will not be eligible for the healthcare FSA.

Not Sure Whether to Participate? Consider This. 4HE FOLLOWING LIST DESCRIBES MANY EXPENSES ELIGIBLE FOR REIMBURSEMENT THROUGH THE HEALTHCARE &3! &OR THE MOST UP TO DATE AND COMPREHENSIVE LIST OF ELIGIBLE EXPENSES SEE )23 PUBLICATION s-EDICAL AND $ENTAL %XPENSESs AT WWW IRS GOV PUB IRS PDF P PDF !CUPUNCTURE

#RUTCHES

!LCOHOLISM TREATMENT

$EDUCTIBLE AMOUNTS YOU PAY

!RTIFICIAL TEETH

$ENTAL FEES

"IRTH CONTROL PILLS

$ENTURES

"RACES

$IAGNOSTIC FEES

#HIROPRACTORS

$RUG AND MEDICAL SUPPLIES

#OINSURANCE AMOUNTS YOU PAY #ONTACT LENSES AND SOLUTION #OST OF OPERATIONS AND RELATED TREATMENTS

%YEGLASSES INCLUDING EXAMINATION FEES %YE SURGERY INCLUDING LASER CORRECTION EYE SURGERY

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

&EES FOR A PRACTICAL NURSE (ANDICAPPED PERSONS SPECIAL SCHOOLS (EARING DEVICES AND BATTERIES (OME IMPROVEMENTS FOR MEDICAL CONSIDERATIONS

,EARNING DISABILITY ,IFE FEE TO RETIREMENT HOME FOR MEDICAL CARE -EDICAL CHARGES IF THEY ARE A PART OF COLLEGE OR PRIVATE SCHOOL TUITION FEES

3MOKING CESSATION PROGRAMS WHEN UNDER DIRECT SUPERVISION AND WITH PRESCRIBED MEDICATION 3PECIAL PLUMBING FOR THE HANDICAPPED

4RANSPLANTS 4RANSPORTATION EXPENSES PRIMARILY FOR RENDERING MEDICAL SERVICE 7EIGHT LOSS PROGRAMS

.URSING HOME

3TERILIZATION FEES

7HEELCHAIRS

/RTHOPEDIC SHOES

3URGICAL FEES

8 RAYS

(OSPITAL BILLS

/XYGEN

)NSULIN

0HYSICIANS FEES

4HERAPEUTIC CARE FOR DRUG AND ALCOHOL ADDICTION

(YPNOSIS FOR TREATMENT OF AN ILLNESS

,ABORATORY FEES

0SYCHIATRIC CARE 0SYCHOLOGISTS FEES

4HERAPY TREATMENTS

Dependent Care FSA #OVERS EXPENSES RELATED TO THE CARE OF YOUR DEPENDENTS SUCH AS DAY CARE 4HE DEPENDENT CARE &3! DOES NOT PAY FOR HEALTHCARE RELATED EXPENSES FOR DEPENDENTS

Contribution Amount 9OU MAY CONTRIBUTE UP TO PER YEAR 5NDER THE DEPENDENT CARE &3! YOU HAVE ACCESS TO YOUR CONTRIBUTIONS ONLY AFTER THEY HAVE BEEN DEDUCTED FROM YOUR PAY

Plan Wisely 4HE PLAN YEAR FOR THE DEPENDENT CARE &3! IS THE SAME AS A CALENDAR YEAR MONTHS LONG ENDING ON $ECEMBER !CCORDING TO )23 LAW YOU WILL FORFEIT ANY MONEY LEFT IN YOUR ACCOUNT AT THE END OF THE YEAR

Examples of Eligible Expenses: 3ERVICES PROVIDED BY BABYSITTERS OR CAREGIVERS INCLUDING YOUR RELATIVES AS LONG AS YOU DO NOT CLAIM THEM AS EXEMPTIONS ON YOUR FEDERAL TAX RETURN • %XPENSES FOR A HOUSEKEEPER WHOSE SERVICES INCLUDE CARE OF AN ELIGIBLE DEPENDENT

Important! Any expenses paid through the dependent care FSA reduce the amount available under the federal childcare tax credit. See your tax advisor for details and advice.

• 3ERVICES PROVIDED BY A LICENSED ELDER CARE CENTER CHILD CARE CENTER OR NURSERY SCHOOL • 3OCIAL 3ECURITY AND OTHER TAXES YOU PAY FOR A CAREGIVER 9OUR &3! CANNOT BE USED TO PAY FOR CHILD SUPPORT PAYMENTS FOOD CLOTHING AND ENTERTAINMENT OVERNIGHT CAMPS EXTRA CURRICULAR ACTIVITIES OR ADMINISTRATIVE FEES AND BOOKS

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Income Protection &ROM LIFE INSURANCE TO SHORT TERM AND LONG TERM DISABILITY PROTECTION -7(# HELPS TO PROTECT YOUR FAMILY IN THE EVENT OF THE UNEXPECTED !LTHOUGH YOU MAY NEVER USE SOME OF THESE INCOME PROTECTION BENEÚTS YOU ARE RECEIVING A SUBSTANTIAL VALUE IN PEACE OF MIND ,INCOLN &INANCIAL 'ROUP UNDERWRITES THE LIFE INSURANCE PLANS AND MANAGES THE DISABILITY PLANS

Basic Life Insurance

Enrolling in Coverage

-7(# AUTOMATICALLY PROVIDES ELIGIBLE !SSOCIATES WITH BASIC TERM LIFE INSURANCE -7(# PAYS THE ENTIRE COST OF THIS COVERAGE FOR YOU )N THE EVENT OF YOUR DEATH BASIC LIFE PROVIDES A BENEÚT TO YOUR BENEÚCIARY

9OU ARE AUTOMATICALLY ENROLLED IN BASIC LIFE COVERAGE ON YOUR DATE OF HIRE !LL YOU NEED TO DO IS COMPLETE YOUR BENEÚCIARY INFORMATION ON THE 3ELF %VIDENT !PPLICATION 3%! 9OU MAY ENROLL IN ANY OF THE ADDITIONAL LIFE OPTIONS WHEN YOU ARE ÚRST HIRED DURING /PEN %NROLLMENT OR WITHIN DAYS OF A QUALIFYING LIFE EVENT CHANGE

#OVERAGE !MOUNTS p &ULL TIME !SSOCIATES TIMES YOUR ANNUAL SALARY UP TO MILLION p 0ART TIME !SSOCIATES IN COVERAGE

Optional Life Insurance

• &OR !$ $ %NROLL ONLINE AT 3%! • &OR SUPPLEMENTAL LIFE OR DEPENDENT LIFE #ONTACT YOUR "ENEÚTS 4EAM TO REQUEST AN ENROLLMENT FORM

9OU MAY PURCHASE ADDITIONAL LIFE BENEÚTS TO FURTHER PROTECT YOUR FAMILY )F ELECTED THE COST OF THESE OPTIONS WILL BE TAKEN FROM YOUR PAYCHECK AFTER TAXES #OSTS ARE BASED ON THE AMOUNT OF COVERAGE SELECTED AND FOR SUPPLEMENTAL LIFE BASED ON AGE 3EE THE ENCLOSED COST SHEET FOR THE RATES

9OU MAY NEED TO PROVIDE EVIDENCE OF INSURABILITY %/) FOR A NEW ELECTION OR TO INCREASE COVERAGE !LL LIFE INSURANCE COVERAGE OR COMBINED LIFE INSURANCE COVERAGE EXCEEDING REQUIRES %/)

"%.%&)4 /04)/. 3UPPLEMENTAL ,IFE 0AYS A BENEÚT TO YOUR BENEÚCIARY IN ADDITION TO YOUR BASIC LIFE BENEÚT !CCIDENTAL $EATH $ISMEMBERMENT !$ $ 0AYS A BENEÚT IN ADDITION TO YOUR BASIC LIFE IF YOUR DEATH IS DUE TO AN ACCIDENT !LSO PAYS FOR ACCIDENTAL LOSS OF SIGHT SPEECH HEARING OR LIMB

$EPENDENT ,IFE 0AYS A BENEÚT TO YOU IN THE EVENT YOUR SPOUSE OR A CHILD DIES

7HAT IS %VIDENCE OF )NSURABILITY

#/6%2!'% !-/5.43 p &ULL TIME !SSOCIATES TIMES YOUR ANNUAL SALARY OR p0ART TIME !SSOCIATES 0URCHASE IN INCREMENTS UP TO 0URCHASE IN INCREMENTS UP TO

%VIDENCE OF INSURABILITY %/) MEANS YOU NEED TO SHOW PROOF THAT YOU OR YOUR DEPENDENTS ARE IN GOOD HEALTH %/) IS REQUIRED IN THE FOLLOWING INSTANCES • )F YOU APPLY FOR SUPPLEMENTAL LIFE OVER THREE TIMES YOUR ANNUAL SALARY OR OR FOR DEPENDENT SPOUSE COVERAGE • )F YOU DECLINE COVERAGE WHEN A NEW HIRE AND LATER DECIDE TO ELECT IT OR YOU INCREASE COVERAGE AT A LATER DATE

p &ULL TIME !SSOCIATES MILLION p 0ART TIME !SSOCIATES 3POUSE 0URCHASE BETWEEN TO UP TO PERCENT OF YOUR BASIC AND SUPPLEMENTAL LIFE COMBINED OR #HILDREN 0URCHASE OR

.OTE ABOUT AGE REDUCTIONS !T AGE BASIC AND SUPPLEMENTAL LIFE INSURANCE AMOUNTS REDUCE TO PERCENT OF THE PRE COVERAGE !T AGE THEY REDUCE TO PERCENT OF THE PRE COVERAGE

.OTES !SSOCIATES AGE OR OVER ARE NOT ELIGIBLE FOR !$ $ INSURANCE )F YOUR SPOUSE IS EMPLOYED BY -7(# HE OR SHE MAY NOT BE ELIGIBLE FOR $EPENDENT 3POUSE ,IFE COVERAGE $EPENDENT #HILD ,IFE INSURES ALL YOUR ELIGIBLE CHILDREN FOR ONE MONTHLY PREMIUM !S YOUR FAMILY GROWS NO ACTION IS NEEDED TO INSURE ADDITIONAL CHILDREN )F BOTH PARENTS ARE -7(# !SSOCIATES ONLY ONE CAN CARRY COVERAGE ON THE CHILDREN

,)&% ).352!.#% #/343 You have the option to purchase additional life insurance (over and above your basic Mary Washington Healthcare-provided benefit) for yourself and/or your dependents. For you — Full-time Associates may purchase supplemental life insurance from one to fives times their base annual salary; part-time Associates may purchase up to $45,000 in supplemental coverage in increments of $5,000. For your spouse* — You may purchase any amount between $5,000 and $100,000 of coverage, up to 100% of your life insurance coverage or $100,000 (whichever is less). For your dependents* — You may purchase either $2,500, $5,000, or $10,000 of coverage. The cost for this coverage depends upon the age of the person you want to insure and the amount of coverage you elect. Use the rate table to determine the cost of additional term life insurance for you, your spouse, and/or your children. *You and your dependents must meet eligibility criteria stated in the Benefits Guide and on the enrollment form. Any additions or changes in coverage may require evidence of insurability.

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

4%2- ,)&% ).352!.#% 2!4%3 (Annual Amounts — see example to understand how to convert to a cost per pay period) AGE OF INSURED 25 or younger 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80 or older TERM LIFE INSURANCE FOR YOUR CHILD

SUPPLEMENTAL LIFE FOR YOU

TERM LIFE INSURANCE FOR YOUR SPOUSE

(rate per $1,000 of coverage)

0.552 0.552 0.744 0.912 1.368 2.280 3.540 6.000 7.260 12.540 22.320 22.320 22.320

COVERAGE AMOUNT $2,500 $5,000 $10,000

0.552 0.552 0.744 0.912 1.368 2.280 3.540 6.000 7.260 12.540 22.320 22.320 22.320

ANNUAL COST $ 4.08 $ 8.16 $16.32

Short-Term Disability

Long-Term Disability

)FÂ&#x;YOUÂ&#x;AREÂ&#x;AÂ&#x;QUALIĂ&#x161;EDÂ&#x;FULL TIMEÂ&#x;!SSOCIATE Â&#x;YOUÂ&#x;MAYÂ&#x;PURCHASEÂ&#x; SHORT TERMÂ&#x;DISABILITYÂ&#x;COVERAGE Â&#x;4HEÂ&#x;PLANÂ&#x;COVERSÂ&#x;YOUÂ&#x;INÂ&#x;THEÂ&#x; EVENTÂ&#x;YOUÂ&#x;BECOMEÂ&#x;DISABLED

)FÂ&#x;YOUÂ&#x;AREÂ&#x;AÂ&#x;QUALIĂ&#x161;EDÂ&#x;FULL TIMEÂ&#x;!SSOCIATE Â&#x;YOUÂ&#x;AUTOMATICALLYÂ&#x; RECEIVEÂ&#x;LONG TERMÂ&#x;DISABILITYÂ&#x;COVERAGEÂ&#x; Â&#x;ATÂ&#x;NOÂ&#x;COSTÂ&#x;TOÂ&#x;YOU Â&#x;9OUÂ&#x; AREÂ&#x;ENROLLEDÂ&#x;INÂ&#x;THEÂ&#x;PLANÂ&#x;AFTERÂ&#x;ONEÂ&#x;YEARÂ&#x;OFÂ&#x;FULL TIMEÂ&#x;EMPLOYMENT Â&#x; 4HEÂ&#x;PLANÂ&#x;PROVIDESÂ&#x;Ă&#x161;NANCIALÂ&#x;PROTECTIONÂ&#x;INÂ&#x;THEÂ&#x;EVENTÂ&#x;AÂ&#x;MEDICALÂ&#x; DISABILITYÂ&#x;LASTSÂ&#x;BEYONDÂ&#x;THEÂ&#x;SHORT TERMÂ&#x;DISABILITYÂ&#x;PERIOD

3UMMARYÂ&#x;OFÂ&#x;"ENEĂ&#x161;TSÂ&#x; pÂ&#x;)FÂ&#x;ELECTED Â&#x;SHORT TERMÂ&#x;DISABILITYÂ&#x;REPLACESÂ&#x; Â&#x;PERCENTÂ&#x;OFÂ&#x; YOURÂ&#x;WEEKLYÂ&#x;BASEÂ&#x;PAY Â&#x;UPÂ&#x;TOÂ&#x; Â&#x;AÂ&#x;WEEK pÂ&#x;$ISABILITYÂ&#x;PAYMENTSÂ&#x;BEGINÂ&#x;ONÂ&#x;DAYÂ&#x;NINEÂ&#x;OFÂ&#x;YOURÂ&#x;DISABILITYÂ&#x; ANDÂ&#x;CANÂ&#x;LASTÂ&#x;UPÂ&#x;TOÂ&#x; Â&#x;WEEKSÂ&#x;PERÂ&#x;CALENDARÂ&#x;YEAR Â&#x;IFÂ&#x;ELIGIBLE pÂ&#x;4OÂ&#x;QUALIFYÂ&#x;FORÂ&#x;PAYMENT Â&#x;YOUÂ&#x;MUSTÂ&#x;BEÂ&#x;UNABLEÂ&#x;TOÂ&#x;PERFORMÂ&#x; ANYÂ&#x;WORKÂ&#x;ACTIVITY pÂ&#x;#LAIMSÂ&#x;MUSTÂ&#x;BEÂ&#x;SUBMITTEDÂ&#x;WITHINÂ&#x; Â&#x;DAYSÂ&#x;FROMÂ&#x;THEÂ&#x;DATEÂ&#x; OFÂ&#x;DISABILITY pÂ&#x;!Â&#x;PRE EXISTINGÂ&#x;CONDITIONÂ&#x;CLAUSEÂ&#x;EXISTS pÂ&#x;)FÂ&#x;YOUÂ&#x;RECEIVEÂ&#x;SHORT TERMÂ&#x;DISABILITYÂ&#x;PAYMENTS Â&#x;YOURÂ&#x;TAXESÂ&#x; ANDÂ&#x;REGULARÂ&#x;PAY PERIODÂ&#x;DEDUCTIONSÂ&#x;WILLÂ&#x;BEÂ&#x;WITHHELDÂ&#x;FROMÂ&#x; EACHÂ&#x;PAYMENT

3UMMARYÂ&#x;OFÂ&#x;"ENEĂ&#x161;TSÂ&#x; pÂ&#x;,ONG TERMÂ&#x;DISABILITYÂ&#x;REPLACESÂ&#x; Â&#x;PERCENTÂ&#x;OFÂ&#x;YOURÂ&#x;MONTHLYÂ&#x;BASEÂ&#x; PAY Â&#x;UPÂ&#x;TOÂ&#x; Â&#x;PERÂ&#x;MONTH pÂ&#x;$ISABILITYÂ&#x;PAYMENTSÂ&#x;BEGINÂ&#x;AFTERÂ&#x; Â&#x;DAYSÂ&#x;OFÂ&#x;DISABILITY Â&#x;IFÂ&#x;YOUÂ&#x; AREÂ&#x;DISABLEDÂ&#x;ASÂ&#x;DEĂ&#x161;NEDÂ&#x;BYÂ&#x;THEÂ&#x;PLAN pÂ&#x;!Â&#x;PRE EXISTINGÂ&#x;CONDITIONÂ&#x;CLAUSEÂ&#x;EXISTS

To elect this coverage, enroll online at SEA. )FÂ&#x;YOUÂ&#x;BECOMEÂ&#x;DISABLED Â&#x;PLEASEÂ&#x;CONTACTÂ&#x;THEÂ&#x;"ENEĂ&#x161;TSÂ&#x; 4EAMÂ&#x;TOÂ&#x;INITIATEÂ&#x;THEÂ&#x;SHORT TERMÂ&#x;DISABILITYÂ&#x;PROCESS

EXAMPLE #1 â&#x20AC;&#x201C; TERM LIFE FOR YOUR SPOUSE

Example 55

Amount 1. Enter age of spouse

$10,000

2. Enter amount of insurance desired

6.000

3. Enter rate per $1,000 (from rate table) 4. Multiply line 2 by line 3 and divide by 1,000 to calculate your annual cost

$60.00 $2.31

5. Divide cost in line 4 by 26 to calculate your cost per pay

EXAMPLE #2 â&#x20AC;&#x201C; TERM LIFE FOR YOUR CHILD

Example $10,000

Amount 1. Enter amount of insurance desired

$16.32

2. Enter rate (from rate table), which is your annual cost

$0.63

3. Divide cost in line 3 by 26 to calculate your cost per pay)

ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCE COSTS Accidental death and dismemberment insurance is available in increments of $50,000 at an annual cost of $11.40 for each $50,000 of coverage. Full-time Associates may purchase up to $1,000,000 in coverage; part-time Associates may purchase up to $250,000. Use the table below to determine your cost for this coverage.

Example $1,000,000 20 $228.00 $8.77

Amount 1. Enter amount of insurance desired 2. Divide by $50,000, to determine the number of increments you want to purchase 3. Multiply number of increments in line 2 by $11.40 to determine your annual cost 4. Divide cost in line 3 by 26 to calculate your cost per pay

A SHORT TERM DISABILITY COSTS Only full-time Associates may purchase short term disability insurance, which replaces 60% of your base pay (up to a maximum amount) for up to 22 weeks, assuming that you are disabled for more than 8-days. Use the table below to determine your cost for this coverage, if eligible.

Example $15,300 153 $30.60 $1.18

Amount 1. Enter your annual base pay or annual benefit salary (i.e., your hourly rate multiplied by annual hours worked) 2. Divide amount in line 1 by 100 3. Multiply amount in line 2 by .20 to calculate your annual cost 4.Divide cost in line 3 by 26 to calculate your cost per pay

â&#x20AC; This example assumes a 24-year old Associate with annual benefits salary of $15,300. NOTE: Maximum cost for Short-Term Disability coverage is $8.00 per pay period or $208.00 annually.

-ARYÂ&#x;7ASHINGTONÂ&#x;(EALTHCAREÂ&#x;"ENEĂ&#x161;TSÂ&#x;'UIDE

Retirement 3AVE FOR A SECURE ÚNANCIAL FUTURE BY ENROLLING IN THE -7(# 2ETIREMENT 3AVINGS 0LAN The Retirement 3AVINGS 0LAN OFFERS PROGRAMS THAT MEET YOUR NEEDS OVER THE COURSE OF YOUR LIFETIME WHETHER YOU ARE BUSY SAVING FOR THE FUTURE OR NEARING RETIREMENT ,INCOLN &INANCIAL 'ROUP PROVIDES INVESTMENT OPTIONS AND ADMINISTRATIVE SERVICES FOR THE RETIREMENT PLAN

Summary of the Plan

Retirement Contribution

• 4HE 2ETIREMENT 3AVINGS 0LAN HELPS YOU SAVE MONEY FOR RETIREMENT USING A VARIETY OF INVESTMENT OPTIONS OFFERED THROUGH ,INCOLN &INANCIAL 'ROUP • 9OU ARE IMMEDIATELY ELIGIBLE UPON HIRE TO BEGIN CONTRIBUTING TO THE PLAN • 9OU WILL BE AUTOMATICALLY ENROLLED AT PERCENT OF YOUR COMPENSATION UNLESS YOU ELECT OTHERWISE • 'ENERALLY YOU CAN CONTRIBUTE AS MUCH OF YOUR ANNUAL COMPENSATION AS YOU WISH UP TO THE )23 ANNUAL PRE TAX LIMIT • 9OU MAY CHANGE YOUR RETIREMENT PLAN CONTRIBUTIONS AT ANY TIME DURING THE YEAR • 2ETIREMENT PLAN CONTRIBUTIONS WILL TAKE EFFECT THE NEXT AVAILABLE PAY PERIOD AFTER YOU ELECT CHANGES • 4HE MONEY YOU SET ASIDE IN THE PLAN AND THE INTEREST IT EARNS ARE NOT TAXED UNTIL YOU WITHDRAW MONEY FROM YOUR ACCOUNT USUALLY AT RETIREMENT

"EGINNING IN -AY -7(# ADDED A NEW ANNUAL 2ETIREMENT #ONTRIBUTION 0ROGRAM BASED ON YEARS OF ELIGIBLE SERVICE

MWHC Adds to Your Savings !SSOCIATES AGE OR OLDER ARE ELIGIBLE FOR -7(# S MATCHING CONTRIBUTIONS 4HE MATCHING CONTRIBUTIONS WILL BEGIN AFTER YOU COMPLETE ONE YEAR OF SERVICE AND HOURS WORKED -7(# WILL DEPOSIT INTO YOUR ACCOUNT FOR EVERY YOU CONTRIBUTE UP TO PERCENT OF YOUR ANNUAL PAY -ATCHING CONTRIBUTIONS ARE MADE EACH PAY PERIOD WITH YOUR REGULAR !SSOCIATE CONTRIBUTIONS 9OU ARE VESTED IN THE MATCH AFTER THREE YEARS OF ELIGIBLE SERVICE

The schedule: 9EARS OF %LIGIBLE 3ERVICE

!MOUNT OF !NNUAL 2ETIREMENT #ONTRIBUTION

,ESS THAN YEARS

OF ELIGIBLE PAY

"ETWEEN AND YEARS

OF ELIGIBLE PAY

OR MORE YEARS

OF ELIGIBLE PAY

Additional features: 4HE 2ETIREMENT #ONTRIBUTION IS AVAILABLE TO !SSOCIATES ELIGIBLE FOR THE 3AVINGS 0LANS 9OU DO NOT NEED TO CONTRIBUTE TO THE 3AVINGS 0LANS TO BE ELIGIBLE FOR THIS ANNUAL CONTRIBUTION • 4HE ANNUAL 2ETIREMENT #ONTRIBUTION IS IN ADDITION TO THE -ATCHING #ONTRIBUTION • 4HE 2ETIREMENT #ONTRIBUTION WILL BE BASED ON BASE SALARY OVERTIME AND CASH BONUSES RECEIVED DURING THE YEAR UP TO THE )23 LIMIT • 4HE 2ETIREMENT #ONTRIBUTION WILL BE MADE ANNUALLY AT THE END OF THE ÚRST QUARTER OF THE FOLLOWING YEAR • 9OU MUST BE AGE ACTIVELY EMPLOYED ON $ECEMBER AND HAVE WORKED AT LEAST HOURS DURING THE YEAR TO RECEIVE THE CONTRIBUTION • 4HE 2ETIREMENT #ONTRIBUTION WILL BE INVESTED THE SAME AS YOUR OWN CONTRIBUTIONS )F YOU DO NOT MAKE AN INVESTMENT ELECTION THE CONTRIBUTION WILL BE INVESTED IN THE APPROPRIATE ,IFE 3PAN -ODE BASED ON YOUR YEAR OF BIRTH • 9OU WILL BE VESTED IN THE 2ETIREMENT #ONTRIBUTION AFTER THREE YEARS OF ELIGIBLE SERVICE !LL SERVICE PRIOR TO -AY WILL COUNT TOWARD VESTING

If you are age 50 or older, or are turning age 50 within this calendar year? 4HE )23 ALLOWS YOU TO MAKE ADDITIONAL CONTRIBUTIONS CALLED CATCH UP CONTRIBUTIONS 4HESE CONTRIBUTIONS ARE OVER AND ABOVE THE ANNUAL LIMIT 4HE AMOUNT YOU CAN CONTRIBUTE IS ADJUSTED EACH YEAR BY THE )23

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Your Investment Options

Managing Your Account

9OU MAY CHOOSE HOW TO INVEST YOUR MONEY 4HE 2ETIREMENT 3AVINGS 0LAN OFFERS A WIDE VARIETY OF INVESTMENT OPTIONS EACH INVOLVING A DIFFERENT DEGREE OF RISK AND POTENTIAL RETURN ON YOUR INVESTMENTS 9OU CAN INVEST YOUR ENTIRE ACCOUNT BALANCE IN ONE FUND OR INVEST IN MULTIPLE FUNDS IN PERCENT INCREMENTS 9OU ARE ALWAYS PERCENT VESTED IN YOUR OWN CONTRIBUTIONS 4HAT MEANS THE MONEY IS YOURS FROM DAY ONE )F ELIGIBLE YOU ARE VESTED IN THE ADDITIONAL EMPLOYER CONTRIBUTION AFTER THREE YEARS

7HETHER IT S ONLINE OR BY PHONE MANAGING YOUR RETIREMENT ACCOUNT COULDN T BE EASIER 9OUR ACCOUNT IS AVAILABLE TO YOU HOURS A DAY SEVEN DAYS A WEEK !ND IF YOU NEED PERSONAL ASSISTANCE ,INCOLN &INANCIAL 'ROUP REPRESENTATIVES ARE AVAILABLE BY PHONE -ONDAY THROUGH &RIDAY A M k P M %ASTERN 4IME

&UND OPTIONS INCLUDE • • • • •

3TOCK BASED INVESTMENTS !LLOCATION INVESTMENTS "OND BASED INVESTMENTS #ASH AND STABLE VALUE INVESTMENTS ,IFE3PAN ASSET ALLOCATION MODELS

&OR FUND FACTS OR A PROSPECTUS FOR EACH INVESTMENT OPTION GO TO WWW LINCOLNALLIANCE COM OR CALL 9OU SHOULD ALWAYS READ THE PROSPECTUS CAREFULLY BEFORE INVESTING OR SENDING MONEY

Accessing Your Money 9OU MAY ACCESS YOUR MONEY AT AGE WITHOUT PENALTY )F YOU TAKE A WITHDRAWAL PRIOR TO THAT YOU WILL INCUR TAX PENALTIES 0LEASE CONSULT A TAX ADVISOR BEFORE MAKING ANY DECISIONS ABOUT WITHDRAWING MONEY FROM YOUR RETIREMENT PLAN

7HAT YOU CAN DO ONLINE OR BY PHONE • 6IEW ACCOUNT SUMMARY • #HECK ACCOUNT BALANCE • 6IEW FUND PERFORMANCE AND INFORMATION • #HANGE ALLOCATION OF FUTURE CONTRIBUTIONS • 4RANSFER ASSETS BETWEEN FUNDS • 2EQUEST A NEW 0). PERSONAL IDENTIÚCATION NUMBER • 2EQUEST A PROSPECTUS +EEP YOUR 0). IN A SAFE PLACE 9OU WILL NEED YOUR 3OCIAL 3ECURITY NUMBER AND 0). EACH TIME YOU ACCESS YOUR ACCOUNT EITHER ONLINE OR BY PHONE

Need Help? ,INCOLN &INANCIAL 'ROUP REPRESENTATIVES ARE ONSITE AT -ARY 7ASHINGTON (OSPITAL TO HELP YOU WITH YOUR INVESTMENT NEEDS 4O MAKE CHANGES IN YOUR DEFERRAL AND INVESTMENT OPTIONS • 'O TO WWW LINCOLNALLIANCE COM • #ONTACT THE ONSITE REPRESENTATIVE AT ON 4UESDAYS A M k P M 4HURSDAYS A M k P M &RIDAYS A M k P M • #ALL CUSTOMER SERVICE AT

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Additional Beneﬁts 7ORK AFFECTS LIFE AND LIFE AFFECTS WORK )T IS A NEVER ENDING CYCLE THAT ALL !SSOCIATES FACE !T TIMES WE ALL NEED HELP BALANCING OUR WORK AND PERSONAL LIVES AND SOMETIMES ASKING FOR HELP IS THE DIFÚCULT PART 4HAT S WHY -7(# IS VERY PLEASED TO PROVIDE MANY ADDITIONAL WORK LIFE BENEÚTS AND PROGRAMS TO ASSIST YOU IN THE BALANCING ACT

Adoption Assistance

Bereavement Leave

4O ASSIST OUR !SSOCIATES WHO ADOPT -7(# WILL PROVIDE FOR FULL TIME !SSOCIATES AND FOR PART TIME &4% OR GREATER !SSOCIATES &OR DETAILS CONTACT THE "ENEÚTS 3ECTION OF (UMAN 2ESOURCES

-7(# RECOGNIZES THAT THE DEATH OF A FAMILY MEMBER PLACES UNUSUAL STRESS ON AN !SSOCIATE 4HUS -7(# WILL PROVIDE UP TO THREE DAYS OF BEREAVEMENT LEAVE TO 0!, ELIGIBLE !SSOCIATES IN THE EVENT OF THE DEATH OF A SPOUSE SIBLING PARENT CHILD PARENT IN LAW SON OR DAUGHTER IN LAW GRANDPARENT OR GRANDCHILD "EREAVEMENT DAYS ARE NOT DEDUCTED FROM YOUR 0!, BANK 9OU MAY BE REQUIRED TO SUBMIT A WRITTEN REQUEST AND A COPY OF YOUR FAMILY MEMBER S DEATH NOTICE TO THE (UMAN 2ESOURCES $EPARTMENT

ASSIST: Employee Assistance Program 4HE !33)34 PROGRAM IS A SERVICE PROVIDED BY -7(# TO ASSIST !SSOCIATES AND FAMILY MEMBERS EXPERIENCING STRESS IN THEIR PERSONAL OR WORK LIVES 3HORT TERM SERVICES ARE PROVIDED FOR PROBLEMS THAT MAY BE INTERFERING WITH FUNCTIONING IN ANY AREA OF ONE S LIFE What problems can ASSIST help with?

What if I’m in crisis?

p 2ELATIONSHIP ISSUES p &AMILY PROBLEMS p 0ARENTING CONCERNS p &INANCIAL DIFÚCULTIES p 3TRESS p %MOTIONAL PROBLEMS p #ONÛICT WITH OTHERS p 7ORK STRESS p 3UBSTANCE ABUSE ISSUES !NY PROBLEM CAUSING SIGNIÚCANT CONCERN IS AN APPROPRIATE ISSUE FOR !33)34

9OU CAN STILL RECEIVE IMMEDIATE HELP FROM OUR TRAINED PROFESSIONALS )F YOU ARE REFERRED TO OTHER RESOURCES !33)34 CAN OFTEN HELP IN FACILITATING THAT REFERRAL THROUGH YOUR MEDICAL INSURANCE ! WIDE VARIETY OF COMMUNITY RESOURCES ARE AVAILABLE THROUGH THE !33)34 PROGRAM

What happens when I call? ! TRAINED PROFESSIONAL TAKES YOUR CALL 9OU ARE THEN OFFERED AN APPOINTMENT WITH AN !33)34 PROFESSIONAL WHO CAN HELP DETERMINE YOUR NEEDS HELP YOU WITH SHORT TERM PROBLEM RESOLUTION OR PROVIDE A REFERRAL TO OTHER RESOURCES FOR HELP !LL !33)34 PROFESSIONALS ARE MASTER S PREPARED LICENSED OR CERTIÚED IN THEIR ÚELD

Who will know that I’ve called? 4HE !33)34 PROGRAM IS CONÚDENTIAL .O INFORMATION IS RELEASED WITHOUT YOUR SPECIÚC WRITTEN CONSENT !LL RECORDS ARE KEPT CONÚDENTIAL IN ACCORDANCE WITH FEDERAL AND STATE LAWS

What is the cost? 4HE !33)34 PROGRAM IS AVAILABLE TO YOU AND YOUR FAMILY MEMBERS AT NO COST 9OU ONLY BECOME RESPONSIBLE FOR COSTS IF YOU RE REFERRED TO A NON !33)34 RESOURCE

What if my supervisor refers me to ASSIST? 9OUR SUPERVISOR IS OFFERING A HELPFUL RESOURCE TO ADDRESS PERSONAL CONCERNS THAT MAY BE AFFECTING YOUR JOB 9OUR INVOLVEMENT WITH !33)34 REMAINS CONÚDENTIAL 4HE ONLY INFORMATION THE SUPERVISOR WILL KNOW IS THAT YOU DID INDEED KEEP YOUR APPOINTMENT AND WHETHER OTHER APPOINTMENTS ARE SCHEDULED ON COMPANY TIME

)F YOU ARE FEELING OVERWHELMED BY PERSONAL OR WORK STRESS CALL !33)34 IS AVAILABLE HOURS A DAY

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Paid Annual Leave -7(# COMBINES VACATION SICK LEAVE AND SOME HOLIDAY TIME INTO ONE TIME OFF PROGRAM CALLED PAID ANNUAL LEAVE 0!, 9OU ARE ELIGIBLE FOR 0!, BASED ON YOUR STATUS SEE CHART ON PAGE AND HOW LONG YOU HAVE BEEN EMPLOYED BY -7(#

Using PAL Days 9OUR SUPERVISOR MUST APPROVE ALL REQUESTS FOR 0!, IN ADVANCE +EEP IN MIND THAT 0!, ALSO INCLUDES SICK TIME SO IT S IMPORTANT YOU USE YOUR 0!, DAYS CAREFULLY AND PLAN FOR ANY UNFORESEEN EMERGENCIES 9OU MAY CARRY OVER A MAXIMUM OF HOURS ANNUALLY -7(# RECOGNIZES THE FOLLOWING HOLIDAYS • .EW 9EAR S $AY • -EMORIAL $AY • ,ABOR $AY • 4HANKSGIVING $AY • )NDEPENDENCE $AY • #HRISTMAS $AY

Things to Know 0!, IS EARNED EACH PAY PERIOD BASED ON ACTUAL HOURS PAID NOT TO EXCEED HOURS FOR EACH TWO WEEK PAY PERIOD /VERTIME HOURS ARE NOT CONSIDERED IN CALCULATING 0!,

0ERSONAL $AY -7(# GIVES 0!, ELIGIBLE !SSOCIATES ONE ADDITIONAL PERSONAL DAY EACH YEAR AFTER ONE YEAR OF SERVICE (OURS ARE PRORATED BASED ON YOUR &4% ASSIGNMENT AND WILL BE ADDED TO YOUR REGULAR 0!, BANK

#ASH IN /PPORTUNITIES !SSOCIATES MAY CASH IN A TOTAL OF HOURS IN DURING TWO CASH IN OPPORTUNITIES HELD IN THE SUMMER AND FALL &ULL TIME !SSOCIATES MUST HAVE AT LEAST HOURS AFTER A CASH IN AND PART TIME !SSOCIATES MUST MAINTAIN A BALANCE OF HOURS !LL FEDERAL AND STATE TAXES WILL BE WITHHELD 0!, CASH INS ARE TAXED

&ULL TIME 0!, !CCRUAL &4% TO "ASED ON HOUR PAY PERIOD

0ART TIME 0!, !CCRUAL &4% 4O !CCURAL RATE BASED ON HOURS PAID

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

ADDITIONAL BENEFITS Kids’ Station: Child Care !S A WORKING PARENT YOU WANT A SAFE AND INNOVATIVE ENVIRONMENT FOR YOUR CHILD DURING THE TIME YOU ARE UNABLE TO BE TOGETHER +IDS 3TATION IS A DYNAMIC CENTER FOR CHILDREN IN A SAFE AND NURTURING ENVIRONMENT )T WAS NOMINATED BY THE .ATIONAL !SSOCIATION OF #HILD #ARE 0ROFESSIONALS AS ONE OF THE TOP THREE CHILDCARE CENTERS IN THE COUNTRY

Kids’ Station offers: • ! FULL RANGE OF DAY CARE SERVICES FOR CHILDREN AGED THREE WEEKS TO YEARS • /CCASIONAL #ARE PROGRAM FOR HOURLY DROP IN • "EFORE AND AFTER SCHOOL CARE &OR MORE INFORMATION CONTACT +IDS 3TATION AT

Errand Solutions: Personal Assistance and Resources -7(# IS HAPPY TO OFFER A FREE !SSOCIATE BENEÚT TO SAVE YOU TIME AND MONEY AND ASSIST YOU IN BALANCING THE RESPONSIBILITIES OF YOUR WORK AND PERSONAL LIFE 7E HAVE PARTNERED WITH %RRAND 3OLUTIONS AN ERRAND CONVENIENCE SERVICE TO ASSIST YOU WITH JUST ABOUT ANY PERSONAL OR BUSINESS TASK ON YOUR TO DO LIST

How It Works 4RAINED %RRAND 3OLUTIONS REPRESENTATIVES ARE LOCATED AT -ARY 7ASHINGTON AND 3TAFFORD (OSPITALS TO MAKE INTERACTION EASY IN PERSON THROUGH E MAIL OR BY TELEPHONE $ROP OFF YOUR ITEMS TO BE SERVICED INCLUDING DRY CLEANING JEWELRY SHOES OR CAR KEYS FOR VEHICLE SERVICES TO THE SITE DURING OPERATING HOURS &OR CAR SERVICES PLEASE MAKE AN APPOINTMENT HOURS IN ADVANCE 9OU WILL BE NOTIÚED WHEN YOUR ITEMS ARE READY FOR PICKUP #OORDINATION OF SERVICES AND ANY ASSISTANCE GIVEN ARE FREE OF CHARGE AND PAYMENT IS ACCEPTED ONLY FOR ACTUAL OUTSIDE SERVICES RENDERED /N SITE RESEARCH AND PLANNING TASKS ARE FREE )NTERACTIONS ARE PRIVATE AND HANDLED WITH PROFESSIONAL EXCELLENCE AND ALL SERVICE PROVIDERS ARE LICENSED AND INSURED

For additional information, contact Errand Solutions: /NLINE AT ERRAND SOLUTIONS MWHC COM OR -7( p 3(

%RRAND 3OLUTIONS TAKES CARE OF EVERYDAY TASKS WHILE YOU WORK SO YOU HAVE MORE FREE TIME TO DO THE THINGS YOU TRULY ENJOY

Personal and Convenience Services • • • • • • • • •

&ULL POSTAL SERVICE $RY CLEANING AND LAUNDRY #AR CARE *EWELRY REPAIR AND BATTERY REPLACEMENT 0HOTO PROCESSING 2ESEARCH AND PRICE TRAVEL OPTIONS %VENT TICKETS AND RESERVATIONS !CTIVITY RESEARCH AND BOOKING 3ERVICE REFERRALS

Home Improvement and Corporate Tasks • • • • • •

-EETING AND EVENT PLANNING !SSOCIATE REWARDS AND RECOGNITION 7ORKPLACE MORALE ACTIVITIES 0HILANTHROPIC EVENTS #USTOMIZED GIFT ACQUISITION AND PRESENTATION 2ESEARCH PROJECTS

Referrals, Child/Pet Care and Special Occasion • • • • •

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

+EY DATE REMINDER SERVICES %VENT AND PARTY PLANNING (OLIDAY SUPPLY AND DECORATION ASSISTANCE "AKERY AND CATERING 'IFT WRAPPING GIFT CARDS AND GIFT BASKETS

Tuition Assistance

Tobacco-Free Associates Program

-7(# PROVIDES ASSISTANCE TO !SSOCIATES FOR QUALIÚED EDUCATION EXPENSES 4O BE ELIGIBLE FOR THIS BENEÚT YOU MUST BE ACTIVELY EMPLOYED HAVE COMPLETED ONE YEAR OR MORE OF SERVICE AND BE EMPLOYED ON A FULL TIME OR PART TIME BASIS WITH AN &4% OF OR GREATER

!S AN !SSOCIATE AT -7(# YOU HAVE A 4OBACCO 4REATMENT 3PECIALIST DEDICATED TO SUPPORTING YOU THROUGH CHANGES IN YOUR TOBACCO USE WHETHER IT S YOUR ÚRST OR TENTH ATTEMPT TO QUIT "Y WORKING WITH A TRAINED COUNSELOR YOU LL GET SUPPORT WITH BOTH PARTS OF YOUR TOBACCO USE THE HABIT AND THE PHYSICAL ADDICTION TO NICOTINE

&ULL TIME !SSOCIATES &4% ARE ELIGIBLE FOR • 'RADUATE PER YEAR • 5NDERGRADUATE PER YEAR 0ART TIME !SSOCIATES &4% ARE ELIGIBLE FOR • 'RADUATE PER YEAR • 5NDERGRADUATE PER YEAR #OURSES MUST BE OFFERED AT AN ACCREDITED INSTITUTION LEADING TO AN UNDERGRADUATE OR GRADUATE DEGREE AND MUST SATISFY ANY ONE OF THE FOLLOWING CRITERIA • • • •

0REPARE !SSOCIATE FOR A PROFESSION AT -7(# %NHANCE CURRENT JOB SKILLS 0REPARE FOR A FUTURE NEED OF -7(# 3UPPORT THE OVERALL NEEDS OF -7(#

(OW )T 7ORKS • 4YPICALLY YOU WILL BE REIMBURSED FOR TUITION PAYMENTS YOU MAKE 9OU MAY REQUEST THAT BENEÚTS BE PAID IN ADVANCE • 9OU MUST SUBMIT A COMPLETE COPY OF THE TUITION ASSISTANCE FORM NO LATER THAN DAYS AFTER BEGINNING THE EDUCATIONAL COURSE IN ORDER TO BE ELIGIBLE FOR THIS BENEÚT • $OCUMENTS OF SUCCESSFUL COMPLETION OF THE COURSE g#s OR BETTER UNDERGRADUATE g"s OR BETTER GRADUATE MUST BE SUBMITTED WITHIN DAYS OF COMPLETION OF THE COURSE &OR DETAILS CONTACT THE "ENEÚTS 4EAM AT

Identity Fraud Expense Reimbursement -7(# IS CONCERNED ABOUT THE ÚNANCIAL SECURITY AND PERSONAL WELL BEING OF ITS !SSOCIATES 7E VE PURCHASED AN IDENTITY FRAUD EXPENSE REIMBURSEMENT POLICY PROVIDED BY 3T 0AUL 4RAVELERS #OVERAGE INCLUDES LIMITS OF LIABILITY OF SUBJECT TO NO DEDUCTIBLE 4HIS COVERAGE REIMBURSES IDENTITY THEFT VICTIMS FOR THE FOLLOWING SUBJECT TO THE CARRIER S CONSENT • ,OST WAGES AS A RESULT OF TIME TAKEN OFF WORK TO DEAL WITH THE FRAUD INCLUDING WRONGFUL INCARCERATION PAYS UP TO PER WEEK FOR ÚVE WEEKS • .OTARY AND CERTIÚED MAIL CHARGES FOR COMPLETING AND DELIVERING FRAUD AFÚDAVITS • &EES TO RE APPLY FOR LOANS DENIED DUE TO ERRONEOUS CREDIT INFORMATION CAUSED BY THE IDENTITY THEFT • ,ONG DISTANCE PHONE CHARGES TO MERCHANTS LAW ENFORCEMENT AGENCIES OR CREDIT GRANTORS TO DISCUSS AN ACTUAL IDENTITY THEFT • !TTORNEY FEES SUBJECT TO CARRIER S CONSENT 4O SPEAK TO A 3T 0AUL 4RAVELERS REPRESENTATIVE CALL

(OW )T 7ORKS • !PPOINTMENTS ARE HELD AT -(3 (EALTH 7ELLNESS AS WELL AS AT -7(# ENTITIES BY DEMAND • !T YOUR ÚRST SESSION YOU LL COMPLETE AN INTAKE PACKET WITH QUESTIONS ABOUT YOUR TOBACCO USE OVER TIME AND THE LIFESTYLE FACTORS THAT MAY IMPACT YOUR PROGRESS • 9OU LL SIT DOWN WITH YOUR SPECIALIST TO DESIGN A PERSONAL QUIT PLAN CHOOSE A QUIT DATE AND LEARN ABOUT THE AVAILABLE CESSATION AIDS • 3HORT FOLLOW UP SESSIONS WILL BE SCHEDULED EVERY TWO WEEKS OR AS NEEDED

#ESSATION !IDS 2ESEARCH SHOWS THAT USING MEDICINE TO HELP YOU QUIT SMOKING CAN DOUBLE YOUR CHANCE OF SUCCESS #ESSATION AIDS BLUNT MANY OF YOUR WITHDRAWAL SYMPTOMS ALLOWING YOU TO ACTIVELY WORK ON CHANGING THE THOUGHTS AND BEHAVIORS THAT MAKE YOU A SMOKER 7HILE ENROLLED IN THE PROGRAM YOU ARE ELIGIBLE TO USE THE FOLLOWING AIDS FREE OF CHARGE • .ICO$ERM #1 PATCHES • #OMMIT LOZENGES • .ICORETTE GUM 9OU MAY ALSO BE ELIGIBLE FOR REIMBURSEMENT OF PRESCRIPTION CESSATION MEDICATIONS 4O ENSURE YOU UNDERSTAND THE REQUIREMENTS FOR REIMBURSEMENT IT IS ESSENTIAL THAT YOU CALL FOR DETAILS ON ELIGIBILITY AND PAPERWORK BEFORE YOU ÚLL YOUR PRESCRIPTION &OR MORE INFORMATION OR TO SCHEDULE AN APPOINTMENT CALL -ELISSA "LASIOL AT

Other Beneﬁts • 5 3 SAVINGS BONDS AVAILABLE THROUGH CONVENIENT PAYROLL DEDUCTION • #REDIT UNIONS CONVENIENT TO WORK FOR ALL YOUR BANKING NEEDS R 4HE 6IRGINIA #REDIT 5NION IS LOCATED AT 'ORDON 7 3HELTON "LVD IN &REDERICKSBURG AND 2OUTE IN 3TAFFORD #ALL TO REACH THE 6IRGINIA #REDIT 5NION R 4HE (EALTHCARE 3YSTEMS &EDERAL #REDIT 5NION OFFERS A FULL ARRAY OF BANKING SERVICES ONSITE AT -ARY 7ASHINGTON (OSPITAL ON 7EDNESDAYS BETWEEN A M AND P M AS WELL AS AN !4- AT &ALL (ILL #ALL TO REACH THE (EALTHCARE 3YSTEMS &EDERAL #REDIT 5NION IN &AIRFAX • ,OCAL MERCHANT DISCOUNTS AVAILABLE ON THE DISCOUNT DATABASE AT WWW -ARY7ASHINGTON(EALTHCARE COM HOMEPAGE OR THE ,OTUS .OTES PORTAL • !UTO AND HOME INSURANCE • #OMPUTER PURCHASING PROGRAMS

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

Questions & Answers (ERE ARE ANSWERS TO SOME OF THE MORE FREQUENTLY ASKED QUESTIONS &OR SPECIÚCS OR MORE INFORMATION ABOUT THE PLANS AND HOW THEY WORK REFER TO YOUR -7(# (EALTH 7ELFARE 3UMMARY PLAN $ESCRIPTION OR CONTACT A MEMBER OF THE "ENEÚTS 4EAM

Medical & Prescription

Additional Beneﬁts

Q: Whom do I contact for medical claims information or problems?

Q: Whom do I contact with questions about paid annual leave (PAL)?

! !ETNA #USTOMER 3ERVICE AT OR LOG ON TO WWW AETNA COM #REATE A LOGIN AND PASSWORD FOR !ETNA .AVIGATOR

Q: How do I ﬁnd medical network providers? ! 9OU HAVE THREE OPTIONS 'O ONLINE TO WWW AETNA COM #LICK ON &IND A 0ROVIDER THEN SELECT g0LAN TYPE !ETNA #HOICE 0/3 )) /PEN !CCESS s #ALL !ETNA #USTOMER 3ERVICE AT !SK YOUR DOCTOR DIRECTLY

Q: When will I receive my medical ID card? ! 9OU SHOULD RECEIVE YOUR MEDICAL )$ CARD WITHIN THREE WEEKS AFTER ENROLLMENT

Q: How do I use the mail-order pharmacy? ! 9OU CAN PLACE ORDERS THROUGH THE !ETNA WEBSITE OR OBTAIN MAIL ORDER FORMS FROM THE "ENEÚTS 3ECTION OF (UMAN 2ESOURCES

Dental Q: Whom do I contact for dental claims information or problems? ! $ELTA $ENTAL #USTOMER 3ERVICE AT

Q: How do I ﬁnd dental network providers? ! #ONTACT $ELTA $ENTAL #USTOMER 3ERVICE OR LOG ON TO WWW DELTADENTALVA COM

Q: When will I receive my dental ID card? ! 9OU SHOULD RECEIVE YOUR DENTAL )$ CARD WITHIN THREE WEEKS AFTER ENROLLMENT

Vision Service Plan Q: Whom do I contact for vision claims information or problems? ! 6ISION 3ERVICE 0LAN 630 #USTOMER 3ERVICE AT

Q: How do I ﬁnd vision network providers? ! #ONTACT 630 #USTOMER 3ERVICE OR LOG ON TO WWW VSP COM

Retirement Savings Plan Q: How can I change or start making contributions to the Retirement Savings Plan? ! #ONTACT ,INCOLN &INANCIAL 'ROUP AT -ARY 7ASHINGTON (OSPITAL AT OR INTERNAL EXTENSION /R CONTACT ,INCOLN &INANCIAL 'ROUP #USTOMER 3ERVICE AT

Q: What if I still have money in a ﬁxed account with AIG Retirement (formerly AIG VALIC)? ! #ONTACT !)' 2ETIREMENT #USTOMER 3ERVICE AT

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

! #ONTACT #INDY +JAR AT OR INTERNAL EXTENSION

Q: How do I apply for Family Medical and Leave (FMLA)? ! #ONTACT !LLISON "LACK AT OR INTERNAL EXTENSION

Q: Where can I ﬁnd forms for many of the beneﬁts programs (such as, PAL Cash-in, Tuition Assistance, etc.)? ! 9OU HAVE SEVERAL OPTIONS • 4HE ,OTUS .OTES PORTAL UNDER g&ORMSs • 3ELF %VIDENT !PPLICATION 3%! UNDER g&ORMSs • 'UIDE ,INK ON WWW -ARY7ASHINGTON(EALTHCARE COM • "ROCHURE RACKS AT EACH -7(# FACILITY • #ONTACT A MEMBER OF THE "ENEÚTS 4EAM

Q: How do I get tuition assistance? ! /BTAIN THE FORM FROM THE FORMS DATABASE OR FROM THE "ENEÚTS 3ECTION OF (UMAN 2ESOURCES 2EMEMBER YOU MUST MEET THE FOLLOWING REQUIREMENTS R #OURSEWORK MUST BE APPROVED BY YOUR MANAGER (UMAN 2ESOURCES WILL DETERMINE ÚNAL APPROVAL 4HE FORM MUST BE COMPLETED AND TURNED IN TO (UMAN 2ESOURCES WITHIN DAYS OF THE START OF THE CLASS R 4HE CLASS INVOICE AS WELL AS PROOF OF REGISTRATION MUST ACCOMPANY THE TUITION FORM R $EGREE PROGRAM MUST BE INDICATED ON THE FORM • !SSOCIATES WHO ARE FULL OR PART TIME WITH AN &4% ASSIGNMENT ARE ELIGIBLE TO PARTICIPATE IN THIS PROGRAM • #OPY OF GRADES MUST BE TURNED IN TO THE "ENEÚTS 3ECTION OF (UMAN 2ESOURCES WITHIN DAYS OF THE CLASS END DATE • )F PREPAY AN AGREEMENT LETTER MUST BE SIGNED AND TURNED IN TO (UMAN 2ESOURCES BEFORE A CHECK IS ISSUED

Notes: ????????????????????????????????????????????????????

????????????????????????????????????????????????????

-ARY 7ASHINGTON (EALTHCARE "ENEÚTS 'UIDE

General BeneďŹ ts and Enrollment Questions

Whom to Contact with Questions

Allison Black, BeneďŹ ts Resource BeneďŹ ts Analyst

Lincoln Financial Group Retirement Savings Plan

ALLISON BLACK -7(# COM

WWW LINCOLNALLIANCE COM

Brooke Perry BeneďŹ ts Representative & Tuition Specialist

Medical and Prescription, Aetna

BROOKE PERRY -7(# COMÂ&#x; Â&#x;

)FÂ&#x;YOUÂ&#x;AREÂ&#x;UNABLEÂ&#x;TOÂ&#x;REACHÂ&#x;!LLISON or Brooke, or NEEDÂ&#x;FURTHERÂ&#x;ASSISTANCE Â&#x;PLEASEÂ&#x;CONTACTÂ&#x; ANYÂ&#x;MEMBERSÂ&#x;OFÂ&#x;THEÂ&#x;"ENEĂ&#x161;TSÂ&#x;4EAM Â&#x; Pam Sullivan BeneďŹ ts & HRIS Manager

Dental, Delta Dental WWW DELTADENTALVA COM Â&#x;

Vision, VSP

PAM SULLIVAN -7(# COMÂ&#x; Â&#x;

WWW VSP COM

Cyndie Imler Senior BeneďŹ ts Analyst

MWHC Health & Wellness

CYNDIE IMLER -7(# COMÂ&#x; Â&#x;

Cindy Kjar BeneďŹ ts Analyst CINDY KJAR -7(# COM

D. L. Sumner Director, Compensation & BeneďŹ ts D L SUMNER -7(# COM Â&#x;

Kathy Wall Executive VP, Human Resources & Organizational Development KATHY WALL -7(# COM

WWW AETNA COM Â&#x;

-ARYÂ&#x;7ASHINGTONÂ&#x;(EALTHCAREÂ&#x;"ENEĂ&#x161;TSÂ&#x;'UIDE

Â&#x;

FSAs, Aetna WWW AETNAFSA COM Â&#x; Â&#x;

(UMAN 2ESOURCES &ALL (ILL !VENUE 3UITE &REDERICKSBURG 6!

4HIS DOCUMENT WAS WRITTEN FOR EASY READABILITY )T MAY CONTAIN GENERALIZATIONS AND COLLOQUIALISMS RATHER THAN PRECISE LEGAL TERMS &OR FULL DETAILS INCLUDING ELIGIBILITY YOU SHOULD CONSULT THE SUMMARY PLAN DESCRIPTIONS )N ALL CASES THE OFÚCIAL PLAN DOCUMENTS GOVERN AND ARE THE ÚNAL AUTHORITY ON THE TERMS OF THE PLANS -7(# RESERVES THE RIGHT TO TERMINATE OR AMEND ANY AND ALL BENEÚT PLANS 0ARTICIPATION IN THE -7(# BENEÚT PLANS IS NEITHER A CONTRACTUAL RIGHT NOR A GUARANTEE OF CURRENT OR FUTURE EMPLOYMENT