The Best Health Insurance Plan For You and Your Family

2014

Benefit Guide

Summit mEDiCAL CENtER

Eligibility Medical Dental Vision

Flexible Spending Accounts Disability and Basic Life Insurance Additional Life Insurance Options Voluntary Benefits Other Benefits Legal Notifications Contact Information 1 2 5 6 7 8 9 10 11 12 14

Table of Contents

Welcome to Your

2014 Benefits!

As the U.S. continues its journey toward wide-sweeping changes in health care, we remain committed to providing our associates with comprehensive, affordable benefit options. However, between healthcare reform compliance, increasing health care trends and the health concerns of our population, we are faced with a balancing act to keep our plans competitive and affordable. As in the past couple of years, the company is addressing medical plan changes required by healthcare reform that are positive in nature, but lead to a direct increase in our medical costs. For example, our medical plans will no longer contain pre-existing condition limitations, and all deductibles and copays will now apply to the annual Out-of-Pocket Maximum. We all benefit from these plan enhancements, but that also means we share in the responsibility of using our benefits wisely. With that in mind, we will continue to offer a choice of medical plans: the Preferred Plan and the Premium Buy-Up Plan. Given the rising costs of medical coverage, we will be increasing the deductibles and Out-of-Pocket maximums for 2014. We are pleased to announce that the per paycheck contributions for the Preferred plan will be decreasing for the employee-only tier and increasing only slightly for family tiers. The per paycheck premiums for the Premium Buy-Up plan will also be increasing so please be thoughtful when making your medical plan election decision. As we introduced last year, associates will be automatically enrolled in the Preferred Plan for 2014. You may still choose to buy-up to the Premium Buy-Up plan, but we stress the importance of evaluating your out of paycheck cost vs. the out of pocket cost for medical care to ensure you are making a wise financial decision. We will also be introducing a working spouse premium surcharge which is explained in more detail on page 2.

Understanding that choice is important beyond the medical plan, we are making significant changes to our dental plan. To offer our associates the best benefits at the most competitive costs, we will be partnering with Ameritas as our dental provider effective 1/1/14. We have also redesigned the benefit options, offering you more choices that better reflect the needs of our associates. You will still have access to plans that cover all dental services; however, we will also be offering a “Core” dental plan that covers preventive and basic restorative dental care only at a much lower premium. Given that 95% of all dental services fall within those two categories, we believe that this will be of great value to our associates.

Benefits are an important part of your total compensation, so please review your options carefully. We will have Benefit Counselors onsite during Annual Enrollment to answer your questions and assist you in the enrollment process. Look for posters in your facility detailing more information about Annual Enrollment and one-on-one counselor meetings.

Eligibility

EligiblE AssociAtEs

All regular associates are eligible for coverage. For benefit plan purposes, “regular associates” are defined as:

• Full-time associates working 32–40 hours per week, or • Part-time associates working 20–31 hours per week. Regular associates are eligible after one month of active employment. Associates changing from a part-time to full-time position are eligible for coverage, subject to each location’s benefit eligibility guidelines and waiting period.

EligiblE DEpEnDEnts

As a regular associate, you may elect certain coverage options for your eligible dependents. Eligible dependents include:

• Your legal spouse;

• Your dependent child or stepchild up to age 26;

• Any child placed with you for adoption or for whom you have legal guardianship;

• Any unmarried, disabled child of any age who resides with you and who was medically certified as disabled prior to his/her 26th birthday and who is primarily dependent upon you for support;

• Any child under 26 years of age (including natural children, stepchildren, legally adopted children, and children placed with you for adoption) for whom health care coverage is required through a Qualified medical Child Support Order (QmCSO) or other court or administrative order – even if the child does not reside with you.

Health management reserves the right to require

documentation confirming dependent eligibility, including marriage and birth certificates, tax returns, court orders, and other legal documents.

EnrollmEnt WinDoW

New enrollments and benefit changes must be completed within 30 days of the date of employment or date of transfer to a benefit eligible position. Once your enrollment is complete, no changes are allowed until the next annual enrollment period (unless you experience a Qualifying Life Event).

QuAlifying lifE EvEnts

Other than during the annual enrollment period, you may only change your benefit elections and covered dependents within 30 days following a Qualifying Life Event.

QualifyinG life events include:

• Birth or adoption of a child by the associate or spouse; • marriage, legal separation, annulment, or divorce of the

associate;

• Death of the associate’s spouse and/or dependent; • Dependent’s loss of eligibility (see definition of Eligible

Dependents);

• termination or commencement of employment of associate’s spouse or dependent with health care coverage;

• Associate or spouse’s eligibility for medicare benefits; and

• Such other events as the plan administrator determines to be permitted under iRS Section 125 or any other applicable guidelines issued by the internal Revenue Service.

Dependents who are added as a result of a Qualifying Life Event are covered the day of the event, provided that enrollment for the dependent is requested within 30 days from the date of the event.

to make a change to your benefits, please call the

Employee Benefit Resource Center at 866.770.6520 within 30 days of the Qualifying Life Event.

Did you know?

As in the past, Health

Management continues to pay

more than 80% of your health

insurance premium.

Reminder for 2014 – Medical Plan Enrollment

If you do not participate in the enrollment process or do not waive medical coverage,

you will be automatically enrolled in the Preferred Plan for 2014. You will have the

option to buy-up to the Premium Buy-Up plan, but you must actively select that benefit

option during the enrollment process.

Medical

Be sure to take advantage of the

non-tobacco user premium discount!

non-tobAcco usEr prEmium Discount

introduced last year, Health management will continue to offer a $50 per month non-tobacco user premium discount in 2014. You have two ways to qualify for the premium discount:

1. At the time of Annual Enrollment, complete a Non-tobacco user Affidavit, stating that you have been tobacco-free for at least 6 months.

2. if you are currently a tobacco user, you can still qualify for the discount – simply enroll in the BCBS tobacco cessation program and complete 5 phone counseling sessions. As long as the program is completed by June 30, 2014, you will be refunded the full amount of non-discount dollars back to January 1, 2014, and you will receive the $50 discount each month going forward.

Working spousE Eligibility rulE

As we’ve communicated in the past, health care costs are rising each year and, in a continued effort to offer our associates benefit packages that are meaningful and affordable, we are introducing a Working Spouse provision to our medical plans in 2014.

to encourage associates to carefully consider their enrollment options, those with spouses who have access to their own employer-sponsored medical coverage will pay an additional $50 monthly fee to continue to cover their spouse under Health management’s medical plan. At the time of Annual Enrollment, if you enroll your spouse for medical coverage, you will be asked to confirm your spouse’s eligibility for other group medical coverage to determine if you will be subject to the $50 monthly fee to continue to cover your spouse in 2014.

sErvicE not AvAilAblE form (snA) AnD

non-HEAltH mAnAgEmEnt fAcility usE

Within our benefit plan, you receive a higher level of benefits if you use a Health management facility. Services are covered at 100% less minimal copays. if you choose to receive services at a non-Health management facility and those services are available at a Health management facility, the charges will not be covered and you will be responsible for 100% of the charges. However, if the service is not available at a Health management facility, the charges will be covered at the applicable in or Out of Network benefit level. to receive this benefit, you will need to submit a Service Not Available form (available in your local HR department) for approval.

there are some services like emergency room care and outpatient services under $500 that do not require a Service Not Available form. For a complete list, please see your local HR representatives.

mEDicAl bEnEfits

the medical program provides the framework for your good health and well-being. two Preferred Provider Organization (PPO) plan options are offered through Blue Cross Blue Shield (BCBS). You are not required to select a Primary Care Physician but may utilize BCBS network providers to access the most cost-effective services and treatments for you and your family. the plans provide in-network and network coverage. if you use out-of-network providers, your benefit levels may be reduced.

Keep in mind that additional rules apply to services performed at non-Health Management facilities when those services are available at a Health Management facility. For complete details regarding each plan, please refer to the individual Summary Plan Descriptions (SPDs), which can be found at https://www.benefitsconnect.net/hma.

nEW for 2014

• No limitations for pre-existing

conditions for all associates and

dependents.

• All medical plan copays will

apply towards your Out of Pocket

maximum (does not include

prescription drug copays).

• Working Spouse eligibility rule

for spouses with access to other

coverage.

• Slight increase in the medical

deductibles and Out of Pocket

maximums. See page 4 for details.

• Dialysis services will be covered at

Medical

Did you know? The mail order pharmacy

program can save you money on

maintenance medications!

prEscription Drug plAn

Prescription medications are categorized into three tiers. the type of medication you choose impacts how much you will pay out of pocket.

1. Generic drugs cost the least, yet they meet the same effectiveness and safety standards of brand name drugs. 2. Preferred brand name drugs are drugs that are on the

CVS Caremark preferred drug list.

3. non-preferred brand name drugs include medications that have equally effective and less costly generic equivalents and/or preferred brand alternatives. this category may include new drugs that do not yet have generic equivalents.

Prior autHorization and steP tHeraPy

to ensure that members receive the most appropriate and cost-effective drug therapy, our plans require that additional steps be taken before certain drugs are covered:

• Prior authorization: Certain clinical criteria must be met before some drugs are covered. Your doctor should call the CVS/Caremark pharmacy help desk to request prior authorization before prescribing a certain drug.

• step therapy: Requires members to try a lower cost prescription before moving to a higher cost brand drug. Your physician can authorize a brand name drug if there is a clinical reason that prevents you from taking the alternative therapy.

WalMart netWorK for non-Maintenance PrescriPtion discounts

We have a partnership with Walmart to provide pharmacy discounts to our associates. Please note that the discount applies to non-maintenance medications only. After two (2) 30-day fills at retail, maintenance medications must still be filled through mail Order whether purchased at Walmart or another pharmacy. See page 4 for discounted copay amounts.

mAintEnAncE AnD spEciAlty

mEDicAtions

fill liMit for lonG-terM Maintenance Medications

Your plan allows two 30-day fills of long-term medications1

at any pharmacy in the CVS Caremark network. After that, your plan will cover long-term medications only if you have 90-day supplies filled through the mail order service or at a CVS pharmacy.

this program is designed to help you avoid paying more out of pocket for your long-term medications. if you continue to have 30-day supplies filled, your plan will not pay for them. in order to have your prescriptions covered, all you need to do is have 90-day supplies filled through the mail order service or at a CVS pharmacy. Whether you choose mail order delivery or pick-up at a CVS pharmacy, you will pay the same copay.2

sPecialty Medications

CVS Caremark requires the use of the Specialty Pharmacy for specialized medicines and supplies. the Specialty Pharmacy offers personalized support services for

individuals suffering from certain chronic illnesses or genetic disorders. if you use specialty medications, you can receive express delivery, follow-up care calls, and expert counseling. to contact the CVS Caremark Specialty Pharmacy, call 800.237.2767.

1_{A term medication is taken regularly for chronic conditions or}

long-term therapy.

2_{Copay, copayment or coinsurance means the amount a plan participant is}

required to pay for a prescription in accordance with a Plan. Prices may vary between mail service and CVS pharmacies due to dispensing factors, such as applicable local taxes.

remember, with the Maintenance Medication Program and the reduced copay for the 90-day supply, you can save up to $200 a year!

Medical

1_{HMA Facilities include all Health Management hospitals.} 2_{Claims must be coded by the provider as routine, preventive care.}

3_{Copayment should not be paid a second time if covered member is readmitted to an HMA hospital for same diagnosis within the same benefit year or if}

covered member is transferred to another facility.

4_{If you do not use a participating CVS Caremark pharmacy, a portion of your costs may still be eligible for reimbursement.}

PRESCRIPTION DRUG BENEFIT

calendar year Prescription deductible: $ 50 individual / $ 100 family

Walmart discount network (excludes maintenance drugs)

retail (30-day supply) at participating4 _{cvs caremark}

pharmacies

Mail order (90-day supply) (this also includes maintenance

medications) Generic $9.00 copay $ 15 copay $ 30 copay Preferred Brand $31.50 copay $ 37.50 copay $ 75 copay Non-Preferred Brand $49.00 copay $ 55 copay $ 110 copay

MEDICAL PLAN COMPARISON

Blue cross Blue shield Preferred Plan Premium Buy-up Plan

HMa facilities1 _{in-network out-of-network in-network out-of-network}

calendar year deductible

individual _{None for hospital} services

$1,000 $1,000 $ 500 $ 500 Family $2,000 $2,000 $1,000 $1,000 calendar year out-of-Pocket Max. Out-of-Pocket Maximum includes medical copays and deductible. It does not include the Prescription Drug deductible or copays.

individual N/A $3,400 $6,800 $2,625 $5,250 Family N/A $6,800 $13,600 $5,250 $10,500 office visits

Preventive or Routine Physical2

(includes Well Baby / Well Child) Based on plan elected

100% covered not subject to deductible 100% covered not subject to deductible 100% covered not subject to deductible 100% covered not subject to deductible Office Visit / Sick Visit Based on plan _{elected after deductible}70% covered 70% of allowable _{charge after ded. after deductible}80% covered 80% of allowable _{charge after ded.} Emergency Room Visit

(copay waived if admitted)

$125 copay then 100%, not subject to ded. excluding physician services $125 copay then 70% covered after deductible $125 copay then 70% if urgent or 50% of allowable charge after ded.

$125 copay then 80% covered after deductible $125 copay then 80% if urgent or 60% of allowable charge after ded. inpatient Hospital services

Facility Charges3

including Room & Board

$250 copay then 100%, not subject to deductible 70% covered after deductible 50% of allowable charge after deductible 80% covered after deductible 60% of allowable charge after deductible Physician and Surgeon Services Based on plan _{elected after deductible}70% covered 70% of allowable charge after

deductible 80% covered after deductible 80% of allowable charge after deductible outpatient facility services

Surgery 100% not subject to _{deductible after deductible}70% covered 50% of allowable charge after deductible 80% covered after deductible 60% of allowable charge after deductible medical 100% not subject to _{deductible after deductible}70% covered 50% of allowable charge after

deductible 80% covered after deductible 80% of allowable charge after deductible Physician and Professional Services Based on plan _{elected after deductible}70% covered 70% of allowable charge after

deductible 80% covered after deductible 80% of allowable charge after deductible Diagnostic Lab & X-ray 100% not subject to _{deductible after deductible}70% covered

70% (physician) 50% (hospital) of allowable charge after deductible 80% covered after deductible 80% (physician) 60% (hospital) of allowable charge after deductible lifetime Maximum unlimited unlimited unlimited

Dental – New for 2014

compAring tHE plAns

• the Core Plan is the least expensive and provides coverage for preventive and basic services both in- and out-of-network.

• the in-Network Dental Only Plan provides coverage for preventive, basic, and major services both in- and out-of-network.

• the in-Network Dental + Ortho plan provides coverage for all types of services (including orthodontia), both in- and out-of-network.

• the PPO Dental + Ortho Plan is the most expensive and provides the most in-depth coverage both in-

and out-of-network.

out of nEtWork sErvicEs

While the in-Network Dental Only and in-Network Dental + Ortho plans cover benefits for Out of Network providers, the reimbursement level for Out of Network providers is much lower and associates may be subject to larger out of pocket costs even for covered services.

to make the most of your dental benefits, it is important for associates to review the network list to confirm that:

1. Your preferred dental provider is in the Ameritas network, or

2. there are in-network providers in your area that you can access.

DENTAL PLAN OPTIONS

ameritas core Plan _{dental only Plan}in-network _{dental + ortho Plan}in-network PPo dental + _{ortho Plan}

Annual Deductible (individual / family) $50 / $150 $50 / $150 $50 / $150 $50 / $150 Annual maximum Benefit (per person) $750 $1,250 $1,250 $1,500 Lifetime Orthodontia maximum (per person) N/A N/A $1,500 $1,500 covered services

Preventive & Diagnostic (Class i) Covered 100% Covered 100% Covered 100% Covered 100% Basic Restorative (Class ii) Covered 80% Covered 80% Covered 80% Covered 80% major Restorative (Class iii) Not covered Covered 50% Covered 50% Covered 50% Orthodontia (Class iV)

Adult and child coverage Not covered Not covered Covered 50% Covered 50%

Health Management offers several dental plan options through Ameritas. The variety of options allows you to choose the plan that best suits you and your family’s dental needs. Benefit plan options range from plans that cover preventive care and basic services only to a full coverage plan that includes orthodontic coverage.

Lowest

Vision

1_{You are required to pay the provider in full at the time of your appointment and submit a claim within a year from the date of}

service to VSP for partial reimbursement. If you decide to see a provider not in the VSP network, call VSP first at 800.877.7195.

2_{Contact lenses may be elected in lieu of lenses and frames.}

VISION PLAN COMPARISON

Base Plan Premier Plan

in-network out-of-network1 _{in-network out-of-network}1

Benefit frequency

Vision Exam Every 12 months Every 12 months Lenses/Contact Lenses2 _{Every 12 months Every 12 months}

Frames Every 24 months Every 12 months covered services

Vision Examination _{after $10 copay}Covered in full $45 allowance _{after $10 copay}Covered in full $45 allowance Laser Vision Correction

Discount at select providers averaging 15% off regular price or 5% off promotional price

Not Covered

Discount at select providers averaging 15% off regular price or 5% off promotional price

Not Covered Additional Services 30% off lens options and Average of

20% off additional glasses Not Covered

Average of 30% off lens options and

20% off additional glasses Not Covered Materials

Standard Lenses _{after $25 copay}Covered in full _{depending on lens type}$45-$85 allowance _{after $25 copay}Covered in full _{depending on lens type}$45-$85 allowance Progressive Lenses Discounted for adults Covered in full $65 allowance Frames _{20% off out-of-pocket costs}$150 allowance $70 allowance _{20% off out-of-pocket costs}$150 allowance $70 allowance Contact Lenses (includes contact lenses$150 allowance

and fitting fees) $105 allowance

$150 allowance (includes contact lenses

and fitting fees) $105 allowance

The VSP Vision Plan provides you and your family with quality vision benefits at an affordable cost. The program is designed to encourage you and your family to visit the optometrist or ophthalmologist regularly to maintain your vision health. In addition, optometrists and local service facilities can supply you with the necessary hardware and materials to meet your daily vision needs.

the following are highlights of the major plan provisions. You should refer to the individual plan brochure for specific details regarding the plan.

• two plan choices

• in- and out-of-network benefits

• Copay for all office visits and glasses in-network • Discounts available at point-of-purchase

• Find a provider in the Signature Network at https://vsp.com/find-doctor-login.html

Flexible Spending Accounts

Even if you use your debit card,

save your receipts! The FSA plan

is a pre-tax benefit and regulated

by the IRS. The IRS requires that all

reimbursed expenses be verified

so you may be required to submit

the receipts to the FSA vendor

as confirmation the expenses are

eligible.

HEAltHcArE fsA

Your entire annual contribution (maximum of $2,500) is available immediately at the beginning of the plan year (January 1) to pay for eligible healthcare expenses. However, your total FSA election amount is deducted from your paycheck in equal amounts during the plan year, January 1 through December 31, 2014.

if you elect a healthcare FSA for the 2014 plan year, you will have a 75-day grace period (until march 15, 2015) in which you can continue to spend dollars left in your account at the close of the 2014 plan year. You will then have 15 days (until march 30, 2015) to submit claims against the funds left in your account. Any funds remaining in an FSA after the claims submission deadline are forfeited; this is known as the “use-it-or-Lose-it Rule.”

eliGiBle exPenses

FSAs and eligible expenses are regulated by the iRS. Some examples of eligible healthcare expenses include:

• Office copays; • Prescription drugs;

• Dental expenses, including child orthodontia and medically-necessary adult orthodontia. Date of service must be within the plan year to receive reimbursement. if you are terminated, the date of service must have occurred while you were actually employed;

• Vision care expenses, including laser eye surgery; • Chiropractic services;

• Acupuncture;

• Over-the-counter healthcare products (must be accompanied by a doctor’s prescription).

HealtHcare fsa deBit card

if you enroll in a healthcare FSA, you will receive a debit card that you may use to pay for eligible expenses. the debit card helps you avoid paying expenses out of your pocket and waiting for reimbursement. Please keep receipts or other records of your FSA debit card purchases, as the iRS requires documentation to prove the expense was for an approved healthcare purchase.

suBMittinG PaPer claiMs

if you would rather submit paper claims forms instead of using the Debit Card (or your dependent care facility doesn’t accept debit cards), go online to www.outsourceone.com and click on “Employees & Participants” to download the necessary forms. Paper claims can be faxed to 877.491.6016 or scanned and emailed to flex@outsourceone.com.

if you have general FSA questions, you can call customer service at 855.828.3954.

accessinG your account

use the following information to log-on and check your account balance or review FSA activity:

1. Visit www.benefitspaymentsystem.com and click “Participant Login.”

2. Enter your user iD (your social security number).

3. Enter your Password (either our Employer iD – OSOHmA – or your 16-digit debit card number).

DEpEnDEnt cArE fsA

unlike the Healthcare FSA, the Dependent Care FSA is not loaded with the full election amount on the first day of the plan year. instead, the funds become available as they are collected from each paycheck. You can only spend funds that are currently available in your account.

• Current tax laws allow you to set aside up to $5,000 annually to pay for employment-related child daycare or adult dependent care. Please keep this in mind as you consider your plan year FSA election.

• Dependent care expenses are reimbursed based on the availability of funds in your account.

A Flexible Spending Account (FSA) is a benefit that allows you to designate pre-tax dollars at the beginning of the plan year to pay for eligible out-of-pocket healthcare and dependent care expenses. The money you set aside reduces your taxable income, which can save you money at tax season. You can participate in an FSA even if you are not enrolled in a medical plan. The FSA plans are administered by CieloStar.

Disability and Basic Life Insurance

For complete details regarding each plan,

please refer to the appropriate Summary Plan

Description (SPD), which can be found by

logging on to https://www.benefitsconnect.

net/hma after January 1, 2014.

DisAbility insurAncE

Disability plans provide you with financial protection if you have to miss work due to a non-occupational disability. Benefits from a disability plan will supplement your income to help you pay for your day-to-day household expenses, as well as co-payments and other medical costs not covered under other plans.

sHort terM disaBility Plan (std)*

Amount of Coverage

Eligible associates that elect StD coverage have a weekly benefit of 60% of salary up to $1,000, subject to plan requirements.

Maximum Benefit Period

Benefits begin on the 22nd day of disability resulting from an accident, sickness, or pregnancy. Benefit payments could continue for up to 23 weeks.

voluntary lonG terM disaBility Plan (ltd)*

Long Term Disability (LTD) is now voluntary.

As of July 1, 2013, Long term Disability is a voluntary, associate-paid benefit. We offer two plans so that as with our other benefits, you can choose the option that best suits your needs.

Eligible associates that elect the LtD plan can receive a monthly benefit designed to replace income lost during periods of disability greater than 180 days.

Amount of Coverage

the LtD benefit option will pay either 50% or 60% of monthly earnings to a maximum benefit of $10,000 per month. if disabled prior to age 60, benefits are payable to age 65. if disabled at age 60 or older, benefits are payable subject to a reduction schedule defined by the plan.

bAsic tErm lifE/AcciDEntAl DEAtH &

DismEmbErmEnt (AD&D) insurAncE

to ensure that all eligible associates have some level of financial protection, Health management provides employer-paid Basic term Life and AD&D insurance to full-time associates. Both policies are provided at no cost to you. You are automatically enrolled in Basic term Life and AD&D insurance when you become eligible for coverage.

Basic terM life

the Basic term Life plan provides non-exempt associates with a policy equal to 1 times annual salary and 2 times annual salary for exempt associates, up to a maximum of $750,000. “Salary” excludes overtime, shift differential, bonuses, etc. and is rounded to the next higher $1,000.

ad&d

AD&D insurance pays a benefit in addition to the Basic term Life insurance if the death or covered loss is due to an accident. the AD&D policy amount is equal to that of the Basic term Life policy provided by Health management.

aGe reduction scHedule for Basic terM life and ad&d

Benefits are reduced to 65% at age 65 and to 60% at age 70. Coverage ends once you terminate employment.

* Note: Evidence of Insurability (EOI)

must be provided for associates

currently enrolled in the 50% LTD plan

who elect the 60% option, as well as

for late entrants. EOI requires carrier

approval. A ‘late entrant’ is someone

who did not enroll when first eligible for

coverage.

Additional Life Insurance Options

Note: Evidence of Insurability (EOI) may be

required for late entrants and requires carrier

approval. A ‘late entrant’ is someone who did not

enroll when first eligible for coverage. Children

under age 19 are not subject to EOI.

AssociAtE optionAl lifE insurAncE

Even if you already have a life insurance policy outside of your benefit plan, it’s important to ask yourself whether it provides the protection you need to cover all of your financial responsibilities in the event of your passing. Optional Life can be purchased in addition to the Basic term Life insurance that is provided by Health management.

Associate Optional Life insurance is yearly renewable group term life insurance that covers you for as long as you remain eligible and continue to pay your premium. Coverage is portable, so you can take it with you if you leave the company, although the premiums may change.

aMount of coveraGe

You may purchase coverage in the amount of 2 times your annual salary, rounded up to the nearest $1,000.

total life insurance coverage (Basic term + Optional Life amount) cannot exceed $750,000. Coverage ends once you terminate employment unless you choose to port the coverage, at your cost.

DEpEnDEnt lifE insurAncE

Dependent Life insurance is a group term life insurance policy that can be purchased for your spouse and children. the dependent life insurance rate is not affected by the number of dependents you want to cover. One rate covers all of your dependent children and your spouse. Newly elected coverage for totally disabled dependents will be delayed until the first of the month following the date the dependent is no longer totally disabled.

WHolE lifE insurAncE

With Whole Life insurance, you own the policy, which means you can keep it even if you leave the company. it is sometimes referred to as “permanent life insurance” because it can provide protection for your lifetime. Whole Life insurance policies can provide protection for both working years and post-retirement, while building cash value to use as a living benefit. under this plan, which is available through unum, you can select the amount of individual coverage that you would like to have for yourself, your spouse, your children, and/or your grandchildren. individual policies are available for you and your spouse up to age 80, and for children from 14 days to 26 years old. You can apply for coverage by completing a simple application with a Benefit Counselor.

tEn yEAr tErm lifE insurAncE

Life insurance comes in a variety of forms. Depending on where you are in life, you may need different amounts and durations of coverage. term insurance is the least expensive form of life insurance. it’s commonly called “temporary insurance” because term life is not designed to last

forever. ten Year term is the most popular form of term life insurance policy because it is very inexpensive even at large face amounts and is relatively easy to obtain.

ten Year term Life guarantees you a fixed premium for 10 years, based on your age at time of purchase. this fixed premium renews after 10 years of coverage and is recalculated based on your age at the time of renewal.

While life insurance can seem like a complex and even unsettling subject, it is actually a wonderfully useful and flexible estate-planning tool that can provide tax-free security for your loved ones. Health Management offers various life insurance options, which are conveniently funded through payroll deductions. If you are unsure which options are right for you, a Benefit Counselor will be able to provide you with guidance.

insured amount of coverage eoi rules Yourself increments of $10,000, _{up to $150,000 $100,000 requires EOi}Coverage above Spouse* up to $50,000 _{$25,000 requires EOi}Coverage above

*For spouses age 51-55, EOI required for over $10,000

amount of coverage age amount Spouse Any $ 25,000 Children 14 days to 6 months $ 500 Children 6 months to 26 years $ 10,000

Voluntary Benefits

Voluntary Benefits can

be a great supplement

to your medical

coverage!

AcciDEnt insurAncE

Designed to supplement your medical coverage, accident insurance pays specific benefit amounts for covered accidents. Benefits from your accident insurance plan can help you pay for out-of-pocket expenses related to an accidental injury. the payment correlates with the type of accident, and can be used any way you choose.

exaMPles of covered injuries include: • broken bones • burns • torn ligaments • concussions • eye injuries • ruptured discs exaMPles of covered exPenses include:

• emergency room treatment • doctor’s office visits

• hospitalization • physical therapy

criticAl illnEss

insurAncE

Critical illness insurance can help fill a financial gap if you experience a life-threatening illness. upon diagnosis of a covered illness, a lump-sum benefit is immediately paid. this will help cover out-of-pocket medical expenses or costs associated with adjusting to life following a covered critical illness. You may choose coverage amounts ranging from $10,000 to $30,000.

covered illnesses include:

• Heart attack • Stroke

• major organ transplant

• Paralysis due to covered accident • End-stage renal (kidney) failure • Coronary artery bypass surgery

exaMPles of covered exPenses include:

• medical expenses and alternative treatments

• Household and childcare expenses • travel and lodging to a treatment

facility in another city

Note: EOI may be required for late entrants and requires carrier approval. A ‘late entrant’ is someone who did not enroll when first eligible for coverage.

cAncEr insurAncE

in the event of a first-occurence covered cancer diagnosis, a lump-sum benefit is paid to the insured. the benefit can be used to cover medical or non-medical expenses. With an extra level of financial protection, it is easier to focus on recovery.

coveraGe Benefits

upon diagnosis1 _{with cancer, a}

policyholder can receive financial benefits that supplement existing medical insurance.

1_{A covered cancer diagnosis includes covered}

treatments received for cancer or for certain specified diseases.

Note: EOI may be required for late entrants and requires carrier approval.

These plans offer enhanced protection for extenuating health circumstances. You can take the coverage with you if you leave the company, as long as you continue making premium payments to the insurance carrier.

Other Benefits

voluntAry lifEstylE

bEnEfits

Lifestyle Benefits can help you and your family save money on a variety of services. the cost for Voluntary Lifestyle Benefits is $14.99 per month.

eMerGency roadside assistance

• With Nations Safe Drivers, be prepared with up to 15 miles of towing (up to $80 retail value) per occurrence. Also receive flat tire assistance, fuel, oil, water delivery, lock-out assistance, battery assistance, and more.

leGal services

• Over 20,000 attorneys offer free services for consultations, new legal matters, legal documents, small claims court representation, welfare and iNS issues, and simple wills. Additional matters receive discounts.

tax HelP line

• Get advice on federal taxes and free tax return preparation for forms 1040 EZ, 1040A, and Standard 1040. Also, access the online member portal for tax tips, tax law changes, tax advice, and more.

lifelocK™ id tHeft Protection

• the identity Alert™ System provides early notification if your personal information is used to apply for multiple lines of credit or services. individual and family coverage options are available.

Pet assure™ savinGs ProGraM

• Save 25% on all in-network vet services – no exclusions, forms, or deductibles. All pets in the household included.

fitness center discounts

• Provides the lowest membership rates at over 8,500 fitness centers nationwide, guaranteed.

EmployEE AssistAncE

progrAm

the Employee Assistance Program (EAP) through ValueOptions is a professional counseling service that offers confidential help for day-to-day concerns or during difficult times. Counseling through the EAP is a free benefit provided to all associates and eligible dependents.

Your EAP provides a full range of counseling and referral services for issues such as:

• individual, family and marital concerns; • Stress and job-related pressures; • Child and domestic abuse; and • Chemical and alcohol dependency

assessment.

Resources are also available to assist with financial issues such as getting out of debt, planning for retirement, and preparing your taxes.

Your ValueOptions plan provides up to five individual counseling sessions for you and your dependents, per person, per problem, per year. When additional help is needed, the EAP will assist with referrals to other providers and programs. Counseling is available by phone or in person and appointments can be scheduled 24 hours a day, seven days a week by calling 866.259.7909.

You also access information, tools, and services online at www.achievesolutions.

net/HMa.

purcHAsing poWEr

For budget-conscious people who don’t want to use cash or credit, Purchasing Power is the premier program that offers you a better way to buy name-brand products. Purchasing Power allows you to purchase and pay for name-brand products through payroll deduction. Purchasing Power makes it easy to budget since manageable payments automatically come out of your paycheck in equal installments over 12 months. to help protect you from overextending your paycheck, individual spending limits are based on your annual income.

After you enroll, there are no fees beyond the all-inclusive enrollment price. Plus, you’ll know the total price up front, which includes the product, financing, taxes and delivery.

PurcHasinG PoWer details

• use payroll deduction to make

manageable payments over just months. • it’s not a layaway plan - your

merchandise is delivered right to your door just a few weeks after your program begins.

• Shopping is easy - you can do it online or by phone.

• No credit check is necessary for qualified employees.

• Over 350,000 orders have been placed by thousands of satisfied program participants.

For additional details, visit www.HmA. purchasingpower.com, and use the group code: HmA2284. You can also contact Purchasing Power at 866.670.3479.

NOTE: To be eligible for this benefit you must have worked at least six months and make $16,000 per year or more.

rEtirEmEnt sAvings plAn,

401(k)

the Health management 401(k) Retirement Savings Plan allows you to put aside money on a pre-tax basis. the money you allocate to a 401(k) account is automatically deducted from your paycheck. You can choose from a variety of investment options to help you grow your retirement savings. this plan is flexible and allows you to increase or decrease your contributions at any time.

upon eligibility, 4% of your compensation will be automatically deducted from your paycheck on a pre-tax basis unless you make a different election in the first 45 days of eligibility. Contributions can range from 1% to 75% of your eligible pay, up to the iRS contribution limits for the year. Refer to www.irs.gov for 2014 contribution limits. to modify your contribution or decline participation, refer to the Health management Retirement Savings Plan Enrollment Learning Guide (available at www.prudential.com) or contact member Services at 877.778.2100.

mEtlifE Auto & HomE

insurAncE progrAm

Health management makes it easy for you to get the advantages of metLife Auto & Home insurance with at a discounted rate. A few perks include:

• Group discount of up to 15%

• up to 10% payroll deduction discount with no down payment needed, in most cases

• Convenient payment options, including debit and credit cards

• Superior driver discount available in most states

• Employment tenure discount available in most states

• identity protection services

All full-time and part-time associates are eligible to enroll in this program. to enroll or get more information on this benefit:

• 1-800-GEt-mEt-8 (1.800.438.6388) • www.metlife.com/mybenefits

Please note that these are individual insurance policies and must be underwritten by a MetLife representative based on your specific circumstances and insurance needs.

Legal Notifications

WomEn’s HEAltH Act

the Women’s Health and Cancer Rights Act of 1998 requires that all health insurance plans that cover mastectomy also cover the following medical care: • Reconstruction of the breast on which

the mastectomy was performed, • Surgery and reconstruction of

the other breast to produce a symmetrical appearance,

• Prostheses and treatment of physical complications at all stages of the mastectomy, including lymphedemas, and mastectomy bras and external prostheses limited to the lowest cost alternative available that meets the patient’s physical needs.

mEDicAiD AnD tHE

cHilDrEn’s HEAltH

insurAncE progrAm (cHip)

offEr frEE or loW-cost

HEAltH covErAgE to

cHilDrEn AnD fAmiliEs

if you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. these States use funds from their medicaid or CHiP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.

if you or your dependents are already enrolled in medicaid or CHiP, you can contact your State medicaid or CHiP office to find out if premium assistance is available.

if you or your dependents are NOt currently enrolled in medicaid or CHiP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State medicaid or CHiP office or dial 1.877.KiDS NOW or www. insurekidsnow.gov to find out how to apply. if you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium

assistance under medicaid or CHiP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. this is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

in some states, you may be eligible for assistance paying your employer health plan premiums. You should contact your State for further information on eligibility. For more information on special enrollment rights, you can contact either:

• u.S. Department of Labor Employee Benefits Security Administration: www.dol.gov/ebsa or 1.866.444. EBSA (3272)

• u.S. Department of Health and Human Services Centers for medicare & medicaid Services: www.cms.hhs.gov or 1.877.267.2323, Ext. 61565

HEAltH insurAncE

portAbility AnD

AccountAbility Act

(HipAA)

Health management, in accordance with HiPAA, protects your Protected Health information (PHi). Health management will only discuss your PHi with medical providers and third-party administrators when necessary to administer the plan that provides your medical, dental, and vision benefits, or as mandated by law. A copy of the Notice of Privacy Practices is available upon request in the Human Resources Department.

continuAtion rEQuirED

by fEDErAl lAW for you

AnD your DEpEnDEnts

the Continuation Required by Federal Law does not apply to any benefits for loss of life, dismemberment or loss of income. Federal law enables you or your dependent to continue health insurance if coverage would cease due

to a reduction of your work hours or your termination of employment (other than for gross misconduct). Federal law also enables your dependents to continue health insurance if their coverage ceases due to your death, divorce or legal separation, or with respect to a dependent child, failure to continue to qualify as a dependent. Continuation must be elected in accordance with the rules of your employer’s group health plan(s) and is subject to federal law, regulations and interpretations.

nEWborns’ AnD motHErs’

HEAltH protEction Act

Federal law (Newborns’ and mothers’ Health Protection Act of 1996) prohibits the plan from limiting a mother’s or newborn’s length of hospital stay to less than 48 hours for a normal delivery or 96 hours for a Cesarean delivery or from requiring the provider to obtain preauthorization for a stay of 48 or 96 hours, as appropriate. However, federal law generally does not prohibit the attending provider, after consultation with the mother, from discharging the mother or her newborn earlier than 48 hours for normal delivery or 96 hours for Cesarean delivery.

importAnt noticE from

HEAltH mAnAgEmEnt

About your prEscription

Drug covErAgE AnD

mEDicArE

Note: if you or your family members aren’t currently covered by medicare and won’t become covered by medicare in the next 12 months, this notice does not apply to you.

the purpose of this notice is to advise you that the prescription drug coverage offered by the Health management medical plan is expected to pay out, on average, at least as much as the standard medicare prescription drug coverage will pay in 2014.

WHy tHis is iMPortant?

if you or your covered dependent(s) are enrolled in any prescription drug coverage during 2013 listed in this

Legal Notifications

medicare, you may decide to enroll in a medicare prescription drug plan later and not be subject to a late enrollment penalty – as long as you had creditable coverage within 63 days of your medicare prescription drug plan enrollment. You should keep this notice with your important records.

notice of creditaBle coveraGe

You may have heard about medicare’s prescription drug coverage (called Part D), and wondered how it would affect you. Prescription drug coverage is available to everyone with medicare through medicare prescription drug plans. All medicare prescription drug plans provide at least a standard level of coverage set by medicare. Some plans also offer more coverage for a higher monthly premium.

individuals can enroll in a medicare prescription drug plan when they first become eligible, and each year from November 15 through December 31. individuals leaving employer coverage may be eligible for a medicare special enrollment period.

if you are covered by any of the medical prescription drug plans offered by Health management, you’ll be interested to know that coverage is, on average, at least as good as or better than the standard medicare prescription drug coverage for 2014. this is called creditable coverage. Coverage under these plans will help you avoid a late Part D enrollment penalty if you are or become eligible for medicare and later decide to enroll in a medicare prescription drug plan. if you decide to enroll in a medicare prescription drug plan and you are an active associate or family member of an active associate, you may also continue your employer coverage. in this case, the employer plan will continue to pay primary or secondary as it had before you enrolled in a medicare prescription drug plan. if you waive or drop the Health management coverage, medicare will be your only payer. You can re-enroll in the employer plan at annual enrollment or if you have a

special enrollment event.

You should know that if you waive or leave coverage with Health management and you go 63 days or longer without creditable prescription drug coverage (once your applicable medicare enrollment period ends), your monthly Part D premium will go up at least 1% per month for every month that you did not have creditable coverage. For example, if you go 19 months without coverage, your medicare prescription drug plan premium will always be at least 19% higher than what most other people pay. You’ll have to pay this higher premium as long as you have medicare prescription drug coverage. in

addition, you may have to wait until the following November to enroll in Part D. You may receive this notice on

future occasions such as your next opportunity to enroll in medicare prescription drug coverage, a change in Health management’s prescription drug coverage, or upon your request.

for More inforMation aBout your oPtions under Medicare PrescriPtion druG coveraGe:

Detailed information about medicare plans that offer prescription drug coverage is in the medicare & You handbook. medicare participants will get a copy of the handbook in the mail every year from medicare. You may also be contacted directly by medicare prescription drug plans. Here’s how to get more information about medicare prescription drug plans:

• Visit www.medicare.gov for personalized help.

• Call your State Health insurance Assistance Program (see a copy of the medicare & You handbook for the telephone number).

• Call 1.800.mEDiCARE

(1.800.633.4227). ttY users should call 1.877.486.2048.

For people with limited income and resources, extra help paying for a medicare prescription drug plan is available from the Social Security Administration (SSA). For

more information, visit SSA online at www.socialsecurity.gov or call 1.800.772.1213 (ttY 1.800.325.0778). Keep this notice. if you enroll in a medicare prescription drug plan after your applicable medicare enrollment period ends, you may need to provide a copy of this notice when you join a Part D plan to show that you are not required to pay a higher Part D premium amount.

For more information about this notice or your prescription drug coverage, call your local Human Resources department.

AvAilAbility of summAry

HEAltH informAtion

As an associate, the health benefits available to you represent a significant component of your compensation package. they also provide important protection for you and your family in the case of illness or injury.

Your plans offer a series of health coverage options. Choosing a health coverage option is an important decision. to help you make an informed choice, your plan makes available a Summary of Benefits and Coverage (SBC), which summarizes important information about any health coverage option in a standard format, to help you compare across options.

You can access the SBC in the following ways:

1. Log in to the intranet at http:// myintranet.hma.com and go to Shared Services > Human Resources > Benefits > Summary of Benefits and Coverage.

2. Contact your local HR department for a paper copy.

3. After January 1, 2014 the SBC will be posted on https://www. benefitsconnect.net/hma.

BENEFIT PLAN ADMINISTRATOR CONTACT NUMBER WEBSITE

Medical BCBS 888.344.7088 MyHealthToolkitFL.com Pharmacy CVS Caremark 888.892.7272 caremark.com

Dental Ameritas 800.598.8014 www.ameritasgroup.com/hma Vision VSP 800.877.7195 VSP.com

Flexible Spending Accounts

(FSAs) CieloStar Phone: 855.828.3954Fax: 877.491.6016 email: flex@outsourceone.comoutsourceone.com Life and AD&D Insurance

• Life Claims Prudential 800.524.0542 prudential.com • Portability Prudential 800.778.3827 prudential.com • Conversions Prudential 877.889.2070 prudential.com • Evidence of Insurability

Status Prudential 888.257.0412 prudential.com Short and Long Term Disability Prudential Contact Human Resources prudential.com Whole Life Insurance Unum 800.635.5597 unum.com Ten Year Term Life Insurance Unum 800.635.5597 unum.com Accident Insurance Unum 800.635.5597 unum.com Critical Illness Insurance Unum 800.635.5597 unum.com Cancer Insurance _{Administrators}Bay Bridge 800.845.7519 bbadmin.com Voluntary Lifestyle Benefits _{Lifestyle Perx}Health and 800.800.7616 HMAperx.com Purchasing Power Purchasing Power 866.670.3479 HMA.purchasingpower.com Retirement Plan / 401(k) Prudential 877.778.2100 prudential.com Employee Assistance Program ValueOptions 866.259.7909 achievesolutions.net/HMA Vacation, Holiday, & Sick Pay Health Management Contact Your Manager N/A