COVERAGE OPTIONS Fixed Indemnity Plans Enhance your coverage by adding Dental, Vision, Short-term Disability and/or Life and AD&D Insurance

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1 2016 NEW HIRE ENROLLMENT IS HERE TIME TO MAKE YOUR BENEFIT CHOICES AMN Healthcare values the contributions of our heatlhcare professionals. In appreciation of your dedicated service, we are pleased to offer an affordable package of benefits provided by The American Worker. A variety of coverage options are available so you can choose the plans that best meet the needs of you and your family. WHY CHOOSE THE AMERICAN WORKER? WHAT IF I DON T HAVE HEALTH INSURANCE? Access to medical care is essential to staying healthy as it can prevent minor issues from becoming more severe. While our medical indemnity plan does not constitute comprehensive health coverage it is designed to cover basic healthcare services so you can get treatment when needed. DO YOU ALREADY HAVE HEALTH INSURANCE (SPOUSAL, INDIVIDUAL OR GOVERNMENTAL)? Many major medical programs have large out-of-pocket costs. Our plans pay in addition to other coverage, so you can use the cash paid by our plan to offset deductibles, coinsurance or other expenses incurred when receiving treatment. DO YOU NEED DENTAL OR VISION INSURANCE? Poor oral and visual health affects your overall well-being. Our plans provide coverage for exams and diagnostic services so you can keep yourself healthy. ARE YOU SEEKING FINANCIAL PROTECTION? Accidents, illnesses or death are emotionally distressing and often financially difficult. Our plan pays cash to help ease the financial burden and protect your loved ones during these troubling times. Fixed Indemnity Plans Enhance your coverage by adding Dental, Vision, Short-term Disability and/or Life and AD&D Insurance Fixed Indemnity Plans Short-term Disability Life and AD&D Insurance Life and Critical Illness Package Dental Vision Short-term Disability Life and AD&D Insurance Life and Critical Illness Package 2016 NEW HIRE ENROLLMENT Enrollment Period: You have 0 days from your date of hire to enroll in coverage Enroll Online: Visit Available anytime day or night Enroll by Phone: Call Monday - Friday: 5:00 AM to 5:00 PM PT LOGIN INSTRUCTIONS ( Click Start Here at the top of the page Then, in the box titled New User? select Social Security # and in the fields below enter your - Social Security Number - Date of Birth After clicking Continue you will create an account by setting up a username, password and security question Click Continue and you will be able to enroll in coverage

2 FIXED INDEMNITY COVERAGE The American Worker Fixed Indemnity plans provide affordable, first dollar coverage. These plans offer coverage for basic healthcare services and prescription expenses. The Fixed Indemnity plans also pay in addition to other coverage you may have, which can help cover out-of-pocket expenses such as deductibles or coinsurance incurred when receiving medical treatment. The Fixed Indemnity plans are underwritten by Nationwide Life Insurance Company. Both plans include the Companion Rx benefit, First Health Network and New Benefits Health Service discount program which are provided by separate vendors. PHYSICIAN S OFFICE OUTPATIENT DIAGNOSTIC LAB OUTPATIENT DIAGNOSTIC X-RAY OUTPATIENT DIAGNOSTIC ADVANCED STUDIES PREVENTIVE CARE EMERGENCY ROOM SICKNESS Standard Plan Pays $60 per Day, 6 Days per Person per Year Plan Pays $50 per Testing Day, Plan Pays $100 per Testing Day, Plan Pays $100 per Testing Day, Plan Pays $75 per Day, Plan Pays $100 per Day, 2 Days per Person per Year Preferred Plan Pays $75 per Day, 6 Days per Person per Year Plan Pays $100 per Testing Day, 4 Days per Person per Year Plan Pays $200 per Testing Day, Plan Pays $500 per Testing Day, Plan Pays $75 per Day, Plan Pays $150 per Day, 2 Days per Person per Year ACCIDENTAL INJURY CARE Plan Pays up to $500 per Occurrence Plan Pays up to $1,000 per Occurrence SURGICAL Daily Inpatient Daily Outpatient Daily Outpatient Minor Outpatient Benefit Maximum Plan Pays $1,000, Plan Pays $500 Plan Pays $100 Plan Pays $2,000, Plan Pays $1,000 Plan Pays $200 ANESTHESIA Plan Pays 0% of Surgical Benefit Plan Pays 0% of Surgical Benefit DAILY OUTPATIENT SURGICAL FACILITY DAILY IN-HOSPITAL INDEMNITY 500 Day Lifetime Maximum Plan Pays $1,000 per Day, 500 Day Lifetime Maximum HOSPITAL ADMISSION (Single Sum) Plan Pays $500 per Confinement Plan Pays $1,000 per Confinement INTENSIVE CARE UNIT SUBSTANCE ABUSE MENTAL ILLNESS SKILLED NURSING Plan Pays $1,000 per Day, Up to 60 Days per Person per Stay Plan Pays $2,000 per Day, Up to 10 Days per Person per Year Up to 60 Days per Person per Stay PRESCRIPTION DRUGS Included - See page Included - See page FIRST HEALTH NETWORK Physicians and Hospitals Physicians and Hospitals NEW BENEFITS DISCOUNT PROGRAM Included - See page Included - See page + Spouse + Child(ren) $26.44 $60.90 $45.57 $68.94 $44.18 $ $77.50 $ IMPORTANT NOTE: The Fixed Indemnity plans are (a) not a substitute for minimum essential health coverage under the Affordable Care Act (ACA); and (b) do not qualify as minimum essential coverage under the ACA. 2

3 ADDITIONAL PLAN FEATURES Prescription Drug Benefit - Companion Rx The Companion Rx pharmaceutical program saves you money and takes the guess work out of paying for prescription medications. Formulary Generic Drugs: $10 co-pay for a typical 0-day supply Formulary Brand Name Drugs: $0 co-pay for a typical 0-day supply Non-formulary Generic and Brand Name Drugs: Discounts Only Monthly Maximum: $250 per member or $500 per family Accepted at nearly 50,000 network pharmacies nationwide. To view the formulary list of covered drugs, visit First Health Network Members have access to the First Health Network, which provides savings on Physician and Hospital services. By visiting a First Health provider you can reduce your out-of-pocket expenses. Over 490,000 provider locations across the country Network providers submit claims for you to simplify the claim process To locate a provider online, visit You can visit a First Health or out-of-network provider for service and the Fixed Indemnity plan will pay the same benefit amount. New Benefits Health Services Discount Program* This package of health service and discount programs can help reduce out-of-pocket expenses and provide savings on a variety of services that promote healthy living. Teladoc 1 : 24/7 access to a network of U.S. board-certified doctors that will diagnose, treat and prescribe medication, when necessary, over the phone for medical issues including cold or flu symptoms, allergies, bronchitis, ear infections and more. Medical Bill Saver TM : can help lower out-of-pocket costs on medical or dental bills over $400 through provider negotiation. Medical Health Advisor 2 : access to Personal Health Advocates that can assist in resolving insurance claim and billing issues. Nurseline TM and Personal Counseling Services In addition, members will receive discounts on the following services or supplies at participating providers. 1 Teladoc is not available to ID residents. 2 Health Advisor does not replace health insurance, provide medical care or recommend treatment. Savings may vary based on geographic location, provider selected and procedure performed. The lab network portion of this benefit is not available in MA, MD, ND, NE, NJ, NY, RI or SD. *Discount benefits administered by New Benefits, Ltd. Lab and Imaging Vision Diabetic Supplies Vitamins Chiropractic Hearing Durable Medical Equipment

4 DENTAL COVERAGE Brushing, flossing and regular preventive care will help you keep a bright, healthy smile in addition to supporting your overall well-being. With affordable coverage, getting the care you need is within your reach. Coverage underwritten by Ameritas Life Insurance Company. CALENDAR YEAR MAXIMUM Plan Pays up to $500 per Covered Member DEDUCTIBLE $20 per Visit COVERED SERVICES Waiting Period Coinsurance PREVENTIVE AND DIAGNOSTIC Routine Exam - 1 in 6 months Bitewing X-Rays - 1 in 6 months Full Mouth/Panoramic X-Rays - 1 in years Periapical X-Rays Cleaning - 1 in 6 months Fluoride for Children 1 and Under - 1 in 12 months Space Maintainers BASIC TREATMENT Sealants - Age 1 and Under Restorative Amalgams Restorative Composites Endodontics Periodontics Denture Repair Simple/Complex Extractions Anesthesia None Months Covered at 100% (U&C Charges) Covered at 60% (U&C Charges) MAJOR TREATMENT Onlays Crowns - 1 in 10 years per tooth Crown Repair Prosthodontics - 1 in 10 years + Spouse + Child(ren) 12 Months $4.75 $9.00 $8.55 $14.69 Covered at 50% (U&C Charges) To find a provider call (800) and select option 2 or visit and click the FIND A PROVIDER link near the top right corner of the page. Then select DENTAL and click on the NETWORK PROVIDER link. SHORT-TERM DISABILITY Your family and daily life can depend on consistent paychecks and income. If you get sick or injured and can t work, this Short-term Disability benefit will pay you cash. Enroll in this benefit to protect your income when you are unable to work. Coverage underwritten by Nationwide Life Insurance Company. WEEKLY MAXIMUM Plan Pays $125 MAXIMUM BENEFIT PERIOD WAITING PERIOD 26 Weeks 7 Days (Accidents and Sickness) Coverage includes disability due to pregnancy and childbirth $.50 Not available if you work in CA, HI, NJ, NY, or RI. 4

5 VISION BENEFIT A regular eye exam means more than getting an updated prescription for glasses or contacts. It is an important tool in detecting the first signs of serious health conditions. Vision coverage will help you maintain consistent overall health. Coverage underwritten by Ameritas Life Insurance Company. VSP Choice Network Out-of-Network DEDUCTIBLES $10 Exam, $25 Eye Glass Lenses or Frames 1 ANNUAL EYE EXAM $45 LENSES (per pair) Single Vision Bifocal Trifocal Lenticular CONTACTS Fit and Follow Up Exams Elective Medically Necessary 15% Discount $105 $0 $50 $65 $100 No Benefit $105 $210 FRAMES $105 2 $70 FREQUENCIES Exam Lens Frame + Spouse + Child(ren) Based on Date of Service 12 Months 12 Months 24 Months $2.02 $.99 $.72 $5.70 Find a VSP Choice provider call (800) or visit and click the FIND A PROVIDER link near the top right corner of the page. Then select VISION: VSP and click on the LOOK UP VSP PROVIDERS link. 1 Deductible applies to a complete pair of glasses or frames, whichever is selected 2 The Costco allowance will be the wholesale equivalent LENS OPTIONS (member cost) PROGRESSIVE LENSES STANDARD POLYCARBONATE VSP Choice Network & Affiliates (Other than Costco) Up to provider s contracted fee for Lined Bifocal Lenses. The patient is responsible for the difference between the base lens and the Progressive Lens charge. Covered in full for dependent children; $ for adults SOLID PLASTIC DYE $15 PLASTIC GRADIENT DYE $17 PHOTOCHROMATIC LENSES (GLASS AND PLASTIC) $1 - $82 SCRATCH RESISTANT COATING $17 - $ ANTI-REFLECTIVE COATING $4 - $85 ULTRAVIOLET COATING $16 Lens Options member costs vary by prescription, option chosen and retail locations 5 5

6 CRITICAL ILLNESS and LIFE/AD&D INSURANCE PACKAGE* Serious illnesses are scary and can be very costly. The Critical Illness plan pays a lump sum cash benefit in the unfortunate event that you are diagnosed with a covered illness. Additionally, life insurance can help your family during a difficult time by providing cash benefits in the event of your death. Enroll in this benefit to protect the future of the ones that depend on you the most. Coverage underwritten by Nationwide Life Insurance Company. CRITICAL ILLNESS (FIRST EVER OCCURRENCE)** Spouse Child(ren) Plan Pays $10,000 Plan Pays $5,000 Plan Pays $2,500 LIFE AND AD&D INSURANCE Plan Pays $10,000 LIFE INSURANCE Spouse Child(ren) 6 Months - 26 Years Child(ren) 10 Days - 6 Months + Spouse + Child(ren) Plan Pays $5,000 Plan Pays $2,500 Plan Pays $400 $.4 $5.14 $4.82 $6.69 **Critical Illness Benefit Description: Plan pays a one-time lump sum benefit in the event an insured person is diagnosed with their first occurrence of End-Stage Renal Failure, Heart Attack, Life Threatening Cancer, Major Organ Transplant or Stroke. The diagnosis must occur after the coverage is effective and while the policy is in force. Plan pays 100% of the Critical Illness benefit if a covered person is diagnosed, after the effective date, with the first occurrence of any covered Critical Illness event except cancer. The plan pays only 10% of the Critical Illness benefit if a covered person is diagnosed with the first occurrence of cancer less than 90 days after the effective date of coverage. If the cancer diagnosis occurs more than 90 days after the effective date 100% of the Critical Illness benefit will be paid. LIFE and AD&D INSURANCE* Life insurance can help your loved ones during a trying time. The benefits provide cash that can assist your family in the event of your death. Enroll in this benefit to protect the future of the ones that depend on you the most. Coverage underwritten by Nationwide Life Insurance Company. LIFE AND AD&D INSURANCE Plan Pays $20,000 LIFE INSURANCE Spouse Child(ren) 6 Months - 26 Years Child(ren) 10 Days - 6 Months + Spouse + Child(ren) Plan Pays $5,000 Plan Pays $2,500 Plan Pays $400 $2.25 $2.75 $2.50 $.00 *You can elect either the Critical Illness and Life/AD&D Package or the Life and AD&D Insurance benefit. You cannot elect both benefits. 6

7 ENROLLMENT INSTRUCTIONS For your convenience, The American Worker allows you to enroll online or by phone. If you have benefits questions, call the enrollment center and a representative will assist you. Please have the information below when enrolling. 1 2 Then 4 Visit and at the top of the page click on the Start Here button. under New User? select Social Security # and in the fields below enter you Your Social Security Number and Date of Birth. Next, create an account by setting up a username, password, and security question. After creating an account, you can elect coverage for yourself and your dependents. Enrollment Period: You have 0 days from your hire date to enroll in coverage. Enroll Online: Online enrollment is available at all times. Enroll By Phone: (866) Monday - Friday: 8:00 AM to 8:00 PM ET Information Dependent Information Enrollment Questions Full Name Social Security Number Date of Birth Home Address Phone Number Full Name Social Security Number Date of Birth Do you want Fixed Indemnity Coverage - If so, which plan? Dental Coverage Short-term Disability Critical Illness and Life/AD&D or Life/AD&D Only Vision Benefit Fixed Indemnity Disclaimer: This program is not intended or recommended to replace any comprehensive program of insurance in which you currently participate, or intend to participate. This plan is not designed to replace or provide major medical or catastrophic coverage. This brochure is for summary purposes only. The insurance benefits for the fixed indemnity plan are offered by Nationwide Life Insurance Company. Additional information will be provided upon enrollment in the Program. Plan exclusions and limitations apply. The Fixed Indemnity plans are (a) not a substitute for minimum essential health coverage under the Affordable Care Act (ACA); and (b) do not qualify as minimum essential coverage under the ACA. Residents of New Hampshire, Vermont and Washington are not eligible for this plan. New Benefits Discount Programs Disclaimers Teladoc is not available to Idaho residents Teladoc, Inc. All rights reserved. Teladoc and the Teladoc logo are registered trademarks of Teladoc, Inc. and may not be used without written permission. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. Teladoc phone consultations are available 24 hours, 7 days a week while video consultations are available during the hours of 7 am to 9 pm, 7 days a week. This plan is NOT insurance. The plan is not insurance coverage and does not meet the minimum creditable coverage requirements under the Affordable Care Act or Massachusetts M.G.L. c. 111M and 956 CMR This plan provides discounts at certain healthcare providers for medical services. This plan does not make payments directly to the providers of medical services. The plan member is obligated to pay for all healthcare services but will receive a discount from those healthcare providers who have contracted with the discount plan organization. This discount card program contains a 0 day cancellation period. The range of discounts for medical or ancillary services provided under the plan will vary depending on the type of provider and medical or ancillary service received. Member shall receive a full refund of membership fees, excluding registration fee, if membership is canceled within the first 0 days after the effective date. AR and TN residents: A refund of all fees will be issued if membership is canceled within the first 0 days. Discount Medical Plan Organization: New Benefits, Ltd., Attn: Compliance Department, PO Box Dallas, TX , Website to obtain participating providers: MyMemberPortal.com. 7 7 AMNNH v1-2015