CommunityCare Provider (Level 1) $25 copay/visit. (deductible waived) $55 copay/visit (deductible waived) $0 copay (deductible waived)

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1 Oregon Large Group Plan Overview CommunityCare - CC3T DX Benefits Deductible per calendar year Out-of-pocket maximum includes deductible Office visits Physician - includes family practice, pediatrics, internal medicine, naturopath, general practice, obstetrics/gynecology Specialist physician providers in specialties other than those listed above Maternity delivery care (professional services only) Preventive care includes but is not limited to: preventive office visit, women s and men s health care, pap test, mammogram, pelvic exam, prostate screening (PSA) and digital rectal exam Alternative care administered by American Specialty Health (ASH) Chiropractic (spinal manipulation) Acupuncture care Naturopathic care Massage therapy maximum 18 visits per year Maximum benefit for chiropractic/ acupuncture/naturopathy/massage therapy per calendar year Emergency and urgent care services Emergency room Urgent care - physician services OR LG CC3T (1/16) CommunityCare (Level 1) Member pays Other Participating (Level 2) Nonparticipating (Level 3) $1,000 single / $2,000 family Level 1, Level 2 and Level 3 combined $4,000 single / $8,000 family Level 1, Level 2 and Level 3 combined $15 copay/visit $55 copay/visit 40% of contract rate 40% MAA 40% of contract rate 40% MAA 20% of contract rate 40% of contract rate 40% MAA $0 copay (deductible waived) $15 copay/visit $15 copay/visit $15 copay/visit $25 copay/visit $1,000 (all services combined) $250 copay/visit, then 20% of contract rate (deductible waived / copay waived if admitted) $55 copay/visit $0 copay (deductible waived) not applicable at level 2 not applicable at level 2 not applicable at level 2 not applicable at level 2 $250 copay/visit, then 20% of contract rate (deductible waived / copay waived if admitted) $55 copay/visit Ground ambulance maximum 3 trips per year 20% 20% 20% Air ambulance maximum 1 trip per year 20% 20% 20% Hospital services 40% MAA not covered not covered not covered not covered $250 copay/visit, then 20% (deductible waived / copay waived if admitted) $55 copay/visit MAA Inpatient hospital 20% of contract rate 40% of contract rate 40% MAA Outpatient at hospital-based facility 20% of contract rate 40% of contract rate 40% MAA Outpatient at ambulatory surgery center 15% of contract rate 35% of contract rate 40% MAA (continued)

2 CommunityCare - CC3T DX Benefits Rehabilitative services CommunityCare (Level 1) The specified deductible must be met each calendar year (January 1 through December 31) before Health Net pays any claims The annual out-of-pocket maximum includes your annual deductible, copays and coinsurance. After you reach the out-ofpocket maximum in a calendar year, we will pay your covered services during the rest of that calendar year at 100% of our contract rates for participating provider services and at 100% of maximum allowable amount (MAA) for out-of-network (OON) services. You are still responsible for OON billed charges that exceed MAA If a newborn patient requires admission to an intermediate or intensive care nursery, the deductible and coinsurance for these services will accumulate under the newborn's coverage, not under the mother's coverage The outpatient emergency room copay is waived if you are admitted Member pays Other Participating (Level 2) For Mental Health or Chemical Dependency services, call For Alternative Care benefits, call American Specialty Health (ASH) at Certain services require prior authorization or must be performed by a specialty care provider This Plan Overview is intended to be used for marketing purposes only and presents general information. Please refer to your Benefit Schedule and Agreement for details, limitations, exclusions and other terms and conditions of coverage Medical services provided by a Naturopath do not apply to the alternative care calendar year benefit limit Nonparticipating (Level 3) Inpatient maximum 30 days per year 20% of contract rate 40% of contract rate 40% MAA Outpatient maximum 30 days per year 20% of contract rate 40% of contract rate 40% MAA Skilled nursing facility maximum 60 days per year Diagnostic lab and X-ray, EKG, ultrasound 20% of contract rate 40% of contract rate 40% MAA 20% of contract rate 40% of contract rate 40% MAA Imaging and testing services CT/MRI/MRA/PET/SPECT/EEG/Holter 20% of contract rate 40% of contract rate 40% MAA Monitor/stress test Allergy and therapeutic injections 20% of contract rate 40% of contract rate 40% MAA Durable medical equipment (DME) 20% of contract rate 40% of contract rate 40% MAA Home health visits 20% of contract rate 40% of contract rate 40% MAA Hospice services 20% of contract rate 40% of contract rate 40% MAA Behavioral Health administered by MHN Mental health and Chemical dependency Inpatient 20% of contract rate not applicable at level 2 40% MAA Outpatient, office visits $15 copay/visit not applicable at level 2 40% MAA Outpatient, other 20% of contract rate not applicable at level 2 40% MAA OR LG CC3T (1/16) Health Net Health Plan of Oregon, Inc., and Health Net Life Insurance Company are subsidiaries of Health Net, Inc. Health Net is a registered service mark of Health Net, Inc. All rights reserved

3 Oregon Large Group Health Net Pharmacy Benefits NXNMSL The following is a brief description of your Health Net Pharmacy benefits. Benefit level In pharmacy (per fill, up to a 30-day supply) 1 Mail order (per fill, up to a 90-day supply) Tier 1 $15 $30 Tier 2 $35 $70 Tier 3 $60 $120 Specialty pharmacy 50% Mail order not available Orally administered anticancer 20% Mail order not available medications Preventive pharmacy, tobacco cessation and women s contraception methods No copay and/or coinsurance No copay and/or coinsurance Out-of-pocket maximum per calendar year $1,000 single / $2,000 family combined both in pharmacy and mail order (separate from medical out-of-pocket maximum) 1 If certain requirements are met, you may be eligible for a 90-day supply when filled in a pharmacy (with three times the retail copay). If your prescription is for a maintenance medication (a drug that you will be taking for an extended period of time), you have the option of filling it through our convenient and cost-saving mail order pharmacy program. For complete information, log on as a Health Net member at Essentials Rx Drug List A listing of preferred drugs and their corresponding benefit levels is shown on the Health Net Essential Rx Drug List (EDL). To view the current EDL, go to Specialty Pharmacy Certain drugs identified on the Essential Rx Drug List are classified as Specialty Pharmacy drugs under your plan. Specialty Pharmacy drugs are high cost biologic, injectable and oral drugs typically dispensed through a limited network of pharmacies and having significantly higher cost than traditional pharmacy benefit drugs. Prior authorization is required for these medications. Preventive Pharmacy Preventive Pharmacy medications require a prescription and are limited to prescription drugs and overthe-counter medications that are determined to be preventive. No Deductible, Copayment and/or Coinsurance apply for each prescription or refill of a generic class drug or brand name drug with no generic class drug available. Deductible, Copayment and/or Coinsurance will apply to brand name drugs that have generic equivalents. OR Rx NoMac / American Institute of Architects (11/17)

4 Women s Contraception Generic class Food and Drug Administration (FDA) approved contraceptive methods, patient education and counseling for all women with reproductive capacity are covered. FDA approved, over-the-counter contraceptive methods for women require a prescription from your participating provider. No Deductible, Copayment and/or Coinsurance apply for each prescription or refill of a generic class drug or brand name drug when no generic class drug is available. Deductible, Copayment and/or Coinsurance will apply to brand name drugs that have generic equivalents. Tobacco Cessation Food and Drug Administration (FDA) approved prescription drugs classified as smoking cessation medications are covered when dispensed by a participating provider pharmacy. FDA approved, over-thecounter tobacco cessation medications require a prescription from your participating provider. No Deductible, Copayment and/or Coinsurance apply for each prescription or refill of a generic class drug or brand name drug when no generic class drug is available. Deductible, Copayment and/or Coinsurance will apply to brand name drugs that have generic equivalents. Participating Pharmacies Participating pharmacy must be used when filling all prescriptions under your plan. The plan does not cover prescriptions filled at a Non-Participating pharmacy. What if I am on a medication that was covered by my previous health insurance? Under the Continuity of Care Policy, within the first 90 days of Health Net coverage, you will receive authorization for any existing medication requiring prior authorization that was covered under your previous health insurance company. The health plan will require verification that the medication was covered by the previous insurance company. This policy excludes the following: injectables, compounded medications, pharmacy benefit exclusions, and overrides on quantity or dosage limits. This is a brief description of your Health Net Pharmacy benefits and is intended for marketing purposes only and presents general information. Please refer to your Prescription Supplemental Benefit Schedule to determine the specific benefits, limitations, exclusions and all other terms and conditions of coverage. OR Rx NoMac / American Institute of Architects (11/17) Health Net Health Plan of Oregon, Inc. is a subsidiary of Health Net, Inc. Health Net is a registered service marks of Health Net, Inc. All rights reserved. Oregon Large Group

5 Section 105 Health Reimbursement Arrangement (HRA) Plan Highlight Your employer has established a Section 105, Health Reimbursement Arrangement (HRA) Plan. This Summary Plan description describes the benefits, terms and conditions of the Plan as it applies to eligible employees on or after the plan year dates. PLAN BENEFITS (Benefit(s) allowed for reimbursement under the Plan) DEDUCTIBLE REIMBURSEMENT INSURED PARTY PAYS The first $ of DEDUCTIBLE expenses (per individual) HRA REIMBURSES Once the insured party has met the first $ of DEDUCTIBLE expenses, he/she will receive reimbursement for the next $1, of incurred DEDUCTIBLE expenses for the calendar year. Maximum reimbursement per calendar year is $3, for the insured party. COINSURANCE REIMBURSEMENT CO-PAYMENT REIMBURSEMENT HRA REIMBURSES Hacker Architects, Inc. will reimburse for incurred COINSURANCE EXPENSES up to $2, per insured party. HRA REIMBURSES Hacker Architects, Inc. will reimburse for MEDICAL & VISION CO-PAYMENTS up to $ per insured party. Insured party: the individuals covered under the insurance policy. REIMBURSEMENT PROCESS Once, you (an eligible member) have reimbursable expenses; please submit your Explanation of Benefits, or EOB, (provided by the insurance company A sample EOB is included for your reference) or proof of the expense, plus a Reimbursement Request to: MAILING ADDRESS FOR REIMBURSEMENTS CLAIM FAXLINE FOR REIMBURSEMENTS REIMBURSEMENTS Polestar Benefits, Inc. 412 Jefferson Parkway, Suite 202 Lake Oswego, OR (888) claims@polestarbenefits.com A copy of the Reimbursement Request form can be obtained at our website or call us and we will send one to you ( ). PLAN DEFINITION AND FUNDING This is a Section 105 Accident and Health Plan, as classified by the Internal Revenue Code. This benefit plan is classified as a welfare plan by the Department of Labor. The Employer funds this Plan. PLAN ADMINISTRATOR/EMPLOYER Hacker Architects, Inc. 733 SW Oak Street Portland, OR Tel TAX ID NUMBER ADMINISTRATION AGENT Polestar Benefits, Inc. 412 Jefferson Parkway, Suite 202 Lake Oswego, OR (503) ERISA NUMBER

6 Health Net Health Plan of Oregon, Inc. Vision Benefits SUPPLEMENTAL BENEFIT SCHEDULE PREFERRED /17 Purpose and Function of this Schedule The purpose of this schedule is to provide vision benefits to Subscriber Groups selecting this supplemental benefit in addition to the basic benefits. This schedule is an amending attachment to the Group Plan Benefits. Subject to all terms, conditions, exclusions and definitions in the Group Medical and Hospital Service Agreement and its attachments, except as expressly amended by benefits provision of this Schedule, you are entitled to receive benefits set forth in this Schedule upon payment of the relevant premiums and Copayments. Benefits Benefits are based on the following Schedule: Exam Exam Options (fit and follow-up) Standard contact lenses Premium contact lenses Participating After you pay a $10 Copayment, Covered Services are paid in full by the plan. After you pay up to $55, Covered Services are paid in full by the plan. You receive 10% off retail cost. Any Other You are reimbursed up to $40 of the cost for Covered Services. You receive no discount. You receive no discount. Eyewear (lenses and frame) Single vision lenses Covered in full after a $25 Copayment. You are reimbursed up to $40. Lined bifocal lenses Covered in full after a $25 Copayment. You are reimbursed up to $60. Lined trifocal lenses Covered in full after a $25 Copayment. You are reimbursed up to $80. Lenticular lenses Covered in full after a $25 Copayment. You are reimbursed up to $80. Standard progressive lenses Covered in full after a $90 Copayment You are reimbursed up to $60. Premium progressive lenses $90 Copayment, then 80% of total charge less $120 allowance. You are reimbursed up to $60. Frame Covered up to $100 allowance. You will receive a 20% discount on the balance You are reimbursed up to $45. HNOR Vision LGrp 1/ (1/1/17)

7 over your allowance. Lens Options UV Coating Covered in full after a $15 Copayment. ** You receive no discount. Tint, solid and gradient Covered in full after a $15 Copayment. ** You receive no discount. Standard scratch-resistance Covered in full after a $15 Copayment. ** You receive no discount. Standard polycarbonate Covered in full after a $40 Copayment. ** You receive no discount. Standard anti-reflective Covered in full after a $45 Copayment. ** You receive no discount. Other add-ons and services You receive 20% off retail cost. ** You receive no discount. ** Your Copayment or eyewear discount applies to any optional items purchased with your lenses and/or frames from a Participating. Listed items are examples of optional items. Contact lenses (instead of spectacle lenses and frame) Materials Conventional You receive a maximum allowance of $90, plus a discount of 15% over your allowance. You are reimbursed up to $105 of the cost for Covered Services. Disposables You receive a maximum allowance of $90, you are responsible for remaining balance over your allowance. You are reimbursed up to $105 of the cost for Covered Services. Medically Necessary Paid in full. You are reimbursed up to $210 of the cost for Covered Services. Frequency of Service Examination Lenses Frame Contact lenses in lieu of lenses Once every 12 months from the last date of service. Once every 12 months from the last date of service. Once every 24 months from the last date of service. Once every 12 months from the last date of service. Limitations, Options and Exclusions To receive maximum benefits, you must utilize Participating s. A list of Participating s is available at or by calling our Customer Contact Center. When services are received from a Participating, we make payment directly to the. You are responsible for paying the Copayment to the. There is no benefit for professional services or materials connected with: a. Orthoptics or vision training, subnormal vision aids and any associated supplemental testing. b. Aniseikonic lenses. c. Medical or surgical treatment of the eyes or supporting structures. d. Corrective eyewear required by an employer as a condition of employment, and safety eyewear unless specifically covered under this plan. HNOR Vision LGrp 1/ (1/1/17)

8 e. Services for any illness, condition or injury occurring in or arising out of the course of employment for which there is an approved workers' compensation claim. f. Plano non-prescription lenses and non-prescription sunglasses. g. Lost or broken materials except at normal intervals when services are otherwise available. Benefits may not be combined with any discount, promotional offering, or other group benefits plans. Allowances are one-time use benefits; no remaining balance. Value Added Discounts Contact Lenses Participating s offer preferred pricing and direct delivery on annual supplies of select brands of disposable contact lenses. Lasik or PRK You may have a discount available for these services. Please contact our Customer Contact Center for more information. Continued Eyewear Savings After your initial benefits have been utilized, you may be able to receive ongoing discounts on additional eyewear purchases at Participating locations. Please contact our Customer Contact Center for more information. This summary presents general information only and does not include all benefits, details and exclusions. HNOR Vision LGrp 1/ (1/1/17)

9 Summary of Benefits Dental Benefit Summary Group ID: Coverage Type: Contributory Group Name: Waiting Period: HACKER ARCHITECTS INC 1st of the month following date of hire Class: As of Date: 0001 ALL ELIGIBLE EMPLOYEES 09/08/2017 Plan Information Your dental networks is: Dental - DentalGuard Pref - Oregon Coverage Information Dental - DentalGuard Pref - Oregon What's the most cost-effective way to use dental insurance? You may go to any dentist, however those who belong to the Dental - DentalGuard Pref - Oregon network will be most cost effective. Calendar year deductible In Network None Out of Network $25, Once the annual deductible is met by each of three family members, no further deductibles apply. Preventive Waived Waived Basic Waived Not Waived Major Waived Not Waived Calendar Year Maximum Benefit Lifetime Orthodontia Maximum The amount shown in the out of network field is your combined Calendar Year maximum for both in and out of network services. The amount shown in the out of network field is your combined Lifetime Orthodontia Maximum for both in and out of network services $1,000 $1,000 Maximum rollover Yes Yes Monthly Switch Not Available Not Available Office Visit Co-pay (one office visit may cover multiple services) How much does the plan pay? None How much does the plan pay?(as a percentage of reasonable and customary.) None Preventive Care: 100% 100% Bitewing X-Rays 100% 100% Full Mouth X-Rays 100% 100% Produced on 09/08/2017 at 10:29:08 EDT

10 Dental - DentalGuard Pref - Oregon What's the most cost-effective way to use dental insurance? You may go to any dentist, however those who belong to the Dental - DentalGuard Pref - Oregon network will be most cost effective. In Network Out of Network Cleaning 100% 100% Oral Exams 100% 100% Sealants (per tooth) 100% 100% Basic Care: 90% 80% Fillings (one surface) 90% 80% General Anesthesia 1 90% 80% Scaling & Root Planing (per quadrant) 90% 80% Simple Extractions 90% 80% Major Care: 60% 50% Dentures 60% 50% Single Crowns 60% 50% Orthodontia 50% 50% General Exclusions Important Information about Guardian's DentalGuard Indemnity and DentalGuard Preferred PPO plans: This policy provides dental insurance only. Coverage is limited to charges that are necessary to prevent, diagnose or treat dental disease, defect, or injury. Deductibles apply. The plan does not pay for: Oral hygiene services (except as covered under preventive services), Orthodontia (unless expressly provided for), Cosmetic or experimental treatments (unless they are expressly provided for). Any treatments to the extent benefits are payable by any other payor or for which no charge is made, prosthetic devices unless certain conditions are met, and services ancillary to surgical treatment. The plan limits benefits for diagnostic consultations and for preventive, restorative, endodontic, periodontic, and prosthodontic services. The services, exclusions and limitations listed above do not constitute a contract and are a summary only. The Guardian plan documents are the final arbiter of coverage. Contract # GP-1-DEN -16 et al. Teeth lost or missing before a covered person becomes insured by this plan. A covered person may have one or more congenitally missing teeth or have lost one or more teeth before he became insured by this plan. We won't pay for a prosthetic device which replaces such teeth unless the device also replaces one or more natural teeth lost or extracted after the covered person became insured by this plan. R3-DG Restrictions apply and may be subject to medical necessity. This Benefit Summary is for illustrative purposes. Your benefits booklet will show exactly what is covered and/or excluded under your plan. If there is a discrepancy between this Benefit Summary and your benefit booklet, the benefit booklet prevails. Definitions shown on this site are in summary form and are for general informational purposes. The terms of the insurance contract prevails. Produced on 09/08/2017 at 10:29:08 EDT