NON-UNION ANNUAL ENROLLMENT. November 18 to November 29

Transcription

1 NON-UNION 2014 ANNUAL ENROLLMENT November 18 to November 29 This publication contains important information about your employee benefit program. Please read thoroughly.

2 ANNUAL ENROLLMENT 2014 Welcome to the 2014 Benefits Annual Enrollment Annual Enrollment Benefits are an integral part of the overall compensation package. Please take time to read this guide thoroughly. It is time for Annual Enrollment for the 2014 plan year. Each year during Annual Enrollment, you have the opportunity to re-evaluate your benefit needs and adjust your coverage for the upcoming plan year. We are happy to continue to offer a wide range of valuable benefits again this year. Please refer to this guide for brief descriptions of many of the plans and resources available to you. Table of Contents Medical...5 CHP Plan...9 Dental...12 Vision...14 Flexible Spending Account...15 Life, AD&D, Disability Other Coverages...21 Special Notices...22 Important Notes about Annual Enrollment This year s Annual Enrollment will be a passive enrollment. This means that your current elections will carry over to Please note that this does not apply to the FSA, Limited FSA (LFSA), and HSA. You will need to make a new election for the 2014 plan year for these accounts. Enrolling in Your Health and Welfare Benefits Your online resource for enrolling in your health and welfare benefits is Workday. When you log on, you will be able to view your current elections, change your elections, add or remove a dependent, and change a beneficiary, if needed. You can also find links to additional information regarding your benefit package. Workday can be accessed by going to For General Benefits and Open Enrollment Questions Call: OneSource Virtual, hussmannbenefits@onesourcevirtual.com Please note when you make your election for Annual Enrollment, you will not be able to change your elections until next Annual Enrollment, unless you experience a qualifying event. Benefits Directory...30 Notes

3 HUSSMANN CORPORATION General Benefits Eligibility You are eligible for the benefits described in this guide based on the following hours worked per week: 20 to 29 hours eligible for Life and AD&D 30+ hours eligible for Life, AD&D, Medical, Dental, Vision, Flexible Spending Account, Disability, and Health Savings Account (depending on medical plan selection) Your coverage under most of the plans described in this guide is effective on your date of hire (your first day of active employment). Definition of Dependent As a reminder, you can also choose to cover certain dependents under Hussmann s health and welfare benefits. Your eligible dependents include: Your legal spouse Your same-sex domestic partner (SSDP) Eligible children including: You, your legal spouse s or your SSDP s biological, adopted (or placed for adoption) or foster children, or your stepchildren, who are under the age 26; Any other unmarried child under age 26 who lives with you in a parent-child relationship based on IRS guidelines and who is primarily dependent on you, your legal spouse, or SSDP for support (for more information on the IRS guidelines, go to Any other child under age 26 which you, your legal spouse, or SSDP are required to cover because of a divorce decree or qualified medical child support order (QMCSO); and A covered child who, as of the date his or her coverage would have otherwise ended, is mentally or physically incapable of self-support and primarily dependent upon you, your spouse, or your SSDP for financial support. To continue covering a disabled child because of mental or physical disability beyond the age coverage would otherwise end, you must provide satisfactory proof of the incapacity and notify Hussmann within 30 days of the date the child would otherwise lose coverage because he or she is no longer eligible. Hussmann reserves the right to validate your dependent s eligibility at any time throughout the year. 3

4 ANNUAL ENROLLMENT 2014 Enrollment Notes Medical Unless you actively change your election, you will be enrolled in the same plan design you are enrolled in today (PPO or CHP) in the same coverage level (employee only, employee + spouse, etc.) you are enrolled in today. Please note If you are currently in the CHP plan, you will still be enrolled in the HSA and will get the company match; however, your employee contribution will be reset to $0. If you wish to contribute to the HSA, you are required to make a new election for If you would like to enroll, waive coverage, change plans, add a dependent, or remove a dependent, you will need to make the change in Workday. Dental Unless you actively change your election, you will be enrolled in the dental plan in the same coverage level you are enrolled in today (employee only, employee + spouse, etc.). If you would like to enroll, waive coverage, add a dependent, or remove a dependent, you will need to make the change in Workday. Vision Unless you actively change your election, you will be enrolled in the vision plan in the same coverage level you are enrolled in today (employee only, employee + spouse, etc.). If you would like to enroll, waive coverage, add a dependent, or remove a dependent, you will need to make the change in Workday. A Note about Same-Sex Domestic Partner (SSDP) Benefit Coverage Under current IRS regulations, the value of the contribution that Hussmann makes toward the cost of medical coverage for a same-sex domestic partner and the partner s dependents is considered imputed income for income tax purposes, unless the covered parties qualify as your tax dependents under IRS rules. Imputed income is reported on the employee s annual Form W-2. IRS regulations also state that before-tax dollars contributed by a covered employee to the Health Care FSA, the Dependent Care FSA, the Limited FSA, or a Health Savings Account (HSA) cannot be used to reimburse expenses incurred by SSDPs or their dependents, unless the person incurring the expense qualifies as your IRS tax dependent. Working Spouse/Same-Sex Domestic Partner Surcharge This surcharge is intended to help manage the overall costs of health benefits while maintaining the value of our programs. Hussmann will pay the majority of coverage costs for a working spouse or SSDP who is enrolled in our medical plan, but you will pay a $1,300 annual surcharge if your spouse or SSDP is eligible for subsidized group medical coverage through his or her employer, waives that coverage, and chooses to enroll in medical coverage through Hussmann. This surcharge will come out evenly from each paycheck. To calculate the amount which will be deducted from your paycheck, divide the annual amount by 26 if you are paid bi-weekly or 52 for bi-monthly. Bear in mind contributions toward coverage for a spouse are made on a beforetax basis and contributions toward coverage for a SSDP are made aftertax; surcharges are assessed on the same basis. 4

5 HUSSMANN CORPORATION Medical Coverage will remain with UnitedHealthcare (UHC). Employees will continue to have the choice of two medical plan designs the PPO (Preferred Provider Organization) and the CHP (Consumer Health Plan). Changes are being made to the current PPO plan design and are illustrated in bold font on page 6. There will be no changes made to the Consumer Health Plan. Hussmann has a self-funded medical plan. A self-funded group medical plan is one in which Hussmann assumes the risk for providing healthcare benefits to its employees. Instead of paying a fixed insurance premium to an insurance company, Hussmann pays medical claims out of its own funds as claims are incurred. Self-funding allows more control and flexibility in the level of benefits offered and the cost of those benefits. The employees and the employer share in the cost of the plan. The cost of the medical plan is a direct result of the claims paid. It is important to understand that Hussmann is interested in the health and well being of its employees and their financial protection through our quality medical plan. Employee contributions will not be changing for Medical/Rx Plan Monthly Employee Contribution PPO CHP Employee (Ee) $89.00 $73.00 Ee + Spouse/SSDP $ $ Ee + Child(ren) $ $ Family $ $ MEDICAL Find a Provider UHC has a large national network of doctors, hospitals, and other health care providers who have agreed to provide services to plan participants at discounted rates. To find an in-network provider, or to see if your provider participates in UHC s Choice Plus network, please visit for current members or for potential members. If you decide to go to an outof-network provider, there are benefits available; however, you will pay more out of your pocket for care. We encourage you to use in-network providers wherever possible to help keep your costs down as well as our plan s costs down. Did you know? Due to the Patient Protection and Affordable Care Act, all Americans are required to have health insurance beginning January 1, The government has established a Public Health Insurance Exchange known as the Marketplace ( The Marketplace is intended to provide healthcare options to individuals without access to qualified and affordable health care; however, all Americans are eligible to enroll. A qualified plan is a plan which covers at least 60% of the allowed charges. An affordable plan is when an employee s premium contribution for single coverage is no more than 9.5% of the employee s income. Hussmann s group medical plans are intended to be qualified and affordable. 5

6 ANNUAL ENROLLMENT Medical Benefits Annual Deductible Annual Out-of-Pocket Maximum 6 PPO In-Network Out-of-Network In-Network Out-of-Network $750 Each Person $1,500 Family $1,500 Each Person $3,000 Family Prescription drugs not subject to deductible $2,750 Each Person $5,500 Family $5,500 Each Person $11,000 Family Includes deductibles; prescription drugs do not count toward medical maximum CHP $1,500 Individual $3,000 Family Prescription drugs subject to deductible $2,975 Individual $5,950 Family $5,950 Individual $11,900 Family Includes deductibles; prescription drugs count toward medical maximum Lifetime Maximum Unlimited Unlimited Unlimited Unlimited Preventive Care (For example: routine physicals, well child care, x-rays and lab tests, immunizations, routine mammogram and gynecological exam, sigmoidoscopy, vision and hearing screenings) 100% No deductible 60% No deductible 100% No deductible 60% No deductible Physician Services/Outpatient Care Physician Office Visit 80% after deductible 60% after deductible 80% after deductible 60% after deductible Outpatient Surgery 80% after deductible 60% after deductible 80% after deductible 60% after deductible (performed in physician office, hospital, or freestanding facility) Diagnostic Tests 80% after deductible 60% after deductible 80% after deductible 60% after deductible Chiropractic Care ($1,000 80% after deductible 80% after deductible 80% after deductible 80% after deductible maximum benefit per year) Emergency Medical Care Emergency Room $75 penalty for non-emergency use 80% after deductible Covered at in-network level X-Rays and Lab Tests 80% after deductible Covered at in-network level Ambulance Services 80% after deductible Covered at in-network level Inpatient Hospital Care * 80% after deductible Covered at in-network level 80% after deductible Covered at in-network level 80% after deductible Covered at in-network level Physician/Surgical Services 80% after deductible 60% after deductible 80% after deductible 60% after deductible Semi-Private Room and 80% after deductible 60% after deductible 80% after deductible 60% after deductible Board Maternity Care 80% after deductible 60% after deductible 80% after deductible 60% after deductible Mental Health and Substance Abuse Inpatient * 80% after deductible 60% after deductible 80% after deductible 60% after deductible Outpatient 80% after deductible 60% after deductible 80% after deductible 60% after deductible Additional Services Physical, Occupational, and 80% after deductible 80% after deductible 80% after deductible 80% after deductible Speech Home Health Care, Hospice, 80% after deductible 60% after deductible 80% after deductible 60% after deductible Extended Care Facility * Private Duty Nursing; Durable Medical Equipment; Prosthetic Devices 80% after deductible 80% after deductible 80% after deductible 80% after deductible * Precertification may be required. Consult plan for terms. This document provides only the highlights of the medical options; specific coverage details and limitations are found in the plan documents and summary plan descriptions. In the event of conflict between this information and relevant plan documents or summary plan descriptions, the plan documents or summary plan descriptions will govern. Only medically necessary services are covered. Note that services from non-network providers are subject to reasonable and customary (R&C) limits; charges in excess of R&C are not covered.

7 HUSSMANN CORPORATION Prescription Drugs Enhancement When you enroll for medical coverage through Hussmann, you automatically receive prescription drug coverage for you and your covered dependents. The prescription drug plan is administered by CVS Caremark. Hussmann understands some medications and supplies can help prevent disease or help manage existing conditions to try and avoid future complications. For this reason, Hussmann is introducing a Diabetic Kit Rule (DKR) on January 1, 2014 (see informational box on the right). Additionally, a preventive medication therapy list will be implemented by February 1, 2014, where you pay $0 for select prescriptions which help you prevent chronic health conditions, when taken regularly. If you take medications on the preventive medication therapy list, you will pay $0 for these medications even if you are on the CHP and have not yet met your annual deductible. Additional information and a link to the $0 Preventive Drug list can be accessed on the Hussmann Intranet by going to: HR Links>Human Resources>Total Rewards>Healthcare Benefits. PPO CHP Deductible None Subject to Medical Plan Deductible Prescription Drug Retail (30-day supply) Preventive Drug List $0 copay* $0 copay no deductible** Coming Soon Generic $6 copay $6 copay after deductible Brand 35% coinsurance 35% coinsurance after deductible Prescription Drug Mail Order (90-day supply) Preventive Drug List $0 copay * $0 copay no deductible ** Coming Soon Generic $15 copay $15 copay after deductible Brand 30% coinsurance ($150 maximum per prescription) 30% coinsurance after deductible ($150 maximum per prescription) Specialty Medications (30-day supply) Must use CVS Caremark Specialty Pharmacy 30% coinsurance ($50 maximum per prescription) Pharmacy Annual Out-of-Pocket $1,500 Individual $3,000 Family 30% coinsurance after deductible ($50 maximum per prescription) Included in medical out-ofpocket maximum Diabetic Kit Rule (DKR) If you order your diabetes supplies through CVS Caremark Mail Service Pharmacy at the same time as your insulin or oral medicines(s), you will be charged the member cost share amount for insulin or the highest cost item only. Supplies include: Lancet Lancet devices Alcohol wipes Syringes Test Strips Note: The DKR requires that supplies are bought at the same time insulin or oral medical is purchased or filled. Log on to to place your next 2014 refill order for your medicine and supplies or call Customer Care toll-free at More information to come! * Applies toward the annual pharmacy out-of-pocket maximum. ** Applies toward the medical out-of-pocket maximum. 7

8 ANNUAL ENROLLMENT 2014 Mandatory Generics If you purchase a brand-name drug when an equivalent generic is available, you will pay the generic copay PLUS the difference between the retail cost of the brand drug and the generic drug, as illustrated below in an example using popular cholesterol medications. An exception applies when your doctor certifies that you have tried the generic equivalent and cannot use it for medical reasons. Medication Generic: Simvastatin Brand Name: Zocor Retail Cost Cost to Participant Explanation $52 $6 Flat generic copayment $99 $53 Mandatory Generic Drug Rule Applies: Generic copayment of $6 Difference between retail cost of brand and generic ($99-$52)=$47 Your cost: $6 + $47 = $53 Additional Pharmacy Information Some prescription drugs may require authorization before they can be dispensed. Check with CVS Caremark to determine if the prior authorization is required. Not all prescription medications are covered by the plan. For example, certain cosmetic and lifestyle medications are not covered. Check with CVS Caremark for coverage details. You have access to several network pharmacies with CVS Caremark, not just CVS. 8

9 HUSSMANN CORPORATION Consumer Health Plan (CHP) with Health Savings Account (HSA) CHP PLAN To begin to understand the CHP, you must first realize that there are two parts to this option: 1. It is a full-fledged, major medical PPO plan that offers you coverage at UHC s large network of physicians, hospitals, and facilities around the country. The major difference between the PPO Plan and the CHP is that in the CHP, everything is subject to the deductible. Also, in order for CHP enrollees to be able to open an HSA, the plan must meet additional requirements, such as a minimum deductible amount. 2. The CHP comes with a Health Savings Account (HSA), which is a special bank account only available to people who participate in a Qualified High Deductible Health Plan, which is Hussmann s CHP. The HSA allows you to pay out-ofpocket medical expenses with pre-tax dollars. You will own and administer your account, and there are no use it or lose it restrictions like with the Flexible Spending Account (FSA) option. HSAs allow you to save and roll over money if you do not spend it in the calendar year. In fact, if you change health plans or jobs, the money in the account is yours to keep. So long as you use it for qualified medical, dental or vision expenses, the money you contribute to an HSA is tax-free when you put it in and when you take it out. Eligible medical expenses are defined by the IRS. These expenses include such things as deductibles, coinsurance, prescription drugs, and lab tests. IRS Publication 502 provides a complete list of eligible expenses. A link to this list can be found at CHP Deductible and Outof-Pocket Note: Deductibles and out-of-pocket maximums in the CHP are nonembedded, meaning no individual family member s deductible or out-ofpocket is satisfied until the full family deductible or out-of-pocket maximum is satisfied. One member of the family can meet the full family deductible or out-of-pocket maximum. 9

10 ANNUAL ENROLLMENT 2014 HSA Eligibility Requirements Because there are so many advantages with the HSA, there are a few eligibility requirements that you must meet in order to open and fund an HSA. To open an HSA, you must meet the following criteria: You must be enrolled in an HSA eligible high deductible health plan, like Hussmann s CHP. You must not be covered by any other health plan that is not a CHP. You must not be covered by a health FSA for the tax year in which you will claim your HSA deposits as tax deductions. You must not be eligible to be claimed as a dependent on someone else s tax return. You must not be enrolled in Medicare, TRICARE, or TRICARE for Life. You must not have received Veterans Administration Benefits within the past three months. Employer Contribution to HSA/ Seed Money To give you a head start to your savings, Hussmann will continue to place seed money into all current HSA participant accounts and new CHP participants that open an HSA. Hussmann will seed $750 for employees enrolled in employee only coverage, and $1,500 for those enrolled in family coverage. Please note Hussmann will only put seed money into a Wells Fargo administered HSA. If you choose to go to a financial institution of your choice, then you will not receive the seed money. HSA Contribution Limits for 2014 * Individual Family Maximum Limit per IRS $3,300 $6,550 Hussmann HSA Seed Money Contribution $750 $1,500 * The annual contribution limit is a combined employee + employer contribution Note: If you are age 55 or older, you can contribute an additional $1,000 10

11 HUSSMANN CORPORATION Three Ways to Maximize Your Tax Savings Contributions to an HSA are tax-free (they can be made through payroll deduction on a pre-tax basis when you open an account with Wells Fargo Bank). The money in this account (including interest and investment earnings) grows tax-free. As long as the funds are used to pay for qualified medical expenses, they are spent tax-free. There are strict regulations governing participation in HSAs and the use of HSA funds. If you use HSA funds for non-qualified expenses, such as health insurance premiums, you will be required to pay income tax on the amount used for non-qualified expenses as well as a 20% penalty. Note that if you wish to use your HSA to pay for eligible over-the-counter medications, the medication must be prescribed by a doctor; otherwise it will be considered a non-qualified expense. More about HSAs can be found at 11

12 ANNUAL ENROLLMENT 2014 DENTAL Find a Provider To find out if your dentist participates in the Delta Dental Premier network, visit their website at Click on Subscriber Then select Find a Participating Dentist For the Product Selection, click the Delta Dental Premier box Dental Change Delta Dental of Missouri (DDMO) will become our new dental carrier on January 1, The high level benefits will closely mirror those benefits offered by MetLife. Please refer to the full benefit summary or summary plan description accessible on the Hussmann Intranet by going to: HR Links>Human Resources>Total Rewards>Healthcare Benefits for frequency, age, and other limitations. You may visit the dentist of your choice and select any dentist on a treatment by treatment basis. It is important to remember your out-of-pocket costs may vary depending on your choice. You have two options. 1. In-Network: Delta Dental Premier Network. Delta Dental s Premier network consists of dentists who have agreed to accept payment based on the applicable Premier Maximum Plan Allowance and to abide by Delta Dental policies. This network offers you cost control and claim filing benefits. 2. Out-of-Network: Non Participating Dentist. If you go to a non-participating dentist (not contracted with Delta Dental plan for the Premier Network), DDMO will make payment directly to you based on the applicable Maximum Plan Allowance for the non-participating dentist. It will be your obligation to make full payment to the dentist and file your own claim. Claim forms can be obtained online at 12

13 HUSSMANN CORPORATION Preventive Dental Care Advantages of Selecting Participating Dentists All participating dentists have the necessary forms needed to submit your claim. Delta Dental Premier participating dentists usually file your claims for you and DDMO will pay them directly for your covered services. You are not responsible for paying the Premier participating dentist any amount which exceeds the applicable Maximum Plan Allowance. You are only responsible for any non-covered charges, deductible, and coinsurance amounts. When it comes to the health of your teeth and gums, preventive dental care is smart. Brushing and flossing help to remove plaque from the surfaces and in between teeth, keeping your teeth looking and feeling clean. Routine dental exams and regular cleanings may help prevent the incidence of highercost treatments such as periodontal surgery, root canals, extractions, and fillings. Dental Benefits Annual Deductible Waived for orthodontia and preventive treatment In-Network None Out-of-Network $50 Single/$150 Family Maximum Annual Benefit $1,750 Per Person $1,500 Per Person Preventive Services Includes exams and cleanings, fluoride treatments, x-rays for diagnosis, sealants Basic Services Includes fillings and extractions, periodontics, repairs to crowns or dentures, endodontics, oral surgery Major Care Services Includes crowns, inlays, dentures, dental implants Orthodontic services coverage for dependents to age 19 Maximum lifetime orthodontia benefit Plan pays 100% Plan pays 100% of reasonable and customary (R&C) Plan pays 80% Plan pays 80% of R&C after deductible Plan pays 50% Plan pays 50% Plan pays 50% of R&C after deductible Plan pays 50% of R&C $1,750 Per Person $1,500 Per Person Dental Rates as of January 1, 2014 Dental Plan Monthly Employee Contribution Employee (Ee) $10.12 Ee + Spouse/SSDP $21.25 Ee + Child(ren) $18.21 Family $

14 ANNUAL ENROLLMENT 2014 VISION To find a VSP doctor, visit or call Vision The vision plan will continue to be offered through Vision Service Plan (VSP) utilizing the Choice network. There will be no changes to the benefit offering; however, rates are increasing as of January 1, 2014, due to fees imposed by the Affordable Care Act s health insurance provider fee. Just a reminder, there are no ID cards issued for the vision plan. Group numbers are available on the Benefit Directory. Benefit Description In-Network WellVision Exam Every calendar year Frame Every other calendar year Lenses Every calendar year Lens Options Every calendar year Contacts Instead of glasses Every calendar year Focuses on your eyes and overall wellness $150 allowance for a wide selection of frames + 20% off the amount over your balance Single vision, lined bifocal, and lined trifocal lenses Standard progressive lenses Premium progressive lenses Custom progressive lenses Average of 20-25% off other lenses options $150 allowance for contacts, copay does not apply; Contacts lens exam (fitting and evaluation) Out-of-Network Reimbursement $10 copay Up to $45 $25 copay Up to $70 $25 copay Single: Up to $30 Lined Bifocal: Up to $50 Lined Trifocal: Up to $65 Standard Progressive: $55 Premium Progressive: $95 $105 Custom Progressive: $150 $175 Contacts Fitting and Evaluation is covered up to $60 Up to $50 Up to $105 Discounts Available (In-Network Only): 20% off additional glasses and sunglasses, including lens options, from any VSP doctor within 12 months of your last WellVision Exam. Average of 15% off the regular price or 5% off the promotional price for laser vision correction at contracted facilities. Note: Frequency is based on a Calendar Year Basis: This means you can get a new exam starting every January 1, as opposed to 12 months from the date of your last exam. Vision Rates as of January 1, 2014 Vision Plan Monthly Employee Contribution Employee (Ee) $4.89 Ee + Spouse/SSDP $9.77 Ee + Child(ren) $10.46 Family $16.71 Diabetic Eyecare Plus Program In-network vision services related to type 1 and 2 diabetes are available for a $20 copay with no frequency limitations. Ask your VSP provider for details. 14

15 HUSSMANN CORPORATION Flexible Spending Accounts (FSAs) ADP will become our new FSA administrator. Even if you enrolled last year, you must enroll again this year. When you enroll in the healthcare FSA, you will automatically receive a Spending Account Card (debit card), remember cards are not available for dependent care FSAs. For those enrolled in the PPO Plan, you will continue to have the option to open a Health Flexible Spending Account. FSAs are a great way to set aside pre-tax money to pay for your outof-pocket health, prescription drug, dental, and vision expenses. Employees are allowed to set aside a maximum of $2,500 into the Health Flexible Spending Account. The Dependent Care Flexible Spending Account will also continue to be offered to employees. You will continue to be allowed to set aside up to $5,000 annually on a pre-tax basis (per household) for day care, elder care, after-school care, or baby-sitting in your home (subject to IRS qualifications). Remember you must use all designated funds by the end of the year ( use it or lose it ) when participating in a Health Care or Dependent Care FSA. Hussmann s plan does offer a grace period extension which allows an additional 75 days to claim reimbursement. If you have money left in your Healthcare FSA and no additional expenses to claim at the end of the year, you do not have to forfeit the balance. Instead, you can use the remaining balance to offset expenses incurred from January 1 through March 15 of the following year. FLEXIBLE SPENDING ACCOUNT Point of Clarification The Health FSA is for eligible medical, prescription drug, dental, and vision expenses for you and your dependents The Dependent Care FSA is for eligible dependent day care expenses for children under the age of 13 or dependents of any age that are incapable of caring for themselves due to a physical or mental handicap FSA and HSA Important Reminders If you are planning to enroll in the CHP for 2014 and are also interested in an HSA for eligible health care expenses, you re ineligible for a Health Care FSA. You are, however, able to participate in the Limited FSA (LFSA) and use it on dental and vision expenses only. Medical expenses cannot be paid for with the Limited FSA (LFSA)/HSA- Compatible FSA because they are intended to be paid from your HSA. If you have eligible dependent care expenses, you can enroll in the As of January 1, 2014, Hussmann is amending our plan to include the Heroes Earnings Assistance & Relief Tax Act of 2008 (HEART). The HEART Act allows "qualified reservist distributions" to those who are called to active duty. Please see your FSA Summary Plan Description for details, which is accessible via the Hussmann Intranet by going to: HR Links>Human Resources>Total Rewards>Healthcare Benefits. Dependent Care FSA regardless of the medical plan you choose. 15

16 ANNUAL ENROLLMENT 2014 How FSA Works 1. During enrollment, you elect to set aside a certain amount of your compensation in an FSA. Depending on your medical election, you can enroll in either the Health Care FSA or the Limited FSA; and independently of that decision, you can also enroll in the Dependent Care FSA. You must enroll each year to participate, even if you participated in the prior year. 2. The amount you decide to contribute for the year will be deducted from your paycheck in equal installments throughout 2014, on a before-tax basis. Your contribution level will remain in effect throughout 2014 unless you have a qualified status change. 3. Use the tax-free money you set aside to pay or reimburse yourself for eligible expenses incurred after the FSA is established. Note that over-the-counter medications are eligible for reimbursement through an FSA only if they are prescribed by a doctor. Using Your FSA Funds If you sign up for the Health Care FSA or the Limited FSA, you ll receive a debit card from ADP. It works like a bank debit card except that it is connected to your FSA. When you ve activated it (according to the Spending Account Card Welcome Kit you will receive in the mail), you can use it to pay for many eligible expenses when you receive services or at the time of purchase. Be sure to save all receipts. For a complete list of eligible expenses or additional resources, please go to myspendingaccount.adp.com or spendingaccountsinfo/knowledgecenter. As a reminder, you cannot use the debit card to pay for over-thecounter medications. You must pay for them and then file an FSA claim for reimbursement; the claim must be accompanied by a doctor s prescription. (Such eligible over-the-counter medications include, for example, pain relievers, cold medicines, antacids, and allergy medication.) You will not receive a debit card for use with the Dependent Care FSA. With this account, you pay for eligible expenses out of your pocket, then fax, mail, or submit online a reimbursement request along with a receipt for the expense to ADP. ADP then processes your request and promptly reimburses you through direct deposit or by check. You can draw on the total amount of your annual contributions to the Health Care FSA and the Limited FSA at any time during the year, regardless of how much has been deducted from your pay to date. With the Dependent Care FSA, however, you can only make claims for as much as you have contributed to the account to date. If you file a claim for more than your account balance, you will be reimbursed as your contributed funds become available in the account. 16

17 HUSSMANN CORPORATION Basic Life Insurance You will receive company-paid Basic Life Insurance in the amount of one times your Base Pay (rounded to the nearest $1,000) with a minimum of $50,000. The benefit maximum is $500,000. If your benefit is more than $50,000 then according to IRS regulations, the value of your life insurance in excess of $50,000 is considered imputed income. Imputed income is the value of non-cash compensation. It is added to your taxable wages and will appear on your W-2. Basic Accidental Death and Dismemberment (AD&D) Insurance You will receive company-paid Basic AD&D Insurance in the amount of one times your Base Pay (rounded to the nearest $1,000) with a minimum of $50,000. The benefit maximum is $500,000. Supplemental Life Insurance You may purchase Supplemental Life Insurance from one to eight times your Base Pay (rounded to the nearest $1,000), up to $1,000,000. Rates are based on the amount of insurance you purchase and your age. Evidence of insurability (EOI) may be required in the following circumstances: If you elect coverage greater than three times your Base Pay or $500,000, whichever is less If you waive coverage when you were first eligible and later choose to enroll If you later choose to increase your Supplemental Life coverage after your initial election LIFE, AD&D, DISABILITY Base Pay Your Base Pay is used to determine the amounts of Basic Life and Accident Insurance, Business Travel Accident Insurance, and Long-Term Disability coverage. The Base Pay is defined in your Summary Plan Description, please see for details. Basic Life, Voluntary Life, and AD&D Carrier Change As of January 1, 2014, coverages will be provided by Cigna. Contract Enhancement Waiver of Premium is being added to our life insurance contracts as of January 1, This means if you or your spouse are disabled prior to age 60, your premiums are waived until age 65. A six month elimination period will apply. Please see your Summary Plan Description for Details. Note: Summary Plan Descriptions can be accessed via the Hussmann Intranet at HR Links>Human Resources>Total Rewards>Healthcare Benefits. 17

18 ANNUAL ENROLLMENT 2014 Supplemental AD&D Insurance You may purchase Supplemental AD&D Insurance from one to eight times your Base Pay (rounded to the nearest $1,000), up to $1,000,000. Rates are based on the amount of insurance you purchase. Spouse or Same-Sex Domestic Partner (SSDP) Life Insurance You may purchase from $10,000 to $100,000 of coverage for your Spouse or SSDP, in $10,000 increments. Please note the Employee must be enrolled in the Voluntary Life coverage in order to purchase amounts on your dependent. The Spouse s or SSDP s coverage amount is limited to 50% of the Employees Basic and Voluntary Life amounts combined. Rates are based on the amount of insurance you purchase and your age. Evidence of insurability (EOI) may be required in the following circumstances: If you elect coverage for your spouse or SSDP over $30,000 If you waive coverage when you were first eligible and later choose to enroll If you later choose to increase your spouse/ssdp life coverage after your initial election Child Life Insurance Enhancement In 2013, you could purchase coverage for your dependent children in the amount of either $2,000 or $4,000 as long as you purchased Voluntary Life Insurance. The program is being enhanced as of January 1, 2014, to automatically increase those amounts to $5,000 or $10,000. Please note that while the cost per $1,000 of benefit will be the same, your current premium amounts will increase due to the increased volume. For example, if you currently purchase $2,000 of life insurance, you pay $0.077 per $1,000 of benefit ($.077 x 2) for a total monthly premium amount of $ As of 2014, your dependent coverage will increase to $5,000, you will pay $0.077 per $1,000 of benefit ($.0077 x 5) for a total monthly premium of $ Rates are based on the coverage level you select, regardless of the number of children you cover. No evidence of insurability (EOI) is required for this coverage. 18

19 HUSSMANN CORPORATION Dependent AD&D Insurance If you purchase Supplemental AD&D Insurance for yourself, you may also purchase AD&D coverage for your spouse or same-sex domestic partner and your dependent children. Coverage for your spouse or same-sex domestic partner will be equal to 50% of your Supplemental AD&D coverage. If you choose to elect additional AD&D for your Spouse or SSDP and not your children, the benefit will increase to 60% of your Supplemental AD&D Coverage. Coverage for each covered child will be equal to 10% of your Supplemental AD&D coverage. Beneficiary Reminder Remember to have your beneficiary information ready when you enroll in the Life or AD&D coverages. For each beneficiary you designate, you ll need to have the following information: name, address, date of birth, and Social Security number. Also, just a reminder to keep your beneficiary information up to date! Short-Term Disability (STD) Hussmann provides Short Term Disability benefits at no cost to you. If you become disabled and are unable to work due to an accident or injury, you may be able to receive STD benefits that will replace a portion of your salary. Enhancement The STD benefit for hourly employees paid weekly will increase from 40% to 70% of your Base Pay as of January 1, Long-Term Disability (LTD) Hussmann also provides Long-Term Disability benefits at no cost to you. Once your STD benefits end, if you continue to be disabled and unable to work due to an accident or injury, then you may be able to receive LTD benefits. LTD benefits are payable for as long as you remain disabled or until your Social Security normal retirement age. 19

20 ANNUAL ENROLLMENT 2014 Basic LTD Hussmann provides a basic LTD benefit equal to 40% of your Base Pay. Hussmann pays the full cost of this benefit. Supplemental LTD You may purchase Supplemental Long-Term Disability coverage that will replace an additional 20% of your Base Pay. If applicable, Base Pay will include commission. See the SPD for further details. The maximum monthly benefit (basic and supplemental LTD combined) is $20,000. This benefit will be reduced by certain other income such as Social Security disability benefits and other sources of income. If you waive this benefit when first eligible and then choose to enroll at a later date, evidence of insurability (EOI) will be required. Pre-Existing Condition Exclusion The LTD plan does not cover disabilities resulting from a pre-existing condition, which is one for which: You received medical treatment, consultation, care, or services (including diagnostic measures), or took prescribed drugs or medicines in the three months immediately prior to your effective date of coverage, and Your disability begins in the first 12 months after your effective date of coverage. If you purchase an increased amount of LTD coverage, the preexisting condition exclusion also applies to the additional amount of coverage. 20

21 HUSSMANN CORPORATION Business Travel Accident Insurance To protect you when you travel on company business, Hussmann provides you with Business Travel Accident Insurance. The benefit equals four times your Base Pay up to $1,000,000. This benefit is provided at no cost to you. OTHER COVERAGES The Employee Assistance Program (EAP) The EAP is a confidential counseling and referral service that can help you and your family deal with life s challenges. Provided by Magellan Health Services, the EAP is available to you and your eligible dependents and other household members at no cost. The EAP can help with issues like job-related stress, parenting, alcohol and drugs, marital problems, anxiety, depression, legal situations, financial concerns, and dependent care concerns. For additional information about the EAP, visit or call ID Card Reminder Medical You will not be receiving a new ID card from UHC unless you have enrollment changes as of January 1, 2014 Rx You will not receive a new ID card from CVS Caremark unless you are enrolling in coverage for the first time HSA You will not receive a new debit card from Wells Fargo unless you are enrolling in the CHP for the first time FSA You will receive a new debit card from ADP Limited FSA You will receive a new debit card from ADP Dental Delta Dental of Missouri will issue and mail ID cards to participants homes prior to January 1, 2014 Vision ID cards are not issued for the vision plan 21

22 ANNUAL ENROLLMENT 2014 SPECIAL NOTICES Required Annual Notices Hussmann Corporation is required by law to provide you with the following notices: Women s Health and Cancer Rights Act The Women s Health and Cancer Rights Act of 1998 ( WHCRA ) provides certain protections for individuals receiving mastectomy-related benefits. Coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: All stages of 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 of the mastectomy, including lymphedemas. The Hussmann Corporation medical plan provides medical coverage for mastectomies and the related procedures listed above, subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. Medicare Part D Creditable Coverage Notice Important Notice from Hussmann Corporation About Your Prescription Drug Coverage and Medicare. Please read this notice carefully for information about your current prescription drug coverage with Hussmann Corporation and about your options under Medicare s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are important things you need to know about your current coverage and Medicare s prescription drug coverage: Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium. Hussmann Corporation has determined that the prescription drug coverage offered by the medical plan options under the Hussmann Corporation Welfare Benefit Plan (the plan ) is creditable. That is, Hussmann Corporation has determined that the prescription drug coverage offered by the medical plan options under the plan is, on average for all plan participants, expected to payout as much as standard Medicare prescription drug coverage pays (and, therefore, is considered to be creditable coverage). Because your existing coverage is creditable coverage, you can keep this coverage and not pay a higher premium (a penalty) if you decide to later join a Medicare drug plan. For deductible and coinsurance information that applies under the medical plan, or if you would like more information on WHCRA benefits, please refer to the summary plan description for the medical plan or contact Human Resources at (314)

23 HUSSMANN CORPORATION When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15 through December 7. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two-month Special Enrollment Period (SEP) to join a Medicare drug plan. What Happens to Your Current Coverage if You Decide to Join a Medicare Drug Plan? If you do decide to join a Medicare drug plan and drop your current Hussmann Corporation coverage, be aware that you and your dependents may not be able to get this coverage back. When Will You Pay a Higher Premium (Penalty) to Join a Medicare Drug Plan? You should also know that if you drop or lose your current coverage with Hussmann Corporation and don t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following November to join. For More Information About Your Options Under Medicare Prescription Drug Coverage More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare and You handbook. You may get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage: Visit Call your State Health insurance Assistance Program (see the inside back cover of the Medicare and You handbook for their telephone number) for personalized help Call l.800.medicare ( ). TTY users should call (TTY ) If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at or call them at (TTY ). Comprehensive Notice of Privacy Policy and Procedures This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. This Notice is provided to you on behalf of Hussmann Corporation. For More Information About This Notice or Your Current Prescription Drug Coverage Contact the benefits office for further information, or call the phone number on the back of your medical ID card. NOTE: You ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan and if this coverage through Hussmann Corporation changes. You also may request a copy of this notice at any time. 23

24 ANNUAL ENROLLMENT 2014 The Plan s Duty to Safeguard Your Protected Health Information. Individually identifiable information about your past, present, or future health or condition, the provision of health care to you, or payment for the health care is considered Protected Health Information ( PHI ). The Plan is required to extend certain protections to your PHI, and to give you this Notice about its privacy practices that explains how, when and why the Plan may use or disclose your PHI. Except in specified circumstances, the Plan may use or disclose only the minimum necessary PHI to accomplish the purpose of the use or disclosure. The Plan is required to follow the privacy practices described in this Notice, though it reserves the right to change those practices and the terms of this Notice at any time. If it does so, and the change is material, you will receive a revised version of this Notice either by hand delivery, mail delivery to your last known address, or some other fashion. This Notice, and any material revisions of it, will also be provided to you in writing upon your request (ask your Human Resources representative), and will be posted on any website maintained by Hussmann Corporation that describes benefits available to employees and dependents. You may also receive one or more other privacy notices, from insurance companies that provide benefits under the Plan. Those notices will describe how the insurance companies use and disclose PHI, and your rights with respect to the PHI they maintain. How the Plan May Use and Disclose Your Protected Health Information. The Plan uses and discloses PHI for a variety of reasons. For its routine uses and disclosures it does not require your authorization, but for other uses and disclosures, your authorization (or the authorization of your personal representative (e.g., a person who is your custodian, guardian, or has your power-of-attorney) may be required. The following offers more description and examples of the Plan s uses and disclosures of your PHI. Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations. Treatment: Generally, and as you would expect, the Plan is permitted to disclose your PHI for purposes of your medical treatment. Thus, it may disclose your PHI to doctors, nurses, hospitals, emergency medical technicians, pharmacists and other health care professionals where the disclosure is for your medical treatment. For example, if you are injured in an accident, and it s important for your treatment team to know your blood type, the Plan could disclose that PHI to the team in order to allow it to more effectively provide treatment to you. Payment: Of course, the Plan s most important function, as far as you are concerned, is that it pays for all or some of the medical care you receive (provided the care is covered by the Plan). In the course of its payment operations, the Plan receives a substantial amount of PHI about you. For example, doctors, hospitals and pharmacies that provide you care send the Plan detailed information about the care they provided, so that they can be paid for their services. The Plan may also share your PHI with other plans, in certain cases. For example, if you are covered by more than one health care plan (e.g., covered by this Plan, and your spouse s plan, or covered by the plans covering your father and mother), we may share your PHI with the other plans to coordinate payment of your claims. Health care operations: The Plan may use and disclose your PHI in the course of its health care operations. For example, it may use your PHI in evaluating the quality of services you received, or disclose your PHI to an accountant or attorney for audit purposes. In some cases, the Plan may disclose your PHI to insurance companies for purposes of obtaining various insurance coverage. However, the Plan will not disclose, for underwriting purposes, PHI that is genetic information. 24

25 HUSSMANN CORPORATION Other Uses and Disclosures of Your PHI Not Requiring Authorization. The law provides that the Plan may use and disclose your PHI without authorization in the following circumstances: To the Plan Sponsor: The Plan may disclose PHI to the employers (such as Hussmann Corporation) who sponsor or maintain the Plan for the benefit of employees and dependents. However, the PHI may only be used for limited purposes, and may not be used for purposes of employment-related actions or decisions or in connection with any other benefit or employee benefit plan of the employers. PHI may be disclosed to: the human resources or employee benefits department for purposes of enrollments and disenrollments, census, claim resolutions, and other matters related to Plan administration; payroll department for purposes of ensuring appropriate payroll deductions and other payments by covered persons for their coverage; information technology department, as needed for preparation of data compilations and reports related to Plan administration; finance department for purposes of reconciling appropriate payments of premium to and benefits from the Plan, and other matters related to Plan administration; internal legal counsel to assist with resolution of claim, coverage and other disputes related to the Plan s provision of benefits. Required by law: The Plan may disclose PHI when a law requires that it report information about suspected abuse, neglect or domestic violence, or relating to suspected criminal activity, or in response to a court order. It must also disclose PHI to authorities that monitor compliance with these privacy requirements. For public health activities: The Plan may disclose PHI when required to collect information about disease or injury, or to report vital statistics to the public health authority. For health oversight activities: The Plan may disclose PHI to agencies or departments responsible for monitoring the health care system for such purposes as reporting or investigation of unusual incidents. Relating to decedents: The Plan may disclose PHI relating to an individual s death to coroners, medical examiners or funeral directors, and to organ procurement organizations relating to organ, eye, or tissue donations or transplants. For research purposes: In certain circumstances, and under strict supervision of a privacy board, the Plan may disclose PHI to assist medical and psychiatric research. To avert threat to health or safety: In order to avoid a serious threat to health or safety, the Plan may disclose PHI as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of harm. For specific government functions: The Plan may disclose PHI of military personnel and veterans in certain situations, to correctional facilities in certain situations, to government programs relating to eligibility and enrollment, and for national security reasons. Uses and Disclosures Requiring Authorization: For uses and disclosures beyond treatment, payment and operations purposes, and for reasons not included in one of the exceptions described above, the Plan is required to have your written authorization. Your authorizations can be revoked at any time to stop future uses and disclosures, except to the extent that the Plan has already undertaken an action in reliance upon your authorization. Uses and Disclosures Requiring You to have an Opportunity to Object: The Plan may share PHI with your family, friend or other person involved in your care, or payment for your care. We may also share PHI with these people to notify them about your location, general condition, or death. However, the Plan may disclose your PHI only if it informs you about the disclosure in advance and you do not object (but if there is an emergency situation and you cannot be given your opportunity to object, disclosure may be made if it is consistent with any prior expressed wishes and disclosure is determined to be in your best interests; you must be informed and given an opportunity to object to further disclosure as soon as you are able to do so). 25

26 ANNUAL ENROLLMENT 2014 Your Rights Regarding Your Protected Health Information. You have the following rights relating to your protected health information: To request restrictions on uses and disclosures: You have the right to ask that the Plan limit how it uses or discloses your PHI. The Plan will consider your request, but is not legally bound to agree to the restriction. To the extent that it agrees to any restrictions on its use or disclosure of your PHI, it will put the agreement in writing and abide by it except in emergency situations. The Plan cannot agree to limit uses or disclosures that are required by law. Effective February 17, 2010, you can restrict disclosure of PHI for payment or health care operations if you pay the health care provider the full out-of-pocket cost. To choose how the Plan contacts you: You have the right to ask that the Plan send you information at an alternative address or by an alternative means. The Plan must agree to your request as long as it is reasonably easy for it to accommodate the request. To inspect and copy your PHI: Unless your access is restricted for clear and documented treatment reasons, you have a right to see your PHI in the possession of the Plan or its vendors if you put your request in writing. The Plan, or someone on behalf of the Plan, will respond to your request, normally within 30 days. If your request is denied, you will receive written reasons for the denial and an explanation of any right to have the denial reviewed. If you want copies of your PHI, a charge for copying may be imposed but may be waived, depending on your circumstances. You have a right to choose what portions of your information you want copied and to receive, upon request, prior information on the cost of copying. To request amendment of your PHI: If you believe that there is a mistake or missing information in a record of your PHI held by the Plan or one of its vendors, you may request, in writing, that the record be corrected or supplemented. The Plan or someone on its behalf will respond, normally within 60 days of receiving your request. The Plan may deny the request if it is determined that the PHI is: (i) correct and complete; (ii) not created by the Plan or its vendor and/or not part of the Plan s or vendor s records; or (iii) not permitted to be disclosed. Any denial will state the reasons for denial and explain your rights to have the request and denial, along with any statement in response that you provide, appended to your PHI. If the request for amendment is approved, the Plan or vendor, as the case may be, will change the PHI and so inform you, and tell others that need to know about the change in the PHI. To find out what disclosures have been made: You have a right to get a list of when, to whom, for what purpose, and what portion of your PHI has been released by the Plan and its vendors, other than instances of disclosure for which you gave authorization, or instances where the disclosure was made to you or your family. In addition, the disclosure list will not include disclosures for treatment, payment, or health care operations. The list also will not include any disclosures made for national security purposes, to law enforcement officials or correctional facilities, or before the date the federal privacy rules applied to the Plan. You will normally receive a response to your written request for such a list within 60 days after you make the request in writing. Your request can relate to disclosures going as far back as six years. There will be no charge for up to one such list each year. There may be a charge for more frequent requests. How to Complain about the Plan s Privacy Practices. If you think the Plan or one of its vendors may have violated your privacy rights, or if you disagree with a decision made by the Plan or a vendor about access to your PHI, you may file a complaint with the person listed in the section immediately below. You also may file a written complaint with the Secretary of the U.S. Department of Health and Human Services. The law does not permit anyone to take retaliatory action against you if you make such complaints. 26

27 HUSSMANN CORPORATION Notification of a Privacy Breach A new federal law, the American Reinvestment and Recovery Act of 2009 (ARRA) has made numerous changes to the rules governing PHI that is maintained by the Plan and its service providers (business associates). Effective September 23, 2009, any individual whose unsecured PHI has been, or is reasonably believed to have been used, accessed, acquired or disclosed in an unauthorized manner will receive written notification from the Plan within 60 days of the discovery of the breach. The notice will be provided to you if the breach poses a significant risk of financial, reputational or other harm to you. If the breach involves 500 or more residents of a state, the Plan will notify prominent media outlets in the state. The Plan will maintain a log of security breaches and will report this information to HHS on an annual basis. Immediate reporting from the Plan to HHS is required if a security breach involves 500 or more people. Contact Person for Information, or to Submit a Complaint. If you have questions about this Notice please contact the Plan s Privacy Official or Deputy Privacy Official(s). If you have any complaints about the Plan s privacy practices, handling of your PHI, or breach notification process, please contact the Privacy Official or an authorized Deputy Privacy Official. Organized Health Care Arrangement Designation. The Plan participates in what the federal privacy rules call an Organized Health Care Arrangement. The purpose of that participation is that it allows PHI to be shared between the members of the Arrangement, without authorization by the persons whose PHI is shared, for health care operations. Primarily, the designation is useful to the Plan because it allows the insurers who participate in the Arrangement to share PHI with the Plan for purposes such as shopping for other insurance bids. Notice of Health Insurance Marketplace Under the Patient Protection and Affordable Care Act, employers covered by the Fair Labor Standards Act are required to provide notice to their employees informing them about their state s Health Insurance Marketplace. Enclosed you will find the required Notice of Exchange which answers questions and provides you with information about the health coverage offered. Please note that this notice does not affect your enrollment in our health plan. It is for informational purposes only. Hussmann s health plan meets the health reform law s minimum value and affordability standards and you are not eligible for federal financial assistance (tax credits) to help you buy an insurance policy for yourself in a Health Insurance Marketplace. And because we offer you minimum value and affordable coverage, and also offer coverage to your family, they might also be ineligible for financial assistance in a Health Insurance Marketplace. If you receive financial assistance in a Health Insurance Marketplace are not entitled to it, you might have to repay the financial assistance you received. If you would like more information about the Marketplace, please visit gov. All questions regarding the Marketplace should be routed to the contact information on the website. Should you have any questions about Hussmann s health insurance benefits, please contact Human Resources. 27

28 ANNUAL ENROLLMENT 2014 New Health Insurance Marketplace Coverage Options and Your Health Coverage PART A: General Information When key parts of the health care law take effect in 2014, there will be a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment based health coverage offered by your employer. What is the Health Insurance Marketplace? The Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers "one-stop shopping" to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Open enrollment for health insurance coverage through the Marketplace begins in October 2013 for coverage starting as early as January 1, Can I Save Money on my Health Insurance Premiums in the Marketplace? You may qualify to save money and lower your monthly premium, but only if your employer does not offer coverage, or offers coverage that doesn't meet certain standards. The savings on your premium that you're eligible for depends on your household income. Does Employer Health Coverage Affect Eligibility for Premium Savings through the Marketplace? Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer's health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the "minimum value" standard set by the Affordable Care Act, you may be eligible for a tax credit. 28

29 HUSSMANN CORPORATION Note: If you purchase a health plan through the Marketplace instead of accepting health coverage offered by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution -as well as your employee contribution to employer-offered coverageis often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an after-tax basis. How Can I Get More Information? For more information about your coverage offered by your employer, please check your summary plan description or contact benefits@hussmann.com or The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit HealthCare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area PART B: Information About Health Coverage Offered by Your Employer This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application. Employer name Employer Identification Number (EIN) Hussmann Employer address Employer phone number Saint Charles Rock Road (314) City State ZIP code Bridgeton MO Who can we contact about employee health coverage at this job? Human Resources Phone number (if different from above) address benefits@hussmann.com Here is some basic information about health coverage offered by this employer: As your employer, we offer a health plan to: All employees. ;; Some employees. Eligible employees are: Full-time non-union employees working 32 or more hours per week Active union employees working 20 or more hours per week With respect to dependents: ;; We do offer coverage. Eligible dependents are: Spouses Domestic Partners Child(ren) to age 26 We do not offer coverage. ;; If checked, this coverage meets the minimum value standard, and the cost of this coverage to you is intended to be affordable, based on employee wages. ** Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount through the Marketplace. The Marketplace will use your household income, along with other factors, to determine whether you may be eligible for a premium discount. If, for example, your wages vary from week to week (perhaps you are an hourly employee or you work on a commission basis), if you are newly employed mid-year, or if you have other income losses, you may still qualify for a premium discount. If you decide to shop for coverage in the Marketplace, HealthCare.gov will guide you through the process. Here's the employer information you'll enter when you visit HealthCare.gov to find out if you can get a tax credit to lower your monthly premiums. 29

30 ANNUAL ENROLLMENT 2014 BENEFITS DIRECTORY Program Provider/Contact Telephone Group Number Website/ General Benefits Questions and Enrollment OneSource Virtual N/A hussmann/login.flex onesourcevirtual.com Medical UnitedHealthcare Prescription Drug CVS Caremark RxGRP: HUSMN Dental Delta Dental of GRP: Missouri (DDMO) Vision VSP GRP: Flexible Spending ADP N/A Accounts Health Savings Accounts (CHP Only) Wells Fargo N/A Disability (Please contact your HR Cigna GRP: 535 mycigna.com Partner to start any leave process) Life Insurance; Accidental Death Cigna FLX mycigna.com and Dismemberment (AD&D) Employee Assistance Program (EAP) Magellan N/A member 401(k) and Pension Transamerica N/A hussmann.trsretire.com 30

31 HU SS MANN C ORP ORAT I ON NOT E S 31

32 All changes must be made by November 29 The descriptions of the benefits are not guarantees of current or future employment or benefits. If there is any conflict between this Guide and the official Plan Documents, the official documents will govern. This Employee Benefits Newsletter is only intended to highlight some of the major benefit provisions of the Company plan and should not be relied upon as a complete detailed representation of the plan. Please refer to the plan s Summary Plan Descriptions for further detail. Should this newsletter differ from the Summary Plan Descriptions, the Summary Plan Descriptions prevail Lockton, Inc. All rights reserved. Images 2013 Thinkstock. All rights reserved. EB\HUSMA08\EE Comm\Anl Enroll including Guide\2014\14Non-Union.pdf