Benefits Enrollment - Life Event Rules and Requirements. When is the change effective? Change is effective on the date of birth.

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1 Benefits Enrollment - Life Event Rules and Requirements You can make changes to your medical plan, coverage level or election during the year if you qualify for a Special Enrollment under HIPAA (Health Insurance Portability and Accountability Act). You can also make changes to your benefit coverage level during the year if you have an eligible in Status (e.g. getting married or having a child) and the new benefit election is consistent with your in Status (see last page for examples). Refer to benefits.medtronic.com (U.S. employees) or the HR Portal (Puerto Rico employees) for additional information and provisions. If you have any questions about mid-year changes to your benefits, please contact AskHR Monday- Friday from 8:00 a.m. - 8:00 p.m. ET at (800) or askhr@medtronic.com. Life Event Birth or Adoption When must I request a change? Birth: child s birth. When is the change effective? on the date of birth. How do I request a change Benefits > Benefits> Benefit Adoption: Within 31 days after the child is placed with you, or after adoption becomes final, whichever comes first. on the date of adoption or placement for adoption, whichever is earlier. Event Type: Birth or Adoption Benefit Event Date: date of Birth Marriage marriage. Benefits > Benefits> Benefit Event Type: Marriage updating 1

2 Divorce Gain Eligibility of Other Gain of other coverage for Spouse or Child (e.g. gain of employment, gain of educational group coverage, gain of Government plan) divorce. **Note: When changing from married to divorced status, your ex-spouse is no longer an eligible dependent and must be removed immediately. date of the gain. Benefits > Benefits> Benefit Event Type: Divorce/End of DP Relationship updating Benefits > Benefits> Benefit Event Type: Gain Eligibility of Other updating Gain eligibility for premium assistance under Medicaid, Medicare, a state child health plan or entitlement of government plan Within 60 days of gain of eligibility. Benefits > Benefits > Benefit Event Type: Gained Eligibility of Other updating Lost Eligibility of Other Loss of other coverage for Spouse or Child (e.g. loss of employment, loss of educational group coverage, employer stops contributing) date of the loss. Event Type: Lost Eligibility of Other updating Loss of coverage under Medicaid, a state child health plan, or entitlement to government plan Within 60 days of loss of eligibility. Event Type: Lost Eligibility of Other Benefit updating

3 New Hire Benefit Correction date of hire. on the date of hire Event Type: New Hire Benefit Correction Benefit Event Date: date of hire Dependent Day Care Significant change in the cost of dependent day care or change in provider that results in a significant change in cost change in cost or provider. Event Type: Dependent Day Care updating HSA Any time. on the date self-service event is Event Type: HSA updating On-Site Wellness Center Membership Any time. on the date self-service event is Event Type: On-site Wellness Center Membership updating LTD Coverage Any time. Will need to provide evidence of insurability and receive approval. Event Type: LTD Coverage updating Life Insurance Beneficiary Any time. on the date of the event. Event Type: Life Insurance Beneficiary updating

4 Life Insurance Coverage AD&D: Anytime Optional / Spouse Life: qualifying life event (described above) or provide evidence of insurability and receive approval. date or date of approval of good health if required, whichever is later. Event Type: Life Insurance Coverage updating Child Life: Only available on qualifying life events that allow changes after initial eligibility (birth, marriage). s to employee s (such as reduction or increase in hours) Contact AskHR within 31 days of employment change. An event will populate in your Inbox. Commencement or return from a leave FMLA/Salary Continuation/Military commencement of or return from an FMLA leave. An event will populate in your Inbox. Return from Leave (LTD, Personal, Sabbatical, Work Comp, Puerto Rico-STD) Death of a spouse or child return from leave. death. the date of death. An event will populate in your Inbox. Contact AskHR.

5 Examples - Benefit Elections MUST be Consistent with in Status. You can make certain changes to your benefit elections during the year (outside of open enrollment) if you have an eligible change in status and the new benefit election is consistent with your change in status. The life event examples below illustrate benefit elections that are consistent versus not consistent with a specific change in status. Life Event ( in status event) Having a baby to your spouse s (i.e. spouse s hours reduce) s to employee s (i.e. relocating from MN to TX) What can be changed? (Benefit Election Consistent with in Status) Adding medical coverage for your new baby directly related to life event Adding medical coverage for your spouse Spouse no longer has coverage through his/her employer You must answer the health care coverage question located in the spouse profile Dropping medical coverage for yourself and dependents in the HealthPartners plan Location change out of MN allows medical coverage to be dropped /changed to a different plan What cannot be changed? (Benefit Election Not Consistent with in Status) Dropping vision coverage for yourself not related to having a baby Reducing or waiving your health care flexible spending account Adding the Dental coverage Location change does not affect dental plan eligibility To determine if a benefit election is consistent with a change in status, or for other questions contact AskHR.