T HE HCSC E M P L O Y E E S P E N S I O N P L A N

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1 T HE HCSC E M P L O Y E E S P E N S I O N P L A N E F F E C T I V E D A T E : J A N U A R Y 1, 2015 P U B L I S H D A T E : M A Y 1,

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3 T A B L E O F C O N T E N T S INTRODUCTION 3 IMPORTANT TERMS 4-5 WHO IS ELIGIBLE 5 WHEN YOU BECOME A PARTICIPANT OF THE PLAN 5-6 COST OF THE PLAN 6 YOUR EMPLOYEE PENSION PLAN ACCOUNT 6-10 Employer Credits 7 Interest Credits 8 Transitional Benefit 9 Vesting 9 Withdrawals 10 WHEN YOU TERMINATE OR RETIRE Payment Options 10 Joint and Survivor Annuity 11 Life Annuity with 10-Year Certain and Continuous Option 11 Life Annuity 12 Lump Sum Option 12 When Benefits Begin 13 Direct Rollovers If You Return to Work with the Company 14 If You Transfer and Your Participation Ends 15 If You Take a Leave of Absence 15 If You Become Disabled If You Die While You Are an Active Participant in the Plan 16 If You Die After You Terminate Employment

4 HOW TO APPLY FOR BENEFITS 17 CLAIMS PROCEDURES OTHER CONSIDERATIONS Statement of Your Employee Pension Plan Account 19 Tax Considerations 19 Consult Your Tax Advisor 19 Qualified Domestic Relations Orders IF THE PLAN BECOMES TOP HEAVY 20 IF THE PLAN IS AMENDED OR TERMINATED PLAN CONTINUATION AND DISCRETION 22 GOVERNMENTAL REQUIREMENTS AFFECTING BENEFITS 22 OTHER IMPORTANT INFORMATION General Information about the Plan Your Rights under the Employee Retirement Income Security Act of 1974 (ERISA) APPENDIX TRANSITIONAL FORMULA 27 2

5 I N T R O D U C T I O N The financial protection provided by HEALTH CARE SERVICE CORPORATION (HCSC or Company), a Mutual Legal Reserve Company, extends beyond your employment. While certain benefits help protect you during the years you work here, your Pension Plan can help provide the financial security you will need when you retire. Your Retirement Program includes THE 401(k) PLAN and THE HCSC EMPLOYEES PENSION PLAN. Whether you retire in 10 years or 25 years, the key to enjoying your retirement is how well you have planned for it. That means look at what you will need for retirement and then decide how you can best meet those needs. In addition to The HCSC Employees Pension Plan, your retirement income will include the benefits provided by Social Security, to which you and the Company have been contributing throughout your career. You also have your personal savings. A component of this may be your savings in THE 401(k) PLAN. Your pension, however, may be the primary part of your retirement income. Therefore, it is important that you understand what the Pension Plan will provide. The HCSC Employees Pension Plan is a cash balance plan, which has these advantages: It is easy to understand; It is completely funded by the Company; It is designed to provide a benefit that increases with pay and interest credits throughout your employment; It s portable if you are vested when you terminate, you can take it with you when you leave the Company; and, It expresses your benefit in a lump sum amount the same as THE 401(k) PLAN making it easier for you to estimate your total retirement savings. This summary gives you many of the details of the Plan and how it works. The Plan is governed by a legal plan document. If there is a difference between information contained in this summary and the plan document, the plan document will govern. Please read this summary carefully. 3

6 I M P O R T A N T T E R M S There are a number of words and phrases that have a very specific meaning when used to describe The HCSC Employees Pension Plan. The following explanations of these special terms are to help you better understand your benefits. Company means Health Care Service Corporation, a Mutual Legal Reserve Company, and each subsidiary that is eligible to participate in the Plan. Active Participant means an employee eligible to participate in the Plan who is either actively employed, on an approved leave of absence, on short-term disability, or reclassified to long-term disability. Disability or Disabled means the inability to perform your job as defined by the Plan. (See the Disability section of this summary for more information.) Employer means the Company and each subsidiary that has adopted The HCSC Employees Pension Plan. Plan or Pension Plan or Employee Pension Plan means The HCSC Employees Pension Plan. Administrative Committee means the Plan Administrative Committee appointed to administer the Plan. (See the General Information section for the address of the Plan Administrative Committee). Pay means your pensionable earnings (not total compensation) from the Company for services rendered during the calendar year as reported on your Form W-2. Pay excludes severance payments, retirement bonuses, service awards, accumulated sick leave, short-term disability reserve paid at termination, unused vacation (PTO) pay for any period extending beyond 501 Hours of Service, Performance Awards (from either or both the Health Care Service Corporation Long Term Performance Plan and/or the Health Care Service Corporation Long Term Incentive Plan) exceeding 75% of your Base Compensation, and all other extraordinary compensation. Pay includes unused vacation/paid time off (PTO) pay paid at termination (up to 501 Hours of Service), the amounts you contribute to a Section 125 plan or 401(k) plan as pre-tax contributions, certain amounts deferred under the Employer s nonqualified deferred compensation program, and (on or after January 1, 2009) any Performance Awards distributed from the Health Care Service Corporation Long Term Incentive Plan. Pay in excess of an indexed amount ($265,000 in 2016) is not included. Plan Year is January 1 through December 31. Social Security Wage Base is the amount of your Pay subject to the Old Age Survivor and Disability Insurance (OASDI) portion of Social Security taxes. Each year the federal government 4

7 announces the wage base that will take effect on January 1 of the following year. The wage base that will be used in determining your credits is the one in effect during each Plan Year. Vesting is your right to the benefits earned when you leave the Company. Vesting Service is the period of service used to determine your right to the benefits you have earned. Generally, vesting service includes all of your service with the Company (and in certain situations other industry related companies if you were hired before January 1, 2001). It excludes breaks in service greater than 12 months. Depending on the length of your breaks, it may also exclude prior periods of service. Vesting Service (measured on an elapsed time basis from January 1, 2001) may be earned during certain periods of leave, including qualified military service that must be credited under federal law, or a leave of absence resulting from a disability. If you are on a leave of absence (including leave under the Family and Medical Leave Act of 1993 [FMLA]), up to the first twelve months of leave will be included as vesting service. If you are on a leave of absence for military service, your qualified military service will be credited as vesting service in accordance with federal law. W H O I S E L I G I B L E You are eligible to participate in The HCSC Employees Pension Plan if you are: Employed by an Employer. You are NOT eligible to participate in The HCSC Employees Pension Plan if you are: A leased employee or, an independent contractor for federal and income tax purposes; or Represented by a collective bargaining agreement, unless your collective bargaining agreement specifically provides for participation in The HCSC Employees Pension Plan. A participant who is accruing benefits under any other qualified defined benefit plan sponsored by the Company. W H E N Y O U B E C O M E A P A R T I C I P A N T O F T H E P LAN You become a participant of the Plan automatically as follows: If you are a newly eligible full-time or part-time employee, you become a participant of the Plan on the first anniversary of your date of hire. 5

8 If you are not eligible to participate in the Plan, but you are reclassified into an employment status under which you become eligible to participate in the Plan, you will become a participant of the Plan on the first anniversary of your date of hire, or, if later, the date you are reclassified as an employee who is eligible to participate in the Plan. You should name a beneficiary when you become a participant of the Plan. If you die after becoming vested in your employee pension plan account, your beneficiary will receive your benefit. If you are single, you may name anyone you wish as your beneficiary. If you are married, the law requires that your spouse be your primary beneficiary unless both you and your spouse agree to designate an "estate, trust, entity, or another individual" as beneficiary. If you designate someone other than (or in addition to) your spouse as your primary beneficiary, your spouse must provide written, notarized consent on forms acceptable to the Plan. C O S T O F T H E P LAN The cost for The HCSC Employees Pension Plan is completely paid by the Company. You are neither required nor permitted to contribute to the Plan. Y O U R E M P L O Y E E P E N S I O N P LAN A C C O U N T Your benefit under The HCSC Employees Pension Plan is shown as an account balance; however, unlike a savings account or your 401(k) Plan account, this employee pension plan account represents credits you have earned, rather than cash you have saved. All of the Plan s assets are held in the master trust fund and are not divided among individual accounts. The Plan Administrative Committee maintains records of the total credits and will convert those credits into one of the forms of payment provided by the Plan if you are vested when you leave the Company. In addition, The HCSC Employees Pension Plan carries the protection of the federal government s Pension Benefit Guaranty Corporation (PBGC). That means that the benefits provided under the Plan are insured to the extent permitted by the PBGC. See If the Plan Is Amended or Terminated in this summary. The statement of benefits provided each year will show your benefit as the current balance of your employee pension plan account. 6

9 E M P L O Y E R C R E D I T S The Employer will credit your employee pension plan account with a certain percentage of your Pay (as defined in this summary) that is determined by your age on the last day of the pay period. Your Age Percentage of Pay Credited to Your Employee Pension Plan Account Percentage of Any Pay that Exceeds the Social Security Wage Base Credited to Your Employee Pension Plan Account Under % 2.0% % 2.0% % 2.0% % 2.0% % 2.0% % 2.0% 55 and Over 6.0% 2.0% Credits are added to your employee pension plan account based on your Pay. When you move to a new age bracket, your percentage will automatically increase for future credits. ILLUSTRATION: EMPLOYER CREDITS John Jones is a new participant in He is 30 years old, his bi-weekly Pay is $1,962, and the Social Security Wage Base for the year is $106,800. Employer credits would be added to John s employee pension plan account equal to 3.5% of his Pay. If Mr. Jones' pay exceeds $106,800 for the year, he will also be credited with an additional 2% for Pay that exceeds the Social Security Wage Base..035 X $1,962 = $ X $ 0 = 0 TOTAL $ 1,962 $

10 I N T E R E S T C R E D I T S In addition to Employer credits, your employee pension plan account is credited with interest each pay period. The interest rate credited to your employee pension plan account is established under the Plan before the beginning of each new calendar quarter. The rate will continue in effect for that quarter. There is no investment risk to you at any time. The rate for interest credits is the annual rate of interest which is the greater of 2% or the annual rate of interest on 30-year Treasury securities for the 4 th full calendar month immediately preceding the applicable calendar quarter, as published in the Federal Reserve Statistical Release. The interest rate credited in prior periods should not be used as an indication of what future interest credits will be. ILLUSTRATION: HOW YOUR EMPLOYEE PENSION PLAN ACCOUNT CAN GROW Let us continue to look at John Jones. If he continues in the Plan until age 65, if his Pay and the Social Security Wage Base remain constant (for purposes of this illustration), and if his employee pension plan account receives interest credits compounded to yield an effective annual rate of 6%, here is how his employee pension plan account will look: OPENING EMPLOYER INTEREST CLOSING AGE BALANCE CREDITS CREDITS BALANCE During the First Year 30 $ 0 $1,785 $ 51 $1,836 During the Second Year 31 $1,836 $1,785 $162 $3,783 Over the remainder of his career, his employee pension plan account will look like this: AGE BALANCE AGE BALANCE 35 $ 10, $ 121, $ 25, $180, $ 47, $258, $ 78,596 8

11 T R A N S I T I O N A L B E N E F I T If you were an active, non-union participant in one of the predecessor plans listed below on December 31, 2000, and you became a participant in The HCSC Employees Pension Plan, you may be eligible to receive benefits under a formula called a transitional formula. The predecessor plans are: Texas Blue Cross Employees Retirement Plan; and Non-Contributory Retirement Program for Employees of Illinois Blue Cross and Blue Shield. If you were an Active Participant in the Non-Contributory Retirement Program For Certain Employees of New Mexico Blue Cross and Blue Shield, Inc. on December 31, 2001, and you became a participant of The HCSC Employees Pension Plan on January 1, 2002, you may also be eligible for a transitional formula. If you were an Active Participant in the Non-Contributory Retirement Program for certain employees of Group Health Service of Oklahoma, Inc. on December 31, 2006, and you became a participant of The HCSC Employees Pension Plan on January 1, 2007, you may also be eligible for a transitional formula. If you were an Active Participant in the Non-Contributory Retirement Program For Certain Employees of Blue Cross and Blue Shield of Montana, Inc. on August 1, 2013, and you became a participant of The HCSC Employees Pension Plan on January 1, 2015, you may also be eligible for a transitional formula. If you are eligible for transitional formula, please refer to the Appendix at the end of this summary. V E S T I N G You can receive your benefit when you leave the Company if you are "vested." Vesting means that you have a right to receive the balance in your employee pension plan account. You become vested in your employee pension plan account after you have completed three (3) years of Vesting Service, or, while an Active Participant, upon the later of your 65 th birthday and the first anniversary of your date of hire. From that point on, you are 100% vested in your account balance, including any future credits that may be added to your employee pension plan account. If you are not vested when you leave the Company, you will not receive any benefit. 9

12 W I T H D R A W A L S You cannot make withdrawals from your employee pension plan account until you are vested and terminate employment. Transfers within Health Care Service Corporation and its subsidiaries are not considered a termination of employment. W H E N Y OU T E R M I N A T E O R R E T I R E When you terminate or retire as a vested participant, and it is time to receive your benefit, The HCSC Employees Pension Plan has various forms of payment available to meet your individual needs. You may elect to receive your benefits under any of the alternatives described in the Payment Options Section below. P A Y M E N T O P T I O N S Your Plan benefits are usually shown as a lump sum. However, you may also elect one of several annuity options. Annuities provide a regular monthly benefit that is the actuarial equivalent of the lump sum. You may elect a monthly benefit payable immediately, or defer benefits until you reach age 65. If you are married, the required normal form of payment is a Qualified Joint and 50% Survivor Annuity. If you and your spouse do not want this type of annuity, you must provide your spouse s written, notarized consent to waive this type of annuity in order to elect an alternative form of payment. If you are not married, the normal form of payment is a Life Annuity, unless you choose to elect one of the alternative forms of payment. The amount of your monthly benefit depends on the following: The balance in your employee pension plan account when you leave; Your age when your monthly payments begin; and, The distribution option you elect. The amount of your monthly benefit is affected by the applicable Revenue Ruling Mortality Table and the interest rate used to convert your balance to an annuity. The rate used to calculate the annuity is the rate in effect at the time you begin receiving benefits. Effective January 1, 2010, this rate is the greater of (1) 4% or (2) the annual rate of interest on 30-year Treasury securities for the 4 th full calendar month immediately preceding the calendar quarter in which your benefit is calculated to commence, however, in no event will this interest rate be greater than 10%. 10

13 Effective on and after July 1, 2016, you may elect to receive your benefit payable in one of the following forms of payment described below and no other forms of payment will be available (except, if you are a participant in the Blue Cross Blue Shield of Montana division who was not otherwise eligible for an immediate distribution of benefits from a predecessor plan upon your termination of service, effective January 1, 2016, you can elect to have payments commence as described below (WHEN BENEFITS BEGIN) for a terminated vested participant either during the initial election opportunity following termination of service or during the annual window election; however, the payment options are limited to a lump-sum payment and immediately payable annuities of the Life Annuity if you are not married and the Qualified Joint and 50% Survivor Annuity or Qualified Optional 75% Survivor Annuity if you are married). JOINT AND SURVIVOR ANNUITY With a Joint and Survivor Annuity option, your retirement benefit is paid to you in monthly payments for the rest of your life. Your payments are reduced from the basic Life Annuity so that, if your spouse is still living when you die, either 50%, 75%, or 100% of your benefit will be paid to your spouse each month after your death for the remainder of his/her life, depending upon the Joint and Survivor option you elect. This option is known as the "Qualified Joint and 50% Survivor Annuity" when 50% is the specified percentage and the "Qualified Optional Survivor Annuity" when 75% is the specified percentage. If your spouse dies before you do, the amount of your monthly annuity will remain the same. LIFE ANNUITY WITH PERIOD CERTAIN OPTION With a Life Annuity with either a 5-year Period Certain, a 10-Year Period Certain, or a 20-year Period Certain option, your retirement benefit is paid to you in monthly payments for the rest of your life, with the added provision that payments will be made for the remainder of the Period Certain you elected (5, 10, or 20 years); however, effective on and after July 1, 2020, a 20-year Period Certain will no longer be available. If you are married, and you and your spouse want your benefit paid as a Life Annuity with a Period Certain option, you will need to provide your spouse s written, notarized consent. You may name a new primary beneficiary at any time before payments commence. If you are married, you are required to designate your spouse as your only primary beneficiary, and you cannot change your primary beneficiary without your spouse s notarized consent. If you die before the end of the guarantee period, your primary beneficiary will receive your retirement payments until the guarantee period is over. If you die after the end of the guarantee period, no payments are made to anyone after your death. If both you and your primary beneficiary die before the end of the guarantee period, the remainder of payments that are unpaid at the time of the last death will be paid to your contingent beneficiary, or to the estate of the second to die. 11

14 LIFE ANNUITY With the Life Annuity option, your retirement benefit is paid to you in equal monthly payments for the rest of your life. No payments are made to anyone after your death. If you are married, and you and your spouse want your benefit paid as a Life Annuity, you will need to provide your spouse s written, notarized consent. The amount of each monthly payment will be larger than the monthly amount you would receive under any of the other annuity options. LUMP SUM OPTION In addition to the annuity options available to you, you can elect to receive your entire retirement benefit as an immediate single Lump Sum, even if you are a vested terminated participant who was not otherwise entitled to elect a lump-sum option prior to July 1, The amount of your Lump Sum is based on your employee pension plan account and the provisions of the Plan (or a transitional formula-see APPENDIX). If you are married, and you and your spouse want your benefit paid as a Lump Sum, you will need to provide your spouse s written, notarized consent. If you do not have a Cash Balance Account, the amount of your immediate single Lump Sum also is affected by applicable Revenue Ruling Mortality Table and the interest rate used. Effective January 1, 2010, the interest rate used is the greater of (1) 4% or (2) the annual rate of interest on 30-year Treasury securities for the 4 th full calendar month immediately preceding the calendar quarter in which your benefit is calculated to commence, however, in no event will this interest rate be greater than 10%. The interest rate used to convert the annuity or the lump sum is the interest rate in effect at the time you begin receiving benefits. The actuarially equivalent value of the Lump Sum will never be less than the value determined using the applicable mortality table and the applicable interest rate defined in Section 417(e)(3) of the Internal Revenue Code. NOTE: If you have a Cash Balance Account at retirement or termination of service, the amount of the Lump Sum distribution on and after January 1, 2008 is equal to the balance of your Cash Balance Account as of the time you receive payments, regardless of the mortality table and interest rate described above. If the value of your employee pension plan account, based on the Lump Sum Option, is $1,000 or less when you retire or otherwise leave the Company, your benefit will automatically be calculated and payable only as an immediate lump sum. Your spouse s written, notarized consent is not required for the $1,000 or less immediate Lump Sum. If you take your benefit as a lump sum, you can continue to defer taxes by rolling it over into an Individual Retirement Account (IRA), or into the qualified plan of another employer or you may be eligible to pay the taxes on the distribution and roll it over into a Roth IRA. (See Tax Considerations for more information.) 12

15 W H E N B E N E F I T S B E G I N As a terminated vested participant you can elect to have payments commence as early as the first day of the third month next following your date of termination of service or, if later, the first day of the month coincident with or next following the 30 th day after the date on which the Administrative Committee informs you in writing of the amount of your benefit. Upon receipt of your benefit election forms, you have 90 days to elect an immediate form of payment. If you do NOT make your election within this 90-day period, your benefits will automatically be deferred until age 65. If you do NOT make your election for an immediate form of payment within this 90-day period, you may elect to commence payment of your benefit before reaching age 65 upon the following conditions: If you have ten (10) or more years of Vesting Service when you terminate, you may elect to receive benefits as early as age 55 (in some instances, age 40, only if you are a transitioned participant in the Non-Contributory Retirement Program for Employees of Illinois Blue Cross and Blue Shield). If you meet these requirements, all alternate forms of payment are available for your election. Effective on and after July 1, 2016, a new annual election will be offered during a specific window of July 1 through September 30 each year, beginning with the year after your employment terminated and ending with the year you reach age 65. The payment options for this special annual election period are limited to a lump-sum payment and immediately payable annuities of the Life Annuity if you are not married and the Qualified Joint and 50% Survivor Annuity or Qualified Optional 75% Survivor Annuity if you are married. As an early retiree you can commence benefit payments on the first day of the third month next following the date you retire from service or, if later, the first day of the month coincident with or next following the 30 th day after the date on which the Administrative Committee informs you in writing of the amount of your benefit. Your benefit payments must commence no later than your normal retirement date. As a normal or late retiree your benefits will automatically be calculated to commence on the first day of the month coincident with or next following your termination of service. D I R E C T R O L L O V E R S You may request that a direct transfer of all or a portion of your lump-sum distribution (if applicable) be made to either a traditional Individual Retirement Account or Roth Individual Retirement 13

16 Account (IRA) or another employer s eligible retirement plan willing to accept the transfer. A direct transfer will result in no tax being due until you withdraw funds from the IRA or other employer s plan. Under certain circumstances all or a portion of the amount to be distributed may not qualify for this direct rollover. If you actually receive all or part of your distribution rather than transferring it directly, 20% of the distribution amount you receive may be withheld for federal income tax purposes, even if you later place the entire amount in an IRA or employer plan. If you decide to directly transfer all or a portion of your distribution amount, you (and your spouse, if you are married) must first waive the annuity form of payment. I F Y O U R E T U R N T O W O R K W I T H T H E C O M P A N Y If you leave the Company before you are vested, no benefit is payable to you. However, if you return to work for the Company or certain other subsidiaries of HCSC within five years of your termination, the employee pension plan account you had when you left will be reinstated, with interest, through the rehire date. The Vesting Service you had earned as of your termination also will be reinstated. Transfers within Health Care Service Corporation and its subsidiaries are not considered a termination of employment. If you leave the Company after you are vested, elect a deferred annuity, and later return to work for the Company, the value of your deferred annuity will be reinstated to your employee pension plan account. If you return to work for the Company or certain other subsidiaries of HCSC after your annuity has begun, the annuity payments will cease for as long as you remain an Active Participant in the Plan. Your annuity payments will begin again when you subsequently retire. You may take the benefit you accrued since your rehire as either a lump sum or an annuity. You should consult with your tax advisor if you are unsure which option is better suited to your particular circumstance. If you leave the Company after you are vested, take your benefit as a lump sum, and later return to work, the employee pension plan account you had when you left will be reinstated. However, upon your subsequent termination or retirement, your employee pension plan account will be reduced by the value of the benefit previously paid to you. During your period of re-employment with the Company, you will accrue Employer credits and interest credits in your employee pension plan account while you are an Active Participant of the Plan. 14

17 I F Y O U T R A N S F E R A N D Y O U R P A R T I C I P A T I O N E N D S If you transfer within the Company to a business that does not participate in the Plan, or to an employment status not covered under the Plan, you will continue to earn Vesting Service. In addition, your employee pension plan account will continue to earn interest credits. However, no Employer credits will be allocated to your employee pension plan account. I F Y O U T A K E A L E A V E O F A B S E N C E If you take an authorized leave of absence for a reason other than qualified military service, you will earn Vesting Service until the first anniversary of the date your leave started. You will not receive Employer credits while you are on an unpaid leave; however, you will continue to earn interest credits. If your leave of absence is for qualified military service, you will continue to earn Vesting Service and receive Employer credits during your leave, as well as your interest credits. The Uniformed Services Employment and Reemployment Rights Act (USERRA) and the Heroes Earnings Assistance and Relief Tax of 2008 (HEART) are federal laws that guarantee certain rights to individuals who enter qualified military service. If you have to leave the Company because of qualified military service, your employment will not be terminated if you return to work with the Company within the period of time that you have reemployment rights under Federal law. Contributions, benefits and service credit with respect to qualified military service will be provided as required by law. HEART expands the benefits provided under USERRA to provide that if you are an Active Participant in the Plan on the date your leave for qualified military service commences: Death during qualified military service must be treated as though the Participant were actively employed on the date of death. Differential pay, if any, provided by the Employer after January 1, 2009 may be included in compensation for purposes of determining retirement benefits. For more information regarding USERRA's and HEART's impact on your benefits, contact the Human Resources Department I F Y O U B E C O M E D I S A B L E D To be considered disabled (as defined by the Plan), you must (a) request Disability Retirement within 6 months of your date of leave due to disability and (b) be eligible for and receiving either disability benefits under the Social Security Act or payments (other than Workers Compensation payments or medical or hospitalization payments) under the long-term disability program maintained by the Company. If you become disabled before you retire, you will continue to receive Employer credits and interest credits to your employee pension plan account for as long as you remain disabled (as defined by the 15

18 Plan), but no Employer credits will be allocated after the date you reach age 65. Your Employer credits while disabled will continue based on your rate of pay before your disability. Once you reach age 65, you will be considered retired, your employee pension plan account will no longer receive Employer credits and your retirement benefit will be payable. You will continue to receive interest credits until your benefit payments commence. I F Y O U D I E W H I L E Y O U A R E A N A C T I V E P A R T I C I P A N T I N T H E P L A N If you are vested and you die while you are an Active Participant of the Plan, each surviving, designated primary beneficiary will receive a Plan death benefit. If none survive, then each surviving, designated contingent beneficiary will receive a Plan death benefit. If you are married at the time of your death, your surviving spouse will be your primary beneficiary and will receive 100% of your death benefit, unless at some time before your death, with your spouse s written, notarized consent, you designated someone other than (or in addition to) your spouse as primary beneficiary. If you have designated multiple primary beneficiaries, and if married, your spouse has consented, your Plan benefit will be calculated and divided into separate death benefits in accordance with what you have specified on your designation of beneficiary form. Each recipient of a death benefit can elect an immediate Lump Sum Payment or an immediate monthly annuity. The amount of each benefit payment is affected by the interest rate used (as described in the PAYMENT OPTIONS section) and in effect at the time the death benefit is scheduled to begin. If the value of the death benefit is $1,000 or less, it is automatically calculated and payable only as an immediate Lump Sum Payment. It is important to keep your beneficiary designation up-to-date. Contact the Plan Administrative Committee if you want to change your beneficiary. I F Y O U D I E A F T E R Y O U T E R M I N A T E E M P L O Y M E N T If you die after you terminate and had already started receiving benefits, each surviving primary beneficiary may be eligible for benefits based on the form of payment you chose. If you had not yet elected a form of payment, your Plan benefit will be re-calculated as a death benefit for each surviving primary beneficiary. Each recipient of a death benefit can elect an immediate Lump Sum Payment or an immediate monthly annuity. The benefits can be deferred until a later date. However, the amount of each benefit payment is affected by the interest rate used (as described in the PAYMENT OPTIONS section) and in effect at the time the death benefit is scheduled to begin. 16

19 A death benefit will not be paid if you die after you terminate, and already received a Lump Sum Payment, or commenced a single Life Annuity. H O W T O A P P L Y F O R B E N E F I T S I F Y O U A R E A D E F E R R E D A N N U I T A N T Contact the Plan Administrative Committee for the forms you need to fill out to apply for benefits under the Plan. When you are eligible to receive and desire to receive benefits, you should apply for benefits at least 90 days before you intend to commence. C L A I M S P R O C E D U R E S If you wish to file a claim for benefits under the Plan, the Plan Administrative Committee will supply you with all the forms necessary for the proper filing of your claim. You should contact the Plan Administrative Committee for these forms. It is your responsibility to inform the Plan Administrative Committee of any change in address. If you apply for a benefit and all or part of it is denied, the Plan Administrative Committee will notify you by written or electronic notification within 90 days after the receipt of your claim of either (1) reasons for such adverse benefit determination, or (2) a notice indicating that special circumstances require an extension of time (up to 90 additional days for a non-disability claim) to process your claim. The extension notice will indicate the special circumstances requiring an extension of time and the date by which the plan expects to render the benefit determination. If your claim is wholly or partially denied, when you receive an initial notification of the adverse benefit determination from the Plan Administrative Committee, it will contain: the specific reason(s) for the adverse benefit determination; a reference to the specific provisions of the Plan upon which the determination is based; a description of any additional material or information that is needed to process your claim, if any, and an explanation of why such material or information is necessary; and a description of the Plan's review procedures and the time limits applicable to such procedures, including a statement of your right to bring a civil action under ERISA following an adverse benefit determination on review. 17

20 If you decide to appeal the Plan Administrative Committee's decision, you must submit a written application within 60 days after the receipt of a notification of an adverse benefit determination; may submit written comments, documents, records, and other information relating to the claim for benefits; will be provided, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to your claim for benefits. The review of your appeal will take into account all comments, documents, records, and other information submitted by you relating to the claim, without regard to whether such information was submitted or considered in the initial benefit determination. The Plan Administrative Committee will notify you by written or electronic notification within 60 days of the receipt of your appeal of either (1) a final decision on the matter, or (2) a statement indicating that an extension of 60 days is needed to process your claim. In the case where an extension is needed, the extension notice will indicate the special circumstances requiring an extension of time and the date by which the plan expects to render the determination on your appeal. In the case of an adverse benefit determination of the claim on appeal, the notification will set forth: the specific reason(s) for the adverse determination; reference to the specific plan provisions on which the benefit determination is based; a statement of your rights to receive, upon request and free of charge, reasonable access to, and copies of, all documents, records, and other information relevant to your claim; and a statement of your right to bring an action under ERISA. The Plan Administrative Committee's decision on an appeal will be final. Once the above appeal process has been followed, there will be no further administrative appeal on any ruling by the Plan Administrative Committee. No legal action related to the Plan to recover benefits or with respect to any other matter related to the Plan may be commenced before the claimant has exhausted the Plan's claim and appeal procedures. In no event may any such action be brought more than six months after the claim was denied or deemed to be denied on appeal. 18

21 O T H E R C O N S I D E R A T I O N S There is some additional information you should know about the Plan. S T A T E M E N T O F Y O U R E M P L O Y E E P E N S I O N P L A N A C C O U N T You will be eligible to request a statement of your employee pension plan account balance once a year. The Plan Administrative Committee may provide this in various forms to Active Participants annually. Contact the Plan Administrative Committee with any questions. T A X C O N S I D E R A T I O N S Any amount you receive from the Plan is subject to federal income taxes. An additional 10% early distribution federal excise tax generally will apply to lump sum distributions on all or a portion of your employee pension plan account balance unless: Distribution is being made because of your retirement at age 55 or older; or, You roll over your employee pension plan account balance to the qualified plan of another employer, or an IRA or Roth IRA, within 60 days of receiving it. Currently federal tax law requires that 20% of your total taxable distribution be withheld if you do not elect a direct rollover of your employee pension plan account balance. This withholding does not represent the actual taxes you may be required to pay. These will be determined by your overall tax situation. You will receive more information about tax withholding and rollovers when you apply for benefits. Other special tax rules may apply if you receive your employee pension plan account balance as a lump sum distribution. CONSULT YOUR TAX ADVISOR This is only a brief summary of the federal tax consequences on a distribution from The HCSC Employees Pension Plan. You also should review the state and local tax laws that may be applicable to you. Because tax laws change from time to time, you should consult with a tax advisor at the time of your election to determine what laws apply, and to discuss what other options and alternatives you should consider. Q U A L I F I E D D O M E S T I C R E L A T I O N S O R D E R S Your benefits generally cannot be assigned to another person. However, federal law requires the Plan to obey certain court orders for payment of a percentage of your employee pension plan account directly to or on behalf of your spouse, former spouse, child or other dependents. If such a court 19

22 order is issued and the Plan determines that it is a Qualified Domestic Relations Order (QDRO), the Plan must obey that order. Any payment made pursuant to a QDRO will not violate the rule of nonassignability of benefits. The Plan Administrative Committee must be notified in writing of any pending or potential domestic relations order. Upon receipt of written notification, the Company will provide the interested parties with the Plan's QDRO procedures. You may request a copy of these QDRO guidelines and procedures from the Company free of charge. I F T H E P LAN B E C O M E S T O P H EAVY When more than 60% of the value of all benefits is attributable to the benefits of certain key employees, the Plan is considered top heavy. If this should occur, federal law requires that an accelerated vesting schedule and minimum benefit accrual and contribution requirements become effective. It is unlikely that the Plan will ever become top heavy. If it does, you will receive more information about the applicable provisions. I F T H E P LAN I S A M E N D E D O R T E R M I N A T E D If the Plan is amended, your benefits which were accrued before the amendment, will be protected. If the Plan is terminated, your accrued benefit will become fully vested. None of the Plan s assets can revert to the Company until all benefits and other expenses owed by the Plan have been satisfied. You will be notified, as required by law, at least 60 days before the proposed termination date. The Employer reserves the right to purchase an annuity in full or partial settlement of benefits provided under the Plan. Any such action would be taken in writing and maintained with the records of the Plan. Plan termination or annuity purchase may be made for any reason, and at any time, and may, in certain circumstances, result in the reduction or elimination of benefits or other features of the Plan to extent permitted by law. The Plan may pay your pension benefit in the form of an annuity purchased from a licensed insurance company. Once the plan purchases an annuity for you, the insurance company will be responsible for paying your benefit. If the insurance company becomes unable to pay, a state guaranty association may be responsible for all, part or none of the annuity. All states, Puerto Rico and the District of Columbia have guaranty associations that protect policyholders, up to specified limits, in the event an insurance company is financially unable to meet its obligations. Generally, where the individual lives at the time the insurance company is unable to pay determines which guaranty association is responsible. In certain circumstances, other factors, such as where the insurance company is licensed to do business, determine which guaranty association may be responsible. 20

23 If the Plan is terminated, benefits under the Plan are insured by the Pension Benefit Guaranty Corporation (PBGC), a federal insurance agency. If the Plan terminates without enough money to pay all benefits, the PBGC may step in to pay pension benefits. Most people receive all of the pension benefits they would have received under the Plan, but some people may lose certain benefits. The PBGC guarantee generally covers: (1) normal and early retirement benefits; (2) disability benefits if you become disabled before the Plan terminates; and (3) certain benefits for your survivors. The PBGC guarantee generally does not cover: (1) benefits greater than the maximum guaranteed amount set by law for the year in which the plan terminates; (2) some or all of benefit increases and new benefits based on plan provisions that have been in place for fewer than 5 years at the time the Plan terminates; (3) benefits that are not vested because you have not worked long enough to acquire adequate vesting service; (4) benefits for which you have not met all of the requirements at the time the plan terminates; (5) certain early retirement payments (such as supplemental benefits that stop when you become eligible for Social Security) that result in an early retirement monthly benefit greater than your monthly benefit at the plan s normal retirement age; and (6) non-pension benefits, such as health insurance, life insurance, certain death benefits, vacation pay, and severance pay. Even if certain of your benefits are not guaranteed, you still may receive some of those benefits from the PBGC depending on how much money the Plan has and on how much the PBGC collects from Employers. For more information about the PBGC and the benefits that it guarantees, contact the PBGC's Technical Assistance Division. Inquiries should be directed to: PBGC Technical Assistance Division 1200 K St., N.W. Suite 930 Washington, DC (Not a toll-free number) TTY/TDD users may call the federal relay service toll-free at and ask to be connected to Additional information about the PBGC s pension insurance program is available through the PBGC s web site on the Internet at 21

24 P LAN C O N T I N U A T I O N A N D D I S C R E T I O N The Company intends to continue The HCSC Employees Pension Plan indefinitely, but reserves the right to amend, suspend, discontinue or terminate the program, in whole or in part, at any time and for any reason. Additionally, the Committee which administers the Plan shall have the authority to decide any questions arising on the administration, interpretation and application of the Plan and such decisions shall be conclusive and binding on all parties. All actions and determinations made by the Committee in good faith shall be final and not subject to review, except as may be provided under the Claims procedures as described on pages G O V E R N M E N T A L R E Q U I R E M E N T S A F F E C T I N G B E N E F I T S F U N D I N G R E Q U I R E M E N T S This Plan is subject to specific funding requirements, which are necessary in order to provide the benefits described in this summary. If those requirements are not met within the ranges specified in the IRS regulations, restrictions take effect, limiting the Plan's ability to accrue additional benefits, improve benefits and/or make certain accelerated benefit payments (such as lump sum payments). In no event will benefit restrictions cause your benefit to decrease. In the event the Plan becomes subject to these restrictions, an explanation will be provided, describing the limitations under which the Plan may operate and how it may affect your benefit. B E N E F I T L I M I T A T I O N S R E Q U I R E D B Y I R S The Internal Revenue Code places maximum benefit limits on the amount of benefits a participant can receive from this defined benefit plan. This limitation changes annually and is unlikely to affect your benefits under the Plan. Generally, the annual limit in 2016 was $210,000 per year as an annuity for life beginning between ages 62 and 65. Other numerous adjustments apply such as adjustments for payment beginning at different ages or under different forms of payment. Benefit restrictions also apply to certain highly compensated employees (the 25 most highly compensated current and former employees of the employer) to prevent them from taking lump sums or other accelerated distributions that might weaken the funded status of the plan. You will be notified, if you are affected by these restrictions. 22

25 O T H E R I M P O R T A N T I N F O R M A T I O N GENERAL INFORMATION ABOUT THE PLAN SPONSOR ( EMPLOYER ): The main office of the Employer is: Health Care Service Corporation 300 E. Randolph Chicago, IL (312) However, all inquiries concerning the Plan should be directed to: Health Care Service Corporation Plan Administrative Committee Financial Benefits 1001 E. Lookout Drive A Richardson, TX (972) PLAN ADMINISTRATIVE COMMITTEE: Requests for forms and information concerning your individual benefits should be directed to the following: Health Care Service Corporation Financial Benefits 1001 E. Lookout Drive A Richardson, TX (972) PLAN NAME: The HCSC Employees Pension Plan IDENTIFICATION NUMBERS: Employer Number: Plan Number: 004 PLAN TRUSTEE: TYPE OF PLAN: Northern Bank & Trust Company 50 South La Salle Street Chicago, IL Defined Benefit Pension Plan 23

26 TYPE OF ADMINISTRATION: AGENT FOR LEGAL PROCESS: Employer Administered Service of legal process should be made on the Plan Administrative Committee at the address shown above. Service of legal process may also be made upon the Plan Trustee at the address shown above. PARTICIPATING EMPLOYERS: A complete list of the Employers sponsoring the Plan is available for review and can be obtained by participants and beneficiaries upon written request to the Plan Administrative Committee. PLAN S FISCAL YEAR END: December 31 24

27 YOUR RIGHTS UNDER THE EMPLOYEE RETIREMENT INCOME SECURITY ACT OF 1974 (ERISA) If you believe that your rights under the Plan have been violated, you have the right to bring legal action against the Plan in a court of law. The Plan Administrative Committee is the agent named to receive service of legal process. The Trustee may also receive service of legal process. As a participant in this Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). ERISA provides that all participants are entitled to: Examine, without charge, at the Company s offices and at other specified locations, such as worksites and union halls, all documents governing the Plan, including insurance contracts and collective bargaining agreements, and a copy of the latest annual report (Form 5500 Series) filed by the Plan with the U.S. Department of Labor available at the Public Disclosure Room of the Pension and Welfare Benefit Administration. Obtain copies of all documents governing the operation of the Plan, including insurance contracts and collective bargaining agreements, and copies of the latest annual report (Form 5500 Series) and updated summary plan description upon written request to the Plan Administrative Committee. The Company may make a reasonable charge for the copies. Receive an annual funding notice providing information about the funding status and financial condition of the Plan, including the Plan's funding percentage, assets and liabilities, and a description of the benefits guaranteed by the PBGC. The Plan Administrative Committee is required by law to furnish each participant with a copy of this annual funding notice. Obtain a statement telling you whether you have a right to receive a benefit on your Normal Retirement Date and if so, what your benefits would be at your Normal Retirement Date if you stop working under the Plan now. If you do not have a right to a benefit, the statement will tell you how many more years you have to work to get a right to a benefit. This statement must be requested in writing. The Plan is not required to provide the statement more than once every twelve (12) months. The Plan must provide the statement free of charge. Department of Labor Regulations also require that you, as a participant, or any beneficiary of the Plan can obtain, without charge, a copy of the procedures governing a qualified domestic relations order (QDRO) from the Plan Administrative Committee. In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate your Plan, called fiduciaries of the Plan, have a duty to do so prudently and in the interest of you and other Plan participants and beneficiaries. No one, including the Company, your union, or any other person, may fire you or otherwise discriminate against you in any way just to prevent you from obtaining a benefit or from exercising your powers under ERISA. If your claim for a benefit is denied or ignored, in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules. 25

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