2016 Benefits Contact Information

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2 2016 Benefits Contact Information Plan Company Web address Phone G&K HR Solutions G&K Services Human Resources Username: 6-digit Person Number 401(k) Plan Wells Fargo GKHR4ME SAVE Basic and Supplemental Life Insurance Claims VOYA Continuation of Benefits (COBRA) WageWorks Convercent (formerly MySafeWorkplace) Convercent Dental Plan Delta Dental Employee Assistance Plan (EAP) ComPsych Company ID: GKS (651) Employee Stock Purchase Plan (ESPP) Computershare Global ID: your Social Security number GK-SERV Flexible Spending Accounts WageWorks GKdirect G&K Services Shop.gkservices.com/store G&K Extras Beneplace Health Savings Account (HSA) SelectAccount Leave of Absence Unum Legal Plan ARAG Access Code: 16221gks Medical Plan Blue Cross and Blue Shield of Minnesota (651) Paid Time Off G&K Services GKHR4ME Prescription Drug Benefits Express Scripts Short Term Disability Long Term Disability Unum Tuition Reimbursement G&K Services GKHR4ME Vision Plan UHC Vision Use your Social Security number to sign in

3 Table of Contents SECTION PAGE Introduction. 1 Terms to Know... 2 Eligibility.. 2 When Coverage Begins 4 When to Enroll... 5 How to Enroll.. 5 When Coverage Ends... 7 Continuation of Coverage 7 Medical Benefits Health Savings Account (HSA) Prescription Drug Coverage Dental Benefits...17 Vision Plan.. 18 Health Care Flex Spending Account (FSA) Dependent Care Flex Spending Account (FSA) Life Insurance Legal Plan Weekly Premium Rates. 23. Employee Assistance Program.. 24 Disability Benefits and Leaves of Absence.. 25 Paid Time Off Tuition Reimbursement (k) Plan Employee Stock Purchase Plan GK Extras 33 Disclosures & Notices Special Enrollment Rights Notice Women s Health and Cancer Rights Act Newborns and Mothers Health Protection Act Important Notice from G&K Services about Your Prescription Drug Coverage and Medicare Premium Assistance under Medicaid and the Children s Health Insurance Program (CHIP) Notice of Privacy Practices Your Rights Under ERISA New Health Insurance Marketplace Coverage; Options and Your Health Coverage

4 Introduction G&K Services provides you with a comprehensive benefits package designed to meet the benefit needs of you and your family. There is a range of diverse options, including medical, dental and vision coverage, life insurance and 401(k) plan (collectively referred to as the Plans). The company also provides additional benefits, including an employee assistance program, paid time off, disability benefits and discounts through GK extras. This booklet describes highlights of the benefit plans available to you if you meet the eligibility requirements. Full information on the plans can be found in the Summary Plan Descriptions (SPDs) and insurance contracts, which are available on or by contacting G&K HR Solutions at GKHR4ME ( ) or hrsolutions@gkservices.com. The Plans summarized in this booklet are governed by the provisions contained in the actual Plan documents, insurance policies and other programs. Should a conflict exist between this summary and the specific Plan document, insurance policy or program, the provisions of the Plan document, insurance policy or program will prevail. Further, the SPD, the Plan document, insurance policy or program will be subject to the final interpretation of the Plan Administrator. The Plan Administrator's determinations regarding coverage, claims and all other aspects of the Plans, policies or programs are binding and conclusive. The Plan Administrator has complete discretionary power and authority with respect to all Plan matters, including eligibility and benefits, factual determinations and interpretation of Plan provisions. A Plan benefit is not payable unless the Plan Administrator determines that it is. The Plan Administrator may delegate its authority to Human Resource employees and Plan service providers, such as the claims administrator. This booklet and the policies and procedures contained here supersede any and all prior practices, oral and written representations, or statements regarding the benefit Plans described. If a clerical error or other mistake occurs, that error does not create a right to benefits. Examples of such errors include, but are not limited to, providing misinformation on eligibility or benefit coverage or entitlements. The terms of the Plan may not be amended by oral statements made by the Plan sponsor, the claims administrator, or any other person. In the event an oral statement conflicts with any term of the Plan, the Plan terms will control. G&K Services reserves the right to amend, reduce, modify, interpret or discontinue all or part of these Plans, policies or programs. This is not a contract of employment. Nothing stated here implies or guarantees any specified or minimum term of employment or entitlement to benefits. If any provisions of bargaining agreements in effect for union employees are inconsistent with this Handbook, such bargaining agreement provisions will control. 1

5 Terms to Know Annual Deductible: You pay the annual deductible before the plan covers eligible non-preventive health care services. Annual Out-of-Pocket Maximum: The most you will pay for covered services during a calendar year. Once you meet the annual out-of-pocket maximum, covered services are paid at 100% for the remainder of the calendar year. Coinsurance: Once the annual deductible is met, you and G&K will share the cost of health care services through coinsurance HSA: A tax-advantaged medical savings account available to U.S. taxpayers who are enrolled in a highdeductible health plan. The funds contributed to an account are not subject to federal income tax at the time of deposit. Premium: The amount you pay each week for medical coverage. Eligibility You are eligible for the benefits that are described below if you are an active, full-time employee of G&K Services who is regularly scheduled to work 30 hours or more per week. These benefits do not apply to employees who are covered by a collective bargaining agreement that does not include G&K standard benefits. Your eligible dependents include: Your spouse, to whom you are legally married Your children under age 26 o Your natural, adopted or foster children, stepchildren, or any child for whom you have legal custody o Your grandchildren who live with you and are financially dependent on you o Children who are required to be covered by reason of a Qualified Medical Child Support Order (QMCSO) Your mentally or physically disabled children age 26 or older who rely on you for support, were covered prior to age 26 under the plan, and became disabled before age 26. You will need to provide documentation certifying your dependents eligibility: Dependent Eligibility Requirements Acceptable Supporting Documents Your Spouse Legally married A copy of your most recently filed Federal income tax return listing your spouse and your marital status. The entire tax return is not required, only the page that lists filing status and exemptions. AND a copy of the following document: Valid legal or religious marriage certificate, which shows your date of marriage. 2

6 Newlywed (Spouse) Newborn (Child) Legally married within less than one year A copy of your marriage certificate Newborn within 30 days A copy of the crib card or hospital documentation listing the employee as the parent. Children to age 26 (Child) Grandchildren to age 26 (Child) Natural born dependent children Children of a legal same gender marriage, legally adopted children and children placed with you for legal adoption Step children Dependent children for whom you or your spouse have been appointed legal guardian Children of the employee who are required to be covered by reason of a Qualified Medical Child Support Order (QMCSO) Grandchildren who live with you, are claimed as exemptions on your Federal income tax return and financially dependent upon you Submit a copy of any one of the following documents: Your most recently filed Federal income tax return showing the child listed as your dependent (daughter, son or child). The entire tax return is not required, only the page that lists filing status and exemptions; or The child s legal or hospital birth certificate naming you, or your spouse as the child s parent; or A final court order (divorce decree/custody agreement) naming you or your spouse as the child s parent. All documents must include the following information: names of the child and parent, official signature and/or court seal/stamp; or Legal adoption papers issued by the courts naming you or your spouse as the adoptive parent. All documents must include the following information: names of the child and parent, official signature and/or court seal/stamp; or Legal guardianship papers issued by the courts naming you or your spouse as the child s guardian. All documents must include the following information: names of the child and guardian, official signature and/or court seal/stamp; or A Qualified Medical Child Support Order (QMCSO) showing you are required to provide medical coverage for the child. Documentation must state your current employer s name and include the names of the child and parent. A copy of your most recently filed Federal income tax return showing the child listed as your dependent. The entire tax return is not required, only the page that lists filing status and exemptions. Newborn: Proof of relationship to grandchild and birth certificate or hospital documentation. 3

7 Children age 26 and over (Child) Disabled dependent children who became disabled prior to reaching the limiting age while covered under this plan Primarily dependent upon you; and Are incapable of selfsustaining employment because of physical disability, developmental disability, mental illness or mental disorders Any one of the documents listed for Children to age 26. AND a copy of the following document: Physician statement certifying that the dependent child cannot support himself or herself because of a physical or mental disability prior to reaching the maximum age. All information must be pre-printed and dated within the last 12 months. When submitting dependent certification documentation, please ensure the following: Mark out confidential information such as financial data and social security numbers. If a document is two-sided or multiple pages, ensure you send all required pages of the document. List your name and 6-digit person number List your dependent(s) name and their relationship to you There are two ways to submit dependent eligibility documentation: 1. your documents to hrsolutions@gkservices.com 2. Fax your documents to When Coverage Begins Medical, Dental and Vision Coverage As a new hire who is eligible for benefits, you must enroll in the medical, dental and vision plans during your first 30 days of employment. Coverage will begin on the first day of the month after 30 days. If you do not enroll within 30 days, you will not be able to enroll for coverage until the next annual enrollment period or you experience a qualifying life event. Flexible Spending Accounts You must enroll in the flexible spending accounts within 30 days from your date of hire. Coverage will begin on the first day of the month after 30 days. If you do not enroll within 30 days, you will not be able to enroll until the next annual enrollment period or you experience a qualifying life event. Life Insurance Your basic life insurance is paid by G&K and will automatically begin the first day of the month after 30 days of employment. You must enroll within 30 days from your date of hire to elect supplemental life insurance. Coverage will begin on the first day of the month after 30 days. If you wish to increase the amount of coverage above the guarantee issue limits, you must apply for and be approved for coverage. If you do not enroll within 30 days, you will not be able to enroll until the next annual enrollment period or you experience a qualifying life event. Legal Plan If you wish to participate in the legal plan, you must enroll during your first 30 days of employment. Coverage will begin on the first day of the month after 30 days. If you do not enroll within 30 days, you will not be able to enroll until the next annual enrollment period or you experience a qualifying life event. 4

8 When to Enroll As a New Hire or Newly Eligible Employee You need to complete your enrollment within 30 days from your hire or eligibility date. additional information on your benefit options and any additional requirements. You will receive Annual Enrollment During the annual enrollment period each year, you have an opportunity to review and make changes to your benefit elections for the next calendar year. You will receive information prior to the Annual Enrollment period on how to make changes and the timeline. Note: Annual Enrollment is also referred to as Open Enrollment. Qualifying Life Event If you experience a qualifying life event during the year, you may enroll in or change your coverage elections, provided that you request the change within 30 days of the event (except in the case of eligibility for or termination of premium assistance through Medicaid or Children s Health Insurance Program (CHIP), in which case, you have 60 days). If you do not change your benefits within 30 days of the event, you will not be allowed to make a change until the next annual enrollment period or you experience a new qualifying life event. In most cases, changes are effective on the date of life event. Below is a list of some of the more common qualifying life events: Marriage, divorce, legal separation or annulment Birth or adoption of a child Placement of a foster child or legal guardianship of a child Change in employment status for your spouse or dependent that affects benefit eligibility, including termination or commencement of employment You or your spouse returns from unpaid leave of absence You or your dependent becomes eligible or loses eligibility for Medicare or Medicaid The death of your spouse or dependent Court-ordered coverage of your child by you or your spouse, allowing you to add or drop the child s coverage Change in place of residence that affects eligibility for you, your spouse or dependent Change in your employment that affects benefits eligibility (working less than 30 hours per week on a regular basis) Loss of child care/elder care provider or a significant cost increase or a change in your daycare provider (applicable only to the dependent care flexible spending account) Eligibility for Medicaid or Children s Health Insurance Program (CHIP) coverage Termination of Medicaid or Children s Health Insurance Program (CHIP) coverage because you or your dependents are no longer eligible The change you request must be consistent with the qualifying event and you must provide proof of the change. How to Enroll 1. Sign on using your username (6-digit person number) and password. 2. Click the Navigator 3. Click on Benefits located under My Information. 4. To begin enrollment, click the button. 5

9 5. Verify the correct people are listed in the Contacts (Dependent, Beneficiary and/or Emergency Contact) page. (Anyone you wish to designate as a dependent or beneficiary during the enrollment process must be listed in this section.) Click if you need to add a new contact. *The relationship for all dependents must be listed as a Spouse or Child. If you re a new hire use today s date as the effective date for your contact. If you have a qualified life event (birth of a child, marriage, etc.) use the date of the life event as the effective date for your contact. 6. Click to go to the next step of enrollment. 7. A will appear, confirm that you have the necessary contacts created. If you have all necessary contacts click 8. To accept the Enrollment Authorization click 9. Begin the enrollment process by checking the box next to the plan you desire. To add a dependent to plans, first highlight the benefit plan row blue, then check the box next to the dependents listed at the bottom of the page. To add a beneficiary to life insurance, enter the allocation percentages for both the primary and contingent beneficiaries. 10. Click the button to continue through each benefit in the enrollment process. 11. Review your selections and press to complete the enrollment. 12. Print your confirmation page by clicking Benefit marked Suspended means additional information is required and is listed in the Pending Action Items section. 13. Review your Pending Action Items. If Dependent Certification is required, send documentation to hrsolutions@gkservices.com or fax to by November 25, NEED HELP? If you need assistance at any point during enrollment you can contact G&K HR Solutions and speak with an HR Analyst by: GK.HR4ME ( ) *Interpreting assistance is available in multiple languages hrsolutions@gkservices.com 6

10 When Coverage Ends Your benefits coverage ends at midnight on the day in which: Your regular work schedule is reduced to fewer than 30 hours per week, Your employment with G&K Services ends due to resignation, termination or death, or You stop paying your share of the coverage. Your dependent(s) coverage ends: When your coverage ends, or At midnight on the day in which your dependent is no longer eligible. Continuation of Coverage The Consolidated Omnibus Budget Reconciliation Act (COBRA) and Minnesota State Continuation give you the right to choose to continue certain benefits when coverage ends. You may be required to pay the entire premium for continuation of coverage up to 102 percent of the cost. Which benefits can I continue? You and/or your dependents are eligible to continue the following benefits: Medical benefits Dental benefits Vision plan Health care flexible spending account Basic life insurance Supplemental life insurance Who is eligible to continue coverage? You and/or your dependents are eligible to continue coverage if coverage is lost because: You leave G&K for any reason other than gross misconduct Your work hours are reduced You die You divorce Your dependent loses dependent status (for example, a child is no longer an eligible dependent due to age) When do I have to make a decision about continuing coverage? You have 60 days after the loss of coverage. Can I make any changes? Changes to the continuation of coverage outside of annual enrollment are only allowed if a qualifying life event change has occurred. 7

11 How long can I continue coverage? The maximum period of time when you can continue coverage depends on the reason you or your dependents lose coverage. If you lose coverage because: You and your eligible dependent(s) can continue coverage for: Termination or reduction of hours 18 months After termination or reduction of hours, either you or your dependent is disabled within 60 days of your qualifying event, coverage is extended to Loss of coverage during a military leave 29 months 24 months If your dependent loses coverage because: Then your dependent(s) can continue coverage for: You die You and your spouse divorce Your dependent no longer qualifies 36 months 36 months 36 months When does continuation coverage end? Coverage will end before the allowed time frame if: You become covered under another group health plan after you choose to continue coverage You become entitled for Medicare after your COBRA election begins You don t make premium payments on time All G&K group benefit plans are discontinued If you have any questions about COBRA, contact WageWorks at or go to 8

12 Medical Benefits G&K medical plans provide you with comprehensive coverage and financial protection against catastrophic conditions. When you enroll in a G&K medical plan, you automatically receive prescription drug coverage, too. Blue Cross Blue Shield of Minnesota is the third party administrator. Express Scripts processes pharmacy claims. Three Medical Plan Options Two of your medical plan options offer a health savings account (HSA) paired with a high-deductible health plan. o HSA1500 has a $1,500 deductible o HSA3000 has a $3,000 deductible. The MED750 is a traditional medical plan and has a $750 deductible. Regardless of which plan you choose, you can go to any doctor, specialist or hospital. However, by seeing an in-network provider, you ll receive the highest level of benefits. Network providers also file claims for you. All plans cover eligible in-network preventive care at 100%. For a list of covered preventive services, go to members.bluecrossmn.com and click on preventive care. mybluecross When you sign in to mybluecross at members.bluecrossmn.com, you ll have these features at your fingertips: View claims, status of any accounts and plan information Search for a network doctor, clinic or hospital Order a replacement member ID card Send a secure message to customer service Provide your address to indicate how you would like to receive some health support communications print or electronic To find a participating doctor, clinic or hospital: Sign in to mybluecross at members.bluecrossmn.com and search doctors & hospitals. Select from the drop down Select a Category and click on the type of provider you are looking for. Once you do this, another drop down box will come up Select a Plan or Network. For employees living in Minnesota, choose Blue Cross Aware. For employees living outside of Minnesota, choose BlueCard PPO. Please note: The tool will find providers for you from the address of the computer doing the research. Or call customer service at (651) or toll free at To find a participating international network provider in the BlueCard Worldwide network: Sign in to mybluecross at members.bluecrossmn.com and search doctors & hospitals. Select from the drop down Select a Category and click on the type of provider you are looking for. Once you do this, another drop down box will come up Select a Plan or Network. Choose BlueCard Worldwide (International). Or call BlueCard toll free at BLUE (2583). When you call, tell the representative that you have PPO network coverage and what type of health care provider you need. Your Member ID Card Your member ID card is your passport to care. It shows providers that you have coverage. Always carry your member ID card and keep it handy when you call customer service. 9

13 What s covered in the HSA3000 Plan? In network Out of network Annual deductible $3,000 individual $4,000 individual $6,000 family 1 $8,000 family 1 Annual out-of-pocket maximum The out-of-pocket maximums for in- and out-of-network cross apply. Non-covered charges and charges in excess of the allowed amount do not apply to the out-of-pocket maximum. $5,000 individual $5,000 individual $10,000 family 1 $10,000 family 1 Preventive care Routine physicals, standard immunizations, vaccinations, vision screening and hearing test Well-child care up to age 6 Cancer screening Prenatal care Physician services Office visits for sickness or injury Inpatient professional services Outpatient professional services Other provider services Chiropractic care 15 visit max per person per calendar year Speech, occupational and physical therapy Home health care $25,000 per calendar year max 100% 100% 100% 100% 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Not covered Not covered Not covered Inpatient hospital services 80% after deductible Outpatient hospital services Outpatient surgery, preadmission tests, radiation therapy, chemotherapy or kidney dialysis Lab or X-rays 80% after deductible 80% after deductible Emergency care Emergency room charges Physician charges Ambulance services 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible Mental health and chemical dependency care 80% after deductible Prescription drugs 2 retail pharmacy (30-day supply) Generic Preferred brand Non-preferred brand Home delivery/approved maintenance pharmacy (90 day supply) Generic Preferred brand Non-preferred brand 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible 1 If you cover one or more family members under the HSA3000 plan, the entire family deductible must be satisfied before the plan begins to pay coinsurance for any covered individual. You do not need to meet the full family out-of-pocket ($10,000) if you cover your dependents. The maximum out-of-pocket for one family member is $6, If you request a brand-name medication when a generic equivalent is available, you will pay the applicable copayment, plus the difference in cost between the brand and the generic. 10

14 What s covered in the HSA1500 Plan? In-network Out-of-network Annual deductible $1,500 individual $3,000 individual $3,000 family 1 $6,000 family 1 Annual out-of-pocket maximum The out-of-pocket maximums for in- and out-of-network cross apply. Non-covered charges and charges in excess of the allowed amount do not apply to the out-of-pocket maximum. $5,000 individual $5,000 individual $10,000 family 1 $10,000 family 1 Preventive care Routine physicals, standard immunizations, vaccinations, vision screening and hearing test Well-child care up to age 6 Cancer screening Prenatal care Physician services Office visits for sickness or injury Inpatient professional services Outpatient professional services Other provider services Chiropractic care 15 visit max per person per calendar year Speech, occupational and physical therapy Home health care $25,000 per calendar year max 100% 100% 100% 100% 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible 80% after deductible Not covered Not covered Not covered Inpatient hospital services 80% after deductible Outpatient hospital services Outpatient surgery, preadmission tests, radiation therapy, chemotherapy or kidney dialysis Lab or X-rays 80% after deductible 80% after deductible Emergency care Emergency room charges Physician charges Ambulance services 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible Mental health and chemical dependency care 80% after deductible Prescription drugs 2 Retail pharmacy (30-day supply) Generic Preferred brand Non-preferred brand Home delivery/approved maintenance pharmacy (90 day supply) Generic Preferred brand Non-preferred brand 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible 1 If you cover one or more family members under the HSA1500 plan, the entire family deductible must be satisfied before the plan begins to pay coinsurance for any covered individual. You do not need to meet the full family out-of-pocket ($10,000) if you cover your dependents. The maximum out-of-pocket for one family member is $5, If you request a brand-name medication when a generic equivalent is available, you will pay the applicable copayment, plus the difference in cost between the brand and the generic. 11

15 What s covered in the MED750 Plan? In-network Out-of-network Annual deductible 1 $750 individual $1,500 family $1,500 individual $3,000 family Annual out-of-pocket maximum 1 The out-of-pocket maximums for in- and out-of-network cross apply. Non-covered charges and charges in excess of the allowed amount do not apply to the out-ofpocket maximum. Preventive care Routine physicals, standard immunizations, vaccinations, vision screening and hearing test Well-child care up to age 6 Cancer screening Prenatal care Physician services Office visits for sickness or injury Inpatient professional services Outpatient professional services Other provider services Chiropractic care 15 visit max per person per calendar year Speech, occupational and physical therapy Home health care $25,000 per calendar year max $3,500 individual $7,000 family 100% 100% 100% 100% $35 copay for office visit 80% after deductible 80% after deductible $35 copay for office visit; 80% after deductible for all other services $35 copay for office visit; 80% after deductible for all other services 80% after deductible $3,500 individual $7,000 family Not covered Not covered Not covered Inpatient hospital services 80% after deductible Outpatient hospital services Outpatient surgery, preadmission tests, radiation therapy, chemotherapy or kidney dialysis Lab or X-rays 80% after deductible 80% after deductible Emergency care Emergency room charges Physician charges Ambulance services 80% after in-network deductible 80% after in-network deductible 80% after in-network deductible Mental health and chemical dependency care Office visits Inpatient or outpatient care $35 copay for office visit 80% after deductible Prescription drugs 2 Retail pharmacy(310day supply) Generic Preferred brand Non-preferred brand Home delivery/approved maintenance pharmacy (90 day supply) Generic Preferred brand Non-preferred brand 20% with a minimum of $15 and max of $30 25% with a minimum of $30 and max of $60 30% with a minimum of $55 and a max of $110 $30 copay $60 copay $110 copay 1 If you cover one or more family members under this plan, the single deductible and the out-of-pocket maximum apply per person, up to the family deductible and out-of-pocket maximum for all family members combined. 2 If you request a brand-name medication when a generic equivalent is available, you will pay the applicable copayment, plus the difference in cost between the brand and the generic. 12

16 How Your Health Savings Account (HSA) Works An HSA stretches your health care dollars with multiple tax advantages, while giving you a great way to pay for medical expenses or save for future expenses: Money deposited into your HSA is tax-free Earnings from investments or interest are tax-free Money you withdraw is tax-free when used for qualifying expenses You can contribute to your HSA each year that you are covered by a qualifying high-deductible health plan; both the HSA1500 and HSA3000 are qualifying plans, per the Internal Revenue Service (IRS) definition. The HSA1500 includes a company contribution to get your savings started. Debit Card Convenience If you have an HSA, you will automatically receive a SelectAccount debit card, which can be used anywhere VISA is accepted. The SelectAccount debit card makes it possible for you to pay for eligible medical-related expenses directly from your HSA with minimal paperwork and no waiting for reimbursement and is best used for purchasing prescription drugs. Money will be withdrawn directly from your account. Or you can pay your medical bills with the debit card by writing the card number on the billing statement. There is no need to pay cash up front, submit a claim form and wait for reimbursement. You will receive your debit card in the mail. Then, simply follow the instructions to activate the card. When using your debit card, remember to always save your receipts. Because your HSA is regulated by the IRS, you should keep your receipts in case you need to verify that an expense is eligible for reimbursement. If you have questions about the debit card, call SelectAccount customer service at between 7 a.m. and 7 p.m. Central Time. Using your HSA Dollars Throughout the year, you can use the money in your HSA to pay for qualified medical expenses. Visit mybluecross at members.bluecrossmn.com for a list of eligible expenses. You can check the balance in your HSA by signing in to mybluecross at members.bluecrossmn.com. While there are funds available in your HSA, you can be reimbursed for your eligible out-of-pocket expenses. If you don t have enough money in your account to cover an expense, any non-reimbursed amount will pend for up to 12 months and you will be reimbursed as more contributions are made. You will receive an Explanation of Payment from SelectAccount which details your account activity every time you receive reimbursement from your HSA. Any money that you don t use in one year rolls over to the following year. 13

17 More Information about Health Savings Accounts (HSAs) Who can enroll in an HSA Employees who enroll in the HSA1500 or HSA3000 can establish an HSA. You cannot enroll in an HSA if you are covered under another medical plan (for example, if you enroll in the MED750 plan or you have coverage through your spouse s plan with another employer, unless it is a qualifying high-deductible plan). You can t have an HSA and a Health Care FSA at the same time. Your HSA contributions You may fund your HSA through payroll deductions on a pre-tax basis. Per the IRS, the maximum allowable annual HSA contribution for 2016 is: $3,350 for individual coverage $6,750 for family coverage (you are covering one or more family members) The maximum includes any company contribution. If you will be age 55 or older by December 31, 2016, you can contribute an additional annual catch-up contribution of up to $1,000. Changes to your You can start, stop or change the amount of your contributions at any contributions time. G&K contribution If you enroll in the HSA1500, G&K will make a weekly contribution to your HSA account (up to an annual maximum of $400 for single coverage and up to $800 for family coverage). If you enroll in the HSA3000, there is no employer contribution to the HSA. When to use your HSA You may use your HSA to pay for eligible out-of-pocket health care costs (for example, deductibles, coinsurance, prescription drugs) and other qualified health care costs including glasses, contact lenses, hearing aids, and dental expenses, such as orthodontia. How to use your HSA You will receive instructions about how to access and manage your account. How your HSA grows The HSA is an interest-bearing account with interest credited monthly; the current interest rate is 0.25 to 1.25% depending on the account balance. This account is not FDIC insured. Once your HSA balance reaches $1,000, you may invest any portion of your HSA balance over this level in select mutual funds. Should your account balance exceed $10,000, you may start a brokerage account and invest your balance as you please. What happens if I leave G&K? The money in your HSA account rolls over from year to year and the balance along with any investment income you earn is yours to keep, even if you stop making contributions. All the money in your HSA account is your money and HSAs are portable, meaning even if you leave G&K Services, you always have 100% ownership and rights to your HSA balance. The HSA tax advantages will continue as long as the money in your account is used to pay for qualifying medical expenses. You can roll over any balance into an HSA with a bank or trust company. 14

18 Prescription Drug Coverage G&K s prescription benefits will be managed by Express Scripts beginning January 1, If you enroll in any of G&K s medical plans, you will receive your Express Scripts ID card along with additional information directly from Express Scripts. (Please note that the member ID card will cover all your dependents. Separate ID cards for dependents will not be issued.) Be sure to show your Express Scripts ID card to your pharmacist when filling a prescription for yourself or a covered family member. You ll also be able to access your member ID card anytime from your Smartphone if you download the Express Scripts Mobile App. With Express Scripts, you ll have 24/7 access to information at Express-Scripts.com, where you can find: A large network of participating retail pharmacies. Express Scripts Customer Service Representatives to assist with questions about your benefit or orders. Helpful resources to assist you with your benefits: Order prescription refills, renewals and check your order status Transfer retail prescriptions to Home Delivery for convenience and potential savings Enroll in Worry-Free Fills to conveniently receive Home Delivery medication automatically Discover possible ways to save money on medications, such as using generics and Home Delivery Receive time-sensitive medication-related alerts on your personalized pharmacy care profile Look up information about your medications and your prescription drug benefit Ask a pharmacist questions anytime, day or night View a financial summary of your prescription expenses, especially valuable at tax time Review your prescription history to share with your doctor How to Stretch Your Health Care Dollars Making the most of your benefits is important. Here are some tips on how you can stretch your health care dollars. Use a network provider Pay the lowest cost by using doctors and other health care providers who are in-network. Take advantage of preventive care One of the best ways to take care of yourself is to see your doctor for checkups and health screenings. Regular exams help catch problems early and save money in the long run. Visit members.bluecrossmn.com and click on preventive care. Remember, eligible in-network preventive care is covered at 100% under all G&K medical plans. Ask for generic drugs Generic drugs are safe and effective, and they are strictly controlled by the Food and Drug Administration. They contain the same active ingredients as brand-name versions yet can cost up to 80 percent less than brand-name drugs. Ask your doctor or pharmacist about choosing a generic when available. If you enroll in the HSA1500 plan or HSA3000 plan, you will pay the full cost of prescription drugs until you meet your deductible, and if you obtain a brand name when a generic is available, you ll pay the additional cost of the brand name over the generic, so using generics can make a big difference to your bottom line. Use a network retail pharmacy: Visit any participating retail pharmacy and show your member ID card to receive the discounted price. Use home delivery or an approved maintenance retail pharmacy: If you have a prescription filled regularly, you can get a three-month supply and save. 15

19 Doctor On Demand Want to go to the doctor without leaving your house? Doctor On Demand (DOD) is the new Online Care vendor that will replace Online Care Anywhere beginning January 1, In addition to traditional board certified physicians, members now have access to licensed psychologists, psychiatrists and lactation consultants by appointment. As an extension of our provider network, DOD provides real-time eligibility and claims processing specific to each member s benefits, requiring no up-front payments (with the exception of co-pays, if applicable). Doctor On Demand key features: Quality medical care at a lower cost ($40 per visit vs. $45) Access to online care (including prescriptions, when appropriate) by appointment or on-demand from board certified physicians in 47 states (not available in Alaska, Arkansas, Louisiana) Access to behavioral health experts and lactation consultants by appointment (7 a.m.-10 p.m.) in all 50 states; appointments start at $50 per visit Connect via any camera-equipped device: smartphone, tablet or computer On-demand care from 7 a.m.-11 p.m., 365 days a year 16

20 Dental Benefits G&K has contracted with Delta Dental for your dental plan. You can go to any dentist you want and receive the same level of benefits. However, if you go to a dentist in the Delta Dental network, you will end up paying less because services will be discounted. To either confirm if your current provider participates in the Delta network or to find a new provider: Call Delta s customer service center at or (651) Customer Service hours are Monday Thursday 7 a.m. 7 p.m. Central Time, Friday 8 a.m. 7 p.m. Central Time. Verify that your dentist is participating in the Delta Dental PPO or Delta Dental Premier network. Visit the Delta Dental website at deltadentalmn.org. Your Dental Plan Coverage Annual deductible Annual maximum (per covered person in addition to orthodontia benefits) Individual: $25 Single plus one: $50 Family: $75 $1,500 Orthodontia lifetime maximum per person $1,500 Diagnostic and preventive services Oral exams and prophylaxis Cleaning at six month intervals Bitewing X-rays at 12-month intervals Full-mouth X-rays at 12-month intervals Fluoride treatment every 12 months, up to age 19 Space maintainers for missing posterior primary teeth 100% No deductible Basic services Emergency treatment for relief of pain Sealants, up to age 16 Amalgam restorations (silver fillings) Anterior (front tooth) resin restorations (white fillings) Composite resin (white fillings) restoration for posterior (back) teeth Nonsurgical periodontics (treatment of gum disease) at 2-year intervals Surgical periodontics at 3-year intervals Oral surgery Endodontics (pupal therapy and root canals) 80% after deductible Major restorative services Crowns at 5-year intervals, to restore lost tooth structure as a result of tooth decay or fracture Inlays Dentures (full and partial) at 5-year intervals Bridges at 5-year intervals Denture repairs and adjustments Re-cement bridge 50% after deductible Orthodontia (age 8 and older) 50% (No deductible) 17

21 Vision Plan The vision plan helps pay for routine periodic eye exams, eyeglasses and contacts, and related supplies. UHC Vision is the third party administrator. Plan Benefits When you see UHC Vision providers, you receive discounted services and the plan pays a percentage of your cost. You do not need to fill out a claim form for reimbursement. Through UHC Vision s provider network, you will receive a comprehensive eye examination, eyeglasses (lenses and frame) or contact lenses. You will receive most services at no additional cost, above any applicable copays Vision Plan Coverage In-Network Out-of-Network Benefit Frequency Examination 12 months 12 months Lenses 12 months 12 months Frames 24 months 24 months Contacts (in lieu of lenses and frames) 12 months 12 months Covered Services Examination 100% after $10 copay $45 reimbursement Single vision lens 100% after $25 copay $50 reimbursement Lined bifocal lens 100% after $25 copay $60 reimbursement Lined trifocal lens 100% after $25 copay $80 reimbursement Elective contact lenses 100% after copay up to 6 boxes or $150 allowance on lenses (in lieu of eye glasses) $150 reimbursement (in lieu of lenses and frames) Frame allowance $150 $50 reimbursement Other Services Polycarbonate Fully covered Not covered Standard scratch coating Fully covered Not covered Tints Fully covered Not covered UV Coating Fully covered Not covered Standard Progressives Fully covered Not covered Additional Lens Options (transitions, etc.) Discounted Not covered Laser vision care Discounted Not covered To Find a Provider: You may easily locate providers by logging onto myuhcvision.com and selecting the provider locator option. You may also contact UHC Vision s 24-hour, toll-free Interactive Voice Response (IVR) systems at to locate a provider near you. Laser vision correction: UHC Vision participants receive access to discounted laser vision correction procedures from numerous providers. To find a participating laser vision correction surgeon in your area, visit myuhcvision.com or call

22 Health Care Flexible Spending Account (FSA) A health care FSA allows you to contribute pre-tax dollars to an account through payroll contributions to pay health care expenses. WageWorks is the third party administrator. You cannot enroll in the health care FSA if you are enrolled in the HSA1500 or HSA3000 plans or are covered by an HSA-eligible plan through your spouse Plan Highlights Health Care Flexible Spending Account (FSA) Eligibility Employees who do not enroll in any G&K medical plan or employees who enroll in the MED750 plan Contributions You make an election once a year Minimum: $50 per year Maximum: $2,500 per year Eligible health care expenses Payment Other important information Your contributions will be deducted evenly from your paycheck before taxes are withheld. Eligible expenses are out-of-pocket medical and dental expenses incurred by you, your spouse and eligible dependents. These expenses include: eye examinations, prescription eye glasses, contact lenses, certain dental expenses, prescription drugs and office visit copays above what your insurance plan covers. Qualified expenses that are incurred during the calendar year must be submitted for reimbursement by March 31 of the following year. You need to estimate your eligible expenses carefully. IRS regulations do not allow the company to return any unused contribution to you. Consult your tax advisor. The FSA Debit Card When you enroll in the health care FSA, WageWorks will automatically send you a debit card by mail. Use your Healthcare FSA debit card to pay your eligible medical, dental and vision care expenses just as you would with a traditional bank debit card or credit card. You do not have to pay eligible expenses first and wait for reimbursement. However, in accordance with IRS guidelines, you still must keep and submit receipts to validate that your expenses were eligible for reimbursement/payment. If you do not provide the required documentation, your Healthcare FSA debit card will be deactivated until you are able to substantiate the eligible expense under the IRS definitions. Register receipts, which do not outline the service or supply, generally are not considered valid documentation. Ask your provider to give you an itemized, detailed receipt for services. 19

23 Dependent Care Flexible Spending Account (FSA) A dependent care FSA allows you to contribute pre-tax dollars to an account through payroll contributions to pay for eligible dependent care expenses. Wage Works is the third party administrator. With the dependent care FSA, you can only be reimbursed for money that you have already contributed to your account. This is different from the health care FSA, which provides access to your entire annual election Plan Highlights Dependent Care Flexible Spending Account (FSA) Eligibility All benefit-eligible employees Contributions You make an election once a year Minimum: $50 per year Maximum: $2,500 per year if you and your spouse file separate tax returns Maximum: $5,000 per household, per year if you are single or if you and your spouse file a joint tax return Eligible dependent care expenses Payment Other important information Your contributions will be deducted evenly from your paycheck pre-tax before taxes are withheld. Eligible expenses include childcare for children up to age 13 or eldercare incurred so you and your spouse can work, licensed nursery school or daycare and care for elderly or disabled adult members of your household. Qualified expenses that are incurred during the calendar year must be submitted for reimbursement by March 31 of the following year. You need to estimate your eligible expenses carefully. IRS regulations do not allow the company to return any unused contribution to you. For some individuals, the federal tax credit for dependent care may be more advantageous than the FSA plan. Consult your tax advisor. Note: IRS regulations may require G&K to reduce highly compensated employees contributions. 20

24 Life Insurance If something happens to you, will your family need money? Life and accident insurance benefits can provide income in the event of your death or accidental injury. VOYA Financial (formerly ING) is the administrator and the insurance carrier. ReliaStar Life Insurance Company is the underwriter. Basic Life and AD&D Insurance G&K provides basic life insurance at no cost to you at a rate of one times your annual base pay, up to a maximum of $200,000. G&K also provides you with free accidental death and dismemberment (AD&D) insurance in the same amount. Examples of accidental injuries covered by this insurance include accidental loss of a limb (arm, leg), fingers or sight, or permanent paralysis. Supplemental Life Insurance Supplemental life insurance is available in the following increments: Employee coverage: You may purchase $10,000 to a maximum of $500,000 (in $10,000 increments). Up to $250,000 is guaranteed without proof of good health if you elect coverage within 30 days after you become eligible for insurance. Spouse coverage: You may purchase $10,000 to a maximum of $100,000 (in $10,000 increments and not to exceed 100% of the amount of your supplemental life insurance). Up to $30,000 is guaranteed without proof of good health if you elect coverage within 30 days after you become eligible for insurance. Child coverage: You may purchase $5,000 for each of your children, from birth to age 26. Reduction in Insurance Based on Employee s Age The amount of basic life insurance, AD&D and supplemental life insurance will decrease as your age increases starting at age 65. This provision applies to insurance for you and your spouse. 21

25 Legal Plan You have the opportunity to enroll in the Ultimate Advisor, a legal plan from ARAG. The plan provides professional legal help to protect you and your family from legal difficulties. Ultimate Advisor As an Ultimate Advisor member, you will have access to professional attorneys, financial counselors and other resources. Legal Representation: When you have a legal need that requires legal representation, you can meet with an attorney in the attorney s office or in the courtroom. Attorney fees for most covered matters are 100% paid-in-full when you work with a network attorney. Telephone Legal Advice and Consultation: Attorneys can easily handle certain issues over the phone. You can consult with an attorney over the phone as often as necessary and as long as necessary for any of the following legal needs: General legal advice and consultation Standard wills preparation Living will and durable powers of attorney preparation Follow-up calls and letters Specific document preparation and review Reduced Fee Services: If you need legal representation for a situation that s not covered under the plan, but not specifically excluded, you can still save money by using an attorney for a Reduced Fee Benefit. Network attorneys can provide a reduced fee of at least 25% off their normal hourly rate for legal matters. Legal Tools and Resources: Simply want to research a certain legal topic in the comfort of your own home? With Ultimate Advisor, it can be as simple as going online to access: Law Guide of easy-to-understand legal articles to help you research and learn more about your legal situation Hundreds of Do-It-Yourself Legal Documents, for when you want the convenience and control of preparing a variety of legal documents yourself Additional included services: Identity Theft Services: toll-free access to certified identity theft case managers Immigration Assistance: toll-free access to a case managers and network attorneys Financial Education and Counseling Services: toll-free access to experienced financial counselors For more information about UltimateAdvisor Talk to an ARAG customer care specialist toll-free from 7:00 a.m. to 7:00 p.m. Central Time, Monday Friday at ARAG s customer care center at service@araggroup.com Visit ARAGLegalCenter.com and enter Access Code: 16221gks for more information 22

26 2016 Weekly Premium Rates MEDICAL 1 Coverage Level HSA3000 HSA1500 MED750 Employee $6.72 $24.29 $33.26 Employee + Spouse $20.52 $57.24 $78.24 Employee + Child(ren) $10.46 $42.48 $60.45 Family (spouse & children) $23.57 $72.08 $99.81 DENTAL 1 Coverage Level Employee $4.65 Employee + Spouse $11.26 Employee + Child(ren) $12.02 Family (spouse & children) $14.73 VISION 1 Coverage Level Employee $1.75 Employee + Spouse $3.08 Employee + Child(ren) $3.21 Family (spouse & children) $4.90 SUPPLEMENTAL LIFE 2 Age at Beginning of Year Cost per $1,000 Coverage Under 35 $ $ $ $ $ $ $ $ $ $ Weekly cost per $5,000 of child coverage regardless of the number of children: $ LEGAL PLAN: $ The weekly premiums for medical, dental, and/or vision are paid with pre-tax dollars deducted from your pay. Using pre-tax dollars lowers your taxable income and increases your take-home pay because the dollars are taken from your pay before Social Security tax, federal income taxes and, in most cases, state income taxes are deducted from your paycheck. 2 The weekly premiums for supplemental life and legal are paid with after-tax dollars deducted from your pay. 23

27 Employee Assistance Program Balancing life activities can create stress that s hard to handle on your own. To help you through those times, you can receive counseling and referrals through the EAP. The EAP is administered by ComPysch, a private firm specializing in employee assistance programs. Any help you receive from the EAP is completely confidential. Your name, records and other confidential information are not shared with G&K. Some resources that are available are listed below. For more information, please visit guidanceresources.com using company code GKS106 or call Confidential Counseling: This no-cost counseling service helps you address stress, relationship and other personal issues you and your family may face. Highly trained masters and doctoral level clinicians listen to your concerns and quickly refer you to in-person counseling and other resources for: -Stress, anxiety and depression -Grief and loss -Substance abuse -Many other issues or concerns Financial Information and Resources Speak by phone with Certified Public Accountants and Certified Financial Planners on a wide range of financial issues including but not limited to: -Getting out of debt -Retirement planning -Credit card or loan problems -Tax questions Legal Support and Resources Talk to attorneys by phone. If you require representation, we ll refer you to a qualified attorney in your area for a free 30-minute consultation with a 25% reduction in customary legal fees thereafter. Call about: -Divorce and family law -Landlord/tenant issues -Real estate transactions -Other legal issues you may face Work-Life Solutions Work-Life specialists will do the research for you, providing qualified referrals and customized resources for: -Child and elder care -Moving and relocation -College planning -Pet care Guidance Resources Online Guidance Resources Online is your one stop for expert information on the issues that matter most to you. Log onto the Guidance Resource website to find: -Timely articles, help sheets, tutorials, streaming videos and self-assessments - Ask the Expert personal responses to your questions -Child care, elder care, attorney and financial planner searches 24

28 Disability Benefits and Leaves of Absence G&K pays the full cost of disability coverage. The benefits provide you some income when you have a nonwork-related illness or injury that prevents you from working. Short Term Disability (STD) and Leaves of Absence Any time you are missing work due to your own medical condition or the care of a family member s condition, or for a personal leave or military leave, please contact Unum. Notify your immediate supervisor that you need a leave of absence. You must provide advance notice whenever possible of you need for leave and, unless there are extenuating circumstances, are required to report your absences before the start of your work shift, and, in all events, within 48 hours of missing work. To request a leave please call our leave administrator, UNUM at Within five business days of your request, Unum will provide you with written documentation of your rights and responsibilities, instructions and additional information. If your leave is associated with a work-related injury, you are not required to provide details regarding the need for your leave to your manager. Please call GK-HR4ME ( ) to report a work-related injury and discuss leave options. Long Term Disability (LTD) Long Term Disability (LTD) is available to certain management employees. For information, contact UNUM at

29 Paid Time Off Everyone needs time off from work to rest, relax and spend time with family and friends. That s why G&K offers paid time off. Holidays Holidays that are observed by G&K vary by location. Standard observed holidays are: New Year s Day Memorial Day Independence Day Labor Day Thanksgiving Day Christmas Day One location-specific holiday One personal holiday Vacation Vacation time allows you to take extended time off with pay. G&K s vacation schedule is based upon your length of service and position within the company. Effective September 1, 2015, we changed vacation from grant date to accrual method. This means that you have access to your vacation as you earn it. Hours will be earned each week. Your accrual levels will continue to be based on service date, as shown in the table below: Role Years of Service Vacation Maximum Weekly Accrual Vacation should be requested two weeks in advance. GM, Director, and Above Exempt Including: Corporate Exempt, Field Exempt, Regional Exempt 0-4 years 4-9 years 9+ years 0-4 years 4-14 years 14+ years 120 hours 160 hours 200 hours 120 hours 160 hours 200 hours Non-exempt employees may use vacation in four-hour increments if desired. You are encouraged to take time off to refresh yourself and spend time away from work. Therefore, no payments may be made instead of taking vacation. Salaried Route Specialist 0-4 years 4-9 years 9-14 years 14+ years 80 hours 120 hours 160 hours 200 hours Non-Exempt Corporate 0-4 years 4-9 years 9-14 years 14+ years 80 hours 120 hours 160 hours 200 hours Non-Exempt Field Including: Regional Non- Exempt, Route Sales Representative, Super Route, and Relief Driver 0-1 years 1-4 years 4-9 years 9+ years 40 hours 80 hours 120 hours 160 hours

30 Tuition Reimbursement The Tuition Reimbursement Program is provided to encourage and support employee development as it relates to your individual development plan. Each course or degree program must be approved by your direct supervisor, department head or location manager in advance. Eligibility After three consecutive months of full-time regular employment, you are eligible to participate if you meet the following criteria: Active on the G&K payroll when course work is taken and when reimbursement is approved and distributed Working at least 30 hours per week Meeting or exceeding and sustaining acceptable performance levels Fulfilling requirements of a development plan agreed to with your supervisor, department head or location manager Receiving acceptable grades of P or C or better Complete and sign required documentation including a payback agreement You must remain an employee in good standing for at least two years past your graduation date (or completion of coursework for which tuition reimbursement was granted) Reimbursement 100% of tuition up to $3,500 per calendar year Required books and non-optional fees Tuition reimbursement requests must be made to your supervisor within 60 days of receiving the official grade report for each course 27

31 401(k) Plan The G&K Services 401(k) Savings Incentive Plan is a retirement savings benefit for employees of G&K Services. Most G&K employees are eligible to join the 401(k) Plan. You can start saving (that is deferring a portion of your compensation) in the plan as soon as administratively practical after your date of hire. Wells Fargo, the Plan record keeper, will mail plan information to you at your home. When you join the 401(k) Plan, you choose how much to save and how to invest your savings. An individual 401(k) account is set up for you in your name. Your 401(k) account can be made up of any or all of the following: An eligible rollover from your former employer s plan Your savings in the G&K 401(k) Plan The company match on your savings Company retirement contributions Company transition contributions Investment earnings/losses A Great Way to Save Saving in the 401(k) Plan is convenient and easy because your savings are deducted from your paycheck each week and put in your 401(k) account. The deductions are taken from your paycheck on a pre-tax basis. That means the money you save comes out of your paycheck before taxes so your savings aren t taxed for federal and, in most states, state income taxes. You can defer taxes on the money until it is paid to you from the Plan. You can save 1%, 2%, 3% to 75% of your pay in the 401(k) Plan, up to the IRS limit on pre-tax contributions. The IRS limit for 2015 is $18,000 if you are under age 50. If you are 50 or older in 2015, the limit is $24,000. These limits may be increased in 2017 for cost of living adjustments. For this Plan, your pay is generally defined as your wages from G&K, including salary and most bonuses, as reported on your annual W-2 statement. It does not include fringe benefits, reimbursements, expense allowances, insurance payments, deferred compensation, equity-related compensation (stock options, restricted stock, long-term cash awards) or severance pay. To Enroll or Make Changes to Your Account Access your account on the Wells Fargo Retirement Plan Web Site at: wellsfargo.com or call (1-800-SAVE-123). If you need a translator, state the name of your language and a translator will assist you. Customer service representatives are available by phone 6:00 a.m. 10:00 p.m., Central Time (CT), Monday through Friday, except holiday weekdays. The first time you sign on, you ll need your Social Security number, date of birth and address. Check the box indicating that you do not have an account number and you will be guided through a short series of security questions. If you have other Wells Fargo accounts that you access online, sign on using your existing username and password, then select the name of your retirement plan to get started. You may change or stop the amount you save in the plan at any time. Please allow up to two weeks for your enrollment or savings rate change to affect your paycheck. Investment changes that are made by 3:00 PM CT on a business day are generally effective the end of that day. Investment changes that are made after 3:00 PM CT are generally effective the end of the following business day. 28

32 Company Match on Your Savings The Plan helps your savings grow with matching company contributions to your 401(k) account. You are eligible for the company match if you have one year of service with G&K and you are at least age 18. For each dollar that you save from 1% to 3% of your pay, G&K matches your savings dollar for dollar. For the next 2% of pay that you save, G&K matches your savings 50 cents on the dollar. You are immediately 100% vested in company matching contributions that are made after Being vested means you own the matching dollars and they are available to you when you leave the company. Company matching contributions that were made before 2006 are 20% vested for each year of your vesting service, up to 100% after five years. What does this mean to me? Here s an example to help you understand how your 401(k) Plan account can grow. Assume G&K employee Ima Saver makes $10/hour. The chart shows the total contributions that would go into Ima Saver s account over a year if she saves 1%, 2%, 3%, 4%, or 5% of pay and she is eligible for the company match. If Ima Saver saves 3% of pay, which is $12/week, she ends up with $1,248 for the year during the year, she will have contributed $624 and G&K will have contributed $624 to her 401(k) account. If Ima Saver saves 5% of her pay, which is $20/week, she ends up with $1,872 for the year over the year, she will have contributed $1,040 and G&K will have contributed $832 to her 401(k) account. That s before any investment earnings! 1% Savings ($4/week) 2% Savings ($8/week) 3% Savings ($12/week) 4% Savings ($16/week) 5% Savings ($20/week) Employee savings $208 $416 $624 $832 $1,040 Company match $208 $416 $624 $728 $832 Total $416/year $832/year $1,248/year $1,560/year $1,872/year What are the investment choices? The 401(k) Plan offers several professionally managed investment fund choices. You choose the investment funds for your 401(k) account. You can make changes to your investment fund choices at any time. The types of funds that are available offer a range of risk/reward (from low to high) potential: principal preservation, bonds, asset allocation and stocks. Detailed information on the funds will be included in the materials that you receive from Wells Fargo as a new hire. Company Retirement Contributions If you were a participant in the 401(k) Plan between January 1, 2007, and December 31, 2010, you may have been eligible to receive company retirement contributions. Please see your Summary Plan Description for more information. 29

33 Company Transition Contributions You may be eligible for company transition contributions to the 401(k) Plan if, as of December 31, 2006, you had completed at least five years of vesting service under the G&K Services Pension Plan and you were either 1) at least age 50 or 2) the combination of your age plus years of vesting service equaled 60 years or more. Please see your Summary Plan Description for more information. How do you access the money in your 401(k) account? While you are working at G&K In the event that you should need to access the money in your 401(k) account while working at G&K Services, there are three options: Option 1: Take a Loan A loan is money that you borrow and pay back into your 401(k) account through payroll deductions. The money borrowed is not taxed or penalized provided the entire amount is paid back into your 401(k) account. The minimum loan amount is $1,000 and the maximum is generally the lesser of $50,000 or 50% of your vested account balance available for loans. Only the vested account balance of your savings, the company match and any rollover account can be used for loans. You may only have one loan outstanding at a time and an annual maintenance fee of $25 applies. Option 2: Request a Hardship Withdrawal A hardship withdrawal occurs when you take money out of your 401(k) account that you do not pay back. A hardship withdrawal will be taxed (and generally subject to an additional 10% early withdrawal penalty if you are under the age of 59½). If you are under age 59½, you can request a financial hardship withdrawal of your savings (but not investment earnings on those savings) and of any pre-2007 matching employer or profit-sharing contributions. The Plan allows a hardship withdrawal in the event of your immediate and heavy financial need, but the amount must not be greater than your need. You must first take a distribution from your rollover account, if any, and take any available loan from the Plan (unless the loan would increase your hardship). Your savings contributions (and the corresponding company match) will be suspended for six months if you request a hardship withdrawal. Company transition contributions are not suspended during this six-month period. The definition of financial hardship includes: Unreimbursed medical expenses for you and/or your dependents Purchase of a principal residence (excluding mortgage payments) Payment of tuition and fees for post-secondary education for yourself, your spouse and/or dependents Need to prevent eviction from your primary residence or foreclosure on the mortgage of your principal residence Payment of burial or funeral expenses for your parent, spouse, child or dependent Payment for repairs to your principal residence that would qualify as a casualty deduction Option 3: Request An In-Service Withdrawal If you are age 59½ or older or have suffered a disability (as defined by the 401(k) Plan), you can request a withdrawal of all or part of your vested account balances including your savings, the company match, company retirement contributions and company transition contributions accounts. You do not need to take out a loan first. You may request a distribution from your rollover account at any time. A $25 distribution fee applies regardless of the type of distribution. 30

34 What happens when you retire or leave G&K? Choose The Option That Is Best For You One of the most important financial decisions you will have to make is what to do with your 401(k) account when you retire or leave the company. You should consider each option carefully and consult with a professional tax advisor before you decide. If your vested account balance is $5,000 or less but more than $1,000, and you do not elect to roll your balance into a new account or have it paid to you, your account will be automatically rolled over to an IRA at Wells Fargo on your behalf. If your account balance is $1,000 or less and you do not make a decision on your distribution, your account will be paid to you in one cash payment as a taxable distribution. If your account balance is greater than $5,000 you have the following options after you leave G&K. Option 1: Stay In The 401(k) Plan You can keep your money invested in the Plan. If you are satisfied with your investment choices under the 401(k) Plan and the performance of your investments, you may want to leave your money where it is. Later, you can make a direct rollover or take the money in cash as described below. Under IRS rules, if you leave your account in the Plan, you must start to receive distributions at age 70½. Option 2: Make A Direct Rollover If you request a direct rollover, the plan administrator transfers your vested account balance into a traditional IRA that you set up with a financial institution or into your new employer s qualified plan (if that plan accepts rollovers). The benefits of a direct rollover are: There are no income taxes due at the time of the rollover. All earnings in your rollover will continue to grow tax deferred. You don t pay taxes until later when you take your money out of the IRA or the new employer s plan. Contact Wells Fargo at for more information and to request forms for a direct rollover. Option 3: Take The Money In Cash With this option, your vested account is paid to you in cash in a single payment or in installments. When you take the money in cash: The Plan is required to withhold 20% of the taxable portion of your distribution for federal income taxes. If you re under age 59½, you may owe an additional 10% early withdrawal penalty on the taxable portion. You may owe state and local taxes. Your tax-deferred investment growth comes to an end. If you take a cash lump sum, you still have the option of rolling the money over to a traditional IRA or a qualified employer plan that accepts rollovers, but you must do this within 60 days of receiving the distribution and you must roll over the entire distribution amount (including the 20% that was withheld) to avoid all taxes and penalties. That means that you must replace the 20% withholding from your personal funds. When you file your income tax return, you may get a refund for part or all of the amount of the withholding. Contact Wells Fargo at for more information and forms to request a distribution. For additional information about the 401(k) Plan, please refer to your Summary Plan Description (SPD). The Summary Plan Description contains more detailed information regarding eligibility, participation and your rights under federal law. In the event of a conflict between the Plan and this booklet, the Plan terms will control. A $25 fee applies for any type of distribution. 31

35 Employee Stock Purchase Plan The Employee Stock Purchase Plan (ESPP) allows you to share in the ownership of G&K by purchasing common stock at the market price through convenient payroll deductions. The plan encourages all employees to work for the continued success of G&K. How Does the ESPP Work? When you participate in the ESPP, you make a regular contribution to an account set up in your name. On approximately the 15th of every month, the money in your account is used to purchase G&K stock through Computershare (formerly BNY Mellon) with the brokerage fees and commissions paid by G&K. To find out more about Computershare, please go to: or you can call GK-SERV. Why Buy Stock Through the ESPP? The G&K ESPP plan is an easy way to purchase G&K stock. You do not have to go through a broker or write a check to buy stock. The plan administrator makes it simple by automatically handling your contribution and purchasing your stock each month. When you purchase stock, you pay no broker commissions or transaction fees. How do you enroll or make deduction changes? Customer service representatives are available to help you from 3 am to 9 pm Eastern Time, Monday through Friday, excluding stock market holidays at GK-SERV. What are the fees when you sell your stock? When you sell the stock in your account, you will pay the standard minimum broker and transaction fees. This amount will automatically be deducted from the proceeds you receive from the sale. How am I taxed on my ESPP shares? If securities are held for less than one year, any gains are taxed at ordinary income rates, or the same rates as your regular wages. If you hold your shares for over one year, any gains are taxed as capital gains. It is advisable to contact your tax professional before enrolling in the ESPP. Can I withdraw from the program at any time? Yes. You can withdraw from contributing or change your contribution level by contacting Computershare customer service representatives at GK-SERV. Any uninvested contributions made before your withdrawal will be used to purchase shares during the next purchase period. In addition, it may take up to one week to process your request, and you may have additional contributions deducted from your paycheck. Those contributions will be used to purchase stock which you can then sell. 32

36 GK extras GK extras is a single destination where employees can research, shop for and purchase discounted consumer goods and services from some of the country s foremost companies at special group rates. You will find all the information you need to take advantage of any offer (including program details and codes), contact information and direct links to providers at beneplace.com/gkservices. As G&K employees, you will be eligible for discounts year round at places such as: GlobalFit New computer discounts from various companies Fred Haas Toyota Country Employee Purchase Program Cruise & Vacation Perks HP Employee Purchase Program Theme parks & attractions Discounts on cell phones and service Sam s Club Purchasing Power 33

37 Disclosures & Notices Special Enrollment Rights If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents' other coverage). However, you must request enrollment within 30 days after your or your dependents' other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days or any longer period that applies under the plan after the marriage, birth, adoption, or placement for adoption. You and your dependents are also eligible for special enrollment if you or your dependents become eligible for premium assistance under a state Medicaid plan or state child health plan (CHIP) or if you lose coverage under a state Medicaid plan or state CHIP. You must request enrollment within 60 days after you or your dependents become eligible or lose eligibility for the Medicaid or CHIP coverage. To request special enrollment or obtain more information, contact GK.HR4ME ( ). Women s Health and Cancer Rights Act Under the federal Women s Health and Cancer Rights Act of 1998, you are entitled to the following services: 1. Reconstruction of the breast on which the mastectomy was performed; 2. Surgery and reconstruction of the other breast to produce a symmetrical appearance; and 3. Prosthesis and treatment for physical complications during all stages of mastectomy, including swelling of the lymph glands (lymphedema). Services are provided in a manner determined in consultation with the physician and patient. Coverage is provided on the same basis as any other illness. Newborns and Mothers Health Protection Act Group health plans and health insurance issuers generally may not, under Federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother s or newborn s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under Federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). 34

38 Important Notice from G&K Services about Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Blue Cross Blue Shield of Minnesota under the G&K Services Medical Plan 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 two important things you need to know about your current coverage and Medicare s prescription drug coverage: 1. 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. All Medicare prescription 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. 2. G&K Services has determined that the prescription drug coverage offered under the G&K Services Medical Plan through Blue Cross Blue Shield of Minnesota is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is on average, at least as good as standard Medicare prescription drug coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan. 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 th to December 7 th. However, if you lose creditable prescription drug coverage through no fault of your own, you will be eligible for a two (2) 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 decide to join a Medicare drug plan, your current coverage will not be affected. You may keep your current coverage under the G&K Services Medical Plan with Blue Cross Blue Shield of Minnesota and the G&K Services Plan will coordinate with your Medicare drug plan. Please contact your employer s human resources department for more information. If you do decide to join a Medicare drug plan and drop your current coverage, be aware that you and your dependents might or might not be able to get this coverage back, depending upon the circumstances under which you lost your Medicare Prescription Drug Plan coverage and your employment status with G&K Services at that time. Please contact your employer s human resources department for more information. 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 G&K Services and do not 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 percent of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without creditable coverage, your premium may consistently be at least 19 percent higher than the Medicare base beneficiary premium. You may have to pay 35

39 this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information about This Notice or Your Current Prescription Drug Coverage Contact Customer Service for Blue Cross Blue Shield of Minnesota at or 1(866) NOTE: You will receive this notice each year. You will also receive it before the next period you can join a Medicare drug plan and if this coverage through G&K Services changes. You may request a copy of this notice anytime. 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 & You handbook. You will 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 your copy of the Medicare & You handbook for their telephone number) for personalized help Call MEDICARE ( ). TTY users should call 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 ). Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage, and therefore, whether you are required to pay a higher premium (a penalty). 36

40 Premium Assistance Under Medicaid and the Children s Health Insurance Program (CHIP) If you or your children are eligible for Medicaid or CHIP and you re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren t eligible for Medicaid or CHIP, you won t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial KIDS NOW or to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren t already enrolled. This is called a special enrollment opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at or call EBSA (3272). If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, Contact your State for more information on eligibility ALABAMA Medicaid Website: Phone: ALASKA Medicaid Website: Phone (Outside of Anchorage): Phone (Anchorage): COLORADO Medicaid GEORGIA Medicaid Website: - Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP) Phone: INDIANA Medicaid Website: Phone: IOWA Medicaid Medicaid Website: Medicaid Customer Contact Center: FLORIDA Medicaid Website: Phone: Website: Phone: KANSAS Medicaid Website: Phone:

41 KENTUCKY Medicaid Website: Phone: LOUISIANA Medicaid Website: Phone: MAINE Medicaid Website: Phone: TTY MASSACHUSETTS Medicaid and CHIP Website: Phone: MINNESOTA Medicaid Website: Click on Health Care, then Medical Assistance Phone: MISSOURI Medicaid Website: htm Phone: MONTANA Medicaid Website: Phone: NEW HAMPSHIRE Medicaid Website: Phone: NEW JERSEY Medicaid and CHIP Medicaid Website: medicaid/ Medicaid Phone: CHIP Website: CHIP Phone: NEW YORK Medicaid Website: Phone: NORTH CAROLINA Medicaid Website: Phone: NORTH DAKOTA Medicaid Website: d/ Phone: OKLAHOMA Medicaid and CHIP Website: Phone: OREGON Medicaid Website: Phone: NEBRASKA Medicaid Website: Phone: PENNSYLVANIA Medicaid Website: Phone:

42 NEVADA Medicaid Medicaid Website: Medicaid Phone: SOUTH CAROLINA Medicaid Website: Phone: SOUTH DAKOTA - Medicaid Website: Phone: TEXAS Medicaid Website: Phone: UTAH Medicaid and CHIP Website: Medicaid: CHIP: Phone: VERMONT Medicaid Website: Phone: RHODE ISLAND Medicaid Website: Phone: VIRGINIA Medicaid and CHIP Medicaid Website: ce.cfm Medicaid Phone: CHIP Website: ce.cfm CHIP Phone: WASHINGTON Medicaid Website: s/ index.aspx Phone: ext WEST VIRGINIA Medicaid Website: n/pages/default.aspx Phone: , HMS Third Party Liability Website: WISCONSIN Medicaid and CHIP htm Phone: WYOMING Medicaid Website: Phone: To see if any other states have added a premium assistance program since July 31, 2015, or for more information on special enrollment rights, contact either: U.S. Department of Labor U.S. Department of Health and Human Services Employee Benefits Security Administration Centers for Medicare & Medicaid Services EBSA (3272) , Menu Option 4, Ext OMB Control Number (expires 10/31/2016) 39

43 Notice of Privacy Practices 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. If you have questions about this notice, please contact the Privacy Officer. This notice describes the medical information practices of the group health, dental, and medical flexible benefits plans (each a Plan ) sponsored by G&K Services, Inc. and associated companies ( G&K or Company ). Title II of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on employer health plans concerning the use and disclosure of individual health information. The HIPAA Privacy Rule protects only certain medical information known as protected health information ( PHI ). Generally, PHI is individually identifiable health information, including demographic information, collected from you or created or received by a health care provider, a health plan, or your employer on behalf of a group health plan, that relates to: 1) your past, present, or future physical or mental health or condition 2) the provision of health care to you 3) the past, present or future payment for the provision of health care to you It is important to note that under Title II of HIPAA, these rules apply to the Plan, not the Company (or any affiliated entities) in its capacity as an employer. This Notice is effective September 1, We reserve the right to change the terms of this Notice and to make new provisions regarding your PHI that we maintain, as allowed or required by law. If we make any material change to this Notice, we will provide you with a copy of our revised Notice of Privacy Practices. HOW WE PROTECT YOUR MEDICAL INFORMATION We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We maintain physical, electronic, and procedural safeguards that comply with Federal and State laws to protect information against unauthorized access and use. Our Privacy Officer has the overall responsibility for implementing and enforcing policies and procedures to safeguard your protected health information against improper access, use and disclosure. This notice applies to all protected health information we may maintain. This notice tells you about the ways in which we may use and disclose your PHI. It also describes our obligations and your rights regarding the use and disclosure of PHI. The law requires us to: Make sure that your PHI is kept private Give you this notice of our legal duties and privacy practices with respect to your PHI Notify you following a breach of your unsecured PHI Follow the terms of the notice that is currently in effect Inform you if we amend this notice HOW WE MAY DISCLOSE MEDICAL INFORMATION ABOUT YOU The statements below describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean, and present some examples. Not every use or disclosure is listed. However, all of the ways we are permitted to use and disclose information will fall into one of the listed categories. 40

44 We will use your health information for treatment and/or Plan payment purposes. We may use and disclose medical information about you without your specific authorization To determine whether benefits are payable under the Plan To assist in making payment for the treatment and services you receive from health care providers To decide who is responsible to pay your benefits under the Plan To coordinate coverage with other third-party payors To provide benefit information to you For example: We may tell your health care provider about your medical history to decide whether a treatment is experimental, investigational or medically necessary, or to decide whether the Plan will cover the treatment. We may share medical information with a utilization review provider to decide how many days a hospital confinement may continue. We may share medical information with a drug card company to decide whether a prescription is medically necessary. We will use your health information for Plan administration and other health care operations. We may use and disclose Plan information about you for necessary health plan administration purposes. For example: We may use medical information in connection with: underwriting, premium rating, and other activities relating to plan coverage; submitting claims for stop-loss (or excess loss) coverage; conducting or arranging for medical review, legal services, audit services, and fraud and abuse detection programs; business planning and development such as cost management and business management; conducting quality assessment and improvement activities and general plan administrative activities. Note: we will not use genetic information for underwriting purposes. We will use your health information as required by law. We will disclose medical information about you when we are required to do so by federal, state or local law or regulation. For example: We may disclose medical information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process. If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested. Generally speaking, the amount of PHI used or disclosed will be limited to the minimum necessary for these purposes, as defined under the HIPAA rules. Other Permitted or Required Uses and Disclosures Disclosure to Health Plan Sponsor. There are circumstances under which the Plan may disclose your health information to the Plan sponsor, G&K. First, the Plan may inform G&K whether you are enrolled in the Plan. Second, the Plan may disclose summary health information to G&K. G&K may use such summary health information to obtain quotes from insurers or to modify, amend, or terminate the Plan. Summary health information is information that summarizes claims history, claims expenses, or types of claims without identifying you. Third, the Plan may disclose your protected health information to G&K for Plan administrative purposes, including for the purpose of determining claims for any Plan benefits for which the Company is a claims adjudicator. This is because employees of G&K perform many of the administrative functions necessary for the management and operation of the Plan. G&K will only use or disclose your protected health information for Plan administrative purposes or as otherwise required or permitted by law. The Company cannot and will not use PHI obtained from the Plan for any employment-related actions. However, other health information collected by the Company, for example under the Family and Medical Leave Act, American with Disabilities Act, or workers compensation, is not protected under HIPAA. 41

45 Business Associates. There are some services provided in our organization through contracts with business associates. Examples include preferred claims administrators, provider organization services, utilization review services, and prescription drug card plan services. If these services are contracted, we may disclose your health information to a business associate so it can perform the job it has been asked to do. An example is a preferred provider organization that calculates the discount available to you when you use a network provider. To protect your health information, however, we require, and federal law requires, the business associate to appropriately safeguard your information. Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority. Workers Compensation. We may release medical information about you for workers compensation or similar programs. These programs provide benefits for work-related injuries or illness. Other Allowable Uses or Disclosures of Your PHI. Except in an emergency, your PHI generally will not be disclosed without your authorization to a family member, close friend, or other person who is involved in your care. PHI may be disclosed to family members and others in connection with payment for health care. PHI may also be provided to an adult acting on behalf of a minor child. The Plan is allowed to use or disclose your PHI without your written authorization for the following activities: Situations involving law enforcement activities, social services or to report abuse or neglect Research purposes, public health activities and public health oversight activities, specialized government functions, and organ donation purposes In emergency situations involving a threat to public safety Other uses and disclosures of medical information not covered by this notice or the laws that apply to the Plan will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the purposes covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of coverage provided to you. Your Rights Regarding Medical Information About You You have the following rights regarding medical information about you. Right to Inspect and Copy. You have the right to inspect and copy medical information that is used to make decisions about your individual claims. This includes, for example, information used to make health care decisions (such as how many days of in-hospital treatment you are allowed) or information used to determine whether a claim will be paid. This does not include information that is not used to make decisions about your individual claim, for example, information used for quality control or peer review. You may request an electronic copy of the information. We will provide the information you request in electronic form if it is readily producible in such format. You must submit your request in writing to the Privacy Officer. We will charge a reasonable, cost-based fee for photocopies. We may deny your request to inspect and copy in limited circumstances. If your request is denied you will be informed in writing of the reason for the denial and you will be informed of the procedure for review of the denial. Right to Amend. If you believe that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Plan. You must submit your request in writing to the Privacy Officer. You must also provide a reason that supports your request. 42

46 We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. We may also deny your request if you ask us to amend information that: is not part of the medical information kept by or for the Plan; or, was not created by us; or, is not part of the information which you would be permitted to inspect and copy; or, is already accurate and complete. Right to an Accounting of Disclosures. You have the right to request an accounting of disclosures (a list that shows when we have disclosed information about you and to whom we disclosed it) where such disclosure was made for any purpose other than treatment, payment, or health care operations. To request this list or accounting of disclosures, you must submit your request in writing to the Privacy Officer. Your request must state a time period which may not be longer ago than six years. Your request should indicate in what form you want the list (for example, paper or electronic). The first list you request within a 12 month period is free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. We are not required to agree to your request. However, if you have paid in full for the services to which the medical information relates, we will honor your request to restrict disclosures for health care operations or payment purposes, except where such disclosures are necessary for treatment. Requests for restrictions must be made in writing to the Privacy Officer. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both, and (3) to whom you want the limits to apply, for example, disclosures to your spouse. Under HIPAA, you have the right to restrict the disclosure of medical information about you to the Plan if the disclosure is for the purpose of carrying out payment or health care operations and you paid for the service in full. You must make that request to the person or entity that provided the care to you. A provider who is covered by HIPAA must agree to such a request. Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to the Privacy Officer. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. Notice of Certain Events. If there is an unauthorized breach of medical information that has not been secured according to standards established by the federal government, affecting you, you will receive notice of the breach in accordance with applicable regulations. Right to a Paper Copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy. How to Contact Us. Send all written requests to: Carita Hibben, Privacy Officer, G&K Services, Inc., 5995 Opus Parkway, Minnetonka, MN If you believe there has been a violation. If you believe your privacy rights have been violated, you may file a complaint with the Plan s Privacy Officer or with the Secretary of the Department of Health and Human Services 200 Independence Avenue, SW, Room 509F, Washington, DC 20201, toll free To file a complaint with the Plan s Privacy Officer, send your complaint to Carita Hibben, Privacy Officer, G&K Services, Inc., 5995 Opus Parkway, Minnetonka, MN All complaints must be submitted in writing. You will not be penalized for filing a complaint. 43

47 YOUR RIGHTS UNDER ERISA As a participant in the Plan, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (ERISA). They are described below. Receiving Information About Your Plan and Benefits You have the right to: Examine, without charge, at the Plan Administrator s office and at other specified locations, such as work sites 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 and available at the Public Disclosure Room of the Employee Benefits Security Administration. Obtain, upon written request to the Plan Administrator, copies of 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. The Plan Administrator may make a reasonable charge for the copies. Receive a summary of the Plan s annual financial report. The Plan Administrator is required by law to furnish each participant with a copy of this summary annual report. Continued health care coverage for you, your Spouse and your Dependent Children if there is a loss of coverage under the Plan as a result of a qualifying event. You or your dependents have to pay for such coverage. Review this Summary Plan Description and the documents governing the Plan on the rules governing your COBRA continuation coverage rights. Prudent Actions by Plan Fiduciaries In addition to creating rights for Plan participants, ERISA imposes duties upon the people who are responsible for the operation of the Employee benefit 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 to prevent you from obtaining a Plan benefit or exercising your rights under ERISA. Enforcing Your Rights 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. Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of Plan documents or the latest annual report from the Plan and do not receive them within 30 days, you may file suit in a Federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Plan Administrator. If you have a claim for benefits that is denied or ignored, in whole or in part, you may file suit in a state or federal court. If it should happen that Plan fiduciaries misuse the Plan s money, or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a Federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay those costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous. Assistance with Your Questions If you have any questions about your Plan, contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA or if you need assistance in obtaining documents from the Plan Administrator, contact the nearest office of the Employee Benefits Security Administration, U.S. Department of Labor, listed in your telephone directory or the Division of Technical Assistance and Inquiries, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue N.W., Washington, D.C You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. 44

48 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. 1 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 coverage- is 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 G&K HR Solutions GK.HR4ME ( ) 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. 1 An employer-sponsored health plan meets the "minimum value standard" if the plan's share of the total allowed benefit costs covered by the plan is no less than 60 percent of such costs. 45

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