Varian Medical Systems 2017 ANNUAL NOTICES. Active Employee

Transcription

1 Varian Medical Systems 2017 ANNUAL NOTICES Active Employee

2 What s Inside GRANDFATHERED PLANS... 3 STATE CONTINUATION OF COVERAGE RIGHTS... 3 CALIFORNIA ENROLLEES CAL-COBRA EXTENDED CONTINUATION COVERAGE... 3 INITIAL COBRA NOTICE CONTINUATION COVERAGE RIGHTS UNDER COBRA... 4 WOMEN S HEALTH AND CANCER RIGHTS ACT REQUIRED ANNUAL NOTICE... 7 NEWBORNS AND MOTHERS HEALTH PROTECTION ACT NOTICE... 7 MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT NOTICE... 7 HIPAA NOTICE OF PRIVACY PRACTICES FOR PERSONAL HEALTH INFORMATION... 8 NOTICE OF SPECIAL ENROLLMENT PERIODS PREMIUM ASSISTANCE UNDER MEDICAID AND THE CHILDREN S HEALTH INSURANCE PROGRAM (CHIP) HEALTH CARE REFORM NOTICE SUMMARY ANNUAL REPORT /6056 REPORTING NOTICE

3 GRANDFATHERED PLANS Varian believes that the only medical plan offered, that s considered a grandfathered health plan under the Patient Protection and Affordable Care Act (PPACA) is the Health Plan of Nevada plan. A grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your Varian medical plan may not include certain consumer protections of the PPACA that apply to other plans; for example: the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the PPACA; for example: the elimination of lifetime limits on benefits. Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed via to corpbene@varian.com. STATE CONTINUATION OF COVERAGE RIGHTS Many states require insured medical plans (e.g., HMOs) to provide extended health coverage to participants after their group coverage ends. These rights generally supplement federal COBRA, or provide continuation coverage to those who are ineligible for federal COBRA coverage. Because the laws vary from state to state, you should review the applicable HMO or insured medical plan material (e.g., your HMO booklet and/or Evidence of Coverage ) and/or contact the medical plan directly to learn about any rights under state law. That way, you can meet any election and premium requirements necessary to take advantage of these state continuation coverage rights. CALIFORNIA ENROLLEES CAL-COBRA EXTENDED CONTINUATION COVERAGE California law requires insured medical plans and HMOs in the state to offer qualified beneficiaries who exhaust their 18 or 29 months of federal COBRA an additional period of continuation coverage, to a total of 36 months from the date federal COBRA began. (Note: Cal-COBRA does not apply to the Anthem PPO and Anthem HSA medical plans, nor dental or vision plans. If you are enrolled in the Anthem PPO and Anthem HSA medical plans and want to be eligible for CAL-COBRA coverage, you will need to enroll in Kaiser California during this annual enrollment period). Contact your medical plan directly for further information on Cal-COBRA. 3

4 Introduction INITIAL COBRA NOTICE CONTINUATION COVERAGE RIGHTS UNDER COBRA You are receiving this notice because you have recently become covered under a group health plan (the Plan). This notice contains important information about your right to COBRA continuation coverage, which is a temporary extension of coverage under the Plan. This notice generally explains COBRA continuation coverage, when it may become available to you and your family, and what you need to do to protect the right to receive it. The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you when you would otherwise lose your group health coverage. It can also become available to other members of your family who are covered under the Plan when they would otherwise lose their group health coverage. For additional information about your rights and obligations under the Plan and under federal law, you should review the Plan s Summary Plan Description or contact the Plan Administrator. You may have other options available to you when you lose group health coverage. For example, you may be eligible to buy an individual plan through the Health Insurance Marketplace. By enrolling in coverage through the Marketplace, you may qualify for lower costs on your monthly premiums and lower out-of-pocket costs. Additionally, you may qualify for a 30-day special enrollment period for another group health plan for which you are eligible (such as a spouse s plan), even if that plan generally doesn t accept late enrollees. What is COBRA Continuation Coverage? COBRA continuation coverage is a continuation of Plan coverage when coverage would otherwise end because of a life event known as a qualifying event. Specific qualifying events are listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person who is a qualified beneficiary. You, your spouse, and your dependent children could become qualified beneficiaries if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who elect COBRA continuation coverage must pay for COBRA continuation coverage. If you are an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because either one of the following qualifying events happens: Your hours of employment are reduced, or Your employment ends for any reason other than your gross misconduct. If you are the spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because any of the following qualifying events happens: Your spouse dies; Your spouse s hours of employment are reduced; Your spouse s employment ends for any reason other than his or her gross misconduct; Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or You become divorced or legally separated from your spouse. Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because any of the following qualifying events happens: The parent-employee dies; The parent-employee s hours of employment are reduced; The parent-employee s employment ends for any reason other than his or her gross misconduct; 4

5 The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both); The parents become divorced or legally separated; or The child stops being eligible for coverage under the plan as a dependent child. When is COBRA Coverage Available? The Plan will offer COBRA continuation coverage to qualified beneficiaries only after the Plan Administrator has been notified that a qualifying event has occurred. When the qualifying event is the end of employment or reduction of hours of employment, death of the employee, or the employee becoming entitled to Medicare benefits (under Part A, Part B, or both), the employer must notify the Plan Administrator of the qualifying event. You Must Give Notice of Some Qualifying Events For the other qualifying events (divorce or legal separation of the employee and spouse or a dependent child s losing eligibility for coverage as a dependent child), you must notify the Plan Administrator within 60 days after the qualifying event occurs. You must provide this notice to: Varian Benefits Center (Trion) at How is COBRA Coverage Provided? Once the Plan Administrator receives notice that a qualifying event has occurred, COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will have an independent right to elect COBRA continuation coverage. Covered employees may elect COBRA continuation coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their children. COBRA continuation coverage is a temporary continuation of coverage. When the qualifying event is the death of the employee, the employee's becoming entitled to Medicare benefits (under Part A, Part B, or both), your divorce or legal separation, or a dependent child's losing eligibility as a dependent child, COBRA continuation coverage lasts for up to a total of 36 months. When the qualifying event is the end of employment or reduction of the employee's hours of employment, and the employee became entitled to Medicare benefits less than 18 months before the qualifying event, COBRA continuation coverage for qualified beneficiaries other than the employee lasts until 36 months after the date of Medicare entitlement. For example, if a covered employee becomes entitled to Medicare 8 months before the date on which his employment terminates, COBRA continuation coverage for his spouse and children can last up to 36 months after the date of Medicare entitlement, which is equal to 28 months after the date of the qualifying event (36 months minus 8 months). Otherwise, when the qualifying event is the end of employment or reduction of the employee s hours of employment, COBRA continuation coverage generally lasts for only up to a total of 18 months. There are two ways in which this 18-month period of COBRA continuation coverage can be extended. Disability extension of 18-month period of continuation coverage If you or anyone in your family covered under the Plan is determined by the Social Security Administration to be disabled and you notify the Plan Administrator in a timely fashion, you and your entire family may be entitled to receive up to an additional 11 months of COBRA continuation coverage, for a total maximum of 29 months. The disability would have to have started at some time before the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of continuation coverage. For more information please contact: Varian Benefits Center at

6 Second qualifying event extension of 18-month period of continuation coverage If your family experiences another qualifying event while receiving 18 months of COBRA continuation coverage, the spouse and dependent children in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36 months, if notice of the second qualifying event is properly given to the Plan. This extension may be available to the spouse and any dependent children receiving continuation coverage if the employee or former employee dies, becomes entitled to Medicare benefits (under Part A, Part B, or both), or gets divorced or legally separated, or if the dependent child stops being eligible under the Plan as a dependent child, but only if the event would have caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred. Are there other coverage options besides COBRA Continuation Coverage? Yes. Instead of enrolling in COBRA continuation coverage, there may be other coverage options for you and your family through the Health Insurance Marketplace, Medicaid, or other group health plan coverage options (such as a spouse s plan) through what is called a special enrollment period. Some of these options may cost less than COBRA continuation coverage. You can learn more about many of these options at If You Have Questions Questions concerning your Plan or your COBRA continuation coverage rights should be addressed to the contact or contacts identified below. For more information about your rights under ERISA, including COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health plans, contact the nearest Regional or District Office of the U.S. Department of Labor s Employee Benefits Security Administration (EBSA) in your area or visit the EBSA website at (Addresses and phone numbers of Regional and District EBSA Offices are available through EBSA s website.) For more information about the Marketplace, visit Keep Your Plan Informed of Address Changes In order to protect your family s rights, you should keep the Plan Administrator informed of any changes in the addresses of family members. You should also keep a copy, for your records, of any notices you send to the Plan Administrator. Plan Contact Information Varian Benefits Center at

7 WOMEN S HEALTH AND CANCER RIGHTS ACT REQUIRED ANNUAL NOTICE The Women s Health and Cancer Rights Act requires group health plans that provide coverage for mastectomies to cover reconstructive surgery and prostheses following mastectomies. All medical plans must provide this coverage. If you receive benefits for a medically necessary mastectomy, and if you elect breast reconstruction after the mastectomy, you will also be covered for: Reconstruction of the breast on which the mastectomy was performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; Prosthesis; and Treatment of physical complications of all stages of mastectomy including lymph edema. These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under your medical plan. Please refer to the information provided by your medical plan for details on any state mastectomy laws that may apply to your medical plan. NEWBORNS AND MOTHERS HEALTH PROTECTION ACT NOTICE 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 issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Please refer to the information provided by your medical plan for details on any state maternity laws that may apply to your medical plan. MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT NOTICE Varian s group medical plans provide and administer mental health and substance abuse benefits as required by the Mental Health Parity and Addiction Equity Act of 2008 ( MHPAEA ). For more information about the Varian s group medical plans and their compliance under the MHPAEA, please contact: corpbene@varian.com. 7

8 HIPAA NOTICE OF PRIVACY PRACTICES FOR PERSONAL HEALTH INFORMATION This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. This is your Health Information Privacy Notice from Group Benefit Plan of Varian Medical Systems (referred to as we or us). This notice is effective February This notice is solely for your information. You do not need to take any action. This notice provides you with information about the way in which we protect Personal Health Information ( PHI ) that we have about you. PHI includes individually identifiable information which relates to your past, present or future health, treatment or payment for health care services. This notice also explains your rights with respect to PHI. The Health Insurance Portability and Accountability Act ( HIPAA ) requires us to: Keep PHI about you private; provide you this notice of our legal duties and privacy notices with respect to your PHI; and follow the terms of the notice that are currently in effect. Use and Disclosure of PHI We obtain PHI in the course of providing and/or administering health insurance benefits for you. In administering your benefits, we may use and/or disclose PHI about you and your dependents. The following are some examples, however, not every use or disclosure in a category will be listed: For Health Care Payment Purposes: For example, We may use and disclose PHI to administer and process payment of benefits under your insurance coverage, determine eligibility for coverage, claims or billing information, conduct utilization reviews, or to another entity or health care provider for its payment purposes. For Health Care Operations Purposes: For example, We may use and disclose PHI for underwriting and rating of the plan, audits of your claims, quality of care reviews, investigation of fraud, performance measurements, care coordination, investigate and respond to complaints or appeals, provider treatment, review and provision of services. We are prohibited from using or disclosing PHI that is genetic information about an individual for underwriting purposes. For Treatment Purposes. For example, we may use and disclose information PHI to health care providers to assist in their treatment of you. We do not provide health care treatment to you directly. For Health Services. For example, we may use your medical information to contact you to give you information about treatment alternatives or other health related benefits and services that may be of interest to you as part of large case management or other insurance related services. For Data Aggregation Purposes. For example, we may combine PHI about many insured participant to make plan benefit decisions, and the appropriate premium rate to charge. To You About Dependents. For example, we may use and disclose PHI about your dependents for any purpose identified herein. We may provide an explanation of benefits for you or any of your dependents to you. To Business Associates. For example, we may disclose PHI to administrators who are contracted with us who may use the PHI to administer health insurance benefits on our behalf and such administrators may further disclose PHI to their contractors or vendors as necessary for the administration of health insurance benefits. If your state has adopted a more stringent standard regarding any of the above uses or disclosures of your PHI, those standards will be applied. 8

9 Additional Uses or Disclosures. We may also disclose PHI about you for the following purposes: To comply with legal proceedings, such as a court or administrative order, subpoena or discovery requests. To law enforcement officials for limited law enforcement purposes. To a family member, friend or other person, for the purpose of helping you with your health care or with payment for your health care, if you are in a situation such as a medical emergency and you cannot give your agreement to the Plan to do this. To your personal representatives appointed by you or designated by applicable law. For research purposes in limited circumstances. To a coroner, medical examiner, or funeral director about a deceased person. To an organ procurement organization in limited circumstances. To avert a serious threat to your health or safety or the health or safety of others. To a governmental agency authorized to oversee the health care system or government programs. To the Department of Health and Human Services for the investigation of compliance with HIPAA or to fulfill another lawful request. To federal officials for lawful intelligence, counterintelligence, national security purposes and to protect the president. To public health authorities for public health purposes. To appropriate military authorities, if you are a member of the armed forces. In accordance with a valid authorization signed by you. Authorizations Other uses or disclosures of your PHI not described above, including the use and disclosure of psychotherapy notes and the use or disclosure of protected health information for fundraising or marketing purposes, will not be made without your written authorization. You may revoke written authorization at any time, so long as your revocation is in writing. Once we receive your written revocation, it will only be effective for future uses and disclosures. It will not be effective for any information that may have been used or disclosed in reliance upon the written authorization and prior to receiving your written revocation. You may elect to opt out of receiving fundraising communications from us at any time. Notification of a Breach We are required to notify you in the event that we (or one of our Business Associates) discover a breach of your unsecured protected health information, as defined by HIPAA. 9

10 Your Rights Regarding PHI That We Maintain About You You have various rights as a consumer under HIPAA concerning your PHI. You may exercise any of these rights by writing to us in care of: Varian Medical Systems, Inc. Attention: HIPAA Privacy Officer - Director, Corporate Benefits 3120 Hansen Way, M/S G101 Palo Alto, CA Phone: (650) You have the right to inspect and copy your PHI that we maintain. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. You have the right to ask us to amend the PHI that is contained in a designated record set, e.g., information used to make enrollment, eligibility, payment, claims adjudication and other decisions. You have the right to request an amendment for as long as we maintain the PHI. Requests must be made in writing and include the reason for the request. We may deny the request if the PHI is accurate and complete or if we did not create the PHI. You have the right to request a list of our disclosures of the PHI. Your request must state a time period, may not include dates before February 2004 and may not exceed a period of six years prior to the date of your request. If you request more than one list in a year, we may charge you the cost of providing the list. We will notify you of the cost and you may withdraw or modify your request before any costs are incurred. Any list of disclosures provided by us will not include disclosures made for payment, treatment or healthcare operations; made to you or persons involved in your care; incidental disclosures, authorized disclosures, for national security or intelligence purposes or to correctional institutions. You have the right to request to restrict the way we use or disclose PHI regarding treatment, payment or health care operations. You also have the right to request to restrict the PHI we disclose about you to someone who is involved in your care or the payment for your care. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. Your request must be in writing and state (1) what information you want to restrict; (2) whether you want to restrict our use, disclosure or both; and (3) to whom you want the restrictions to apply. Uses and disclosures of your PHI, other than those listed above; require prior written authorization from you. You may revoke that authorization at any time by writing to us at the address at the end of this notice. You have the right to request that we communicate personal information to you in a certain way or at a certain location. Your request must specify how or where you wish to be contacted. We will comply with reasonable requests. 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 of this notice upon request. You may request a paper copy of this notice any of the above described by submitting the request to: 10

11 Varian Medical Systems, Inc. Attention: HIPAA Privacy Officer - Director, Corporate Benefits 3120 Hansen Way, M/S G101 Palo Alto, CA Phone: (650) Complaints If you believe your privacy rights have been violated, you may file a complaint with us. When filing a complaint, include your name, address and telephone number and we will respond. All complaints must be submitted in writing to: Varian Medical Systems, Inc. Attention: HIPAA Privacy Officer - Director, Corporate Benefits 3120 Hansen Way, M/S G101 Palo Alto, CA Phone: (650) You may also contact the Secretary of the Department of Health and Human Services. You will not be retaliated against for filing a complaint. Changes To This Notice We reserve the right to modify this Privacy Notice and our privacy policies at any time. If we make any modifications, the new terms and policies will apply to all PHI before and after the effective date of the modifications that we maintain. If we make material changes, we will send a new notice to the insured/subscribers. All questions regarding this notice should be sent to: Varian Medical Systems, Inc. Attention: HIPAA Privacy Officer - Director, Corporate Benefits 3120 Hansen Way, M/S G101 Palo Alto, CA Phone: (650)

12 NOTICE OF SPECIAL ENROLLMENT PERIODS If you are declining enrollment in a Varian medical plan 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 Varian medical 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 after the marriage, birth, adoption, or placement for adoption. Also, if you or your eligible dependent are covered under Medicaid or a State Children s Health Insurance Program (CHIP) and that coverage ends, you may be able to enroll yourself and any affected dependent in this Plan s medical coverage. You must request enrollment within 60 days after the Medicaid or CHIP coverage ends. If you or your eligible dependent becomes eligible under Medicaid or a State CHIP plan for financial assistance to pay for health coverage under this Plan, you may be able to enroll yourself and any affected dependent in this Plan. You must request enrollment within 60 days after the date a government agency determines that you are eligible for that financial assistance. To request special enrollment or obtain more information, contact: Varian Benefits Center at

13 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 The AK Health Insurance Premium Payment Program Website: Phone: CustomerService@MyAKHIPP.com Medicaid Eligibility: ARKANSAS Medicaid Website: Phone: MyARHIPP ( ) COLORADO Medicaid Medicaid Website: Medicaid Customer Contact Center: FLORIDA Medicaid Website: Phone: GEORGIA Medicaid Website: - Click on Health Insurance Premium Payment (HIPP) Phone: INDIANA Medicaid Healthy Indiana Plan for low-income adults Website: Phone: All other Medicaid Website: Phone IOWA Medicaid Website: Phone:

14 KANSAS Medicaid KENTUCKY Medicaid LOUISIANA Medicaid MAINE Medicaid MASSACHUSETTS Medicaid and CHIP MINNESOTA Medicaid MISSOURI Medicaid MONTANA Medicaid NEBRASKA Medicaid NEVADA Medicaid NEW HAMPSHIRE Medicaid NEW JERSEY Medicaid and CHIP NEW YORK Medicaid NORTH CAROLINA Medicaid NORTH DAKOTA Medicaid OKLAHOMA Medicaid and CHIP OREGON Medicaid and CHIP PENNSYLVANIA Medicaid RHODE ISLAND Medicaid SOUTH CAROLINA Medicaid SOUTH DAKOTA - Medicaid TEXAS Medicaid UTAH Medicaid and CHIP Website: Phone: Website: Phone: Website: Phone: Website: Phone: TTY: Maine relay 711 Website: Phone: Website: Phone: Website: Phone: Website: Phone: Website: ska/pages/accessnebraska_index.aspx Phone: Medicaid Website: Medicaid Phone: Website: Phone: Medicaid Website: dmahs/clients/medicaid/ Medicaid Phone: CHIP Website: CHIP Phone: Website: Phone: Website: Phone: Website: Phone: Website: Phone: Website: Phone: Website: Phone: Website: Phone: Website: Phone: Website: Phone: Website: Phone: Website: Medicaid: CHIP: Phone:

15 VERMONT Medicaid VIRGINIA Medicaid and CHIP WASHINGTON Medicaid WEST VIRGINIA Medicaid WISCONSIN Medicaid WYOMING Medicaid Website: Phone: Medicaid Website: Medicaid Phone: CHIP Website: CHIP Phone: Website: index.aspx Phone: ext Website: Phone: , HMS Third Party Liability Website: Phone: Website: Phone: To see if any other states have added a premium assistance program since July 31, 2016, 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) 15

16 HEALTH CARE REFORM NOTICE As a result of recent Health Care Reform legislation, your medical plan benefits include the following mandated changes: Coverage for eligible dependent children to age 26 regardless of marital or student status First dollar coverage of preventive care (office visit copayment may still apply) No maximum lifetime benefit limitations No annual benefit limitations Selection of any available participating primary care provider, including a Pediatrician for children No pre-authorization requirement for OB/Gyn care or emergency care provided by non-network providers No pre-authorization requirement for emergency care provided by non-network providers and paid at in-network benefit level Pre-existing exclusions do not apply to children under age 19 No discrimination in favor of highly-compensated employees Includes enhanced claims appeals process Limits on out-of-pocket expenses and cost-sharing Women s preventive care services have been expanded to cover counseling and medication to reduce the risk of breast cancer in at-risk women with no costing sharing Changes to FSA and HSA accounts Beginning January 1, 2011, over-the-counter medication will no longer be considered qualified medical expenses for FSA or HSA health accounts with the exception of insulin. Employees cannot use funds from any of these health accounts for medications, unless it is prescribed by a physician. Employees that use funds from an HSA for non-qualified medical expenses are subject to a 20 percent excise tax (up from 10 percent). 16

17 2015 SUMMARY ANNUAL REPORT GROUP BENEFITS PLAN OF VARIAN MEDICAL SYSTEMS This is a summary of the annual report of the Group Benefits Plan of Varian Medical Systems, Inc., EIN , Plan Number 501, for the plan year January 1, 2015 through December 31, The annual report has been filed with the Employee Benefits Security Administration, as required under the Employee Retirement Income Security Act of 1974 (ERISA). Varian Medical Systems, Inc. has committed itself to pay medical, dental and prescription drug claims incurred under the terms of the plan out of general assets. The remaining benefits are fully-insured and are paid under insurance contracts. Insurance Information The plan has insurance contracts with Life Insurance Company of North America, Aetna Life Insurance Company, Ace American Insurance Company, Health Plan of Nevada/Sierra Health and Life, Kaiser Foundation Health Plan Inc., Selecthealth, Vision Service Plan, Kaiser Foundation Health Plan of Georgia, Health Medical Service Association - Blue Cross Blue Shield of Hawaii, Cigna Health and Life Insurance Company, Minnesota Life Insurance Company and Cigna Life Insurance Company Of New York to pay all AD&D, life insurance, temporary disability, long-term disability, dental, business travel accident, health, prescription drug, vision, medical benefits abroad, salutary disability and evacuation claims incurred under the terms of the plan. The total premiums paid for the plan year ending December 31, 2015 were $24,518,820. Because there are so-called experience-rated contracts, the premium costs are affected by, among other things, the number and size of claims. Of the total insurance premiums paid for the plan year ending December 31, 2015, the premiums paid under such experience-rated contracts were $574,166 and the total of all benefit claims paid under these experience-rated contracts during the plan year was $490,547. Your Rights to Additional Information You have the right to receive a copy of the full annual report, or any part thereof, on request. Insurance information, including sales commissions paid by insurance carriers, is included in that report. To obtain a copy of the full annual report, or any part thereof, write to the office of Varian Medical Systems, Inc. at 3120 Hansen Way, Palo Alto, CA 94304, or call (650) There is no charge for the full annual report and no charge for any part thereof. You also have the legally protected right to examine the annual report at the main office of the plan (Varian Medical Systems, Inc. at 3120 Hansen Way, Palo Alto, CA 94304) and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N- 1513, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C

18 6055/6056 REPORTING NOTICE Most large employers, including Varian Medical Systems, Inc. are required to offer minimum essential health coverage that provides minimum value and is affordable to full-time employees (defined by the government as working on average at least 30 hours each week) or else pay a potential penalty. This is called the employer mandate. In addition, most individuals must maintain minimum essential health coverage for themselves or else pay a penalty. This is called the individual mandate. Earlier this year the Internal Revenue Service (IRS) issued guidance on new ACA reporting requirements under Internal Revenue Code (Code) sections 6055 and Generally, the forms that will be used by large employers are the Form 1094-C (transmittal of information to the IRS regarding self-insured group health plan) and Form 1095-C (statement to employees regarding health coverage under a self-insured group health plan). The Code requires applicable large employers, such as Varian Medical Systems, Inc. to report information to the IRS highlighting the following: Section 6055: Each person who enrolled in minimum essential health care coverage (for example, full-time and part-time employees, COBRA qualified beneficiaries, individuals on shortterm disability, long-term disability, leave of absence, severance, pre-65 retirees, etc.) offered under the Company s self-insured group health plan. This information is reflected in Part III of Form 1095-C and helps the IRS enforce the ACA s individual mandate. Section 6056: Each full-time employee (who averages at least 30 hours each week) and the details on his or her offer of coverage (even if no offer of coverage is actually made). This information is reflected in Part II of Form 1095-C and will help the IRS enforce the employer mandate. As a result of this reporting requirement, you will receive a Form 1095-C in January The form provides confirmation of the health care coverage you were enrolled in (6055) and/or offered (6056) through Varian Medical Systems, Inc. There is no action required of you. If you purchased health insurance coverage through the Health Insurance Marketplace and wish to claim the premium tax credit, this information will assist you in determining whether you are eligible. You may receive multiple Forms 1095-C if you had multiple employers during the year that were applicable large employers (for example, you left employment with one applicable large employer and began a new position of employment with another applicable large employer). In that situation, each Form 1095-C would have information only about the health insurance coverage offered to you by the employer identified on the form. 18