2014/2015. Employee Benefits Guide Century Healthcare Plan

Transcription

1 2014/2015 Employee Benefits Guide Century Healthcare Plan

2 Have a Smartphone? This Benefit Guide is equipped with mobile-friendly barcodes like the one shown on this page. These barcodes are more commonly referred to as Quick Response codes, or QR codes. Scanning these codes will take you to a new place on your phone, allowing you to see new content. They might show you a website, video or article. They can take you anywhere you just have to scan them first. So how do I scan them? First, you ll need one of the many free QR Reader Apps available for smartphones or tablets. After the download, just open your new App and follow the directions to scan the QR code. The App will read it and immediately take you to that code s content. RECON S BENEFITS WEBSITE MyReconBenefits.com It s available 24/7. RECON provides this Benefits portal as an efficient way for you to obtain information and answers to your questions regarding all employee benefit plans. Select the Benefits Site link for details on all benefit options. Choose the Online Enrollment link to access the benefitsconnect online enrollment site to make your personal plan elections. Through this tool, our goal is to empower you to meet your specific needs, as well as enhance your understanding of our benefit program. Specifically through the Benefits Site link, you will have access to benefit materials, such as: Plan highlights, documents and summaries Provider and network links and contact information Fliers, brochures and forms Weekly rates Daily wellness updates and many other resources Please be sure to access this great resource any time you desire information about your benefit plans!

3 Welcome At Remedial Construction Services, L.P. (RECON), our employees are our greatest asset and your well-being means a healthier, more productive workplace, which is why we are pleased to offer you a comprehensive benefits package. This Guide is designed to assist you and your family make the best choices for your needs for the 2014/2015 plan year. Please read this Guide in its entirety; it explains some very important points for you to consider this year. At RECON, we strive to provide benefits that: 3 Meet your needs, and the needs of your eligible family members Are easy to understand and use Help keep money in your pockets by delivering greater value What s Changing for 2014 There will be an enhancement to the benefits under your Century Healthcare plan. Preventive care will now be covered at 100% for in-network procedures. Domestic partner coverage will be added May 1, WORKING SPOUSE PROVISION: A spouse or domestic partner employed by a company that offers medical and prescription drug insurance (Rx) will not be eligible to be covered under the RECON medical and Rx plan.»» New Hire waiting periods will be reduced. Elections will be effective on the first day of the month following 60 days after hire or rehire.

4 In this Guide, we use the term Company to refer to RECON. This Guide is intended to describe the eligibility requirements, enrollment procedures and coverage effective dates for the benefits offered by the Company. It is not a legal plan document and does not imply a guarantee of employment or a continuation of benefits. While this Guide is a tool to answer most of your questions, full details of the plans are contained in the Summary Plan Descriptions (SPDs) which govern each plan s operation. Whenever an interpretation of a plan benefit is necessary, the actual plan documents will be used.

5 Contents 6 Eligibility & Enrollment 7 Domestic Partner Coverage 10 Medical Benefits 12 Dental Benefits 14 Survivor Benefits 16 Income Protection 17 Planning for Retirement 18 Additional Benefits 20 Required Notices 23 Important Contacts See Page 20 for important information concerning Medicare Part D coverage.

6 Eligibility & Enrollment We offer a variety of options to help you select the benefits plans that best suit you and your family s needs. Consider factors such as spousal benefits, dependent eligibility and qualifying life events as you make your benefits selections. Eligibility Enrollment 6 Tip If you have a qualifying event that impacts your benefits status, you must make changes within 31 days of the event. Evidence of the event is required. If you are a full-time employee of RECON who is regularly scheduled to work at least 30 hours per week, you are eligible to participate in the Medical, Dental, Life, and Disability plans as well as additional benefits. When does coverage begin? The elections you make are effective on the first day of the month following 60 days after hire or rehire. Due to IRS regulations, once you have made your choices for the plan year, you can t change your pre-tax benefits (Medical and/or Dental plans) until the next enrollment period beginning May 1, 2015, unless you have a qualifying life event. Your Eligible Dependents Dependents eligible for coverage in the RECON benefits plans include: Your legal spouse.* A domestic partner (see Domestic Partner Coverage - Page 7).* Your dependent children up to age 26 (includes stepchildren, legally adopted children or children placed with you for adoption, and foster children). Your dependent child, regardless of age, provided he or she is incapable of self-support due to a mental or physical disability, is fully dependent on you for support as indicated on your federal tax return and is approved by your medical plan to continue coverage past age 26. Please note that verification of eligibility will be required once dependents are enrolled. * If your spouse or registered domestic partner is employed by a company that offers medical and prescription drug insurance (Rx) to your spouse or domestic partner, he or she is not eligible to be covered under the RECON medical and Rx plans.

7 Things to Consider Before you enroll, it is a great idea to closely evaluate your benefit needs in order to accurately set up your benefits under your new plans with RECON. Situations that you should take into account as you assess your benefits decisions: Does your spouse have benefits coverage available through another employer? Did you get married, divorced or have a baby recently? If so, you may require coverage for a new addition to your family. Did any of your covered children reach their 26th birthday this year? If so, they are no longer eligible for benefits. Qualifying Life Events When one of the following events occurs, you have 31 days from the date of the event to notify the Benefits Department and/or request changes to your coverage. Your change in coverage must be consistent with your change in status. Change in your legal marital status (marriage, divorce or legal separation) Change in the number of your dependents (for example, through birth, death or adoption, or if a child is no longer an eligible dependent) Change in your spouse s employment status (resulting in a loss or gain of coverage) Change in your employment status from full time to part time, or part time to full time, resulting in a gain or loss of coverage Entitlement to Medicare or Medicaid Change in your address or location that affects the plans for which you are eligible Enrollment NOTE: Your change in coverage must be consistent with your change in status. 7 Your new coverage becomes effective on the date specified for the Annual Enrollment period or on your eligibility date or status change date. Domestic Partner Coverage To be eligible for domestic partner coverage, you and your domestic partner must meet the conditions outlined in the Domestic Partner Certification Affidavit. This form must be submitted at time of enrollment. Proof of the ongoing nature of the domestic partnership may be requested as needed. Domestic partner tax note: For domestic partner benefits, the IRS treats RECON s contributions as taxable income. Contributions will be made on an after-tax basis. For questions or to review a document with additional tax information about domestic partners, please contact your Benefits Department at

8 Enrollment 8 Curious About Qualifying Life Events and How They May Affect Your Coverage? Preparing to Enroll RECON provides its employees the best coverage possible. As a committed partner in your health, RECON will be absorbing a significant amount of the costs. Contributions for Medical and Dental benefits are deducted on a pre-tax basis - this lessens your tax liability. Please note that employee contributions for Medical, Dental, Life, Disability and additional benefits coverage vary depending on the level of coverage you select. In general, the higher your level of coverage, the higher your employee contribution will be. Keep in mind that you may select any combination of Medical, Dental, Life, Disability and additional benefits. For example, you could select medical coverage for you and your entire family, but select dental coverage only for yourself. The only requirement is that you, as an eligible employee of RECON, must elect coverage for yourself in order to elect any dependent coverage. You have the option to select coverage from the following categories: Employee Only Employee + Spouse Employee + Child(ren) Employee + Family Be sure to have the Social Security numbers and birth dates for any eligible dependent(s) that you plan to enroll. You cannot enroll your dependent(s) without this information.

9 How to Enroll 1. Understand your choices! Read this Benefits Guide carefully to get answers to your questions. This Guide helps you to prepare for enrollment and contains very useful reference material. Keep it handy so you can refer to it throughout the year. 2. Review your options with your family. Make sure you include any other individuals who will be affected by your elections in the decision-making process. 3. Enroll online. Go to Select the Online Enrollment link to access the benefitsconnect site. 4. Log in with your Username and Password. Username: First 6 letters of last name + first initial + last four digits of SSN. (lowercase, no spaces) If last name is fewer than 6 letters, enter entire last name. Password: Those who have previously enrolled online will use the password they elected at their prior login. First-time users will use entire SSN, with no spaces or dashes. Once you log in, you will be required to change your password. Example: Jane Johnson, with SSN USERNAME: johnsoj3456 PASSWORD: Enrollment 9 5. Confirm your personal and dependent information. 6. Review existing coverage, if any. Make any elections or changes, or waive plans offered. 7. Save your elections! Print out your benefits statement for your records and then click Finished in order to save your elections.

10 Medical Benefits Our medical coverage helps you maintain your well-being and provides affordable prescription medication. These resources help you enjoy the benefits of good health. This Medical plan is a Minimum Essential Coverage Plus Plan. Unlike major comprehensive medical coverage, this plan will only pay the scheduled amount per procedure for benefits listed on page 11. There are no copays or deductibles to be met. Medical 10 Find tips for a healthy lifestyle here. PHCS PPO Network and Providers PHCS Limited Benefit Network is the PPO network for Century Healthcare participants. If you have a preferred doctor, please confirm that your provider is considered in-network with PHCS Limited Benefit Network prior to your next visit. There are no out-of-network benefits with this plan. To see a list of Century Healthcare PHCS network providers, please visit or call (888) for additional information. 2014/2015 Medical Premiums Premium contributions for Medical benefits will be deducted from your paycheck on a pre-tax basis. Once you have reached your one-year anniversary with the Company, RECON will pay the employee s premium of the Century plan. Dependent premiums will continue to be the employee s expense.* It is up to you to choose the coverage that best matches your needs. Please keep in mind that the option you elect will be in place until April 30, 2015, unless you have a qualifying life event. Your level of coverage will determine your weekly premiums. Coverage Levels Employee Only Employee + Spouse Employee + Child(ren) Employee + Family Weekly rates - for employees with 1+ years of employment at RECON $0.00 $24.09 $32.88 $56.44 Weekly rates - for employees with 0-1 years of employment at RECON $34.05 $58.14 $66.93 $90.49 * Employee must already be enrolled in the medical plan upon reaching the one-year anniversary to receive RECON s paid medical benefit. If not enrolled, he/she must wait to elect the medical plan at the following Open Enrollment or Qualifying Life Event. Medical Plan Summary The chart on the following page gives a summary of the 2014/2015 plan year medical coverage provided by Century Healthcare. All covered services are subject to medical necessity as determined by the Plan.

11 Century Healthcare Description of Service Plan Pays Preventive Care Services Covered at 100% Doctor s Office Visit Outpatient Lab Outpatient X-Ray Emergency Room Benefit Inpatient/Outpatient Surgery Inpatient/Outpatient Anesthesia Benefits Hospital Confinement Maternity ICU Confinement Substance Abuse Confinement Mental Illness Disorder Confinement Skilled Nursing Facility Confinement Accident Medical Accidental Death & Dismemberment Pays $70 per day - Up to 6 visits per benefit year Pays $65 per day - Up to 3 visits per benefit year Pays $125 per day - Up to 1 visit per benefit year Pays $250 per day - Up to 1 sickness / 1 injury per benefit year In-Patient Pays $1,500 (1 IP ) Out-Patient Pays $600 (1 OP surgery) Benefit paid if a covered person undergoes medically necessary surgery at the direction of a doctor for a covered injury or sickness. Anesthesia - Pays 25% of Surgery Benefit Benefit paid for anesthesia services for preoperative screening and the administration of anesthesia during a surgical procedure whether on an inpatient or outpatient basis. Pays $300 per day - Benefits paid if a covered person is confined as an inpatient in a hospital because of a covered injury or sickness. (Maximum of 100 days per benefit year) Benefits paid under the applicable provision for doctors office visits, outpatient X-ray & lab, surgery or hospital confinement for pregnancy-related expenses. Pays $600 per day - Up to 30 days per benefit year. Pays in lieu of the Hospital Confinement Benefit. Pays $150 per day - Up to 30 days per benefit year Pays $150 per day - Up to 30 days per benefit year Pays $150 per day - Up to 60 days per benefit year ($100 deductible per occurrence) - Up to $5,000 per occurrence Employee $15,000 Spouse $7,500 Child(ren) $3,000 Term Life Employee $10,000 Dental / Vision / Nurseline Pharmaceutical Benefits / Discount Drug All Plan designs provide covered individuals 24-hour telephone access to nurses for medical decision support and patient advocacy (available in multiple languages with an audio health information library); dental savings from 20%-60% on most procedures; and vision savings from 10%-60% on exams, lenses and contacts. Pharmacy benefits are provided through the Century Discount program. Employees and their dependents pay the lesser of the pharmacy s usual and customary fee or the contract rate. Discounts are available on both generic and brand name drugs. Contraceptive drugs are included. Savings range from 15% to 80% based on the drug type (brand or generic) and the participating pharmacy filling the claim. No claim forms required. Prescriptions for 30-day supplies can be filled at more than 55,000 participating pharmacies nationwide including all of the national chains and over 90% of independent pharmacies. For additional savings, you may also utilize our mail order pharmacy for 90-day supplies. Medical 11 You may find information on your benefits coverage and search for participating pharmacies by logging on to or calling Customer Care at Your cost is determined by the tier assigned to the prescription drug product. All products on the list are assigned as Generic, Formulary or Non-Formulary.

12 Dental Benefits Dental Brush Up on Dental Care. Our Dental Plan helps you maintain good dental health through affordable options for preventive care including regular checkups and other dental work. Our Dental Plan is designed to encourage preventive treatment, allowing employees to achieve oral health while striving to minimize dental costs. RECON employees receive dental coverage from Guardian. 12 Network Dentists Using a network dentist lowers your out-of-pocket costs. This is because dentists in your network have agreed to charge lower fees, and your plan s in-network services cover a larger share of the charges. If you choose to use a dentist who doesn t participate in the network, your out-of-pocket costs will be higher, and you are subject to any charges beyond the Reasonable and Customary (R&C). To find a network dentist, visit Select the Find a Provider link at the top of the page, then Find a Dentist. For network providers in the PPO dental plans, select the DentalGuard Preferred network. For the DHMO dental plan, select the Managed DentalGuard-TX network. Vision Discount Plan All dental plans include access to discounts on vision care services or supplies from a vision provider that is under contract with Vision Service Plan s (VSP) SIGNATURE PLAN network. The participant must pay the entire discounted fee directly to the network doctor. To find a VSP network provider, go to Select Find a Provider at the top of the page, then select Find A Vision Provider. You may also call VSP Member Services at

13 2014/2015 Plan Year Dental Premiums Premium contributions for Dental benefits will be deducted from your paycheck on a pre-tax basis. Your tier of coverage will determine your weekly premiums. Coverage Levels Low PPO - Plan 1 DentalGuard Preferred Network High PPO - Plan 2 DentalGuard Preferred Network DHMO Managed DentalGuard Network (Available to Texas residents only) Employee Only Employee + Spouse Employee + Child(ren) Employee + Family $4.45 $8.61 $10.32 $14.83 $6.30 $12.99 $12.69 $18.49 $2.32 $4.67 $4.55 $6.89 Dental Plan Summary The chart below gives a summary of the 2014/2015 plan year dental coverage provided by Guardian. All out-of-network services are subject to Reasonable and Customary (R&C) limitations. Guardian Calendar Year Deductible Individual Family Calendar Year Maximum Low PPO - Plan 1 DentalGuard Preferred Network High PPO - Plan 2 DentalGuard Preferred Network DHMO Managed DentalGuard Network In-Network Out-of-Network In-Network Out-of-Network Available to TX residents only Member Pays Member Pays Member Pays $50 $150 $50 $150 Per Person $1,000 $1,000 $1,000 $1,000 Services Preventive Services (Once every 6 months) Oral Exams, Routine Cleanings, Bitewing X-rays, Fluoride Applications, Sealants, Space Maintainers, Panoramic X-rays Basic Services Full Mouth X-rays, Fillings, Oral Surgery, Simple Extractions Major Services Oral Surgery, Complex Extractions, Denture Adjustments and Repairs, Root Canal Therapy, Periodontics, Crowns, Dentures, Bridges Orthodontics * After deductible 0% 0% 0% 0% 20%* 20%* 20%* 20%* Not Covered Not Covered 50%* 50%* Not Covered Summary: - $5 Office visit copay - Preventive at no charge - No Annual Limit - No Deductible - You pay a discounted rate for each covered procedure - Each covered person must select a network provider at time of enrollment (network is only in Texas). - Schedule of costs is located on RECON benefits site. Limits: Child: $2,500 Adult: $2,800 Orthodontics in progress prior to plan election are not covered. Dental 13

14 Survivor Benefits 14 Tip It is important that you name a primary and contingent beneficiary to receive your Life insurance benefits. Survivor Benefits Life insurance is very important to those who depend on you for financial security. Survivor benefits provide continuing financial assistance in your absence. Basic Life Insurance Life benefits are essential to the financial security of you and your family. As such, it is important to understand how your plan works and what benefits you will receive. Term Life Insurance is available to you through Allstate. This guarantees that loved ones, such as a spouse or other designated survivors, continue to receive part of an employee s benefits after the employee s death. Your Term Life insurance benefit is available in $10,000 increments up to five times your annual salary, to a maximum of $100,000.* Basic Dependent Life Term Life coverage is available for your spouse in $10,000 increments, up to 50% of your Term Life coverage, and for your child(ren) in the amount of $10,000 each.* * Age limitations may apply

15 Basic Life Coverage Amount: Benefits are Payable: Available in $10,000 increments, up to five times your annual salary.* If you die, lose a limb or suffer paralysis in an accident. Maximum Benefit: $100,000* Guaranteed Issue: (Available only during the initial election period.) Guaranteed issue means regardless of health history, all applicants are guaranteed coverage. After the employee s initial election period has passed, an EOI questionnaire (evidence of insurability) and underwriting approval will be required. * Age limitations may apply Employees hired prior to January 2, 2014: EOI is required for employees and dependents. New Hire Employees: Guaranteed Issue (no EOI required). Spouse is Guaranteed Issue up to $20,000*; EOI required for additional amount, up to 50% of the employee s benefit. Children are Guaranteed Issue. Beneficiary Designation A beneficiary is the person you designate to receive your Life insurance benefits in the event of your death. This includes any benefits payable under the Term Life insurance plan available through RECON. Benefits payable for a dependent s death under the Voluntary Life insurance plan are payable to you. It is important that your beneficiary designation is clear so that there will be no question as to your intentions. It is also important that you name a primary and contingent beneficiary. Your Primary beneficiary(ies) will receive the benefit amount at the time of your death. If the Primary beneficiary(ies) is no longer living at that time, the benefit amount will go to your Contingent beneficiary(ies). When naming your beneficiary(ies), please indicate their full name, address, Social Security number, relationship, date of birth and distribution percentage. If the beneficiary is not related either by blood or by marriage, insert the words Not Related in the relationship field. If you need assistance, contact the Benefits Department or your own legal counsel. Survivor Benefits 15 Primary Mary J. Doe, Wife (100%) OR Mary J. Doe, Wife (34%), Jane Doe, Daughter (33%), and John Doe, Son (33%) Contingent Joseph W. Doe, Son, and Jane Doe, Daughter (50% each) OR Estate of the Insured (100%) If you name more than one beneficiary with unequal shares, please show the amount of insurance to be paid to each beneficiary in percentages, for example: 33% to Pauline Smith, Mother, and 67% to Mary J. Doe, Wife. If there is insufficient space for your beneficiary designations, attach a separate sheet of paper indicating your designations and share percentages. NOTE: Percentages should total 100% for each category (Primary and Contingent).

16 Income Protection If you have to miss work due to illness or an off-the-job injury, this benefit helps to ensure that at least part of your income continues. Our Disability Plans cover a portion of your income until you can return to work, or until you reach retirement age. Short Term Disability Insurance Short Term Disability (STD) benefits are available to you on a voluntary basis. STD insurance protects a portion of your income if you become partially or totally disabled for a short period of time. Short Term Disability insurance replaces 60% of your income. Income Protection Learn More About Disability Insurance You must be sick for at least eight days, or disabled for at least one day, before you can receive your Short Term Disability insurance benefit payment. Payments may last up to 13 weeks maximum. Certain exclusions as well as pre-existing condition limitations may apply. Please refer to your Summary Plan Description for details or contact the Benefits Department for specific benefits. Long Term Disability Insurance 16 Long Term Disability (LTD) benefits are available to you on a voluntary basis. LTD insurance protects a portion of your income if you become partially or totally disabled for a long period of time. This insurance replaces 60% of your income, up to a maximum of $10,000 per month, depending on your current annual earnings. You must be sick or disabled for at least 90 days before you can receive a Long Term Disability insurance benefit payment. Payments will last for as long as you are disabled or until you reach your Social Security Normal Retirement Age, whichever is sooner. Certain exclusions as well as pre-existing condition limitations may apply. Please refer to your Summary Plan Description for details or contact the Benefits Department about specific benefits. Voluntary Employee Disability Insurance Voluntary Short Term Disability Voluntary Long Term Disability $0.57 / $10 (Weekly) Varies Both STD and LTD benefits are Guaranteed Issue at the employee s initial enrollment period. After this time, an Evidence of Insurability (EOI) form must be submitted for underwriting approval.

17 Planning for Retirement It is critical to plan for your retirement. Making 401(k) contributions is an important step toward achieving your financial goals for later in life. We offer several options to help you make the most of your retirement and live a secure and happy life once your work years are behind you. A 401(k) plan can be a powerful tool in promoting financial security in retirement. The RECON 401(k) Plan helps eligible employees save and invest for retirement while receiving certain tax advantages. RECON currently offers a weekly match of 50% of the employee s contribution, up to a maximum of 3% of the eligible annual wages. There is also the possibility of an additional year-end match, based on Company profitability. Matching is discretionary and evaluated periodically by the Board of Directors, and is not guaranteed from year to year. Administrative and record-keeping services for the 401(k) plan are provided by Transamerica Retirement Solutions. Deferred contributions are based on a flat dollar amount or percent of income, not to exceed plan limits set by the IRS. The limit for 2014 is $17,500. All eligible employees are automatically enrolled in the 401(k) with a 2% deferral rate into the Vanguard Target Retirement Fund closest to the employee s 65th birthday. Opt out forms are available for employees not wishing to begin automatic contributions upon eligibility. Eligible employees are those who are employed full time, at least 18 years of age and have completed 90 days of service. Rehires will be effective immediately, as long as 90 days have passed since the employee s original hire date. Planning for Retirement Vesting Vesting refers to your ownership of the money in your account. You are always 100% vested in your own contributions right away. You will be vested in your employer contributions based on the following vesting schedule: Catch-up Contributions Years of Service Percentage Vested After 2 years 20% 3 years 40% 4 years 60% 5 years 80% 6 years 100% If you will be age 50 or older in this calendar year and contribute the maximum allowed to your account, you may also make catch-up contributions to your account. The catch-up contribution is intended to help you accelerate your progress toward your retirement goals. The maximum catch-up contribution is $5,500 for See your Benefits Administrator for more details. 17 Changing or Stopping Your Contributions You may change the amount of your contributions any time. Changes requested by the 25th of any month will become effective the first paycheck of the following month. Changes will remain in effect until modified or terminated by you. You may discontinue your contributions anytime. Once you stop making contributions, you may start again at any time. Employees may change their contributions by accessing their account online at or by calling Transamerica s Customer Service department at

18 Consolidating Your Retirement Savings If you have an existing qualified retirement plan (pre-tax) with a prior employer, you may transfer or roll over that account into RECON s 401(k) Plan anytime. To initiate a rollover into your Plan, contact Transamerica at for details. Investing in the Plan You decide how to invest the assets in your account. The RECON 401(k) Plan offers a selection of investment options for you to choose from. You may view available fund options and change your investment choices anytime by accessing your account online at Additional Benefits 18 Additional Benefits RECON believes in a well-rounded benefits package and provides options for additional benefits to help you manage your life. Legal Services Plan As a RECON employee, you may sign up for a discounted legal services plan through LegalShield. This service gives you access to a full-service, quality Provider Law Firm in your state, as well as to more than 9,000 attorneys nationwide. Telephone and in-person legal consultations are available. Your coverage is portable, so you can continue to take advantage of low rates even if you leave RECON. Call if you have questions. Covered services include: Real estate issues Motor Vehicle Services, such as moving traffic violations, accidents, etc. Debt and credit concerns Document preparation and review Wills and estate planning Family law Optional Identity Theft Protection (can only be elected as an addition to Legal Services Plan) ID Theft Shield includes a free credit report, continuous monitoring of your credit file, and credit restoration through Kroll Advisory Solutions. ID Theft Shield covers the employee and spouse. Adding Safeguard for minors will allow monitoring and restoration of credit reports for your minor children up to age 18.

19 Teladoc Consult A Doctor Call or visit for FREE access to a licensed physician 24 hours, seven days a week. This benefit helps members reduce healthcare claims, out-of-pocket expenses, overuse of emergency rooms and urgent care trips, and time wasted waiting days or weeks for an appointment. Consultations can be done by phone, or video. This benefit is provided for employees of RECON at no additional cost. Voluntary Allstate Plans Critical Illness Through Allstate, RECON provides a lump-sum benefit to help you with the out-of-pocket expense associated with a serious illness. There are two options to choose from. Cancer High/Low Options available for $20,000 and $10,000 that will be paid when these serious illnesses occur: heart attack, stroke, coronary artery by-pass-surgery, major organ transplant & end-stage renal failure. Second event benefits pay a one-time benefit when you are diagnosed a second time, 12 or more months after the initial diagnosis. Covered dependents receive 50% of your basic benefit amount. Coverage will supplement any existing medical coverage you have or can be used even if you don t have any major medical insurance. Benefit is portable you can keep it even if you leave employment with RECON. Additional Benefits One-time diagnosis benefit of $5,000 per covered family member. Up to $5,000 every 12 months toward radiation and chemotherapy treatments, and blood, plasma and platelets replacement. Up to $5,000 every 12 months toward new and experimental treatments. Two plans are offered as High/Low options. The High Plan includes a $600 intensive care rider to be used for any reason you are in ICU (not just for Cancer). Additionally, a $100 wellness benefit is payable every calendar year for each covered dependent. Benefit is portable you can keep it even if you leave employment with RECON. Accident 19 Benefit includes up to $40,000 for loss of life or limb due to an off-the-job accident. Benefits paid for ER, ICU, follow-up doctors visits, PT, dislocation and fractures, $1,000 initial hospital stay due to an accident. High/Low plan options are available. High Plan includes an additional $1,000 disability rider for an off-the-job injury (employee only). This benefit will pay in addition to any other disability insurance you may have. Benefit is portable you can keep it even if you leave employment with RECON.

20 Required Notices 20 Required Notices Important Notice from Remedial Construction Services, L.P. About Your Prescription Drug Coverage and Medicare under the Century Healthcare Plan(s) Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Remedial Construction Services, L.P. 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. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are three 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 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. Remedial Construction Services, L.P. has determined that the prescription drug coverage offered by the Century Healthcare plan is, on average for all plan participants, NOT expected to pay out as much as standard Medicare prescription drug coverage pays. Therefore, your coverage is considered Non-Creditable Coverage. This is important because, most likely, you will get more help with your drug costs if you join a Medicare drug plan, than if you only have prescription drug coverage from the Remedial Construction Services, L.P. plan. This also is important because it may mean that you may pay a higher premium (a penalty) if you do not join a Medicare drug plan when you first become eligible. 3. You can keep your current coverage from Remedial Construction Services, L.P.. However, because your coverage is non-creditable, you have decisions to make about Medicare prescription drug coverage that may affect how much you pay for that coverage, depending on if and when you join a drug plan. When you make your decision, you should compare your current coverage, including what drugs are covered, with the coverage and cost of the plans offering Medicare prescription drug coverage in your area. Read this notice carefully - it explains your options. When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare during a seven-month initial enrollment period. That period begins three months prior to your 65th birthday, includes the month you turn 65, and continues for the ensuing three months. You may also enroll each year from October 15th through December 7th. However, if you decide to drop your current coverage with Remedial Construction Services, L.P., since it is employer/ union sponsored group coverage, you will be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan; however you also may pay a higher premium (a penalty) because you did not have creditable coverage under the Remedial Construction Services, L.P. 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 Remedial Construction Services, L.P. coverage will not be affected. For most persons covered under the Plan, the Plan will pay prescription drug benefits first, and Medicare will determine its payments second. For more information about this issue of what program pays first and what program pays second, see the Plan s summary plan description or contact Medicare at the telephone number or web address listed herein. If you do decide to join a Medicare drug plan and drop your current Remedial Construction Services, L.P. coverage, be aware that you and your dependents will not be able to get this coverage back. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? Since the coverage under Remedial Construction Services, L.P. is not creditable, depending on how long you go without creditable prescription drug coverage you may pay a penalty to join a Medicare drug plan. Starting with the end of the last month that you were first eligible to join a Medicare drug plan but didn t join, if you go 63 continuous days or longer without prescription drug coverage that s creditable, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (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 the person listed at the end of these notices for further information. NOTE: You ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Remedial Construction Services, L.P. changes. You also may request a copy of this notice at any time. 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 ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans.

21 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 Medicare Part D 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 or not you are required to pay a higher premium (a penalty). Date: May 1, 2014 Name of Entity/Sender: Contact Position/Office: Remedial Construction Services, L.P. Benefits Department Address: 9977 W. Sam Houston Parkway North Suite 100 Houston, TX Phone Number: Women s Health and Cancer Rights Act The Women s Health and Cancer Rights Act of 1998 was signed into law on October 21, The Act requires that all group health plans providing medical and surgical benefits with respect to a mastectomy must provide coverage for all of the following: Reconstruction of the breast on which a mastectomy has been performed Surgery and reconstruction of the other breast to produce a symmetrical appearance Prostheses Treatment of physical complications of all stages of mastectomy, including lymphedema This coverage will be provided in consultation with the attending physician and the patient, and will be subject to the same annual deductibles and coinsurance provisions which apply for the mastectomy. For deductibles and coinsurance information applicable to the plan in which you enroll, please refer to the summary plan description or contact the Benefits Department at HIPAA Privacy and Security The Health Insurance Portability and Accountability Act of 1996 deals with how an employer can enforce eligibility and enrollment for health care benefits, as well as ensuring that protected health information which identifies you is kept private. You have the right to inspect and copy protected health information that is maintained by and for the plan for enrollment, payment, claims and case management. If you feel that protected health information about you is incorrect or incomplete, you may ask your benefits administrator to amend the information. The Notice of Privacy Practices has been recently updated. For a full copy of the Notice of Privacy Practices, describing how protected health information about you may be used and disclosed and how you can get access to the information, contact the Benefits Department at HIPAA 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 later 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). Loss of eligibility includes but is not limited to: Loss of eligibility for coverage as a result of ceasing to meet the plan s eligibility requirements (i.e. legal separation, divorce, cessation of dependent status, death of an employee, termination of employment, reduction in the number of hours of employment); Loss of HMO coverage because the person no longer resides or works in the HMO service area and no other coverage option is available through the HMO plan sponsor; Elimination of the coverage option a person was enrolled in, and another option is not offered in its place; Reaching the plan s lifetime benefit maximum on all benefits, if the person is covered under a separate plan or a single plan with multiple options and the other option has a higher lifetime maximum, or the benefits paid under the first option were not integrated with the second option; Failing to return from an FMLA leave of absence; and Loss of coverage under Medicaid or the Children s Health Insurance Program (CHIP). Unless the event giving rise to your special enrollment right is a loss of coverage under Medicaid or CHIP, you must request enrollment within 31 days after your or your dependent s(s ) other coverage ends (or after the employer that sponsors that coverage stops contributing toward the coverage). If the event giving rise to your special enrollment right is a loss of coverage under Medicaid or the CHIP, you may request enrollment under this plan within 60 days of the date you or your dependent(s) lose such coverage under Medicaid or CHIP. Similarly, if you or your dependent(s) become eligible for a state-granted premium subsidy towards this plan, you may request enrollment under this plan within 60 days after the date Medicaid or CHIP determine that you or the dependent(s) qualify for the subsidy. 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 31 days after the marriage, birth, adoption, or placement for adoption. To request special enrollment or obtain more information, contact the Benefits Department at Required Notices 21

22 Notes 22

23 Important Contacts Coverage Medical Coverage and Prescription Drugs Dental Coverage Life Insurance Disability Retirement Additional Benefits Contact Century Healthcare Group # CHC5199 To access certificate documents, explanation of the plan limits, benefits, and exclusions, log in as follows: Username: CHC5199 Password: remedial Guardian - DMHO Group # Guardian - PPO (Low and High) Group # Allstate (Term Life) Group # Guardian (Short Term Disability) Group # Guardian (Long Term Disability) Group # Transamerica Retirement Solutions Live Help (weekdays) hr Automated Allstate (Critical Illness, Cancer and Accident Plans) Group # AY220 LegalShield (Legal Plan and Optional Identity Theft Protection) account # Teladoc Consult A Doctor (Free Medical Advice) VSP (Discount Vision Care - Signature Plan) included with all dental plans Group # RECON Benefits Department Joy Gossett 9977 West Sam Houston Pkwy North Suite 100 joy.gossett@reconservices.com Houston, TX RECON Benefits Portal To access Benefits information: Click Benefits Site link Select CENTURY HEALTHCARE under Medical Plans listing. To access Online Enrollment: Click Online Enrollment link and see Username and Password information on page 9 Important Contacts 23

24 RECON-CHC 14/15