Stryker Corporation Legal Notices and Disclosures: Annual Enrollment for 2016 Benefits: Contents Equal Employment Opportunity and Affirmative Action Notice... 2 Summary Annual Report (SAR): Stryker Corporation Welfare Benefits Plan... 2 Notice of Your Right to Request a Special Enrollment Opportunity... 3 Women s Health and Cancer Rights Act of 1998 Notice... 3 Notice of Creditable Status of Your Prescription Drug Coverage... 4 Notice: Premium Assistance Under Medicaid and the Children s Health Insurance Program (CHIP)... 6 If you and/or your dependents have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. Please see pages 4 5 for more details. Benefits Teams: Contact Information Several notices in this packet refer to the Benefits Teams as additional resources for information. Their contact information is below. Benefits Teams Phone Email Fax Orthopaedics Shared 201 831 6996 hshared@stryker.com 201 831 6000 Services Spine 201 760 8096 spinebenefits@stryker.com 201 962 4249 Benefits Shared Services 877 795 2002 benefits@stryker.com 877 204 1328
Equal Employment Opportunity and Affirmative Action Notice Stryker Corporation is committed to taking affirmative action to employ and advance in employment qualified disabled individuals. If you have a physical or mental impairment that substantially limits a major life activity and would like to be considered under our affirmative action program, please contact Human Resources. You may inform Human Resources of your desire to benefit under the program at any time after a conditional offer of employment at Stryker. Submission of this information is voluntary and refusal to provide it will not subject an employee to discharge or disciplinary treatment. Summary Annual Report (SAR): Stryker Corporation Welfare Benefits Plan This is a summary of the annual report of the Stryker Corporation Welfare Benefits Plan, EIN 38-1239739, Plan No. 501, for the period January 1, 2014 through December 31, 2014. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA). Stryker Corporation has committed itself to pay certain health, dental and vision claims incurred under the terms of the plan. Insurance Information The plan has contracts with Blue Cross and Blue Shield of Alabama, Hartford Life and Accident, John Hancock Life Insurance Company (U.S.A.), Kaiser Foundation Health Plan Inc., BlueCross BlueShield of South Carolina, Kaiser Foundation Health Plan of Hawaii, Cigna Health and Life Insurance Company, Unum Life Insurance Company of America and Life Insurance Company of North America to pay health, dental, vision, life insurance, long-term disability, prescription drug, employee assistance program and accidental death and dismemberment claims incurred under the terms of the plan. The total premiums paid for the plan year ending December 31, 2014 were $13,069,404. Because they 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, 2014, the premiums paid under such "experience-rated" contracts were $1,239,125 and the total of all benefit claims paid under these contracts during the plan year was $1,087,951. Your Rights to Additional Information You have the right to receive a copy of the full annual report, or any part thereof, on request. The items listed below are included in that report: insurance information, including sales commissions paid by insurance carriers To obtain a copy of the full annual report, or any part thereof, write or call the office of Stryker Corporation at 2825 Airview Blvd, Kalamazoo, MI 49002, or by telephone at (269) 389-2600. You also have the legally protected right to examine the annual report at the main office of the plan (Stryker Corporation, 2825 Airview Blvd, Kalamazoo, MI 49002) 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 N1513, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210. 2
Notice of Your Right to Request a Special Enrollment Opportunity 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 toward your or your dependents other coverage). However, you must request enrollment within 30 days of the date 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 of the marriage, birth, adoption, or placement for adoption. Stryker will also allow a special enrollment opportunity if you or your eligible dependents either: Lose Medicaid or Children s Health Insurance Program (CHIP) coverage because you are no longer eligible, or Become eligible for a state s premium assistance program under Medicaid or CHIP. For these enrollment opportunities, you will have 60 days instead of 30 days from the date of the Medicaid/CHIP eligibility change to request enrollment in the Stryker group health plan. Note that this 60-day extension doesn t apply to enrollment opportunities other than those due to the Medicaid/CHIP eligibility change. To request special enrollment or obtain more information or to enroll due to another qualifying life event, contact your Benefits Team. Women s Health and Cancer Rights Act of 1998 Notice Under federal law, group health plans and health insurance issuers that provide medical and surgical benefits for mastectomies must also provide coverage for the services listed below. For individuals receiving mastectomy-related benefits, the following services are to be provided in a manner determined in consultation with the attending physician and the patient: All stages of reconstruction of the breast on which the mastectomy has been performed. Surgery and reconstruction of the other breast to produce a symmetrical appearance. Prosthesis and treatment of physical complications in all stages of the mastectomy, including lymph edemas. These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. If you would like more information on WHCRA benefits, contact your Benefits Team. 3
Notice of Creditable Status of Your Prescription Drug Coverage Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage if you are enrolled in a Stryker 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. Be sure to read this notice carefully and keep it in a safe place where you can find it. Following are some answers to questions you may have regarding creditable coverage and how it relates to Medicare Part D plans. What do I need to do? To stay with your current prescription drug coverage from Stryker, you don t have to do anything. Just keep using the coverage you have now. You will still use the same pharmacy network, keep the same affordable copays for your prescription drugs and will not need to go through an enrollment process. You re already enrolled in your current plan, which provides you with coverage that is, on average, at least as good as that offered under Medicare Part D. Why do I need to keep my notice of creditable coverage? If you are satisfied with your prescription drug coverage from Stryker, just keep using it as you do now. However, if you consider enrolling in one of the many Medicare Part D prescription drug plans, you may be asked for a copy of this notice. This notice will let a Medicare Part D plan know that you have creditable coverage now and are not required to pay a late enrollment penalty, which could result in a higher premium on your new coverage. Remember, the coverage you have now through Stryker is creditable coverage. That is, your current coverage is, on average, at least as good as that offered by Medicare Part D. What if I lose my notice of creditable coverage? If you need another copy of your notice of creditable coverage, please contact your Benefits Team. Do I have to enroll in a Medicare Part D plan now? No. You have the option to enroll in one of Medicare Part D s many prescription drug plans when you are first eligible and again each year from October 15 to December 7. However, you do not have to enroll in a Medicare Part D plan if you are satisfied with your current coverage. If you qualify for Medicare due to age, you may enroll in a Medicare drug plan 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. If you qualify for Medicare due to disability or end-stage renal disease, your initial Medicare Part D enrollment period depends on the date of your disability or when treatment began. If you choose to enroll in a Medicare Part D plan during the annual open enrollment period, your coverage will be effective on the following January 1. If you choose to enroll in a Medicare Part D plan when you are first eligible, your coverage will be effective on the first of the month after which you join. If, for some reason, you no longer have Stryker coverage, you also may be eligible for a special enrollment period to sign up for a Medicare prescription drug plan. If I am eligible and decide to enroll in a Medicare plan, how does this impact my coverage under the plan with Stryker? If you decide to join a Medicare drug plan while covered under the Stryker plan, your coverage under the Stryker plan will not be affected. For most persons, the Stryker plan will pay prescription drug benefits first, and Medicare will determine its payments second. If I decide to enroll in a Medicare Part D plan but don t like it, can I go back to my old plan with Stryker? If you consider enrolling in a Medicare Part D prescription drug plan, check with Stryker before you enroll. If you enroll in a Medicare Part D plan and drop your creditable coverage with Stryker, you may not be able to return to the same plan through Stryker until the next open enrollment period. It is important that you compare your current plan, including which drugs are covered, with the coverage and costs of Medicare Part D plans in your area. 4
What if I drop my coverage with Stryker, but don t enroll in a Medicare Part D plan? If you drop your current coverage, but do not enroll in a prescription drug plan approved by Medicare after your current coverage ends, you will have to pay full price for your prescription drugs. You also may have to pay more for Medicare prescription drug coverage later. If you go for 63 days or longer without coverage that is, on average, at least as good as Medicare s prescription drug coverage, your monthly premium under a Medicare plan will increase at least 1% for each month that you did not have coverage. This increase will be effective as long as you have Medicare Part D prescription coverage. For example, if you do not have coverage for 19 months before enrolling in Medicare Part D prescription drug coverage, your premium with a Medicare plan will always be 19% higher than what you would have paid if you had enrolled when you first lost Stryker coverage or when you first became eligible for a Medicare Part D plan. Also, you may have to wait until the next October 15 to enroll. If I keep my current coverage with Stryker, can I enroll in a Medicare Part D plan later? Yes. You have the opportunity to enroll in a Medicare Part D prescription drug plan each year from October 15 to December 7. However, if you decide you want to enroll in a Medicare Part D prescription drug plan, be sure you re covered under your current plan until your Medicare Part D coverage becomes effective. If you choose to enroll in a Medicare Part D plan without having creditable coverage with another plan like this one, you may have to pay an increased premium, as explained above. There are special enrollment periods that allow you to add Medicare Part D coverage months or even years after you first became eligible to do so, without a penalty. For example, if after your Medicare Part D initial enrollment period you lose or decide to drop the Stryker Plan, you will be eligible to join a Medicare drug plan at that time. In addition, if you otherwise lose other creditable prescription drug coverage (such as under an individual policy) through no fault of your own, you will be able to join a Medicare drug plan, again without penalty. These special enrollment periods end two months after the month in which your other coverage ends. How can I get more information? Each year, if you are Medicare eligible, you will receive a mailed copy of the handbook Medicare & You from Medicare. This book contains more detailed information about Medicare plans that offer prescription drug coverage. If you would like more information, you can find it by: Visiting www.medicare.gov. Calling 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. Calling 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048. For people with limited income and resources, extra help to pay for a Medicare prescription drug plan is available. For more information about this extra help, visit the Social Security Administration Web site at www.socialsecurity.gov, or call 1-800-772-1213. TTY users should call 1-800-325-0778. Be sure to keep this notice. You may be asked for a copy of this notice if you enroll in one of the prescription drug plans approved by Medicare. This notice will let your new plan know that you are not required to pay a higher premium amount. For more information about this notice or your current prescription drug coverage, visit www.totalrewards.stryker.com or contact your Benefits Team. Note: You will receive this notice annually and at other times, such as before the next period you can enroll in Medicare prescription drug coverage or if your Stryker coverage changes. You also may request a copy. Date: October 1, 2015 Name of Entity: Stryker Corporation Contact/Position: Health Plan Administrator Address: 2825 Airview Boulevard, Kalamazoo, Michigan 49002 Telephone Number: 269-389-2600 5
Notice: 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 www.healthcare.gov. 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 1-877-KIDS NOW or www.insurekidsnow.gov 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 www.askebsa.dol.gov or call 1-866-444-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, 2015. Contact your State for more information on eligibility: Alabama Medicaid Website: www.myalhipp.com Phone: 1-855-692-5447 Alaska Medicaid Website: http://health.hss.state.ak.us/dpa/programs/medicaid Phone (Outside of Anchorage): 1-888-318-8890 Phone (Anchorage): 907-269-6529 Colorado Medicaid Medicaid Website: http://www.colorado.gov/hcpf Medicaid Customer Contact Center: 1-800-221-3943 Florida Medicaid Website: https://www.flmedicaidtplrecovery.com Phone: 1-877-357-3268 Georgia Medicaid Website: http://dch.georgia.gov o Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP) Phone: 404-656-4507 Indiana Medicaid Website: http://www.in.gov/fssa Phone: 1-800-889-9949 Iowa Medicaid Website: www.dhs.state.ia.us/hipp Phone: 1-888-346-9562 Kansas Medicaid Website: http://www.kdheks.gov/hcf Phone: 1-800-792-4884 6
Kentucky Medicaid Website: http://chfs.ky.gov/dms/default.htm Phone: 1-800-635-2570 Louisiana Medicaid Website: http://dhh.louisiana.gov/index.cfm/subhome/1/n/331 Phone: 1-888-695-2447 Maine Medicaid Website: http://www.maine.gov/dhhs/ofi/publicassistance/index.html Phone: 1-800-977-6740 TTY 1-800-977-6741 Massachusetts Medicaid and CHIP Website: http://www.mass.gov/masshealth Phone: 1-800-462-1120 Minnesota Medicaid Website: http://www.dhs.state.mn.us/id_006254 o Click on Health Care, then Medical Assistance Phone: 1-800-657-3739 Missouri Medicaid Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005 Montana Medicaid Website: http://medicaid.mt.gov/member Phone: 1-800-694-3084 Nebraska Medicaid Website: www.accessnebraska.ne.gov Phone: 1-855-632-7633 Nevada Medicaid Medicaid Website: http://dwss.nv.gov Medicaid Phone: 1-800-992-0900 New Hampshire Medicaid Website: http://www.dhhs.nh.gov/oii/documents/hippapp.pdf Phone: 603-271-5218 New Jersey Medicaid and CHIP Medicaid Website: http://www.state.nj.us/humanservicesdmahs/clients/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 New York Medicaid Website: http://www.nyhealth.gov/health_care/medicaid Phone: 1-800-541-2831 North Carolina Medicaid Website: http://www.ncdhhs.gov/dma Phone: 919-855-4100 North Dakota Medicaid Website: http://www.nd.gov/dhs/services/medicalserv/medicaid Phone: 1-800-755-2604 Oklahoma Medicaid and CHIP Website: http://www.insureoklahoma.org Phone: 1-888-365-3742 Oregon Medicaid Website: http://www.oregonhealthykids.gov Website: http://www.hijossaludablesoregon.gov Phone: 1-800-699-9075 Pennsylvania Medicaid Website: http://www.dhs.state.pa.us/hipp Phone: 1-800-692-7462 Rhode Island Medicaid Website: http://www.eohhs.ri.gov Phone: 401-462-5300 7
South Carolina Medicaid Website: http://www.scdhhs.gov Phone: 1-888-549-0820 South Dakota - Medicaid Website: http://dss.sd.gov Phone: 1-888-828-0059 Texas Medicaid Website: http://gethipptexas.com Phone: 1-800-440-0493 Utah Medicaid and CHIP Website: Medicaid: http://health.utah.gov/medicaid CHIP: http://health.utah.gov/chip Phone: 1-866-435-7414 Vermont Medicaid Website: http://www.greenmountaincare.org Phone: 1-800-250-8427 Virginia Medicaid and CHIP Medicaid Website: http://www.coverva.org/programs_premium_assistance.cfm Medicaid Phone: 1-800-432-5924 CHIP Website: http://www.coverva.org/programs_premium_assistance.cfm CHIP Phone: 1-855-242-8282 Washington Medicaid Website: http://www.hca.wa.gov/medicaid/premiumpymt/pages/ index.aspx Phone: 1-800-562-3022 ext. 15473 West Virginia Medicaid Website: http://www.dhhr.wv.gov/bms/medicaid%20expansion/pages/defa ult.aspx Phone: 1-877-598-5820, HMS Third Party Liability Wisconsin Medicaid and CHIP Website: https://www.dhs.wisconsin.gov/badgercareplus/p- 10095.htm Phone: 1-800-362-3002 Wyoming Medicaid Website: https://wyequalitycare.acs-inc.com Phone: 307-777-7531 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 Employee Benefits Security Administration www.dol.gov/ebsa 1-866-444-EBSA (3272) Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 6156 OMB Control Number 1210-0137 (expires 10/31/2016) 8