Health Savings Account (HSA) Plan User Guide

Page 1 Health Savings Account (HSA) Plan User Guide Welcome to Symantec s Health Savings Account (HSA) Plan You ve enrolled in the Health Savings Account (HSA) Plan, a medical plan option that represents a different way to pay for health care. This guide is designed to help you make the most of the HSA Plan medical benefits and your HSA. It s important to understand how this medical plan works so you can plan for costs throughout the year and use its unique features to your advantage. What s Inside Understanding how the HSA Plan Works 2 Using the HSA Using Your HSA for Eligible Expenses 6 Using Your HSA to Pay for Care 7 Going to the Doctor 8 Filling a Prescription 9 Managing Your HSA 10 Growing Your HSA 10 Benefit from Triple Tax Savings 11 Tips for Being a Smart Health Care Buyer Know Before You Go 12 Ten Tips to Manage Costs 12 Contact Information 13

Page 2 Understanding How the HSA Plan Works The HSA Plan features lower monthly employee payroll contributions, comprehensive Preferred Provider Organization (PPO) medical coverage, and a Health Savings Account (HSA) a taxadvantaged savings account funded by both you and Symantec that allows you to save money on a tax-advantaged basis to pay for current or future health care expenses. A Closer Look Medical Coverage and the Health Savings Account: How They Work Together Contributions to your HSA from Symantec and you can cover your deductible and coinsurance HSA Plan Medical Benefits at a Glance Plan Feature In-Network Out-of-Network Annual Deductible Employee Employee + spouse/domestic partner 1 Employee + child(ren) 1 Employee + family 1 Coinsurance Out-of-Pocket Maximum Employee Employee + spouse/domestic partner 2 Employee + child(ren) 2 Employee + family 2 $1,500 $3,000 $3,000 $4,500 After deductible Symantec pays 90%, you pay 10% $2,500 $5,000 $5,000 $6,850 $1,500 $3,000 $3,000 $4,500 After deductible Symantec pays 70%, you pay 30% $4,500 $7,500 $7,500 $10,500 1 HSA deductible: All enrolled family members contribute toward a collective, family deductible. The plan will not pay an individual s claims, less any co-insurance, until the total collective family deductible has been met. 2 HSA out-of-pocket maximum: All enrolled family members contribute toward a collective, family out-of-pocket maximum. The plan will not pay 100% for covered services until the total collective family out-of-pocket maximum has been met. Note the out-of-pocket maximum amount is lower in network. Stay Healthy with Free Preventive Care Make the most of your health care dollars by taking advantage of the HSA Plan s preventive care benefits. The Plan pays 100% of the cost for these important medical services with no deductible when you use in-network providers.

Page 3 Children Women Men Well-baby care Annual physicals Generic preventive drugs Immunizations Well-woman care Cancer screenings Annual physicals Immunizations Osteoporosis test Colonoscopy Blood pressure and cholesterol checks Generic preventive drugs Well-man care Cancer screenings Annual physicals Immunizations Colonoscopy Blood pressure and cholesterol checks Generic preventive drugs Information on age- and gender-specific preventive care guidelines can be found at mycigna.com Your Health Savings Account (HSA) An HSA is an individual bank account that lets you pay for current health expenses and save for future health expenses on a tax-free basis. It s like a 401(k) for health care. Key Features Company contribution. Symantec will deposit money into your HSA by mid-january 2017, or as soon as administratively possible after you coverage begins. This is free money! Triple tax-free savings. You can contribute tax-free up to IRS limits, lowering your taxable income and grow your account. You pay no federal income taxes on contributions, interest, earnings, or amounts used to pay for qualified health care expenses (some state exceptions apply). Account ownership. The money in your account, including Symantec s contribution, is yours to keep even if you leave the Company. No use it or lose it rule. Your HSA balance rolls over from year to year. You never lose it, even if you decide to enroll in a different type of medical plan in the future.

Page 4 How the HSA Works Start It After you enroll in the HSA Plan, your account is automatically established with HSA Bank, our HSA administrator You have around-the-clock access to your account via the HSA Bank portal. To access the HSA Bank portal: Visit mycigna.com and enter your username and password to log in Go to Review My Coverage in the main menu and select HSA from the dropdown menu Select Visit Your HSA Bank to Manage Your Account to access the HSA Bank portal. Build It Symantec makes a contribution to your HSA when you enroll on the HSA plan When you first enroll, you may select an annual contribution amount, to be distributed to your HSA through pre-tax payroll contributions (limits and state taxes may apply) You can change your contribution amount any time (but only once per pay period) Grow It Unused money rolls over from year to year until you spend it Your account earns tax-free interest Once your account reaches $2,000, you can invest in mutual funds investment earnings are tax-free Use It Pay for current and future health care expenses, tax-free Use your HSA debit card to pay for out-of-pocket expenses. The card can also be used to get cash at ATMs 1 to reimburse qualified expenses paid for with personal funds 2 Pay your Medicare premiums using your HSA funds once you reach age 65 Keep It You own the account You can take it with you when you leave Symantec HSA Eligibility You can contribute to an HSA if you: Are enrolled in the Symantec HSA Plan Are not enrolled in Medicare Do not have coverage outside of Symantec under a health care plan that is not an HSA eligible consumer directed health plan (CDHP), including a health care flexible spending account Cannot be claimed as a dependent on someone else s tax return

Page 5 Making Contributions to Your Account Symantec helps you get started by making a contribution to your account. You can contribute taxfree, up to IRS limits. The combined contribution amounts for 2017 are shown below. For 2017, the contribution limit for individual coverage is up to $3,400 for in individual and up to $6,750 for family coverage. Both your contributions and Symantec s count toward the annual IRS limit. HSA Contributions Coverage Level 2017 IRS HSA Contribution Limit Symantec automatically contributes Employee Only $3,400 $500 $2,900 Employee + Spouse/Domestic Partner $6,750 $1,000 $5,750 Employee + Children $6,750 $1,000 $5,750 Employee + Family $6,750 $1,500 $5,250 You can contribute up to this amount to your HSA for 2017 Note: If you will be age 55 or older by the end of 2017, you may contribute an additional $1,000 If you enroll in the HSA Plan during the year as a new hire, or due to a qualifying family status change, Symantec s contribution will be distributed to your account with the next available account update, once your coverage begins. HSA contributions are subject to state income tax in California, New Jersey, and Alabama. How to Contribute You elect a contribution amount when you enroll for the HSA Plan. Your contributions are deducted from your pay on a pre-tax basis in equal amounts each pay period. For example, if you elect your total employee contribution for 2017 to be $1,200, your per-paycheck contribution will be $50. You can stop, start, or change your contribution amount at any time, but not more than once per pay period. To make changes, access Mercer BenefitsCentral enrollment portal or call 1-800-457-1664. You can also make a deposit, online or by check. Online Log in to mycigna Choose Review My Coverage Choose Health Savings Account Click Visit your HSA Bank to Manage your Account From the Home tab, click Make HSA Transaction under I Want To Follow the instructions to make a deposit If you need additional help: By Check: Send HSA deposits in the form of a check, directly to HSA bank. Make check payable to: HSA Bank Fill out the HSA Contribution form. To find the form: Log in to mycigna Choose Review My Coverage Choose Health Savings Account Click Visit your HSA Bank to Manage your Account

Page 6 Go to the Tools & Support tab Quick Links >> Customer Website Guide Scroll to the I Want To Make a Transaction section for detailed instructions Click on the Tools & Support tab Under Forms, choose the HSA Contribution form Mail the check with the completed HSA Contribution form to: HSA Bank P.O. Box 939 Sheboygan, WI 53082 It is your responsibility to be sure you don t contribute more than the IRS-allowed amount shown above. If you exceed the limit, taxes and IRS penalties may apply. Using Your HSA for Eligible Expenses You can use your HSA to cover expenses for yourself, your spouse, and your dependent children who qualify as tax dependents and are under age 19 (or age 24 if a full time student). You may not use your HSA for a domestic partner unless he or she qualifies as your tax dependent. Examples of eligible expenses are shown below. Examples of Eligible Expenses Medical Expenses Deductible Out-of-pocket costs, including copays and coinsurance Office visits Prescriptions drugs Procedures, lab work, exams, X-rays, and expenses due to hospitalization Smoking cessation programs or products Chiropractic care, acupuncture, and physical therapy Bandages, crutches, and other over-the-counter items (a prescription from your doctor may be required) Dental Expenses Deductible Copays and coinsurance Orthodontia Vision Expenses Exam copays Eyeglasses, including frames Contact lenses For a full list of eligible expenses, visit Cigna.com or review the IRS publication 502, available online at www.irs.gov. Using Your HSA to Pay for Care Paying for eligible health care services with your HSA is easy. Here are your options: Debit card

Page 7 Use your HSA Bank debit card at the doctor s or dentist s office, pharmacy, or medical facility, just as you would use a debit or credit card. Use it when paying a bill by mail by entering your card number on the invoice. Be sure to use your HSA payment card for eligible health care expenses only. Otherwise, you ll be subject to a tax penalty. The card can also be used to get cash at ATMs 1 to reimburse qualified expenses paid for with personal funds 2 Online bill pay & withdrawals Pay health care expenses directly from the HSA Payments can be scheduled on a one-time or recurring basis Withdrawals/Payments can also be sent directly to your personal account for reimbursement of qualified expenses paid for with personal funds Checkbook You can purchase and write checks to pay for out-of-pocket expenses (deductibles and coinsurance) You can order a book of 50 checks for $10.65 from the HSA Bank portal. Medical AutoPay There are two levels to Medical Claim Auto Pay: You can have all claims be paid automatically from the HSA account as long as there are sufficient funds. The other option is to link the claims to HSA Bank, but elect which claims to pay on a claim by claim basis. This feature can be turned on or off at any time by logging on to mycigna and linking to the HSA Bank Portal. Reimbursement Pay for your care out of pocket with cash, a check, or a credit card and request reimbursement from your HSA, either online or from your phone or tablet. Reimbursement checks are issued daily, or you can sign up for direct deposit through the HSA Bank portal. Regardless of how you access your HSA funds, all balance and transaction activity is available online at mycigna or on the mycigna Mobile App.

Page 8 Going to the Doctor When you receive care from a doctor, dentist, or vision provider, you can use your HSA to pay for care you receive during the appointment, or afterwards, when you receive a bill from the provider. In-Network Provider Out-of-Network Provider 1 Present your Cigna ID card at the time you receive care. Do not pay anything at the time of your visit. 2 After your visit, the doctor will submit a bill to Cigna. You may also receive a copy of the bill for your records. Present your Cigna ID card at the time you receive care. You may be asked to pay the full amount of the bill up front. After your visit, the doctor will submit a bill to Cigna. You may also receive a copy of the bill for your records. If your doctor does not submit a bill, you should submit one to Cigna. 3 You will receive an EOB from Cigna showing what the plan pays and what you owe the provider. 4 Check the amount listed as your responsibility on your EOB that s what you should pay the provider. 5 You can use your HSA to make a payment. You can use personal funds if you prefer to save your HSA funds for future use. Tracking Your Expenses An Explanation of Benefits (EOB) provides detailed information about: The services you receive The amount the plan covers The amount you owe Whether you ve met your deductible and when coinsurance starts to apply Reviewing and keeping a record of your EOBs is a great way to track your expenses throughout the year and make sure you are only billed for the services you receive and the amount that you owe. If you do not receive an EOB after a doctor s visit or service, contact Cigna to request one. Note: For doctor visits and some medical services, it s a good idea to wait until you receive an Explanation of Benefits from Cigna before paying the provider so you re not charged more than the amount allowed by the plan.

Page 9 Filling a Prescription You can use your HSA dollars to pay for prescriptions. Certain generic preventive medications will be covered at no cost to you, review Cigna s Preventive Prescription Drugs list for more details. For all other covered medications you will pay a copayment or coinsurance after you have reached your deductible. Retail Pharmacy Mail Order or Retail 90 When you need a prescription right away For medications you take regularly (maintenance medications) 1 Present your Cigna ID card at the pharmacy. Note: Your deductible is lower if you use in-network providers, including pharmacies that are inside Cigna s network. Additionally, not all pharmacies charge the same amount for a certain prescription. Be sure to compare prescription drug prices websites like GoodRx.com can help you. Maintenance medications -- including drugs that help in the treatment of chronic illnesses, such as heart conditions, allergies, and high blood pressure -- must be filled in a 90-day supply at a Cigna 90-Day Retail Pharmacy or through Cigna Home Delivery Pharmacy Note: Number of days supplied may vary depending on the Specialty drug. Go to symantecbenefits.com to determine what medications are considered Specialty drugs. 2 You can use your HSA to make a payment or you can use personal funds if you prefer to save your HSA funds for future use.

Page 10 Managing Your HSA HSA Bank offers several ways to manage your account: From your computer: You can access your account through the HSA Bank portal from mycigna. You can access mycigna when you re on the go from any web-enabled device. To access the HSA Bank portal: Visit mycigna and enter your username and password to log in Go to Review My Coverage in the main menu and select HSA from the dropdown menu Select Visit Your HSA Bank to Manage Your Account Through the HSA Bank portal you can: Check your HSA account balance View and pay claims, and more From your smartphone or tablet: Use the mycigna Mobile App or log on to your online account at any time. Your mobile and online accounts are secure and updated in real time. Check your HSA balance Pay providers Review payments and claims Take and upload images of bills and receipts Call customer service You can find mycigna Mobile in your smartphone s app store. By phone: Call Customer Support at the number on the back of your HSA debit card for information any time. Growing Your HSA The funds in your HSA are yours to use, now and in the future. If you do not use all the money in your HSA during the year, it will roll over to the next year and help you build savings for future health care expenses. Your HSA earns interest right away, and when your balance reaches $2,000, you can invest amounts over $2,000 in a variety of funds. Immediately Grow Your HSA in an Interest- Bearing Account Interest paid on balances of $1 or more Interest is calculated daily and paid monthly, based on average HSA balance FDIC-insured Investment Options Once Your Balance Reaches $2,000 Choose from a variety of world-class mutual funds covering a range of fund families* Easy, online platform allows you to set up investments within minutes *Certain funds require you to invest a minimum amount. For more information, log in to your account on the HSA Bank portal.

Page 11 Benefit from Triple Tax Savings Take advantage of your HSA s tax savings features. Save When You Contribute Save as You Build It Save When You Use It You don t pay federal income tax on the HSA dollars you contribute* through payroll deduction As your HSA funds grow, any interest and investment earnings you gain are free from federal taxes *State taxes apply in California, Alabama, and New Jersey You don t pay taxes on withdrawals from your account that are used for eligible expenses Example: Tim Saves $600 in Income Taxes Tim is in a 25% federal income tax bracket. For each $100 he contributes to his HSA, Tim saves $25 in federal income tax. His state income tax rate is 5%, so for each $100 he contributes, he saves another $5. If Tim contributes $2,000 for the year, he will save $600 in taxes. Example for illustrative purposes only

Page 12 Know Your Health Care Resources Symantec and Cigna have a number of resources to help you make smart health care decisions. MD LIVE For Cigna members only A telehealth or telemedicine provider An additional resource does not replace your existing doctors A virtual doctor s office; you meet with a doctor through online video chat, by phone, or email Provides immediate, on-demand, 24/7/365 access to affordable, quality, non-urgent medical care Uses a national network of licensed, boardcertified U.S.-based doctors, including Pediatricians Best Doctors Best Doctors is available to your family including parents and parents-in-law. This free patient advocacy program offers expert assistance when you need to make decisions about a medical diagnosis or treatment option. Experts will review your medical case, confirm the diagnosis and treatment plan, or offer an alternative approach. You do not need to elect this benefit in order to utilize the services. For more information, call Best Doctors at 866-904-0910 or visit the Best Doctors website. To learn how to pre-register for MDLIVE and to review more information, please visit SymantecBenefits.com. Ten Tips to Manage Costs Consider these additional tips to manage or even reduce your health care costs. 1 Get Your Preventive Care 2 Save Your Receipts 3 Come Prepared and Take Notes 4 Coordinate Your Providers 5 Use Virtual Visits 6 Consider Urgent Care Over the ER Prevention is the key to living well and controlling costs. In-network preventive checkups will help you stay on top of any small health issues that could eventually turn into more serious health problems. Preventive care is covered at 100%. Pay only for services you receive. Keep records of your Explanation of Benefits (EOBs) and payments you make. Before a doctor visit, write down all of your questions or concerns. After the visit, ask your doctor or a nurse to write down any special care instructions you ve been asked to follow. Make sure your doctors and providers are talking to each other and coordinating your care. Ask your doctor to contact your other providers/specialists to make sure they are all aware of your current health status, medications, and treatment. This will help to avoid any duplication of tests or procedures. Need to speak to a provider about your symptoms? Use MD Live to consult with a licensed doctor, anytime, day or night, on basic and routine ailments. MD Live could save you a trip to the ER or urgent care center and also save you money. If you need to see a doctor in person for a non-life threatening but urgent condition, use an urgent care center instead of going to the emergency room. You ll be seen more quickly, and also pay less for your care. If your symptoms are life-threatening, go directly to the ER. Visit mycigna to find an in-network urgent care center in your area.

Page 13 7 Research Your Care Options & Costs 8 Stay In-Network 9 Go Generic 10 Participate in the Wellness Incentive Program If you are expecting to use certain health care services (such as planning for the birth of a child or a major surgery), discuss payment options with your providers ahead of time and compare providers and facilities for the highest quality and lowest costs. You ll pay less a lot less when you go to providers who participate in the network. Cigna has pre-negotiated rates with in-network providers. If a doctor refers you for care, ask for a provider or facility in your network. When you receive a new prescription, ask your doctor or pharmacist if a generic, option (instead of its brand-name equivalent) is available and would be appropriate for you. Most of the time, the generic drug is just as effective as the brand-name, but costs less. Your future health is largely determined by the decisions you make now. You and your spouse can participate in the Wellness Incentive Program and be rewarded for pursuing a happier and healthier you! Contact Information Need more information about your plan? Reach out to your plan provider directly. Additional information and resources are also available on SymantecBenefits.com. Contact Contact Information Medical Benefits Covered services, deductible status, providers, health care tools and resources Health Savings Account (HSA) HSA balance and activity, pay bills, submit HSA claims Cigna mycigna.com 1-800-845-7616 HSA Bank HSA Bank Portal through mycigna.com Call the number on the back of your HSA Bank debit card MD Live Cigna SymantecBenefits.com Best Doctors Best Doctors bestdoctors.com 1-866-904-0910