2013 benefits guide - amazon web servicesuba-ebc.portals.s3.amazonaws.com/40900_infosys_2_05... ·...

2013 Benefits Guide

2Your 2013 Benefits Guide

TABLE OF CONTENTSWelcome to the Infosys Limited Benefits Plan 3

Who Can Enroll 4

When You Can Enroll 6

How to Enroll 7

Medical and Prescription Drug Benefits 8

Dental Benefits 11

Aetna’s Discount Programs 13

Vision Benefits 14

Health Savings Account 16

Dependent Care Flexible Spending Account 18

Disability Income Benefits and Basic Life and AD&D Insurance 20

Other Benefits 23

� Employee Assistance Program 24

� Retirement Benefits 24

� Commuter Benefits 25

� Group Auto and Home Insurance Program 26

� Relocation and Mileage Reimbursement 27

� Vacation, Holidays and Sick Time 28

Web Tools 30

Contact Information 31

Notices 33


OPEN ENROLLMENT FEBRUARY 11 - 22, 2013

If your enrollment is not completed during the Open Enrollment period, your benefits will be set to the default enrollment elections and you will have to wait until the next year’s Open Enrollment to change these elections.

Please Note: This is the only time you will be allowed to change your benefit elections without a qualifying life event.

View page 6 for more information on qualifying life events.

Annual Open Enrollment Elections for All Benefits Become Effective April 1, 2013.

Disclaimer: This brochure provides only a brief summary of the benefits available under Infosys Limited’s plans. In the event of a discrepancy between this summary and the Plan Document, the Plan Document will prevail. Infosys Limited retains the right to modify or eliminate these or any other benefits at any time and for any reason. More detailed information on a particular benefit plan may be found in the Summary Plan Description for that plan.


WELCOME TO THE INFOSYS LIMITED BENEFITS PLAN

Infosys Limited offers you and your eligible family members a comprehensive array of employee benefits to make sure you always have the benefits that best meet your needs.

� Health Benefits – We understand that a comprehensive health program is the key to maintaining a healthy workforce. We offer comprehensive health coverage which includes medical, dental and vision that you may choose separately.

� Dependent Care Flexible Spending Account – Our benefits plan allows you to participate in a dependent care flexible spending account to pay for dependent daycare expenses with pre-tax dollars, reducing your taxable income, resulting in a tax savings.

� Life Insurance Benefits – Our benefits program includes basic life and accidental death & dismemberment insurance coverage to protect you and your family in the event of accidental injury or death. You also have the opportunity to elect optional life coverage on yourself, spouse and children.

� Disability Insurance Benefits – We provide you with short-term and long-term disability income insurance benefits that would cover you in the event of an accident or illness resulting in an extended absence from work.

� Employee Assistance Program (EAP) – Our EAP program is a company provided benefit that helps you and your family balance the demands of work, home and life.

� Retirement Benefits – As a way of saving for retirement, eligible employees may contribute pre-tax dollars to the Infosys Limited 401(k) plan.

� Commuter Benefits – You may enroll in the commuter benefits if you utilize the train, the bus or pay parking costs for your commute to work.

� Group Auto and Home Insurance Program – To help you protect your property, MetLife Auto & Home insurance is available to you at discounted rates.

� Relocation Services and Mileage Reimbursement – We provide reimbursement for eligible moving expenses in the event you are required to relocate as a result of business reasons and for mileage if you use your personal vehicle for business purposes.

� Vacation, Holidays and Sick Time – To help balance your work and personal life, we offer a variety of programs and policies to meet your time-off needs. This includes vacation, paid holidays and sick time.


4Your 2013 Benefits Guide 4

You are eligible to enroll in the benefit plans described in this document if you are a regular full-time employee working 30 hours or more per week, unless otherwise indicated. If you enroll in the medical, dental or vision plans you may also enroll your eligible dependents in the same benefits you enroll in. Your newly elected benefits become effective on April 1, 2013. If you are a new hire, your benefits become effective the first day of regular full-time employment. Short-term Assignments

If you are contracted for short-term assignments, you are eligible for the following benefits:

� Medical Plans (Standard Plan with HSA or Plus Plan) � Basic Life and Accidental Death & Dismemberment Insurance � 401(k) Plan � Dependent Coverage (Employee + 1 or Employee + Family)

Eligibility does not include: � Dental � Vision � Dependent Care FSA � Commuter Benefits

WHAT HAPPENS IF

I DON’T ENROLL? If your enrollment is not completed within

the enrollment period, you will automatically be enrolled in the Employee Only Standard Medical Plan, the Employee Only Basic Dental Plan, Employee Only

basic life and accidental death & dismemberment insurance and Employee Only long-term and short-term disability. Your vision coverage will be waived.

You will have to wait until next year’s Open Enrollment to change your coverage,

unless you experience a qualifying life status event prior.

WHO CAN ENROLL

Your 2013 Benefits Guide

5Your 2013 Benefits Guide 5

Eligible Dependents Generally, for the purposes of Infosys Limited’s benefits programs, dependents are defined as:

� Legal spouse or registered domestic partner � Dependent children up to age 26 (disabled children up to any age),

regardless of student or marital status. Children include: - Your biological children

- Your stepchildren

- Your legally adopted children

- Your foster children, including any children placed with you for adoption

- Any children for whom you are responsible under court order

- Your grandchildren in your court-ordered custody

- Any other child who lives with you in a parent-child relationship

- Disabled children may be covered, regardless of age. Coverage for disabled children requires completion and submittal of a disabled child form, and approval by Aetna.

Documentation may be requested to support proof of dependent relationship.

WHO CAN ENROLL



WHEN YOU CAN ENROLL

You have 31 days from the date of the event to update your benefits or your dependent’s benefit election in the web-based enrollment system. For assistance with making changes due to your qualifying life event, call the Benefits Desk at (877) 745-6303 or e-mail [email protected].


Annual Open Enrollment Our annual Open Enrollment will take place from February 11 through February 22, 2013. The choices you make will be effective from April 1, 2013 through March 31, 2014. This is your one chance during the year to make changes for the upcoming year, unless you have a qualifying life event.

Qualifying Life EventsA qualifying life event, as defined by IRS regulations, allows you to make a change to your benefit coverage if you experience any of the following:

� Change In Life Status including but not limited to: – Marriage or divorce – Death of a dependent – Birth or adoption of a dependent (includes adoption assistance) – Loss of medical coverage associated with change in employment

status – Dependent satisfying or ceasing to satisfy plan’s eligibility

requirements – Loss of, or significant change to, your current coverage � Judgment, decree or court order � Enrollment/Ceasing to be enrolled in Medicare � The employee’s, spouse’s or dependent’s Medicaid or SCHIP coverage

is terminated as a result of loss of eligibility and the employee requests coverage under the plan within 60 days after the termination; or the employee, spouse, or dependent becomes eligible for a premium assistance subsidy under Medicaid or SCHIP and the employee requests coverage under the plan within 60 days after eligibility is determined

� Family Medical Leave Act (FMLA) special requirements


HOW TO ENROLL

Web-Based Enrollment System Instructions Follow the steps below to enroll in your benefits.

Review your enrollment materials carefully, including reviewing this guide Evaluate your needs Go to: www.Infosys.benefits-desk.com

- Select Online Enrollment

- Enter your username and password: If you are an Infosys Limited Employee, your username is INFY_your employee ID number. If you are an IPS Employee, your username is IPS_your employee ID number. Your password is known only to you. If you need assistance, please click on the e-mail me my password link.

- You will be taken through the disclosure, disclaimer and acknowledgment screens. Please take time to review this information.

Once you are logged in, you will be presented a pop up message. - To make your 2013 plan elections click on the “Proceed to Open

Enrollment” button. You will be taken through the benefit enrollment screens where you will make your plan choices.

Upon completion of your plan selections, you must click on the “Submit” link on the benefit summary page to complete your enrollment.

- After submitting your elections, you will receive an e-mail that will include your confirmation.

1

2

3

4

HELPFUL HINTS: � During the New Account Setup, review any information that is pre-populated for accuracy such as your first and last name and gender.

� You may view and compare the plan choices by clicking on the “Benefits Information Site” link located under “Enrollment Resources” in the enrollment screens.

� Remember, you must complete the enrollment process during Open Enrollment or within 31 days of date of hire by returning to the system and completing the process.

Additional assistance is available if you have questions regarding the benefits plans or how to enroll online. Contact the Benefits Desk at (877) 745-6303 or by e-mail at [email protected]. Representatives are available to answer your questions Monday through Friday between 6 a.m. to 6 p.m. PT.

5


MEDICAL and PRESCRIPTION DRUG BENEFITS


Medical and Prescription Drug Plans

You may choose to enroll in the Standard Medical Plan which includes a Health Savings Account (HSA) or the Plus Medical Plan. If you elect to participate in one of the medical plans, you may also enroll your eligible dependents. An overview comparison on the following page provides a brief outline of the in-network and out-of-network benefits for each plan.

The Standard Medical Plan and Plus Medical Plan use the same network of Aetna health care providers. However, if you are a Plus Medical Plan member and live in an area serviced by Aetna’s Aexcel network, you will also be able to take advantage of no-referral access to Aexcel-designated doctors in 12 selected categories of specialty care. As an Aexcel plan member, you’ll generally pay the lowest out-of-pocket expense under the terms of the plan when you visit an Aexcel-designated specialist.

All deductibles and out-of-pocket amounts accumulate on a plan year (from April 1st through March 31st). Please refer to your SPD for a complete list of benefits and any applicable limitations on the plan.



Standard Plan Plus Plan

Plan Features In-Network Out-of-Network In-Network Out-of-Network

Plan Year Deductible$1,500 EE Only

$3,000 EE + 1 or more

$2,500 EE Only

$5,000 EE + 1 or more

$600 Individual

$1,800 Family

$2,000 Individual

$6,000 Family

Member Coinsurance Aetna covers 80% after deductible Aetna covers 50% after deductible Aetna covers 80% after deductible Aetna covers 50% after deductible

Out-of-Pocket Maximum $2,500 EE Only

$5,000 EE + 1 or more

$3,500 EE Only

$7,000 EE + 1 or more

$1,750 Individual

$5,250 Family

$3,500 Individual

$10,500 Family

Lifetime Maximum Unlimited Unlimited

Physician Office Visit

Primary Care PhysicianCovered 80% after deductible Covered 50% after deductible

You pay $20 copayCovered 50% after deductible

Designated Specialist You pay $35 copay

Non Designated Specialist You pay $50 copay

Preventive Care Covered 100%; no deductible Covered 50% after deductible Covered 100%; no deductible Covered 50% after deductible

Hospital Services Covered 80% after deductible Covered 50% after deductible Covered 80% after deductible Covered 50% after deductible

X-Ray and Lab Covered 80% after deductible Covered 50% after deductible Covered 80% after deductible Covered 50% after deductible

Emergency Room (Emergency Care) Covered 80% after deductible $150 copay, then covered 80%; no deductible

Emergency Room (Non Emergency Care) Covered 50% after deductible Covered 50% after deductible

Urgent Care Clinics (Non Emergency Clinic) Covered 80% after deductible Covered 50% after deductible $50 copay; no deductible Covered 50% after deductible

Prescription Drugs

Retail - Up to 30 Day Supply After Deductible Is Met No Deductible

Generic

Preferred Brand

Non-Preferred

$10 copay

$20 copay

$35 copay

Not Covered

$20 copay

$40 copay

$75 copay

Not Covered

Mail Order – 31 to 90 day supply After Deductible is Met No Deductible

Generic

Preferred Brand

Non-Preferred Brand

$20 copay

$40 copay

$70 copay

Not Covered

$40 copay

$80 copay

$150 copay

Not Covered

NOTES: 1. Out-of-pocket maximum includes the deductible. Unless otherwise indicated, any applicable deductible must be met before benefits are paid by the plan.2. Out-of-pocket maximum does not include copays. 3. On the Standard Plan, if coverage is elected for one or more dependents, the entire family deductible ($3,000 in-network) must be met in full before any one member will receive coinsurance or prescription drug copayments under the plan. The EE + 1 or EE + Family out-of-pocket maximum can be met with a combination of family members or any single individual within the family. Once met, the plan will pay 100% of the family’s covered expenses for the rest of the plan year. 4. The Standard Plan medical deductible must be met before prescription drugs will be covered at the stated copays. Until the deductible is satisfied, members are responsible for all Rx costs.

Aetna Medical and Prescription Drug Plan Group Number: 883499 Member Service Phone Number: (888) 219-9153 Web Site: www.aetnanavigator.com

Your 2013 Benefits Guide 10


Standard Plan Contribution Rates

EE EE + 1 EE + Family

Bi-weekly Contribution $39.03 $90.67 $129.54

Monthly Contribution $84.56 $196.46 $280.66

EE = Employee OnlyEE + 1 = Employee + 1 DependentEE + Family = Employee + 2 or More Dependents

Bi-weekly and Monthly Contribution Rates

Plus Plan Contribution Rates

EE Only EE + 1 EE + Family



EE = Employee OnlyEE + 1 = Employee + 1 DependentEE + Family = Employee + 2 or More Dependents


DENTAL BENEFITS

Dental Benefits Infosys Limited offers you a choice to enroll in Aetna’s Basic Dental PPO Plan or the Premium Dental PPO Plan. If you elect to participate in the dental plan, you may also enroll your eligible dependents.

Each plan includes Aetna’s Dental PPO. As an Aetna Dental PPO participant, you may visit any dentist you choose. However, if the dentist you choose is out-of-network, you may experience higher out-of-pocket costs. If possible, try to use a provider in the network. If you choose to visit a provider outside the network, you may be charged more than the Aetna Recognized Charge (ARC) amount; you are responsible for paying any amount incurred above the ARC.

An overview of dental benefits is on the following page. Please refer to your SPD for a complete list of benefits and any limitations to the plan.



DENTAL BENEFITS

Plan Features Basic Dental Plan PPO Plan Premium Dental Plan PPO Plan

In-Network Out-of-Network In-Network Out-of-Network

Plan Year Deductible$50 Individual

$150 Family $50 Individual $150 Family

Annual Maximum (per Individual) $2,500 $3,000

Diagnostic & Preventive (Type A Expenses)

Covered 100%; no deductible 100% covered up to *ARC, no deductible 100% covered; no deductible 100% covered up to *ARC; no deductible

Basic Services (Type B Expenses) Covered 80% after deductible Covered 80% up to *ARC, after deductible Covered 90% after deductible Covered 90% up to *ARC after deductible

Major Services (Type C Expenses) Covered 60% after deductible Covered 60% up to *ARC, after deductible Covered 70% after deductible Covered 70% up to *ARC after deductible

Orthodontic Expenses Not Covered Covered 50% up to $3,000 lifetime

NOTES 1. Unless otherwise indicated, any applicable deductible must be met before benefits are paid by the plan.2. For more information refer to the carrier’s document for complete details, including plan exclusions and limitations.*ARC is the maximum amount Aetna will pay for a covered expense from an out-of-network provider.

Basic Dental Plan PPO Plan Contribution Rates




EE = Employee OnlyEE+1 = Employee + 1 DependentEE + Family = Employee + 2 or More Dependents

Aetna Dental Group Number: 883499 Member Service Phone Number: (877) 238-6200 Web Site: www.aetnanavigator.com


Premium Dental Plan PPO Plan Contribution Rates






AETNA DISCOUNT PROGRAMS

Aetna Discount Programs Any member enrolled in an Aetna medical or dental plan is eligible for Aetna’s Discount Programs. Aetna’s Discount Programs help you be well and save you money on gym memberships, eyeglasses, contacts, weight-loss programs, chiropractor visits and more.

Aetna’s Discount Programs include:

� Aetna VisionSM discount program � Aetna FitnessSM discount program � Aetna Natural Products and ServicesSM discount program � Aetna HearingSM discount program � Aetna Weight ManagementSM discount program

To learn more about Aetna’s Discount Programs: � Log in to www.aetna.com � Choose “Health Programs,” then “See the savings”


http://www.aetna.com


VISION BENEFITS

Vision PlanInfosys Limited offers you a choice to enroll in a voluntary vision plan administered through VSP. If you elect to participate in the vision plan, you may also enroll your eligible dependents.

Finding the right eyecare provider is important to your eye health and overall wellness. That’s why you can see a VSP doctor, retail chain affiliate provider or any other provider. However, if the provider you choose is out-of-network, you may experience higher out-of-pocket costs.

The vision plan covers eye exams, frames, lenses and more. You can order contact lenses online and have them delivered to your home. If you are enrolled in the Standard Medical Plan with HSA, keep in mind that most vision care expenses are eligible for reimbursement through a health savings account.

Using your VSP benefit is easy. � You can choose any eyecare provider—your local VSP doctor, a retail chain affiliate, or any other provider. To find a VSP doctor or retail chain affiliate, visit vsp.com or call (800) 877-7195.

� Review your benefit information — visit vsp.com to review your plan coverage before your appointment.

� At your appointment, tell your provider you have VSP. There are no ID cards.

That’s it! VSP handles the rest —there are no claim forms to complete when you see a VSP doctor or retail chain affiliate.

An overview of vision benefits is on the following page. Please refer to your SPD for a complete list of benefits and any limitations to the plan.


Note: Any member enrolled in an Aetna medical or dental plan is eligible for the Aetna Vision Discount Program at no additional cost. You do not have to be enrolled in the VSP plan to be eligible for discounts.

� The Aetna Vision Discount Program includes discounts on eye exams, glasses, contact lenses, and Lasik surgery.

� You can visit many doctors in private practice plus, these national chains:* JCPenney® Optical, LensCrafters®, Target Optical®, Sears Optical® and Pearle Vision®.

� The Aetna Vision Discount Program requires no claim forms, the discount is given at the time of service.

� Show your Aetna ID card to a participating vision provider for immediate savings. A list of participating providers can be found on the Aetna web site. *EyeMed Select Network and Provider List, 1/12

http://www.vsp.com

http://www.vsp.com

http://www.aetna.com


VISION BENEFITS

VSP Vision Plan Contribution Rates

EE Only EE +1 EE + Family




VSP Vision Group Number: 30020863 Member Service Phone Number: (800) 877-7195 Web Site: www.vsp.com


15

Benefit Description of Your Coverage with VSP Doctors and Affiliate Providers* Copay Frequency

WellVision Exam Focuses on your eyes and overall wellness $0 Every 12 months

Prescription Glasses Frame $200 allowance for a wide selection of frames; 20% off amount over your allowance $0 Every 12 months

Lenses Single vision, lined bifocal, and lined trifocal lenses; polycarbonate lenses for dependent children $0 Every 12 months

Lens Options Progressive lenses; average 35-40% off other lens options $0 Every 12 months

Contacts(instead of glasses) $200 allowance for contacts; contact lens exam (fitting and evaluation up to $60 copay ) Up to $60 Every 12 months

Primary Eyecare Treatment and diagnosis of eye conditions like pink eye, vision loss and monitoring of cataracts, glaucoma, and diabetic retinopathy $20 As needed

Computer Vision Care Computer Vision Exam

Evaluates your needs related to computer use $0 Every 12 months

Frame $90 allowance for a wide selection of frames; 20% off amount over your allowance $0 Every 12 months

Lenses Single vision, lined bifocal, lined trifocal, and occupational lenses $0 Every 12 months

*You coverage provides you access to the VSP Signature Doctor Network. Coverage with a retail chain affiliate may be different. Once your benefit is effective, visit vsp.com for details.Coverage information is subject to change. In the event of a conflict between this information and your organization’s contract with VSP, the terms of the contract will prevail.

Your Coverage with Other Providers

Exam up to $50 Single Vision Lenses up to $50 Lined Trifocal Lenses up to $100 Contacts up to $105

Frame up to $70 Lined Bifocal Lenses up to $75 Progressive Lenses up to $75

Visit vsp.com for details, if you plan to see a provider other than a VSP doctor.

Extra Savings and Discounts Using the VSP Signature Network Glasses and Sunglasses

� 30% off additional glasses and sunglasses, including lens options from the same VSP doctor on the same day as your WellVision Exam, or get 20% off from any VSP doctor within 12 months of your last WellVision Exam.

Retinal Screening � Guaranteed pricing on retinal screening as an enhancement to your WellVision Exam.

Laser Vision Correction � On an average, receive 15% off the regular price or 5% off the promotional price;

discounts only available from contracted facilities. � After surgery, use your frame allowance (if eligible) for sunglasses from any VSP

doctor.

2013 PLAN ENHANCEMENTSDiscounts and coverage are now available with VSP retail chain affiliate providers (includes Costco). Contact VSP for details on your vision coverage and exclusive savings and promotions for VSP members.

http://www.vsp.com

http://www.vsp.com


HEALTH SAVINGS ACCOUNT

Health Savings Account (HSA) When enrolling in the Standard Medical Plan, you may have the option of setting up a Health Savings Account (HSA) through JP Morgan Chase (Aetna’s HSA vendor partner) should you meet the eligibility requirements. Eligibility requirements are as follows: you must be enrolled in a high deductible health plan; you must not be covered by any other health plan; you must not be enrolled in Medicare; and you must not be claimed as a dependent on another individuals tax return. An HSA is a special tax-advantaged account that you and your family members can use to pay for qualified medical expenses – ranging from deductibles and co-insurance to pharmacy bills, dental care, vision care and much more. You can make pre-tax contributions to your HSA via payroll deduction. Once deposited, your money grows tax-free year after year, much like an IRA. And it’s yours to keep, even if you change jobs.

Features of an HSA: � An HSA account is an individually owned account. � HSA contributions are made on a pre-tax basis and can be used for future qualified medical expenses.

� Funds you withdraw tax-free must be used to pay for qualified medical expenses, as defined by Section 213(d) of the Internal Revenue Code (“Code”).

� Funds carry over year after year. � You can withdraw the money on a taxable basis for any purpose after age 65 – your unused HSA funds can help fund your retirement.

� You can create a balanced HSA portfolio tailored to your specific needs and risk preferences.

16

Contribution elections to your HSA do not roll over. You must make these elections each plan year.



HEALTH SAVINGS ACCOUNT

JP Morgan Chase Health Savings Account (HSA) Member Services Phone Number: (866) 524-2483 Investments: (866) 774-7129 Web Site: www.chase.com/health-savings-account

IRS Annual Maximum Plan Year Contributions to Your HSA

Individual $3,250

Family $6,450

Over 55 catch up contributions $1,000

When you pay for qualified medical expenses with your HSA, the funds you withdraw are tax-free, provided they:

� Are qualified medical expenses as generally described in IRS publication 502 titled, “Medical and Dental Expenses,” Catalog Number 15002Q. You can order the publication by calling (800) TAX-FORM or view it online at www.irs.gov/pub/irs-pdf/p502.pdf .

� Have not been compensated or reimbursed by insurance or otherwise.

Examples of Qualified Medical Expenses � Deductibles and coinsurance for medical and dental care � Prescription drugs (some over the counter drugs with a prescription) � Vision care, including glasses and Lasik eye surgery � Smoking cessation treatment and prescriptions � Some insurance premiums, such as long-term care, COBRA and health care coverage premiums while receiving unemployment income

* For a detailed list, visit the IRS web site at: www.irs.gov/pub/irs-pdf/p502.pdf

Examples of Non-Qualified Medical Expenses � Air purifiers � Cosmetic surgery and related expenses � Health club dues (unless prescribed by a physician to treat illness) � Illegal operations and treatments � Massages for general well-being � Transportation, unless specifically for and essential to medical care � Toothpaste, cosmetics and toiletries � Vitamins and nutritional supplements � Weight loss programs (unless for a specific illness)

Establishing Your HSAWhen you enroll in the Standard Medical Plan you will receive a welcome kit in the mail from JP Morgan Chase with instructions on how to set up your HSA account and complete the enrollment process.

MONTHLY HSA ACCOUNT FEES: � No fee to establish the HSA account � Monthly service charge of $3.75 � A complete list of account fees will be included in the welcome kit and posted on the web site

17

Please Note: For questions regarding your HSA, first call Aetna’s medical member services at (888) 219-9153 or log on to www.aetnanavigator.com.

http://www.irs.gov/pub/irs-pdf/p502.pdf

http://www.irs.gov/pub/irs-pdf/p502.pdf


DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT

Dependent Care Flexible Spending Account (FSA)This account enables you to pay for out-of-pocket, work-related dependent daycare cost with pre-tax dollars. Dependent care expenses must be incurred during the coverage period so you (and your spouse, if married) can work or look for work, or in some cases if your spouse is a full-time student.

The care must be provided by a dependent care center or by an individual who can provide a name, address, and taxpayer identification number. Although you may not take the childcare tax credit if you choose this option, you may save more depending on your income level.

The dependent care FSA should only be considered for anticipated expenses. You should be conservative when estimating the amount to contribute to your account. If you overestimate your expenses and have money left in the account at the end of the year, it will be forfeited.



DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT

Eligible dependent care facilities: � A dependent (day) care center, provided that if care is provided by the facility for more than six individuals, the facility complies with applicable state and local laws;

� An educational institution for pre-school children. For older children, only expenses for non-school care are eligible; and

� An “individual” who provides care inside or outside your home. The “individual” may not be a child of yours under age 19 or anyone you claim as a dependent for federal tax purposes.

Eligible expenses must be for the care of: � A dependent child who is under age 13 and whom you claim as an exemption on your income tax return.

� A dependent child, elderly parent or relative who is physically or mentally incapable of caring for him - or herself.

Eligible expenses include those to cover:

� Licensed day care center � Nursery school � In-home care for dependents unable to care for themselves (children or adults)

� Daytime summer recreational camp � Adult day care center � Adult private sitter (nanny or home care companion)

“Use It Or Lose It Rule”The IRS mandates that any amount not spent in the FSA plan year will be forfeited.

Flex-Plan Dependent Care Flexible Spending Account Member Service Phone Number: (800) 669-3539 Web Site: www.flex-plan.com

Plan Contribution

Dependent Care FSAYou may contribute between $900 (annual minimum) and $5,000 (annual maximum).

19


DISABILITY INCOME BENEFITS and BASIC LIFE and AD&D INSURANCE

Disability Income BenefitsYou are eligible for short-term and long-term disability income benefits if you are a regular full-time employee. In the event you become disabled from a non work-related injury or sickness, disability income benefits are provided as a source of income. Infosys Limited pays the full cost of this benefit – there is no cost to you.

Basic Life and Accidental Death & Dismemberment (AD&D) Insurance Regular, full-time employees are provided with company paid life insurance and AD&D insurance. Eligible employees are automatically enrolled in life insurance and AD&D insurance of $150,000. Infosys Limited pays the full cost of this benefit – there is no cost to you. You also have the opportunity to elect optional life coverage on yourself, spouse and children.




Short-term DisabilityRegular, full-time employees are provided with company paid short-term disability coverage. This coverage provides eligible employees with up to 66.67% of base pay in the event of a qualified disability which renders the employee unable to work. Short-term disability payments are applicable for up to 13 weeks, with a maximum of $2,000 per week. Short-term disability payments are subject to a seven day waiting period.

Long-term Disability Regular, full-time employees are provided with company paid long-term disability coverage after one year of employment. This coverage provides eligible employees with up to 66.67% of their base pay in the event of a qualified disability which renders the employee unable to work as defined by the summary plan documents. Long-term disability payments pay out at a maximum of $10,000 per month and are subject to a 90 day waiting period.

Aetna Disability Benefits Member Service Phone Number: (877) 832-8241 Web Site: www.aetnadisability.com

Plan Features Short-term Disability Long-term Disability

Benefits Begin On the 8th day of approved claim for illness or injury

On the 91st day of approved claim for illness of injury

Benefit Duration Up to 13 weeks Up to age 65 if totally disabled. Limitations for specific conditions.

Percentage of Income Replaced

66.67% of basic weekly earnings

66.67% of basic monthly earnings (minus other income benefits)

Maximum Benefit $2,000 per week $10,000 per month

Eligibility Approved claim paperwork 1 year of US Infosys Limited employment

Employee Cost None - Infosys Limited pays all costs None - Infosys Limited pays all costs

Use the

online enrollment system to update your

beneficiary!

Disability Benefits

21

Aetna Basic Life and AD&D Benefits Member Service Phone Number: (800) 523-5065 Web Site: www.aetna.com/group/aetna_life_essentials

Plan Features

Life Benefit Amount $150,000

AD&D Amount Pays an additional one times the life insurance amount should you die by accidental means

Age Reduction Reduce by 50% at age 70

Accelerated Death Benefit

Included up to $25,000 of your life benefit if you are diagnosed with a terminal illness and have a life expectancy of 12 months or less.

Conversion Included - 31 days to convert to individual policy in most cases

Employee Cost None - Infosys Limited pays all costs



You have opportunity to elect optional life and AD&D coverage on yourself. If you elect coverage on yourself, you may also elect coverage on your spouse and children. See the chart below for plan features.

Plan Features

Employee Life and AD&D

Benefit Increments 1x, 2x, 3x, 4x, 5x or 6x base annual earnings

Benefit Maximum $1,000,000

Guarantee Issue Amount 3x annual earnings or $500,000

Age Reduction Schedule 50% at age 70

Spouse Life and AD&D

Benefit Increments $5,000

Benefit Maximum $250,000 or 50% of employee election

Guarantee Issue Amount $30,000

Age Reduction Schedule 50% at age 70

Child Life and AD&D

Benefit Increments $1,000

Benefit Maximum $10,000 or 50% of employee election

Voluntary Life and AD&D Insurance Voluntary Life Insurance Rates

Age Banded Employee (Voluntary Life) Spouse (Dependent Life)

Cost per $1,000 of Coverage

Under 25 $0.05

25 - 29 $0.06

30 - 34 $0.08

35 - 39 $0.09

40 -44 $0.10

45 - 49 $0.15

50 -54 $0.26

55 - 59 $0.52

60 - 64 $1.04

65 - 69 $1.84

70 - 74 $2.68

75+ $3.47

Dependent Child $0.05

Voluntary AD&D Insurance Rates

Please Note: Evidence of Insurability (EOI) will be required unless you elect voluntary life insurance within 31 days of your benefit eligibility date. EOI is also required for amounts above the Guarantee Issue. You must be enrolled in optional life in order to elect spouse and/or child dependent life.

Employee (Voluntary AD&D) Employee + 1 or more (Dependent AD&D)

Cost per $1,000 of Coverage

Employee Only $0.040

Employee + 1 or More $0.050


OTHER BENEFITS



EMPLOYEE ASSISTANCE PROGRAM and RETIREMENT BENEFITS

The EAP is a company paid benefit that is available to all eligible employees. This program offers confidential telephonic counseling services around the clock by licensed clinical staff to help you, members of your household and your adult children up to age 26 balance the demands of work, life and personal issues.

The EAP can assist with topics such as: � Marital distress � Relationship issues � Substance abuse � Workplace conflict � Stress � Personal and family issues

Balancing the demands of work, home and life can lead to improved productivity, increased employee satisfaction and better managed health costs.

Aetna EAP Member Service Phone Number: (888) 238-6232 Web Site: www.aetnaeap.com Company Code: EAP4INFY

If you are an employee in Personal Level 6 or below and are not defined as a Highly Compensated Employee (HCE) per IRS regulations, you may contribute pre-tax dollars to the Infosys Limited 401(k) plan, exclusively through payroll. Infosys Limited does not provide a matching contribution. The maximum annual employee deferral in the 401(k) plan is governed by the IRS limits specified for the plan year. You have a choice of investing your salary deferrals in funds from different families of mutual funds. You may enroll in this plan starting the first calendar month after date of hire.

Fidelity 401(k) Plan Benefits Member Service Phone Number: (800) 294-4015 Web Site: www.401kxpress.com

401(k) IRS Maximum Deferrals for 2013 �Deferral Limit: $17,500 � Catch-up Limit $5,500

Employee Assistance Program (EAP) Retirement Benefits

24


COMMUTER BENEFITS

The Flexi-Commuter Benefit Plan enables you to use pre-tax dollars to pay for transportation and parking expenses spent on your commute to work. You may purchase tickets online every month for the following month. You can save anywhere between 20-40% on these expenses depending on your tax bracket.

Here’s How it Works � Register on Flexi-Commuter Plan web site, and go through the three-step ordering process. Your passes will be mailed to your home address.

� Registration and orders must be completed via the Flexi-Commuter Plan web site by the 8th of the month for the following month benefit access.

� A minimum monthly contribution of $75 is required or a $3.50 administration fee will be assessed.

� Purchases are made a month in advance for the following month’s transit. � Mass Transit Expenses (i.e. Train or Bus) are subject to a $245/month maximum contribution.

� Parking Expenses are subject to a $245/month maximum contribution.

Flexi-Commuter Benefits Plan Member Service Phone Number: (800) 669-3539 Web Site: www.flex-plan.com

Eligible Mass Transit & Parking Expenses � Bus vouchers and passes used to commute to and from work. � Vanpooling in a “commuter highway vehicle” to and from work as long as 80% of the mileage is for transportation of employees between work/home and the vehicle is at half the maximum adult seating.

� Ferry passes used to commute to and from work.

Mass Transit FSA Non-Allowable Expenses � Mass transit costs not associated with the commute to work. � Mass transit costs from an employee bought voucher or bus pass when a voucher system is already sponsored or available by the employer.

Parking FSA Eligible Expenses � Parking costs associated with a lot at or near the place of business. � Parking costs from a lot that is at or near the place of commute (i.e. rideshare, carpool, vanpool).

Parking FSA Non-Allowable Expenses � Parking costs incurred at your residence. � Parking costs at a lot that is owned or sponsored by the employer.

Please Note: Parking lot fees arising from a company owned lot are not eligible under the Parking Reimbursement Account. These costs are deducted through the Parking Conversion Plan.

25

http://www.flex-plan.com/parthome.aspx




GROUP AUTO and HOME INSURANCE PROGRAM

MetLife Auto & Home® Call MetLife Auto & Home at 800 GET-MET 8 ((800) 438-6388) for your FREE quote anytime after March 1, 2013 Web Site: www.metlife.com/mybenefits

MetLife Auto & Home’s group insurance program will be available to you beginning March 1, 2013 as a voluntary benefit made available by your employer. As part of the program you will have access to value-added features and benefits, including special group discounts on auto and home* insurance, as well as a variety of other insurance policies including: condo, renter’s, motor home, motorcycle, recreational vehicle, boat and personal excess liability policies.

You could also benefit from these program features: � 24-hour claim reporting � Extended customer service hours, including weekday evenings and Saturdays

� Coverage you can take with you, should you retire or leave the company for another reason

� Enhanced product coverages that are built into every auto policy**

You can also choose from a variety of flexible and convenient payment options to make paying for your insurance easier. You can choose an automated payment option and receive added-savings or select direct bill as your preferred payment option. *Home insurance is not part of MetLife Auto & Home’s benefit offering in Florida and Massachusetts.

**See policy for restrictions.

26

Since everyone’s insurance policies renew at different times during the year, you may apply for group auto and home insurance at any time after March 1, 2013.

Additional information about this NEW Employee Benefit will be coming your way soon, so be on the lookout for more details.


RELOCATION and MILEAGE REIMBURSEMENT

In the event that you are required to relocate as a result of business reasons and with prior written approval by management, you may be eligible for reimbursement under Infosys Limited’s relocation policy. Relocation is defined as the transfer of work to a new location which is 50 miles or more from the existing work location of the employee post joining or location as captured in the application form for a new joinee.

Expenses for which you may be eligible for reimbursement include travel to the new location for yourself and applicable family members (spouse and children) via air, personal car or rental car, transportation of goods and movement of one vehicle within the US. You will also be eligible for reimbursement of Lease Breakage expenses due to relocation as per the Policy on Relocation within USA or Policy on Reimbursement of Relocation Expenses for Inter-Country Movements, whichever is applicable.

Maximum allowable reimbursement towards the transportation of goods: � Up to $3,000 for relocations of less than or equal to 1,500 miles or $4,000 for relocations more than 1,500 miles.

� All employees will be eligible for transportation of one vehicle and will be reimbursed at actuals on submission of bills up to $1,000. This is applicable only for domestic relocation i.e., within the US.

Travel by personal car will be eligible for mileage reimbursement as per the chart on the right. If a rental car is used, rental charges and fuel expenses are reimbursable upon submission of bills up to a maximum limit of airfare between the two locations; the exact amount applicable at a time can be confirmed with the Human Resource Department. Driving options are available only if airfare is not utilized.

All reimbursements will be based on actuals upon submission of bills. You will be reimbursed for expenses against bill towards accommodation (hotel expense) and conveyance for their initial stay. The entitlement towards the reimbursement would be as per your Base Location and Personal Level. You will be entitled for the reimbursement of Initial Settlement Expense of USD.

Please Note: The above mentioned Initial Settlement Expense eligibility is applicable only for Bellevue, WA, USA. In case there is a change in your location, please discuss Initial Settlement Expense eligibility with the Recruitment Manager or the Human Resource Manager upon your joining.

All transit expenses (bus, train, and airfare) will be reimbursed on submission of bills and reimbursement is limited to economy fare only. For claims purposes, please keep all original tickets and boarding passes.

Mileage Reimbursement Employees who use their personal vehicles for business purposes may be eligible for mileage reimbursement. For more information contact the Human Resources Department.

Mileage Reimbursement Rates

Particulars Rate (per mile)

Business travel 56.5 cents

Using your own car for relocation purposes 24.0 cents

Relocation and Mileage Reimbursement

27


VACATION, GENERAL AND FLOATING HOLIDAYS, and SICK LEAVE

VacationInfosys Limited provides paid vacation to regular, full-time employees. Employees can accrue 10 days of paid vacation in the first year of employment (the leave year runs from April 1st to March 31st). The amount of vacation increases to 12 days per year after two years and to 15 days per year after five years of employment. Additional, approved time-off will be treated as unpaid leave.

Vacation accruals are capped at 1.5 times an employee’s annual leave entitlement. When the accrual cap is reached, an employee will not earn additional vacation until the employee has taken enough vacation such that the accrued amount falls below the cap.

In case an employee is moving across multiple locations in the US, the accrued leave gets carried forward to each subsequent location. However, in case an employee is required to relocate to another country, carry forward will not be permissible and the leave balance in the USA would be compulsorily encashed.

Vacation encashment would be applicable at the time of separation /termination from the organization.

Holidays All employees will be eligible for 10 paid holidays in a calendar year. The dates of the holidays will depend on whether the employee is assigned to a client or works out of an Infosys Limited location or another non-client location.

Holiday Policy – Effective 1/1/13 � All employees who are in the US from January 1st – December 31st of each year will get 10 holidays on January 1st to be applied as per the Infosys Limited or client holiday calendar. Employees joining onsite for part of the year will get holidays pro-rated based on the number of days at onsite for that year. A “year” is based on the calendar year.

� Employees working in Infosys Limited offices have to follow the Infosys Limited holiday calendar. All 10 holidays are fixed and must be applied through the leave system.

� Employees working in client locations should follow the client holiday calendar. Employees can only apply for holidays as per the list of holidays in the Leave System.

� All holidays, statutory or otherwise, need to be applied for through the Leave System.

� If an employee (either working in an Infosys Limited office or at a client location) is unable to take a holiday as designated by Infosys Limited or the client due to project requirements, he/she may take an “alternate holiday” and apply for the same through the Leave System. Alternate holidays are additional days designated in the Leave System in the same month in which that holiday applies and are listed in the leave system.

� Legacy Infosys Consultants (IC) employees, please note: All Legacy IC employees need to continue to follow the current process to apply for holiday leaves as you have been doing last year. If you have any specific questions, you may reach out to your MCS HRBP.

Vacation, Holidays and Sick Leave HR Helpdesk: (888) 237-8763 Option 4 Web Site: AHD > HR Helpdesk

28

VACATION, HOLIDAYS and SICK LEAVE


VACATION, HOLIDAYS and SICK LEAVE

During Client Shutdowns: � Employees must either use their available holidays and apply for the leave through the Leave System, or

� They may work from home wherever possible, with their Manager’s approval.

� If working from home is not an option, the employee can create a task in iTime for “On duty” or any other non-billable project code and enter 8 hours in their time sheet for every holiday that the client is closed and the employee does not have sufficient leave to apply. In this circumstance, employees are not required to use their vacation leave or LOP.

Sick LeaveInfosys Limited offers paid sick leave to regular, full-time employees. Employees accrue paid sick leave at a rate of six days per year. The leave year is April 1st to March 31st. Half of the annual sick leave is credited twice per year in both April and October respectively. In the first year of employment, sick leave will be pro-rated for the half year (April or October) in which the employee has joined. One day of accrued sick leave per year can be carried over to the next year and must be utilized in the first quarter of the next fiscal year or it will lapse. Infosys Limited does not pay employees for unused sick leave.

29


WEB TOOLS

Aetna Navigator - www.aetnanavigator.com It’s the one place to go for coverage, claims, costs and more.Aetna Navigator is easy to use. Aetna Navigator is your secure web site for planning and managing your health and health care. It’s organized to help you do what you want to do. Register for Aetna Navigator to:

� Check claim status � Find doctors, dentists, hospitals and pharmacies � View and print temporary ID cards � Request replacement Aetna member ID cards � Contact Aetna Member Services � Utilize tools to manage your health care:

- Simple Steps – Health and Wellness

- Moms to Babies Program

- Access expert sources of medical and dental health information

- Review coverage details

- Estimate health care costs

- Find doctors, dentists, hospitals and pharmacies

� Get explanation of benefits statements and much more...

INSURANCE ID CARDS � ID cards will be mailed to your home address within 30 days of enrollment.

� Providers will be able to verify your coverage with Aetna even if you have not received your ID card.

� You will be able to print a temporary ID card from the Aetna Navigator site.

� There are no ID cards issued for the VSP vision plan.


http://www.aetnanavigator.com

http://www.aetnanavigator.com


CONTACT INFORMATION



CONTACT INFORMATION

Carrier Phone Number Web SiteMedical Benefits

Aetna Medical and Prescription Drugs (888) 219-9153 www.aetnanavigator.com

Aetna Dental (877) 238-6200 www.aetnanavigator.com

Aetna Discount Vision Plan (888) 219-9153 www.aetnanavigator.com

VSP Vision (800) 877-7195 www.vsp.com

JP Morgan Chase HSA (866) 524-2483 www.chase.com/health-savings-account

JP Morgan Chase HSA Investments (866) 774-7129 www.chase.com/health-savings-account

Flexible Spending Account

Flex-Plan Dependent Care Flexible Spending Account (800) 669-3539 www.flex-plan.com

Insurance

Aetna Disability Income (Short-term and Long-term) (877) 832-8241 www.aetnadisability.com

Aetna Basic Life and AD&D (800) 523-5065 www.aetna.com/group/aetna_life_essentials

Other Benefits

Aetna Employee Assistance Program (EAP) (888) 238-6232 www.aetnaeap.com

Fidelity 401(k) Plan a (800) 294-4015 www.401kxpress.com

Flexi-Commuter Plan (800) 669-3539 www.flex-plan.com

MetLife Auto & Home® (800) 438-6388 www.metlife.com/mybenefits

Vacation, General and Floating Holidays, and Sick Leave (888) 237-8763 Option 4 AHD > HR Helpdesk

Check with the plan’s administrator directly for specific information about the plan for 2013.

Still have questions about your benefits?

� Go online to www.Infosys.benefits-desk.com � Call the Benefits Desk at (877) 745-6303. Representatives are available Monday through Friday between 6 a.m. to 6 p.m. Pacific Time.

� E-mail [email protected] � Call or visit a specific plan administrator’s web site

32


NOTICES



NOTICES

If you are eligible for health coverage from your employer, but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can 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, you can 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, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance.

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 April 16, 2010. You should contact your State for further information on eligibility.

MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP)

Medicaid and The Children’s Health Insurance Program (CHIP) Offer Free or Low-Cost Health Coverage to Children and Families

ALABAMA – Medicaid ARIZONA – CHIP

Web Site: http://www.medicaid.alabama.gov Phone: 1-800-362-1504

Web Site: http://www.azahcccs.gov/applicants/default.aspx Phone: 1-877-764-5437

ALASKA – Medicaid ARKANSAS – CHIP

Web Site: http://health.hss.state.ak.us/dpa/programs/medicaid/ Phone (Outside of Anchorage): 1-888-318-8890

Phone (Anchorage): 907-269-6529

Web Site: http://www.arkidsfirst.com/ Phone: 1-888-474-8275


NOTICES

CALIFORNIA – Medicaid KENTUCKY – Medicaid

Web Site: http://www.dhcs.ca.gov/services/Pages/TPLRD_CAU_cont.aspx Phone: 1-866-298-8443

Web Site: http://chfs.ky.gov/dms/default.htm Phone: 1-800-635-2570

COLORADO – Medicaid and CHIP LOUISIANA – Medicaid

Medicaid Web Site: http://www.colorado.gov/ Medicaid Phone: 1-800-866-3513

CHIP Web Site: http:// www.CHPplus.org CHIP Phone: 303-866-3243

Web Site: http://www.la.hipp.dhh.louisiana.gov Phone: 1-888-342-6207

FLORIDA – Medicaid MAINE – Medicaid

Web Site: http://www.fdhc.state.fl.us/Medicaid/index.shtml Phone: 1-866-762-2237

Web Site: http://www.maine.gov/dhhs/oms/ Phone: 1-800-321-5557

GEORGIA – Medicaid MASSACHUSETTS – Medicaid and CHIP

Web Site: http://dch.georgia.gov/ Click on Programs, then Medicaid

Phone: 1-800-869-1150

Medicaid & CHIP Web Site: http://www.mass.gov/MassHealth Medicaid & CHIP Phone: 1-800-462-1120

IDAHO – Medicaid and CHIP MINNESOTA – Medicaid

Medicaid Web Site: www.accesstohealthinsurance.idaho.govMedicaid Phone: 1-800-926-2588

CHIP Web Site: www.medicaid.idaho.govCHIP Phone: 1-800-926-2588

Web Site: http://www.dhs.state.mn.us/ Click on Health Care, then Medical Assistance

Phone: 800-657-3739

INDIANA – Medicaid MISSOURI – Medicaid

Web Site: http://www.in.gov/fssa/2408.htm Phone: 1-877-438-4479

Web Site: http://www.dss.mo.gov/mhd/index.htm Phone: 573-751-6944

IOWA – Medicaid MONTANA – Medicaid

Web Site: www.dhs.state.ia.us/hipp/ Phone: 1-888-346-9562

Web Site: http://medicaidprovider.hhs.mt.gov/clientpages/clientindex.shtmlTelephone: 1-800-694-3084

KANSAS – Medicaid NEBRASKA – Medicaid

Web Site: https://www.khpa.ks.gov Phone: 800-766-9012

Web Site: http://www.dhhs.ne.gov/med/medindex.htm Phone: 1-877-255-3092


NOTICES

NEVADA – Medicaid and CHIP OREGON – Medicaid and CHIP

Medicaid Web Site: http://dwss.nv.gov/Medicaid Phone: 1-800-992-0900

CHIP Web Site: http://www.nevadacheckup.nv.org/ CHIP Phone: 1-877-543-7669

Medicaid & CHIP Web Site: http://www.oregonhealthykids.gov Medicaid & CHIP Phone: 1-877-314-5678

NEW HAMPSHIRE – Medicaid PENNSYLVANIA – Medicaid

Web Site: http://www.dhhs.state.nh.us/DHHS/MEDICAIDPROGRAM/default.htm Phone: 1-800-852-3345 x 5254

Web Site: http://www.dpw.state.pa.us/partnersproviders/medicalassistance/doingbusiness/003670053.htm

Phone: 1-800-644-7730

NEW JERSEY – Medicaid and CHIP RHODE ISLAND – Medicaid

Medicaid Web Site: http://www.state.nj.us/humanservices/dmahs/clients/medicaid/ Medicaid Phone: 1-800-356-1561

CHIP Web Site: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710

Web Site: www.dhs.ri.gov Phone: 401-462-5300

NEW MEXICO – Medicaid and CHIP SOUTH CAROLINA – Medicaid

Web Site: http://www.nyhealth.gov/health_care/medicaid/ Phone: 1-800-541-2831

Web Site: http://www.scdhhs.gov Phone: 1-888-549-0820

NEW YORK – Medicaid TEXAS – Medicaid

Web Site: http://www.nyhealth.gov/health_care/medicaid/ Phone: 1-800-541-2831

Web Site: https://www.gethipptexas.com/ Phone: 1-800-440-0493

NORTH CAROLINA – Medicaid UTAH – Medicaid

Web Site: http://www.nc.govPhone: 919-855-4100

Web Site: http://health.utah.gov/medicaid/ Phone: 1-866-435-7414

NORTH DAKOTA – Medicaid VERMONT– Medicaid

Web Site: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-800-755-2604

Web Site: http://ovha.vermont.gov/ Telephone: 1-800-250-8427

OKLAHOMA – Medicaid VIRGINIA – Medicaid and CHIP

Web Site: http://www.insureoklahoma.org Phone: 1-888-365-3742

Medicaid Web Site: http://www.dmas.virginia.gov/rcp-HIPP.htm Medicaid Phone: 1-800-432-5924

CHIP Web Site: http://www.famis.org/ CHIP Phone: 1-866-873-2647


NOTICES

WASHINGTON – Medicaid WISCONSIN – Medicaid

Web Site: http://hrsa.dshs.wa.gov/premiumpymt/Apply.shtm Phone: 1-877-543-7669

Web Site: http://dhs.wisconsin.gov/medicaid/publications/p-10095.htm Phone: 1-800-362-3002

WEST VIRGINIA – Medicaid WYOMING – Medicaid

Web Site: http://www.wvrecovery.com/hipp.htm Phone: 304-342-1604

Web Site: http://www.health.wyo.gov/healthcarefin/index.html Telephone: 307-777-7531

To see if any more States have added a premium assistance program since April 16, 2010, or for more information on special enrollment rights, you can contact either:

U.S. Department of Labor Employee Benefits Security Administration

www.dol.gov/ebsa 1-866-444-EBSA (3272)

U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services

www.cms.hhs.gov 1-877-267-2323, Ext. 61565


NOTICES

MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP)

Notice of HIPAA Special Enrollment Rights

This notice is being provided to ensure that you understand your rights to apply for group health insurance coverage. You should read this notice even if you plan to waive coverage at this time.

Loss of Other CoverageIf 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 31 days or any longer period that applies under the plan after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).

Marriage, Birth, or AdoptionIn 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 or any longer period that applies under the plan after the marriage, birth, adoption, or placement for adoption.

Medicaid or CHIPIf you or your dependents lose eligibility for coverage under Medicaid or the Children’s Health Insurance Program (CHIP) or become eligible for a premium assistance subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents. You must request enrollment within 60 days of the loss of Medicaid or CHIP coverage or the determination of eligibility for a premium assistance subsidy. To request special enrollment or obtain more information, contact the Benefits Desk at (877) 745-6303.


NOTICES

Medicare Part D – Standard Plan and Plus Plan

Important Notice From Infosys Limited About Your Prescription Drug Coverage and Medicare

Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Infosys Limited Health & Welfare Plan and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage:

1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare 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. Infosys Limited has determined that the prescription drug coverage offered by the Standard Plan and Plus Plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium

(a penalty) if you later decide to join a Medicare drug plan.

When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th.

However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current Standard Plan and Plus Plan coverage will not be affected. If you do decide to join a Medicare drug plan and drop your current Infosys Limited coverage, be aware that you and your dependents may be able to get this coverage back.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage with Standard Plan and Plus Plan and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% 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 (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.


For More Information About This Notice Or Your Current Prescription Drug Coverage… Contact the department listed below for further information. NOTE: You will get a notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Infosys Limited 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.

For more information about Medicare prescription drug coverage: � Visit www.medicare.gov � 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 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

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 www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

NOTICES

Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

Date: April 1, 2013 Name of Entity/Sender: Hanna Global SolutionsContact--Position/Office: Benefits DeskAddress: 1390 Willow Pass Road, Suite 940 Concord, CA 94520 Phone Number: (877) 745-6303


NOTICES

This Notice Describes How Medical Information About You May BeUsed and Disclosed and How You Can Get Access to this Information. Please Review It Carefully.

As a participant in the Infosys Limited Health and Welfare Plan (the “Plan”), you are eligible for certain health care benefits. In the course of providing these benefits to you, the Plan may receive and maintain some of your medical information. Federal law requires that the Plan protect the privacy of, generally, medical information that identifies you and relates to your past, present or future health or condition, the provision of health care to you, or the payment for health care received by you. The Plan may hire other companies (“Business Associates”) to help provide health care benefits to you. These Business Associates may also receive and maintain your medical information.

Federal law requires that the Plan provide you with this Notice about its privacy practices and its legal duties regarding your medical information. The Plan is required to abide by the terms of the Notice currently in effect.

The Plan may change its privacy practices and the terms of this Notice at any time. Changes will be effective for all of your medical information received or created by the Plan. If the Plan changes its policies regarding the protection of your medical information, the Plan will mail you a new notice of privacy practices that incorporates any changes within 60 days. The Plan will also will post a new notice on its internet web site.

How the Plan May Use and Disclose Your Medical InformationThe Plan may use and disclose your medical information without your written permission for the following purposes:

For treatment. While the Plan does not directly participate in decisions

Notice Of Privacy Practices

regarding your health treatment, the Plan may disclose medical information it has created or received for treatment purposes. For example, the Plan may disclose your medical information to your doctor, at the doctor’s request, for his or her treatment of you.

For payment. The Plan or one of its Business Associates may use or disclose your medical information to pay claims for medical services provided to you or to provide eligibility information to your doctor when you receive medical treatment.

For health care operations. The Plan may provide your medical information to our accountants, attorneys, consultants, and others in order to make sure we are complying with federal law. Also, your medical information may be used or disclosed to assess the quality of health care that you receive or to assist the Plan in the management of its performance of administrative activities.

To you, your personal representative, or others involved in your healthcare. The Plan may provide your medical information to you and your legal representative. The Plan may also provide medical information to a person, including family members, other relatives, friends or others identified by you and acting on your behalf, so long as you do not object and the information is directly relevant to such person’s involvement in your health care. For this purpose, a person acts on your behalf by being involved in the provision and/or payment of your health care.

As required by law. For example, the Plan may disclose your medical information to comply with workers’ compensation laws or other similar laws.

To Business Associates. The Plan may disclose your medical information to its Business Associates so that they may perform the services that the Plan has


asked them to perform. The Plan requires that these entities appropriately safeguard your medical information.

For health-related benefits. The Plan or one of its Business Associates may contact you about treatment alternatives or other health benefits or services that may be of interest to you.

For other uses and disclosures permitted by law such as:

� To public health authorities for public health purposes (e.g. the reporting of communicable diseases);

� To state agencies handling cases of abuse, neglect, or domestic violence; � To a government agency authorized to oversee the health care system or government programs (e.g. determining eligibility for public benefits);

� To law enforcement officials for limited law enforcement purposes (e.g. to locate a missing person or suspect);

� To a coroner, medical examiner, or funeral director about a deceased person (e.g. to identify a person);

� To an organ procurement organization under limited circumstances; � For research purposes in limited circumstances (e.g. if identifying information is removed or a research board has approved the use of the information);

� To avert a serious threat to your health or safety or the health or safety of others;

� To military authorities if you are a member of the armed forces or a veteran of the armed forces;

� To federal officials for lawful intelligence, counterintelligence, and other national security purposes;

� To an executor or administrator of your estate; and � To any other persons and/or entities authorized under law to receive medical information.

For any other use or disclosure of your medical information, the Plan must have your written authorization. You may cancel your written authorization for the use and disclosure of any or all of your medical information, unless the Plan has taken action in reliance on your permission.

Your RightsYou may make a written request to the Plan to do one or more of the following concerning your medical information received or created by the Plan and/or the Plan’s Business Associates:

� The right to request restrictions on certain uses and disclosures of medical information; however, the Plan is not required to agree to such request.

� The right to receive confidential communications of medical information by alternative means or at alternative locations.

� The right to inspect and copy medical information. � The right to amend medical information. � The right to receive an accounting of disclosures of medical information. � The right, even if you have agreed to receive this notice electronically, to obtain a paper copy of this from the Plan upon request.

Although the Plan will utilize its best efforts to comply with your request, the Plan may legally deny your request under certain circumstances. The Plan will notify you of the reason for the denial and you will get a chance to respond. The Plan may not deny a request to communicate with you in confidence by a different means or location if the current means or location used by the Plan endangers you. The Plan may, however, request payment for any additional expenses it incurs to comply with your request. Your request to communicate by a different means or location must be in writing, include a statement that disclosure of all or part of the medical information by the current means could endanger you, specifically state the different means or location by which you would like the Plan to communicate with you, and continue to allow the Plan to pay claims.

NOTICESNOTICES


ComplaintsIf you feel as if your privacy rights have been violated, you may file a written complaint with: Angie Reese, SPHR Practice Lead – Compensation & Benefits Privacy Inquiries 6100 Tennyson Parkway Suite 200 Plano, Texas 75024

You may also send a written or electronic complaint to the Secretary of the Department of Health and Human Services. The complaint must state the name of the entity that is the subject of the complaint and describe the act or omissions believed to be in violation of law. A complaint must be filed within 180 days of when you knew or should have known that the act or omission complained of occurred. The Plan may not retaliate against you if you file a complaint.

More InformationIf you would like more information about this Notice, please contact: Angie Reese, SPHR Practice Lead – Compensation & Benefits (469) 229-9530

NOTICES


NOTICES

The Women’s Health and Cancer Rights Act of 1998

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:

� All stages of reconstruction of the breast on which the mastectomy was performed;

� Surgery and reconstruction of the other breast to produce a symmetrical appearance;

� Prostheses; and � Treatment of physical complications of the 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.

If you would like more information on WHCRA benefits, call your plan administrator’s Benefits Desk at (877) 745-6303.


NOTICES

Notice Regarding Electronic Disclosure

To: Infosys Limited Employees

From: Infosys Limited

Date: April 1, 2013

Re: Important Information About the Infosys Limited Employee Benefit Plan (the “Plan”)

A Summary of Material Modification/revised Summary Plan Description describes important changes in the benefits provided to you and/or your dependents under the Plan.

It can be accessed electronically through the Infosys Americas portal at http://usahrapp01/americas/.

You have a right to request and obtain a paper version of the document at no charge. Contact the Benefits Desk at (877) 745-6303 or [email protected] to request a paper version.

mailto:[email protected]

2013 benefits guide - amazon web servicesuba-ebc.portals.s3.amazonaws.com/40900_infosys_2_05... ·...

Documents