2016–2017 Provider

BENEFITS GUIDEAnnual Enrollment for plan year: 8/1/2016–7/31/2017

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BENEFITS FOR YOU AND YOUR FAMILYWelcome to the Pediatric Associates benefit guide for 2016–2017!Welcome to the Pediatric Associates family! We are delighted you are joining our team. Your role is critical in fulfilling the mission of Pediatric Associates.

We offer you a specialized and affordable benefits package designed with you and your family in mind.

WHO IS ELIGIBLE?When reading this guide, please be mindful of the following icons, designating which employee group is eligible for that benefit:

WELCOME...

All full-time physicians, physician assistants, and ARNPs are eligible to participate in the benefits featuring the yellow full-time label.

All part-time physicians, physician assistants, and ARNPs are eligible to participate in the designated benefits featuring the orange part-time label.

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Pediatric Associates employees who choose to enroll dependents in coverage will need to be able to provide:

• For Children up to age 26 - Certificate of Birth, Adoption, or Legal Guardianship

• For Spouses - Certificate of Marriage or your most recent tax filing

• For a child age 26 or older who is mentally or physically disabled - A statement of disability verified by your medical provider

• For a child age 26 or older who lives with you AND is unmarried AND has no dependent children of his/her own - Proof of your child's residence via a copy of his/her driver's license or an official joint bill or bank account statement

• For a child age 26 or older who is a full-time or part-time student AND is unmarried AND has no dependent children of his/her own - Proof of your child's current student status via a copy of the most recent semester's enrollment

Please provide your required documents verifying dependent eligibility to the HR/Benefits Department or fax them to 954-967-7338.

REMEMBER: Open Enrollment is the only opportunity to enroll in the benefits program for the 2016–2017 plan year. Once enrolled, your elections will apply to the entire plan year, except in the instance of a qualifying event. Contact Benefits for more information.

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ELIGIBILITY

BENEFITS EFFECTIVE DATE COMPANY PAID AMOUNT

Cigna Medical Insurance (for yourself and qualified dependents)

Start Date (Up to $22,800 annual savings)

Long Term Care Start Date $1,000/month

Cigna Dental Insurance (for yourself and qualified dependents)

First of the month following start date

Cigna Vision Insurance (for yourself and qualified dependents)

First of the month following start date

Cigna Basic Life InsuranceFirst of the month following

90 days of employment

$500,000 (Providers) or $250,000 (ARNP & PA)

Cigna Voluntary Term Life Insurance

Effective once Medical Underwriting is complete

and your policy is delivered

Up to 5x your annual salary or $500,000 (which ever is lower)

Cigna Long Term DisabilityFirst of the month following

90 days of employment

$15,000 per month (Providers) or $5,000 per month (ARNP & PA)

Cigna Short Term DisabilityFirst of the month following

90 days of employment

Empower 401(k) Retirement Plan

First of the month following 90 days of employment

Voluntary Benefits PortalFirst of the month

following start date

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NEW MDLIVE: VIRTUAL CARE, ANYWHEREEffective June 1, 2016, Pediatric Associates is pleased to offer access to telemedicine services through MDLIVE.

What is telemedicine? If you have a minor illness like a sore throat, runny nose, or a rash then going to the emergency room can be expensive and urgent care may be unnecessary. Also, you may not be able to see your primary care physician right away. Telemedicine through MD Live provides you with virtual access to board certified doctors for minor health conditions 24/7/365 from your phone or computer.

How will it work? Once the benefit becomes available in June you simply:1. Activate your account through the MD Live website using your date of birth

and last 4 digits of your Social Security Number2. Select a doctor when you need to receive care3. Consult with a doctor over the phone or through video chat from your

computer, smart phone, or tablet.

How much will it cost to use MD Live? Nothing! For 2016, employees and their family members enrolled in a Pediatric Associates Cigna Health plan can use MD Live at no cost.

Employees who are not enrolled can still sign up for MD Live on their own by visiting MDLive.com. Signing up is free but a cost will apply if you see a doctor (generally about $49 per visit).

What can I use MD Live for? Doctors through MD Live can help treat minor medical conditions such as:• Allergies • Urinary problems / UTI• Cough • Respiratory Problems• Ear Problems • Sore throats• Flu • Minor Skin Irritations • Nausea / Vomiting • And more!

Can MD Live doctors write prescriptions? Yes! Doctors are able to prescribe medications when appropriate. Prescription drug copays will apply if you have a prescription filled.

MDLIVE

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CIGNA MEDICAL FT

The Pediatric Associates medical plan is an Open Access Plan. The plan covers all eligible preventive care at 100%, including immunizations, mammograms, and PSA/Pap Smear tests. There are no plan design changes for the 2016–2017 plan year.

PLAN DESIGN CIGNA OPEN ACCESS PLANIn-Network Out-of-Network

Medical

Deductible - Individual/Family $2,000/$4,000 $4,000/$8,000

Out-of-Pocket Max- Individual/Family $3,250/$6,500 $6,250/$12,500

Deductible Reimbursement Fund – Your Requirement

Individuals are responsible for the first $500/Families for $1,000

Deductible Reimbursement Fund – PA’s Commitment

Individuals: up to $2,750Families: up to $5,500

Coinsurance 80% 60%

PCP Copay $30 60% after deductible

CCN Specialist Copay/Non-CCN Specialist Copay $60/$90 60% after deductible

Preventive Care (copay/deductibles may apply) 100% 60%

ER Copay $325 $325

Urgent Care Copay $50 $50

Prescription Drug - Separate Out-of-pocket maximum of $1,500 Individual/$3,000 Family

Retail • Generic • Preferred Brand • Non-Preferred Brand

$10$70$140

Mail Order • Generic • Preferred Brand • Non-Preferred Brand

$20$140$280

Pediatric Associates pays the total health premium for employee only coverage and 90% of the difference in cost for those electing to cover dependent spouses and/or children - a value of up to $22,800 per year!

Tier Per Paycheck 2016-2017 IncreaseEmployee Only $0.00 $0.00Employee + Child(ren) $27.04 $0.00Employee + Spouse $32.88 $0.00Family $66.83 $0.00

MEDICAL CONTRIBUTIONS - Per Paycheck Costs

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DEDUCTIBLE CREDIT PROGRAM• Pediatric Associates has established a fund to reimburse you and your

dependents for your out-of-pocket costs for medical care. Each member is eligible for this reimbursement with proof of eligible expenses.

• Pediatric Associates will reimburse in-network deductible expenses over $500 (or $1,000 for employees with dependents). The medical deductible is for major services such as admissions to the hospital, MRI’s, CT scans, etc.

• The program does not apply to copays or dental or vision expenses.

DEDUCTIBLE CREDIT PROCESS1. Fill out the Medical Deductible Credit Form located on the ADP Portal.

2. Attach a deductible credit statement from Cigna by visiting mycigna.com to print your deductible/OOP maximum tracker statement.

3. Submit to Benefits Department via fax at 954-965-7338 or email: benefits@pediatricassociates.com.

Forms must be completed no later than October 31, 2016 for reimbursement for the previous plan year.

DEDUCTIBLE REIMBURSEMENT REQUIREMENTSIn order to receive the deductible reimbursement, you will need to complete a biometric screening and a health assessment.

1. Biometric Screening You can take the biometric screening in one of our offices by our Clinical Managers or you can have it done by your own primary care physician using a form located on the ADP Portal.

2. Health Risk Assessment Through taking the online HRA, TriWellness will determine your wellness score and show you where to start improving your health. Sign onto triwellnessconnect.net and click on “Start Your HRA” on the homepage.

Screening and assessment must be completed within 30 days of joining the medical plan.

PA DEDUCTIBLE REIMBURSEMENT

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CIGNA DENTAL FT PT

OPTION 1: CIGNA DPPO PLAN DESIGN

PLAN DESIGN CIGNA DPPOIn-Network Out-of-Network

Annual Maximum $1,500 $1,000

Deductible (Individual/Family)

$50/$150 $100/$300

Preventive and Diagnostic Care 100% no deductible 100% no deductible

Basic Services 80% after deductible 80% after deductible

Major Services 50% after deductible 10% after deductible

Orthodontia 50% after deductible 50% after deductible

Orthodontia Lifetime Maximum (Separate from Annual Maximum)

$1,500 $1,500

OPTION 2: CIGNA DHMO PLANPediatric Associates offers you a second dental option, a prepaid plan provided by Cigna Dental. This plan features:• No Deductibles• No Waiting Periods• Coverage for Pre-existing Conditions• Includes Orthodontic Copayments• No Claim Forms to File for Plan Dentist • No Annual Maximum for Plan Dentist• No Referrals Required for Specialist Services• Preventive services, including two exams and cleanings per year, X-rays, and two

fluoride treatments for children.

This prepaid dental plan offers benefits through a nationwide network of Plan Dentists. Please visit www.cigna.com and reference benefit schedule “KASV9” for a complete listing. Once a provider is selected, ID cards will be provided to new enrollees only.

Please carefully review the plan summary before making a final dental plan selection.

DPPO RATES - based on 24 pay periodsEnrollment Tier DPPO 2016–2017 Increase

Employee Only $15.93 $0.00

Employee + Child(ren) $34.07 $0.00

Employee + Spouse $30.79 $0.00

Family $49.70 $0.00

DHMO RATES - based on 24 pay periods

Enrollment Tier DHMO 2016–2017 Increase

Employee Only $7.93 $0.31

Employee + Child(ren) $17.94 $0.69

Employee + Spouse $13.36 $0.52

Family $23.56 $0.91

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CIGNA VISION FT PT

PLAN DESIGN CIGNAIn-Network Out-of-Network

Exam Copay $10 N/A

Materials Copay $20 N/A

ExamCovered in Full

After Copay$45 allowance

Single Vision LensesCovered in Full

After Copay$32 allowance

Bifocal LensesCovered in Full

After Copay$55 allowance

Trifocal LensesCovered in Full

After Copay$65 allowance

Lenticular LensesCovered in Full

After Copay$80 allowance

Frames (Retail Allowance) $100 allowance $55 allowance

Contact Lenses (Retail Allowance) - Elective

$100 allowance $87 allowance

Contact Lenses (Retail Allowance) - Therapeutic

Covered in Full After Copay

$210 allowance

Frequency of ServiceExam Copay Every 12 months

Lenses Every 12 months

Frames Every 24 months

VISION RATES - based on 24 pay periods

Enrollment Tier Rate 2016–2017 Increase

Employee Only $2.91 $0.15

Employee + Child(ren) $5.86 $0.28

Employee + Spouse $5.81 $0.28

Family $9.24 $0.44

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EMPOWER 401(k) RETIREMENT PLAN FT PT

The Pediatric Associates 401(k) Plan provides you the opportunity to save money on a pre-tax basis to help you on your journey to and through retirement. To jump start your efforts, Pediatric Associates provides automatic enrollment in the 401(k) plan the first of the month following 90 days of employment. This benefit is provided to all full and part-time employees.

About the Plan• You are automatically enrolled at a 3% pre-tax contribution rate, invested in a

default asset allocation model.• The Company provides a match of $0.50 for every dollar contributed up to

3% of earnings for the non-highly compensated employees.

Accessing the PlanOur mobile-optimized participant website gives you the ability to access your account wherever and whenever you want. Use the website to:

• Adjust contributions and rebalance your portfolio• Request a loan, model a new loan or obtain outstanding loan information (if

applicable)

To access your account online, visit www.empower-retirement.com/participant and select REGISTER from the Login box.

If you know your PIN:• Choose I have a PIN.• Enter your Social Security number and PIN and click CONTINUE.• Provide your contact information and create a username and password.

Click REGISTER.

If you do not know your PIN:• Choose I do not have a PIN.• Complete the requested personal information and click CONTINUE.• Provide your contact information and create a username and password.

Click REGISTER.

You can also access your account by phone at 1-800-338-4015. Automated services are available 24 hours a day, 7 days a week. Participant Service Representatives are available weekdays between 8 a.m. – 8 p.m. CT.

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EMPOWER 401(k) RETIREMENT PLAN FT PT

Plan AdvisorsIf you have questions about choosing fund selections, you can contact the Plan Advisors at Dwyer and Associates at 888-657-3767 to assist in this process as well as provide education on the funds available for investment. Questions related to the company’s 401(k) plan should be directed to the Plan Administrator, Director of Human Resources.

SUPPLEMENTAL RETIREMENT SAVINGS PLANThe Supplemental Retirement Savings Plan (SRP) is a Voluntary after-tax savings plan. The plan objectives are to assist you in preparing for your family’s long term savings needs on a tax favored basis, while at the same time providing the financial security of life insurance.

EligibilityAll Providers and select management with full time status earning total compensation of $125,000 or more are eligible to participate in the Plan. Enrollment is done on an annual basis.

ContributionsYou determine how much of your compensation you would like to save. There is a minimum contribution of 2.5% of total compensation. The Company will provide dollar for dollar matching contributions on the first 2.5% of savings to qualifying eligible participants. You are always 100% vested in your own contributions. Pediatric Associates matching contributions are subject to 3 year rolling cliff vesting until you have been a participant for 10 years.

Investment OptionsYou can direct the investments of your cash value account among 60+ diverse mutual fund type accounts ranging from conservative to aggressive.

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FTLIFE AND DISABILITYCompany pays for your monthly premium for Life & Disability Coverage from your start date.

• Providers Coverage Amount: Life Coverage Policy : $500,000 Disability Coverage of $15,000 per month

• ARNPs/PAs Coverage Amount: Life Coverage Policy : $250,000 Disability Coverage of $5,000 per month

VOLUNTARY TERM LIFE - CIGNAIn addition to your employer paid life and AD&D insurance, you may have the opportunity to purchase additional life insurance protection for you and your family through Cigna on the first of the month following 90 days of employment.

• INITIAL ENROLLMENT: You may elect additional coverage for yourself in increments of $10,000 up to 5x your annual salary or $500,000, whichever is lower, and coverage for your spouse in increments of $10,000 up to 2.5x your annual salary or $250,000, whichever is lower (spouse election may not exceed 50% of employee election). Cigna guarantees elections up to $100,000 for yourself and $50,000 for your spouse. If you elect coverage in excess of the guarantee issue amount, you must submit Evidence of Insurability (EOI). You may also elect coverage for your child in increments of $2,500 up to $10,000 (coverage is limited to $250 for children age 0-6 months). All coverage for children is guaranteed.

CIGNA BASIC LIFE & DISABILITY & VOLUNTARY TERM LIFE

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SUPPLEMENTAL BENEFITS

BENEFIT PERIOD

Max amount of time to receive benefits after becoming disabled:• 3 months

ELIMINATION PERIOD

Amount of time that must pass between the first day of disability and the day benefits are paid to you:• Accident/Sickness: 7 days/7 days• Pre-Existing conditions: Conditions present up to 3 months prior to

the plan effective date will be excluded from benefit eligibility for the first 12 months of the policy.

BENEFIT AMOUNT

This is the monthly benefit payable to you:• 60% of your regular earnings, up to $2,000 per week.

CIGNA SHORT TERM DISABILITY INSURANCE You are eligible for Short Term Disability the first of the month following 90 days of employment.

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NEW: VOLUNTARY BENEFITS ONE-STOP SHOP ENROLLMENT PORTALAvailable for enrollment this fall, Pediatric Associates will be partnering with AlliantCHOICE Plus to offer employees access to a one-stop voluntary benefit shopping portal, where you can easily pick and choose benefits customized to your personal needs. More information will be provided once the online shopping portal is available. The products and vendors available to you are:

LEGAL: Hyatt Legal

PET: Nationwide

(VPI)

PURCHASING: Purchasing Power

ACCIDENT: Aflac & Unum

AUTO & HOME:

Liberty Mutual, MetLife, Travelers

DISCOUNT PROGRAM:

BenPlace

ID THEFT PROTECTION:

LifeLock

CRITICAL ILLNESS:

Aflac & Unum

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LONG TERM CARE - UNUMThis plan offers coverage for a skilled or custodial care in a nursing facility, assisted living facility, hospice, rehabilitation, Alzheimer’s or residential care facility (the benefit includes, but is not limited to: nursing care, therapist, homemaker service, any other services provided by/through a licensed Home Health Care Agency). You are eligible for Long Term Care effective your start date.

Plan options range from coverage of $1,000-$6,000 per month with duration options of 1 year of coverage to lifetime coverage

Option to elect buy-up coverage for yourself and/or dependent coverage for a variety of family members, including spouses, parents, siblings, grandparents, and in-laws.

All new elections will be subject to Evidence of Insurability.

Rates are age-banded and, depending upon the plan you choose, begin at the affordable rate of $4.50 per month.

To enroll in buy-up coverage, please visit UNUM’s website at http://w3.unum.com/enroll/pedassoc001.

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SUPPLEMENTAL BENEFITS

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Discover how Pediatric Associates in providing mobile access to key HR functions - and enjoying improved productivity and worker satisfaction along the way.

Visit www.adp.com/mobilesolutions for more information.

ADP SELF-SERVICE ENROLLMENT ONLINEHOW TO ENROLL IN ALL YOUR BENEFITSWe will continue to use the online enrollment system hosted by ADP. We hope that you continue to find this enrollment process faster and more convenient. All changes to your benefits must be completed during Open Enrollment, between July 1 and July 15, 2016 or within the first 60 days of your start date if you are a new hire.

Prior to completing your Open Enrollment you must confirm and update some personal and dependent information.

1. Log on to the ADP Payroll Portal.

2. Navigate to the Benefits Tab and select Review/Change Benefits.

3. A wizard-based Enrollment Tool begins the Enrollment process. You can check your progress while you make changes, or stop in the middle to return later, and the system will remember where you left off. The following three benefit enrollment options are available:

• Walk me through this process (recommended) • I know the changes I want to make • Review my benefits coverage

4. When you are finished making your changes, click View/Print Summary of Changes for a print out of your changes. You can log out of ADP Payroll Portal by clicking Logout on the top navigation bar.

If you have any questions using the ADP Payroll Portal, or if you’ve made an enrollment error, please contact your HR team.

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ADDITIONAL BENEFITS FT PT

AT&T TICKETS AT WORK

SAM’S CLUBSPRINT

DISCOUNT PROGRAMSAs an employee of Pediatric Associates, you are eligible for discounts and benefits from a variety of vendors.

PER DIEM EMPLOYEE RATES Pediatric Associates offers medical, dental, and vision benefits to Per Diem employees working over 130 hours per month in accordance with ongoing ACA compliance.

Once you are eligible, you will be notified by the Benefits Department.

PER DIEM EMPLOYEE RATES - per paycheck

Tier Medical DPPO DHMO Vision

Employee Only $257.97 $15.93 $7.93 $2.91

Employee + Child(ren) $484.97 $34.07 $17.94 $5.86

Employee + Spouse $533.99 $30.79 $13.36 $5.81

Family $819.03 $49.70 $23.56 $9.24

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Did you know that Pediatric Associates Life Assistance Program (LAP) offers FREE benefits to you and to any immediate family members?

YOUR FREE LIFE ASSISTANCE PROGRAM OFFERS:• Confidential guidance and resources for short-term issues, via phone and web

access, 24/7 :

• In-person help with short-term issues (up to three sessions per person, per issue, per year)

• A 25% discount on in-person consultations with network lawyers

To learn more about the Cigna Life Assistance Program, visit www.cignabehavioral.com/CGI or call 800-538-3543.

CIGNA LIFE ASSISTANCE PROGRAM FT

– Family Concerns – Child/Parenting – Developmental/Attention Issue – Marital/Partner – Any form of abuse – Physical Health – Stress/Anxiety – Sexual Disorders – Depression Concerns

– Alcohol Problems – Drug Problems – Suicidal /Homicidal – Grief and Loss issues – Eating Disorder Issues – Anger Management – Job/Career Issues – Workplace Aggression – Gambling

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Women’s Health ActThe Women’s Health and Cancer Rights Act of 1998 requires that all health insurance plans that cover mastectomy also cover the following medical care:• 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 at all stages of the mastectomy,

including lymphedemas, and Mastectomy bras and external prostheses limited to the lowest cost alternative available that meets the patient’s physical needs.

Medicaid and the Children’s Health Insurance Program (CHIP)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 on the next page, 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.

You may be eligible for assistance paying your employer health plan premiums. You should contact your State for further information on eligibility. Web: https://www.flmedicaidtplrecovery.com Phone: 1-877-357-3268

To see if any more States have added a premium assistance program since January 31, 2015, or for more information on special enrollment rights, you can contact either:

U.S. Department of LaborEmployee Benefits Security Administrationwww.dol.gov/ebsa1-866-444-EBSA (3272)

U.S. Department of Health and Human ServicesCenters for Medicare & Medicaid Serviceswww.cms.hhs.gov1-877-267-2323, Ext. 61565

LEGAL NOTICES

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LEGAL NOTICES

Newborns’ and Mothers’ Health Protection ActFederal law (Newborns’ and Mothers’ Health Protection Act of 1996) prohibits the plan from limiting a mother’s or newborn’s length of hospital stay to less than 48 hours for a normal delivery or 96 hours for a Cesarean delivery or from requiring the provider to obtain preauthorization for a stay of 48 or 96 hours, as appropriate. However, federal law generally does not prohibit the attending provider, after consultation with the mother, from discharging the mother or her newborn earlier than 48 hours for normal delivery or 96 hours for Cesarean delivery.

Notice of Special Enrollment Rights for Medical/Health Plan CoverageIf you decline enrollment in a your employer’s health plan for you or your dependents (including your spouse) because of other health insurance or group health plan coverage, you or your dependents may be able to enroll in your employer’s plan without waiting for the next open enrollment period if you:• Lose other health insurance or group health plan coverage. You must request

enrollment within 30 days after the loss of other coverage.• Gain a new dependent as a result of marriage, birth, adoption, or placement for

adoption. You must request health plan enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.

• Lose Medicaid or Children’s Health Insurance Program (CHIP) coverage because you are no longer eligible. You must request medical plan enrollment within 60 days after the loss of such coverage.

If you request a change due to a special enrollment event within the specified timeframe, coverage will be effective the date of birth, adoption or placement for adoption. For all other events, coverage will be effective the first of the month following your request for enrollment. In addition, you may enroll in your employer’s medical plan if you become eligible for a state premium assistance program under Medicaid or CHIP. You must request enrollment within 60 days after you gain eligibility for medical plan coverage. If you request this change, coverage will be effective the first of the month following your request for enrollment. Specific restrictions may apply, depending on federal and state law.

Note: If your dependent becomes eligible for a special enrollment rights, you may add the dependent to your current coverage or change to another medical plan OR health plan.

Health Insurance Portability and Accountability Act (HIPAA)Pediatric Associates, in accordance with HIPAA, protects your Protected Health Information (PHI). Pediatric Associates will only discuss your PHI with medical providers and third party administrators when necessary to administer the plan that provides your medical, dental, and vision benefits or as mandated by law. A copy of the Notice of Privacy Practices is available upon request in the Human Resources Department.

Michelle’s Law Notice — Extended dependent medical coverage during student medical leavesYour employer’s plan may extend medical coverage for dependent children if they lose eligibility for coverage because of a medically necessary leave of absence from school.

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LEGAL NOTICES

Coverage may continue for up to a year, unless your child’s eligibility would end earlier for another reason.

Extended coverage is available if a child’s leave of absence from school — or change in school enrollment status (for example, switching from full-time to part-time status) — starts while the child has a serious illness or injury, is medically necessary and otherwise causes eligibility for student coverage under the plan to end. Written certification from the child’s physician stating that the child suffers from a serious illness or injury and the leave of absence is medically necessary may be required.

If your child will lose eligibility for coverage because of a medically necessary leave of absence from school and you want his or her coverage to be extended, contact the Human Resources Department as soon as the need for the leave is recognized. In addition, contact your child’s health plan to see if any state laws requiring extended coverage may apply to his or her benefits.

Continuation Required by Federal Law for You and Your DependentsThe Continuation Required by Federal Law does not apply to any benefits for loss of life, dismemberment or loss of income.

Federal law enables you or your dependent to continue health insurance if coverage would cease due to a reduction of your work hours or your termination of employment (other than for gross misconduct). Federal law also enables your dependents to continue health insurance if their coverage ceases due to your death, divorce or legal separation, or with respect to a dependent child, failure to continue to qualify as a dependent. Continuation must be elected in accordance with the rules of your employer’s group health plan(s) and is subject to federal law, regulations and interpretations.

DisclaimerThis brochure is only a summary of the healthcare and income protection benefits that are available to Pediatric Associates employees and their eligible dependents. Official plan documents, policies, and certificates of insurance contain the details, conditions, maximum benefit levels and restrictions on benefits. These documents govern your benefits program. If there is any conflict, the official documents prevail. These documents are available upon request through the Human Resources Department. Information provided in this brochure is not a guarantee of benefits.

Medicare Part DIf you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months, a federal law gives you more choices about your prescription drug coverage. A copy of the notice is available upon request in the Human Resources Department.

2016–20178/1/2016–7/31/2017