2017 health & welfare benefit enrollment guide for new ... · 2017 health & welfare benefit...

2017 Health & Welfare

Benefit Enrollment

Guide for New Exempt

and Non-Exempt Employees

Enroll by phone or online:

1-877-SABIC US

(1-877-722-4287)

www.benefits.sabic-ip.com

Contents of This Guide

Welcome to the SABIC Health and Welfare Benefits Program 2

Enrolling via the SABIC Your Total Rewards Website 4

Medical—Quality Protection for You and Your Family 6

Health Plan Administrators by State 10

Dental Plan Benefits 23

Vision Plan Benefits 24

Flexible Spending Accounts 26

Life Insurance and AD&D 28

Long-Term Disability 29

Salary Continuation Plan 30

Long-Term Care 30

SABIC U.S. Employee Retirement Savings Plan 31

Other Benefits 34

Enrolling via Your SABIC Total Rewards Website 35

Enrolling in Health and Welfare Benefits via the SABIC Benefits Service Center 36

Appendix

Health Care, Dental and Vision Contributions 38

Optional Life Insurance—A Plus Enhanced and Voluntary AD&D 44

Long Term Disability Contribution Rates 45

Long-Term Care Rates 45

HIPAA Privacy Notice 46

Summary of Modification Materials 50

Required Notices 76

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There are many rewards to working at SABIC, including our comprehensive and affordable

Health & Welfare Benefits Program. This Enrollment Guide provides an overview of your

benefits choices and the information you need to make benefits decisions that best fit your

personal needs.

The SABIC Health & Welfare Benefits Program provides you coverage under the following

benefit plans:

Medical/Prescription Drug*

Employee Assistance Program

Dental

Vision

Life Insurance

Dependent Life Insurance

Accidental Death and Dismemberment

Health Care/Dependent Day Care Flexible Spending Accounts

Long-Term Disability

Salary Continuation

Long-Term Care *Health Savings Account available

Welcome to the SABIC’s Health & Welfare Benefits Program!

You have 63 days including your hire date to enroll in benefits or waive coverage. Once you have missed the 63-day window – you will be placed in

Default Coverage and be responsible for retroactive contributions at the family level. Default Coverage is SABIC Plan for Health Option A, Basic Dental, Basic

Vision, Basic Life Insurance, Basic AD&D Insurance and Long Term Disability at 50% coverage level. Medical, Dental and Vision coverage is at the 3-person coverage level. Default coverage will continue until the end of the current

calendar year. You will be able to make changes to the default coverage during the next annual enrollment window usually held in the October timeframe with a

following January 1 effective date.

You are required to show proof of dependent status. For example to add a

spouse, you must show a valid marriage certificate and proof of current marital status such as a current tax form showing your spouse or some other form of documentation. For children, a birth certificate will be required.

Dependents effective date of coverage is the same as your hire date. However, dependents will not be added to your coverage until this proof is supplied.

Information must be supplied within the 63 days.

3

For More Information

This Enrollment Guide highlights benefits for SABIC employees. It is not an official summary

plan description and is not intended to provide full details of the plans described. Complete

details can be found in the official plan documents, which govern in all cases.

For employees covered by a collective bargaining agreement, participation in programs or

plans described in this document shall only occur upon agreement by the employees’ union

representative. Participation in programs or plans incorporated by reference into the

agreement is only to the extent provided through the incorporation. SABIC reserves the

right to terminate, amend, eliminate or replace any program, plan or benefit at its discretion

and at any time to the extent permitted by law.

Benefits described in this Enrollment Guide apply to eligible employees who are on the

active payroll, unless expressly stated otherwise.

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You will find a step-by-step guide for enrolling through the SABIC Your Total

Rewards Website and the SABIC Benefits Service Center on pages 35/36.

Ceridian provides payroll, AonHewitt provides health, and welfare benefits administration

services. The AonHewitt hosted Website, referred to as the SABIC Your Total Rewards

Website provides employees with one resource for all of their payroll and health and welfare

questions. The SABIC Your Total Rewards Website and the SABIC Benefits Service Center

are your Health and Welfare benefits information resources.

Before you make your benefit elections, you should access the SABIC Benefits website to

review your options.

Two Ways to Enroll

You have two options for enrolling—online via the SABIC Your Total Rewards Website or by

phone through the SABIC Benefits Service Center. The SABIC Benefits Service Center is

open Monday–Friday from 8 a.m. to 8 p.m. Eastern Time (ET), except Federal holidays.

Please note you can call and enroll through a benefits representative or by using the

Website as early as two days after your new hire date.

When you call the SABIC Benefits Service Center at 1-877-SABIC US, (1-877-722-4287) a

representative can help you through the online enrollment process, or simply take your

elections over the phone.

The SABIC Your Total Rewards Website is open 24 hours a day, seven days a

week. The online system provides a very robust enrollment experience. Go to

www.benefits.sabic-ip.com to enroll and for information about the benefits available to you

and your family.

SABIC Married Employees

If two SABIC employees want to be covered under one medical policy, the higher-paid

employee must cover the lower-paid employee and any dependents. If you are married to

another SABIC employee and you want to be covered under separate Medical Plan policies,

then either employee may cover the dependent children.

Eligible Dependents

Your eligible dependents include:

• Your spouse;

• For Medical, Dental and Vision coverage - Your children:

Up to the end of the month in which they turn age 26.

Enrolling via the SABIC Your Total Rewards Website

5

Appropriate documentation and social security number(s) of dependents will be required

prior to enrollment. Coverage end dates are as of the birthday of the dependent.

In the case of a child who, prior to age 26, is incapable of self-sustaining employment due

to mental or physical disability, dental, vision and dependent life insurance coverage will

continue up to the earlier of the date of recovery or age 65.

Continuation of this coverage requires the employee to submit medical documentation to

the health plan prior to the child turning age 26.

Once a dependent child’s coverage stops after age 26, it cannot begin again. However,

your child may be eligible to continue health care coverage at his or her own expense

through COBRA. For the child to be eligible for this COBRA coverage the parent must have

been working for the Company and covering that dependent child before he or she turns 26.

You will be asked periodically for information about a dependents continuing eligibility

(employment, education, disability or marital status). If the information to support

eligibility is not supplied, the coverage may be terminated. Documentation will be required

to add or maintain dependents based on life status events. This documentation may

include birth certificates, marriage certificates, tax forms and other appropriate

documents.

To qualify for medical, prescription drug, dental or vision coverage, your dependents must:

Not be on the SABIC U.S. payroll in the United States or Puerto Rico as an

employee;

Not be in the armed services of any country; and

Not be covered under any other group medical plan as the employee or subscriber.

6

Medical—Quality Protection for You and Your Family

SABIC is committed to providing access to a variety of high-quality health care coverage

options designed to meet the unique needs of our employees.

When you go to the SABIC Your Total Rewards Website or call the SABIC Benefits Service

Center, you will see or hear the Medical Plan options available to you.

Your Medical Plan Options for 2017

Your Medical Plan benefits help you, and your family, maintain good health. SABIC

employees may choose from three medical plans:

SABIC Health Care Preferred SABIC Plan for Health Option A

SABIC Plan for Health Option B

An important feature of the SABIC Medical Plans Option is that you can use out of network providers, however, this will be at an increased cost to you. In all cases, it

is financially advantageous to you to use in network providers.

SABIC Health Care Preferred

The SABIC Health Care Preferred (HCP) plan provides comprehensive medical coverage

through a network of health care providers. When you see your primary care physician* and

are referred to other providers within the HCP network, your care is covered at 100% after

you pay a co-payment. There is an annual deductible for services obtained in-network and

some services may require a co-pay.

Other HCP network advantages include:

Coordinated care through your primary care physician;

Low out-of-pocket costs for covered services;

Full coverage for preventive care;

Wellness Incentives paid as a reduction to your payroll contribution; and

No claim forms to file.

You always have the option to go out-of-network for care, although you will have to pay

greater out of pocket cost and, in general, file claim forms if you do.

* Not all HCP administrators require that you choose a primary care physician.

SABIC Plans for Health Option A and B

The SABIC Plan for Health combines a health plan with a Health Savings Account (HSA)

funded by you and SABIC with pre- and/or post-tax contributions. An HSA helps you plan,

save and pay for health care. The funds in your HSA can be invested through a bank

associated with your health plan according to the investment options you choose. This

means your money can potentially grow year over year—allowing you to accumulate funds

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for future medical expenses. Medical plans with HSAs work differently than traditional

medical plans. For example, when you enroll in the SABIC Plan for Health Option A or Option

B, SABIC contributes $500 (individual) or $1,000 (2 or more coverage level) to a HSA when

you open the bank account affiliated with the health plan you are enrolled in. You can earn

an additional contribution of $150 employee/$150 spouse or dependent over the age of 18

when you complete the actions required at the ActiveHealth website

(www.myactivehealth.com/sabic ).

Who Pays for What in the SABIC Plan for Health (Options A and B)?

Here is how the SABIC Plan for Health (Options A and B) and the HSA work together:

Use Your Health Savings Account (HSA) to Pay for Eligible Expenses

HSA dollars you spend on eligible medical, prescription drug and behavioral health services

help satisfy SABIC Plan for Health’s annual deductible. Both in-network and out-of-network

expenses are covered, but in-network services are provided at a discounted rate—so you

save. You may also elect to contribute your own pre-tax dollars to the HSA. 2017 maximum

amounts permitted by the IRS are $3,400 (individual) and $6,750 (2 or more coverage

level). If you are age 55 or over, you may contribute an additional $1,000. Maximum

amounts include your own and the company’s contributions. Your account balance can roll

over to the next plan year.

A Health Savings Account used in conjunction with a high-deductible health insurance policy

allows users to save money tax-free against medical expenses. This incentive and any

payroll contributions can only be deposited if the employee was eligible to open an

account prior to December 1.

A Health Savings Account (HSA) gives you a triple tax break:

• Your contributions are sheltered from income taxes

• The money grows tax-deferred

• The funds can be withdrawn tax-free for medical expenses

It is similar to a flexible spending account that never expires, and it can even serve as an

extra retirement-savings fund. Up to the age of 65 for health care use with no penalty or tax

applied. For any purpose after age 65, no penalty applies, with regular withdrawal taxes

(same as 401k).

Incentives available from SABIC

If the employee enrolls into SABIC Plan for Health and opens the Health Savings Account

with the bank affiliated with the health plan administrator, SABIC will deposit $500

Individual or $1,000 for a Family plan into the HSA. This incentive and any payroll

contributions can only be deposited if the employee was eligible to open an

account prior to December 1.

The annual wellness incentive each active employee who is enrolled in a SABIC Medical Plan Options can earn up to $150 for Plan Year 2017. The $150 would also be available to one enrolled dependent/spouse over the age of 18. For an employee enrolled in a family plan (2 or more enrollees) there is a maximum of $300. This Wellness Incentive is available for both Health Care Preferred and SABIC Plan for Health Option A & B.

http://www.myactivehealth.com/sabic

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The process to earn the incentive will be contingent on the completion of the Health Assessment at the ActiveHealth website (www.myactivehealth.com/sabic) during the calendar year of January 1 to December 31, 2017. If the Health Assessment is not completed, incentives will not be paid.

The process to earn a $75 incentive will be to complete and report the claim number and date of service for your Annual Physical on the ActiveHealth website (www.myactivehealth.com/sabic).

To earn the additional $75 a participant must complete one of the following options:

Digital coaching on MyActiveHealth.com/sabic – complete 100 heartbeats ($75)

Telephonic coaching – complete 3 calls with ActiveHealth for either Active Lifestyle Coaching or Condition Management ($75)

Note: Members are limited to earning a maximum of 25 heartbeats per week on the Digital Coaching Program.

For participants of the SABIC Plan for Health Option A or B, up to a total of $150 will be deposited in the employee’s Health Savings Account. The account must be open to allow the deposit of the incentive.

For participants of the SABIC Health Care Preferred Plan, up to a total of $150 will be deducted from your payroll contribution once the incentive has been recorded.

All incentive actions for plan year 2017 must be completed by December 31, 2017. Incentives for Plan Year 2017 will be paid out no later than April 15, 2018. This is a voluntary program.

ActiveHealth will report on a monthly basis to SABIC Benefits Team to record all completed actions. It may take up to 2 months to receive your incentive.

In total, you can receive a maximum annual contribution to your HSA of $650 (individual) or

$1,300 (2 or more coverage level).

You use your HSA account to pay eligible expenses before spending your own money.

Under both the SABIC Plan for Health (Options A and B), the plan pays 100% of the cost of

many in-network preventive care services, even before you have satisfied your deductible.

You do not pay for these services, so you save money.

You keep your unused HSA balance and it may grow based on your investment elections. If

you do not use all of your HSA dollars in 2017, the unused balance carries over to 2018 and

you retain these funds in the future if you remain enrolled in this plan. This allows you to

build an account balance and decrease the amount of the deductible you may have to pay

out of your own pocket.

The employee is responsible to open the Health Savings Account as soon as possible after

enrolling. The IRS dictates rules surrounding the HSA and in all cases if an account is not

open by December 1 of the current year, no payroll contributions or incentives can be paid.

Once April 15 of the following year has passed, no payments for the prior year are available

according to IRS regulations.

These incentive payments as well as the employee pre-tax contributions into the Health

Savings Account can only be made into the banks affiliated with the health plans.

If the employee is enrolled in United Healthcare, the bank is Optum Bank. If the employee is

enrolled in Anthem, the bank is BenefitWallet.

http://www.myactivehealth.com/sabichttp://www.myactivehealth.com/sabic

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Who is eligible for an HSA? Any individual that:

• Is covered by a high deductible health plan

• Is NOT covered by other health insurance

• Is NOT enrolled in Medicare

• Cannot be claimed as a dependent on someone else’s tax return

• Dependent children cannot establish their own HAS

There is no income limits on who may contribute to an HSA.

The employee owns the account. The Health Savings Account is portable – if employee

leaves or retires, the account goes with the employee and money that is in the account

belongs to the employee.

You can withdraw funds for non-healthcare related reason at age 65 with no tax penalty. Tax

applies to funds once withdrawn after age 65. You can continue to use funds to pay health

care expenses past age 65 with no penalty.

For additional information on Taxes and an HSA, you should consult with a Tax Advisor and

review information at the IRS website (www.irs.gov).

How to Open a Health Savings Account (HSA)

Once you have enrolled in the SABIC Plan for Health, you can open your Health Savings

Account. Usually you can enroll within 2 weeks of completing the enrollment actions on the

SABIC Total Rewards website (www.benefits.sabic-ip.com). For information on how to open

a Health Savings Account (HSA), see below.

Anthem and CDPHP affiliated with MyBenefitWallet (formerly Mellon Bank)

• Use link at www.mybenefitwallet.com

• First Name, Last Name, last 4 digits of SSN, date of birth, and zip code

• Must match what is on Enrollment System

UHC affiliated with Optum Bank

• Use link at www.myuhc.com once you have registered; or

• Use link at www.optumbank.com

• Account #729704

Meet Your Annual Deductible

The annual deductible amount varies depending upon whether you elect SABIC Plan for

Health Option A or B, the coverage level you choose and whether you use in-network or out-

of-network providers. You can use your HSA to pay for expenses that count towards

satisfying your deductible.

http://www.irs.gov/http://www.benefits.sabic-ip.com/http://www.mybenefitwallet.com/http://www.optumbank.com/

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Coinsurance Phase

After meeting the individual (and/or family) deductible, the plan (company) pays 80%, you

pay 20% for in-network services for Option A. For Option B once the deductible has been

met, the plan (company) pays 60%; you pay 40% for in-network services. The plan

(company) pays 60% and you pay 40% for out-of-network services in both Option A and B.

The balance is then billed to you and you can use your HSA funds to pay this amount

Out-of-Pocket Maximum

Once the out-of-pocket maximum is met, SABIC pays 100%. This “safety net” guards you

against high or unexpected medical costs by limiting the amount you pay for medical

services each year. For example, if you chose Individual coverage under SABIC Plan for

Health Option A, and you paid a total of $4,350 on eligible in-network expenses, the

company would begin paying 100% of your eligible expenses for the rest of the year.

Expenses that count toward your deductible and were paid by your HSA count toward

reaching your out-of-pocket maximum so you won’t have to spend $4,350 of your own

money.

In both SABIC Plan for Health Option A and B for family coverage, there is a maximum out

of pocket amount of $6,850 for in network services. Once an individual in a family plan has

paid $6,850 in network services, the company will pay 100% of in network services for that

individual. The remaining family members would pay coinsurance amounts (Option A – 20%,

Option B – 40%) until the total family out of pocket amount was met.

Medical Plan Administration

The Medical Plan is serviced by a group health administrator based on the state in which you

live. Refer to the chart on page 10 for a detailed state-by-state listing.

Health Plan Administrator

The following chart shows the medical plan administrator by the state in which you reside.

State

Health Care

Preferred

SABIC Plan for

Health

(Option A and B) AL and WV United Healthcare (UHC) Anthem

AK, AZ, AR, CA, CO, CT, DE, DC, FL, GA, HI, ID,

IA, KS,KY, LA,ME, MD, MN, MS, MO, MT, NE, NV, NH, NJ, NM, ND, OK, OR, RI, SC, SD, TN, TX,

UT, VT, VA, WA, WI, WY

UHC UHC

IL, IN, MA, MI, NC Anthem Anthem

NY Albany NY area - CDPHP

NYC area - UHC All other NY - Anthem

Albany NY area –

Anthem and CDPHP NYC area - UHC All other NY - Anthem

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State

Health Care

Preferred

SABIC Plan for

Health

(Option A and B) OH UHC WV Border -

Washington, Athens, Meigs County OH -

Anthem All other OHIO - UHC

PA UHC Anthem or UHC

Please visit the respective plan administrator websites for more information:

www.myuhc.com (Choice Plus Network)

www.anthem.com (National PPO Network)

www.cdphp.com (ASO – Self-insured)

www.express-scripts.com

Enrollment Tip: Use the SABIC Your Total Rewards Website Tools!

Make informed elections—use the tools on the SABIC Your Total Rewards Website to

compare the benefits available under each medical plan. Use the following chart for an overview of your SABIC Medical Plan options.

http://www.myuhc.com/http://www.anthem.com/http://www.cdphp.com/http://www.express-scripts.com/

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Your SABIC Medical Plan Options at a Glance

Medical Plan Comparison Chart

Following is a comparison of SABIC medical plan options. You may also view a plan comparison on the SABIC Benefits Website at www.benefits.sabic-ip.com.

SABIC Health Care Preferred SABIC Plan for Health with HSA

PPO Consumer Directed

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

Care must be

performed or

authorized by your

primary care

physician or

benefits

administrator, as

required

Benefits are paid

up to reasonable,

necessary and

customary

amounts

Benefits are paid

up to reasonable,

necessary and

customary

amounts

General Information

Medical Plan Annual Deductible

No carryover

deductible

In and Out of

Network Deductible

Amounts are

separate

Individual Annual Deductible on all services except preventive and

pharmacy is $300 Family (2 or more) Annual Deductible

on all services except preventive and pharmacy is

$600

Individual Out of Network Annual Deductible on all services $1,000.

Family (2 or more) Annual Deductible

on all services $2,000.

Option A

Deductible Individual: $1,300 2 or more: $2,600

Medical and Pharmacy combined

Out of Pocket

Individual: $4,350 Individual in a family plan - $6,850, total

family $7,900 2 or more considered

family and OOP Includes deductible

Option A

Deductible Individual: $2,700 2 or more: $4,800

Medical and Pharmacy combined

Out of Pocket

Individual: $8,700 2 or more: $15,800 Includes deductible

Maximum Out-of-Pocket

In and out of Network Out of Pocket Amounts are separate

Medical Annual Out- of- Pocket Individual

$3,700 Family $7,400 (Includes

Deductible and co-pays) Pharmacy

$2,250 per member up to $4,500 per

family

Includes Deductible

Annual Out-of-Pocket Individual $7,500 / Family

$15,000

Other Plan Option Offered

NO Yes, Option B

Option B Components

Does Not Apply Option B all components the same except Deductible and coinsurance

Differences for Option B

Does Not Apply Option B Deductible

Individual: $4,000 - $4,500

2 or more: $6,850 Medical and

Pharmacy combined. Coinsurance would

Option B Deductible

Individual: $4,000 - $4,500

2 or more: $8,000 - $9,000

Medical and

http://www.benefits.sabic-ip.com/

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be at 100% after deductible met for an

individual.

Out of Pocket

Individual: $4,000 -$4,500

Individual in a family plan (2 or more):

$6,850. Total family OOP is $8,000 - $9,000. Once 1

individual in family has met deductible,

other family members pay 40% coinsurance until Total OOP is met.

Pharmacy combined

Out of Pocket

Individual: $11,000 2 or more $18,000 Includes deductible

Fee Schedule Contracted rates for network providers/facilities; Out-of-Network

providers/facilities reasonable and customary amounts apply

Contracted rates for network providers/facilities; Out-of-network

providers/facilities reasonable and customary amounts apply

Claims Filing Limit You must submit claims by June 30th for expenses incurred during previous calendar

year

You must submit claims by June 30th for expenses incurred during previous calendar

year

Secondary Coverage Payments

Maintenance of Benefits rules apply HSA rules drive maintenance of benefits

Contributions Higher per pay period contributions based on Wage Band and Family Size

Option A less than HCP – Option B is $0

Option A is according to Wage Band and Family Size Tier

Health Savings Account

Does Not Apply 2017 maximum Amounts permitted by IRS 1 person - $3400

2 or more persons - $6,750 55+ catch up - $1,000

Incentives for well and sick for initial enrollments to total no more than $650

individual and $1,300 family

HSA-eligible expenses will only be applied against available HSA account balance if

employee elects to use account

Incentive amounts apply to over age 18

Health Savings Account Company Contribution Amount

Does Not Apply Automatic $500 Individual to open account, up to $650 with incentives—Individual

Automatic $1,000 to open account, up to $1,300 with incentives—Family

Existing HSA participants will also receive initial $500/$1,000 contribution

Wellness Incentives and Initiatives

Payroll Contribution Reductions - $150 Employee / $150 dependent over the age of

18. Wellness Incentive actions must be

Health Savings Account -- $150 Employee / $150 dependent over the age of 18.

Wellness Incentive actions must be complete

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See Incentive details on page 7 & 8

complete to earn reduction in payroll contribution. Incentive payments require

completion of the Health Assessment on the ActiveHealth website

(www.myactivehealth.com/sabic) .Actions must be completed by December 31, 2017. Payments will be made no later than April 1,

2018.

to earn deposit in HSA affiliated with health plan. Incentive payments require completion

of the Health Assessment on the ActiveHealth website

(www.myactivehealth.com/sabic) .Actions must be completed by December 31, 2017. Payments will be made no later than April 1,

2018.

Flexible Spending Account (SPFH Limited Purpose Only)

Up to $2,550 annually to be used for Medical, Pharmacy, Vision, Dental and other OTC as allowed by IRS regulations; Medical Claims automatically fed to vendor for FSA

Limited FSA account up to $2,550 annually to be used for Vision, Dental and other OTC

as allowed by IRS regulations; Not to be used for medical or pharmacy co-pays,

coinsurance or deductibles

Lifetime Maximum N/A N/A

Cancer screenings 100% coverage,

no deductible

80% coverage,

after deductible

100% coverage,

no deductible

60% coverage,

no deductible

Centers of Excellence – For

organ transplants and other highly specialized procedures. Refer to the health plan administrator for specific requirements for Bariatric Surgery and Spine and Back surgeries.

If you accept treatment at a recommended Center of Excellence, the plan covers eligible hospital expenses. It also covers reasonable expenses for lodging, transportation for the patient and one member of the patient’s immediate family, provided the travel is approved in advance by the benefits administrator

Approval by Benefits Administrator

required

100% Coverage, after deductible

T & L guidelines – up to $10,000 lifetime

per covered individual or 12 months from the

surgery date

Not applicable Approval by Benefits Administrator

required

100% coverage, after deductible.

T& L guidelines – up to $10,000 lifetime

per covered individual or 12 months from the

surgery date

Not covered; See hospital, physician

and surgery benefits

Chemotherapy and radiation therapy

100% coverage

after deductible

80% coverage,

after deductible

80% coverage

after deductible*

80% coverage,

after deductible

Spinal Manipulations – up to 15 visits in a

calendar year

100% coverage,

after deductible with a $25 co-pay for

80% coverage,

after deductible

80% coverage

after deductible*

60% coverage,

after deductible

http://www.myactivehealth.com/sabichttp://www.myactivehealth.com/sabic

15




(network and out-of-network combined), when necessary to treat a medical condition and when performed by a licensed chiropractor

each office visit/treatment

session

Dental Plan Services

Not Covered; Carve Out Vendor METLIFE Not Covered; Carve Out Vendor METLIFE

Diagnostic imaging procedures – such

as X-rays and EKGs used to diagnose an illness or injury

100% coverage

after deductible

80% coverage,

after deductible

80% coverage

after deductible*

60% coverage

after deductible

Diagnostic laboratory procedures – such

as blood and urine tests used to diagnose an illness or injury

100% coverage

after deductible

80% coverage,

after deductible

80% coverage

after deductible*

60% coverage,

after deductible

Dialysis – services

provided for end-stage renal dialysis in your home or at a facility

100% coverage

after deductible

80% coverage,

after deductible Advance approval

is required by benefits

administrator or benefits will not be

paid

80% coverage

after deductible*

60% coverage,




paid

Extended care facilities –

semiprivate room and board, special services, prescription drugs and medical supplies in a facility that provides 24-hour skilled nursing care, for up to 120 continuous days, when the stay is for convalescent care that requires medical supervision and skilled nursing services and when ordered by a physician

100% coverage,

after deductible

80% coverage,



administrator; otherwise, benefits will be reduced by

half, up to a maximum of $1,000

80% coverage

after deductible*

60% coverage,

after your deductible Advance approval



paid

Home health care –

when services are performed by a home health care agency and the treatment

100% coverage

after deductible

80% coverage,

after deductible

Advance approval is required by

80% coverage

after deductible*

60% coverage,

after deductible

Benefits administrator

16




program is approved in advance by the benefits administrator

benefits administrator or

benefits will not be paid

requires advance approval or

benefits will not be paid.

Office Visits

$15 copay after deductible met for

Primary Care Physician visits and Mental Health visits

$25 visit for OB/GYN, P.T., O.T., other rehab visits at

an office visit

$30 copay after deductible met for Specialists Visits

80% coverage after deductible



Inpatient Hospital $300 copay after deductible




Outpatient Hospital $100 copay after deductible




*Option B once deductible is met for an individual plan pays 100% for network-level services. Plan B if total OOP is not met for entire family, after $6,850 paid for 1 individual, plan pays at 60%, member pays 40%.

SABIC Plan for Health Option A and B Mental Health/Substance Abuse – CDPHP, UHC or Anthem

When you enroll in a SABIC Medical Plan, you automatically receive Mental Health/Substance

Abuse coverage. This coverage provides access to a network of psychiatrists, psychologists,

certified addiction counselors, social workers, hospitals and treatment centers to treat the

mental health and substance abuse issues of employees and their families.

For SABIC Plan for Health Option A & B, the health plan administrator – Anthem, CDPHP or

UHC administers the Mental Health/Substance Abuse programs. The participating network

can be found at your medical plan administrator’s website – www.anthem.com,

www.cdphp.com or www.myuhc.com . Authorization for network care is not necessary,

however only medically necessary services will be covered. It is recommended that the

employee /dependent call the health plan administrator at the number on the Medical ID

Card prior to receiving all services. The chart above is also the benefit level for Mental

Health/ Substance Abuse services for inpatient and outpatient services.

http://www.anthem.com/http://www.cdphp.com/http://www.myuhc.com/

17

2017 SABIC Plan for Health Option A & B

Option A Option B

In-Network

Deductible

$1,300 indiv / $2,600

family

$4,000 or $4,500 indiv

$6,850 family

EE Coinsurance 20% 40%

OOP Max (includes

deductible)

$4,350 indiv / $6,850 for

an indiv in a family plan,

Total for family is $7,900

$4,000 or $4,500 indiv

$6,850 maximum OOP for

an indiv in a family plan,

total for family is $8,000 or

$9,000

Preventive Care 100% covered, no ded 100% covered, no ded

Out-of-Network

Deductible

$2,700 indiv / $4,800

family

$4,000 or $4,500 indiv

$8,000 or $9,000 family

EE Coinsurance 40% 40%

OOP Max (includes

deductible)

$8,700 indiv / $15,800

family

$11,000 indiv / $18,000

family

Preventive Care 60% covered, no ded 60% covered, no ded

HSA Maximum Contribution

$3,400 indiv / $6,750 fam

55+ additional $1,000

$3,400 indiv / $6,750 fam

55+ additional $1,000

Incentives for Electing SABIC Plan for Health

When you elect the SABIC Plan for Health, you will receive an incentive in your Health

Savings Account for Plan Year 2017 if your account is active. This money will be

deposited into your Health Savings Account approximately 45 days after you have

enrolled if your account is open. This money is your money to use or save.

You are eligible for Wellness incentives throughout the year, once you (and your

spouse or dependent over the age of 18) have completed the Wellness Incentive

Requirements described earlier in this document.

The Wellness Incentive Actions can be completed on the ActiveHealth website –

www.myactivehealth.com/sabic .

Individual enrollees can earn up to $650 and Families can earn up to $1300 in Plan

Year 2017 to be deposited into their Health Savings Account (HSA).

http://www.myactivehealth.com/sabic

18

Coverage Category Employee Action Incentive Amount to

be Deposited into

Your HSA if eligible

prior to December 1

Single (1) Enroll in SABIC Plan

for Health

$500

Family *(2 or more) Enroll in SABIC Plan

for Health

$1,000

Single (1) Complete Annual

Physical & HA on

ActiveHealth Site

$150

Family *(2 or more) Complete Annual

Physical & HA on

ActiveHealth Site

$300

Total Incentive for

Single (1)

Complete All

Incentives Available

$650

Total Incentive for

Family *(2 or more)

Complete All

Incentives Available

$1,000

*2 or more applies to Adults only over the age of 18. In order to receive the maximum

amount for Family Incentives – 2 Adult members must complete the requirement.

19

2017 Health Care Preferred Plan Design

2017 Plan Design Deductible / Co-pay

Amount for In Network

Care

Deductible / Coinsurance

Amount for Out of Network

Care

Deductibles $300 Individual / $600

Family

$1,000 Individual / $2,000

Family

PCP Visit $15 co-pay, after ded 80% Reasonable and Customary

Amount after ded

Mental Health /

Substance Abuse Visit

$15 co-pay, after ded 80% Reasonable and Customary

Amount after ded

OB/GYN Visit $25 co-pay, after ded 80% Reasonable and Customary

Amount after ded

Chiropractic Visit $25 co –pay, after ded 80% Reasonable and Customary

Amount after ded

Urgent Care Visit $30 co-pay, after ded 80% Reasonable and Customary

Amount after ded

Specialist Visit $30 co-pay, after ded 80% Reasonable and Customary

Amount after ded

ER Visit $100 co-pay, after ded 80% Reasonable and Customary

Amount after ded

MRI, CT & PET Scan $100 co-pay, after ded 80% Reasonable and Customary

Amount after ded

Outpatient Surgery $100 co-pay, after ded 80% Reasonable and Customary

Amount after ded

Inpatient Hospital Visit $300 co-pay, after ded 80% Reasonable and Customary

Amount after ded

Preventive Care $0 co-pay 80% Reasonable and Customary

Amount after ded

20

Health Care Preferred Mental Health/Substance Abuse – Beacon Health

When you enroll in a SABIC Medical Plan, you automatically receive Mental Health/Substance

Abuse coverage. This coverage provides access to a network of psychiatrists, psychologists,

certified addiction counselors, social workers, hospitals and treatment centers to treat the

mental health and substance abuse issues of employees and their families.

For Health Care Preferred participants, Beacon Health Options administer Mental

Health/Substance Abuse programs. The participating network can be found at

www.achievesolutions.net/sabic. Authorization for network care is not necessary, however

only medically necessary services will be covered. It is recommended that the employee

/dependent call Beacon Health at 1-877-339-6152 prior to receiving all services. The chart

above is also the copay amounts for Mental Health/ Substance Abuse services for inpatient

and outpatient services.

Wellness Incentive Plan for Health Care Preferred

For all active employees enrolled in Health Care Preferred for plan year 2017, the wellness

incentive plan is available to them. This is a voluntary program.

To receive the reduction in payroll contributions, an employee / dependent, must complete

the Health Assessment on the ActiveHealth website (www.myactivehealth.com/sabic) and

complete the other requirements as described on Page 7 & 8 of this document. Actions

must be complete by December 31, 2017 for any reimbursement to occur. If both actions

are reported to the Benefits Team prior to April 1, 2018, the incentive can be paid out for

plan year 2017. There will be no incentive payments for the prior year after April 15.

Prescription Drug Coverage

You automatically receive prescription drug coverage through Express Scripts, Inc. when you

enroll in a SABIC Medical Plan.

The following chart shows how prescription drugs are paid for if you are enrolled in SABIC

Health Care Preferred.

Express Scripts Network Services ONLY

Retail (up to 30 day supply)

Mail Order (up to 90 day supply)

Out of Pocket Maximum (indiv/family)

Generic $15 $22 $2,250/$4,500

Preferred Brand $30 $65 $2,250/$4,500

Non Preferred Brand $50 $125 $2,250/$4,500

If cost of drug is less than copay then cost is charged, once Out of Pocket is met, coverage is paid at 100%. No out of network coverage available. If lowest cost drug not purchased, employee must pay cost difference plus copay. Routine maintenance drugs are offered exclusively by mail order.

Note: Copay applies for preventive drugs under SABIC Plan for Health – Option A & B. See

next slide for preventive drug list.

http://www.achievesolutions.net/sabichttp://www.myactivehealth.com/sabic

21

Preventive Drug List for SABIC Plan for Health with Examples of drug names

Drug Classification examples where co-pay applies, no deductible

HCP Pharmacy co-pays apply for preventive drugs.

If you are not sure what drug classification you are taking, check with your pharmacy. These

examples are the drug classifications that are considered preventive. In most cases, generic

drugs only are covered at low or no cost copay. Routine maintenance drugs must be

purchased through the mail order program.

Prenatal, Geriatric and Pediatric vitamins

Weight-loss agents

Fluoride preparation

Disulfiram (alcoholism treatment)

Oral contraceptives

Intravaginal/Implantable Contraceptives

Diaphragms/Cervical Caps

Lipid-/cholesterol-lowering agents

Proton pump inhibitors – change to “Anti-Ulcer Medications”

Antihypertensives (high blood pressure)

Agents for osteoporosis

Erythroid and Myeloid stimulants (used to treat certain leukemia cases)

Antiplatelet drugs - Aggrenox, Plavix

Aromatase inhibitors (used to treat some breast and ovarian cancers)

Diabetic Agents

Vaccines

Anti-Malarial Drugs

Identification Cards

You will receive separate Medical Plan and Prescription Drug Identification Cards.

Employee Assistance

All employees have access to the Employee Assistance Program (EAP). These services

include personal, confidential assessments and counseling and referral services to help

employees and their families cope with a variety of concerns, such as stress, marital and

family conflicts and depression. Beacon Health Options administer the EAP and WorkLife

programs. To see what resources are available under Beacon Health Options and to check

for participating providers go to www.achievesolutions.net/sabic (1-877-339-6152). You can

also call the SABIC Benefits Service Center at 1-877-722-4287. Throughout the year, you

can view on line services and webinars on various topics by going to

www.achievesolutions.net/sabic.

My Wellness Program by ActiveHealth

MyWellness Program is available to all employees and their covered dependents. You are

automatically enrolled in the program and have access to the website

(www.myactivehealth.com/sabic ). My Wellness is a benefit offered by SABIC in partnership

with ActiveHealth that helps you identify specific ways to improve your health and live a

healthier lifestyle.

http://www.achievesolutions.net/sabichttp://www.myactivehealth.com/sabic

22

The MyWellness Program by ActiveHealth will alert you and your doctor of possible issues

that may affect your health. In addition, by using the tools offered through this program,

you will be able to track your exercise activity, nutrition intake, and setup reminders of

doctor appointments and annual physicals. We encourage you to take on a greater interest

in your own health and ensure that you are on your way to a healthier lifestyle.

All of the information you share on the MyWellness Program website is completely secure

and confidential. You can choose to share this information with your personal physician, but

SABIC will never see any of your personal health information.

ActiveHealth will call you and eligible dependents directly if you have a condition that is

covered under this program. You are encouraged to participate with this program for your

wellbeing. This program is voluntary.

Take advantage of this tremendous benefit and either get started, or continue taking the

steps towards living a healthy lifestyle. For more information, go to the website

www.myactivehealth.com/sabic .

https://was9.hewitt.com/ytr/US05320/epc/jump_ActiveHealth.htmhttp://www.myactivehealth.com/sabic

23

SABIC Dental Plan Benefits

There are two Dental Plans—the Basic Dental Plan and the Premium Dental Plan. MetLife

administers both plans and employees must either actively select or waive this coverage. To

view participating dentists in your area, you can log onto

www.mybenefits.metlife.com/MyBenefits. You will receive a dental card when you are

enrolled in dental coverage. When using the benefits, inform your dentist to bill MetLife

using your ID number from the ID card.

Dental Plan Design The Basic Dental Plan features a coinsurance design. The coinsurance plan differentiates

between in - and out-of-network benefits. This means that reimbursements are based on a

pre-determined coinsurance level—that is, a percentage of the covered expenses you incur.

Under both Dental Plans, preventive care reimbursement is covered at 100% in-network.

If you or your dependents anticipate needing a higher level of dental care coverage, you

may want to consider purchasing the Premium Dental Plan to obtain a higher level of

coverage for major restorative dental care.

You do not have to select the same coverage category for medical, dental and

vision coverage.

Your SABIC Dental Plan Benefits

Premium Dental Plan Basic Dental Plan

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

Basis of Reimbursement

Negotiated PDP** fee

90% of R&C* Negotiated PDP** fee

90% of R&C*

Type A—Preventive (e.g., cleanings)

100% 100% 100% 90%

Type B—Basic (e.g., fillings)

80% 80% 70% 70%

Type C—Major (e.g., crowns, implants)

50% Includes implants




Type D—Orthodontia (child and adult)

50% 50% 40% 40%

Individual Deductible (Annual)

$0 $0 $0 $0

Family Deductible (annual)

$0 $0 $0 $0

Calendar-Year Max $2,500 $2,500 $1,250 $1,250

Lifetime Ortho Max 50% up to $2,500 50% up to $2,500 40% up to $2,500 40% up to $2,500

* Reasonable and customary. **PDP – Preferred Dental Provider.

http://www.mybenefits.metlife.com/MyBenefits

24

SABIC Vision Plan Benefits

You have access to two Vision Plan options—the Basic Vision Plan and the Premium Vision

Plan. Davis Vision administers both Vision Plans. When you enroll in a SABIC Medical Plan,

you will not automatically receive Vision coverage. To view participating providers you can

log on to www.davisvision.com. You will receive an ID card when enrolled in the Vision

plan. Ask your provider to bill Davis Vision using your ID number from your card.

You do not have to select the same coverage category for medical, dental and

vision coverage.

http://www.davisvision.com/

25

The following table provides an overview of some of the covered services and the benefits

provided under both options.

Service Basic Vision Plan Premium Vision Plan

Eye examination, frames and spectacle

lenses, or contact lenses (in lieu of

eyeglasses – regular fashion frames or

safety glasses)

Covered once every

12 months with a $10

copay

Covered once every

12 months

Benefits for Selected Services

Frames

In-network retail allowance:

$110

$150

Benefits are also available for fashion, designer and premier frames.

Laser Eye Surgery

The Laser Eye Surgery $1,000 $1,000

benefit is a total lifetime

benefit per participant

Contact Lenses (in lieu of eyeglasses)

Single vision $130 $200

Bifocal $175 $200

Formulary with Fitting/Follow-Up Care

(in lieu of Elective Allowance):

Standard, soft or daily wear $25 copayment Included

Disposable or planned

replacement (when purchased at

one time)

$65 copayment (4 boxes) Included (up to 8 boxes)

Spectacle Lens Options (selected examples): Your Cost for Network Benefits

Double Segment Lenses $0 $0

Quadrifocals $0 $0

Blended Myodisc $0 $0

Mirror Coating $0 $0

Intermediate Vision Lenses $40 $0

Standard Progressive Lenses (PALs)

Digital Progressive Lenses

$75

$150

$0

$140

Premium PALS (Varilux™, etc.) $90 $25

Polarized Lenses $75 $75

Standard Anti-Reflective Coating (ARC) $35 $0

Premium ARC $48 $13

Value-Added Network Features

One-year Breakage Warranty Included Included

Lens 1-2-3! ® Membership Included Included

Laser Vision Discount Program Included plus allowance Included plus allowance

Vision Value Option Included Included

26

Flexible Spending Accounts

Flexible Spending Accounts (FSAs) can help save you money. You can reduce the amount of

income tax you owe by enrolling in the Health Care and/or the Dependent Day Care Flexible

Spending Account (FSA). The maximum amount you can contribute is $2,550 for plan year

2017. If you participate, you can contribute a portion of your pay from each paycheck into a

spending account before taxes are taken, which reduces your taxable income. You can then

use the money in this account to pay for your out-of-pocket health care as you incur them

and/or dependent day care expenses as your balance accrues If you enroll in the SABIC Plan for Health Option A or Option B, there will be an impact on how the FSA is used. Please

see section titled “Limited FSA” for a description of how to use the FSA plan in combination

with the SABIC Plan for Health.

Limited Purpose FSA

If you elect SABIC Plan for Health Option A or B, there will be an impact on your Health

Care Flexible Spending Account (FSA). First, your SABIC Plan for Health HSA will be used to

pay eligible medical, behavioral health and prescription drug expenses. If you have typically

used your FSA funds for payment of prescription drugs and copays, you should now

consider that your HSA funds would pay these expenses before your FSA funds are used.

You should only contribute enough to your FSA to cover vision and dental expenses, as well

as major medical expenses that cannot be paid with your HSA, such as LASIK surgery.

Tips on How to Use the HSA and FSA Together: If you enroll in SABIC Plan for Health

Option A or B and participate in the Health Care FSA, you can use both accounts to pay for

your eligible expenses. Here are some quick tips on how to use the HSA and FSA together:

Do not put too much in your Limited Purpose Health Care FSA. Only contribute what

you are sure you will use. You may not need to contribute as much to your Limited

Purpose Health Care FSA to cover all of your expected health care expenses. Only

Dental and Vision expenses will be eligible for reimbursement under the Limited

Purpose Health Care FSA.

Use the FSA Calculator on www.benefits.sabic-ip.com to determine how much to

contribute.

The HSA, funded by SABIC (and you if you choose to do so), is the first source of

funds for employees and eligible dependents to pay for all eligible medical,

behavioral health and prescription drug expenses. These are the only types of

expenses the HSA can pay.

The Limited Purpose Health Care FSA can be used to pay medical expenses like

dental, vision hardware and LASIK procedures.

How Dependent Day Care FSAs Help You Save

You can use your Dependent Day Care FSA to reimburse yourself for a number of different

expenses, including:

Child care fees

Day care fees for a handicapped dependent

Day care fees for an elderly dependent

27

Timing of Flexible Spending Account Eligible Expenses

The following chart lists the deadlines for incurring

expenses that can be reimbursed from your 2017 FSA

accounts (This information applies regardless of

whether you participate in the regular or limited

purpose health care FSA).

Type of Flexible Spending Account

If you elect to participate in an

FSA in 2017

Health Care FSA

Maximum amount is $2,550 for Plan Year 2017

You have from January 1, 2017

through December 31, 2017 to incur

eligible expenses for the 2017 plan

year.

Dependent Day Care FSA

Maximum amount is $5,000 unless a highly

compensated individual – limit is $2,500

according to IRS rules

You have from January 1, 2017

through December 31, 2017 to incur

eligible expenses for the 2017 plan

year.

Important FSA Information: If you want to participate in either the Health Care or

Dependent Day Care FSA in 2017, you MUST enroll within 63 days of your hire date. In

2017, you may contribute from $100 to $2,550 in the Health Care FSA. You can contribute

from $100 to $5,000 in the Dependent Day Care FSA if you file a joint tax return or $2,500

if you and your spouse file separate returns. Special rules apply if your spouse is disabled or

a full-time student or if the IRS considers you to be highly compensated. Highly

compensated employees (HCE) may be reduced mid-year due to IRS rules. 2017 HCEs will

be reduced to $2,500.00 at enrollment. Please consult with your tax advisor to determine

how these rules apply to your situation.

Calculate and Estimate Your FSA Deductions and Savings The annual amount you

contribute to one or both FSAs will be deducted from your paycheck in equal installments

during the year. You can estimate your FSA contributions, view your FSA account, and sign

up for direct deposit of your FSA reimbursement checks online at the Your Total Rewards

Website (www.benefits.sabic-ip.com).

Use the tools available on www.benefits.sabic-ip.com to estimate and view potential tax

savings when participating in a Flexible Spending Account. You can find these tools under

the link for Your Flexible Spending Account. Additional information can be found at

http://www.irs.gov.

If you are enrolling or making changes in December, you may be limited to the amount you

are allowed to select due to plan-year elections for remaining payroll checks.


28

SABIC provides Basic Life Insurance and Accidental Death and Dismemberment (AD&D)

coverage administered by MetLife that protects your loved ones financially in the event of

your death. The company pays this coverage in full.

Your Basic Life and AD&D Coverages

Basic Life Insurance

SABIC provides Basic Life Insurance equal to 2.5 X eligible pay. You have the option

to elect only $50,000 of coverage to avoid imputed income. The benefit maximum is

capped at $4.5 million.

MetLife Will Preparation Services- All employees enrolled in the Basic Life Plan will have access to Will Preparation Services. Participating plan attorney’s fees for the

preparation of wills for employees and their spouses are fully covered. Call the Hyatt

Legal Client Service Center at 800-821-6400 Monday through Friday 8 a.m. to 7 p.m.

EST to get started. Please use the following group number for SABIC –

Group#123227.

Basic Accidental Death & Dismemberment (AD&D)

The company-paid AD&D benefit for all employees is 1.5 X eligible pay. The benefit

maximum is capped at $1.5 million.

A Plus Enhanced Supplemental Life

The plans outlined on this page are also administered by MetLife and allow you to purchase

additional financial protection for you and your dependents.

Supplemental Life

The A Plus Enhanced Life Insurance plan is a group term life product with these features:

You can elect coverage of up to 10 X your eligible pay or a total of $6.5 million (when

combined with your Basic Life coverage).

As a new hire (elections must be made within 63 days from your hire date), medical

Evidence of Insurability (MEOI) will be required if you are electing total coverage exceeding

the lesser of 3 X eligible pay or $500,000. Until your MEOI is approved, you will be covered

only at the guaranteed issue amount.

See the next page for a complete definition of MEOI.

Dependent Life

You may elect to purchase coverage for your eligible dependents:

The benefit range is from $5,000 to $250,000 for your spouse—the available coverage

increments are listed on the SABIC Your Total Rewards Website. As a new hire, (elections

must be made within 63 days from your hire date), MEOI is required if you are electing

spouse life coverage greater than $25,000.

Life Insurance and AD&D

29

The benefit range is from $1,000 to $10,000 per child (no MEOI required).

You do not need to choose Supplemental Life Insurance for yourself in order to choose this

coverage for your family members. You can “mix and match” coverage amounts and your

choice for spouse coverage is separate from your choice for child coverage.

Voluntary AD&D

You can elect coverage of up to 5 X eligible pay (up to a $3.5 million maximum) for

yourself:

Under the Voluntary AD&D plan, you may choose coverage for yourself only or extend

coverage to your family (spouse and children). If you elect to extend coverage to your

family, your spouse is automatically covered at 50% of your coverage amount and your

child (ren) automatically is (are) covered at 20% of your coverage amount.

For example, assume your eligible pay is $60,000 and you elect 1 X eligible pay for yourself

and choose family coverage. In this example, your spouse is covered for $30,000 and each

of your children is covered for $12,000. In the event your spouse or child (ren) dies

accidentally, the benefit would be paid to you.

Medical Evidence of Insurability (MEOI) Process

MEOI may be required for some of your elections.

As part of your election process, the MEOI form will be available online. Based on your

response, MetLife may require you to undergo a medical examination.

If MEOI applies to you, the hard-copy Confirmation Statement you receive after you enroll

will also include an MEOI form. Please be sure to complete and return your MEOI form to

the MetLife address shown on the form. Alternatively, you may fax your completed MEOI

form to MetLife at 1-859-225-7909. If you do not return the form within 90 days or if your

form is denied, you will receive the minimum coverage available without providing MEOI.

If you have specific questions related to this process, you may call the SABIC Benefits

Service Center at 1-877-SABIC US (1-877-722-4287).

The Cost of Life and AD&D Coverage

You will find extensive cost and rate tables for both employee and dependent coverages in

the Appendix of this Enrollment Guide.

Long-Term Disability

Long-Term Disability (LTD) provides important income protection in the event you are

unable to work because of an illness, injury or other serious medical condition. LTD is

designed to provide you with income after your Salary Continuation Plan benefits have been

exhausted. You pay the full cost of this coverage on an after-tax basis. Medical Evidence of

Insurability is not required for new elections performed within 63 days of your date of hire.

The LTD plan provides monthly income of 50%, 60% or 70% of your eligible pay. In your

first six months of disability, the Salary Continuation Plan provides income replacement. If

after six months your condition meets the definition of disability under the LTD plan, you

will begin to receive LTD benefits.

30

While on LTD, you may remain eligible for other benefit coverages for up to a

maximum of 12 months from date of disability (up to a maximum of 18 months

from date of disability if a worker’s compensation injury).

Salary Continuation Plan

The Company automatically provides the Salary Continuation Plan for salaried employees.

This plan offers limited financial protection due to an illness, injury or other serious medical

condition. The Salary Continuation Plan has two components:

Personal Illness Payments

You can continue to receive 100% of your pay during a brief illness for up to 20 days in a

rolling 12-month period, subject to your manager’s approval.

Extended Illness Payments

Exempt Employees – May be eligible for payments up to 100% of their pay for 26 weeks.

Non-Exempt Employees – May be eligible for payments up to 100% of their pay for the first

13 weeks, and up to 60% pay for the next 13 weeks.

Long-Term Care

Effective for new participant elections as of 1/1/17:

Under the voluntary SABIC Long-Term Care Plan, you have the following coverage options:

$3,000, $4,500 or $6,000 a month. You also may choose between 2, 3 or 4-year options.

Long-Term Care is available to you and your eligible family members (spouse, parents and

parents-in-law) to help pay expenses in the event of a long-term or chronic illness that

prevents individuals from caring for themselves.

Long-Term Care premiums are determined by the participant’s age at enrollment. Employee

and spouse contributions are paid directly to the administrator—Genworth Life Insurance.

The younger you are when you elect coverage, the lower your cost.

If you elect coverage within 60 days of your hire date, are an actively at work full time

employee and under age 66, you can apply with streamlined short form medical

underwriting. If you are age 66 or older or if you apply any time after your first 60 days,

you will need to go through the long form for medical underwriting.

Long-Term Care options will not be shown on the SABIC Your Total Rewards Website. If you

are interested in learning more about your options or electing to participate, you will need

to contact Genworth Life Insurance directly to request a quote.

Be sure to evaluate your options and follow Genworth’s administrative processes for billing

to ensure you have the coverage you need.

To get more details about this coverage, including sample premiums for you, your spouse

and other family members, go to the Genworth website at www.genworth.com/groupltc.

Enter the Group Name/User ID: SABIC and the Access Code: groupltc. Or, if you prefer, you

can call the Group Long-Term Care Insurance Customer Service Center at 1-800-416-3624.

Anyone already enrolled in Long Term Care coverage prior to 1/1/17 will not be impacted by

the above changes.

http://www.genworth.com/groupltc

31

SABIC U.S. Employee Retirement Savings Plan

Retirement Benefits What do you want to do when you retire? Whatever your goals are, the SABIC U.S.

Employee Retirement Savings Plan, which includes both a contributory and non-contributory

component, is a powerful tool to help you save for the future.

U.S. Employee Retirement Savings Plan (the “Savings Plan”) The Savings Plan can help you save for the future. Valuable tax benefits and two types of

company contributions work together with your own savings to help bring you closer to your

financial goals.

You will be eligible to participate in the Savings Plan immediately when you join the

company. Note that, due to the plan’s automatic enrollment feature, if you do not make an

active election to participate in the Plan within 30 days of your hire date, you will be

automatically enrolled to contribute 8% of your pay to the plan unless you either opt out or

enroll on your own within 30 days. Your contributions will be invested in the Alliance

Bernstein Target Retirement Fund (based on age). For more details on the automatic

enrollment feature, please see your 401(k) Enrollment Guide and the special notice that will

be provided as part of your 401(k) new hire enrollment packet (sent separately). Employees

who are automatically enrolled in the plan may change their contribution and investment

elections prospectively at any time.

You can contribute up to the lesser of 80% of your pay up to the 2017 IRS Limit of

$54,000 in pre-tax, Roth 401(k), and post-tax contributions.

The company matches $0.50 for each $1.00 of the first 8% of eligible pay designated

for pre-tax, Roth 401(k), or after-tax contributions that you make to the plan,

helping you reach your savings goals faster. The match is performed on a per pay

period basis, therefore, the sooner you enroll in the Savings Plan, the sooner you will

begin earning the company match.

Pre-tax contributions are limited to the 2017 IRS Limit of $18,000. You are also

eligible to make Roth 401(k) contributions to the plan. The combined total of your

Roth 401(k) and pre-tax contributions is limited to the 2017 IRS Limit of $18,000.

Roth 401(k) contributions are made on a post-tax basis and grow tax-free. Please

note that once you reach the $18,000 Roth 401(k)/Pre-Tax limit, your contributions

will automatically convert to after-tax, so that you can continue receiving the

Company match.

If you’re age 50 or above (or will turn age 50 in the calendar year), you can also

make a catch-up contribution up to the 2017 IRS Limit of $6,000 of combined pre-

tax and Roth 401(k) catch-up contributions. These catch-up contributions are not

taken into account for purposes of the 2017 $54,000 IRS Limit and there is no

Company match on catch-up contributions.

You vest—or earn ownership of—company matching contributions immediately. You

are always 100% vested in your own contributions and their earnings.

You can borrow money from your account and pay yourself back with interest. You

may also be able to withdraw money if you are facing a financial hardship.

Employer Retirement Contribution Account

Whether or not you participate with your own contributions in the Savings Plan to

receive a Company matching contribution, the Company will automatically set up an

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Employer Retirement Contribution Account equal to 5% of your eligible pay each pay

period.

For this account, you vest—or earn ownership of—100% of the Employer Retirement

Contribution Account after 3 years of service with the Company.

Since these non-contributory Company contributions are meant to assist our

employees attain adequate retirement income, the Company has limited the types of

transactions allowed by employees for this account. For example, you cannot borrow

money from your Employer Retirement Contribution Account. Additionally, you

cannot withdraw money from this account if you are facing a financial hardship.

If you leave the company, you can take your vested balance with you and keep it

growing by rolling it over into an individual retirement account.

Should you wish to change your contributions, please call the SABIC Benefits Service

Center at 877-SABIC US and select Retirement.

You are automatically enrolled in the Savings Plan after 31 days, and you must elect to

waive this benefit if you do not desire to participate. Go to the SABIC Your Total Rewards

Website at www.benefits.sabic-ip.com, click on Retirement, then 401(k). The Website

provides information about the basics of saving and investing and in-depth information on

the plan’s investment funds.

You may also call 1-877-SABIC US (1-877-722-4287) and elect the application option for

Retirement, then follow the prompts to speak to a 401(k) Customer Service Representative.

Customer Service Representatives are available Monday through Friday, between 8 a.m.

and 8 p.m. Eastern Time, except Federal holidays.

Your Investment Choices

The company offers two investment portfolios: Core Funds (9 funds) and Lifecycle

Funds (7 funds). Additionally, a self-directed brokerage window account is also

available for the Savings Plan.

Lifecycle Funds

These portfolios are designed to make investing easy. They are set up for you to put 100%

of your contributions and savings in the professionally designed and monitored portfolio that

most closely matches your retirement age. Lifecycle Funds include:

AB Target Retirement 2010









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Core Funds The Core Funds let you create your own investment mix. Following are the available funds

from most conservative to the most aggressive:

Federated U.S. Treasury Cash Reserves Money Market Fund

BlackRock Inflation Protected Bond Fund

NT Aggregate Bond Index Fund

T. Rowe Price U.S. Value Equity Fund

NT S&P 500 Index Fund

Nuveen Winslow Large Cap Growth Fund

NT Extended Equity Market Index Fund

RS Small Cap Value Equity

Dodge & Cox International Stock Fund

Self-Directed Brokerage Window Account Through this account, you may invest in thousands of different mutual funds using the

money that is already in your Retirement Savings Plan. The self-directed brokerage window

feature is not appropriate for everyone. It is designed for plan participants who have a

strong knowledge of the investment marketplace, want greater flexibility to create a more

customized portfolio, and have the ability, time, and desire to personally research and

evaluate different investments. The self-directed brokerage window investment platform is

provided through Hewitt Financial Services, a broker-dealer subsidiary of Hewitt Associates

LLC and member FINRA/SIPC. The Savings Plan does not play any role in selecting or

limiting the mutual funds that Hewitt Financial Services makes available through the self-

directed brokerage window, and neither Hewitt Financial Services, SABIC nor the Savings

Plan endorses or recommends any particular investment offered through the window.

Should you need more information, please visit www.benefits.sabic-ip.com. You can also

access self-directed brokerage window account reference tools and materials by visiting the

Hewitt Financial Services website at www.hewittfs.com.

If you decide to open a self-directed brokerage account, you may then access it in two

ways:

The Internet—Access the Hewitt Financial Services website directly at www.hewittfs.com

from any computer with internet access.

The Telephone—The automated telephone system is available 24 hours a day. You can

also call 1.800.890.3200 to speak with a licensed representative 9:00 a.m. -7:00 p.m. EST

Monday through Friday.

Shortly after your hire date with the Company, you will receive a 401(k) enrollment kit, that

also includes a Self-Directed Brokerage Account brochure, from our 401(k) Administrator

with additional information on how to enroll in this benefit program. Should you wish to

enroll before receiving your 401(k) new hire guide, you can either go online at

www.benefits.sabic-ip.com and elect Retirement from the 401(k) (Your Savings Resources)

section, or you can call 1-877-SABIC US (1-877-722-4287), elect Retirement, and follow

the prompts to speak to a 401(k) Customer Service Representative. Please note that due to

file feed schedules, it may take up to 7 days for your information to be transmitted to the

various carriers.


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Other Benefits

SABIC provides a number of other benefits (at no cost to you) that add value to your life:

Adoption Assistance

Educational Assistance

Educational Loan Program

Layoff Benefits

Leaves of Absence

Service Award Program

Emergency Aid and Family Aid

Will Preparation Assistance

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Enroll Enroll for your 2017 benefits at the Your SABIC Total Rewards Website.

Remember, you are required to actively enroll. You must make active benefit elections

or you will receive default benefits.

Your SABIC Total Rewards Website You will enroll via the Your SABIC Total Rewards Website. The URL is

www.benefits.sabic-ip.com and the site is a one-stop shop for all of your pay and

benefits needs. In addition to having all benefits information in one location, only one

user ID and password is required. Once you are logged in, you will have a

personalized directory of all your benefits information, including Health and Insurance,

Retirement, Your Total Rewards, & more! Below is a screen shot of the first page to

get started as a new user.

Enroll via the Your SABIC Total Rewards Website

All employees must enroll via the Benefits Website at www.benefits.sabic-ip.com or

if you prefer, through a SABIC Benefits Service Representative at 1-877-SABIC-US

(1.877.722.4287). Usually you may enroll within 2 days of your new hire date.

It is easy to enroll via the Benefits Website:

1. Go to www.benefits.sabic-ip.com.

2. Look for the Register as a New User link on the left side of the page.

3. Then enter the last 4 digits of your SSN, DOB and zip code.

4. The screen after you enter the information above asks you to create a user ID

and a password.

First Time user Web Authorization steps:

5. After you create your password and hint, the next step is the security questions.

6. You will be asked to choose 5 security questions before you can access the site

(you must do all 5 questions). This is to protect your personal information.

http://www.benefits.sabic-ip.com/http://www.benefits.sabic-ip.com/http://www.benefits.sabic-ip.com/

36

7. When answering the security questions, please keep the answers simple. (NOTE: Do

not use special characters in your answers)

8. Last step is to register the computer you are using. Please select Yes. If you select not

to register the device, it will result in the user being challenged for additional

authentication on subsequent logon attempts.

9. After you register your computer, you will then see completed successful and can log

on to the site.

10. Once in the site, click on Health & Insurance to be directed to the Your

Benefits Resources website to complete your New Hire elections. There will be a

Red Message alert button and all you need to do is click “Enroll” to begin the

enrollment process.

11. You will first enter the information for any dependents you would like to cover –

keep in mind; you will need to submit the appropriate documentation before

they are covered in benefits.

12. You will now have access to all of your benefits options.

13. Be sure to click through each option, take advantage of the many calculators,

and plan comparison tools available to help you make the best choices for you

and your family.

14. Pay particular attention to medical, dental and vision—there are three medical

plans to consider; and employees who elect a medical plan will NOT

automatically receive dental and vision coverage. You must make a separate

election for both dental and vision.

15. Do not forget active enrollment is required—be sure to make a positive election

for each benefit plan you want.

16. Once you have completed your enrollment you will receive a confirmation that

you should print for your records.

17. If you chose to cover any dependents in your benefits, you will have to submit

qualifying documentation to be approved before they are covered. Information

will be mailed to your home on what documentation is required. However, you

can also print out the forms online by visiting the Home tab and clicking the

Your Action Needed. The Your Action Needed will be viewable; the next time

you visit the Your Benefit Resources Health and Welfare site.

Enroll via the Benefits Service Center If you prefer, you may also enroll via the SABIC Benefits Service Center by calling 1-877-SABIC-US

(1-877-722-4287). Usually you can enroll within 2 days of your new hire date.

If you are already registered or a current user of the www.benefits.sabic-ip.com

Website - all you do is use your current User ID and password.

If you have any issues with your user ID or password, please call the SABIC Benefits

Service Center, 1-877-SABIC-US (1-877-722-4287).

One User ID and Password The Your SABIC Total Rewards Website also gives you the option to change your User ID and

Password. This includes the flexibility of using your current SABIC single sign-on (single sign-on

User ID and Password synchronization will not be performed automatically since some employees

may choose not to use it). To change your User ID and Password, log into the Your SABIC Total

Rewards Website (www.benefits.sabic-ip.com) and click on the ‘Your Security Profile’ link.


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Questions If you have any questions, you may contact the SABIC Benefits Service Center at 1-877-SABIC US

(1-877-722-4287). Customer Service Representatives are available Monday through Friday,

between 8 a.m. and 8 p.m. Eastern Time, except Federal holidays.

On-Going Benefit Enrollment The 63-day enrollment period for new SABIC employees provides employees the opportunity to

make elections to all available benefits for the current year. Many benefits such as Medical, Dental

and Vision Coverage can only be elected or changed during the 63-day Enrollment Period or if you

experience a qualified change in family status. However, there are a number of benefits that can be

elected anytime during the year by accessing the Your SABIC Total Rewards Website

(www.benefits.sabic-ip.com) or by contacting the SABIC Benefits Service Center at 1-877-

SABIC-US (1-877-722-4287). These benefits include:

SABIC U.S. Employee Retirement Savings Plan

SABIC Roth 401(k) Plan

Long Term Care Insurance*

Long Term Disability Insurance*

A+ Enhanced Supplemental Life Insurance*

Dependent Life Insurance for your Child and Spouse*

Voluntary AD&D Insurance

*Medical evidence of insurability (MEOI) acceptable to the insurance carrier will be required. Coverage becomes effective on the date the insurance carrier approves the application. No MEOI is required for Child Dependent Life Insurance.

Other Benefits

Your SABIC Total Rewards (YSTR)

At SABIC, people are our priority. That is why our Company is committed to providing you with

competitive compensation and benefits. Our comprehensive programs help you manage your

health care, prepare for retirement, provide financial protection for your family and deal with

everyday life. This comprehensive program can be thought of as Your SABIC Total Rewards.

Your SABIC Total Rewards offers an individualized summary of the components of your

compensation and benefits to serve as an ongoing reference for you as you plan your current and

future needs.

Safe and Secure

The Your SABIC Total Rewards Website provides a high level of security. Your personal information

is protected by data encryption and a personal password that only you know.

Check it Out

Log on today to see and print your comprehensive personalized pay and benefits statement and

review the value of the investment that SABIC makes in you. You can access Your SABIC Total

Rewards 24 hours a day, 7 days a week, and 365 days a year via the Your SABIC Total Rewards

website at www.benefits.sabic-ip.com from any computer with Internet access.

For assistance with either your User ID or password, please contact the SABIC Benefits Service

Center by calling 1-877-SABIC US (1-877-722-4287) and electing Retirement, then following the

prompts to speak to a 401(k) Customer Service Representative.


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Appendix This section lists the rates that determine your cost for coverage for each plan that requires

contributions. When you log on to the Your SABIC Total Rewards Website

(www.benefits.sabic-ip.com), you will find personalized contribution amounts that reflect

factors specific to you such as your location (for some medical options), your income (for

medical contributions), your age (for life insurance), your employment status (full-time vs.

part-time), and your pay frequency. If you have any questions about your costs for coverage,

please call the SABIC Benefits Service Center at 1-877-SABIC US (1-877-722-4287).

2017 Health Care Contributions Full-Time Employees Your contributions for medical coverage, as well as for dental and vision coverage if you “buy

up” from the Basic plans depend on the plan you choose and the coverage category you

select. The coverage categories available to you are shown below:

Coverage

Categories Examples

One-Person Employee

Two-Person Employee plus spouse

Employee + 1 child

Three or More Employee plus spouse or Employee + spouse and children

Employee plus 2 or more children

In addition, your contributions depend on your pay and your access to other coverage through

a working spouse. On the following pages, the weekly contribution rates for each of the

medical plan options are shown. If you log onto the Your SABIC Total Rewards Website

www.benefits.sabic-ip.com, you will find only the specific rates for the options you are eligible

to choose. If your pay changes during the year, your contributions could change. The medical

plan contribution rates shown in the following charts are the starting point for calculating your

contributions:

2017 SABIC Health Care Preferred Contribution Rates

Your weekly payroll deductions are:

Annual Pay One-Person Coverage Two-Person Coverage Three or More Coverage

Up to $24,999 $26.43 $58.53 $75.72

$25,000–$37,499 $26.43 $58.53 $75.72

$37,500–$49,999 $32.93 $71.44 $94.07

$50,000–$74,999 $37.62 $80.07 $108.26

$75,000–$99,999 $42.65 $89.69 $

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