220001119 9 benefits guide - comanco...2 table of contents enrolling in your benefits 4 wellness...

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Table of Contents

Enrolling in Your Benefits 4

Wellness Credit 5

Medical 6

Health4Me Mobile App 7

Pharmacy Benefits 8

Dental 9

Vision 10

Basic Life/AD&D 11

Voluntary Life/AD&D 12

Short-Term Disability 13

Voluntary Accident 14

Voluntary Critical Illness 15

Employee Assistance Program 16

401k 17

BenefitsVIP® 18

Disclosures 19-20

COMANCOCOMANCOCOMANCOCOMANCO is pleased to introduce our employee medical, dental, and vision plan offerings, designed specifically to benefit you, effective March 1, 2019.

COMANCOCOMANCOCOMANCOCOMANCO strives to provide its employees with a comprehensive, valuable benefits program offering the flexibility to customize benefits to meet your needs both now and in the future. We continue to make every effort to target the best quality benefit plans for our staff and your families.

We are proud to announce that your medical rates will continue to remain the same, with no increase. We will also continue to offer our medical plan with the current medical carrier, United Healthcare. We will offer the UHC Choice medical plan with no changes to the plan. Details can be found on page 6.

Guardian will continue to be the dental carrier. Superior Vision will continue to be the vision carrier. Details can be found on pages 9-10.

Mutual of Omaha will continue to be the carrier on Basic Life/AD&D, Voluntary Life/AD&D, Short Term Disability, and Voluntary Accident coverage. Details can be found on pages 11-15.

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W E L C O M EW E L C O M EW E L C O M EW E L C O M E

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B E N E F I T S O V E R V I E WB E N E F I T S O V E R V I E WB E N E F I T S O V E R V I E WB E N E F I T S O V E R V I E W

We encourage you to take the time to review the benefit plans described in this guide and to choose the best options for you and your family.

If you have questions regarding any of the above benefits or the enrollment process, please contact your dedicated BenefitsVIP team at 866.293.9736 866.293.9736 866.293.9736 866.293.9736 or email [email protected]. [email protected]. [email protected]. [email protected].

Monday—Friday, 8:30am—8:00pm (EST).

Following is a brief description of each benefit being offered to COMANCOCOMANCOCOMANCOCOMANCO employees for the plan year March 1, 2019 March 1, 2019 March 1, 2019 March 1, 2019 ---- February 29, 2020. February 29, 2020. February 29, 2020. February 29, 2020.

Medical Medical Medical Medical Our medical coverage is offered through UnitedHealthcare. UnitedHealthcare. UnitedHealthcare. UnitedHealthcare.

Dental Dental Dental Dental Our dental coverage is offered through GuardianGuardianGuardianGuardian.

Vision Vision Vision Vision We offer a comprehensive vision plan through Superior Vision. Superior Vision. Superior Vision. Superior Vision.

Basic Life and AD&D Basic Life and AD&D Basic Life and AD&D Basic Life and AD&D We provide life insurance and accidental death & dismemberment coverage to all full time, benefit eligible employees in the amount $15,000. This coverage is provided by COMANCO COMANCO COMANCO COMANCO through Mutual of Omaha. Mutual of Omaha. Mutual of Omaha. Mutual of Omaha.

Voluntary Life Voluntary Life Voluntary Life Voluntary Life You will have the opportunity to purchase voluntary life coverage for yourself and your dependents. Coverage is offered through Mutual of Omaha. Mutual of Omaha. Mutual of Omaha. Mutual of Omaha.

Short Term Disability Short Term Disability Short Term Disability Short Term Disability Short term disability coverage is provided by COMANCOCOMANCOCOMANCOCOMANCO through Mutual of OmahaMutual of OmahaMutual of OmahaMutual of Omaha.

401(k) 401(k) 401(k) 401(k) COMANCOCOMANCOCOMANCOCOMANCO automatically enrolls you into the VOYA VOYA VOYA VOYA 401(k) retirement plan and provides matching funds.

Employee Assistance Program Employee Assistance Program Employee Assistance Program Employee Assistance Program Care24 Employee Assistance Program is available through UnitedHealthcareUnitedHealthcareUnitedHealthcareUnitedHealthcare.

Voluntary Critical Illness and Voluntary Accident Voluntary Critical Illness and Voluntary Accident Voluntary Critical Illness and Voluntary Accident Voluntary Critical Illness and Voluntary Accident Voluntary supplemental benefits are available for purchase through Mutual of OmahaMutual of OmahaMutual of OmahaMutual of Omaha.

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E N R O L L I N G I N Y O U R E N R O L L I N G I N Y O U R E N R O L L I N G I N Y O U R E N R O L L I N G I N Y O U R B E N E F I T SB E N E F I T SB E N E F I T SB E N E F I T S

COMANCO COMANCO COMANCO COMANCO utilizes the online website for benefits administration. Before you enroll, it is important that you review all benefit information to determine which plans will best fit the needs of you and your family. You will be required to list a beneficiary and their information, as well as dependent information, if you choose to cover dependents on any benefit plan. You will need the social security number and date of birth of all You will need the social security number and date of birth of all You will need the social security number and date of birth of all You will need the social security number and date of birth of all beneficiaries and dependents in order to enter them into the system to proceed through the enrollment process. beneficiaries and dependents in order to enter them into the system to proceed through the enrollment process. beneficiaries and dependents in order to enter them into the system to proceed through the enrollment process. beneficiaries and dependents in order to enter them into the system to proceed through the enrollment process. Please make sure you gather this information before beginning the process. If you do not have the information, the system will not allow you to make any elections.

LOG IN TO ENROLL Once you decide what benefits you would like to elect, and have gathered all beneficiary and dependent Information, log onto the enrollment website at www.benefitsolver.com www.benefitsolver.com www.benefitsolver.com www.benefitsolver.com or call 1111----877877877877----936936936936----3774. 3774. 3774. 3774. If you are a first time user, click on “Register” to set up your username, password and security questions. Our “Company Key” is benefits benefits benefits benefits (case sensitive).

Benefits Solver answers all Open Enrollment related questions, for benefit questions after Open Benefits Solver answers all Open Enrollment related questions, for benefit questions after Open Benefits Solver answers all Open Enrollment related questions, for benefit questions after Open Benefits Solver answers all Open Enrollment related questions, for benefit questions after Open Enrollment please contact BenefitsVIP for more information please review page 18.Enrollment please contact BenefitsVIP for more information please review page 18.Enrollment please contact BenefitsVIP for more information please review page 18.Enrollment please contact BenefitsVIP for more information please review page 18.

FORGOT YOUR PASSWORD? 1. Visit www.benefitsolver.com www.benefitsolver.com www.benefitsolver.com www.benefitsolver.com and click on the “Forgot your password” link.

2. Enter your Social Security number, company key and date of birth.

3. Answer your security phrase.

4. Enter and confirm your new password, then click “Continue” to return to this page and login

www.benefitsolver.com www.benefitsolver.com www.benefitsolver.com www.benefitsolver.com or call 877.936.3774877.936.3774877.936.3774877.936.3774

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W E L L N E S S C R E D I TW E L L N E S S C R E D I TW E L L N E S S C R E D I TW E L L N E S S C R E D I T

COMANCOCOMANCOCOMANCOCOMANCO employees who participate in our Medical Plan need to get their annual physical exam completed if they want to maintain their Wellness discount rate for their medical insurance in 2019. Annual Physical:Annual Physical:Annual Physical:Annual Physical: Many of our COMANCO COMANCO COMANCO COMANCO employees who participate in our Medical Plan still need to complete their physical exam. Please contact Human Resources, to verify that we have your completed physical form on file. If your spouse is on our medical plan, we need their completed 2019 Annual Physical Form as well to maintain your Wellness discount rate. Remember:Remember:Remember:Remember: We only require a completed Annual Physical form- please do not send us any results! If you have any questions or need help with finding a clinic or a Doctor, call United Healthcare 1-866-844-4864, visit www.myuhc.com or log into United Healthcare’s Health4Me appHealth4Me appHealth4Me appHealth4Me app (find details on page 7) on your mobile device.

FAQ’S I had my last physical in December 2018. Will I be charged for my 2019 physical if I go before December 2019 I had my last physical in December 2018. Will I be charged for my 2019 physical if I go before December 2019 I had my last physical in December 2018. Will I be charged for my 2019 physical if I go before December 2019 I had my last physical in December 2018. Will I be charged for my 2019 physical if I go before December 2019 as it has not been an entire year in between the two physicals?as it has not been an entire year in between the two physicals?as it has not been an entire year in between the two physicals?as it has not been an entire year in between the two physicals?

• No. You are eligible for ONEONEONEONE Annual Physical per calendar year under Preventative Care. Therefore, there is

no charge if you go to an in-network primary care physician’s office to complete your physical.

Will I need to get a blood test?Will I need to get a blood test?Will I need to get a blood test?Will I need to get a blood test?

• Yes, and you will review the results with your physician. This is preventative healthcare and why you maintain your eligibility for the Wellness Discount the following year.


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M E D I C A L B E N E F I T SM E D I C A L B E N E F I T SM E D I C A L B E N E F I T SM E D I C A L B E N E F I T S

UHC CHOICE PLAN

BENEFIT IN-NETWORK

Annual Deductible Individual: $1,500 Family: $3,000

Out-of-Pocket Maximum Individual: $5,000 Family: $10,000

Preventive Care Adult Preventive Care

Adult Annual Physical Exam Well-Child Care

100% 100% 100%

Outpatient Care Primary care physician office visits

Specialist office visits Outpatient facility surgery

$25 Copayment $35 Copayment

Deductible, then 20%

Outpatient Lab & X-Ray Initial visit, and all subsequent visits


Emergency Care Ambulance when medically necessary

At hospital emergency room Urgent Care


$250 Copayment $50 Copayment

Maternity Care Prenatal and Post-natal care

Hospital services for mother and child

$25 Copayment


Mental Health Inpatient

Outpatient


$25 Copayment

Prescription Drugs

Retail Pharmacy (31 day supply) Preferred Generic/Generic/Preferred Brand/ Non-Preferred Brand

Mail Order (90 day supply)

Preferred Generic/Generic/Preferred Brand/ Non-Preferred Brand

Tier 1: $10 Tier 2: $30 Tier 3: $50

Tier 4: $250 Deductible, then $125 Copay

$25/$75/$125/$250 Deductible, then $312.50 Copay

Weekly Contributions Employee Only

Employee + Spouse

Employee + Children

Employee + Family

Inpatient Hospital stay


Premium Rate* Value Rate

$90.00 $162.59

$84.92 $145.49

$165.00 $270.43

$20.00 $54.57

IMPORTANT

INFORMATION ABOUT

YOUR PLAN It is important to note that the UnitedHealthcare Choice medical plan offers ININININ----NETWORK BENEFITS NETWORK BENEFITS NETWORK BENEFITS NETWORK BENEFITS ONLYONLYONLYONLY. This means you MUST MUST MUST MUST Verify that your provider participates in United’s network beforebeforebeforebefore your visit, or you will not have coverage. Searching for Providers:Searching for Providers:Searching for Providers:Searching for Providers: You may search for in-network providers by accessing the website www.myuhc.comwww.myuhc.comwww.myuhc.comwww.myuhc.com

♦ Click on “Find a Physician, Laboratory or Facility” on the right

♦ Click on “All UnitedHealth Plans’

♦ Click on “Choice” ♦ Enter your zip code ♦ Click on “People”, then

choose either Primary Care or Specialty Care

♦ Choose the type of Physician

♦ Once you are enrolled in the plan, be sure to register on www.myuhc.com www.myuhc.com www.myuhc.com www.myuhc.com so you can receive personalized benefit information.

You may no longer use CVS You may no longer use CVS You may no longer use CVS You may no longer use CVS pharmacy pharmacy pharmacy pharmacy to fill your prescription. Walgreens is the preferred pharmacy. Please contact UHC to verify your local pharmacy is in-network.


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H E A LT H 4 M E M O B I L E A P PH E A LT H 4 M E M O B I L E A P PH E A LT H 4 M E M O B I L E A P PH E A LT H 4 M E M O B I L E A P P

HHHHOMEOMEOMEOME SSSSCREENCREENCREENCREEN • View or print health plan ID cards

• See account balances

• Get current coverage information

SSSSEARCHEARCHEARCHEARCH SSSSCREENCREENCREENCREEN • Locate physicians and facilities

• Learn about procedures and treatments

• Research available providers

• Review hospital quality and safety data

• Provides price and quality for over 875 medical services across nearly 600 health events

• Compare costs

CCCCLAIMSLAIMSLAIMSLAIMS • Find out how each claim was processed and paid

• Pay claims online

• Add notes on claims to watch

• Filter by claim type, family member or payment status and see claim details

MMMMEDICINEEDICINEEDICINEEDICINE CCCCABINETABINETABINETABINET • Keep track of the prescription drugs being taken, by subscribers and

dependents

• Makes it easier to order refills by mail

• Research lower cost pharmacy options

CCCCOVERAGEOVERAGEOVERAGEOVERAGE • See how much of the deductible has been met

• View the out-of-pocket maximum

• Information available for subscriber and dependents

HHHHEALTHEALTHEALTHEALTH CARECARECARECARE RESOURCESRESOURCESRESOURCESRESOURCES ININININ YOURYOURYOURYOUR HANDSHANDSHANDSHANDS Health4Me is designed to make managing healthcare a lot simpler. You can easily access your health plan ID card, benefit amounts, account balances and Personal Health Records. You can manage claims, estimate costs, search drug pricing and find nearby providers and quick care facilities anytime and anywhere. Health4Me allows you to personalize the interface, pay a doctor’s bill and even talk to someone at the push of a button if you have questions.


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P H A R M A C Y B E N E F I T SP H A R M A C Y B E N E F I T SP H A R M A C Y B E N E F I T SP H A R M A C Y B E N E F I T S

LEARN ABOUT YOUR PRESCRIPTION DRUG BENEFITS

What is the difference between brandWhat is the difference between brandWhat is the difference between brandWhat is the difference between brand----name and generic medications?name and generic medications?name and generic medications?name and generic medications? Generic medications contain the same active ingredients as brand medications, but they often cost less. Once the patent of a brand-named medication ends, the FDA can approve a generic version with the same active ingredients. Generic medications must meet the strict FDA brand medication standards for quality, strength and purity. Sometimes the same company that makes a brand-name medication also makes a generic version.

What if my doctor writes me a brandWhat if my doctor writes me a brandWhat if my doctor writes me a brandWhat if my doctor writes me a brand----name prescription?name prescription?name prescription?name prescription? The next time your doctor gives you a prescription for a brand-name medication, ask if a generic equivalent or lower-cost option is available and if it might be right for you. Generic medications are usually your lowest cost option, but not always.

What is a Prescription Drug List or PDL?What is a Prescription Drug List or PDL?What is a Prescription Drug List or PDL?What is a Prescription Drug List or PDL? A Prescription Drug List, or PDL, is a list that places commonly prescribed medications for certain conditions in to “tiers”. This list includes brand and generic prescription medications approved by the FDA.

What are the tiers and what do they mean?What are the tiers and what do they mean?What are the tiers and what do they mean?What are the tiers and what do they mean? Prescription medications are placed into tiers and each tier is assigned to a cost. Tier 1 is usually the lowest cost tier option.

Drug Tier What it means Cost

Tier 1Tier 1Tier 1Tier 1 Preferred GenericPreferred GenericPreferred GenericPreferred Generic—these are commonly prescribed generic drugs.

For most plans, you’ll pay around $1 to $3 for drugs in this tier.

Tier 2Tier 2Tier 2Tier 2 GenericGenericGenericGeneric————these are also generic drugs, but they cost a little more than drugs in Tier 1

For most plans, you’ll pay around $7 to $11 for drugs in this tier

Tier 3 Tier 3 Tier 3 Tier 3

Preferred brandPreferred brandPreferred brandPreferred brand—these are brand name drugs that don’t have a generic equivalent. They’re the lowest-cost brand name drugs on the drug list.

For most plans, you’ll pay around $38 to $42 for drugs in this tier.

Tier 4Tier 4Tier 4Tier 4 NonNonNonNon----preferred drugpreferred drugpreferred drugpreferred drug—these are higher priced brand name and generic drugs not in a preferred tier.

For most plans, you’ll pay around 45% to 50% of the drug cost in this tier.

SERVICES TO HELP YOU SAVE MailMailMailMail----order services: order services: order services: order services: For medications you take regularly, choosing home delivery can save money. Filling a three-month prescription through mail-order costs less than refilling your prescription monthly as a retail pharmacy. Specialty medications: Specialty medications: Specialty medications: Specialty medications: Specialty medications are high-cost and may be used to treat rare or complex conditions, and are managed through the Specialty Pharmacy Program. If you are taking a specialty medication, visit www.myuhc.com www.myuhc.com www.myuhc.com www.myuhc.com for personalized support and assistance in finding lower-cost options.

Medication pricing tool: Medication pricing tool: Medication pricing tool: Medication pricing tool: With myuhc.com you are able to search and compare prescriptions medication costs and see costs based on your specific plan. You can also find lower-cost alternative medications.


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D E N TA L B E N E F I T SD E N TA L B E N E F I T SD E N TA L B E N E F I T SD E N TA L B E N E F I T S

NEED HELP FINDING AN

IN-NETWORK PROVIDER?

Follow the steps below to locate a participating dental provider:

STEP 1: STEP 1: STEP 1: STEP 1: Go to www.guardiananytime.comwww.guardiananytime.comwww.guardiananytime.comwww.guardiananytime.com

STEP 2: STEP 2: STEP 2: STEP 2: Click on “Find a provider” on the top navigation bar

STEP 3: STEP 3: STEP 3: STEP 3: Click on “Search Providers”

STEP 4: STEP 4: STEP 4: STEP 4: Select “ Find a Dentist”

STEP 5: STEP 5: STEP 5: STEP 5: Select “PPO” plan

STEP 6: STEP 6: STEP 6: STEP 6: Enter search location (city, state or zip code)

If you have any additional questions, please call Guardian member services at 800.541.7846800.541.7846800.541.7846800.541.7846

DENTALGUARD PREFERRED

BENEFIT IN-NETWORK OUT-OF-NETWORK

Annual Deductible

Benefit Maximum Annual

$1,500

Diagnostic & Preventive Services Preventive Procedures which included, but

are not limited to: Periodic Oral Examinations X-Rays Frequency and limitations may apply

100%

No Deductible

100% of U&C No Deductible

Basic Services Procedures which included, but are not

limited to: Fillings; Extractions; Oral Surgery; Endodontics; Periodontics; Periodontal Surgery; Anesthesia; Consultations;

90%

after Deductible

80% of U&C

after Deductible

Major Services Procedures which included, but are not

limited to: Bridge and Dentures; Crowns, Inlays, Onlays

60%

after Deductible

50% of U&C

after Deductible


Employee + Spouse Employee + Children Employee + Family

$2.40 $8.10

$6.80 $14.20

Individual: $50 Family: $150

DENTAL COVERAGE The Guardian dental plan is designed to allow you to seek care from the dentist of your choice, but please remember that you will incur lower out-of–pocket costs if you utilize in-network providers because of negotiated discount rates. If you choose to use an out-of-network provider, your reimbursement will be based upon “Usual and Customary” (U&C) at the 90th percentile This means you will be responsible for your coinsurance AND any charges above 90% of the U&C rate for each service rendered.


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V I S I O N B E N E F I T SV I S I O N B E N E F I T SV I S I O N B E N E F I T SV I S I O N B E N E F I T S

VISION COVERAGE Properly caring for your eyesight is of the utmost importance. As part of keeping up with maintaining your overall health, routine eye exams should be scheduled on a regular basis. Without coverage, an exam and prescription glasses can cost $300 or more. With Superior Vision coverage the same exam and prescription glasses might only cost $25 - you’ll save!

SELECT PLUS 150 PLAN

BENEFIT IN-NETWORK OUT-OF-NETWORK

Eye Exam $10 copay $10 copay and reimbursed up to

$40

Hardware (Frames and Lenses) $15 copay $15 copay

Frequency Exam

Lenses Frames Contact Lenses

12 months 12 months

24 months 12 months

12 months 12 months

24 months 12 months

Frames $150 retail allowance Reimbursed up to $60

Lenses Single Vision Lenses

Bifocal Vision Lenses Trifocal Vision Lenses Lenticular Vision Lenses

Standard Progressive Lenses Photochromic Lenses

Covered in full Covered in full

Covered in full Covered in full

Additional $50 copay

Additional $60 copay

Reimbursed up to: $20 $40

$60 $100

Not covered

Not Covered

Medically Necessary Elective Contact Lenses

$250 retail allowance $150 retail allowance

Reimbursed up to $250 Reimbursed up to $80


Employee + Spouse Employee + Child(ren) Employee + Family

$1.56 $3.12

$3.31 $5.21

NEED HELP FINDING AN

IN-NETWORK PROVIDER?

Follow the steps below to locate a provider participating with Superior Vision:

Step 1: Step 1: Step 1: Step 1: Go to www.superiorvision.com www.superiorvision.com www.superiorvision.com www.superiorvision.com

Step 2: Step 2: Step 2: Step 2: Click on “Find an eye care professional” on the top left of the home screen

Step 3: Step 3: Step 3: Step 3: Choose your location

Step 4: Step 4: Step 4: Step 4: Choose your coverage type “through your employer”

Step 5: Step 5: Step 5: Step 5: Select Superior National as the network

Step 6: Step 6: Step 6: Step 6: Select the distance then hit search

If you have additional questions, please call Benefits VIP at 866.293.9736866.293.9736866.293.9736866.293.9736


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B A S I C L I F E / A D & DB A S I C L I F E / A D & DB A S I C L I F E / A D & DB A S I C L I F E / A D & D

EMPLOYER PAID LIFE AND AD&D COMANCO provides all full-time, benefit eligible employees with Basic Life/AD&D coverage through Mutual of Omaha.

Coverage amount: $15,000Coverage amount: $15,000Coverage amount: $15,000Coverage amount: $15,000 ♦ Age ReductionAge ReductionAge ReductionAge Reduction: Basic Life/AD&D benefits are reduced to 65% at age

70, and to 45% at age 75. ♦ Accelerated Death BenefitAccelerated Death BenefitAccelerated Death BenefitAccelerated Death Benefit: 75% of $15,000, not to exceed $11,250.

If you are diagnosed with a terminal illness, and your life expectancy is less than 12 months you can receive a portion of your life benefit. The remaining balance will then be paid to your beneficiaries upon your passing.

VALUE ADDED

SERVICES: Travel AssistanceTravel AssistanceTravel AssistanceTravel Assistance: This program is an added benefit that provides assistance for your travels over 100 miles away from home or outside the country. Will PrepWill PrepWill PrepWill Prep: Mutual of Omaha partners with Willing® to offer employees an online will prep tool. In just a few clicks you can complete a customized plan to protect your family and property. To get started visit www.willing.com/www.willing.com/www.willing.com/www.willing.com/MutualofOmahaMutualofOmahaMutualofOmahaMutualofOmaha Hearing Discount Program: Hearing Discount Program: Hearing Discount Program: Hearing Discount Program: This program provides you and your family discounted hearing products, including hearing aids and batteries. Call 888.534.1747 888.534.1747 888.534.1747 888.534.1747 or visit www.amplifonusa.com/www.amplifonusa.com/www.amplifonusa.com/www.amplifonusa.com/mutualofomahamutualofomahamutualofomahamutualofomaha

Make Sure to Update Your Beneficiary Information NOW!!

A beneficiary is the person or entity you name in a life insurance policy to receive the death benefit.

You can name: ♦ One person ♦ Two or more people ♦ The trustee of a trust you’ve set up ♦ Your estate

If you don’t name a beneficiary, the death benefit will be paid to your estate.

Two “levels” of beneficiaries:

Your Life Insurance policy should have both “primary” and “contingent” beneficiaries. The primary beneficiary receives the death benefit upon your passing, if they are found. Contingent beneficiaries receive the death benefit if the primary beneficiary can’t be found. If no primary or contingent beneficiaries can be found, the death benefit will be paid to your estate.

As part of naming beneficiaries, you should identify them as clearly as possible and include their Social Security numbers. This will make it easier for the Life Insurance company to find them, and it will make it less likely that disputes will arise regarding the death benefits.


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V O L U N TA R Y L I F E / A D & DV O L U N TA R Y L I F E / A D & DV O L U N TA R Y L I F E / A D & DV O L U N TA R Y L I F E / A D & D

VOLUNTARY LIFE AND AD&D In addition to the Basic Life/AD&D insurance, employees have the option to elect voluntary coverage through Mutual of Omaha.

Minimum Guarantee Issue Maximum

For You $10,000 7 times annual salary, up to

$100,000 7 times annual salary, up to

$500,000

Spouse $5,000 100% of employees benefit,

up to $30,000 100% of employees benefit,

up to $100,000

Children $10,000 $10,000 10,000

COVERAGE GUIDELINES

If you are newly eligible newly eligible newly eligible newly eligible you may elect 7 times your annual salary up to $100,000 for yourself and 100% of your elected amount up to $30,000 for your spouse without medical underwriting. Any elections over these amounts will require an Evidence of Insurability (EOI) form to be completed.

At Annual Enrollment:

If you previously waived this coverage and now wish to enroll, you and/or your spouse if electing coverage must complete an Evidence of Insurability form. If you are currently enrolled and your coverage amount is less than the guarantee issue limit, you may increase your amount by one $10,000 without completing an EOI. Any request for an increase over the guarantee issue limit will require an EOI to be completed. Any increases on spousal insurance will require an EOI.

Things to remember: ♦ Your spouse’s rate is

based on your age ♦ You pay just one

payroll deduction for child coverage, no matter how many children you are covering

♦ Benefits reduce to 65% at age 70, and to 45% at age 75

♦ Coverage is available for child(ren) 14 days to 26 years

♦ You must enroll in coverage in order to elect coverage for your dependents

♦ Spouse coverage terminates when the employee attains age 70

♦ Payroll deductions may vary due to rounding

13

S H O R TS H O R TS H O R TS H O R T---- T E R M D I S A B I L I TT E R M D I S A B I L I TT E R M D I S A B I L I TT E R M D I S A B I L I T YYYY

SHORT-TERM DISABILITY COMANCOCOMANCOCOMANCOCOMANCO provides all benefit eligible employees with Short-Term Disability coverage, at no cost to you. This coverage is designed to replace a portion of your income should you become unable to work due to a non-work related injury or sickness. A brief summary of the plan is outlined in the following chart. Please refer to your Mutual of Omaha summary for additional details, including limitations and exclusions. NOTE: NOTE: NOTE: NOTE: CA, NY, NJ and RI residents have State mandated STD rates.

Income BenefitIncome BenefitIncome BenefitIncome Benefit 40% of your weekly income to a maximum of $250

Elimination PeriodElimination PeriodElimination PeriodElimination Period Benefits begin on the 8th day of a non-work related accident or illness

Benefit durationBenefit durationBenefit durationBenefit duration You may receive benefits for up to 13 weeks if you continue to be disabled and unable to work

Short-Term Disability

BUY-UP OPTION You may purchase increased Short-Term Disability coverage through Mutual of Omaha as follows:

Income Benefit 60% of your weekly income to a maximum of $1,000

Elimination Period Benefits begin on the 8th day of a non-work related accident or illness

Benefit duration You may receive benefits for up to 13 weeks if you continue to be disabled and unable to work

Short-Term Disability Buy-Up Option

Pre-Existing Condition Exclusion The pre-existing condition under this plan is 3/12 which means any condition that you receive medial attention for in the 3 months prior to your effective date of coverage that results in a disability during

the first 12 months of coverage, would not be covered.

Rate $0.17 per $10 of Weekly Benefit

HOW TO CALCULATE YOUR BUY-UP SHORT-TERM DISABILITY:

Employee earns $500 per week

$500 x 60% = $300 weekly benefit

$300 / $10 (of weekly benefit) = $30

$30 x $.17 = $5.10 monthly or $1.18 per paycheck (52 pay periods)


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V O L U N TA R Y A C C I D E N TV O L U N TA R Y A C C I D E N TV O L U N TA R Y A C C I D E N TV O L U N TA R Y A C C I D E N T

VOLUNTARY ACCIDENT COMANCOCOMANCOCOMANCOCOMANCO provides the option to purchase Accident coverage through Mutual of Omaha to all full-time benefit eligible employees. This insurance offers financial protection by paying a cash benefit if you or your insured dependent are injured as a result of a covered accident. Unless otherwise stated, the benefit amount payable is the same for you and your insured dependent(s). A brief summary of the plan is outlined in the chart below. Accident benefits pay in addition to other insurance, and can be used to help cover gaps in health insurance or other expenses if the unexpected happens.

Plan Information Information/Amounts

Coverage TypeCoverage TypeCoverage TypeCoverage Type 24-hour (On and off-job)

Express BenefitExpress BenefitExpress BenefitExpress Benefit $100

PortabilityPortabilityPortabilityPortability Included

Benefits Amounts

Initial Care & Emergency - Most treatment / service required within 72 hours of accident; Once per accident per insured person

Emergency Room $200

Urgent Care Center $125

Initial Physician Office Visit $100

Ambulance Up to $1,500

Specified Injuries

Fractures (Surgical / Non-surgical) Up to $5,000/Up to $2,500

Dislocations (Surgical / Non-surgical) Up to $6,000/Up to $3,000

Lacerations Up to $600

Burns Up to $10,000

Dental Up to $200

Hospital, Surgical & Diagnostic

Admission $1,500

Daily Confinement (Up to 365 days per accident) $300 per day

ICU Confinement (Up to 15 days per accident) $600 per day

Physician Follow-Up Visit $75; Up to 2 per accident

Therapy Services $50; Up to 6 per accident

Follow-Up Care—Treatment / service required within 365 days of accident

COVERAGE TIER

PREMIUM AMOUNT

Employee $3.92 ($0.56 per day)

Employee +

Spouse $5.31 ($0.76 per day)

Employee +

Child(ren $6.46 ($0.92 per day)

Employee +

Family $8.31 ($1.18 per day)


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V O L U N TA R Y C R I T I C A L IV O L U N TA R Y C R I T I C A L IV O L U N TA R Y C R I T I C A L IV O L U N TA R Y C R I T I C A L I L L N E S SL L N E S SL L N E S SL L N E S S

VOLUNTARY CRITICAL ILLNESS COMANCOCOMANCOCOMANCOCOMANCO provides the option to purchase Critical Illness coverage through Mutual of Omaha to all full-time benefit eligible employees. This insurance offers financial protection by paying a cash benefit if you or your insured dependent are diagnosed with a covered illness. The chart below is a short summary of benefits. Please refer to the Mutual of Omaha contract for more details.

Benefit Category Condition Percent of CI Principal Sum

Heart/Circulatory Heart Attack, Heart Transplant, Stroke 100%

Heart Valve Surgery, Coronary Artery Bypass, Aortic Surgery

25%

Major Organ Transplant/Placement on UNOS List, End-Stage Renal Failure

100%

Acute Respiratory Distress Syndrome (ARDS) 25%

Cancer Cancer (Invasive) 100%

Bone Marrow Transplant 50%

Carcinoma In Situ, Benign Brain Tumor 25%

Organ

Age $10,000 $20,000

0-29 $.92 $1.85

VOLUNTARY CRITICAL ILLNESS EMPLOYEE OR

SPOUSE WEEKLY PREMIUM RATES

30-39 $1.85 $3.69

40-49 $4.62 $9.23

50-59 $8.08 $16.15

60-69 $16.15 $32.30

70+ $32.30 $64.62

Coverage Guidelines

Minimum Guarantee Issue Maximum

For You Elect in $10,000 increments

$10,000 $20,000 $20,000

Spouse Elect in $10,000 increments $10,000 $20,000

100% of employees Principal Sum, up to $20,000

Child(ren) *benefit for each child N/A $5,000

25% of employee’s Principal CI Sum, up to $5,000

The pre-existing condition under this plan is 12/12 which means any condition that you receive Medical Attention for in the 12 months prior to your effective date of coverage that results in a disability during the first 12 months of coverage, would not be covered.


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E M P L O Y E E A S S I S TA N C E E M P L O Y E E A S S I S TA N C E E M P L O Y E E A S S I S TA N C E E M P L O Y E E A S S I S TA N C E P R O G R A MP R O G R A MP R O G R A MP R O G R A M

UNITED HEALTHCARE EMPLOYEE ASSISTANCE PROGRAM—CARE24 Care24 Employee Assistance Program can help you with health concerns, personal or family issues or work-related challenges. It gives you access to a wide range of health and well-being information.

♦ Care24 allows you to speak directly with an experienced registered nurse or master’s-level specialist at any time.

♦ Call the Care24 toll-free number whenever you have health-related questions. Registered nurses can help you with questions about health conditions or symptoms and provide information that can help you choose the appropriate care.

♦ The Care24 specialists can help you address a wide range of personal concerns such as emotional distress, relationship worries, anxiety, grief and more. When you call, you can also connect with legal and financial professionals.

♦ Care24 can help you find a doctor in your area or provide health coaching or emotional support.

CONTACT CARE24

Available 24 hours per day / 7 days Available 24 hours per day / 7 days Available 24 hours per day / 7 days Available 24 hours per day / 7 days a weeka weeka weeka week

www.myuhc.comwww.myuhc.comwww.myuhc.comwww.myuhc.com

1111----888888888888----887887887887----4114411441144114


17

4 0 1 ( K )4 0 1 ( K )4 0 1 ( K )4 0 1 ( K )

VOYA 401(K) RETIREMENT PLAN COMANCO COMANCO COMANCO COMANCO offers an automatic enrollment feature and Company match to employees under the COMANCO COMANCO COMANCO COMANCO 401(k) Plan. All new employees, 18 years of age and over, will be automatically enrolled in the 401(k) plan on the first quarter that follows six months of service. COMANCO COMANCO COMANCO COMANCO matches employee contributions at 50% up to 6% of the employee contribution, and 15% for employee contributions over 6%. You may choose to contribute any amount from your weekly salary, and your taxable income will be reduced by that amount through a salary deferral. Your total salary deferral for 2019 may not be more than $18,000. Employees aged 50 and over who have met the plan limit for deferrals may contribute an additional $6,000 as a catch-up contribution. Please see Human Resources Human Resources Human Resources Human Resources if you would like to contribute a catch-up deferral, Your maximum deferral percentage and/or dollar amount may also be limited by IRS regulations. You may increase or decrease your salary deferral amount or stop making contributions at any time by calling Voya at 1111----800800800800----584584584584----6001600160016001. Your contributions to the plan are fully vested. Once you complete six years of service you will be fully vested in the matching contributions made by COMANCOCOMANCOCOMANCOCOMANCO. Fully vested means that the contributions, along with any investment gain or loss, belongs to you and you will not lose them should you leave employment with COMANCOCOMANCOCOMANCOCOMANCO. You decide where to invest your contributions and the company’s matching contributions in the plan’s professionally managed investment funds. Investment elections can be changed at any time by accessing your online account at www.voyaretirementplans.com www.voyaretirementplans.com www.voyaretirementplans.com www.voyaretirementplans.com or by calling Customer Service at 1111----800800800800----584584584584----6001600160016001.


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HELP STARTS HERE

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19

SPECIAL ENROLLMENT RIGHTS (HIPAA) If you have previously declined enrollment for yourself or your dependents (including your spouse)

because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment within 30 days after your

other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll

yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.

NO GUARANTEE ON TAX CONSEQUENCES Neither the Administrator nor the

Company makes any commitment or guarantee that any amounts paid to or for the benefit of an Employee under any Plan will be excludable from the

Employee’s gross income for federal or state income tax purposes, or that any other federal or state tax treatment will apply to or be available to any Employee. An Employee shall indemnify

and reimburse the Company for any liability it may incur for failure to withhold federal or state income tax or social security tax from such payments

or reimbursements.

NEWBORNS & MOTHERS HEALTH PROTECTION ACT Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with

childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery or less than 96 hours following a cesarean section.

However, federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother

or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer

for prescribing a length of stay not in excess of 48 hours (or 96 hours).

MICHELLE’S LAW Michelle’s Law permits seriously ill or injured college students to continue

coverage under a group health plan when they must leave school on a full-time basis due to their injury or illness and would otherwise lose coverage.

The continuation of coverage applies to a dependent child’s leave of absence from (or other change in enrollment) a postsecondary educational institution

(college or university) because of a serious illness or injury, while covered under a health plan. This would otherwise cause the child to lose

dependent status under the terms of the plan. Coverage will be continued until: 1. One year from the start of the

medically necessary leave of absence, or

2. The date on which the coverage would otherwise terminate under the

terms of the health plan; whichever is earlier.

EMPLOYEE RETIREMENT INCOME SECURITY ACT (ERISA) Federal law imposes certain requirements on employee benefit plans

voluntarily established and maintained by employers. [29 USC §1001 et seq.; 29 CFR 2509 et. seq.] ERISA covers two (2) general types of plans: retirement plans, and welfare benefit plans designed to

provide health benefits, scholarship funds, and other employee benefits. As a participant, you are entitled to certain rights & protections under ERISA.

• Examine, without charge, at the

office of the Administrator and at other specified locations, such as worksites, all Plan documents and

copies of all documents filed by the Plan with the US Department of Labor, such as detailed annual reports and Plan descriptions.

• Obtain copies of all Plan documents and other Plan information upon written request to the Administrator.

The Administrator may make a reasonable charge for the copies.

• Receive a summary of the Plan’s annual financial report. The Administrator is required by law to furnish each participant with a copy

of this Summary Annual Report. • Obtain a statement telling you

whether you have a right to receive a benefit at normal retirement age and, if so, what your benefit would be at

normal retirement age if you stopped working under the Plan now. If you do not have a right to a benefit, the statement will tell you how many

more years you have to work to get a right to a benefit. This statement must be requested in writing, and no one is required to give such a statement more than once a year.

The Administrator must provide the statement free of charge.

In addition to creating rights for Plan

participants, ERISA imposes duties upon the people who are responsible for the operation of the Plan. The people who operate your Plan, called “fiduciaries” of the Plan, have a duty to run the Plan

prudently and in the interest of you and other Plan participants and beneficiaries. No one, including your employer or any other person, may fire

your or otherwise discriminate against you in any way to prevent you from obtaining a benefit or exercising your rights under ERISA. If your claim for a benefit is denied in whole or in part, you

must receive a written explanation of the reason for the denial. You have the right to have the Plan review and reconsider your claim. Under ERISA,

there are steps you may take to enforce your rights. For instance, if you request materials from the Plan and do not receive them within 30 days, you may file suit in a federal court. In such a

case, the court may require the Administrator to provide the materials and pay you up to $100 a day until you receive the materials, unless the

materials were not sent because of reasons beyond the control of the Administrator. If you have a claim for benefits which is denied or ignored, in whole or in part, you may file suit in a

state or federal court. If it should

happen that Plan fiduciaries misuse the Plan’s money, or if you are discriminated

against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will

decide who should pay court costs and legal fees. If you win the suit, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs

and fees – for example, if it finds that your claim is frivolous. If you have any questions about the

Plan, you should contact the plan administrator at your Human Resources Department. If you have any questions about this statement or about your rights under ERISA, you should contact

the nearest office of the Pension and Welfare Benefits Administration, U.S. Department of labor, listed in your telephone directory or the Division of

Technical Assistance and Inquiries, Pension and Welfare Benefits Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

MEDICARE PART D NOTICE OF CREDITABLE COVERAGE Written notice stating whether or not the expected amount of paid claims under a group health plan’s prescription drug coverage is at least as much as the expected amount of paid claims under

the standard drug benefit under Medicare Part D. Must be sent to participants and beneficiaries eligible for Medicare Part D.

The notice must be provided by (1) October 15th each year; (2) prior to an individual’s individual enrollment period for Part D; (3) prior to the effective date

of coverage for any Part D eligible individual who enrolls in the employer’s prescription drug coverage; (4) when the plan no longer provides drug coverage

or when the coverage is no longer creditable; and (5) upon request.

JANET’S LAW WOMEN’S HEALTH AND CANCER RIGHT’S ACT OF 1998 On October 21, 1998, Congress enacted the Women’s Health and Cancer Rights

D I S C L O S U R E SD I S C L O S U R E SD I S C L O S U R E SD I S C L O S U R E S


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Act of 1998. As required by this law, annual notice of the mandated post-

mastectomy benefits must be provided to all covered persons. Please review this information carefully. If your spouse is covered under a health plan

sponsored by your employer, please make certain that she or he also has the opportunity to review this information. The Women’s Health and Cancer Rights

Act of 1998 requires that all group health plans that provide medical and surgical benefits for a mastectomy also must provide coverage for:

• Reconstruction of the breast on

which the mastectomy has been performed;

• Surgery and reconstruction of the

other breast to produce a symmetrical appearance; and

• Prostheses and coverage for any complications in all stages of

mastectomy, including lymphedemas.

The Act requires that coverage be provided in a manner that is consistent

with other benefits provided under the plan. The coverage may be subject to annual deductibles and coinsurance provisions.

The Act prohibits any group health plan from: • Denying a participant or a beneficiary

eligibility to enroll or renew coverage under the plan in order to avoid the requirements of the Act;

• Penalizing, reducing, or limiting

reimbursement to the attending provider (e.g., physician, clinic or hospital) to induce the provider to provide care consistent with the Act; and Providing monetary

CHILDREN'S HEALTH INSURANCE PROGRAM REAUTHORIZATION ACT (CHIPRA) Effective April 1, 2009 employees and dependents who are eligible for

coverage, but who have not enrolled, have the right to elect coverage during the plan year under two circumstances:

• The employee’s or dependent’s state Medicaid or CHIP (Children's Health

Insurance Program) coverage terminates because the individual cease to be eligible.

• The employee or dependent

becomes eligible for a CHIP premium assistance subsidy under state Medicaid or CHIP (Children's Health Insurance Program).

Employees must request this special enrollment within 60 days of the loss of coverage and/or within 60 days of when eligibility is determined for the premium

subsidy.

MENTAL HEALTH PARITY AND ADDICTION EQUITY ACT OF 2008 This act expands the mental health parity requirements in the Employee Retirement Income Security Act, the

Internal Revenue Code and the Public Health Services Act by imposing new mandates on group health plans that provide both medical and surgical benefits and mental health or substance

abuse disorder benefits. Among the new requirements, such plans (or the health insurance coverage offered in connection with such plans) must

ensure that: the financial requirements applicable to mental health or substance abuse disorder benefits are no more restrictive than the predominant financial requirements

applied to substantially all medical and surgical benefits covered by the plan (or coverage), and there are no separate cost sharing requirements that are applicable only with respect to mental

health or substance abuse disorder benefits.

CONSOLIDATED OMNIBUS BUDGET RECONCILIATION ACT (COBRA) The Consolidated Omnibus Budget

Reconciliation Act of 1985 (COBRA) requires employers who provide medical coverage to their employees to offer such coverage to employees and

covered family members on a temporary basis when there has been a change in circumstances that would otherwise result in a loss of such coverage [26 USC §4980B ] This benefit, known as

“continuation coverage,” applies if, for example, dependent children become

independent, spouses get divorced, or employees leave the employer.

HIPAA INFORMATION NOTICE OF PRIVACY PRACTICES In compliance with the Health Insurance Portability and Accountability Act of

1996 (HIPAA), your employer recognizes your right to privacy in matters related to the disclosure of health related information. The Notice of privacy

Practices (provided to you upon your enrollment in the health plan) details the steps your employer has taken to assure your privacy is protected. The Notice also explains your rights under HIPAA. A

copy of this Notice is available to you at any time, free of charge, by request through your local Human Resources Department.

QUALIFIED MEDICAL CHILD SUPPORT ORDER (QMCSO) is a medical child support order issued

under State law that creates or recognizes the existence of an “alternate recipient’s” right to receive benefits for which a participant or

beneficiary is eligible under a group health plan. An “alternate recipient” is any child of a participant (including a child adopted by or placed for adoption with a participant in a group health plan)

who is recognized under a medical child support order as having a right to enrollment under a group health plan with respect to such participant. Upon

receipt, the administrator of a group health plan is required to determine, within a reasonable period of time, whether a medical child support order is qualified. In the event you are served

with a notice to provide medical coverage for a dependent child as the result of a legal determination, you may obtain information from your employer

on the rules for seeking to enact such coverage. These rules are provided at no cost to you and may be requested from your employer at any time.

COVERAGE EXTENSION RIGHTS UNDER THE UNIFORMED SERVICES EMPLOYMENT AND REEMPLOYMENT RIGHTS ACT (USERRA) If you leave your job to perform military service, you have the right to elect to continue your existing employer-based

health plan coverage for you and your dependents (including spouse) for up to 24 months while in the military. Even if you do not elect to continue coverage

during your military service, you have the right to be reinstated in your employer’s health plan when you are reemployed, generally without any waiting periods or exclusions for

preexisting conditions except for service-connected injuries or illnesses.

CAN CHILDREN STAY ON A PARENT’S PLAN UNTIL AGE 26? If a plan covers children, they can be added or kept on the health insurance

policy until they turn 26 years old. Children can join or remain on a plan even if they are: • married

• not living with their parents • attending school • not financially dependent on their

parents

• eligible to enroll in their employer’s plan

HOW TO GET COVERAGE FOR ADULT CHILDREN Adult child may be enrolled during a plan’s open enrollment period or during other special enrollment opportunities.

The employer or insurance company can provide details. Under-26-year-olds can be signed up directly in new Marketplace plans. Be

sure to include him or her on the list of people to be covered. Questions? Call 1-800-318-2596, 24

hours a day, 7 days a week. (TTY: 1-855-889-4325)

D I S C L O S U R E SD I S C L O S U R E SD I S C L O S U R E SD I S C L O S U R E S


This benefit summary provides selected highlights of the employee benefits program available. It is not a legal document and shall not be

construed as a guarantee of benefits nor of continued employment. All benefit plans are governed by master policies, contracts and plan documents. Any discrepancies between any information provided through this summary and the actual terms of such policies, contracts and plan documents shall be governed by the terms of such policies, contracts and plan documents. Our company reserves the right to amend, suspend or terminate any benefit plan, in whole or in part, at any time. The authority to make such changes rests with the Plan Administrator.

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