table of contents - weeblyenovabenefits.weebly.com/uploads/2/4/0/5/24059052/enova...2014/10/22 ·...

Table of Contents contact information 1

the Enova benefits and payroll contact center 1 the Enova benefits department 1 benefit carrier contacts 2

i.d. cards 3

timeline summary of benefits eligibility for new hires 4

eligibility for benefits 4

effective date of benefits 5

life events 5

irc section 125 6

taxation and payment of benefits 7 pre-tax deductions 7 post-tax deductions 7

medical coverage (Provided by CIGNA) 8 health reimbursement account (hra) faqs 11 MDLive 12

dental coverage (Provided by CIGNA) 13

vision coverage (Provided by VSP) 14

commuter and parking tax savings benefit 15

flexible spending accounts 16 health care flexible spending account 16 dependent care flexible spending account 17

basic life and accidental death & dismemberment insurance 19

supplemental life and accidental death & dismemberment insurance 20

spouse/domestic partner & child supplemental life insurance 20

disability coverage 21 basic short-term & basic long-term disability 21 buy-up short-term disability 21 buy-up long-term disability 21

evidence of insurability (eoi) 22

pre-paid legal 23

associate assistance program 23

pet insurance (Provided by VPI) 24

no cost benefits 25 emergency travel assistance (no cost) provided by Assist America® 25 will preparation (no cost) provided by SunLife 25 identity theft protection (no cost) provided by SecurAssist® 26

legal notices 27 medicare part d notice 27 notice of privacy practices 30 whcra enrollment notice 37 availability of summary of benefits and coverage 37 special enrollment notice 38 newborns’ act disclosure 39 medicaid and the children’s health insurance program (chip) 40 preexisting conditions removed effective 2014 (ACA compliance) 43

IMPORTANT NOTICE This newsletter contains highlights of the Enova International, Inc. Welfare Benefit Plan and the Enova International, Inc. 401(k) Savings Plan (collectively the “Plan”). Although every attempt has been made to ensure this overview accurately reflects the Plan, the information in this summary does not supersede the actual provisions of the Plan or the policies or contracts related to the Plan. If there are discrepancies in this summary, your benefit will be determined in accordance with the Plan documents. Please refer to your Summary Plan Descriptions for additional benefits information. The Company may amend or terminate the benefits under the Plan at any time. For a copy of the appropriate Summary Plan Description or Plan Policy Documents, please refer to the Forms and Documents section of the Ceridian Self-Service Knowledge Base. Participation in the Plan is not an offer or guarantee of employment or an employment contract. Receipt of this communication should not be considered to mean that you are a participant or eligible to participate in the Plan or benefit programs described in this summary document if you do not otherwise meet the eligibility requirements set forth in the documents which govern the Plan.

2015 ENOVA BENEFITS SUMMARY GUIDE 1

contact information You always have two points of contact when you have questions about benefits or the online benefits enrollment system. Please refer to the contact information listed below when you have questions regarding your benefits.

the Enova benefits and payroll contact center

Phone: 855-246-4111 (7am – 7pm Central Time, Monday-Friday) Email: [email protected] Fax: 727-865-3120 Contact the Enova Benefits and Payroll Contact Center when you: Have questions about the on-line enrollment system, Have username or password issues with the Ceridian Self-Service website, Need to initiate a benefit-related Life Event, Have a question about your payroll deductions as they relate to your benefits, Need additional high-level information on the Enova Benefit Plans.

Refer to the Ceridian Self-Service Knowledge Base to get answers to most of your benefit and enrollment questions.

the Enova benefits department Phone: 312-564-7BEN (312-564-7236) Email: [email protected]

Contact the Enova Benefits Department when you: Have questions about specific plans or coverages, Have questions about Leave of Absence, Need to confirm eligibility or need temporary medical ID cards

mailto:[email protected]


https://sourceselfservice2.ceridian.com/_select.sso??SelectAccessData=true


benefit carrier contacts

MEDICAL CIGNA (Open Access Plus Network) Group# 3335418 Phone: 800-CIGNA24 (800-244-6224) / Web: www.myCIGNA.com

MDLive Phone: 888-726-3171 / Web: www.mdlive.com/enova

DENTAL CIGNA (Radius Network) Group# 3335418 Phone: 800-CIGNA24 (800-244-6224) / Web: www.myCIGNA.com

VISION VSP (Signature Network) Group# 30030608 Phone: 800-877-7195 / Web: www.vsp.com

FSA’s – HEALTH CARE AND DEPENDENT CARE WageWorks Group# 26524 Phone: 877-WageWorks (877-924-3967) Web: www.wageworks.com

PRE-PAID LEGAL Legal Shield Group# 151461 Phone: 800-654-7757 / Web: www.legalshield.com

COMMUTER/PARKING PRE-TAX BENEFIT WageWorks Phone: 877-WageWorks (877-924-3967) Web: www.wageworks.com

LIFE INSURANCE, AD&D INSURANCE, DISABILITY INSURANCE Sun Life Life Insurance Group#231850, Accident Group#231850 Short Term Disability Group#231850, Long Term Disability Group#231850 Phone: 800-247-6875 Web: http://sunlife-usa.com/planmembers/

REPORTING A LEAVE OF ABSENCE, DISABILITY OR FMLA CLAIM Sun Life Group# 231850 Phone: 877-SUN-FMLA (877-786-3652) Web: https://fmla.sunlife-usa.com/

Associate Assistance Program (AAP) Phone: 877-595-5284 / Web: www.guidanceresources.com

http://www.mycigna.com/

http://www.mdlive.com/enova


http://www.vsp.com/

http://www.wageworks.com/

http://www.legalshield.com/


http://sunlife-usa.com/planmembers/

https://fmla.sunlife-usa.com/

http://www.guidanceresources.com/


i.d. cards NEW HIRES CIGNA Medical ID cards should arrive 14-21 calendar days after a participant enrolls in coverage on the Benefits Self-Service enrollment website. If you require an ID card sooner, a temporary ID card can be printed at www.MyCigna.com around 7-10 calendar days after the enrollment is completed.

OPEN ENROLLMENT IMPORTANT NOTE REGARDING MEDICAL ID CARDS New CIGNA Medical ID cards will be sent to associates enrolled in a medical plan in 2015 due to the addition of CIGNA’s MDLive benefit.

ALL ASSOCIATES CIGNA Dental and VSP Vision do not require identification cards. For CIGNA DENTAL: Be sure to access www.MyCigna.com to find a CIGNA In-Network dentist. When you schedule an appointment, tell your dentist that you have CIGNA dental and they will be able to process your claim using your social security number. For VSP VISION: Be sure to access www.vsp.com to find a VSP In-Network eye care professional. When you schedule an appointment, tell your eye care professional that you have VSP Vision and they will be able to process your claim using your social security number. In-Network doctors, dentists, and vision care professionals have partnered with CIGNA and VSP to offer exceptional services at a cost savings to Associates. Flexible Spending Account (FSA) – HealthCare FSA Debit Cards should arrive 14-21 days after enrolling in the benefit. If expenses are incurred before a card is issued, participants pay out of pocket and submit a claim reimbursement to WageWorks. Claims for the Dependent Care FSA are handled on a reimbursement basis only.

All cards are mailed to the Associate’s home address shown in Ceridian



http://www.vsp.com/


timeline summary of benefits eligibility for new hires

eligibility for benefits

• Full Time associates working a minimum of 30 hours per week • If you enroll in coverage, you may enroll your Eligible Dependents in coverage. Your Eligible

Dependents include your: Legal Spouse - meaning the one person to whom you are legally married under the laws

of the state in which you reside. Same sex spouses are eligible, if you were married in a state that recognizes same sex marriage.

Domestic Partner – meaning the one person of the same sex with whom you are in a committed relationship, provided: (i) you currently share the same residence and have shared the same residence for at least six months, (ii) you are both 18 years or older, (iii) you are not related by blood or in any manner closer than permitted by state law for marriage, and (iii) neither are married or in a civil union with another person. You must submit a Domestic Partnership Affidavit to enroll your Domestic Partner in coverage.*

Dependent children to the age of 26 - meaning your direct offspring, stepchildren, foster children, legally adopted children, children placed with you for the purpose of adoption, and children of your Domestic Partner who live with you. You must enroll your Domestic Partner in coverage in order to enroll the children of your Domestic Partner in coverage.*

You may be required to submit proof of eligibility to enroll and / or maintain coverage for your Eligible Dependents. * Domestic Partners and the children of Domestic Partners are not eligible dependents for purposes of the Health Care FSA or Dependent Care FSA due to Federal Tax limitations. * Due to the reversal of DOMA (Defense of Marriage Act), Enova will cease offering same sex domestic partner benefits coverage in 2016 in states that recognize same sex marriage.

Date of Hire 1st of the month after 30 days

1st of the month after 1 year

• Cigna Medical & Rx • MDLive Cigna Dental • VSP Vision • Basic Life and AD&D • Supplemental Life/AD&D • Dependent Life/AD&D • Health Care FSA • Dependent Daycare FSA • Pre-Paid Legal Services • Associate Assistance Program • Commuter Tax Savings Benefit *

• Paid Time Off • 401(k)

• Basic Short-Term & Long-Term Disability • Buy-Up Short-Term &

Long-Term Disability

*Cutoff for commuter benefit sign-up is the 5th of the month, for the following month’s benefit.


effective date of benefits The benefit plans you choose as a new hire and during the Open Enrollment period are effective for the entire benefit plan year. If you are newly eligible for benefits, you must enroll within 30 days from your date of hire or you will be enrolled in Basic Life & Basic Accidental Death & Dismemberment (AD&D) ONLY. The following are effective on your date of hire: • Medical / Prescription Drug • Dental • Vision • Health Care Flexible Spending

Account • Dependent Care Flexible

Spending Account • Basic Life and Basic AD&D

• Supplemental Employee Life • Supplemental Dependent Life • Supplemental AD&D • Commuter/Parking • Associate Assistance Program • Legal Services

The following are effective 1st of the month following 1 year of employment: • Basic Short-Term Disability • Basic Long-Term Disability • Supplemental (Buy-Up) Short

Term Disability • Supplemental (Buy-Up) Long

Term Disability

life events If you do not enroll in the applicable plans during the Open Enrollment period or your new hire enrollment period, you will not be able to enroll (or make changes) until the next Open Enrollment period, unless you experience a special enrollment right (aka a qualifying life event) such as:

• Marriage, new domestic partnership*, divorce or dissolution of domestic partnership. • Birth, adoption, or change in custody of your child(ren) • Death of your spouse/domestic partner or child(ren) • Change in your spouse’s or domestic partner’s employment status • Child(ren)’s loss of dependent status • A change in your residence that affects benefit coverage • Qualified Medical Child Support Order

*See ELIGIBILITY FOR BENEFITS on previous page for additional details on domestic partner eligibility.

If you experience a qualifying event, you must initiate, enroll and send proof documentation of the life event within 30 days by contacting the Enova Benefits and Payroll Contact Center. You may also have the right to make changes to your benefits if you experience a special enrollment right. Refer to the Special Enrollment Rights Notice included in this packet for a description of special enrollment rights and the enrollment timeframes. Enova requires associates to submit proof of eligibility when a qualifying event is initiated. Depending on the type of qualifying event, you will need to supply proof such as marriage certificate, domestic partner affidavit, birth certificate, court documents or loss of other coverage certification (HIPAA Notice).


irc section 125 The Internal Revenue Code Section 125 allows Payroll to deduct certain benefit contributions on a pre-tax basis, which reduces your taxable income.

• You can also defer pre-tax money into a Flexible Spending Account (FSA) for qualified medical and/or dependent care expenses

• Once enrolled, you cannot make any changes unless you experience a special enrollment right or qualifying event.

Benefit contributions for the medical, dental, and vision coverage provided to your Domestic Partner and children of your Domestic Partner cannot be deducted on a pre-tax basis, unless your Domestic Partner and the children of your Domestic Partner qualify as your tax dependents. If your Domestic Partner qualifies as your tax dependent, you will need to complete and return the Domestic Partnership Affidavit (for Tax Treatment Determination) in order to receive pre-tax treatment of the medical, dental, and vision coverage provided to your Domestic Partner or the child(ren) of your Domestic Partner. If your Domestic Partner does not qualify as your tax dependent, benefit contributions made for your Domestic Partner or the child(ren) of your Domestic Partner will be deducted on a post-tax basis. In addition, per IRS rules, you will be required to pay Imputed Income on the fair market value of health coverage provided to your Domestic Partner (less any post-tax benefit contributions made by you). You will see the appropriate amount reflected as income on your pay stub and then it will be taxed accordingly.


taxation and payment of benefits

pre-tax deductions Your cost for coverage under some benefits will be paid on a pre-tax basis through payroll deductions. This means your premiums are deducted from your paycheck before taxes are calculated on the remaining income. This results in tax savings for you each pay period for most federal and state income taxes and Social Security taxes. Benefit contributions for your Domestic Partner and children of your Domestic Partner who do not qualify as your tax dependents cannot be deducted on a pre-tax basis. post-tax deductions Some coverages are deducted on a post-tax basis, which means you are taxed on your income before the premiums are deducted from your paycheck. The chart below illustrates who is paying for your benefit and how deductions will be taxed on your paycheck.

BENEFIT WHO PAYS THE COST? HOW IS IT TAXED TO YOU?

Medical / Prescription Drug Enova & Associate Pre-tax* Dental Associate Pre-tax* Vision Associate Pre-tax* Commuter/Parking Associate Pre-Tax Health Care Flexible Spending Account Associate Pre-tax** Dependent Care Flexible Spending Account Associate Pre-tax** Basic Life and Basic AD&D Enova No Cost Supplemental Employee Life Associate Post-tax Supplemental Dependent Life Associate Post-tax Supplemental AD&D Associate Post-tax Basic Short-Term Disability Enova No Cost Basic Long-Term Disability Enova No Cost Supplemental (Buy-Up) Short Term Disability Associate Pre-tax Supplemental (Buy-Up) Long Term Disability Associate Pre-tax Legal Services Associate Post-tax Associate Assistance Program Enova No Cost

*Benefit contributions for your Domestic Partner and the Children of your Domestic Partner who do not qualify as your tax dependents are deducted on a post-tax basis. ** Domestic Partners and the children of Domestic Partners are not eligible dependents for purposes of the Health Care FSA or Dependent Care FSA.


medical coverage (Provided by CIGNA) Cigna Medical and Prescription Drug There are four (4) coverage level options available to you under the Medical plan.

• GOLD • TITANIUM • PLATINUM • DIAMOND

Below are the 2015 Bi-Weekly (Per Pay Period) costs for Medical coverage.

GOLD PLAN HRA COMPONENT Enrollment in the GOLD plan includes an annual contribution to an HRA (Health Reimbursement Account) with CIGNA on your account. Enova covers the cost of this HRA contribution. ANNUAL HRA CONTRIBUTION AMOUNTS:

• $500 for Associate Only coverage • $1,000 for Associate + Spouse, Child(ren) or Family coverage

Your HRA fund will be used to pay 100% of your eligible health care expenses until the money is used up. The money used from your HRA counts toward your deductible, reducing your cost when you utilize services. You can track your account balance by logging on to www.mycigna.com. Please refer to the HRA FAQ Section in this guide for more detailed information on how the HRA plan works, as well as examples.

GOLD TITANIUM PLATINUM DIAMOND

Non-

Tobacco Tobacco Non-Tobacco Tobacco Non-Tobacco Tobacco Non-Tobacco Tobacco

Associate Only $17.89 $21.47 $28.35 $34.02 $43.84 $52.61 $74.15 $88.98

Associate + Spouse/ Domestic Partner

$58.76 $70.51 $93.14 $111.77 $127.02 $152.42 $197.59 $237.11

Associate + Child(ren) $42.06 $50.47 $66.67 $80.00 $97.00 $116.40 $155.46 $186.55

Associate + Family $78.12 $93.74 $123.83 $148.59 $173.44 $208.13 $267.37 $320.84



Medical Benefit Coverage Summary:

GOLD TITANIUM PLATINUM DIAMOND

CIGNA CHOICE FUND OA PLUS NETWORK CIGNA OPEN ACCESS PLUS NETWORK

In Network Out of Network




COPAYS

Physician Office Visit

20% after Deductible

50% after Deductible $25 50% after

Deductible $25 50% after Deductible $25 50% after

Deductible

Specialist Office Visit


50% after Deductible $60 50% after

Deductible $60 50% after Deductible $60 50% after

Deductible

Urgent Care 20% after Deductible

50% after Deductible $75 $75 $75 $75 $75 $75

ER Room 20% after Deductible

50% after Deductible $300 $300 $300 $300 $300 $300

ANNUAL DEDUCTIBLE

Individual $2,000 $6,600 $1,500 $4,500 $1,000 $3,000 $500 $1,800

Individual + 1 or more

$4,000 $13,200 $3,000 $9,000 $2,000 $6,000 $1,000 $3,600

OUT OF POCKET (OOP) EXPENSE - (INCLUDES DEDUCTIBLE)

Individual $6,000 $19,800 $4,500 $13,500 $3,000 $9,000 $1,500 $5,400

Individual + 1 or more

$12,000 $39,600 $9,000 $27,000 $6,000 $18,000 $3,000 $10,800

Routine Exams and Well Child Care

100 % Covered

Not Covered 100 % Covered



Not Covered

Inpatient Hospital Care




$200 per adm. Then 50% after

Deductible



Deductible



Deductible

Preadmission Certification

Provider Required

Patient Required

$400 Penalty

Provider Required

Patient Required

$400 Penalty

Provider Required

Patient Required

$400 Penalty

Provider Required

Patient Required

$400 Penalty

Max Lifetime Benefit

Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited

Max Annual Benefit

Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited Unlimited


Below are the 2015 costs for Prescription coverage.

PRESCRIPTION DRUG COVERAGE (Included with Medical Plan enrollment)

GOLD TITANIUM

Pharmacy/Retail & Mail Order

(Same benefit for both)

Pharmacy/Retail (up to 30 day supply)

Mail Order (up to 90 day supply)

GENERIC 20% Coinsurance

($10 Minimum/$250 Maximum)

$10 $10

PREFERRED $35 $75

NON-PREFERRED

$50 $105

PLATINUM DIAMOND

Pharmacy/Retail Mail Order Pharmacy/Retail (up to 30 day supply)

Mail Order (up to 90 day supply)

GENERIC $10 $10 $10 $10

PREFERRED $35 $75 $35 $75

NON-PREFERRED

$50 $105 $50 $105


health reimbursement account (hra) faqs • At the start of the plan year (January 1st), Enova deposits a specific dollar amount into an HRA ($500 for

Associate Only or $1,000 for Associate + Spouse, Child or Family). • The dollars in your HRA are used to pay eligible health care expenses. The money used counts toward

your deductible (the amount of money you pay out of pocket before the plan starts to pay). • Your HRA dollars are used first. After the money in your account is used up, you pay for all of your health

care expenses up to your annual deductible amount. • When you reach your deductible, you and your plan share the costs (coinsurance) for covered services. • Money not used during the plan year may roll over to your account the next year (up to the annual

deductible amount). • Preventative care is covered at no cost to you when received by an in-network provider. (This means that

approved preventative care services will NOT come out of your HRA dollars. This includes annual physicals, pap smears, breast cancer screenings, etc.)

• You are protected by an out-of-pocket maximum and once you meet the maximum, your plan pays eligible expenses at 100%.

• If you leave employment or you do not re-elect the HRA Value plan the next plan year, any balance in your HRA account will be forfeited.

EXAMPLE George is a 35-year-old single man who is healthy, with the exception of an occasional sports injury. He enrolled in the Value HRA plan with a $500 health fund (funded by Enova), a $2,200 deductible and a coinsurance of 20% for in-network services. Here is how the plan worked for George: Year 1 George receives an annual preventative care exam that is covered $ 0 100% by the medical plan He also receives care for his sports injuries:

• Visit to Urgent Care Center $ 70 • Visits to a Sports Medicine Specialist $ 160 • Prescriptions $ 165

Total Medical Expenses $ 395 The HRA pays first -$ 395 George pays $ 0 George’s fund balance to carry over to next year’s HRA $ 105 ($500 - $395) Year 2 George receives an annual preventative care exam that is covered $ 0 100% by the medical plan He also receives care for his sports injuries:

• Visit to a Specialist (2 visits) $ 320 • Prescriptions $75

Total Medical Expenses $ 395 The HRA pays first - $ 395 George pays $ 0 George’s fund balance to carry over to next year’s HRA $ 210 ($105 bal from prev. year + $500 for current yr - $395)


MDLive You are automatically eligible for MDLive with your enrollment in the CIGNA Medical Plan. MDLive services are available to your spouse, domestic partner, and child(ren) if they are covered in the Medical Plan. MDLive is a national network of board certified primary-care doctors and pediatricians available 24 hours a day, 365 days a year (even holidays). MDLive is accessible by secure video, phone or email to: • Diagnose • Recommend treatment • Write short-term prescriptions when appropriate Examples of treatable conditions include: • Sinus Infections • Allergies • Sore Throat • Cold or Flu MDLive is a cost-effective alternative for minor medical problems. For a $10.00 fee, call MDLive when: • Your physician is not available • You are on vacation or on a business trip • You need assistance after your primary care physician’s hours of operation Before receiving a consultation with MDLive: Register online or by phone by calling 888-726-3171 or mdlive.com/enova and complete a medical history form. A medical history disclosure must be completed separately for each enrolled subscriber and dependent. For more information contact MDLive -- 888-726-3171 or mdlive.com/enova

https://www.mdlive.com/enova

https://www.mdlive.com/enova


dental coverage (Provided by CIGNA)

Below are the 2015 Bi-Weekly (Per Pay Period) costs for Dental coverage.

** You can elect Dental coverage separately from Medical and Prescription Drug coverage.

GOLD DIAMOND CIGNA RADIUS NETWORK

In Network Out of Network In Network Out of Network

ANNUAL DEDUCTIBLE

Individual $50 $50 $0 $0

Family $100 $100 $0 $0

PREVENTIVE SERVICES

Semi-annual Cleanings/Annual X-rays 100% 100% 100% 100%

COVERAGE AFTER DEDCUTIBLE IS MET

Basic Services 80% 80% 80% 80%

Oral Surgery 80% 80% 80% 80%

Major Services 50% 50% 50% 50%

Root Canals & Periodontics 80% 80% 80% 80%

Implants 50% 50% 50% 50%

CALENDAR YEAR MAXIMUM BENEFIT

Preventive, Basic & Major $1,500 per person $1,500 per person $2,000 per person $2,000 per person

ORTHODONTIA

Adults Covered? NO NO YES YES

Coinsurance 50% 50% 50% 50%

Lifetime Maximum $1,000 $1,000 $2,000 $2,000

CALENDAR YEAR MAXIMUM FOR ORAL SURGERY

Annual Maximum $2,000 $2,000 $2,000 $2,000

GOLD DIAMOND

Associate Only $12.00 $19.00

Associate + Spouse/Domestic Partner $15.00 $27.00

Associate + Child(ren) $16.00 $28.00

Associate + Family $21.00 $41.00


vision coverage (Provided by VSP)

VSP SIGNATURE NETWORK

IN-NETWORK OUT-OF-NETWORK

VISION EXAM

Copay $15 $15

After Copay Covered in Full Covered in Full

GLASSES

Copay $25 $25

Materials after Copay

Lenses Once Per Year Once Per Year

Single Covered in Full Reimbursed up to $50

Bifocal Covered in Full Reimbursed up to $75

Trifocal Covered in Full Reimbursed up to $100

Frames (Once per 24 months)

Covered up to $130 Reimbursed up to $70

CONTACT LENSES

Evaluation & Fitting Once per 12 months Once per 12 months

Elective Covered up to $140 Reimbursed up to $140

Medically Necessary Covered in full, after $25 Copay

Reimbursed up to $210, after copay

1. Vision Exam does NOT include contact lens exam and fitting

2. Copay for glasses is applied to lenses and frames.

3. Polycarbonate, tints and photochromic lenses are covered in full by a VSP provider

4. Elective contact lenses - Allowance is in addition to 15% discount on contact lens exam. Any costs exceeding this allowance are the patient's responsibility.

5. Medically necessary contact lens - Doctor's diagnosis required.

To find a listing of in-network eye care professionals and retail providers in your area, logon to www.VSP.com, go to Doctor Directory/Search, then select the Signature Network and then click “include affiliate providers”. If you are having trouble, you can always get this information from VSP Customer Service by calling 800-877-7195. Below are the 2015 Bi-Weekly (Per Pay Period) costs for Vision coverage. Vision Service Plan

Associate Only $3.44

Associate + Spouse/Domestic Partner $5.35

Associate + Child(ren) $5.46

Associate + Family $8.80

http://www.vsp.com/


commuter and parking tax savings benefit The WageWorks commuter and parking benefit gives Enova Associates a way to lower cost of living expenses by reducing the costs of commuting to work. With enrollment in the WageWorks commuter and parking plan, Associates can save up to 40% off commuting and parking expenses. The money that pays for the transit pass and/or parking comes from your paycheck and is taken out before federal income tax, FICA, and state income tax (in most states) are deducted. Because Associates do not pay taxes on this money, savings are seen each month in the form of reduced tax withholding. You are eligible to enroll in the benefit on your date of hire. If you enroll by 11pm Central Time on the 5th of the month, you will be eligible for reimbursement or your pre-paid transit card will be funded on the first of the following month.

For Example: Enrolled Date = May 3rd First day to receive transit card funding or be eligible for reimbursement = June 1st OR Enrolled Date = May 7th (After 5th of the month deadline) First day to receive transit card funding or be eligible for reimbursement = July 1st You can enroll in the WageWorks Commuter and Parking plan by logging on to www.wageworks.com.



flexible spending accounts health care flexible spending account The annual maximum amount you can contribute to the Health Care FSA is $2,500. Do you need help paying for copays, deductibles or coinsurance? If so, a flexible spending account may be able to help you! You can set up a spending account through WageWorks, which will allow you to set aside pre-tax dollars from your paycheck. You can use the money from this account to pay for eligible medical, dental and vision expenses.

How It Works The average household spends $185 in over-the-counter items alone each year. It is up to you to estimate your own expenses and make sure you elect the right amount to set aside for the year. Start by estimating the out-of-pocket medical expenses (copay(s), deductible(s) or coinsurance) you anticipate spending for yourself and/or dependents for the coming year.

You do not have to participate in Enova’s medical, dental or vision plans to be eligible for the flexible spending account.

Some Eligible Expenses Include

Visit www.wageworks.com for a complete list of eligible expenses. Important ⋅ You cannot change your election during the year unless you experience a qualifying event. ⋅ Only expenses for services received in the plan year (January 1, 2015 - December 31, 2015) or its related grace period

(January 1, 2016 – March 15, 2016) and while you are covered under the Health Care FSA, can be reimbursed by the contributions you make in 2015.

⋅ Domestic Partners and the children of Domestic Partners are not eligible dependents for purposes of the Health Care FSA.

you lose what you don’t use! Any expenses not incurred by March 15, 2016 will be forfeited, as required by the IRS! (Be sure to plan your annual contribution accordingly.) Claims that are incurred by March 15, 2016 can be filed for reimbursement up to April 30, 2016.

⋅ Acupuncture ⋅ Artificial Limb ⋅ Contact Lenses & Solutions ⋅ Chiropractic Services ⋅ Copays ⋅ Coinsurance ⋅ Crutches ⋅ Medical or Dental

Deductibles

⋅ Dental Treatments ⋅ Hearing Aids ⋅ Hospital Charges ⋅ LASIK Eye Surgery ⋅ Orthodontia ⋅ Physical Therapy ⋅ Prescription Drugs ⋅ Psychiatric Care

⋅ Smoking Cessation Programs ⋅ Vaccines ⋅ Vision Care ⋅ Well-baby Care ⋅ Wheelchairs & X-Rays ⋅ Over-the-counter

Medications-Prescribed by a Physician Used for Treatment of Illness or Injury

*You may not use the account to pay for cosmetic expenses or to benefit your general well-being.


wageworks® visa® health care card The WageWorks Visa Health Care Card makes funds immediately available to you for payment of eligible health care services, goods and prescriptions. You can also use your Card at qualified merchants to pay for eligible over-the-counter (OTC) items. The WageWorks Flex Spending Account (FSA) makes it easy to access your money. Below are some examples of how to access your Health Care FSA Account:

• Swipe your WageWorks Visa Health Care Card wherever it’s accepted to have eligible expenses deducted directly from your health care FSA. Use your card at your doctor, dentist, vision center, qualified pharmacy or other qualified merchants.

• Sign up to schedule (Pay My Provider) payments from your Health Care FSA online. • Send in traditional (Pay Me Back) claims for quick reimbursement.

You will need to hold on to your receipts for tax purposes. Go to www.getwageworks.com/fsa to learn more!

dependent care flexible spending account The maximum annual amount you can elect for the Dependent Care Flexible Spending Account is $5,000. ($2,500 if married, but file separate tax returns) Enova offers you a way to pay for your dependent day care expenses with pre-tax dollars through a Dependent Care Flexible Spending Account. You may voluntarily set aside from each paycheck pre-tax dollars that can be used to pay for dependent care expenses incurred so that you can work. Through this account, you can pay for day care or baby sitter expenses for your children under age 13 and qualifying older dependents such as dependent parents. To be eligible, you must be a single parent or your spouse must be employed outside the home, disabled or a full-time student. The dependent care provider cannot be your child under age 19 or anyone who is your dependent for income tax purposes.

http://www.wageworks.com


Important ⋅ You cannot change your election during the year unless you experience a qualifying event. ⋅ Only expenses for services received in the plan year (January 1, 2015 - December 31, 2015) or its related grace

period (January 1, 2016 – March 15, 2016) and while you are covered under the Dependent Care FSA, can be reimbursed by the contributions you make in 2015.

⋅ Domestic Partners and the children of Domestic Partners are not eligible dependents for purposes of the Dependent Care FSA.

Expenses Eligible For Reimbursement ⋅ Adult Day Care ⋅ Au Pair ⋅ After-school Program ⋅ Before-school Program ⋅ Baby-sitting (work-related, in

your home or someone else’s, but not provided by your own dependent)

⋅ Child Care

⋅ Custodial Elder Care (work-related)

⋅ Dependent or Elder Care (work-related)

⋅ Educational Services (for preschool, but not kindergarten or above)

⋅ Extended Care (supervised program before or after school)

⋅ Nanny

⋅ Nursery School ⋅ Payroll Taxes Related to

Eligible Care ⋅ Preschool ⋅ Senior Day Care ⋅ Sick Child Care ⋅ Summer Day Camp (but not

overnight camp) ⋅ Transportation To and From

Eligible Care (provided by your care provider)

Filing for Reimbursement Online Claim You can pay for many of your eligible dependent care expenses directly from you FSA

account by logging on to www.wageworks.com and selecting “Pay My Provider.”

Paper Claim If you prefer to submit a paper claim form to request reimbursement for your eligible expenses, choose the “Pay Me Back” option at www.wageworks.com.

you lose what you don’t use! Any expenses not incurred by March 15, 2016 will be forfeited, as required by the IRS! (Be sure to plan your annual contribution accordingly.) Claims that are incurred by March 15, 2016 can be filed for reimbursement up to April 30, 2016.

For questions on either the Health Care or Dependent Care Flexible Spending Accounts, call WageWorks at 877-924-3967.


basic life and accidental death & dismemberment insurance Enova automatically provides you with Basic Life and Basic Accidental Death & Dismemberment Insurance at no cost to you. Benefits will be payable to the person(s) you designate as your beneficiary in the event of your death. • Beneficiary designations can be made during your new hire enrollment or during Enova’s annual open

enrollment. You may also update your Life and AD&D beneficiaries at any time throughout the year by contacting The Enova Benefits and Payroll Contact Center ([email protected] or 855-246-4111).

Note: Coverage amounts for Life Insurance and AD&D are based on your salary as of January 1st, the year the benefit becomes effective (1/1 of each plan year). IMPUTED INCOME

If your Basic Life Insurance amount exceeds $50,000, the IRS requires Imputed Income to be paid on the amount that exceeds $50,000. The following illustrates an example of how this is calculated:

For example calculation below: Basic Life Insurance Volume: $75,000 Age: 37

You will see the appropriate amount reflected as income on your pay stub and then it will be taxed accordingly. It is this tax that you are required to pay to satisfy the IRS Imputed Income requirement. For more information on Imputed Income, go to www.irs.gov and search for “Group-Term Life Insurance”.

Plan Benefit Coverage Amount

Basic Life Insurance An amount equal to one times your annual salary rounded to the next $1,000 ($10,000 minimum/$600,000 maximum)

Basic Accidental Death & Dismemberment (AD&D)

An amount equal to one times your annual salary rounded to the next $1,000 ($10,000 minimum/$600,000 maximum) (In addition to Basic Life Amount)

Age RangeRate per $1,000 over $50,000 Per Month

Less than 25 .0525 to 29 .0630 to 34 .0835 to 39 .0940 to 44 .1045 to 49 .1550 to 54 .2355 to 59 .4360 to 64 .6665 to 69 1.27

70 and above 2.06

IRS Imputed Income Rates


http://www.irs.gov/


supplemental life and accidental death & dismemberment insurance

Note: Your cost and coverage amounts for Life Insurance and AD&D are based on your age and salary as of January 1st, the year the benefit becomes effective (1/1 of each plan year).

spouse/domestic partner & child supplemental life insurance You may also cover your dependents by electing Dependent Supplemental Life Insurance. You are automatically the beneficiary if your spouse, domestic partner or dependent child dies. Your options for coverage are outlined in the chart below:

Note: You must elect Supplemental Life Insurance for yourself in order to be eligible to elect coverage for dependents under this plan. In addition, the amount you elect for your dependent(s) may not exceed 100% of your total life insurance coverage (Basic and Supplemental combined).

Plan Benefit Coverage Amount

Supplemental Employee Life Insurance

You can choose from One (1) to six (6) times your annual salary. *($600,000 Maximum)* Evidence of Insurabi l i ty (EOI) may apply to your election. Please see the Evidence of Insurabi l i ty section in this document for more deta i l s .

Supplemental Employee AD&D You can choose from One (1) to six (6) times your annual salary. ($600,000 Maximum)

($600,000 Maximum)

Supplemental Dependent AD&D

You have the option to elect AD&D coverage for your family. AD&D coverage pays a benefit if your spouse, domestic partner, and/or child(ren) are seriously injured or die in a covered accident. Your dependents will be insured for a percentage of YOUR Supplemental AD&D coverage.** You must elect Supplemental Employee AD&D coverage in order to elect Dependent Supplemental AD&D

Dependent AD&D Coverage Options:

Spouse/Domestic Partner - 60% of your Supplemental AD&D Coverage

Child(ren) - 15% of your Supplemental AD&D Coverage for each child

Spouse/Domestic Partner Supplemental Life Insurance

Increments of $5,000 $2,000, To a Maximum of $50,000 $4,000,

$8,000,$10,000

Live Birth to 6 months old, max coverage is $2,000

Foster children cannot be covered under the Dependent Life Insurance Benefit

Child Supplemental Life Insurance


disability coverage Enova automatically provides you with Basic Short-Term Disability and Basic Long-Term Disability coverage as a result of a non-occupational injury or illness. Both of these plans replace a percentage of your income if you are unable to work. You may elect Supplemental/Buy-Up Short-Term and/or Long-Term Disability coverage to increase your salary replacement.

basic short-term & basic long-term disability Basic Short-Term Disability You are automatically enrolled on the first of the month following 1 year of employment. Benefits begin after you’ve been disabled seven (7) consecutive days while under the care of a physician and continue, if medically necessary, for up to 25 weeks. • Replaces 60% of your weekly salary to a maximum of $2,500. • Paid 100% by Enova. Basic Long-Term Disability You are automatically enrolled on the first of the month following 1 year of employment. Benefits begin after six (6) months of continuous disability while under the care of a physician and continue to age 65.

• Replaces 40% of your monthly salary to a maximum of $3,000. • Paid 100% by Enova.

buy-up short-term disability • You are eligible to elect supplemental or “buy-up” short-term disability coverage the first month following 1

year of employment. The buy-up is an additional 40% of coverage that, if elected, is added to your basic short-term disability coverage.

• This would provide you with a total of 100% of your WEEKLY salary to a maximum of $2,500 (combined Basic & Buy-Up benefit) for the first 12 weeks and 85% of your monthly salary up to a maximum of $2,500 (combined Basic & Buy-Up benefit) for the last 13 weeks.

buy-up long-term disability • You are eligible to elect supplemental or “buy-up” long-term disability coverage the first of the month

following 1 year of employment. The buy-up is an additional 20% of coverage that, if elected, is added on to your basic long-term disability coverage.

• This would provide you with a total of 60% of your MONTHLY salary to a maximum of $5,000. (40% Basic + 20% Buy-Up = 60% Total) Note: You can elect the Buy-Up STD and Buy-Up LTD plans separately. You are NOT required to enroll in both.


evidence of insurability (eoi) Depending on your election in Supplemental Life and/or Buy Up Long-Term Disability, you may be required to complete Evidence of Insurability in order to be approved for the coverage amount you have elected. Please refer to the chart below to determine if EOI will be required for your election. If EOI is required for any benefit, the confirmation page of your on-line benefits enrollment portal will reflect the approved amount in force right away, as well as the portion that is pending and requires EOI. Sun Life will mail you the necessary EOI information automatically within 2-4 weeks after your on-line benefits enrollment is completed. If approved, Enova will automatically be notified and will process the approved or denied amount to your benefit and any changes to your payroll deductions will be handled accordingly. (Deductions will increase to cover the approved amount or deductions will remain the same if denied and the denied coverage amount will not be applied.) Please be sure to read all mail received from Sun Life and follow the instructions carefully. You must meet all deadlines and all communication must be made directly with Sun Life. Due to the private nature of the health information disclosed in the EOI process, the Enova Benefits Department CANNOT assist you with the completion or mailing of required documentation. Associate

Supplemental Life Spouse/Domestic Partner

Supplemental Life Child Supplemental

Life Buy Up LTD

NEW HIRE EVENT EOI required for any election greater than 5x annual pay or $400,000

No EOI for any election No EOI for any election No EOI for any election

ANNUAL/OPEN ENROLLMENT

Current participants can increase by one benefit level without EOI, unless that increase goes over Guarantee Issue (5x annual pay or $400K). Any election increase greater than 1X annual pay or total election greater than Guarantee Issue (5x annual pay/$400,000) will require EOI. Non-participants can enroll in 1x annual pay without EOI. Any election greater than 1x annual pay will require EOI.

Spouse/Domestic Partner current participants can increase by one benefit level ($5,500). Anything over one benefit level will require EOI. Spouse/Domestic Partner non-participant can enroll in $5,000 coverage option without EOI. Anything greater than that option will require EOI.

No EOI for any election EOI Required

LIFE STATUS EVENTS

Current participants can increase by one benefit level without EOI, unless that increase is over Guarantee Issue (5x annual pay/$400K), then amount over Guarantee Issue would require EOI. Non-participants can enroll in 1x annual pay without EOI. Any election greater than 1x annual pay will require EOI.

Spouse/Domestic Partner current participants can increase by one benefit level ($5,500). Anything over that one benefit level will require EOI. Spouse/Domestic Partner non-participant can enroll in $5,000 coverage option without EOI. Anything greater than that option will require EOI. MARRIAGE/DOMESTIC PARTNER EVENT ONLY: Spouse/Domestic Partner can be covered up to Guarantee Issue ($50,000) without EOI.

No EOI for any election EOI Required


pre-paid legal

Comprehensive Group Legal Plan (Option 1) $ 6.80 Per Pay Period

Comprehensive Group Legal Plan with ID Shield (Option 2) $11.40 Per Pay Period Option 1: The Comprehensive Group Legal Plan offers toll-free phone consultations on any legal issue that might arise, such as home purchases, will preparation, child support, divorce, credit matters, bankruptcy, guardianship and DUI. In addition, the Comprehensive Group Legal Plan offers representation by your Provider Law Firm for uncontested legal separation or uncontested civil annulment, uncontested divorce, uncontested adoption, power of attorney or a living will. Option 2: The Comprehensive Group Legal Plan with ID Shield offers all of the benefits of Option 1, with an added Identity Theft benefit. A professional thief can assume your identity in just a few hours, but it can take years for you to restore your good name. ID Shield helps you with your credit report, identity restoration and provides continuous credit monitoring.

You may contact Pre-Paid Legal Services at 800-654-7757 for additional information. Benefits Include: • Toll-free Phone Consultations on Any Subject • Phone Calls & Letters on Your Behalf • Contract & Document Review • Mortgage Document Assistance

• In-office Consultations • Child Support • Credit Matters • Will Preparation

• Bankruptcy • Guardianship • DUI / DWI • Uncontested Divorce

/ Adoption

associate assistance program An Associate Assistance Program is provided to all Associates through Sun Life. Through this confidential service, you and your immediate family members have unlimited access to consultants by telephone, resources and tools online and up to five (5) face-to-face visits with counselors for help with a short-term problem.

Ease the stress of any uncomfortable situation by calling and speaking with master’s level consultants when you or your family members need help and information with issues such as: • Problems with a manager or colleague

• Improving your health or controlling a chronic condition

• Coping with stress, anxiety and depression

• Getting out of debt and managing your finances

• Organization tips and prioritization ideas

• Dealing with a family member who has an addiction

• Caring for an elderly relative or finding senior assistance

• Relationship/Marital issues

• Raising children and finding child care in your area

• Legal issues... and much more!

Contact the SunLife AAP by phone: 877.595.5284, or on the Web: guidanceresources.com



pet insurance (Provided by VPI) VPI® Pet Insurance is a part of Enova’s voluntary benefits package. VPI Pet Insurance provides healthcare coverage for your dog, cat, bird, hamster or other exotic pet. Payroll Deduction Discounts As an Enova Associate, you’ll receive a 5% group discount, per pet on your VPI policy. Plus you will save an additional $2 per month, per pet by simply electing the payroll deduction option. Peace of Mind With coverage from VPI, your pets are protected if they are injured or become ill. VPI policies are easy to use and reimburse you for eligible veterinary expenses related to surgeries, hospitalization, X-rays, prescription medications and more. Best of all, you’re free to visit any veterinarian, anywhere in the world. Easy Enrollment Call 877-PETS-VPI or visit www.petinsurance.com/enova today for a no-obligation quote or to begin your enrollment. If you have questions about VPI Pet Insurance, how it works, what’s covered or anything else, please call a pet insurance specialist at 877-PETS-VPI (877-738-787).

Visit the Enova wiki and search keyword “VPI” to get more information and frequently asked questions about the benefit.


no cost benefits

emergency travel assistance (no cost) provided by Assist America®

If you have a medical emergency while you are more than 100 miles away from home, you don’t have to face it alone. With one simple phone call, you can be connected to Assist America’s staff of medically trained, multilingual professionals who can advise you in a medical emergency, 24x7. You will be immediately connected to: • pre-qualified, English-speaking doctors, hospitals, pharmacies, and dentists anywhere in the world, • medical consultation, evaluation, and referral, • hospital admission guarantee, • emergency medical evacuation, • lost prescription assistance, and • legal and interpreter services and more

You or your family (whether traveling together or separately) can activate Assist America’s emergency services with one call to the number below, whether you are on vacation or on a business trip (spouse business travel excluded). ETA Membership #: 01-AA-SUL-100101 Phone: Inside U.S. - 800-872-1414, or Outside U.S. - 301-656-4152 Email: [email protected]

will preparation (no cost) provided by SunLife

EstateGuidance® offers you the ease and simplicity of online will preparation—right on your computer! To access EstateGuidance, you must have a computer with access to the internet and then log in to guidanceresources.com. Then click on the link under Site Highlights to get to EstateGuidance. Once you are on EstateGuidance, simply supply the information at the prompts. You can complete your will online and download it to your computer. In addition, you will receive instructions about how to execute and store your will properly.



identity theft protection (no cost) provided by SecurAssist®

Identity theft is a serious crime. Each year, millions of Americans have their personal financial information stolen and must spend a significant amount of time and money to restore their records. If you ever become a victim of identity theft, you don’t have to face it alone. You have the support of a powerful Identity Theft Protection program through Assist America’s SecurAssist® Identity Protection program. It provides: • 24x7 telephone support and step-by-step guidance by anti-fraud experts, • an expert case worker who is assigned to you and will help you notify your credit bureaus and file paperwork

to correct your credit reports, • help canceling stolen cards and reissuing new cards, and help notifying police, financial institutions, and

government agencies.

ID Theft Membership #: 01-AA-SUL-100101 Phone: 877-409-9597

You can also help stop identity theft before it happens: • You can securely register up to 10 credit or debit cards for 24x7 surveillance. • Registered cards are monitored using sophisticated web-crawling technology that watches underground chat

rooms where thieves are selling and trading stolen personal information. • You receive early warning of potential threats and are notified if your identity has been misused. To proactively protect your credit cards, you can register up to 10 credit or debit cards for Identity Fraud Protection surveillance by enrolling on the website below. Web: www.securassist.com/sunlife/ Access Code: 18327

http://www.securassist.com/sunlife/


legal notices

medicare part d notice Important Notice from Enova International, Inc. About Your Prescription Drug Coverage and Medicare Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with the Enova International, Inc. Welfare Benefit Plan (the “Plan”) and about your options under Medicare’s prescription drug coverage. The prescription drug benefits under the Plan are administered by Connecticut General. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice. There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: 1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can

get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

2. Enova International, Inc. has determined that the prescription drug coverage offered by the Plan is, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered “Creditable Coverage.” Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

____________________________________________________________________________


When Can You Join A Medicare Drug Plan? You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two month Special Enrollment Period (“SEP”) to join a Medicare drug plan. What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan? If you decide to join a Medicare drug plan, your current coverage under the Plan will not be affected. A description of the prescription drug coverage offered by the Plan can be found in the Plan’s summary plan description. If you do decide to join a Medicare drug plan and drop your current coverage under the Plan, be aware that you and your dependents may not be able to get this coverage back unless you enroll during annual enrollment, during a HIPAA special enrollment period or you experience another event that would permit you to enroll in this coverage during the plan year. When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan? You should also know that if you drop or lose your current coverage under the Plan and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without prescription drug coverage that is Creditable Coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without Creditable Coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join. For More Information About This Notice Or Your Current Prescription Drug Coverage… Contact the person listed below for further information. NOTE: You’ll get this notice each year during the Plan’s open enrollment period. You will also get it if the prescription drug coverage under the Plan changes. You also may request a copy of this notice at any time.


For More Information About Your Options Under Medicare Prescription Drug Coverage… More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook. If you are eligible for Medicare, you’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage:

• Visit www.medicare.gov • Call your State Health Insurance Assistance Program (see the inside back cover

of your copy of the “Medicare & You” handbook for their telephone number) for personalized help • Call 800-MEDICARE (800-633-4227). TTY users should call 877-486-2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 800-772-1213 (TTY 800-325-0778).

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

Date: January 1, 2015 Name of Entity/Sender: Enova International, Inc. Contact–Position/Office: Benefits Department Address: 200 Jackson Blvd. Chicago, IL 60606 Phone Number: 312-564-7BEN

http://www.medicare.gov/

http://www.socialsecurity.gov/


Enova International, Inc. welfare benefits plan

notice of privacy practices THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO YOUR INFORMATION. PLEASE REVIEW IT CAREFULLY.

Why am I receiving this Notice? Enova International, Inc. (the “Company”) sponsors the Enova International, Inc. Welfare Benefit Plan (the “Plan”), which offers an array of welfare benefits to certain Company employees, including medical, prescription drug, dental, vision, and health care flexible spending account programs (“health benefits”). The Health Insurance Portability and Accountability Act of 1996 (“HIPAA”), and the rules to carry out this law (“Privacy Rules”), require health plans to notify participants and beneficiaries about the policies and practices the Plan has adopted to protect the confidentiality of their health information, including health care payment information.

This Notice describes the privacy policies of the portion of the Plan that provides the health benefits. These policies protect medical information relating to your past, present and future medical conditions, health care treatment and payment for that treatment that is created, received by or maintained by the Plan (“Protected Health Information” or “PHI”).

This Notice does not cover:

• health information that does not identify you and for which there is no reasonable basis to believe that the information could be used to identify you; or

• health information that the Company can have under applicable law (e.g., the Family and Medical Leave Act, the Americans with Disabilities Act, workers’ compensation, federal and state occupational health and safety laws, as well as other state and federal laws), or that the Company properly can get for employment-related purposes through sources other than the Plan and that is kept as part of your employment records (e.g., pre-employment physicals, drug testing, fitness for duty examinations, etc.).

The law requires the Plan to maintain the privacy of your PHI, to provide you with this Notice of its legal duties, and to abide by the terms of this Notice. In general, the Plan may only use and/or disclose your PHI where required or permitted by law or when you authorize the use or disclosure. The Plan may also only use the minimum amount of your PHI that is necessary to accomplish the intended purpose of the use or disclosure as permitted by HIPAA.

Some health benefits are provided through insurance, where the Company does not obtain access to PHI. If you are enrolled in any insured arrangement, including any insured HMO option under the Plan,


you will receive a separate privacy notice from your insurer or HMO. That notice applies to the insurer’s privacy practices under that option.

When will the Plan use or disclose my PHI? The Plan must:

• give your PHI to you or your legal representative when you ask for information; • give your PHI to the U.S. Department of Health and Human Services (“DHHS”),

if necessary, to make sure your privacy is protected; and • use or give out your PHI where otherwise required by applicable law.

The Plan and the individuals who administer it may use, receive or disclose your PHI for the following purposes:

• Treatment. The Plan does not provide medical treatment directly, but it may disclose your PHI to a health care provider who is giving treatment. For example, the Plan may disclose the types of prescription drugs you currently take to an emergency room physician, if you are unable to provide your medical history due to an accident.

• Payment. The Plan may disclose your PHI, as needed, to pay for your medical, dental or vision benefits. For example, receiving claims or bills from your health care providers, processing payments, sending explanations of benefits (“EOBs”), precertifying hospital admissions or otherwise reviewing the medical necessity of services, conducting claims appeals and coordinating benefit payments under the Plan.

• Health Care Operations. The Plan may use and disclose your PHI to make sure the Plan is well run, administered properly and does not waste money. For example, the Plan may use information about your claims to project future benefit costs or audit the accuracy of its claims processing functions. The Plan may also disclose your PHI for a claim under a stop-loss or re-insurance policy. Among other things, the Plan may also use your PHI to undertake underwriting, premium rating and other insurance activities relating to changing health insurance contracts or health benefits. However, federal law prohibits the Plan from using or disclosing PHI that is genetic information (e.g. family medical history) for underwriting purposes which include eligibility determinations, calculating premiums, application of any preexisting conditions, exclusions and any other activities related to the creation, renewal, or replacement of a health insurance contract or health benefits.

• Treatment Alternatives of Health-Related Benefits and Services. The Plan may use and disclose your PHI to provide you with appointment (or treatment) reminders, information about treatment alternatives, or information about other health-related benefits and services that may be of interest to you.

• Business Associates. Our Plan contracts with other businesses for certain administrative services. These “business associates” maintain and use most of the PHI under the Plan, and must agree in writing to protect the privacy of your information. In addition to performing services for the Plan, business associates may use PHI for their own management and legal responsibilities, for purposes of aggregating data for Plan design and for other health care operations.


• To the Company. In certain cases, the Plan, insurers or HMOs may disclose your PHI to the Company.

• Some of the people who administer the Plan work for the Company. Before your PHI can be

used by or disclosed to these Company employees, the Company must certify that it has: (1) amended the Plan documents to explain how your PHI will be protected; (2) identified the Company employees who need your PHI to carry out their duties to administer the Plan; and (3) separated the work of these employees from the rest of the workforce so that the Company cannot use your PHI for employment-related purposes or to administer other benefit plans. For example, these designated employees will be able to contact an insurer or third-party administrator to find out about the status of your benefit claims without your specific authorization.

• The Plan may disclose information to the Company that summarizes the claims experience

of Plan participants as a group, but without identifying specific individuals, to get new benefit insurance or to change or terminate the Plan. For example, if the Company wants to consider adding or changing organ transplant benefits, it may receive this summary health information to assess the costs of those services.

• The Plan may also disclose limited health information to the Company in connection with

the enrollment or disenrollment of individuals into or out of the Plan.

• Other Covered Entities. The Plan and their business associates may disclose PHI to certain other entities (including other health plans and health care providers) for the other entity’s treatment, payment or health care operations purposes.

• To Individuals Involved with Your Care or Payment for Your Care. The Plan may disclose your PHI to adult members of your family or another person identified by you who is involved with your care or payment for your care if: (1) you authorize the Plan to do so; (2) the Plan informs you that it intends to do so and you do not object; or (3) the Plan infers from the circumstances, based upon professional judgment, that you do not object to the disclosure. The Plan will, whenever possible, try to get your written objection to these disclosures (if you wish to object), but in certain circumstances it may rely on your oral agreement or disagreement to disclosures to family members.

• To Personal Representatives. The Plan may disclose your PHI to someone who is your personal representative. Before the Plan will give that person access to your PHI or allow that person to take any action on your behalf, it will require him/her to give proof that he/she may act on your behalf; for example, a court order or power of attorney granting that person such power. Generally, the parent of a minor child will be the child’s personal representative. In some cases, however, state law allows minors to obtain treatment (e.g., sometimes for pregnancy or substance abuse) without parental consent, and in those cases the Plan may not disclose certain information to the parents. The Plan may also deny a personal representative access to PHI to protect people, including minors, who may be subject to abuse or neglect.


Under what other circumstances will my PHI be used or disclosed? The Plan is also permitted to use or disclose your PHI in the following circumstances:

• For certain required public health activities (such as reporting disease outbreaks);

• To prevent serious harm to you or other potential victims, where abuse, neglect or domestic violence is involved;

• To a health oversight agency for oversight activities authorized by law;

• For judicial or administrative proceedings (such as in response to a court order or subpoena and discovery request, but only if the Plan has received adequate assurances that the information to be disclosed will be protected);

• For a law enforcement purpose to a law enforcement official (such as providing limited information to locate a missing person);

• To a coroner, medical examiner or funeral director;

• For certain organ, eye or tissue donations;

• For research studies (such as research related to the prevention of disease or disability) that meet all privacy law requirements;

• To avert a serious threat to the health or safety of you or any other person;

• For specified government functions, such as intelligence activities;

• To the extent necessary to comply with laws and regulations related to workers’ compensation or similar programs;

• To organizations engaged in emergency and disaster relief efforts for emergencies or disaster relief; and

• When otherwise required by law.

These uses and disclosures may be subject to special legal requirements.

What if the circumstances described above do not apply? The Plan will not use or disclose your PHI without your written authorization on a prescribed form for (1) uses and disclosures for marketing purposes, (2) uses and disclosures that constitute the sale of PHI, (3) most uses and disclosures of psychotherapy notes, and (4) any other uses and disclosures not found in this notice. You may take back your written authorization at any time, except if the Plan has already acted based on your authorization. You may not, however, cancel your authorization if it was obtained as a condition for obtaining insurance coverage and if your cancellation will interfere with the insurer’s right to contest your claims for benefits under the insurance policy. You may obtain an authorization form by contacting the Plan’s Information Contact.

If you have questions or a problem relating to a claim, a network provider or other health care matter, you will generally be directed to a contact person with the relevant business associate to resolve the matter.


Do State Privacy Laws also apply to PHI? Generally, no. Federal law often supersedes state law from applying to the Plan, particularly where benefits are self-funded by the Company. In certain unusual circumstances where state law is not superseded, a state law may impose more stringent privacy requirements.

What are my individual rights with respect to my PHI? You have the right to:

• Copy or Access Your PHI. See and get a copy of the PHI held by the Plan; except for information compiled in reasonable anticipation of, or for use in, a civil, criminal or administrative action or proceeding. Your request should be made in writing. Certain cost-based fees may apply. The Plan may deny you access to your PHI in the Plan’s records. You may, under some circumstances, request a review of that denial. You may, under some circumstances, request a review of that denial. If the Plan or a Business Associate maintains electronic records of your PHI, you may request an electronic copy of your PHI. You may also request that your electronic records be sent to a third party.

• Amend. Request that the Plan amend your PHI or record if you believe the information is incorrect or incomplete. The Plan may deny your request if the information in its records: (1) was not created by the Plan; (2) is not part of the Plan’s records; (3) would not be information to which you would have a right of access; or (4) is deemed by the Plan to be complete and accurate as it then exists.

• Accounting of Disclosures. At your request, the Plan must provide you with the Plan’s disclosures of your PHI made within the six-year period before your request, except for disclosures made:

• for purposes of treatment, payment or health care operations;

• directly to you or close family members involved in your care;

• for purposes of national security;

• incidental to otherwise permitted or required disclosures;

• as part of a limited data set;

• to correctional institutions or law enforcement officials; and

• with your express authorization.

You may request one accounting, which the Plan must provide at no charge, within a single 12-month period. If you request more than one within the same 12-month period, the Plan may charge you a reasonable fee.

• Paper Copy of This Notice. Get a paper copy of this Notice at any time.

• Request Restrictions on Uses and Disclosures of Your PHI. Request the Plan to limit how it uses and gives out your PHI. You will be required to provide specific information as to the disclosures that you wish to restrict and the reasons for your request. Please note that the Plan may not be able to agree to your request. A restriction cannot prevent uses or disclosures that are required by


the Secretary of DHHS to determine or investigate the Plan’s compliance with the Privacy Rules, or that are otherwise required by law. You may also request that your health care provider not disclose your PHI for a health care item or service to the Plan for payment or health care operations if you have paid for the item or service out-of-pocket in full. Please note if your health care provider does not disclose the item or service to the Plan, the amount you paid for the item or service will not count toward your annual deductible or any out-of-pocket maximums under the Plan. The provider may also charge you the out-of-network rate for the item or service.

• Request Restrictions and Confidential Communications. Request that the Plan’s confidential communications of your PHI be sent to you at another location or by alternative means. The Plan will accommodate your request if it is reasonable and you state clearly that disclosure of all or part of the information could endanger you. Any alternative used must still allow for payment information to be effectively communicated and for payments to be made.

• Receive Notification. You have the right to receive notification of a breach of your unsecured PHI.

As most of your PHI under the Plan is held by a claims administrator or insurance carrier (or HMO), you may wish to contact that entity directly to exercise your individual rights. To exercise your individual rights with respect to enrollment and other information, you should contact the Plan’s Information Contact. Certain administrative or other rules may apply to these individual rights.

How do I make a complaint if I think my rights have been violated? You may file a complaint with the Plan’s Information Contact and with the Secretary of DHHS if you believe the Plan has violated your privacy rights. If your complaint is with an insurer or HMO, you may file a complaint with the individual named in their Notice of Privacy Practices to receive complaints. If your complaint is with the Plan, you may submit your complaint to the Information Contact at the address at the end of this Notice.

To file a complaint with the Secretary of the DHHS, you must submit your complaint in writing, either on paper or electronically, within 180 days of the date you knew or should have known that the violation occurred. You must state who you are complaining about and the acts or omissions you believe are violations of the Privacy Rules. Complaints sent to the Secretary must be addressed to the regional office of the DHHS’ Office of Civil Rights (OCR) for the state in which the alleged violation occurred. For information on which regional office at which you must file your complaint, and the address of that regional office, go to the OCR web site at www.hhs.gov/ocr/hipaa/. You will not be retaliated against for filing a complaint.

http://www.hhs.gov/ocr/hipaa/


Who is the Plan’s Information Contact? If you have any questions about this Notice, please contact the Information Contact:

Enova International, Inc. Benefits Department 200 Jackson Blvd. Chicago, IL 60606 Phone: 312-564-7BEN

What is the effective date of this updated Notice? The effective date of this updated Notice is October 20, 2015.

How can this Notice be changed? The Plan reserves the right to change the terms of this Notice with respect to its privacy and information practices and to make the new provisions effective for all PHI it maintains. Any revisions to the Notice, or an amended Notice, will be provided to you electronically or on paper, as appropriate.


whcra enrollment notice

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

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

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

• Prostheses; and

• Treatment of physical complications of the mastectomy, including lymphedema.

These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. Therefore, the deductibles and coinsurance as noted in your Summary Plan Description may apply. If you would like more information on WHCRA benefits, call your plan administrator at the number listed on the back of your medical plan identification card.

availability of summary of benefits and coverage Choosing a health coverage option is an important decision. To help you make an informed choice, the Plan makes available a Summary of Benefits and Coverage, which summarizes important information about the Plan’s health coverage options available to you in a standard format, to help you compare across options. You may access the Summary of Benefits and Coverage on the Enova Benefits and Total Rewards wiki page during the online enrollment process.


special enrollment notice

You and your eligible dependents may enroll in the medical benefit program offered under the Enova International, Inc. Welfare Benefit Plan (the “Plan”) under the following circumstances:

• Individuals Losing Other Coverage. If you declined coverage under the medical benefit program when it was first available because of other health coverage, and that coverage is later lost on account of:

• exhaustion of COBRA continuation coverage,

• Lost Eligibility for Other Coverage, or

• termination of employer contributions toward the other coverage,

you and your eligible dependents may enroll in the medical benefit program on or before the date that is 30 days after the date you lost that other coverage. Your enrollment will take effect no later than the first of the month following your loss of coverage and your timely request to enroll.

“Lost Eligibility for Other Coverage” includes a loss of other health coverage as a result of your legal separation or divorce, a dependent’s loss of dependent status, death, termination of employment or reduction in number of hours of employment, meeting or exceeding a lifetime limit on health benefits, or you no longer reside, live or work in the service area of a health maintenance organization in which you participated.

• New Eligible Dependents. If you initially declined enrollment for yourself or your eligible dependents and you later have a new eligible dependent because of marriage, birth, adoption, or placement for adoption, you may enroll yourself and your new eligible dependents (including an eligible dependent spouse if you have a new eligible dependent child) as long as you request enrollment on or before the date that is 30 days after the marriage, birth, adoption, or placement for adoption. For example, if you and your eligible dependent spouse have a child, you may enroll yourself, your eligible dependent spouse and your new child in the medical benefit program, even if you were not previously enrolled. You will not, however, be able to enroll existing eligible dependent children for whom coverage has been waived in the past. For birth, adoption, or placement for adoption, your or your eligible dependent’s participation will start as of the date of the birth, adoption, or placement for adoption, as long as you timely requested enrollment. For marriage, your or your eligible dependent’s participation will start no later than the first of the month following the date of the marriage, as long as you request enrollment and submit proof of dependent status on or before the date that is 30 days after the marriage.


• Medicaid and CHIP. If you or your eligible dependent children are eligible for, but not enrolled in, the medical benefit program and you or your eligible dependent children:

• lose coverage under Medicaid or a State child health plan (“CHIP”), or • become eligible for a premium assistance subsidy through Medicaid or CHIP,

you and your eligible dependent children may enroll in the medical benefit program, as long as you request enrollment on or before the date that is 60 days after the loss of coverage or the date you or your eligible dependent children became eligible for the premium subsidy. Your enrollment will take effect no later than the first of the month following your timely request for enrollment.

These 30-day and 60-day periods are “Special Enrollment Periods.”

To request special enrollment or obtain more information, contact:

Enova International, Inc. Benefits Department 200 Jackson Blvd. Chicago, IL 60606 Phone: 312-564-7BEN

newborns’ act disclosure

The Enova International, Inc. Welfare Benefit Plan (the “Plan”) 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, the Plan and insurance issuers may not, under federal law, require that a provider obtain authorization from the Plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).


medicaid and the children’s health insurance program (chip)

Offer Free or Low-Cost Health Coverage To Children And Families

If you are eligible for health coverage from Enova International, Inc., but are unable to afford the premiums, some States have premium assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premiums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, you can contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, your employer’s health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, you can contact the Department of Labor electronically at www.askebsa.gov or by calling toll-free 800-444-EBSA (3272).

If you live in one of the following States, you may be eligible for assistance paying your employer health plan premiums. Contact your State for further information on eligibility –

ALABAMA – Medicaid COLORADO – Medicaid

Website: http://www.medicaid.alabama.gov Phone: 1-855-692-5447

Medicaid Website: http://www.colorado.gov/ Medicaid Phone (In state): 1-800-866-3513 Medicaid Phone (Out of state): 1-800-221-3943 ALASKA – Medicaid

Website: http://health.hss.state.ak.us/dpa/ programs/medicaid/ Phone (Outside of Anchorage): 1-888-318-8890 Phone (Anchorage): 907-269-6529


ARIZONA – CHIP FLORIDA – Medicaid Website: http://www.azahcccs.gov/applicants Phone (Outside of Maricopa County): 1-877-764-5437 Phone (Maricopa County): 602-417-5437

Website: https://www.flmedicaidtplrecovery.com/ Phone: 1-877-357-3268 GEORGIA – Medicaid Website: http://dch.georgia.gov/ Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP)

IDAHO – Medicaid and CHIP MONTANA – Medicaid Medicaid Website: www.accesstohealthinsurance.idaho.gov Medicaid Phone: 1-800-926-2588 CHIP Website: www.medicaid.idaho.gov CHIP Phone: 1-800-926-2588

Website: http://medicaidprovider.hhs.mt.gov/clientpages/ clientindex.shtml Phone: 1-800-694-3084

INDIANA – Medicaid NEBRASKA – Medicaid Website: http://www.in.gov/fssa Phone: 1-800-889-9949

Website: www.ACCESSNebraska.ne.gov Phone: 1-800-383-4278

IOWA – Medicaid NEVADA – Medicaid Website: www.dhs.state.ia.us/hipp/ Phone: 1-888-346-9562

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

KANSAS – Medicaid Website: http://www.kdheks.gov/hcf/ Phone: 1-800-792-4884

KENTUCKY – Medicaid NEW HAMPSHIRE – Medicaid Website: http://chfs.ky.gov/dms/ default.htm Phone: 1-800-635-2570

Website: http://www.dhhs.nh.gov/oii/ documents/hippapp.pdf Phone: 603-271-5218

LOUISIANA – Medicaid NEW JERSEY – Medicaid and CHIP Website: http://www.lahipp.dhh.louisiana.gov Phone: 1-888-695-2447

Medicaid Website: http://www.state.nj.us/humanservices/ dmahs/clients/medicaid/ Medicaid Phone: 1-609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710

MAINE – Medicaid Website: http://www.maine.gov/dhhs/ofi/public-assistance/index.html Phone: 1-800-977-6740 TTY 1-800-977-6741

http://www.accesstohealthinsurance.idaho.gov/

http://www.medicaid.idaho.gov/

http://dhhs.ne.gov/medicaid/Pages/med_kidsconx.aspx

http://dwss.nv.gov/


MASSACHUSETTS – Medicaid and CHIP NEW YORK – Medicaid Website: http://www.mass.gov/MassHealth Phone: 1-800-462-1120

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

MINNESOTA – Medicaid NORTH CAROLINA – Medicaid Website: http://www.dhs.state.mn.us/ Click on Health Care, then Medical Assistance Phone: 1-800-657-3629

Website: http://www.ncdhhs.gov/dma Phone: 919-855-4100

MISSOURI – Medicaid NORTH DAKOTA – Medicaid Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm Phone: 573-751-2005

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

OKLAHOMA – Medicaid and CHIP UTAH – Medicaid and CHIP Website: http://www.insureoklahoma.org Phone: 1-888-365-3742

Website: http://health.utah.gov/upp Phone: 1-866-435-7414

OREGON – Medicaid and CHIP VERMONT– Medicaid Website: http://www.oregonhealthykids.gov http://www.hijossaludablesoregon.gov Phone: 1-800-699-9075

Website: http://www.greenmountaincare.org/ Phone: 1-800-250-8427

PENNSYLVANIA – Medicaid VIRGINIA – Medicaid and CHIP Website: http://www.dpw.state.pa.us/hipp Phone: 1-800-692-7462

Medicaid Website: http://www.dmas.virginia.gov/rcp-HIPP.htm Medicaid Phone: 1-800-432-5924 CHIP Website: http://www.famis.org/ CHIP Phone: 1-866-873-2647

RHODE ISLAND – Medicaid WASHINGTON – Medicaid Website: www.ohhs.ri.gov Phone: 401-462-5300

Website: http://hrsa.dshs.wa.gov/premiumpymt/ Apply.shtm Phone: 1-800-562-3022 ext. 15473

SOUTH CAROLINA – Medicaid WEST VIRGINIA – Medicaid

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

Website: www.dhhr.wv.gov/bms/ Phone: 1-877-598-5820, HMS Third Party Liability


SOUTH DAKOTA - Medicaid WISCONSIN – Medicaid

Website: http://dss.sd.gov Phone: 1-888-828-0059

Website: http://www.badgercareplus.org/pubs/p-10095.htm Phone: 1-800-362-3002

TEXAS – Medicaid WYOMING – Medicaid Website: https://www.gethipptexas.com/ Phone: 1-800-440-0493

Website: http://health.wyo.gov/healthcarefin/equalitycare Phone: 307-777-7531

To see if any more States have added a premium assistance program, or for more information on special enrollment rights, you can contact either: U.S. Department of Labor U.S. Department of Health Employee Benefits and Human Services Security Administration Centers for Medicare & Medicaid Services www.dol.gov/ebsa www.cms.hhs.gov 866-444-EBSA (3272) 877-267-2323, Ext. 61565 Menu Option 4, Ext. 61565

preexisting conditions removed effective 2014 (ACA compliance) Effective January 1, 2014, preexisting condition limitations are no longer allowed in any creditable medical plan. All of Enova’s Medical Benefit options are considered “creditable” and for that reason no longer contain preexisting condition limitations in accordance with applicable federal law. If you receive any notice of preexisting conditions limitations for a medical claim with a date of service of January 1, 2014 or later, please contact the Enova Total Rewards Department immediately, to have the issue rectified. Email: [email protected]