BENEFITS WITH PRINCIPLE SOLUTIONS GROUP June 1, 2015 – May 31, 2016 Next

MEDICAL OPTIONS EE Only $70.70 EE+Spouse $ EE+Child(ren) $ EE+Family EE Only $84.65 EE+Spouse $ EE+Child(ren)$ EE+Family$ Option 1: $4,000 Deductible (Health Savings Account) Option 1: $4,000 Deductible (Health Savings Account) Option 2: $5,000 Deductible Point of Service Plan Option 2: $5,000 Deductible Point of Service Plan Deductible: (In-Network) Single: $4,000 Family $8,000 Family $10,000 Insurance Carrier: United Health Care Policy Number: EE Only$ EE+Spouse$ EE+Child(ren)$ EE+Family$ Single: $5,000 Family $7,500 Option 3: $2,500 Deductible Point of Service Plan Option 3: $2,500 Deductible Point of Service Plan Single: $2,500 Deductible: (In-Network) Previous Rates Reflect Employee Biweekly Deductions Next Option 2 Option 3 Dental Vision Life Ins Disability Electing Benefits Electing Benefits Option 1 Use the Menu to navigate, or click “Next to go to the next slide.

Coinsurance: In Network: 70% / Out of Network: 60% In-Network Deductible: Single $4,000/Family: $8,000 In Network Out of Pocket Max: Single: $6,400/ Family: $13,200 Employee pays 100% of medical cost up to deductible, with the option to pay any out of pocket medical, dental or vision cost, with tax free dollars, up to annual limits. (See next slide for more details.) OPTION 1: HSA MEDICAL PLAN Option 1 EE Only $70.70 EE+Spouse $ EE+Child(ren) $ EE+Family $ Rates Reflect Employee Biweekly Deductions Next Previous Insurance Carrier: United Health Care Policy Number:

Option WHAT IS AN HSA? Watch Video Previous Next 1 What is an HSA? Is an HSA right for me? 2015 Contribution Limits Frequently Asked Questions Retirement HAS Comparison Additional Resources

Health Savings Account (HSA) Advantages:  Tax-deductible Contributions to the HSA are 100% deductible (up to the legal limit) — just like an IRA  Tax-free Withdrawals to pay qualified medical expenses, including dental and vision, are never taxed.  Tax-deferred Interest earnings accumulate tax-deferred, and if used to pay qualified medical expenses, are tax-free.  HSA money is yours to keep Unlike a flexible spending account (FSA), unused money in your HSA isn’t forfeited at the end of the year; it continues to grow tax- deferred. HSA holders can choose to save up to $3,350 for an individual and $6,650 for a family (HSA holders 55 and older get to save an extra $1,000 which means $4,350 for an individual and $7,650 for a family) - and these contributions are 100% tax deductible from gross income. Minimum annual deductibles are $1,300 for self-only coverage or $2,600 for family coverage. Annual out-of-pocket expenses (deductibles, copayments, and other amounts, but not premiums) cannot exceed $6,450 for self-only coverage and $12,900 for family coverage. Tier Contribution Limit 55+ Additional Contribution Single $3,350$1000 Family $6,650$1000 Previous Maximum Annual Contribution Next Option 1

OPTION 2: $5,000 DEDUCTIBLE POINT OF SERVICE Dr. Visit: Co-Pay- $30 Specialist: Co-pay-$60 Urgent Care: Co-pay-$75 Emergency Room: Co-pay-$200 (Waived if admitted) Brand Name and Generic RX coverage, with tiered co-pays. Co-insurance: In Network: 70%/ Out of Network 60% In-Network Deductible: Single $5,000/Family: $10,000 Out of Network Deductible: Single $10,000/Family: $20,000 In Network Out of Pocket Max: Single: $6,600/ Family: $13,200 Out of Network Out of Pocket Max: Single: $13,200/ Family: $26,400 No RX Deductible Insurance Carrier: United Health Care Policy Number: Previous Rates Reflect Employee Biweekly Deductions EE Only$84.95 Next EE+ Spouse$ EE+Child(ren)$ EE+Family$ Option 1 Option 3 Dental Vision Life Ins Disability Electing Benefits Electing Benefits Option 2

OPTION 3: POINT OF SERVICE EE Only$ EE + Spouse$ EE+ Child(ren)$ EE + Family$ Previous Dr. Co-Pay- $25 Specialist Co-pay-$50 Urgent Care Co-pay- $75 Prescription drugs (Tier based co-pays) Emergency Room Co-pay-$ 150 (Waived if admitted) Co-insurance: In Network: 80% / Out of Network 60% In-Network Deductible: Single $2,500/Family: $7,500 Out of Network Deductible: Single $5,000/Family: $15,000 In Network Out of Pocket Max: Single: $6,600/ Family: $13,200 Out of Network Out of Pocket Max: Single: $8,200/ Family: $16,000 No RX Deductible Rates Reflect Employee Biweekly Deductions Next Insurance Carrier: United Health Care Policy Number: Option 1 Dental Vision Life Ins Disability Electing Benefits Electing Benefits Option 2. Option 3

Teladoc is a 100% employer paid service that gives all participants of a PSG medical plan access to a Doctor through your phone or video consults. 27/7/365 access to a licensed Doctor with over 15 years experience. They can even call in a prescription for you or your dependents!  Talk to a doctor anytime, anywhere you happen to be.  Receive quality care via phone or online video.  Prompt treatment, average call back in 16 min.  A network of doctors that can treat children of any age.  Secure personal and portable electronic health record.  No limits on consults, so take your time! Teladoc is a 100% employer paid service that gives all participants of a PSG medical plan access to a Doctor through your phone or video consults. 27/7/365 access to a licensed Doctor with over 15 years experience. They can even call in a prescription for you or your dependents!  Talk to a doctor anytime, anywhere you happen to be.  Receive quality care via phone or online video.  Prompt treatment, average call back in 16 min.  A network of doctors that can treat children of any age.  Secure personal and portable electronic health record.  No limits on consults, so take your time! Next Previous

DENTAL COVERAGE EE Only $ 9.50 EE+Spouse $20.39 EE+ Child(ren) $18.76 EE+ Family $32.37 Insurance Carrier: MetLife Deductible: Single $50/ Family $150 Max plan will pay per year per member: $3,000 Preventative: 100% Covered Deductible Waived: Cleanings (1 per 6 months) Space maintainers (Under Age 15) X-Rays- Bitewings & Full Mouth Sealants – Under Age 16 Deductible Applies: 80% Co- Insurance Fillings Simple Extractions Oral Surgery Periodontics Endodontics Deductible Applies: 50% Co-Insurance Crowns Bridges Dentures Implants Previous Next Rates Reflect Employee Biweekly Deductions Option 1 Option 2 Option 3 Vision Life InsIns Life InsIns Electing Benefits Electing Benefits Disability

VISION EE Only $3.42 EE+Spouse $6.00 EE+ Child(ren) $6.32 EE+ Family $9.95 Insurance Carrier: MetLife (Once Every 12 months) Eye Exams: InNetwork $10 Copay/ OutNetwork $45 Copay Frames: InNetwork $130 allowance/OutNetwork $70 allowance Lenses: (Once every 12 months) Single: In Network $20 copay/Out of Network $30 allowance Lined Bifocal:$20 copay/Out of Network $50 allowance Lined Trifocal: $20 copay/Out of Network $65 allowance Contact Lenses (Instead of Frames or Lenses/Once every 12 months ) In Network: $130 allowance OutNetwork: $105 allowance Previous Next Rates Reflect Employee Biweekly Deductions Option 1 Option 2 Option 3 Option 3 Life Ins Disability Dental Electing Benefits Electing Benefits

VOLUNTARY LIFE INSURANCE Previous Next Insurance Carrier: Mutual of Omaha Employee Optional group term life insurance benefit You may purchase coverage in an amount of $10,000 to $500,000 in increments of $10,000. Your family or beneficiary will get this additional benefit amount if you pass away. If you choose an optional life benefit amount more than $120, you will need to have an EOI (Evidence of Insurability) approved by Mutual of Omaha. An EOI form will be sent to you within 48 hours of your election. AgeCost Per $1, and over4.630 Option 1 Option 2 Option 3 Option 3 Dental Life Ins Disability Electing Benefits Electing Benefits

SPOUSAL AND CHILD LIFE INSURANCE Previous Next Insurance Carrier: Mutual of Omaha Optional Life Coverage for your family You may also choose additional life coverage for your spouse and your children. If you choose Optional Life coverage for your Spouse of more than $30, you will need to have an EOI (Evidence of insurability ) approved by Mutual of Omaha. Within 48 hours of your election, the EOI form will be sent to you via . *Dependents coverage may not exceed 50% of the employee’s own elected Life insurance amount. Child Optional group term life rates- Monthly Rate per $1000 of coverage: $0.20 AgeCost Per $1, and over4.630

LONG TERM DISABILITY(LTD) Help Protect Your Loved Ones- And your Income with Long Term Disability Long term disability will pay you 60% of your annual gross income until retirement age in the event of injury or illness which would prevent you from working. Your monthly LTD benefit will be 60% of your monthly pre-disability earnings, up to the maximum of $10,000, less deductible sources of income. **No medical questions asked if you enroll at your time of hire. How to Calculate Your Total LTD biweekly cost Previous Next Insurance Carrier: Mutual of Omaha

NOW IT’S TIME TO ELECT YOUR BENEFITS! Log on to the Employee Self Service Click the “My Self” tab at the top of the screen: Click “Benefits” and then Enrollments. Click Here for Instructions to Register Previous Next But first, you will need to register in our Employee Self Service Portal. Please Note: New Hires must be loaded in our system prior to enrolling. This may take up to a week from your start date. If you are unable to register, please try back in a few days. Close