IMPAQ I N T E R N A T I 0 N A L

Transcription

1 IMPAQ I N T E R N A T I 0 N A L October 1, September 30, 2016 EMPLOYEE BENEFITS GUIDE

2 NOTES

3 CONTENTS INTRODUCTION About This Guide... 3 Eligibility for Benefits... 4 Making Changes to Your Benefits... 4 MEDICAL BENEFITS Overview... 5 Medical CoreSource Cigna PPO I Plan... 6 Medical CoreSource Cigna EPO Plan... 6 Medical CoreSource Cigna PPO II Plan CoreSource Administration OTHER HEALTH BENEFITS Vision... 8 Dental Plan... 9 Flexible Spending Accounts (FSA) DISABILITY AND LIFEINSURANCE Short Term Disability Long Term Disability Basic Life and AD&D Insurance Voluntary Life and AD&D Insurance RETIREMENT SAVINGS NOTICES 401K Plan Your Rights COST AND CONTACTS 2015 Contributions Client Health Advocate Benefits Contacts ABOUT THIS GUIDE We understand that choosing your benefits is an important decision for you and your family. Everyone s needs are unique. IMPAQ offers a variety of benefits and options so you may choose what works best for you and your family. A number of these benefits are provided at no cost to you. We created this guide to help you make informed decisions. It is not a complete detailed description, nor is it a contract of employment or a guarantee of benefits. More detailed information for each benefit is contained in the relevant insurance policy. Great care has been taken to ensure that this guide is accurate. However, oversights can occur or condensed summaries can be misinterpreted. If there is a difference between this overview and the SPD or official plan documents governing the plan, the plan documents will be followed. IMPAQ International reserves the right to amend or terminate the program in whole or in part at any time. 3

4 ELIGIBILITY FOR BENEFIT Full-time and Part-time IMPAQ employees working 30 or more hours a week are eligible for benefits on the first day of employment. Affordable Care Act Compliance (ACA) Eligibility Groups Variable 30+ Hour Employees: IMPAQ employees hired to work as a variable 30+ hour employee (working 1,560 hours annually) are offered medical benefits following successful completion of his/her probationary period. Part time Employees: IMPAQ employees hired to work part time hours are reviewed annually to determine whether they meeting the ACA eligibility criteria (working 1,560 hours annually), and if eligible offered medical benefits Each October, IMPAQ will review the ACA eligibility groups to confirm whether the benefit shall continue. The following family members may be enrolled in the medical, dental, and vision programs: Your legal spouse or qualified domestic partner For medical and dental benefits, children to age 26 Your dependent child who is incapable of self-support because of a mental or physical disability For the purpose of our benefits plans, your children include: Natural and adopted children Children of your qualified domestic partner Stepchildren who you support and who live with you in a parent-child relationship Any other children you support for whom you are the legal guardian or for whom you are required to provide coverage as the result of a qualified medical child support order. MAKING CHANGES TO YOUR BENEFITS Open Enrollment typically occurs once each year. You may change your benefit elections during the open enrollment period. Once you have made your selection, you may not change benefit elections until the next open enrollment unless you have a qualifying event in employment or family status. Qualifying events include: Marriage, divorce or legal separation (state specific) Dependent child through birth, adoption or court- ordered custody Death of a spouse or child Your work schedule changes (i.e. reduction or increase in hours which affects eligibility) Your dependent loses eligibility for coverage You or your dependent become eligible for Medicare Your spouse involuntarily loses health coverage through his/her employer You and/or your spouse and dependents become eligible for COBRA You and/or your spouse and dependents gain or lose Medicaid coverage You received a Qualified Medical Child Support Order (QMCSO) If you experience one of the above qualifying events, you have 30 days from the date of the event to notify the Human Capital Department and make any desired benefit changes. Otherwise, elections you make during open enrollment will remain in effect for the entire plan year. Also, if you or your eligible dependents are covered under Medicaid or a State Children s Health Insurance Program (CHIP) and that coverage ends, you may be able to enroll yourself and any affected dependent in this Plan s medical coverage. You must request enrollment within 60 days after the Medicaid or CHIP coverage ends. If you or your eligible dependent becomes eligible, under Medicaid or a State CHIP plan for financial assistance to pay for health coverage under this Plan, you may be able to enroll yourself and any affected dependent in this Plan. You must request enrollment within 60 days after the date a government agency determines that you are eligible for hat financial assistance. 4

5 experience a family status change and want to change your benefits, you MUST contact Human Capital within 30 days of the change. MEDICAL OVERVIEW IMPAQ offers 3 medical plans through the Cigna physician provider network. Cigna PPO I Plan, Cigna EPO Plan, Cigna PPO II. IMPAQ uses CoreSource, a third party claims administrator for benefit verification and for processing medical and Rx claims. As you evaluate your options, it s important to understand: How each plan works Which services are covered If your doctors are covered by the plan Your total cost (the amount deducted from your semimonthly paycheck + the amount you pay when you receive care) PRESCRIPTION COVERAGE IMPAQ offers prescription coverage through CareMark. You can also review pharmacy cost comparisons by going directly A to Caremark s website at Please note you will need to create a user name and password if you would like to run a pharmacy cost comparison. PROVIDER INSTRUCTIONS FOR FINDING A PARTICIPATING MEDICAL PROVIDER Please note: employees will be unable to access the CoreSource website until There are three ways to find what you need: 1. If you are already enrolled, visit mycoresource.com and login using you User ID and Password 2. Visit Cigna.com and click Find a doctor. Be sure to select the PPO, Choice Fund PPO network regardless of what medical plan you are enrolled in 3. Call your third party benefit and claims administrator from 8 AM ET to 7 PM ET at for any claims, eligibility or plan design questions 5

6 MEDICAL IMPAQ International offers up to three medical options through the Cigna physician provider network. The following chart provides an overview of these benefits and the different options available for the plan year. If you select the HRA plan, please note that IMPAQ no longer contributes annually $1,000 for an individual (50% of $2,000) and $2,000 for a family (50% of $4,000) as the monthly premiums have been significantly been reduced for employees. In addition, the deductibles for innetwork services on the Cigna PPO I has been reduced by 50% from the HRA plan. 1 AB = Allowed Benefit; is the amount established for payment of covered In-Network services. The Allowed Benefit will generally be lower than the amount charge d. You are responsible for copayments, coinsurance and all charge s 6

7 CORESOURCE ADMINISTRATION CORESOURCE IMPAQ will use CoreSource as our third party benefit administrator. If you have any questions regarding claims process, benefit verification, or what is covered under your medical and dental plans, please contact the CoreSource Administrative team at BENEFITS DEPARTMENT If you have any questions or concerns about benefit eligibility, and/or plan design, you can also contact the Benefits Department at MY ACCOUNT My Account provides you with online access to your claims. By visiting you will have access to who is covered on your policy, what is covered, claims history and current amount paid towards your deductible and out-ofpocket maximums. You can also review pharmacy cost comparisons by going directly to Caremark s website at You will need to create a user name and password if you would like to run a pharmacy cost comparison. CUSTOMER SERVICE CONTACT INFORMATION Medical, Rx, and Dental: If you have concerns or questions about your plan our customer service line is available to you. You can reach us by phone at: CoreSource customer service is available from 8 AM ET to 7 PM ET. There is an answering service after 7 PM ET and eligibility can be verified 24/7 through IVR. Flexible Spending Accounts: If you have concerns or questions about your plan our customer service line is available to you. You can reach us by phone at: CoreFlex customer service is available from 9 AM ET to 7 PM ET. Vision: If you have concerns or questions about your plan our customer service line is available to you. You can reach us by phone at: VSP s customer service is available from 8 AM ET to 10 PM ET. Please note: Vision claims are not processed through CoreSource 7

8 VISION TRADITIONAL PLAN IMPAQ International offers a vision plan option through Vision Service Plan (VSP). VSP claims and plan eligibility questions will be processed by VSP. With this plan, you can receive care from any provider. However, you will receive a higher level of benefit if you stay in-network because these providers offer discounts for their services prior to your benefit percentage is applied. Vision: If you have concerns or questions about your plan our customer service line is available to you. You can reach us by phone at: VSP s customer service is a available from 8 AM ET to 10 PM ET t use the funds, unless you elect this option under COBRA. BenefitWallet is the administrator of the HRA. 8

9 DENTAL TRADITIONAL PLAN IMPAQ International offers a dental plan option through the Cigna dentist provider network. IMPAQ uses CoreSource, a third party claims administrator for benefit verification and for processing claims. By seeing a participating dentist, you will incur lower out-of- pocket costs for all dental services. Seeing an in-network dentist will give you the maximum savings and most coverage. Your out-of-pocket expenses will generally be higher if you visit a dentist out-ofnetwork. With this plan, you can receive care from any provider. However, you will receive a higher level of benefit if you stay in-network because these providers give discounts for their services prior to your benefit percentage being applied. Please see below for a brief description of the benefits and an estimate of what your out-of-pocket costs will be. More details can be found in the Traditional Dental Plan description. PLAN PROVISIONS PLAN YEAR IN-NETWORK TRADITIONAL Maximum benefit $1,500 Deductible - Individual $50 Deductible - Family $150 Orthodontic Lifetime Maximum (under age 19) COVERED SERVICES You Pay After Deductible $1,000 Preventive 0% Basic 20% Major Care (surgical) 20% Major Care (restorative) 50% Orthodontia (under age 19) Lifetime maximum ** Out of Network Dentist will balance bill 50% $1,000 OUT-OF- NETWORK You Pay After Deductible ** INSTRUCTIONS FOR FINDING A PARTICIPATING DENTAL PROVIDER Please note: employees will be unable to access the CoreSource website until There are three ways to find what you need: 1. If you are already enrolled, visit mycoresource.com and login using you User ID and Password 2. Visit To locate a dental provider: and select the Shared Administration Plus Option 3. Call your third party administrator from 8 AM ET to 7 PM ET hours at for any claims, eligibility or plan design questions

10 FLEXIBLE SPENDING ACCOUNT (FSA) Flexible Spending Accounts allow you to pay for goods and services you already use with your pre-tax dollars. This can reduce your eligible health care and dependent care expenses by as much as 30%. These plans are administered by CoreFlex To make the most of these benefits, it s important to understand the following: Plan year: The plan year for our Flexible Spending Accounts (FSA) are 6/1/15 to 5/31/16. Open enrollment: You must re-enroll in these benefits each year during Open Enrollment. Grace period: For the Healthcare FSA plan year June, 2015 through May 31, 2016, you will now have a grace period to continue spending any remaining FSA balance for 75 days after the end of the plan year. Funds not claimed by the end of the 75-day grace period are forfeited. During the grace period all claims will be paid from your prior plan year funds until they are diminished. Therefore, you should wait to submit claims dated during the grace period until you are sure you have no remaining claims to submit from the prior plan year. There is no grace period for a Dependent Care FSA. Run-out period: The run out period to submit eligible claims continues to be 90 day following the end of the plan year for both FSA plans. Funds not claimed by the end of the 90-day run out period are forfeited. Reimbursement: Your FSA may be used to cover your medical plan deductible that begins on June 1, 2015 through May 31, Employees will have three ways to pay and/or receive reimbursement for claims: Benny Card - the debit card is used to pay for healthcare expenses upfront at the point of purchase. The card can be used at any location that accepts MasterCard. Remember to keep receipts for at least seven years to meet IRS requirements. Note: You may be asked by CoreSource to substantiate your claim. If you fail to substantiate the claim after 90 days, the vendor will terminate your card access until you do substantiate the claim. Submit a reimbursement form with receipts. CoreFlex will review and if approved will provide you with a reimbursement check or you can set up direct deposit. HEALTH CARE FSA UP TO $2,550 ANNUALLY This account allows you to pay for qualifying out-of-pocket health care expenses for you and your dependents. The amount you choose to contribute will be deducted from your pay in equal installments throughout the year. You may not change this amount unless you have a qualifying life event (see Eligibility for Benefits). For a list of eligible Health Care and Dependent Care Flexible Spending please go to the CoreSource website at DEPENDENT CARE FSA UP TO $5,000 ANNUALLY PER HOUSEHOLD This account allows you to pay for dependent daycare so that you can work. If your spouse also contributes to a Dependent Care FSA, your total contributions as a couple cannot exceed $5,000. While you may use these funds to pay a relative that individual must be over the age of 19 and cannot be considered one of your tax dependents. COREFLEX SERVICE CENTER If you have concerns or questions about your plan our customer service line is available to you. You can reach us by phone at: CoreFlex customer service is available from 8 AM ET to 7 PM ET. 8

11 DISABILITY SHORT TERM AND LONG TERM DISABILITY INSURANCE Disability insurance replaces a percentage of your income during extended periods of illness or injury that prevent you from performing your regular work. These benefits will coordinate with any state disability programs in which you are automatically enrolled (e.g., SDI in California, HI, NJ, NY, & RI). There is no cost to employees for Short Term Disability or Long Term Disability coverages. Employees can elect to prepay the taxes on the Short- and Long-Term Disability benefit with a post-tax deduction PLAN PROVISIONS Your benefit Benefit period When benefits begin Definition of disability SHORT TERM DISABILITY 67% of your weekly pre-disability earnings, up to a maximum of $1,000 per week. You will receive benefits as long as you qualify as disabled, for up to 13 weeks. Benefits begin after the 8th day of illness or injury. You are qualified if you are unable to work due to illness or injury as determined by a physician in writing. PLAN PROVISIONS Your benefit Benefit period When benefits begin Pre-existing conditions LONG TERM DISABILITY 60% of your monthly pre-disability earnings, up to a maximum of $5,000 per month. You will receive benefits as long as you qualify as disabled. If you become disabled prior to age 60, benefits will continue until you reach SSNRA. Benefits begin after 90 days of disability. If you are treated for a condition 3 months prior to your effective date, and become disabled as a result of such condition within the first 12 months of your coverage, you will not be eligible for disability payments for such condition. 11

12 LIFE AND AD&D INSURANCE BASIC Basic Life and Accidental Death and Dismemberment (AD&D) coverage is provided at no cost to eligible employees. Life insurance provides some financial security to your dependents in the event of your death. If you have a qualifying accident which results in the loss of limb(s) or eyesight, you will receive a percentage of the AD&D amount. Carrier insures these benefits. IRS regulations allow employers to provide up to $50,000 of life insurance to employees on a tax-free basis. The premium paid on behalf of employees for coverage amounts in excess of $50,000 will be added to the employee s gross income for tax purposes. This is referred to as imputed income PLAN PROVISIONS Death benefit AD&D benefit Reductions to the benefits if you are working Accelerated benefit Conversion Beneficiary designation BASIC LIFE AND AD&D INSURANCE One times your basic earnings rounded up to the next $1,000, to a maximum benefit of $150,000. One times your basic earnings rounded up to the next $1,000, to a maximum benefit of $150,000. At age 70: coverage is reduced by 35% If you are terminally ill, you can receive up to 50% of your lifetime life insurance benefit. Your death benefit will be reduced by this accelerated payment. This policy can be converted to an individual policy in a case of termination. The employee has 31 days to initiate the conversion process. It is your responsibility to ensure that your beneficiary information is correct. If you experience a life event change, be sure to update your beneficiary (ies). 12

13 LIFE AND AD&D INSURANCE VOLUNTARY While the basic life insurance benefit is designed to provide a foundation for you and your dependents, we recognize the potential need to increase your family s protection. Through IMPAQ s benefit program, you have access to Voluntary Life and AD&D insurance. This program allows you to purchase additional amounts of insurance at favorable group rates with certain amounts of coverage guaranteed. These benefits are insured by Sun Life Financial To apply for additional Life and AD&D insurance, please contact Human Capital for the necessary paperwork. PLAN PROVISIONS Your benefit Spouse benefit VOLUNTARY LIFE INSURANCE AND AD&D Coverage is available in increments of $10,000 up to the lesser of five times annual earnings or $300,000. If you apply when initially eligible, you are guaranteed issue up to $100,000. Evidence of Insurability (EOI) is required for amounts over $100,000 or for any amount if you do not apply when you are initially eligible. If you enroll in Voluntary Life insurance, you will automatically be enrolled in Voluntary AD&D at the same election amount. Spouse coverage is available in increments of $5,000 up to the lesser of 50% of the employees benefit amount, or $50,000 whichever is less. EOI is required for amounts over $25,000 or for any amount, if you do not apply when initially eligible. Child benefit Reductions to the benefits Accelerated benefit Portability Conversion Children 6 months and older can be covered for up to $5,000. EOI is required if you do not apply when initially eligible or if your child has been hospitalized within 90 days prior to the date benefits are requested; Children 15 days old but less than 6 months old are covered for $250. Benefits begin reducing at age 70 by 35%. Refer to the plan documents for additional information. If you are terminally ill, you can receive up to 50% of your lifetime benefit in a lump sum. Your death benefit will be reduced by this accelerated payment. You may continue your current coverage at the premium for this policy will be based upon your attained age. Contact the insurance company for details and rates within 31 days of termination. You may convert this policy to an individual policy upon termination of your employer provided coverage. Contact Human Capital for details and rates within 31 days of termination. 13

14 401 (k) (RETIREMENT PLAN) IMPAQ s 401(k) plan helps you save and invest for retirement while receiving certain tax advantages. You choose how your contributions and IMPAQ s matching contributions are invested. You have the option to participate in a Traditional 401(k) and/or a Roth 401(k). In addition to your contribution, IMPAQ will provide an Employer Match. ELIGIBLITY TO ENROLL All employees must meet the eligibility requirements listed below for: You must be 21 years old. The 1 st of the month following your 30 days of completed service. ELIGIBLITY FOR COMPANY MATCH Employees must meet the following criteria for company match: Complete one year service Must have worked at least 1,000 hours. ENROLLMENT PERIOD On meeting the eligibility requirements you may join the Plan: Monthly for Employee Contributions Semi-Monthly for Company Match EMPLOYEE CONTRIBUTIONS Through payroll deduction, you may make contributions up to 100% of your eligible compensation on a pre- and post-tax basis. The combined Internal Revenue Service (IRS) dollar limit is $18,000 for Catch-Up Contributions - If you are age 50 or older and make maximum allowable deferrals to your 401(k), you are entitled to contribute an additional "catch-up contribution". The IRS maximum catch-up contribution is $6,000 for Website: Customer Service: EMPLOYER CONTRIBUTION IMPAQ matches your contributions at 100% of your Contributions up to 3% of your compensation, plus 50% of your contributions up to an additional 2% of compensation. TRADITIONAL 401(K) The Traditional 401(k) allows you to reduce your taxable income by contributing a portion of your gross income to the 401(k) on a pre-tax basis. Contributions and earnings are not taxed until they are received. ROTH 401(K) Unlike the Traditional 401(k), the Roth 401(k) offers you the potential for tax-free retirement income later by investing on an after-tax basis now. The Roth 401(k) allows you the opportunity to take tax-free distributions upon retirement, as long as you meet certain qualifications, by paying taxes on contributions up front. WITHDRAWALS Funds may be withdrawn from your Plan account in these events: Early Retirement Age Financial Hardship Permanently Leave Company Disability Death For further information, please contact Human Capital. 14

15 YOUR RIGHTS COORDINATION OF BENEFITS (COB) Coordination of Benefits applies if you or your covered dependents are insured under more than one health insurance plan. The plans coordinate with each other on payments so that there are no duplicate payments for the same medical service. The order in which payments are made is determined as follows: The plan that covers the patient as an employee (nondependent) is considered the primary plan, initially responsible for payment. The plan that covers the patient as a dependent is the secondary plan. When a dependent child is covered by the plan of more than one parent, (unless court ordered) generally the plan of the parent whose birthday falls earlier in the year is considered the primary plan. HIPAA PRIVACY We are required by law to maintain the privacy of your Protected Health Information (PHI) and to provide individuals with notice of our legal duties and privacy practices with respect to PHI. The HIPAA Notice of Privacy Practices for the Company Employee Health Plans was effective April 14, 2004 and remains in effect. NEWBORNS AND MOTHERS HEALTH PROTECTION ACT Federal law (Newborns and Mothers Health Protection Act of 1996) prohibits the plan from limiting a mother s or newborn s length of hospital stay to less than 48 hours for a normal delivery, 96 hours for a cesarean delivery or from requiring the provider to obtain preauthorization for a stay of 48 hours or 96 hours, as appropriate. However, federal law generally does not prohibit the attending provider, after consultation with the mother, from discharging the mother or her newborn earlier than 48 hours for normal delivery or 96 hours for cesarean delivery. THE WOMEN S HEALTH AND CANCER RIGHTS ACT 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. If you would like more information on WHCRA benefits, call your plan administrator. COBRA Under the Consolidated Omnibus Budget Reconciliation Act (COBRA) of 1985, COBRA qualified beneficiaries (QBs) generally are eligible for group coverage for a maximum of 18 months for qualifying events due to employment termination or reduction of hours to work. Certain qualifying events, or a second qualifying event during the initial period of coverage, may permit a beneficiary to receive a maximum of 36 months of coverage. COBRA coverage is not extended for those terminated for gross misconduct. Upon termination, or other COBRA qualifying event, the former employee and any other QBs will receive COBRA enrollment information. Qualifying events for employees include voluntary/ involuntary termination of employment, and the reduction in the number of hours of employment. Qualifying events for spouses or dependent children include those events above, plus, the covered employee s becoming entitled to Medicare; divorce or legal separation of the covered employee; death of the covered employee; and the loss of dependent status under the plan rules. If a QB chooses to continue group benefits under COBRA, they must complete an enrollment form and return it to Corporate Services Group. Upon receipt of premium payment and enrollment form, the coverage will be reinstated. Thereafter, premiums are due on the 1st of the month. If premium payments are not received in a timely manner, federal law stipulates that your coverage will be cancelled after a 30-day grace period. If you have any questions about COBRA or the Plan, please contact Human Capital. Please note, if the terms of the Plan and any response you receive from the Human Capital Department reprehensive conflict, the Plan document will control. 15

16 EMPLOYEE CONTRIBUTIONS 2015 ABOUT YOUR PREMIUMS Any contributions you make for yourself, your spouse or your children s medical, dental or vision plan coverage are automatically deducted from your paycheck on a pre-tax basis per IRS guidelines under Section 125. This decreases your taxable earnings and can increase your take-home pay. You are enrolled in this program when you become eligible for benefits and do not need to take any action if no changes are needed. You must notify Human Capitol in writing if you would like your contributions to be taken post-tax. IMPAQ reserves the right to change employee contributions to the health plan at any time during the year. PLAN MEDICAL PREMIUMS FOR DOMESTIC PARTNERS AND THEIR CHILDREN Because the IRS does not recognize domestic partners or their children (unless they qualify as dependents under Section 152) for tax filing purposes, we are required to impute the value of these benefits and report that value, less any post-tax deductions, as taxable income to you. The applicable amount will be added back into your paycheck as taxable income and you will pay taxes on that amount. In addition, deductions for your Domestic Partner and their children will be taken post-tax. If you enroll a domestic partner in these plans, you may be able to deduct your portion of the premium costs on your state tax return. Each state s requirements vary; please consult your tax advisor for details. Some states do not permit pre- tax or tax-free coverage for adult children. As a result, we may impute the value of this coverage and report it as taxable income. To determine the applicable imputed income for the plan you have chosen, please contact Human Capital. (PAY PERIOD) EMPLOYEE CONTRIBUTIONS Cigna PPO I Plan (Formerly BluePreferred HRA) Individual Only $72.50 Individual + Spouse/DP $ Individual + Child(ren) $ Family $ Cigna EPO Plan (Formerly BlueChoice HMO) Individual Only $ Individual + Spouse/DP $ Individual + Child(ren) $ Family $ Cigna PPO II Plan (Formerly BlueChoice Opt-Out Open Access) Individual Only $ Individual + Spouse/DP $ Individual + Child(ren) $ Family $ DENTAL Cigna Traditional Dental Plan Individual Only $4.00 Individual + Spouse/DP $13.00 Individual + Child(ren) $7.00. Family $15.00 VISION Vision Service Plan Individual Only $4.00 Individual + Spouse/DP $6.00 Individual + Child(ren) $7.00 Family $11.00 ADDITIONAL BENEFITS Basic Life and AD&D These benefits are provided at no cost to you. Short and Long Term Disability

17 CONTACT CLIE NT HEA LTH A DV O CA TE When questions, concerns, and benefit issues arise, you as an IMPAQ employee are encouraged to call the number on the back of your insurance card as a first response. If you are not satisfied with the answers you receive or if you need more individualized assistance, call either IMPAQ s Benefit Manager, Allison Stauffer. Allison is IMPAQ s HIPAA Compliance Officer. She will provide assistance with your healthcare and insurance-related issues. She will advocate on your behalf to best assist you with claims & billing issues, eligibility, appeals, coverage, and benefit issues. She will provide IMPAQ employees with one-to-one support for you and for your dependents. We understand your needs and follow careful protocols, including government privacy standards such as HIPAA PRIVACY. Your medical and personal information is strictly confidential. Claims Billing Eligibility Appeals Please feel free to contact with any questions or concerns Allison Stauffer Benefits & Compensation Manager Direct: Fax: astauffer@impaqint.com 17

18 CONTACTS PLAN GROUP NUMBER MEMBER SERVICES WEBSITE MEDICAL CoreSource Administration (Cigna PPO I Plan) CoreSource Administration (Cigna EPO Plan) CoreSource Administration (Cigna PPO II Plan) CoreFlex Flexible Spending Accounts DENTAL & VISION BENEFITS CoreSource Traditional Dental Vision Service Plan (VSP) DISABILITY AND LIFE INSURANCE Sun Life Financial - Short Term Disability Sun Life Financial - Long Term Disability Sun Life Financial - Life and AD&D Insurance EMPLOYEE ASSISTANCE PROGRAM (EAP) Employee Assistance Program User ID: eap Password: advantage RETIREMENT SAVINGS PLAN 401 (k) benefits@impaqint.com CDM IMPAQ BENEFITS TEAM benefits@impaqint.com Please Note: This booklet provides a summary of the benefits available, but this is not your Summary Plan Description (SPD). The Company reserves the right to modify, amend, suspend, or terminate any plan at any time, and for any reason without prior notification. The plans described in this book are governed by insurance contracts and plan documents, which are available for examination upon request. We have attempted to make the explanations of the plans in this booklet as accurate as possible. However, should there be a discrepancy between this booklet and the provisions of the insurance contracts or plan documents, the provisions of the insurance contracts or plan documents will govern. In addition, you should not rely on any oral descriptions of these plans, since the written descriptions in the insurance contracts or plan documents will always govern. 18