Tier II: Providers and HPN/Geisinger. After Deductible 80% - Ancillary Services (x-rays, labs) (of Professional Allowance) After Deductible

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1 Health Insurance Third-Party Administrator: Geisinger Health Plan Coverage: *Begins the first month after benefit eligibility Deductibles *Dependent children covered to age 26 Annual, calendar year deductibles Separate deductibles for each Tier Tier I: $100 individual / $200 family Tier II: $250 individual / $500 family Tier III: $450 individual / $900 family Coverage is dependent on where services are rendered in our three-tier structure (see below). Tier I Providers: Ruby Memorial Physician Office Center Chestnut Ridge Center Family Medicine Mary Babb Randolph Cancer Center WVU Cheat Lake Physicians WVU Urgent Care Healthworks WVUH-East Camden Clark UHA Potomac Valley Hospital Tier I: WVUHS/UHA Tier II: Providers and HPN/Geisinger Tier III: Out-Of-Network Providers and HPN/Geisinger Network Facilities Inpatient & Outpatient Procedures 80% - Ancillary Services (x-rays, labs) (of Professional Allowance) 60% (of Professional Allowance) Office Visit $15 co-pay Primary Care Physician $35 co-pay Specialty Care Physician $25 co-pay Primary Care Physician $50 co-pay Specialty Care Physician 60% Emergency Room $100 co-pay if true emergency (co-pay waived if admitted, unless for observation) $100 co-pay if true emergency (co-pay waived if admitted, unless for observation) $100 co-pay if true emergency (co-pay waived if admitted, unless for observation) Urgent Care $25 co-pay $50 co-pay 60% co-insurance

2 Prescription Coverage Prescription drug coverage depends on whether the drugs are generic, formulary brand, or non-formulary brand; and where they are purchased. Retail Pharmacy Medical Center Pharmacy Only (located in the Physician Office Center) $4.00 co-pay generic (or 30%, whichever is less) $15.00 co-pay formulary brand (or 30%, whichever is less) $25.00 co-pay non-formulary brand (or 50%, whichever is less) All other Retail Pharmacies Employee co-insurance (minimum $5.00 per prescription) 30% generic and formulary brand 50% non-formulary brand Maintenance Medications (Medical Center Pharmacy) Employee co-pays for the 90-day supply for long-term maintenance prescriptions: $10.00 co-pay generic (or 30%, whichever is less) $30.00 co-pay formulary brand (or 30%, whichever is less) $60.00 co-pay non-formulary brand (or 50%, whichever is less) * Certain medications used to treat chronic conditions are offered at no cost through the Medical Center Pharmacy only. Biologic Expensive Medications $35.00 for generic $60.00 for formulary brand $ for non-formulary brand Other Important Things to Note: Once you enroll in Health Insurance and receive your ID cards, there are many self-service options on Geisinger s website thehealthplan.com. You can: Look up physicians in the Geisinger Network Check claims status Elect to receive your Explanation of Benefits (EOBs) online Access a wealth of information on health and wellness topics Request additional insurance cards

3 Dental Insurance (2015) Carrier: United Concordia The coverage is effective the first day of month following your date of benefit eligible employment. Dependent children covered to age 26 Deductibles: $50 individual $100 family Schedule of Benefits Concordia Flex Level of Coverage for each Benefit Category If enrolled as a late entrant in the first 12 months that an employee and dependents are insured, the only available coverage will be for exams, cleanings and fluoride application (Class 1). 80% 80% 80% 80% 80% 80% 50% 50% 50% $1,500 Diagnostic & Preventative Services Exams (twice in any 12 consecutive months) Cleanings (twice in any 12 consecutive months) Fluoride Application age 18 and under (once in any 12 consecutive months) Sealants (limited permanent first molars once during a 3-year period for persons age 16 and older) Bitewing X-rays (limited to 2 allowances in a calendar year) Palliative Emergency Treatment Full Mouth X-rays (once in any 36 consecutive months) Basic Service Simple Extractions Repairs Endodontics Basic Restorative Non-Surgical Periodontics Complex Oral Surgery Major Services Inlays, Onlays and Crowns Prosthetics Orthodontics (dependents to age 19) Diagnostic, Active and Retention Treatment Orthodontic Lifetime Maximum * The level of coverage percentage shown above is based upon United Concordia s Maximum Allowable Charge (MAC). Participating providers will accept United Concordia s allowance as payment in full (less any deductible or coinsurance amounts that are the member s responsibility). The network of participating providers for this program is Advantage Plus. Using a non-participating provider may result in additional out-of-pocket expenses.

4 Dental Insurance (2015) The maximum benefit per calendar year per participant is $1,500. Note: If you do not sign up for the dental insurance when you are first eligible, you will be considered a late entrant and will have coverage for Class 1 services only for the first 12 months. After the 12-month waiting period, you will have coverage for all services. Visit the United Concordia website at unitedconcordia.com.

5 Vision Insurance Carrier: Superior Vision The coverage is effective the first day of month following your date of benefit eligible employment. Dependent children covered to age 26 Coverage: Comprehensive eye exam once every 12 months Lenses every 12 months Frames every 24 months (up to $100) Contacts every 12 months (up to $120) Benefits are on a rolling calendar year. For example, if you receive an eye exam in March, you are not eligible for another exam until at least the following March. In-network and out-of-network benefits. (Out-of-network benefits may result in much larger out-of-pocket expenses for employees.) $10 co-pay for exams $10 co-pay for materials Visit the Superior Vision website at superiorvision.com.

6 Life Insurance Carrier: Unum Basic Life Insurance Corporate paid benefit No cost to you! Beneficiary receives 2 times your annual base salary (or $10,000, whichever is greater) in the event of your death. Supplemental Life Insurance - You can elect up to the lesser of 5 times your annual base salary or $1,500,000 (when combined with the basic life insurance). - Supplemental life insurance at UHA is a voluntary benefit. You pay of the premium. - Premiums are based on age, amount elected and tobacco use. - If you do not elect this benefit now or if you increase your level of coverage in the future, then you must go through an underwriting process, which requires disclosure of medical history. Dependent Life Insurance - Life insurance coverage for spouse and eligible dependent children (to age 19 or 25 if a full-time student). - Premiums for spousal coverage are based on age, amount elected and tobacco use. - Any amount over $20,000 now, or any amount at a later date, requires a spouse to complete the underwriting process, which requires disclosure of medical history. Increment of Coverage Maximum Benefit Child $2,000 The lesser of 50% of your life insurance amount or $10,000. Spouse $5,000 The lesser of 50% of your life insurance amount or $250,000.

7 Spending & Salary Reduction Accounts Third-Party Administrator: Flex Compensation Medical Spending Account (MSA) You can set aside up to $2,500 per year on a pre-tax basis to pay for out-of-pocket expenses. Examples of what you can use an MSA for Doctor visit co-pays Hearing aids Prescription costs Glasses, contacts, frames, etc. Health insurance deductibles Dental treatment (including orthodontia) Child Care 2 Salary Reduction Account You can set aside up to $5,000 per year on a pre-tax basis to pay for the reimbursement of child care expenses. This account is for reimbursement of child care expenses from day care or a private babysitter for children up to age 13. You can only be reimbursed for the amount that has accumulated in your account. Account can only be used for you and your spouse to be able to work or go to school full-time. * For access to claims forms, balance information, claims status, or direct deposit forms, visit the Flex Compensation website at flexcompensation.com. *

8 Sick Time (STD) Third-Party Administrator: Unum - Corporate paid benefit No cost to you! - When medically supported, short-term disability (STD) pays of your base salary while off work for a non-work related illness or disability. - Employees with a claim must call after being off for 16 work hours. Also, you must call and file a claim in advance for events that are pre-planned (i.e. surgery, pregnancy, etc.). The first 16 hours missed, the elimination period, will be paid out of PTO. - The 16-hour PTO elimination period will be waived if the absence is due to an inpatient admission or for a procedure that requires moderate sedation. - STD may also be used to care for immediate family members (spouse, children or parents of the employee), provided that the employee s presence is medically necessary and certified as such by the family member s physician. *Accumulation Rate Per Pay Period: *Accumulation Rate Per Year: Maximum Benefit: 3.70 hours per pay 12 Days 130 Days (1040 Hours) * Part-time employees accumulate Short-Term Disability on a pro-rated basis. The maximum benefit is also pro-rated. ** For detailed information regarding you benefit coverage please visit the HR website on Connect.

9 Long-Term Disability Carrier: Unum All UHA employees working 25 or more hours per week (.63 FTE or above) are eligible. Long-Term Disability insurance guarantees a monthly income should you become totally disabled by a non-work related illness or injury. Coverage Corporate paid benefit No cost to you! When medically supported, long-term disability pays 60% of your base salary for a non-work related illness or disability, with a maximum monthly benefit of $5,000. Continues until the age of 65 as long as you remain disabled. Eligible after 31 days of benefit eligible service. Mental health disability will be covered for a 24-month maximum. Pre-existing conditions and limitations apply.

10 Retirement UHA Offers Several Retirement Plan Options 401(a) Corporate Pension Plan - funded by the employer. - Contributions begin the first day of the month following date of benefit eligible employment. - You will be vested in the plan after two years of benefit eligible employment. - Contributions are based on service and base pay rates. - You can choose TIAA-CREF, Valic, or Fidelity as your retirement vendor for this plan. Years of Service or more years % of Employer Contribution 6% 7% 8% 10% 403(b) Supplemental Retirement Plan - You can contribute up to IRS MAC* annually on a pre-tax basis. Pre-tax contribution are not subject to federal income tax (but is subject to Social Security taxes) and results in a deduction from your taxable income for that plan year. - If you are age 50 or over, you can contribute an additional IRS CUC* per year. - You are immediately vested in your contributions. - You can choose TIAA-CREF, Valic, Fidelity, or Vanguard as your retirement vendor for this plan. 403(b) Roth Retirement Plan - You can contribute up to the IRS MAC* annually on a post-tax basis. - If you are age 50 or over, you can contribute an additional IRS CUC* per year. - You are immediately vested in your contributions. - You can choose TIAA-CREF, Valic, or Fidelity as your retirement vendor for this plan. * Total contributions between the 403(b) Supplemental Retirement Plan and the 403(b) Roth Retirement Plan cannot exceed the annual IRS Maximum Allowed Contribution (MAC). If you are age 50 or over, total combined contributions cannot exceed the annual IRS Catch-Up Contribution (CUC). Visit the TIAA-CREF website at tiaa-cref.org/uha Visit the Valic website at valic.com Visit the Fidelity website at fidelity.com MAC for 2015 is $18,000 CUC for 2015 is $6,000

11 Additional Benefits Paid Time Off (PTO): The annual allowance of PTO depends on your length of service. After the first year of service, a full-time employee will have earned a total of 18 paid days off. Eligibility begins immediately. PTO is pro-rated for part-time employees. Holidays: UHA provides 9 designated paid holidays each year. If you work on a designated holiday, you will receive compensatory time off to be used within 90 days of the holiday. Holidays are pro-rated for part-time employees. Tuition Assistance (Non-Faculty): Tuition assistance provides reimbursement up to a specific dollar amount per year for an approved job or career-related coursework. This benefit is prorated for part-time employees. Eligibility begins after one year of employment. Long-Term Care: Employees are eligible to receive a discount for Long-Term Care insurance through Northwestern Mutual. AFLAC Disability Insurance: Voluntary program that offers disability coverage for some illnesses, accidents, or injuries. Maternity is a covered benefit.

12 Alternate Health Insurance Third-Party Administrator: Geisinger Health Plan Coverage: *Begins the first day of the month following your date of benefit eligible employment (provided enrollment in our HRIS system is complete within required timeline). *Dependent children covered to age 26 Deductibles Annual, calendar year deductibles Separate deductibles for each Tier Tier I: $1,000 individual / $2,000 family Tier II: $1,500 individual / $3,000 family Tier III: $2,500 individual / $5,000 family Tier I Providers: Ruby Memorial Physician Office Center Chestnut Ridge Center Family Medicine Mary Babb Randolph Cancer Center WVU Cheat Lake Physicians WVU Urgent Care Healthworks WVUH-East Camden Clark UHA Potomac Valley Hospital Coverage is dependent on where services are rendered in our three-tier structure (see below). Tier I: WVUHS/UHA Tier II: Providers and HPN/Geisinger Tier III: Out-Of-Network Providers and HPN/Geisinger Network Facilities Inpatient & Outpatient Procedures 80% 80% - Ancillary Services (x-rays, labs) (of Professional Allowance) 60% (of Professional Allowance) Office Visit $25 co-pay Primary Care Physician $40 co-pay Specialty Care Physician $35 co-pay Primary Care Physician $60 co-pay Specialty Care Physician 60% Emergency Room $200 co-pay if true emergency (co-pay waived if admitted, unless for observation) $200 co-pay if true emergency (co-pay waived if admitted, unless for observation) $200 co-pay if true emergency (co-pay waived if admitted, unless for observation) Urgent Care $25 co-pay $50 co-pay 60% co-insurance

13 Alternate Prescription Coverage Prescription drug coverage depends on whether the drugs are generic, formulary brand, or non-formulary brand; and where they are purchased. Retail Pharmacy Medical Center Pharmacy Only (located in the Physician Office Center) $20.00 co-pay generic (or 30%, whichever is less) $40.00 co-pay formulary brand (or 30%, whichever is less) $60.00 co-pay non-formulary brand (or 50%, whichever is less) All other Retail Pharmacies Employee co-insurance (minimum $5.00 per prescription) 40% generic and formulary brand 60% non-formulary brand Maintenance Medications (Medical Center Pharmacy) Employee co-pays for the 90-day supply for long-term maintenance prescriptions: $20.00 co-pay generic (or 30%, whichever is less) $60.00 co-pay formulary brand (or 30%, whichever is less) $85.00 co-pay non-formulary brand (or 50%, whichever is less) * Certain medications used to treat chronic conditions are offered at no cost through the Medical Center Pharmacy only. Biologic Expensive Medications $65.00 for generic $ for formulary brand $ for non-formulary brand Other Important Things to Note: Once you enroll in Health Insurance and receive your ID cards, there are many self-service options on Geisinger s website thehealthplan.com. You can: Look up physicians in the Geisinger Network Check claims status Elect to receive your Explanation of Benefits (EOBs) online Access a wealth of information on health and wellness topics Request additional insurance cards

Tier II: Providers and HPN/Geisinger. After Deductible 80% - Ancillary Services (x-rays, labs) (of Professional Allowance) After Deductible

Tier II: Providers and HPN/Geisinger. After Deductible 80% - Ancillary Services (x-rays, labs) (of Professional Allowance) After Deductible Health Insurance Third-Party Administrator: Geisinger Health Plan Coverage: *Begins your first day of benefit eligibility Deductibles *Dependent children covered to age 26 Annual, calendar year deductibles

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