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1 P.O. Box , MD 5675 DFW Airport, TX AME292-M John Sample 123 Any Street 123 Any Street Any Town, US PRESORTED STANDARD U.S. POSTAGE PAID Hamburg, NY PERMIT NO. 356
2 Management and Support Staff Your 2015 American Airlines Benefits Learn more at my.aa.com
3 New benefits for legacy US Airways management and support staff effective January 1, We ve made a lot of progress in our merger with American Airlines this year thanks in part to your hard work. In 2015, we will reach another important milestone by integrating our management and support staff health and welfare benefits. At American Airlines, we believe that the quality of your life off the job is as important as the work you do on it. This brochure provides a brief overview of your new American benefits to help make your transition as smooth as possible. American is committed to providing you with access to information about your benefits in a clear, simple, practical manner. This means information that supports informed decisions about your health coverage, including: Resources that will help you use health care wisely. Tools that will help you plan and secure your financial future. Readily available benefits information via my.aa.com. You ll receive more information (including rates) in time for annual enrollment this fall. This guide provides an overview of your benefits plans and programs. The complete provisions of the benefit plans are set forth in the plan documents, available for review on my.aa.com. If the information in this guide is inconsistent with the plan documents or company policies, the plan documents or company policies will govern. This guide is not intended as a contract of employment or a guarantee of current or future employment. To the extent these plans and programs conflict with state or local law, we will, of course, follow the applicable laws. The company(s) reserve the right to amend or terminate each plan or program at any time. 1
4 Here is a brief summary of your new 2015 benefits. For additional details, visit my.aa.com. Three Medical Options American offers three medical plan options to all employees: Standard, Core and Value. Each medical plan option comes with a corresponding health spending account administered by Aon Hewitt. Standard with HRA: Medium out-of-pocket costs with medium monthly contributions compared to the Core and Value options Core with HSA: Higher out-of-pocket costs with lower monthly contributions Value with HIA: Lower out-of-pocket costs with higher monthly contributions In most cases, American pays 100% of your in-network preventive care under all three medical options. Health Spending Account Standard Option Core Option Value Option HRA (Health Reimbursement Account) HSA (Health Savings Account) HIA (Health Incentive Account) Compatible with Health Care FSA Limited Purpose FSA Health Care FSA Deductibles: Individual/ Family In-Network Deductibles: Individual/ Family Out-of-Network OOP Max: Individual/ Family In-Network $800/$2,400 $2,000/$4,000 1 $350/$1,050 $3,050/$9,150 $4,000/$8,000 1 $1,550/$4,650 $2,000/$5,000 (Does not include deductible) $4,000/$8,000 (Includes deductible) $2,000/$5,000 (Does not include deductible) OOP Max: Individual/ Family Out-of-Network $6,000/$15,000 (Does not include deductible) $12,000/$24,000 (Includes deductible) $6,000/$15,000 (Does not include deductible) What you pay for care (unless otherwise noted, here s how you pay for services after you meet the deductible) Co-insurance: In-Network/Out-of-Network Preventive Care: In-Network/Out-of-Network Office Visit: In-Network/Out-of-Network Specialist and Urgent Care: In-Network/Out-of-Network 20%/40% 20%/40% 20%/40% $0/40% $0/40% $0/40% $30 co-pay 2 /40% 20%/40% $20 co-pay 2 /40% 20%/40% 20%/40% $40 co-pay 2 /40% Emergency Room $100 co-pay + 20% 2,3 20% $100 co-pay + 20% 2,3 Emergency Ambulance 20% 20% Covered at 100% This is a brief plan design overview. The summary plan description will prevail for actual coverage terms. 1 If more than one person is covered, the family deductible/family out-of-pocket maximum must be met. 2 Co-pays do not count toward deductible. 3 You must pay the $100 co-pay plus 20% co-insurance based on the full eligible amount. 2
5 Your Medical Plan Administrator BlueCross BlueShield of Texas and United Healthcare administer our plan options. Your medical administrator is determined based on your address of record. It is important to note that BlueCross BlueShield and United Healthcare are national networks and you will use that administrator regardless of where you access care. For example, if you live in Texas and have BlueCross BlueShield but need to see a provider in New York, you can still access the BlueCross BlueShield network in New York. BlueCross BlueShield of Texas United Healthcare ALASKA HAWAII PUERTO RICO AND U.S. VIRGIN ISLANDS 3
6 Prescription Drugs Express Scripts is the Pharmacy Manager for all three medical options. Prescription Drugs Pharmacy Retail (up to 30-day supply) Generic 20% co-insurance ($10 min/$40 max) Preferred 1 30% co-insurance ($30 min/$100 max) Non-Preferred 1 50% co-insurance ($45 min/$150 max) Pharmacy Mail (up to 90-day supply) Generic 20% co-insurance ($5 min/$80 max) Preferred 1 30% co-insurance ($60 min/$200 max) Non-Preferred 1 50% co-insurance ($90 min/$300 max) Standard Option Core Option Value Option 20% co-insurance after deductible 2 20% co-insurance after deductible 2 20% co-insurance after deductible 2 20% co-insurance after deductible 2 20% co-insurance after deductible 2 20% co-insurance after deductible 2 20% co-insurance ($10 min/$40 max) 30% co-insurance ($20 min/$75 max) 50% co-insurance ($35 min/$90 max) 20% co-insurance ($5 min/$80 max) 30% co-insurance ($40 min/$150 max) 50% co-insurance ($70 min/$180 max) 1 If you select a brand drug when a generic is available, you pay the generic co-pay or co-insurance plus the cost difference between generic and brand prices. Maximums do not apply. 2 Certain preventive prescription drugs purchased in-network are not subject to the deductible; co-insurance still applies. Filling your prescription through Express Scripts: Retail When you need it right away, get your prescription filled at an in-network Express Scripts pharmacy. Mail Order or CVS Pharmacy If you are taking a long-term medication, you can avoid paying more by having your 90-day prescription filled through mail order or at a CVS or Safeway retail pharmacy. After your initial purchase plus two refills at a non-cvs or Safeway retail pharmacy, you will pay 50% of the drug cost for maintenance medications if you don t move your prescription to mail order, CVS or Safeway pharmacy. StayWell Rx Save money on diabetes and high blood pressure medications by enrolling in the StayWell Rx program. By enrolling, you can get a 90-day supply of eligible generic medications for free and brand name medications for $15. 4
7 Healthmatters Healthmatters, American s award winning wellness program, provides you with the tools and support to help you reach your personal health goals. With Healthmatters you have access to a personal health coach, Quest screenings and MyActiveHealth.com all at no cost to you. By participating in Healthmatters, you can earn up to $250 in rewards for you and your covered spouse/domestic partner ($500 total). The funds which you can use for medical, dental, vision and prescription expenses are deposited into your HRA, HSA or HIA. Check out my.aa.com/healthmatters for details! 5
8 Dental Healthy teeth and gums are important to your overall health, and dental coverage administered through MetLife helps you pay for trips to the dentist. $50 per person Annual Deductible Annual Maximum Benefit for Basic and Major Care $1,500 per person Lifetime Maximum Benefit for Orthodontic Care $1,500 per person Preferred Providers* Non-preferred Providers Preventive Care Plan pays 100%, no deductible Plan pays 80% after deductible Basic Care Plan pays 80% after deductible Plan pays 80% after deductible Major Care Plan pays 80% after deductible Plan pays 80% after deductible Orthodontia Plan pays 50%, no deductible Plan pays 50%, no deductible *Preferred providers offer services at negotiated rates, which can mean significant savings for you. Vision Get focused with vision insurance through Spectera. By using Spectera, you can save on the cost of glasses, contacts and eye exams. In-network Out-of-network Comprehensive Eye Exam $10 co-pay Reimbursement up to $40 Materials $25 co-pay See below Eyeglasses Included in your $25 co-pay: Standard lenses: Single, lined-bifocal, lined tri-focal or lenticular Frames: up to $130 retail allowance Lens options: Standard scratch resistant coating, basic progressives, polycarbonate lenses or UV coating Reimbursements Single vision lenses: up to $40 Bi-focal lenses: up to $40 Tri-focal lenses: up to $80 Lenticular lenses: up to $80 Frames: up to $45 Included in your $25 co-pay: U p to $150 for the evaluation, fitting fees for non-selection contact lenses and two follow-up visits Reimbursements Up to $150 for elective contact lenses Up to $210 for medically necessary contact lenses Contact Lenses (in lieu of lenses and frames) or Selection of disposable contact lenses (for up to six boxes per year) 6
9 Life & Accidental Dealth Insurance American provides basic life insurance at no cost, and offers voluntary life and accident insurance. Options Basic Life/Accidental Death & Dismemberment Insurance (AD&D) Voluntary Term Life Insurance* Voluntary AD&D* How It Works American pays the full cost, equal to 2x your annual pay with a maximum of $70,000. You have the option of purchasing Voluntary Term Life Insurance of up to 8x your annual pay for yourself, up to 3x your annual pay for your spouse/domestic partner and $15,000 for child coverage. Accident insurance provides extra security for your family in case of an accidental injury or death. You can purchase up to $500,000 for yourself, $350,000 for your spouse/domestic partner and $10,000 for each child. Administered Through MetLife MetLife Cigna *Purchase through payroll deductions after tax Since your Life Insurance plans are changing in 2015, American will allow you to convert your current level of coverage into 2015 without being subject to Statement of Health (SOH). For example, John is a legacy US Airways manager and makes $50,000 annually and has $300,000 in voluntary life insurance. In 2014 his basic life insurance is $100,000 which combined with his voluntary life insurance equals $400,000 of total coverage. Since his 2015 basic life insurance is capped at $70,000 he will have $330,000 of coverage that he can convert into Voluntary Term Life during 2015 annual enrollment without SOH. This would equate to 7x his pay, or $350,000 of Voluntary Term Life Insurance. Any future increase in Voluntary Term Life coverage will require SOH. 7
10 Sick & Disability Starting in 2015, American employees will be eligible to earn eight sick days each year to management and support staff employees to be used for personal illness. Any unused sick days at the end of the year will not carry over to the next year. All management and support staff will be provided with company-paid short-term and long-term disability plans. We re working to provide better income protection so starting January 1, 2015, the long-term plan benefit will be increased to 67% of your pay (previously it paid 50% income replacement). Short-Term Disability (STD) Provides a benefit of 67% of base weekly salary. Benefits start on the 8th day of your non-work related disability. STD is paid for by the company at no cost to you. Long-Term Disability (LTD) After your STD ends, LTD provides a benefit of 67% of your average monthly pay. LTD is paid for by the company at no cost to you. 401(k) Company Match: 401(k) Company Match Benefit Effective January 1, 2015, you will be eligible for a company match of 5.5% if you have at least one year of service with the company. The company will match 100% of your contributions to the 401(k) plan up to 5.5% of your eligible compensation. The company match applies to both pre-tax and Roth contributions. Any management or support staff employee who is a participant in the Employee Savings Plan as of December 31, 2014, will begin receiving the company match as of January 1, 2015, and the 3% non-elective company contributions will cease as of December 31, Automatic Enrollment Effective January 1, 2015 In order to help ensure that legacy US management and support staff take advantage of the company match, anyone contributing less than 3% to the Employee Savings Plan will be automatically enrolled at a 3% pre-tax contribution. Watch for communications from the 401(k) and Savings Programs Department/Fidelity on your new company match benefit and any notification of automatic enrollment. If you do not wish to take advantage of this benefit, you will have the opportunity to opt out of this automatic enrollment. Upcoming Changes In the coming months you will see additional changes to your 401(k) plan, including some changes to plan provisions and a new fund line-up for the legacy US plan as well as the American Airlines $uper $aver Plan. Watch for communications regarding these upcoming changes. You will receive plenty of notice and information as you need to consider changes to your contributions and investment options. 8
11 Voluntary Benefits American offers a number of voluntary benefits for your convenience. See the chart below Voluntary Benefit Contact Information When to Enroll Auto and Home Insurance through MetLife Auto & Home, Travelers and Liberty Mutual Apply online at VoluntarybenefitsUS.com. You may also call Apply anytime Group Accident Insurance Group Critical Illness Insurance Enroll online at VoluntarybenefitsUS.com. You may also call Annual Enrollment November 3-14, 2014 VPI Pet Insurance Apply online at VoluntarybenefitsUS.com. You may also call Apply anytime Hyatt Legal Plan Enroll online at VoluntarybenefitsUS.com. You may also call Annual Enrollment November 3-14, 2014 LifeLock Identity Theft Protection Enroll online at VoluntarybenefitsUS.com. You may also call Enroll anytime For more information, visit my.aa.com 9
12 for an overview and information on how to enroll. Purchase/ Payment Info Coverage Overview Pay premium through payroll deduction, Electronic Funds Transfer, or direct bill. Offers money-saving discounts that could help you save on your auto and home insurance. Compare quotes on competitive coverage from the three leading national carriers. Pay premium through payroll deduction, Electronic Funds Transfer, or direct bill. Protects your finances from the expenses of an accident or a serious health problem, such as a stroke or heart attack. Cancer coverage is also available. Both plans pay lump-sum benefits that can help offset the out-of-pocket expenses which medical insurance does not pay, including deductibles and co-pays. Pay premium through payroll deduction, Electronic Funds Transfer, or direct bill. Covers a multitude of medical problems and conditions and a wide range of services. Visit any veterinarian worldwide, even specialists or emergency providers. $18.98 per month, conveniently paid via payroll deduction. Provides representation, unlimited phone advice and office consultations on a wide variety of personal legal matters including, but not limited to: estate planning, sale or purchase of primary residence, family law, uncontested divorce, immigration assistance and document review/preparation. Enroll yourself or your family members to receive LifeLock at a 40% discount. Provides monitoring services 24 hours a day, 7 days a week to safeguard your personal information both online and off, helping to protect you from identity theft before it happens. 10
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