Sprint Flex Plans Eligibility and Enrllment Sectin Effective January 1, 2015
What is Inside Sprint Flex Plans... 3 Wh Is Eligible T Participate In Sprint Flex Plans... 3 Duplicate Cverage... 7 Enrllment... 7 Enrllment Appeals... 9 Csts... 10 When Cverage Begins... 11 When Cverage Ends... 11 Legal Infrmatin and Other Sectins... 11 Rev. 1/1/15 Page 2
Sprint Flex Plans Except as superseded by any insurance plicies/certificates prvided by any applicable insurer, this Sectin is part f a Summary Plan Descriptin fr the fllwing Sprint flexible welfare benefit plans (Sprint Flex Plans): Grup Health Plans Medical Plans (including prescriptin drug cverage) Basic Plan Health Accunt Plan Cnsumer Access Plan HMO Medical Plans TRICARE Supplement Medical Plan Dental Plan Visin Plan Health Care Flexible Spending Accunt Plan Dependent Care Flexible Spending Accunt Plan Supplemental Emplyee Life Insurance Plan Supplemental Dependent Life Insurance Plan Accidental Death and Dismemberment (AD&D) Plan Supplemental Lng-Term Disability Plan Legal Services Plan Wh Is Eligible T Participate NOTE: This dcument des nt cver the eligibility and enrllment, if any required, fr yur ther Sprint benefits, such as Retirement and Wealth (401(k), Pensin, ESPP, Deferred Cmpensatin), Discunts (e.g., Phne Prgrams), Other Benefits (e.g., Aut/Hme/Pet insurance, universal life, accident (Aflac)), PTO, incentive cmpensatin r equity awards. Fr this infrmatin, please visit i-cnnect>life and Career> Benefits>Benefits Plan Infrmatin>Benefits Overview. This Sectin prvides imprtant details abut wh is eligible t participate in and enrllment rules fr the Sprint Flex Plans, spnsred by Sprint Cmmunicatins, Inc, ( Sprint ), a whlly-wned US subsidiary f Sprint Crpratin. This Sectin will use the terms we, ur r us t refer t, as the cntext requires, Sprint r its whlly-wned US subsidiary that is a participating emplyer in the applicable Sprint Flex Plan and the terms yu r yur t refer t ur emplyees eligible t participate in a Sprint Flex Plan as described belw (and their Eligible Dependents, as applicable). Emplyees Yu are eligible t participate in the Sprint Flex Plans if yu are classified n ur payrll recrds as: ur regular, cmmn law emplyee; and regularly scheduled t wrk 20 r mre hurs per week; and nt n a persnal leave f absence exceeding 30 cnsecutive calendar days. A regular, cmmn-law emplyee des nt include an individual classified in ur payrll recrds as an intern, temprary emplyee r temprary wrker Rev. 1/1/15 Page 3
r cntractr, even if a curt, administrative agency r ther persn r entity determines such an individual is a cmmn law emplyee. In additin: fr Life Insurance/AD&D nly, yu must be a U.S. citizen r resident f the U.S. and nt a resident f Puert Ric; and yu are nt eligible t participate in the Health Care Flexible Spending Accunt ( FSA ) if yu are rehired after 30 cnsecutive calendar days after yur terminatin f emplyment, r return frm an unpaid leave f absence (except extended military) f mre than 30 cnsecutive calendar days, and within the same calendar year f yur prir Sprint Health Care FSA cverage (nt COBRA-cntinued) ending. Yur Eligible Dependents If yu (and fr this sectin, yu means the Emplyee) participate in a Sprint Medical, Dental, Visin, Life r AD&D Plan, yu may als cver yur Eligible Dependents, defined belw, under that plan. Yu may nt cver any persn wh des nt meet the definitins belw. Enrlling, attempting t enrll r maintaining enrllment fr ineligible persns is cnsidered misrepresentatin r fraud, which is prhibited by the Sprint Flex Plans and will result in (a) the immediate end f cverage fr such persn retractive t the date f the persn s ineligible cverage and yur bligatin t repay any benefits paid after that date by a Sprint Flex Plan n behalf f such persn and (b) applicable emplyment and/r incme tax cnsequences. We, ur applicable third party administratrs r ur insurers may frm time t time require prf, satisfactry in ur/their sle judgment, that a persn yu have enrlled fr cverage is an Eligible Dependent. Minimum prf dcuments are listed belw (yu may redact (black ut) persnal financial infrmatin). Yu will be given 45 calendar days t prvide satisfactry prf; failure t timely d s is cnsidered yur admissin f misrepresentatin r fraud as t the eligibility f the persn whse eligibility is nt prved, with the cnsequences described abve. Fax the required dcumentatin t 866-523-8544. If yur request t cver an individual is denied, see the Legal Infrmatin Sectin fr infrmatin n yur rights t appeal that determinatin. Eligible Dependents Defined and Prf Requirements Spuse Spuse a Spuse is the persn t whm yu are legally married (nt a civil unin r dmestic partnership) under the laws f any state r freign cuntry. Minimum prf requirements are a cpy f yur mst recently filed federal tax return; and a cpy f yur marriage certificate under the applicable state law. Tax Return Requirement. Yur mst recently filed federal tax return must be fr the calendar year immediately preceding ur deadline fr prviding unless it is unavailable slely because such deadline is befre Rev. 1/1/15 Page 4
yur return filing deadline, in which case yu must prvide yur return fr the previus tax year (and timely-filed extensin applicatin if applicable). If yur filing status was nt married filing jintly r married filing separately, shwing yur Spuse, further dcumentatin will be required, unless a return with a married filing status is unavailable because ur deadline fr prviding is befre the filing deadline fr yur first required return filing as married r neither yu nr yur Spuse earned incme fr any prir tax year during which yu were married. Marriage Certificate Requirement. A cpy f yur marriage certificate may be btained by cntacting the vital recrds department f the state in which yu btained yur license. If yu were nt statutrily/ceremnially married, but are married accrding t cmmn law in the states belw, yu must instead prvide a dcument evidencing yur jint residency, dated at least ne year befre yur Spuse s Benefit Effective Date (r grandfather date, if applicable), shwing bth yur and yur Spuse s name at the same address, such as a residential lease agreement, mrtgage statement r ther lan statement r cupn, a bank r credit card statement, a prperty tax statement, a utility bill, r bth parties drivers licenses. Jurisdictins currently recgnizing cmmn-law marriages are AL, CO, DC, IA, KS, MT, RI, SC, TX and UT, as well as the Navaj Natin Tribe and the Puebl f Acma Tribe. Jurisdictins that recgnized the creatin f cmmn-law marriages befre the date indicated ( grandfather date ) are GA (1/1/97), ID (1/1/96), OH (10/10/91), OK (11/1/98), and PA (1/1/05). Dmestic Partner Dmestic Partner* a Dmestic Partner (DP) is yur same- r ppsite-sex partner, including ne with whm yu have a civil unin r dmestic partnership under state law, fr s lng as yu bth: are at least 18 years ld and legally cmpetent t cnsent t the DP relatinship; are nt related t each ther by bld; are in an exclusive cmmitted relatinship similar t marriage and intend t remain s indefinitely but are nt married under federal law t each ther r any ther persn; have nt ended any federally recgnized marriage r any dmestic partnership with each ther r any ther persn fr at least 12 mnths; have resided tgether cntinuusly fr at least 12 mnths and intend t reside tgether indefinitely; share jint respnsibility fr each ther s cmmn welfare r financial bligatins; and are nt dmestic partners fr the sle purpse f btaining Sprint benefits. Minimum prf requirements are Sprint Affidavit f Dmestic Partnership certifying t the abve eligibility criteria, and a dcument, dated at least 12 mnths befre yur DP s Benefits Effective Date shwing yur jint residency with yur Rev. 1/1/15 Page 5
DP. (Example: Benefit Effective Date 1/1/2014, jint residency r jint financial dcument must be dated 1/1/2013 r prir); and if nt indicated in the jint residency dcument, additinal dcument shwing jint financial r welfare respnsibility. Jint residency requirement. Yu may submit ne dcument shwing bth parties names r tw dcuments, shwing a party s name n each, at the same address. Examples include: third party residential lease agreement; mrtgage statement r ther third party lan statement r cupn; bank r credit card statement; prperty tax statement; utility bill; and bth parties drivers licenses Jint respnsibility requirement. In additin t the abve (where bth names are n the same dcument), examples f jint respnsibility dcuments include: a will naming yur DP as primary beneficiary; a frm designating yur DP as health care pwer f attrney; and a c-parenting agreement r an adptin agreement with yur DP. *Fr residents f Califrnia under the HMO Plan nly, DP may als mean yur CA Registered Dmestic Partner and the nly required dcumentatin is yur Registratin. Child Child - a Child is a persn frm life birth up t age 26* wh is: yur, yur Spuse s r DP s* bilgical, legally adpted r step child; placed fr adptin r therwise placed by curt rder r placement agency (e.g., fster children, under legal guardianship) with yu, yur Spuse r yur DP; r a child wh is an alternate recipient pursuant t a Qualified Medical Child Supprt Order (QMCSO) per the QMCSO Prcedures in the Legal Infrmatin Sectin. Minimum prf requirements are, shwing bth yu (r Spuse/DP as applicable) and the Child, and the Child s birth date/age, a cpy f ne f the fllwing: birth certificate; baptismal certificate; paternity/maternity test; schl recrd with parent signature; curt adptin r guardianship rder; r placement agreement. If n birth date/age is indicated in the abve, minimum prf includes a cpy f gvernment dcumentatin (e.g., driver s license, city clerk ntice with fficial seal dcumenting birth date, r state issued birth registratin card) shwing date f birth r age. Als, if the Child is nt yur child, Spuse r DP dcumentatin is required. *Or yur, yur Spuse s r DP s (if DP als enrlled) bilgical r legally adpted child is age 26 r mre wh is ttally disabled and was cvered Rev. 1/1/15 Page 6
Duplicate Cverage under the applicable Sprint Flex Plan immediately befre turning age 26 and cntinuusly cvered thereafter ( Disabled Child ). Minimum prf requirements fr a Disabled Child are the abve dcumentatin and a statement frm the Child s health care prvider that the Child is unable t engage in any substantial gainful activity because f a medically determinable physical r mental impairment which can be expected t result in death r which has lasted r can be expected t last fr a perid f nt less than 12 mnths. Enrllment Please nte that n persn, including yu, may be duble-cvered under a Sprint Grup Health Plan as: bth an emplyee and a Dependent r a Dependent f tw emplyees. If bth yu and anther Sprint emplyee are hired at the same time r bth elect cverage during Annual Enrllment fr a dependent nt currently cvered under a Sprint Grup Health Plan, which results in dual cverage, Sprint will request yu bth t agree n the cntrlling electin with respect t that cverage. If this request is nt met timely, the latest electin will cntrl, retractive t the Benefits Effective Date. If a dependent child is currently cvered under a Sprint Grup Health Plan and anther Sprint emplyee enrlls the dependent child ( as the result f New Hire r Annual Enrllment electins), resulting in dual cverage, the earliest electin will cntrl. If a dependent child r spuse is currently cvered under a Sprint Grup Health Plan and becmes emplyed by Sprint, Sprint will request yu bth t agree n the cntrlling electin with respect t that cverage. Persns may, hwever, be duble- cvered under the FSA, Life Insurance, AD&D and Legal Services as: bth an emplyee and a Dependent r a Dependent f tw emplyees (except fr the Legal Services Plan). Fr tax and ther reasns, yur enrllment in r waiver f cverage under any Sprint Flex Plan is a binding electin fr the entire calendar year (r remainder f the year, as applicable), unless yu experience a Life Event permitting a mid-year electin change as described in the Life Events Sectin. Regular enrllment perids and rules are: WHO Current Emplyees New Hires (See belw) WHAT Annual Enrllment each fall emplyees may enrll r re-enrll in, r waive Sprint Flex Plans cverage fr the fllwing calendar year withut any waiting perid r prf f New Hire Enrllment as a newlyhired emplyee yu becme eligible fr cverage in the Sprint Flex Plans n and effective beginning the 30 th cnsecutive calendar day after yur date f hire (except fr Supplemental LTD, which is effective Rev. 1/1/15 Page 7
insurability (except fr certain life insurance cverage levels, as described in the applicable materials) NOTIFICATION Annual Enrllment materials mailed t yur hme address befre the Annual Enrllment perid ENROLLMENT PROCEDURE ENROLLMENT DEADLINE AUTOMATIC DEFAULT COVERAGE www.sprint.cm/be nefits r at i-cnnect > Life & Career > Benefits > Benefits Enrllment>Enrllm ent Guide Fllw the applicable links n i-cnnect > PepleSft Emplyee Self Service > Benefits>Benefits Enrllment End f Published Annual Enrllment Perid as f the first calendar day in which yu are actively at wrk immediately after yu cmplete 12 mnths f emplyment) New Hire Enrllment materials mailed t yur hme address after yur emplyment ffer www.sprint.cm/benefits r at i-cnnect > Life & Career > Benefits >Benefits Enrllment> Benefits Enrllment Guide Fllw the applicable links n i- Cnnect > PepleSft Emplyee Self Service > Benefits>Benefits Enrllment 30 th cnsecutive calendar day after yur date f hire If yu d nt enrll in r waive cverage in the Sprint Flex Plans by the applicable deadline, yu will autmatically be enrlled in and will have t pay fr: Fr the entire next calendar year all f yur prir year Sprint Flex Plans that are still available in the new calendar year (except fr Flexible Spending Accunts, which require enrllment every year), and/r a replacement plan as described in the applicable Annual Enrllment materials if a prir year Sprint Flex Plan will nt be available in the new calendar year Effective n the 30 th cnsecutive calendar day after yur date f hire thrugh the entire rest f the calendar year: Medical/Prescriptin Drug: Sprint Health Accunt Plan fr yu nly Special Medical (including Prescriptin Drug) premium rates will apply Life Insurance: $10,000 Emplyee Life Insurance cverage fr yu nly AD&D: $10,000 cverage fr yu nly Yu will nt be eligible fr any ther Sprint Flex Plan benefit until the next Annual Enrllment perid, unless yu experience a Life Event permitting a mid-year Benefit Change. New Hires includes emplyees wh: have an increase in regularly scheduled hurs per week t 20 r mre; r return frm an unpaid leave f absence (except extended military) f mre than 30 cnsecutive calendar days; r are rehired frm prir Sprint emplyment mre than 30 cnsecutive calendar days after their terminatin date. Rev. 1/1/15 Page 8
New Hires excludes emplyees wh: return frm any extended military leave f absence r frm any persnal leave f absence within 30 cnsecutive calendar days; r are re-hired within 30 cnsecutive calendar days after their terminatin date. Instead, these emplyees will be re-enrlled autmatically, retractive t their prir terminatin date, in their previus Sprint Flex Plan benefits. Enrllment Appeals Yur benefits enrllment must be cmpleted by 11:59 p.m. CT n the applicable deadline. It is yur respnsibility t ensure that Emplyee Self Service (ESS) reflects the enrllment yu elected s yu need t check yur pay advice and ESS regularly. Sprint vluntarily prvides an pprtunity fr yu t appeal any Sprint Flex Plan enrllment r denial theref by filing a written request fr review t Sprint s Health & Prductivity Grup within 60 cnsecutive calendar days after the date f the applicable enrllment deadline. Appeals filed after 60 cnsecutive calendar days after the applicable enrllment deadline will nt be reviewed. Appeals must be sent t Sprint Health and Prductivity Benefits, ATTN: Benefit Appeals, at: Sprint s Intranet: POSTAL SERVICE: Type ehlticket in yur i-cnnect brwser KSOPHL0312-3A524 6500 Sprint Parkway Overland Park, KS 66251 FAX: 866-523-8544 Interffice Mail: KSOPHL0312-3A524 Appeals must include dcumentatin supprting yur request t enrll r change yur benefit electin specifically as t missed deadlines, either prf f yur meeting the deadline r extenuating circumstances fr yur failure t meet the deadline. If yu have any questins abut this prcess, please cntact the Emplyee help Line at 800-697-6000 The decisin rendered n yur appeal is final and binding. There is n further r ther prcess fr appeal. New Hire Enrllment Example: Hire date Enrllment Deadline Appeal Deadline April 1 st May 1 st (30th calendar day after date f hire) June 30 th (60 th cnsecutive calendar day after enrllment deadline Annual Enrllment Example: Enrllment Enrllment Deadline Perid Nvember 1 Nvember 30th (last day f Nvember 30 enrllment perid) Appeal Deadline January 29 th (60 th cnsecutive calendar day after enrllment deadline Rev. 1/1/15 Page 9
Csts Yu are required t pay sme r all f the cst f cverage under the Sprint Flex Plans. Cntributin amunts fr yur prtin are available in the Benefits Enrllment Guide and/r n the n-line enrllment system n i-cnnect > PepleSft Emplyee Self Service > Benefits>Benefits Enrllment. Mst f the Sprint Flex Plans are ffered n a pre-tax basis, meaning that yu can pay fr yur prtin f the cverage cst thrugh payrll deductins frm yur befre-tax incme. The fllwing, hwever, are ffered nly n an after-tax basis, meaning that yu pay fr yur prtin f the cst f such cverage thrugh payrll deductins frm yur after-tax incme: Life and ADD Insurance and the Grup Legal Services Plan, and Other cverage fr yur DP and yur DP s Child wh is nt als yur Child ( DP Excepted Individuals ), and Other cverage fr yur same sex Spuse (and any children nt als yur Children) with respect t nly state taxable wages reprted in a state nt recgnizing such marriage ( Same Sex Marriage Excepted Individuals ). Als, as a general rule, Sprint s prtin f the cverage cst is nt cnsidered taxable incme t yu. The exceptin t this rule is that Sprint s prtin f the cst f cverage fr DP Excepted Individuals is cnsidered taxable incme t yu; and Same-Sex Marriage Excepted Individuals is cnsidered state taxable incme t yu. This taxable incme is subject t applicable withhlding taxes. Medical/Prescriptin Drug Plans Healthy Living Discunt* T receive the Healthy Living Discunt fr Medical/Prescriptin Drug premiums, yu must select the with Discunt ptin when enrlling in yur Medical/Prescriptin plan and bth f the fllwing statements must be true: Yu must be 100% tbacc free* frm the date yu enrll thrugh then end f the calendar year r earlier end f yur cverage. Yu have cmpleted (r will cmplete) an nline Health Assessment at www.sprintalive.cm within the published deadline r 30 calendar days after hire/rehire/life event benefits effective date. Tbacc free means never smking r chewing tbacc r any similar prduct and living in a hme cmpletely free f secnd-hand smke. Alternatively, yu may cmplete the QuitPwer smking cessatin prgram within the published deadlines. If bth criteria are nt met, yu will nt receive the Healthy Living Discunt fr yur Medical/Prescriptin Drug plan premiums. If yu meet the 100% tbacc free requirement but stp during the year, yu are required t ntify Sprint within five business days after, and will be charged the undiscunted premium rate as f the date Sprint is ntified that, yu n lnger meet the criteria. Als if yu select the with Discunt ptin but d nt take a Health Assessment by the deadline, yur premiums will be switched t the undiscunted premium rate fr all f the applicable calendar year, even if the 100% tbacc-free requirement is met. Rev. 1/1/15 Page 10
*The Healthy Living Discunt is nt applicable t 2015 New Hires r new enrllees due t a mid-year Life Event. In these situatins special Medical (including Prescriptin Drug) premium rates will apply. Life Insurance Plans Nn-Smker Discunt When enrlling in Emplyee and/r Spuse/Dmestic Partner (DP) Life Insurance cverage, yu must select the apprpriate ptin based n whether yu/yur cvered Spuse/DP, if applicable, are a smker r nn-smker. Fr Life Insurance Plans, a smker is defined as anyne wh will use a tbacc prduct during the applicable plan year such as cigars, cigarettes r chewing tbacc. Fr Life Insurance, the smker status is based upn the cvered individual and nt the husehld. Fr example, if yu are a nn-smker but yur Spuse smkes, the Emplyee Life Insurance will be at the nn-smker discunt, but the Spuse Life Insurance will be at the smker rate. The same rules fr n lnger meeting the tbacc free requirement abve apply t the nn-smker status. When Cverage Begins Sprint Flex Plan cverage yu elect begins n the Benefit Effective Date as fllws: Fr New Hires, as f the 30 th cnsecutive calendar day after yur date f hire (subject t apprval f evidence f insurability fr certain life insurance cverage levels). Fr Annual Enrllment, as f the January 1 after the Annual Enrllment (subject t apprval f evidence f insurability fr certain increases in life insurance cverage levels). Fr Life Events, as described in the Life Events Sectin. When Cverage Ends Sprint reserves the right t change r end a Sprint Flex Plan at any time and cverage wuld end prspectively frm the date f any terminatin. Otherwise, cverage ends as f the earlier f the end f the: applicable calendar year if yu s elect r d nt re-enrll, as applicable, during the Annual Enrllment perid fr that year; r as described in the separate Life Events Sectin that is als a part f a Summary Plan Descriptin fr the Sprint Flex Plans, incrprated herein by reference n the Benefits site f i-cnnect under Summary Plan Descriptins. Legal Infrmatin and Other Sectins Fr imprtant infrmatin n participating emplyers, plan identificatin, service f legal prcess, ERISA rights, including claims and appeals prcedures, and ther legally-required ntices regarding the Sprint Flex Plans, see the separate Legal Infrmatin Sectin that is als a part f a Summary Plan Descriptin fr the Sprint Flex Plans, incrprated herein by reference n the Benefits site f i-cnnect under Summary Plan Descriptins. Rev. 1/1/15 Page 11
Fr ther infrmatin n changes in yur electins, see the separate Life Events Sectin that is als a part f a Summary Plan Descriptin fr the Sprint Flex Plans, incrprated herein by reference n the Benefits site f i-cnnect under Summary Plan Descriptins. Fr infrmatin n each individual benefit under a Sprint Flex Plan, see the applicable Cverage Infrmatin Sectin that is als a part f a Summary Plan Descriptin fr the applicable Sprint Flex Plan, incrprated herein by reference n the Benefits site f i-cnnect under Summary Plan Descriptins. Rev. 1/1/15 Page 12