2015 BENEFIT FACTS & FEATURES

2015 BENEFIT FACTS & FEATURES

BENEFIT BASICS After you make your elections as a new employee, each year you will have the opportunity to make changes to your benefit elections during Open Enrollment. The decisions you make during this Open Enrollment will be effective for the July 1, 2015 Plan Year. Typically, your benefit elections will remain in place for the entire Plan Year unless you experience a Qualified Life Event. A Qualified Life Event is a life status change that allows you to make adjustments to your benefit elections during the Plan Year. QUALIFIED LIFE EVENTS YORK COLLEGE FLEXIBLE BENEFITS PLAN Change in status, which include, marital, number of dependents, employment, change in residence, dependent satisfies or ceases to satisfy eligibility requirements Dependent s employer s Open Enrollment ELIGIBLE DEPENDENTS Eligible dependents include your legal same sex or opposite sex spouse, your unmarried natural, step and adopted children, and your adult children up to age 26 regardless of marital status or student status (medical and prescription only). Unless otherwise noted, dependent children are eligible for coverage to the end of the month in which they reach age 19, or age 25 if attending a certified educational institution on a full-time basis (12 credit hours per semester). Coverage is continued for disabled dependent children over age 19, pending proof of disability. ENROLLMENT Eligible employees may register his/her benefit elections or changes by completing online enrollment through YCP web located on My YCP and returning applicable forms to the Human Resources Department. The Human Resources staff is available to answer questions concerning the benefits provided under the Flexible Benefits Plan. Current employees must register during the designated Open Enrollment period to make a change or elect/reelect Spending Accounts Newly Eligible employees must register for benefits within 31 days of hire date REQUIRED FORMS Please complete and return any of the following required forms which apply to your elections: Waiver Form: Must complete if you are applying or re-applying for the Medical Waiver Bonus Credit Monitoring and Identity Theft Insurance: Must complete if electing for the first time. Group Legal Plan Enrollment Form: Must complete if electing for the first time Beneficiary Designation Form (Both Life and 403(b) Plans): Must complete if desire is to change beneficiaries. Complete the 403(b) form online at tiaa-cref.org. Grumbacher Access Form: Fee or enrollment in MSA/Limited MSA or HSA contribution applies Student Certification Form: Must complete to maintain dental, vision and supplemental life and A&D coverage for fulltime student dependents age 19-25 EOI: Applies to Supplemental Life Insurance. The Benefits Office will provide this documentation to employees if applicable. Open Your HSA: Must perform if you are newly enrolled in the HSA Plan. The Benefits Office will provide this documentation to employees if applicable. CORE BENEFITS Core Benefits are provided for you automatically at no cost. Your Core Benefits take effect the day you meet the eligibility requirements for the Flexible Benefits Plan. The College provides you with the following Core Benefits: Significant cost or coverage changes FMLA special requirements HIPAA special enrollment rights Changes due to a judgment, decree or court order Entitlement to Medicare or Medicaid EMPLOYEE ASSISTANCE PROGRAM SHORT-TERM DISABILITY INSURANCE Provides confidential telephonic counseling and up to 3 counseling sessions per incident per calendar year to help you resolve a broad range of issues including relationship, stress, family, alcohol/drug, and life changes. Telephonic Life Management Services are also available for legal and financial issues, child & elder care assistance and pre-retirement planning. 60% of your weekly base salary, begins upon later of five workdays or after sick days are exhausted and continues 180 days. Benefit available the first of the month following one year of service. LONG-TERM DISABILITY INSURANCE 60% of your monthly base salary, monthly benefit maximums dependent upon annual salary, Minimum monthly benefit is the greater of $100 or 10% of monthly salary, Begins first of month after 6 months of continuous short-term disability until retirement as long as you remain disabled (effective date may be sooner with proof of prior coverage) LIFE INSURANCE WITH AD&D VACATION DAYS/HOLIDAYS TUITION EXCHANGE PROGRAM TUITION REMISSION PROGRAM 1.5x annual salary; $40,000 minimum to $150,000 maximum benefit See respective handbook for your job classification See respective handbook for your job classification See respective handbook for your job classification; includes remission and discount program at York College and also discount program for dependents at York Country Day School

BENEFIT LIFE INSURANCE For you For spouse For dependent child(ren) AD&D INSURANCE For you For spouse For dependent child(ren) BENEFIT CHOICES You may choose your benefit options based on your needs and those of your family. The College subsidizes many of these choices, such as the medical/prescription, vision and dental plans. However, most options also require a contribution from your pay. Refer to the 2015-2016 Benefit Cost Sheet and the enclosed Plan Summaries for additional information. MEDICAL / PRESCRIPTION PLANS The College provides you with the following medical plan options. Each include prescription coverage. ClassicBlue Traditional Plan: Only available to participants currently enrolled or enrolled as of June 30, 2006, this Major Medical plan provides supplemental coverage to basic Blue Shield. PPOBlue Plan: Under a PPO Plan, you have the choice to use In- and Out-of-Network providers. You are not required to use a Primary Care Physician (PCP) or obtain referrals. Out-of-Network coverage is subject to deductible and coinsurance amounts. In-Network coverage is subject to deductible and copay amounts. PPOBlue High Deductible Health Plan: This plan combines a PPOBlue High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) to work hand-in-hand to give you greater control over your health care dollars. Under the HDHP you have the choice to use In- and Out-of-Network providers and are not required to use a PCP or obtain referrals, however, you must first meet the deductible before services are covered per the plan s schedule (including prescription drugs). Refer to the enclosed Plan Summary for complete plan details and prescription information. The HSA is a tax-advantaged savings account for qualified health expenses. York will fund your HSA with $1,000 single / $2,000 family. This amount will be deposited during the first week of July, 2015. The total deductible of the plan is $1,300 single/$2,600 family. After you enroll in the HDHP for the first time you must establish your own HSA account through Highmark Blue Shield. Prescription Drug Coverage: The above plans use Express Scripts Premier 2012 Pharmacy Network. The program is a Mandatory Generic plan. You are responsible for the copay plus the difference in cost between a generic and brand name drug, if a generic is available and you opt for the brand name. If your doctor specifies brand name required you are not responsible for the cost difference. DENTAL INSURANCE The College offers a dental plan through Delta Dental that covers routine check-ups and other types of dental work. Please note, the deductible does not apply to diagnostic or preventive services. Under this plan, you have the flexibility of selecting any licensed dentist to provide your dental care. After you satisfy your deductible, eligible expenses are paid according to a Usual, Customary and Reasonable (UCR) schedule. VISION INSURANCE The Vision Insurance is provided through NVA. Under this plan you can to go any eye care provider of your choice; however, you receive maximum benefits and savings when you use a Preferred provider. You do not file a claim form when you use a Preferred Provider simply present your ID card at the time of your visit. When you use an out-of-network provider you are responsible for the full payment at the time of service and you must file your own claim form. WAIVER BONUS*/ DUAL COVERAGE If you waive medical/prescription coverage, you will receive a per pay waiver bonus. Please note you are required to provide evidence of other medical coverage. Employees are not eligible if covered as a dependent on the plan of another York College employee. Employees and dependents cannot be covered more than once under the benefit plans. *Federal regulations prohibit Medicare eligible employees over age 65 who waive their employer s medical coverage from receiving a waiver bonus if their primary source of other coverage is Medicare. VOLUNTARY LIFE AND ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) INSURANCE Voluntary Life and AD&D Insurance is available to provide you and your family with additional financial security. To purchase dependent coverage for either benefit, you must enroll in employee coverage. AVAILABLE COVERAGE $25,000 increments to lesser of 5x salary or $500,000 max; $100,000 guaranteed issue when 1 st eligible $25,000 increments to lesser of 100% of your benefit or $150,000 maximum $5,000 increments to a $10,000 max; all amounts guaranteed issue; You are not required to purchase individual coverage when electing dependent child(ren) coverage * Total combined maximum of core and supplemental life insurance may not exceed 6.5x annual salary. $10,000 increments to a maximum of the lesser of 10x annual salary or $500,000 100% or 50% of the employee benefit up to a maximum of $300,000 Flat $50,000

ACCOUNT USE FOR CONTRIBUTIONS MEDICAL SPENDING LIMITED PURPOSE MEDICAL SPEND- ING DEPENDENT CARE SPENDING* BENEFIT CHOICES FLEXIBLE SPENDING ACCOUNTS Flexible Spending Accounts work like a savings account each pay period a pre-tax payroll deduction is deposited to your Medical and/or Dependent Care Spending Account. When you need money to cover an eligible expense, you make a pre-tax withdrawal by utilizing the debit card or completing a claim form and providing your receipts or an explanation of benefits statement for medical services. Plan carefully, the IRS mandates funds left in the account at the end of the plan year must be forfeited. If you elect a Spending Account, you will be sent instructions, claim forms and a list of eligible expenses. For a full list of covered expenses please refer to Publication 502 at www.irs.gov. Most medical, dental, and vision care expenses (like copayments, deductibles, and eyeglasses) If you elect the PPOBlue High Deductible Health Plan, (HDHP) you can participate in a Limited Use Medical Spending Account to be used only for dental and vision expenses due to IRS regulations for HSA participants. Dependent care expenses (like daycare, after-school programs, or elder care programs) so you and your spouse can work or go to school full-time $2,000 annual maximum $2,000 annual maximum $5,000 annual maximum * Your Plan Year election may be reduced as a result of required IRS Discrimination Testing. You will be advised of any changes to your elected amount that may be required by the actual testing of employee elections. 403(B) RETIREMENT SAVINGS PLAN Defined Contribution Plan accepts employee and employer funds matching $1 for $1 up to 4%, however if you contribute 5% the College will contribute 10%. Tax Deferred Annuity (GSRA) accepts employee supplemental contributions. York College is committed to providing the tools you need to prepare for the future. Additional information on this benefit is available in the Human Resources Office. An online enrollment tool is now available at www.tiaa-cref.org/ycp. GROUP LEGAL PLAN You have the opportunity to enroll in a group legal plan that provides telephonic counseling services for basic legal issues. The plan provides unlimited telephone advice and consultations for assistance with simple wills, review of legal documents, limited identity theft protection, living wills, letters and phone calls on your behalf, warranty problems, small claims court and government programs. Face-to-face consultation is also available along with discounted rates for additional services. CREDIT MONITORING AND IDENTITY THEFT INSURANCE Available on a voluntary basis is credit monitoring and identity theft insurance. Credit monitoring will alert you if there is any suspicious activity or changes that signal the possibility while also providing $25,000 in ID Theft Insurance. Coverage also includes credit dispute assistance, daily three bureau credit monitoring, fraud restoration assistance and monthly score updates. REFERENCES AND RESOURCES Need additional information? Here is a list of contact information for each benefit. FOR CALL WEB ADDRESS Phone Number ENROLLMENT & BENEFIT Email: ccarico@ycp.edu or Human Resources 717-815-6871 QUESTIONS tmacdona@ycp.edu FLEXIBLE SPENDING ACCOUNTS HR Simplified www.hrsimplified.com 888-318-7472 MEDICAL PLANS Highmark Blue Shield www.highmarkblueshield.com 800-345-3806 HEALTH SAVINGS ACCOUNT (HSA) - For general questions For financial & debit card issues Highmark Blue Shield Bank of America www.highmarkblueshield.com Log in to Manage Your Plan & access Your Spending Tab 800-345-3806 PRESCRIPTION DRUGS Express Scripts www.express-scripts.com 800-903-6228 DENTAL PLAN Delta Dental www.deltadentalins.com 800-932-0783 VISION PLAN NVA www.e-nva.com 800-672-7723 403(B) RETIREMENT PLAN TIAA-CREF www.tiaa-cref.org/ycp 800-842-2776 EMPLOYEE ASSISTANCE PLAN WellSpan EAP www.wellspaneap.org 800-673-2514 GROUP LEGAL PLAN Countrywide Pre-Paid Legal Services, Inc. www.countrywideppls.com 800-550-LAWS About this guide: This guide describes the benefit plans available to you as an employee of York. The details of these plans are contained in the official Plan documents, including some insurance contracts. This guide is meant only to cover the major points of each plan. It does not contain all of the details that are included in your Summary Plan Description (SPD) (as described by the Employees Retirement Income Security Act). If there is ever a question about one of these plans, or if there is a conflict between the information in this guide and the formal language of the Plan documents, the formal wording in the Plan documents will govern. Please note that the benefits described in this guide may be changed at any time and do not represent a contractual obligation on the part of York.

YOUR MEDICAL BENEFITS The College provides the following medical coverage options for you and your eligible dependents. The ClassicBlue Traditional plan is only available to participants currently enrolled in the plan, or enrolled as of June 30, 2006. CLASSICBLUE TRADITIOL* PPOBLUE* PPOBLUE* HDHP IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK PCP REQUIRED? No No No No No PREVENTATIVE CARE 100% 100% 80%** 100% 80%** DEDUCTIBLE Single Family CO-INSURANCE $100 $300 $150*** $300*** $300 $600 $1,300 $2,600 80% under major medical only 100%** 80%** 100%** 80%** OUT-OF-POCKET MAXIMUM Single Family $500 $1,500 $1,500 $3,000 LIFETIME MAX. Unlimited Unlimited Unlimited Unlimited $1,500 $3,000 OFFICE VISITS 80% 100% after $20 co-pay 80%** 100%** 80%** HOSPITALIZATION 100% after $5 copay 100% Medical Care/ Surgical Expenses 100% after deductible 80%** 100%** 80%** EMERGENCY ROOM 100% 100% after $100 co-pay Waived if admitted 100% after $100 co-pay Waived if admitted 100%** PRESCRIPTION Retail Co-Pay $10 Generic $25 Single Source $35 Multi Source $10 Generic $25 Single Source $35 Multi Source Copays apply after deductible $10 Generic** $25 Single Source ** $35 Multi Source ** Mail Order Co-Pay $20 Generic $50 Single Source $70 Multi Source $20 Generic $50 Single Source $70 Multi Source DEPENDENT CHILDREN AGE LIMIT To age 26 $20 Generic** $50 Single Source ** $70 Multi Source ** * All reimbursements are subject to the Plans established UCR fee schedule. ** After deductible has been met. *** Refer to Highmark Summary of Benefits for the various services that the deductible applies to. The medical plan summaries are for information purposes only; the terms of the contract shall govern all coverage and eligibility. Please note the medical plans run on the Plan Year which is from July 1, 2015 to June 30, 2016, not on a calendar year schedule. This is especially important to keep in mind when calculating your deductible.

YOUR DENTAL AND VISION BENEFITS DENTAL INSURANCE The York Dental Plan covers the following types of dental expenses: DELTA DENTAL SERVICES DIAGNOSTIC (Deductible does not apply) Exams, X-Rays PREVENTIVE (Deductible does not apply) Fluoride Treatments to age 19, Teeth Cleaning, Sealants to age 14 COVERAGE 100% UCR* 100% UCR* BASIC RESTORATIVE SERVICES Fillings, Extractions, Endodontics (including Root Canals), Periodontics, Existing Denture Repair & Relining MAJOR RESTORATIVE SERVICES Crowns, Dentures, Bridgework, Implants ORTHODONTICS (adults & children) 85% UCR* 50% UCR* 50% UCR* DEDUCTIBLE (applicable only to basic & major services) Ÿ Individual / Family $50 / $150 BENEFIT MAXIMUMS Ÿ Dental (per person per year) Ÿ Orthodontic (per person per lifetime) DEPENDENT CHILDREN AGE LIMIT $1,000 $1,500 To age 19; to age 25 if fulltime student * UCR is the Usual, Customary and Reasonable Charge. The dental plan summary is for information purposes only; the terms of the contract shall govern all coverage and eligibility. Please note the dental plan runs on a calendar year which is from January 1, 2015 to December 31, 2015. VISION INSURANCE The School s Vision Plan provides the following In and Out-of-Network benefits. Our Plan Year is from July 1, 2015 to June 30, 2016, services are provided once a year regardless of age. Lenses or contact lenses are covered once every plan year regardless of age. NVA BENEFIT IN-NETWORK COVERAGE OUT-OF-NETWORK REIMBURSEMENT EYE EXAMITION Covered in full Up to $32 allowance STANDARD FRAMES STANDARD EYEGLASS LENSES per pair Standard Lenses Material copay Single Vision Bifocal Trifocal Lenticular CONTACT LENS EVALUATION AND FITTING Daily Wear Extended Wear CONTACTS per pair Conventional Specialty Disposable Medically necessary (prior approval required) Covered up to $60 Retail Allowance (20% discount off remaining balance over $60) $10 Covered in full after copay Covered in full after copay Covered in full after copay Covered in full after copay Covered in full Covered in full Covered in full Up to $30 $25 reimbursement $36 reimbursement $46 reimbursement $72 reimbursement Up to $20 allowance Up to $30 allowance Up to $225 allowance LASER VISION CORRECTION BENEFIT FREQUENCY DEPENDENT CHILDREN AGE LIMIT Discount apply to participating providers Eye examinations, eyeglass lenses, frames and contact lenses, in lieu of glasses, are covered once every plan year To age 19; to age 25 if fulltime student

CONSUMER DRIVEN HEALTH PLAN (CDHP) York College of Pennsylvania - Consumer Driven Health Plan (CDHP) The York College of Pennsylvania CDHP combines a High Deductible Health Plan (HDHP) with a tax-favored savings account known as a Health Savings Account (HSA). Paired together, an HDHP and HSA empower you to be an involved healthcare consumer. Keep in mind that you can use your HSA dollars at the FSA Store. Please see FSA Store flier for additional details. HIGH DEDUCTIBLE HEALTH PLANS An HDHP provides coverage after you meet the Plan s deductible. To qualify as an HDHP under IRS guidelines, the plan must satisfy certain deductible and out-of-pocket amounts which may change each year. For 2015, a qualified HDHP has a single annual deductible of at least $1,300 ($2,600 for family) and annual out-of-pocket expenses (i.e., deductibles, coinsurance, copayments) not exceeding $6,450 single ($12,900 for family). Per Federal regulations, an HDHP cannot have a separate drug card or prescription benefit. Prescription charges are also subject to the Plan s deductible. Once the deductible is met, prescription benefits are subject to copays. Under the HDHP, services are covered at a higher percentage when in-network providers are used; however, you can use any licensed doctor or facility you choose and receive coverage at the out-ofnetwork levels. Refer to the enclosed HDHP medical plan summary for complete plan details including In- and Out-of-Network coverage, co-payments and coinsurance. THE COLLEGE S 2015 HDHP CONTAINS A $1,300 SINGLE AND A $2,600 FAMILY DEDUCTIBLE. HEALTH SAVINGS ACCOUNT An HSA is a tax-advantaged health savings account for participants enrolled in an HDHP. You can use funds in an HSA to help pay for qualified expenses, or save for the future. You may contribute pre-tax funds up to the annual contribution limit (with an additional catch-up contribution for participants age 55 and over) regardless of your HDHP annual deductible amount. Once you reach age 65 or over and enroll in Medicare Part A or B, you can not continue to make contributions to an HSA; however, you can still make eligible withdrawals. For 2015, the annual contribution limit is $3,350 for single coverage / $6,650 for family coverage. The Catch-Up contribution limit is $1,000. Any funds in your account at the end of the plan year accumulate and earn non-taxable interest over the life of the account. The dollars in your HSA are your money both the College s contributions and your own and remain your money even if you leave the College. You can take your account with you if you retire or leave your employment. Remember, it is always your money. Additional information on banking options will be provided to you after you enroll. Please refer to How to Submit a Claim to your Health Savings Account (HSA) document for additional information on managing your account. HSA money rolls-over indefinitely so you do not need to make a withdrawal, however, you must be enrolled in an HDHP to contribute funds. Since HSA funds are your money, it is important to keep accurate records and carefully track your account activity to show that your distributions were used to reimburse qualified medical expenses only. THE COLLEGE WILL FUND YOUR 2015 HSA WITH AN AMOUNT OF $1,000 IF YOU ELECT SINGLE COVERAGE OR $2,000 IF YOU ELECT FAMILY COVERAGE. THE AMOUNT WILL BE DEPOSITED INTO YOUR HSA THE FIRST WEEK OF JULY, 2015 IF YOU JOIN THE PLAN MID-YEAR, THE COLLEGE WILL FUND YOUR ACCOUNT WITH THE APPROPRIATE PRO- RATED AMOUNT. YOU MAY MAKE ADDITIOL CONTRIBUTIONS TO YOUR HSA WHICH CANNOT EXCEED A COMBINED TOTAL OF $3,350 SINGLE OR $6,650 FAMILY FOR 2015.

HSA FACTS Money in the account belongs to the account holder. Funds earn interest tax free. Pay for qualified medical expenses with tax free dollars. Enrollment in an HDHP is required to make contributions to an HSA. Maximum allowed contribution to an HSA is permitted regardless of when enrollment in the plan begins; however, you must remain enrolled in an HDHP for the following 12 month period. Account balance is portable upon retirement or termination from the college. Funds not used for qualified expenses are taxed at the regular income tax rates (plus a 20% penalty if withdrawn before age 65). QUALIFIED HSA EXPENSES Only qualified healthcare expenses, as allowed by the IRS, are eligible for reimbursement from a Health Savings Account. Be aware that not all items listed as a qualified expense by the IRS are eligible for coverage under your company s benefits plan. The following listing provides a sampling of eligible reimbursement expenses under an HSA. Medical, dental, and vision deductibles and co-insurance amounts for yourself or qualified dependents Long-Term Care insurance premiums COBRA Continuation Health Coverage premiums Hearing aids Smoking cessation programs Wheelchairs Organ transplants Some Medicare premiums You can obtain additional information from the IRS concerning allowable expenses by calling 1-800-829-3676 to request a copy of IRS Publication 502 or by visiting the IRS website at www.irs.gov and clicking on More Forms and Publications. YOUR HDHP AND HSA WORKING TOGETHER Your HDHP and HSA pair together and are simple to use. It is a simple process: 1. Receive care under your HDHP 2. Pay for qualified expenses using funds from your HSA OR Pay out-of-pocket and let your HSA continue to gain interest Each time you receive medical care and incur a charge for the HDHP deductible, a co-payment or coinsurance amount, you choose whether to pay from your HSA or out-of-pocket. WHAT S THE CATCH? When something seems relatively simple to follow, provides comprehensive medical coverage for you and your family, and gives you a savings vehicle for current and future expenses, it can seem too good to be true. A Consumer-Driven Health Plan provides motivation for you and your family to live a healthy life and become involved in how you spend your healthcare dollars. In the end it is your involvement that leads to lower healthcare costs and unused money in your HSA that can grow over time. HSA ELIGIBILITY REQUIREMENTS IN ORDER TO BE ELIGIBLE FOR AN HSA ACCOUNT, AN INDIVIDUAL MUST: BE COVERED BY A PLAN THAT QUALIFIES AS A "HIGH DEDUCTIBLE HEALTH PLAN (OUR PPOBLUE HIGH DEDUCTIBLE PLAN) AND NOT BE COVERED BY ANY OTHER HEALTHCARE PLAN NOT BE CLAIMED AS A DEPENDENT ON ANOTHER PERSON'S TAX RETURN NOT BE ENROLLED IN MEDICARE PART A OR B. HOWEVER, ACTIVE EMPLOYEES AGE 65 OR OVER CAN CONTRIBUTE TO AN HSA AS LONG AS THEY ARE NOT ENROLLED IN EITHER MEDICARE PART A OR PART B NOT BE ENROLLED IN TRICARE OR IN RECEIPT OF VA MEDICAL OR PRESCRIPTION BENEFITS WITHIN THE PREVIOUS THREE MONTHS. TAX REPORTING FILE FORM 8889 WITH ANNUAL TAX RETURN.