HEALTH PLAN NOTICES Special Enrollment Rights - If you are declining enrollment for yourself or same deductibles and co-insurance applicable to other medical and surgical your dependents (including your spouse) because of other health benefits provided under the ABC Company Health Plan. If you would like more insurance or group health plan coverage, you may be able to enroll yourself information on WHCRA benefits, please call your Plan Administrator and your dependents in this plan if you or your dependents lose eligibility Notice Regarding Lifetime and Annual Dollar Limits - In accordance with for that other coverage(or if the employer stops contributing toward your or applicable law, any lifetime dollar limits and annual dollar limits set forth in the your dependents’ other coverage). However, you must request enrollment Plan shall not apply to “essential health benefits,” as such term is defined under within 30 days after your or your dependents’ other coverage ends (or after Section 1302(b) of the Affordable Care Act. The law defines “essential health the employer stops contributing toward the other coverage). In addition, if benefits” to include, at minimum, items and services covered within certain you have a new dependent as a result of marriage, birth, adoption, or categories including emergency services, hospitalization, prescription drugs, placement for adoption, you may be able to enroll yourself and your rehabilitative and habilitative services and devices, and laboratory services. A dependents. However, you must request enrollment within 30 days after determination as to whether a benefit constitutes an “essential health benefit” the marriage, birth, adoption, or placement for adoption. To request special will be based on a good faith interpretation by the Plan Administrator of the enrollment or obtain more information, contact the Plan Administrator. guidance available as of the date on which the determination is made. Grandfathered Status -The Plan believes that none of the group health Patient Protection Disclosure - You have the right to designate any plans available under the Plan are “grandfathered health plans” as participating primary care provider who is available to accept you or your described under the Patient Protection and Affordable Care Act (the family members (for children, you may designate a pediatrician as the primary “Affordable Care Act”). care provider). For information on how to select a primary care provider and for Special Rule for Maternity and Infant Coverage -Group health plans and a list of participating primary care providers, contact the Plan Administrator. health insurance issuers generally may not, under Federal law, restrict You do not need prior authorization from the Plan or from any other person, benefits for any hospital length of stay in connection with childbirth for including your primary care provider, in order to obtain access to obstetrical or the mother or newborn child to less than 48 hours following a vaginal gynecological care from a health care professional; however, you may be delivery, or less than 96 hours following a cesarean section. However, required to comply with certain procedures, including obtaining prior Federal law generally does not prohibit the attending provider or authorization for certain services, following a pre-approved treatment plan, or physician, after consulting with the mother, from discharging the mother procedures for making referrals. For a list of participating health care or her newborn earlier than 48 hours (or 96 hours, as applicable). professionals who specialize in obstetrics or gynecology, contact the health Special Rule for Women’s Health Coverage (WHCRA) -If you have had or are plan. going to have a mastectomy, you may be entitled to certain benefits under Michelle’s Law - Michelle’s Law provides continued health and dental insurance the Women's Health and Cancer Rights Act of 1998 (WHCRA). For benefits under the Plan for dependent children who are covered under the individuals receiving mastectomy-related benefits, coverage will be Plan as a student but lose their student status in a post-secondary school or provided in a manner determined in consultation with the attending college because they take a medically necessary leave of absence from school. physician and the patient, for: all stages of reconstruction of the breast on If your child is no longer a student because he or she is out of school because of which the mastectomy was performed; surgery and reconstruction of the a medically necessary leave of absence, your child may continue to be covered other breast to produce a symmetrical appearance; prostheses; and under the Plan for up to one year from the beginning of the leave of absence. treatment of physical complications of the mastectomy, including lymphedema. These benefits will be provided subject to the