HEALTH PLAN NOTICES If you are covered by FMLA, you will have certain rights to maintain health benefits during the FMLA leave. You will be Medicare Prescription Drug Plan Information – Creditable Coverage notified of any requirement for you to make any premium payments to maintain health benefits and the arrangements for making such payments along with the possible consequences of failure to make such payments on a Important Notice About Your Prescription Drug Coverage Under the Company Group timely basis (i.e., the circumstances under which coverage may lapse) and your potential liability for payment of health insurance premiums paid by the employer during your unpaid FMLA leave if you fail to return to work after Health Plan and Medicare Prescription Drug Coverage: This notice is applicable to the taking FMLA leave. For more information about FMLA, contact the Plan administrator. Company employees eligible for medical plan coverage and who have Medicare or will Genetic Information Nondiscrimination Act (GINA) become eligible for Medicare in the Next 12 Months. This notice is applicable to Medicare eligible participants ONLY. If you or one of your covered dependents is not The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employers and other entities covered by Medicare eligible or will not be within the next 12 months, you can disregard this notice. GINA from requesting or requiring genetic information of an individual or family member of the individual, except as specifically allowed by this law. To comply with this law, we are asking that you not provide any genetic information when responding to this request. “Genetic information” as defined by GINA, includes an individual’s family medical This notice has information about your current prescription drug coverage under the history, the results of an individual’s or family member’s genetic tests, the fact that an individual or an individual’s group health plan coverage offered by the Company Group Health Plan (Plan) and about family member sought or received genetic services, and genetic information of a fetus carried by an individual or an your options under Medicare’s prescription drug coverage. This information can help you individual’s family member or an embryo lawfully held by an individual or family member receiving assistive reproductive services. Please do not include any family medical history or any information related to genetic testing, decide whether or not you want to join a Medicare drug plan. If you are considering genetic services, genetic counseling or genetic diseases for which an individual may be at risk. joining, you should compare your current coverage, including which drugs are covered at Grandfathered Status what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions The Plan believes that none of the group health plans available under the Plan are “grandfathered health plans” as about your prescription drug coverage is at the end of this notice. described under the Affordable Care Act. HIPAA Special Enrollment Rights There are two important things you need to know about your current coverage under If you are declining enrollment for yourself or your dependents (including your spouse) because of other health the Company Plan and Medicare’s prescription drug coverage: insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage(or if the employer stops contributing toward your or your 1. Medicare prescription drug coverage is available to everyone with Medicare. You can dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. This new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or coverage is sometimes referred to as Medicare Part D prescription drug coverage. In placement for adoption. To request special enrollment or obtain more information, contact the Plan Administrator. general, Medicare Part D provides coverage for prescription drugs not covered under Medicare Part A and Part B. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.