2017-2018 Benefit Decision Guide

U.S.
Benefits Decision Guide

May 1, 2017 – April 30, 2018
Welcome to Your Benefits!
You have access to a range of core benefits such as medical, dental and vision, as well as voluntary
benefits like critical illness insurance, accident insurance and hospital indemnity coverage. Plus,
online tools and resources will be available to help you make confident healthcare decisions. These
options allow you to build a customized package that meets the needs of you and your family. It’s all
part of your easy-to-use benefits experience
— Point. Click. Healthy!
Decision Guide in a Nutshell

This Decision Guide will help you understand the benefit options available to you and your
family, so you can start thinking about the plans that meet your overall healthcare needs. You’ll also
learn how to use the Mercer Marketplace, which features built-in decision support to guide you
through the benefits selection process — one step at a time.
If you (and/or your dependents) have Medicare or will become eligible for Medicare in the next 12 months,
a federal law gives you more choices for your prescription drug coverage. Please see the Creditable Prescription Drug
Coverage and Medicare Notice in the legal notices section of this guide for more details.
Your Benefits. Your Choice.

The Mercer Marketplace helps you take control of your
healthcare spending by:
• Showing the costs associated with each plan.
• Offering a range of options at different prices.
• Helping you find the most cost-effective plan for your needs.
• Offering income tax-saving opportunities through health and
dependent care spending accounts.
• Giving you access to group discounts on additional benefit
options, like auto and home insurance, identity theft protection,
pet insurance and more.
2
What’s inside? Questions?
Health Benefits...........................................................................................2
Flexible Spending Accounts................................................................. 12
401(k) Plan............................................................................................... 13
Life and AD&D Insurance....................................................................... 14 Mercer Marketplace Call Center
Licensed benefit counselors are
Disability Insurance................................................................................. 16
available by phone to answer
Additional Benefit Options.................................................................... 17
general questions about your
It’s Easy to Enroll..................................................................................... 18 benefits, provide
Questions?............................................................................................... 19 personalized support and help walk
Glossary................................................................................................... 20 you through the enrollment process.
Legal Notices........................................................................................... 21 They can even advise on which
benefit plan may best meet the
needs of you and your family. Call
What’s in Store? the Mercer Marketplace at (844)
287-9495.
Being a smart healthcare shopper means making sure you know what
you’re getting and what it’s going to cost. Hours
Monday – Friday, 7 a.m. to 9 p.m.
The Mercer Marketplace is set up like an online benefits store so you
Eastern Time.
can easily view coverage details and costs for each plan before de-
ciding what to put in your shopping cart. When you check out, you’ll
have a chance to review your selections and see your total cost — it’s
as simple as Point. Click. Healthy!
Hablas español?
Llame al (844) 287-9495 y
seleccione 9 para conectar
Your Options con un consejero de beneficios
Your selection of benefit options include: que puede ayudar.
Medical plans — Choose from a PPO Plan or three High Deductible
Health Plans with health savings account (HSA) options that can help
you save on healthcare expenses.
Supplemental medical insurance — Protect yourself from the

high cost of a critical illness, accident or hospital stay. Sometimes
a traditional medical plan isn’t enough.
Don’t forget the Mercer Marketplace is
Health Savings Account (HSA) — If you enroll in the $1,500 available 7 days a week, 24 hours a
Deductible Plan, $2,850 Deductible Plan or $4,500 Deductible day with online resources to help
Plan, you automatically receive access to a triple-tax advantaged answer enrollment questions at
HSA. www.mercermarketplace.com/Radial.
Dental and vision plans — Select dental and vision coverage to
meet your specific needs.
Flexible Spending Accounts (FSAs) — Save on taxes by

contributing to an FSA for healthcare, combination (dental and Glossary
vision) and/or dependent care expenses.
Check out the Glossary on page 20
Life and disability insurance — Life’s unpredictable. Protect your for definitions to terms used through-
family’s finances with a range of life and disability coverage op- out this guide.
tions.
More benefits — Find additional benefits including auto and home

insurance, a legal plan, identity theft protection and pet insurance.
Health Benefits
When it comes to healthcare, one size does not fit all. That’s why we’re It’s the Law!
offering a selection of medical plans designed to let you choose ex- As part of the Healthcare Reform law,
actly the coverage you need — at a cost that’s right for your budget. most Americans must have medical
insurance or pay a federal tax penalty.
Through the Mercer Marketplace, you have a choice of medical, supple-
Be sure you’re covered, either through
mental medical, dental, and vision plans, as well as tax-
one of the company plans or through
advantaged healthcare spending accounts that can save you money.
another option available to you, such
as your spouse’s/domestic partner’s
Medical employer benefits.
Medical coverage offers valuable benefits to help you stay healthy
and pay for care if you or your covered family members become sick Summary of Benefits and Coverage
or injured. You have access to a Summary of
Benefits and Coverage (SBC) for each
Start with standard coverage: Then, you may choose to add: of your medical plan options. These
documents provide detailed information
Medical plans Supplemental medical plans
about coverage and costs to help you
Enroll in core coverage for peace Supplement your core medical
compare plans and make informed
of mind. plan to protect yourself from
decisions. To access the SBCs, visit
significant or unexpected
the Mercer Marketplace at
out-of-pocket expenses.
www.mercermarketplace.com/Radial.
Choose from: Choose from:
• $800 Deductible PPO Plan • Critical Illness Insurance
• $1,500 Deductible Plan with HSA • Accident Insurance
•$2,850 Deductible Plan with HSA • Hospital Indemnity Insurance
• $4,500 Deductible Plan with HSA
Finding Providers is Easy!

You can see any provider you choose, but
keep in mind you’ll typically pay less when you
visit a UnitedHealthcare in-network provider.
UnitedHealthcare has negotiated discounted
rates for most services. To see if your provider
is in-network, visit www.myuhc.com, and
select Find Physician, Laboratory or Facility,
next click All UnitedHealthcare Plans, then
choose the Choice Plus Network. Or call
(844) 255-3066.
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Your Medical Plan Options A Note About Eligibility
Your medical plan options are offered through UnitedHealthcare. Regular employees on the U.S. payroll
working 20 (or more) hours a week on a
$800 Deductible PPO Plan continuous basis will be eligible for benefits.
You pay a portion of the covered expenses before the plan begins to You’re eligible for coverage on the 1st of
pay for certain benefits — this amount is called the deductible. At the the month following 60 days of employment
time of service, you’ll pay out-of-pocket for certain services — this is and the elections made during new hire
called a copay. enrollment will remain in effect for the
entire benefit plan year unless you have a
Once your deductible is met, you’ll pay a percentage of covered
qualifying life event (see Changing Your
medical expenses — this percentage is called coinsurance. If your
Benefit Selections on page 18). New hires
share of medical expenses reaches the out-of-pocket maximum, you
have 31 days to make their benefit elections
won’t have to pay anything for the rest of the plan year.
once they become eligible.
Compatible with: Healthcare FSA and Dependent Care FSA.
Plan Features
All of these medical plans include:
$1,500 Deductible Plan with HSA
$2,850 Deductible Plan with HSA 1. In-network preventive care provided
$4,500 Deductible Plan with HSA
at no cost. Services like annual physicals
The $1,500 Deductible Plan, $2,850 Deductible Plan and $4,500
and well-woman exams, immunizations,
Deductible Plan are designed to encourage you to know your
and routine cancer screenings are cov-
treatment options and the costs associated with your choices. With
ered at 100%. That means you pay noth-
these plans:
ing for these services.
• You have a higher deductible.
2. Annual deductible. You pay for
• You get a tax-free HSA. Money in your HSA can be carried forward initial medical and prescription drug costs
from year to year and is always yours to keep, even if you leave the out-of-pocket until you meet your annual
company or retire. deductible. For the $1,500 Deductible Plan,
• Your lower monthly contributions can help you cover out-of- $2,850 Deductible Plan and $4,500 De-
pocket costs. ductible Plan, contributions to your HSA
can help you pay for your out-of-pocket
Compatible with: HSA, Combination FSA and Dependent Care FSA. costs.
3. Coinsurance. Once the deductible is met,

What Will You Pay? you and the plan share any further health
expenses during the plan year until you
Your specific benefit costs will be provided as you’re
meet your out-of-pocket maximum. This
enrolling on the Mercer Marketplace at
is known as coinsurance.
4. Out-of-pocket maximum. The plan
protects you by limiting the total amount
you’ll pay each plan year for medical care.
Once you meet your out-of-pocket maxi-
mum, the plan pays 100% of your eligible
expenses for the rest of the plan year.
Your May 1, 2017 - April 30, 2018 U.S. Benefits Decision Guide
Health Benefits continued
A Closer Look at the Health Savings Account (HSA) HSA: What’s Eligible?
With the $1,500 Deductible Plan, $2,850 Deductible Plan, and $4,500 You can use your HSA for eligible
Deductible Plan, you’re eligible to open and contribute money to an out-of-pocket expenses like:
HSA available through Discovery. The HSA is a tax-advantaged savings • Deductibles
account you can use to help cover the costs of your healthcare.
• Office visits
HSA features: • Prescription drugs
• Works like a bank account. Use account funds to pay for eligible • Hospital stays and lab work
healthcare expenses by using your plan-provided HSA debit card at
• Speech/occupational/physical thera-
the point of service after you receive care, or reimburse yourself for
py
payments you’ve made (up to the available balance in the account).
• Dental and vision care
• Change your contribution amount at any time. You decide how
much to contribute to the HSA and can change that amount at any For a complete list of eligible
time. Contribute up to the annual (January 1 – December 31) IRS limit expenses, visit www.irs.gov and
of $3,400 for individuals or $6,750 for family coverage (this amount see Publication 502.
includes the company’s contribution, as appropriate). Employees age 55
and older can make an additional $1,000 catch-up contribution.
If you currently own an HSA, and have already made all or part of your
total HSA contribution for 2017, you will need to factor in your prior
contributions to avoid going over the calendar year limit. Contact the
Mercer Marketplace Center at (844) 287-9495 for more information.
• It’s tax-advantaged. Contributions are made from your paycheck

on a pretax basis, and the money will never be taxed when used Prescription Drugs
for eligible medical expenses. When you enroll in one of our
medical plan options, you receive
• It’s your money. Unused funds can be carried over each year and
prescription drug coverage
invested for the future — you can earn tax-free interest on your HSA
through CVS/caremark. With over
balance. You can even take the account with you if you leave the
7,000 locations, CVS/caremark
company, or save it to use during retirement.
is one of America’s largest
• Can be paired with a Combination FSA. Combine the HSA with this prescription drug retailers.
account for additional tax savings. Use the funds to pay for eligible dental
and vision expenses. When you meet the IRS statutory deductible,
then eligible medical expenses are also allowed. The IRS statutory de-
ductible is $1,300 for individual coverage or $2,600 for family cover-
age. See the Mercer Marketplace for more details.
How the $1,500 Deductible Plan, Health Savings Account (HSA)

$2,850 Deductible Plan and Your contributions to the Health Savings Account
can cover your deductible and coinsurance
$4,500 Deductible
Plans Work Together Preventive Deductible Coinsurance Out-of-Pocket
Care You pay 100%. Once You and the plan share a Maximum
with the HSA The plan pays you meet the deduct- percentage of the cost of Once you reach this,
100%. ible, coinsurance kicks services until you meet the the plan pays 100%
in. out-of-pocket maximum. of in-network costs.
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How the Medical Plans Compare
$800 Deductible $1,500 Deductible Plan $2,850 Deductible $4,500 Deductible
PPO Plan with HSA Plan with HSA Plan with HSA
HSA Eligible No Yes Yes Yes
Preventive Care Covered 100% in-network
In-Network
Employee Only/ $800/$1,600 $1,500/$3,000 $2,850/$5,700 $4,500/$9,000

Family Deductible
Employee Only/Family $2,400/$4,800 $3,000/$6,000 $5,500/$11,000 $6,550/$13,100

Out-of-Pocket Maximum
Plan Coinsurance Plan pays 80%, after de- Plan pays 80%, after Plan pays 70%, after Plan pays 70%, after
ductible deductible deductible deductible
Office Visit $20/$35 copay Plan pays 80%, after Plan pays 70%, after Plan pays 70%, after
(primary care/specialist) deductible deductible deductible
Prescription Drug Coverage
Retail Prescriptions
Generic $10 copay, Tier One1 Plan pays 80%, after Plan pays 70%, after Plan pays 70%, after
deductible4 deductible4 deductible4
Formulary2 Plan pays 70%, Tier Two Plan pays 80%, after Plan pays 70%, after Plan pays 70%, after
(min. $25/max. $50)1,3 deductible4 deductible4 deductible4
Non-formulary Plan pays 55%, Tier Three Plan pays 80%, after Plan pays 70%, after Plan pays 70%, after
Mail Order Prescriptions
Generic $25 copay, Tier One1 Plan pays 80%, after Plan pays 70%, after Plan pays 70%, after
deductible4 deductible4 deductible4
Formulary2 Plan pays 70%, Tier Two Plan pays 80%, after Plan pays 70%, after Plan pays 70%, after
(min. $62.50/max. $125)1,3 deductible4 deductible4 deductible4
Non-formulary Plan pays 55%, Tier Three Plan pays 80%, after Plan pays 70%, after Plan pays 70%, after
1
Deductible does not apply.
2
Formulary prescriptions are brand name drugs that generally save you money over other brand name drugs because they are on
the CVS/caremark Prescription Drug List. These medications typically fall under Tier 2 of the prescription drug list (PDL) and are
considered your moderate cost option.
3
Formulary (Tier Two) and Non-formulary (Tier Three) drug costs are based on coinsurance. You are required to pay at least the minimum
amount for a prescription drug, but you will never pay more than the maximum coinsurance amount for a prescription.
4
Preventive Prescriptions (as defined under ACA regulations) ffor the $1,500, $2,850 and $4,500 Deductible Plans are covered at
100%, prior to the deductible. Maintenance medications are covered at the coinsurance level and the deductible is waived.
Supplemental Medical
Supplemental Medical Insurance through Voya can help protect you from significant expenses not covered by your
medical plan. In fact, based on your situation, you may be able to save money by adding a supplemental plan to a
lower cost medical plan. Be sure to consider your anticipated medical needs for the coming year — for example, a
major
surgery — and the cost of the insurance plans available to you.
Keep in Mind
Supplemental medical plans are intended to supplement your primary medical plan.
On their own, they don’t provide the minimum level of medical coverage needed to meet
Affordable Care Act (ACA) requirements.
Critical Illness Insurance

When a serious illness strikes, Critical Illness Insurance through Voya can provide financial support to help you
through a difficult time. It protects against the financial impact of certain illnesses, such as a heart attack or cancer. You
receive a lump-sum benefit to cover out-of-pocket expenses for your treatment that are not covered by your medical
plan. You can also use the money to take care of your everyday living expenses like housekeeping services, special
transportation and daycare. Critical Illness Insurance is available to employees, their spouse/domestic partner and
child(ren); however, you must enroll in coverage for yourself before you can enroll a dependent.
Benefits are paid:
• Directly to you, unless assigned to someone else.
• As a lump sum.
How Critical Illness Insurance Coverage Works

Let’s say, three months after enrolling, you are diagnosed with a cancer. Three years later you suffer a stroke. In both cases,
Critical Illness insurance would provide you with a lump-sum payment to use however you see fit. Benefits are not
paid for any critical illness diagnosed before the coverage effective date. As the example below shows, the full
benefit may
be paid up to once per year.
Voya would pay you:
Cancer (100%) – year 1 $15,000
Stroke (100%) – year 3 $15,000
Total benefit paid directly to you $30,000
Critical Illness Overview
Carrier Voya
Coverage You: $15,000, $30,000 Spouse: $10,000, $15,000 Child(ren): $5,000, $10,000
Employee must elect coverage for the spouse and/or child(ren) to elect coverage.
Cost Paid by you.

6
Accident Insurance
Accidents happen — but you can help protect yourself from accident-related costs that can strain your budget. Voya
Accident Insurance supplements your medical plan by providing a cash benefit in case of accidental injury. As you recov-
er, use this money to help pay for:
• Medical expenses not covered by your medical plan, such as your deductible or coinsurance.
• Ongoing living expenses, such as your mortgage or rent.
Accident Insurance coverage is available to employees, their spouse/domestic partner and child(ren); however, you
must enroll in coverage for yourself before you can enroll a dependent.
Benefits are paid:

• As a lump sum.
• In addition to any other coverage, like medical or an Accidental Death & Dismemberment (AD&D) plan.
The policy pays you a benefit up to a specific amount for:

• Accidental death • Intensive care
• Dismemberment • Ambulance
• Dislocation or fracture • Medical expenses
• Initial hospital confinement • Outpatient physician’s treatment
The benefit amount depends on the type of injuries you have and the medical services you need.
How Accident Insurance Coverage Works

Let’s suppose you are involved in a bicycle accident. You suffer a fractured leg and a dislocated wrist, and also need
stitches. You take an ambulance to the emergency room, receive X-rays and spend two days in the hospital. Although
your medical plan pays most of the medical expenses, you are still responsible for a remainder of the cost. That’s
where Accident Insurance can help, as shown in the example below.
Voya would pay you:
ER services, physician fees, and medical equipment $300

Key Things to Know
• If you choose to cover your
Fractured leg requiring surgery $1,600 dependents, the covered
Large (greater than 6”) laceration requiring stitches $400 spouse/domestic partner and
child benefit amount is 100%
Dislocated wrist requiring surgery $600
of your benefit amount with
Ambulance $100 certain exceptions.
Blood, plasma, platelets $300 • You can take your Accident

Insurance coverage with you
Follow-up doctor treatment $50 if you leave the company.
Hospital admission $900
Hospital confinement (plan pays $225 a day up to 365 days) $450 (two days)
Physical therapy (six treatments) $150
Hospital Indemnity Insurance
A trip to the hospital can be stressful — so can the bills. Even with a medical plan, you may still be responsible for
copays, deductibles and other out-of-pocket costs. A Hospital Indemnity Insurance plan through Voya provides
supplemental payments that you can use to cover expenses that your medical plan doesn’t cover for hospital stays,
ambulance service, surgery, and certain inpatient or outpatient treatments. Hospital Indemnity Insurance coverage
is available to employees, their spouse/domestic partner and child(ren); however, you must enroll in coverage for
yourself before you can enroll a dependent.
Benefits are paid:

• As a lump-sum or on a benefit schedule.
How Hospital Indemnity Insurance Coverage Works

Let’s say your appendix ruptures, and your recovery keeps you in the hospital for five days.
Voya would pay you:
Hospital admission benefit $500
Daily hospital confinement benefit (plan pays $100 per day) $500 (five days)
Learn More
For additional plan details, including out-of-network benefits, visit the Mercer Marketplace at
8
What’s Your Best Fit?
Then consider…
$1,500, $2,850
If this describes you… $800 Why?
or $4,500 Supplemental
Deductible
Deductible Plan Plans
PPO Plan
with HSA
You expect your The $1,500, $2,850, and $4,500

need for medical care Deductible Plans with HSAs have the
to be relatively low lowest premiums, so you’ll pay less
(preventive visits, per paycheck. Since you don’t expect
occasional illnesses). to need a lot of care, these plans could
save you money.
You want to keep The $800 Deductible PPO Plan has the
your costs for lowest deductible, so you’ll pay the
receiving medical least amount out of your pocket when
care to a minimum. you receive care.
You want to lower your These plans have an HSA, which allows
taxable income while you to save money for healthcare
saving for healthcare expenses and save money on your
expenses — using the taxes as well.
money only when you
need to.
In the event of an Critical Illness, Accident and Hospital

expensive illness or Indemnity Insurance provide benefits
injury, you aren’t that can pay for medical bills your
confident that you medical plan doesn’t cover — and
could afford to pay bills even for other expenses, depending
not covered by your on the plan. Keep in mind, these plans
medical plan. are meant to supplement your primary
medical insurance, not to serve as your
only insurance.
Dental
Healthy teeth and gums are important to your overall health. Learn about the dental plans available to you through
Delta Dental.
Enhanced Plan Basic Plan
Annual Maximum Benefit $2,000 $750
In-Network
Employee Only/Family Deductible $50/$150 $50/$150

(waived for preventive services)
Preventive Services Plan pays 100% Plan pays 90%
Basic Services Plan pays 80% Plan pays 70%
Major Services Plan pays 50% Not covered
Orthodontia Services* Plan pays 50% Not covered
Orthodontia Lifetime Maximum $1,500 Not covered

(in-network and out-of-network)
* Orthodontia coverage under the enhanced plan is available to adults and children (up to age 26).
Learn More
For additional plan details, including out-of-network benefits, visit the Mercer Marketplace at
Finding Providers is Easy

To search for providers in the Delta Dental network or VSP network, go to:
Delta Dental: VSP:

www.deltadentalins.com www.vsp.com
10
Vision
You can enroll in vision coverage to save money on eligible vision care expenses, such as eye exams, glasses, and con-
tact lenses. Learn about the vision plans available to you through VSP.
Enhanced Plan Standard Plan
In-Network
Copay Frequency Copay Frequency
Exam $10 Every 12 months $10 Every 12 months
Lenses $10 Every 12 months $25 Every 12 months
Retail Allowance Frequency Retail Allowance Frequency
Frames $175 Every 12 months $130 Every 24 months
Contact Lenses Covered up to $175 Every 12 months Covered up to $130 Every 12 months
(in lieu of frames
and lenses)
Contact Lens Fitting Covered in full with a Every 12 months in lieu Covered in full with a Every 12 months in lieu
copay not to exceed $60 of frames and lenses copay not to exceed $60 of frames and lenses
11
Flexible Spending Accounts
Flexible Spending Accounts (FSAs)
Save money on your healthcare and/or dependent care expenses by using a tax-advantaged FSA. The money you
contribute comes from your paycheck pretax (lowering your taxable income). And withdrawals for eligible expenses
are also tax-free.
Healthcare FSA
$800 Deductible PPO Plan
• Contribute up to $2,600 annually to help cover qualified medical, vision and dental expenses. For a complete list
of eligible expenses, visit www.irs.gov and see Publication 502.
• Choose your contribution amount once a year (if your personal situation changes, such as getting married or having
a baby, you may be able to change your election during the year).
• Use a plan-provided debit card to pay for your eligible expenses.
• Your entire annual contribution is available to you at the beginning of the plan year.
• You can carry forward up to $500 in unused funds each year. Anything not used over $500 at the end of the year
will be forfeited.
Dependent Care FSA

Any medical plan
• Contribute up to $5,000 a year to reimburse yourself for qualified dependent care (child or adult) expenses.
For a complete list of eligible expenses, visit www.irs.gov and see Publication 503.
• Eligible expenses include child care and care for dependent elders.
• Cannot be used toward medical expenses for yourself or dependents.
• Unused money does not carry forward at the end of each year — you must “use it or lose it.”
Healthcare FSA Reimbursement

Reimbursement requests for eligible healthcare expenses that are incurred between your
initial plan year start date (the date your flexible spending account and medical coverage
became effective) through April 30, 2018, must be submitted no later than July 31, 2018
to receive reimbursement.
Combination FSA
$1,500 Deductible Plan, $2,850 Deductible Plan and $4,500 Deductible Plan
• Contribute up to $2,600 annually.
• Only dental and vision expenses can be paid with the Combination FSA until you have met the IRS statutory
deductible for medical expenses — $1,300 for individual coverage or $2,600 for family coverage. After you have
met the statutory deductible, then eligible medical expenses are allowed.
• Use a plan-provided debit card to pay for your eligible expenses.
• Your entire annual contribution is available to you at the beginning of the plan year.
• Unused money does not carry forward at the end of each year — you must “use it or lose it.”
12
Take a Look: HSA vs. FSAs
See how these accounts compare.
HSA Healthcare FSA Combination FSA Dependent Care FSA
Available if you • $1,500 Deductible Plan $800 Deductible • $1,500 Deductible Plan All medical plans
enroll in the: PPO Plan
• $2,850 Deductible Plan • $2,850 Deductible Plan
• $4,500 Deductible Plan • $4,500 Deductible Plan
Annual You can contribute up You can contribute You can contribute You can contribute up
contributions: to: up to $2,600 up to $2,600 to $5,000 (per individual
or married couple)
Employee Only: $3,400
Family: $6,750
“Use it or No, the money in your Yes, but you can carry Yes, money cannot be Yes, money cannot be
lose it”? account is yours to keep forward up to $500 in carried forward to the carried forward to the
unused funds each year next year next year
Learn More
For additional details about the HSA and FSAs, visit the Mercer Marketplace
at www.mercermarketplace.com/Radial.
401(k) Plan
The 401(k) Plan helps you build savings for an active, healthy and financially stable future. Employees may
participate in the 401(k) Plan once they meet eligibility requirements. Please visit the Benefits page (under the Human
Resources tab) on the Intranet for more information.
Your May 2017 – April 2018 U.S. Benefits Decision Guide | 13

Life and AD&D Insurance
For Your Financial Wellbeing Evidence of Insurability (EOI)
Life and disability insurance provide important financial protection for Life insurance over a certain amount may
you and your family. You can choose from several different levels of require Evidence of Insurability (EOI) —
coverage to meet your needs. amounts greater than the guaranteed
issue amount of $300,000 and spouse
term life elections greater than $50,000.
Basic Life Insurance
After electing coverage, you will receive
Because life can suddenly take an unexpected turn, it’s good to know
more information if you need to take
you’re covered if the worst occurs. The company provides basic life
further action to enroll.
insurance through MetLife to assist you and your family in the event of a
death. This benefit is fully paid for by the company, and you do not Select a Beneficiary
need to enroll to receive coverage. It’s important to choose a beneficiary
or beneficiaries to receive the policy’s
The basic life insurance benefit is equal to 1.5 times your annual salary,
benefit payment in the event of the insured
up to $2,000,000.
person’s death. You should designate
Supplemental Life and AD&D Insurance your beneficiary(ies) on the Mercer
You also can choose to purchase additional life insurance for yourself, Marketplace. The employee is automati-
your spouse/domestic partner, and your child(ren). You pay the full cost cally the beneficiary for spouse/domestic
of any supplemental life insurance and/or supplemental AD&D insurance partner and child(ren) coverage.
coverage. See the following page for more information about supplemen- An Important Note
tal life and AD&D insurance.
If electing life insurance, you must
be actively at work on the plan effective
date with a valid Social Security number
What Will You Pay?
or U.S. government issued ID for your
Your specific benefit costs will be displayed as you’re
coverage to begin.
enrolling on the Mercer Marketplace at
Questions?
For general questions related to disability benefits,
contact the Mercer Marketplace at (844) 287-9495.
Learn More
For more coverage details, visit the
Mercer Marketplace at
14
Your Supplemental Life and AD&D Options
Type of coverage Purchase for How it works
Employee Term Life Yourself • To supplement the coverage provided by the company, you can purchase
additional term life insurance.
• This coverage is tied to your employment and ends if you leave the company.
• Depending on the amount of coverage you choose, this benefit can be be-
tween one and six times your annual salary, up to $2,000,000.
• The guaranteed issue amount for this benefit is $300,000 — this means you
are guaranteed to be insured up to this amount without having to provide
evidence of insurability (EOI).
Spouse Term Life Your spouse/ • This coverage is tied to your employment and ends if you leave the company.
domestic partner • $25,000 increments, up to the lesser of 50% of employee term life amount
or $250,000.
• You are guaranteed coverage of up to $50,000 without having to provide EOI.
Child Term Life Your child(ren) • This coverage is tied to your employment and ends if you leave the company.
• Depending on the amount of coverage you choose, this benefit can be
$5,000, $10,000, $15,000 or $20,000.
• You are guaranteed coverage of up to $20,000 without having to provide EOI.
• Child(ren) can be covered up to age 26.
Supplemental Yourself • You can purchase AD&D insurance for yourself.

Accidental Death • Depending on the amount of coverage you choose for yourself, you can
& Dismemberment receive a benefit between one and six times your annual salary, up to
(AD&D) $2,000,000, without having to provide EOI.
Spouse/Domestic Your spouse/ • If you elect supplemental AD&D insurance for yourself then you also
Partner and Child domestic partner can purchase AD&D insurance for your spouse or domestic partner and
Supplemental AD&D and child(ren) your child(ren).
• The benefits differ depending on the amount of coverage you choose for your
spouse or domestic partner (or spouse/domestic partner and child(ren)).
• You can elect up to the maximum coverage without having to provide EOI.
Covered person Benefit
Your spouse/domestic partner 50% of employee’s AD&D election.
Child(ren) 15% of the employee’s

AD&D election.
Spouse/domestic partner AND • Spouse/domestic partner: 40%

Child(ren) (up to age 26) of employee’s AD&D election.
• Child(ren):10% of employee’s
AD&D election.
Disability Insurance
Disability Insurance
If you become ill or injured and need to miss work for an extended
time, disability insurance can replace a percentage of your lost income
(up to a maximum benefit).
Short-Term Disability
Questions?
This benefit is completely paid by the company. Short-term disability
For general questions related to
provides a weekly benefit amount of 60% of your salary, up to $2,500
disability benefits, contact the
per week, for a maximum duration of 90 days. Short-term disability
Mercer Marketplace at
coverage begins after seven days of disability.
(844) 287-9495.
Supplemental Short-Term Disability
You also have the opportunity to increase your short-term disability
coverage by purchasing “buy-up coverage.” This benefit is paid for by An Important Note
you and the cost of the plan is based on your age and annual earnings. If electing disability coverage,
Supplemental short-term disability provides a weekly benefit amount you must be actively at work on
of 70% of your salary (60% employer-paid short-term disability plus the plan effective date with a valid
10% employee-paid supplemental short-term disability), up to $6,500 Social Security number or U.S.
per week, for a maximum of 90 days. government issued ID for your
Long-Term Disability coverage to begin.
The company also provides long-term disability coverage if you have
been disabled for a continuous period of 90 days. Long-term disability
provides a monthly benefit amount of 60% of your salary, up to $15,000
per month, for a maximum duration up to the Social Security Normal
Retirement Age.
Learn More
For more coverage details, visit
the Mercer Marketplace at
16
Additional Benefit Options
You also have the option of enrolling in additional benefits through the Mercer Marketplace. Keep in mind that the
enrollment window for the following benefits may be separate from your open enrollment period. These benefits are
offered at competitive group rates, which could save you money compared to purchasing them on your own.
Benefit What is it? Why would I need it?
Identity Theft Services from InfoArmor that monitor your • Get peace of mind by protecting yourself
Protection identity, detect fraud, and restore your identity against the damage of identity theft.
in the event of theft. You can enroll in this benefit • Certified privacy advocates act on your behalf
during the new hire eligibility period and during to resolve identity theft issues.
annual Open Enrollment.
Legal Benefits Hyatt Legal Assistance Plan offers economical • Give yourself, your spouse/domestic partner,
access to attorneys for legal services such as and your dependents access to a nationwide
will preparation, estate planning and family law. network of 13,000 attorneys.
You can enroll in this benefit during the new • Legal advice is a phone call away.
hire eligibility period and during annual Open • Representatives help you find an attorney in
Enrollment. your area.
Auto & Home MetLife gives you access to personal insurance • Save up to 15% by purchasing this coverage
Insurance policies including home landlord’s rental dwell- through the Mercer Marketplace.
ing, condo, recreational vehicle and boat. • No-obligation quotes and cost comparisons.
• Enroll any time of year.
Pet Insurance Nationwide Pet Insurance provides coverage • Protect against the financial impact of
to help you cover the costs of veterinary care. veterinary care while using any veterinarian
Available for dogs, cats, birds and exotic animals. worldwide.
• You are eligible to receive a discount of 5% or
more on premiums.
• Enroll any time of year.
17
It’s Easy to Enroll
The Mercer Marketplace takes you through your benefits shopping one
decision at a time, providing helpful education and decision support If You Don’t Enroll,
every step of the way. Enroll for your benefits via the website or the You Won’t Have Coverage
Mercer Marketplace Call Center at (844) 287-9495. New employees are eligible for
benefits on the 1st of the month
Log In following 60 days of employment.
From the intranet: New employees have 31 days from
Visit the Human Resources page and click “Mercer Marketplace.” the day they become eligible to
make benefit elections. If you do
From an external computer: not enroll for benefits during this
Start by visiting www.mercermarketplace.com/Radial. The first time you 31-day window, you will not have
visit the Mercer Marketplace, select “Create an Account.” Next, enter another opportunity to enroll until
your Social Security number, last name, and date of birth. Then, you’ll the next open enrollment period, or
select a unique user name and password to use whenever unless you have a qualifying life
you come back to the site. event as described below. For
more information, contact Mercer
Start Shopping Marketplace at (844) 287-9495.
To select your benefits, click on the “Get Started” button and then follow
Changing Your Benefit Selections
the simple enrollment steps.
In accordance with IRS regulations,
1. Profile you can only make changes to some
• Review your personal information. benefits (such as medical and dental
insurance) during the employer’s
• If you have dependents and are extending coverage to them, you
Open Enrollment period, or if you
will need to add your dependents in the Mercer Marketplace.
have a qualifying life event. For
2. Enrollment example, if you get married or have a
• Answer some questions to help identify the best coverage for baby, you can add coverage for your
you and your family’s needs. spouse/domestic partner or new
• Compare plan features and costs. child. You can learn more about
• Use the educational resources to learn more. which situations allow you to change
your benefits and how to make
• Select the benefits you want to enroll in.
changes by visiting the Mercer
3. Confirmation Marketplace or calling a benefits
• Review the benefits summary and confirm your enrollment counselor. If you experience a family
selections. Last, print a copy of your confirmation statement status change, please contact Mercer
for your records. Marketplace within 31 days of the
event. Other benefits, such as the
Mercer Marketplace Call Center HSA or Pet Insurance, can be
started, stopped, or changed at any
A benefit counselor can walk you through the enrollment process
time during the year.
and advise you on what plan options they think are the best fit.
Call (844) 287-9495 to speak with a counselor Monday – Friday,
7 a.m. to 9 p.m. Eastern Time. Spanish-speaking counselors are
also available.
18
Questions?
As you use the Mercer Marketplace for the first time, you may have questions. And that’s okay, because there’s a team
of licensed, English- and Spanish-speaking benefits counselors ready to help you. They’re specially trained at helping
employees understand their healthcare options and figuring out the best choices for your and your family’s unique
needs and budget. Simply call the toll-free number to receive personal support from a benefits counselor.
Hablas español?
Mercer Marketplace Call Center Llame al (844) 287-9495 y
(844) 287-9495 seleccione 9 para conectar
con un consejero de beneficios
Monday – Friday, 7 a.m. to 9 p.m. Eastern Time que puede ayudar.
Benefit Administrator Phone Number Website Policy #
Medical UnitedHealthcare (844) 255-3066 www.myuhc.com 907804
Prescription Drug CVS/caremark (844) 297-0510 www.caremark.com 1182

Services
Flexible Spending and Marketplace (877) 248-0510 www.mercermarketplace.com/Radial Not Required

Health Saving Accounts
(FSAs/HSAs) (Discovery
Benefits)
Supplemental Medical Voya Financial (866) 448-7351 http://foremployers.voya.com 694410

(Critical Illness, Accident
Insurance, Hospital
Indemnity)
Dental Delta Dental (800) 932-0783 www.deltadentalins.com 18317
Vision VSP (800) 877-7195 www.vsp.com 30066569
Life and AD&D MetLife (800) 523-2894 www.metlife.com/mercermarketplace 00164439
Disability/ Cigna Claim intake: radial.iamselfservice.com Not Required

Leave Administrator 888-84Cigna
Medical underwriter:
(800) 732-1603
Legal MetLaw (Hyatt (800) 438-6388 www.legalplans.com 609/1279

Legal) Access code: GETLAW
Auto & Home MetLife (800) 438-6388 www.metlife.com/group-auto/mpe 9164439
Identity Theft InfoArmor (800) 789-2720 www.infoarmor.com/exchange 1259
Pet Insurance Nationwide (877) 738-7874 www.petinsurance.com 4732
Employee Assistance Magellan (800) 424-4485 www.magellanhealth.com/member Radial Holdings

Program (EAP)
Glossary
Coinsurance: The way in which you and the company share healthcare costs after you meet the plan’s deductible,
but before you meet the out-of-pocket maximum.
Copay: A flat dollar amount you pay for a covered service each time you use that service.
Deductible: The amount you pay toward your medical insurance plan before the plan begins to share in the cost
of covered benefits.
Flexible Spending Accounts (FSAs): A type of account that lets you use pretax funds to pay for eligible medical,
dental and vision expenses, and/or dependent care expenses.
Health Savings Account (HSA): An account that lets you use pretax funds to pay for eligible healthcare expenses.
Out-of-Pocket Costs: Expenses you pay yourself, such as deductibles, copays and services not covered by your
medical plan.
Out-of-Pocket Maximum: The maximum amount you pay for covered healthcare services during a plan year.
Prescriptions:
• Generic medications contain the same active ingredients as more costly alternatives, but are not sold using
a brand name.
• Formulary medications are brand name drugs that are available at a lower cost to you.
• Non-formulary medications may be purchased at a higher cost to you.
20
Legal Notices
The official plan document and summary plan description for the Radial Commerce, Inc. Group Welfare Benefits Plan
and their respective coverage options provide more complete details regarding the terms of the plan. If there is any
conflict between the statements in this guide and the official plan documents, the terms of the plan documents will
govern all rights and obligations of plan participants, beneficiaries, and fiduciaries of Radial Commerce, Inc. The
plan administrator (or its delegate) has the sole discretion to interpret and apply the terms and conditions of the plan
described in this guide. Radial Commerce, Inc. reserves the right to amend or terminate these benefits or change the
cost of coverage at any time and for any reason.
The Benefits Decision Guide, combined with these legal notices, provides an overview of the benefits available to you
and your family. In the event of a discrepancy between the information presented in the Benefits Decision Guide and
official plan documents, the official plan documents will govern.
Statement of Material Modifications (ERISA Plans)

This enrollment guide constitutes a summary of modifications to the employer’s group health plan. It is meant to
supplement and/or replace certain information in the existing plan descriptions. Please share these materials with your
covered family members.
Summary of Benefits Coverage

A Summary of Benefits Coverage (SBC) for each of the employer-sponsored medical plans is available at
www.mercermarketplace.com/Radial. You may also request a paper copy by calling the Mercer Marketplace Call
Center at (844) 287-9495.
Important Notice from Radial Commerce, Inc. about Creditable Prescription Drug
Coverage and Medicare
The purpose of this notice is to advise you that the prescription drug coverage listed below under the Radial Commerce,
Inc. medical plan is expected to pay out, on average, at least as much as the standard Medicare prescription drug
coverage will pay in 2017. This is known as “creditable coverage.” Why this is important: if you or your covered
dependent(s) are enrolled in any prescription drug coverage during 2017 listed in this notice and are or become
covered by Medicare, you may decide to enroll in a Medicare prescription drug plan later and not be subject to a late
enrollment penalty — as long as you had creditable coverage within 63 days of your Medicare prescription drug plan
enrollment. You should keep this notice with your important records.
If you or your family members aren’t currently covered by Medicare and won’t become covered by Medicare in the
next 12 months, this notice doesn’t apply to you.
Please read the notice below carefully. It has information about prescription drug coverage with Radial Commerce, Inc.
and prescription drug coverage available for people with Medicare. It also tells you where to find more information to
help you make decisions about your prescription drug coverage.
Notice of creditable coverage

You may have heard about Medicare’s prescription drug coverage (called Part D), and wondered how it would affect
you. Prescription drug coverage is available to everyone with Medicare through Medicare prescription drug plans. All
Medicare prescription drug plans provide at least a standard level of coverage set by Medicare. Some plans also offer
more coverage for a higher monthly premium.
Legal Notices continued
Individuals can enroll in a Medicare prescription drug plan when they first become eligible, and each year from
October 15 through December 7. Individuals leaving employer/union coverage may be eligible for a Medicare Special
Enrollment Period.
If you are covered by one of the Radial Commerce, Inc. prescription drug plans listed below, you’ll be interested to know
that coverage is, on average, at least as good as standard Medicare prescription drug coverage for 2017. This is called
creditable coverage. Coverage under one of these plans will help you avoid a late Part D enrollment penalty if you are
or become eligible for Medicare and later decide to enroll in a Medicare prescription drug plan.
• $800 Deductible PPO Plan

If you decide to enroll in a Medicare prescription drug plan and you are an active employee or family member of an
active employee, you may also continue your employer coverage. In this case, the employer plan will continue to pay
primary
or secondary as it had before you enrolled in a Medicare prescription drug plan. If you waive or drop Radial Com-
merce, Inc. coverage, Medicare will be your only payer. You can re-enroll in the employer plan at annual enrollment
or if you have a special enrollment event for the Radial Commerce, Inc. plan.
You should know that if you waive or leave coverage with Radial Commerce, Inc. and you go 63 days or longer without
creditable prescription drug coverage (once your applicable Medicare enrollment period ends), your monthly Part D
premium will go up at least 1% per month for every month that you did not have creditable coverage. For example, if
you go 19 months without coverage, your Medicare prescription drug plan premium will always be at least 19% higher
than what most other people pay. You’ll have to pay this higher premium as long as you have Medicare prescription
drug coverage. In addition, you may have to wait until the following October to enroll in Part D.
You may receive this notice at other times in the future — such as before the next period you can enroll in Medicare
prescription drug coverage, if this Radial Commerce, Inc. coverage changes, or upon your request.
For more information about your options under Medicare prescription drug coverage
More detailed information about Medicare plans that offer prescription drug coverage is in the Medicare & You hand-
book. Medicare participants will get a copy of the handbook in the mail every year from Medicare. You may also be
contacted directly by Medicare prescription drug plans. Here’s how to get more information about Medicare prescrip-
tion drug plans:
Visit www.medicare.gov for personalized help.
Call your state Health Insurance Assistance Program (see a copy of the Medicare & You handbook for the telephone number).
Call (800) MEDICARE ((800) 633-4227). TTY users should call (877) 486-2048.
For people with limited income and resources, extra help paying for a Medicare prescription drug plan is avail-
able. Information about this extra help is available from the Social Security Administration (SSA). For more information
about this extra help, visit SSA online at www.socialsecurity.gov or call (800) 772-1213 (TTY (800) 325-0778).
22
Remember: Keep this notice. If you enroll in a Medicare prescription drug plan after your applicable Medicare enroll-
ment period ends, you may need to provide a copy of this notice when you join a Part D plan to show that you are not
required to pay a higher Part D premium amount.
For more information about this notice or your prescription drug coverage, contact:
Radial Commerce, Inc.
Attn: HIPAA Privacy Officer
935 First Avenue
King of Prussia, PA 19406
(610) 491-7000
ASKPrivacy@radial.com
HIPAA Special Enrollment Notice

Notice of special enrollment rights for health plan coverage
If you decline enrollment in a Radial Commerce, Inc. health plan for you or your dependents (including your spouse)
because of other health insurance or group health plan coverage, you or your dependents may be able to enroll in a
Radial Commerce, Inc. health plan without waiting for the next Open Enrollment period if you:
• Lose other health insurance or group health plan coverage. You must request enrollment within 31 days after the
loss of other coverage.
• Gain a new dependent as a result of marriage, birth, adoption, or placement for adoption. You must request health
plan enrollment within 31 days after the marriage, birth, adoption, or placement for adoption.
• Lose Medicaid or Children’s Health Insurance Program (CHIP) coverage because you are no longer eligible. You
must request medical plan enrollment within 60 days after the loss of such coverage.
If you request a change due to a special enrollment event within the 31 day timeframe, coverage will be effective the
date of birth, adoption or placement for adoption. For all other events, coverage will be effective the first of the
month following your request for enrollment. In addition, you may enroll in a Radial Commerce, Inc. medical plan if
you become eligible for a state premium assistance program under Medicaid or CHIP. You must request enrollment
within 60 days after you gain eligibility for medical plan coverage. If you request this change, coverage will be
effective the first of the month following your request for enrollment. Specific restrictions may apply, depending on
federal and state law. Please see the section entitled “CHIP/MEDICAID NOTICE” below for further information.
Note: If your dependent becomes eligible for a special enrollment rights, you may add the dependent to your current cov-
erage or change to another health plan. Any other currently covered dependents may also switch to the new plan in which
you enroll.
Women’s Health And Cancer Rights Act (WHCRA) Notice

If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health
and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy related benefits, coverage will be provided
in a manner determined in consultation with the attending physician and the patient, for:
• All stages of reconstruction of the breast on which the mastectomy was performed.
• Surgery and reconstruction of the other breast to produce a symmetrical appearance.
• Prostheses.
• Treatment of physical complications of the mastectomy, including lymphedema.
These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and
surgical benefits provided under this plan. If you would like more information on WHCRA benefits, call UnitedHealthcare
at (844) 255-3066.
Newborns’ and Mothers’ Health Protection Act (NMHPA or “Newborns’ Act”) Notice
Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hos-
pital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a
vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit
the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her
newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law,
require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not
in excess of 48 hours
(or 96 hours). If you would like more information on maternity benefits, call UnitedHealthcare at (844) 255-3066.
CHIP/Medicaid Notice
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer,
your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or
CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium as-
sistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace.
For more information, visit www.healthcare.gov.
If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your
State Medicaid or CHIP office to find out if premium assistance is available.
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your depen-
dents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial (877) KIDS
NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might
help you pay the premiums for an employer-sponsored plan.
If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your
employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is
called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligi-
ble for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of
Labor at www.askebsa.dol.gov or call (866) 444-EBSA (3272).
If you live in one of the following states, you may be eligible for assistance paying your employer health plan
premiums. The following list of states is current as of July 31, 2015. Please visit the Benefits page on Radial Central
for an updated list. Contact your State for more information on eligibility.
24
ALABAMA – Medicaid
MAINE – Medicaid
Website: www.myalhipp.com
Phone: (855) 692-5447 Website: http://www.maine.gov/dhhs/ofi/public-
assistance/index.html
Phone: (800) 977-6740
ALASKA – Medicaid
TTY: (800) 977-6741
Website: http://health.hss.state.ak.us/dpa/programs/
medicaid MASSACHUSETTS – Medicaid and CHIP
Phone (Outside of Anchorage): (888) 318-8890
Phone (Anchorage): (907) 269-6529 Website: http://www.mass.gov/MassHealth
Phone: (800) 462-1120
COLORADO – Medicaid MINNESOTA – Medicaid
Medicaid Website: http://www.colorado.gov/hcpf Website: http://www.dhs.state.mn.us/id_006254
Medicaid Customer Contact Center: (800) 221-3943 Click on Health Care, then Medical Assistance
Phone: (800) 657-3739
FLORIDA – Medicaid
MISSOURI – Medicaid
Website: http://www.flmedicaidtplrecovery.com/
Phone: (877) 357-3268 Website: http://www.dss.mo.gov/mhd/participants/pages/
hipp.htm
GEORGIA – Medicaid Phone: (573) 751-2005
Website: http://dch.georgia.gov – Click on Programs, then

MONTANA – Medicaid
Medicaid, then Health Insurance Premium Payment (HIPP)
Phone: (404) 656-4507 Website: http://medicaid.mt.gov/member
Phone: (800) 694-3084
INDIANA – Medicaid
NEBRASKA – Medicaid
Website: http://www.in.gov/fssa
Phone: (800) 889-9949 Website: www.ACCESSNebraska.ne.gov
Phone: (855) 632-7633
IOWA – Medicaid
NEVADA – Medicaid
Website: www.dhs.state.ia.us/hipp
Phone: (888) 346-9562 Medicaid Website: http://dwss.nv.gov
Medicaid Phone: (800) 992-0900
KANSAS – Medicaid
NEW HAMPSHIRE – Medicaid
Website: http://www.kdheks.gov/hcf/
Phone: (800) 792-4884 Website: http://www.dhhs.nh.gov/oii/documents/
hippapp.pdf
KENTUCKY – Medicaid Phone: (603) 271-5218
Website: http://chfs.ky.gov/dms/default.htm
NEW JERSEY – Medicaid and CHIP
Phone: (800) 635-2570
Medicaid Website: http://www.state.nj.us/humanservices/
LOUISIANA – Medicaid dmahs/clients/medicaid
Website: http://dhh.louisiana.gov/index.cfm/ CHIP Website: http://www.njfamilycare.org/index.html
subhome/1/n/331 CHIP Phone: (800) 701-0710
Phone: (888) 695-2447
NEW YORK – Medicaid
VERMONT– Medicaid
Website: http://www.nyhealth.gov/health_care/medicaid
Phone: (800) 541-2831 Website: http://www.greenmountaincare.org/
Phone: (800) 250-8427
NORTH CAROLINA – Medicaid
VIRGINIA – Medicaid and CHIP
Website: http://www.ncdhhs.gov/dma
Phone: (919) 855-4100 Medicaid Website: http://www.coverva.org/programs_
premium_assistance.cfm
NORTH DAKOTA – Medicaid
CHIP Website: http://www.coverva.org/programs_
Website: http://www.nd.gov/dhs/services/medicalserv/ premium_assistance.cfm
medicaid/ CHIP Phone: (855) 242-8282
Phone: (800) 755-2604
WASHINGTON – Medicaid
OKLAHOMA – Medicaid and CHIP
Website: http://www.hca.wa.gov/medicaid/premiumpymt/
Website: http://www.insureoklahoma.org pages/index.aspx
Phone: (888) 365-3742 Phone: (800) 562-3022 ext. 15473
OREGON – Medicaid WEST VIRGINIA – Medicaid

Website: http://www.oregonhealthykids.gov Website: http://www.dhhr.wv.gov/bms/Medicaid%20
http://www.hijossaludablesoregon.gov Expansion/Pages/default.aspx
Phone: (800) 699-9075 Phone: (877) 598-5820, HMS Third Party Liability
PENNSYLVANIA – Medicaid WISCONSIN – Medicaid

Website: http://www.dpw.state.pa.us/hipp Website: http://www.badgercareplus.org/pubs/p-10095.
Phone: (800) 692-7462 htm
Phone: (800) 362-3002
RHODE ISLAND – Medicaid
Website: http://www.eohhs.ri.gov/ WYOMING – Medicaid
Phone: (401) 462-5300 Website: https://wyequalitycare.acs-inc.com/
Phone: (307) 777-7531
SOUTH CAROLINA – Medicaid
Website: http://www.scdhhs.gov To see if any other states have added a premium assistance
Phone: (888) 549-0820 program since July 31, 2015, or for more information on
special enrollment rights, contact either:
SOUTH DAKOTA - Medicaid
U.S. Department of Labor U.S. Department of Health and
Website: http://dss.sd.gov Human Services Employee Benefits Security Administration
Phone: (888) 828-0059 www.dol.gov/ebsa
(866) 444-EBSA (3272)
TEXAS – Medicaid
U.S. Department of Health and Human Services Centers
Website: http://www.gethipptexas.com/ for Medicare & Medicaid Services
Phone: (800) 440-0493 www.cms.hhs.gov
(877) 267-2323, Menu Option 4, Ext. 61565
UTAH – Medicaid and CHIP
Website: Medicaid: http://health.utah.gov/medicaid
CHIP: http://health.utah.gov/chip
Phone: (866) 435-7414
26
HIPAA Privacy Notice
Please carefully review this notice. It describes how medical information about you may be used and disclosed and how you can get
access to this information.
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) imposes numerous requirements on the use and disclosure
of individual health information by Radial Commerce, Inc. health plans. This information, known as protected health information
(PHI), includes almost all individually identifiable health information held by a plan — whether received in writing, in an electronic
medium, or as an oral communication. This notice describes the privacy practices of these plans: Medical, Dental, and Vision. The
plans covered by this notice may share health information with each other to carry out treatment, payment, or healthcare operations.
These plans are collectively referred to as the Plan in this notice, unless specified otherwise.
The Plan’s duties with respect to health information about you

The Plan is required by law to maintain the privacy of your health information and to provide you with this notice of the Plan’s legal
duties and privacy practices with respect to your health information. If you participate in an insured plan
option, you will receive a notice directly from the Insurer. It’s important to note that these rules apply to the Plan, not
Radial Commerce, Inc. as an employer — that’s the way the HIPAA rules work. Different policies may apply to other Radial
Commerce, Inc. programs or to data unrelated to the Plan.
How the Plan may use or disclose your health information

The privacy rules generally allow the use and disclosure of your health information without your permission (known as
an authorization) for purposes of healthcare treatment, payment activities, and healthcare operations. Here are some examples of
what that might entail:
• Treatment includes providing, coordinating, or managing healthcare by one or more healthcare providers or doctors. Treatment
can also include coordination or management of care between a provider and a third party, and consultation and referrals be-
tween providers. For example, the Plan may share your health information with physicians who are treating you.
• Payment includes activities by this Plan, other plans, or providers to obtain premiums, make coverage determinations, and provide
reimbursement for healthcare. This can include determining eligibility, reviewing services for medical
necessity or appropriateness, engaging in utilization management activities, claims management, and billing; as well
as performing “behind the scenes” plan functions, such as risk adjustment, collection, or reinsurance. For example, the Plan may
share information about your coverage or the expenses you have incurred with another health plan to coordinate payment of
benefits.
• Health care operations include activities by this Plan (and, in limited circumstances, by other plans or providers), such
as wellness and risk assessment programs, quality assessment and improvement activities, customer service, and
internal grievance resolution. Health care operations also include evaluating vendors; engaging in credentialing,
training, and accreditation activities; performing underwriting or premium rating; arranging for medical review and
audit activities; and conducting business planning and development. For example, the Plan may use information about your
claims to audit the third parties that approve payment for Plan benefits.
The amount of health information used, disclosed or requested will be limited and, when needed, restricted to the
minimum necessary to accomplish the intended purposes, as defined under the HIPAA rules. If the Plan uses or discloses PHI for un-
derwriting purposes, the Plan will not use or disclose PHI that is your genetic information for such purposes.
How the Plan may share your health information with Radial Commerce, Inc.
The Plan, or its health insurer or HMO, may disclose your health information without your written authorization to Radial
Commerce, Inc. for plan administration purposes. Radial Commerce, Inc. may need your health information to administer benefits
under the Plan. Radial Commerce, Inc. agrees not to use or disclose your health information other than as permitted or required
by the Plan documents and by law. The Radial Commerce, Inc. Benefits Department (including the Chief Human Resources
Officer, Compensation, Benefits, Human Resources Operations, and the HIPAA Privacy Officer are the only Radial Commerce, Inc.
employees who will have access to your health information for
plan administration functions.
Here’s how additional information may be shared between the Plan and Radial Commerce, Inc., as allowed under the HIPAA rules:
• The Plan, or its insurer or HMO, may disclose “summary health information” to Radial Commerce, Inc., if requested, for purposes
of obtaining premium bids to provide coverage under the Plan or for modifying, amending, or terminating the Plan. Summary
health information is information that summarizes participants’ claims information, from which names and other identifying
information have been removed.
• The Plan, or its insurer or HMO, may disclose to Radial Commerce, Inc. information on whether an individual
is participating in the Plan or has enrolled or disenrolled in an insurance option or HMO offered by the Plan.
In addition, you should know that Radial Commerce, Inc. cannot and will not use health information obtained from the Plan
for any employment-related actions. However, health information collected by Radial Commerce, Inc. from other sources — for
example, under the Family and Medical Leave Act, Americans with Disabilities Act,or workers’ compensation programs — is not
protected under HIPAA (although this type of information may be protected under other federal or state laws).
Other allowable uses or disclosures of your health information

In certain cases, your health information can be disclosed without authorization to a family member, close friend, or other person you
identify who is involved in your care or payment for your care. Information about your location, general condition, or death may be
provided to a similar person (or to a public or private entity authorized to assist in disaster relief efforts). You’ll generally be given
the chance to agree or object to these disclosures (although exceptions may be made — for example, if you’re not present or if
you’re incapacitated). In addition, your health information may be disclosed without authorization to your legal representative. The
Plan also is allowed to use or disclose your health information without your written authorization for the following activities:
Workers’ compensation Disclosures to workers’ compensation or similar legal programs that provide benefits
for work-related injuries or illness without regard to fault, as authorized by and neces-
sary to comply with the laws
Necessary to prevent serious threat Disclosures made in the good-faith belief that releasing your health information is neces-
to health or safety sary to prevent or lessen a serious and imminent threat to public or personal health or
safety, If made to someone reasonably able to prevent or lessen the threat (or to the
target of the threat); includes disclosures to help law enforcement officials identify or
apprehend an individual who has admitted participation in a violent crime that the
Plan reasonably believes may have caused serious physical harm to a victim, or
where it appears the individual has escaped from prison or from lawful custody
Public health activities Disclosures authorized by law to persons who may be at risk of contracting or spreading
a disease or condition; disclosures to public health authorities to prevent or control
disease or report child abuse or neglect; and disclosures to the Food and Drug Admin-
istration to collect or report adverse events or product defects
28
Victims of abuse, neglect, or Disclosures to government authorities, including social services or protected services
domestic violence agencies authorized by law to receive reports of abuse, neglect, or domestic violence,
as required by law or if you agree or the Plan believes that disclosure is necessary to
prevent serious harm to you or potential victims (you’ll be notified of the Plan’s disclo-
sure
if informing you won’t put you at further risk)
Judicial and administrative Disclosures in response to a court or administrative order, subpoena, discovery re-
proceedings quest, or other lawful process (the plan may be required to notify you of the request
or receive satisfactory assurance from the party seeking your health information that
efforts were made to notify you or to obtain a qualified protective order concerning the
information)
Law enforcement purposes Disclosures to law enforcement officials required by law or legal process, or to identify
a suspect, fugitive, witness, or missing person; disclosures about a crime victim if you
agree or if disclosure is necessary for immediate law enforcement activity; disclosures
about a death that may have resulted from criminal conduct; and disclosures to pro-
vide evidence of criminal conduct on the plan’s premises
Decedents Disclosures to a coroner or medical examiner to identify the deceased or determine

cause of death; and to funeral directors to carry out their duties
Organ, eye, or tissue donation Disclosures to organ procurement organizations or other entities to facilitate organ,
eye, or tissue donation and transplantation after death
Research purposes Disclosures subject to approval by institutional or private privacy review boards, subject
to certain assurances and representations by researchers about the necessity of using
your health information and the treatment of the information during a research project
Health oversight activities Disclosures to health agencies for activities authorized by law (audits, inspections,
investigations, or licensing actions) for oversight of the healthcare system, government
benefits programs for which health information is relevant to beneficiary eligibility, and
compliance with regulatory programs or civil rights laws
Specialized government functions Disclosures about individuals who are armed forces personnel or foreign military
personnel under appropriate military command; disclosures to authorized federal
officials for national security or intelligence activities; and disclosures to correctional
facilities or custodial law enforcement officials about inmates
HHS investigations Disclosures of your health information to the Department of Health and Human Ser-
vices to investigate or determine the Plan’s compliance with the HIPAA privacy rule
Except as described in this notice, other uses and disclosures will be made only with your written authorization. For example, in most
cases, the Plan will obtain your authorization before it communicates with you about products or programs if the Plan is being paid
to make those communications. If we keep psychotherapy notes in our records, we will obtain your authorization in some cases
before we release those records. The Plan will never sell your health information unless you have authorized us to do so.
You may revoke your authorization as allowed under the HIPAA rules. However, you can’t revoke your authorization with respect to
disclosures the Plan has already made. You will be notified of any unauthorized access, use, or disclosure of your unsecured health
information as required by law.
The Plan will notify you if it becomes aware that there has been a loss of your health information in a manner that could compromise
the privacy of your health information.
Your individual rights

You have the following rights with respect to your health information the Plan maintains. These rights are subject to
certain limitations, as discussed below. This section of the notice describes how you may exercise each individual right.
Right to request restrictions on certain uses and disclosures of your health information and the Plan’s
right to refuse
You have the right to ask the Plan to restrict the use and disclosure of your health information for treatment, payment,
or healthcare operations, except for uses or disclosures required by law. You have the right to ask the Plan to restrict the use and
disclosure of your health information to family members, close friends, or other persons you identify as being involved in your care or
payment for your care. You also have the right to ask the Plan to restrict use and disclosure of health
information to notify those persons of your location, general condition, or death — or to coordinate those efforts with entities
assisting in disaster relief efforts. If you want to exercise this right, your request to the Plan must be in writing.
The Plan is not required to agree to a requested restriction. If the Plan does agree, a restriction may later be terminated by your
written request, by agreement between you and the Plan (including an oral agreement), or unilaterally by the Plan for health in-
formation created or received after you’re notified that the Plan has removed the restrictions. The Plan may also disclose health
information about you if you need emergency treatment, even if the Plan has agreed to a restriction.
An entity covered by these HIPAA rules (such as your healthcare provider) or its business associate must comply with your request
that health information regarding a specific healthcare item or service not be disclosed to the Plan for
purposes of payment or healthcare operations if you have paid out of pocket and in full for the item or service.
Right to receive confidential communications of your health information

If you think that disclosure of your health information by the usual means could endanger you in some way, the Plan will accom-
modate reasonable requests to receive communications of health information from the Plan by alternative means or at alternative
locations.
If you want to exercise this right, your request to the Plan must be in writing and you must include a statement that
disclosure of all or part of the information could endanger you.
Right to inspect and copy your health information

With certain exceptions, you have the right to inspect or obtain a copy of your health information in a “designated record set.” This
may include medical and billing records maintained for a healthcare provider; enrollment, payment, claims
adjudication, and case or medical management record systems maintained by a plan; or a group of records the Plan uses to make
decisions about individuals. However, you do not have a right to inspect or obtain copies of psychotherapy notes or information
compiled for civil, criminal, or administrative proceedings. The Plan may deny your right to access, although in certain circumstanc-
es, you may request a review of the denial.
If you want to exercise this right, your request to the Plan must be in writing. Within 30 days of receipt of your request (60 days if the
health information is not accessible on site), the Plan will provide you with one of these responses:
• The access or copies you requested.

• A written denial that explains why your request was denied and any rights you may have to have the denial reviewed
or file a complaint.
• A written statement that the time period for reviewing your request will be extended for no more than 30 more days, along with
the reasons for the delay and the date by which the Plan expects to address your request.
30
You may also request your health information be sent to another entity or person, so long as that request is clear,
conspicuous, and specific. The Plan may provide you with a summary or explanation of the information instead of access to or cop-
ies of your health information, if you agree in advance and pay any applicable fees. The Plan also may charge
reasonable fees for copies or postage. If the Plan doesn’t maintain the health information but knows where it is maintained, you will be
informed where to direct your request.
If the Plan keeps your records in an electronic format, you may request an electronic copy of your health information
in a form and format readily producible by the Plan. You may also request that such electronic health information be sent to another
entity or person, so long as that request is clear, conspicuous, and specific. Any charge that is assessed to you for these copies must
be reasonable and based on the Plan’s cost.
Right to amend your health information that is inaccurate or incomplete

With certain exceptions, you have a right to request that the Plan amend your health information in a designated record set. The
Plan may deny your request for a number of reasons. For example, your request may be denied if the health
information is accurate and complete, was not created by the Plan (unless the person or entity that created the information is no longer
available), is not part of the designated record set, or is not available for inspection (e.g., psychotherapy notes or information com-
piled for civil, criminal, or administrative proceedings).
If you want to exercise this right, your request to the Plan must be in writing, and you must include a statement to
support the requested amendment. Within 60 days of receipt of your request, the Plan will take one of these actions:
• Make the amendment as requested.

• Provide a written denial that explains why your request was denied and any rights you may have to disagree
or file a complaint.
• Provide a written statement that the time period for reviewing your request will be extended for no more than
30 more days, along with the reasons for the delay and the date by which the Plan expects to address your request.
Right to receive an accounting of disclosures of your health information

You have the right to a list of certain disclosures of your health information the Plan has made. This is often referred to as an “account-
ing of disclosures.” You generally may receive this accounting if the disclosure is required by law, in connection with public health
activities, or in similar situations listed in the table earlier in this notice, unless otherwise indicated below.
You may receive information on disclosures of your health information for up to six years before the date of your request. You do not
have a right to receive an accounting of any disclosures made in any of these circumstances:
• For treatment, payment, or healthcare operations.

• To you about your own health information.
• Incidental to other permitted or required disclosures.
• Where authorization was provided.
• To family members or friends involved in your care (where disclosure is permitted without authorization).
• For national security or intelligence purposes or to correctional institutions or law enforcement officials in
certain circumstances.
• As part of a “limited data set” (health information that excludes certain identifying information).
In addition, your right to an accounting of disclosures to a health oversight agency or law enforcement official may
be suspended at the request of the agency or official.
If you want to exercise this right, your request to the Plan must be in writing. Within 60 days of the request, the Plan will provide you
with the list of disclosures or a written statement that the time period for providing this list will be extended for no more than 30
more days, along with the reasons for the delay and the date by which the Plan expects to address your request. You may make one
request in any 12-month period at no cost to you, but the Plan may charge a fee for
subsequent requests. You’ll be notified of the fee in advance and have the opportunity to change or revoke your request.
Right to obtain a paper copy of this notice from the Plan upon request
You have the right to obtain a paper copy of this privacy notice upon request. Even individuals who agreed to receive this notice elec-
tronically may request a paper copy at any time.
Changes to the information in this notice

The Plan must abide by the terms of the privacy notice currently in effect. This notice takes effect on May 1, 2017.
However, the Plan reserves the right to change the terms of its privacy policies, as described in this notice, at any time and to make
new provisions effective for all health information that the Plan maintains. This includes health information that was previously creat-
ed or received, not just health information created or received after the policy is changed. If changes are made to the Plan’s privacy
policies described in this notice, you will be provided with a revised privacy notice
by email or U.S. Postal Service (USPS) mail to your home address on file.
Complaints
If you believe your privacy rights have been violated or your Plan has not followed its legal obligations under HIPAA,
you may complain to the Plan and to the Secretary of Health and Human Services. You won’t be retaliated against
for filing a complaint. To file a complaint, send an email detailing your concerns to the Privacy Officer at
ASKPrivacy@radial.com.
Contact
For more information on the Plan’s privacy policies or your rights under HIPAA, send an email detailing your request
and/or concerns to the Privacy Officer at ASKPrivacy@radial.com.
32

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U.S.

Benefits Decision Guide

Decision Guide in a Nutshell

Your Benefits. Your Choice.

Supplemental medical insurance — Protect yourself from the

Flexible Spending Accounts (FSAs) — Save on taxes by

More benefits — Find additional benefits including auto and home

Finding Providers is Easy!

3. Coinsurance. Once the deductible is met,

• It’s tax-advantaged. Contributions are made from your paycheck

How the $1,500 Deductible Plan, Health Savings Account (HSA)

HSA Eligible No Yes Yes Yes

Preventive Care Covered 100% in-network

Employee Only/ $800/$1,600 $1,500/$3,000 $2,850/$5,700 $4,500/$9,000

Employee Only/Family $2,400/$4,800 $3,000/$6,000 $5,500/$11,000 $6,550/$13,100

Prescription Drug Coverage

Mail Order Prescriptions

Critical Illness Insurance

How Critical Illness Insurance Coverage Works

Voya would pay you:

Cancer (100%) – year 1 $15,000

Stroke (100%) – year 3 $15,000

Total benefit paid directly to you $30,000

Critical Illness Overview

Cost Paid by you.

Benefits are paid:

The policy pays you a benefit up to a specific amount for:

How Accident Insurance Coverage Works

Voya would pay you:

ER services, physician fees, and medical equipment $300

Blood, plasma, platelets $300 • You can take your Accident

Physical therapy (six treatments) $150

Total benefit paid directly to you $4,850

Benefits are paid:

How Hospital Indemnity Insurance Coverage Works

Voya would pay you:

Hospital admission benefit $500

Total benefit paid directly to you $1,000

You expect your The $1,500, $2,850, and $4,500

In the event of an Critical Illness, Accident and Hospital

Enhanced Plan Basic Plan

Annual Maximum Benefit $2,000 $750

Employee Only/Family Deductible $50/$150 $50/$150

Preventive Services Plan pays 100% Plan pays 90%

Basic Services Plan pays 80% Plan pays 70%

Major Services Plan pays 50% Not covered

Orthodontia Services* Plan pays 50% Not covered

Orthodontia Lifetime Maximum $1,500 Not covered

Finding Providers is Easy

Delta Dental: VSP:

Enhanced Plan Standard Plan

Copay Frequency Copay Frequency

Exam $10 Every 12 months $10 Every 12 months

Lenses $10 Every 12 months $25 Every 12 months

Retail Allowance Frequency Retail Allowance Frequency

Frames $175 Every 12 months $130 Every 24 months

Dependent Care FSA

Healthcare FSA Reimbursement

HSA Healthcare FSA Combination FSA Dependent Care FSA

• $4,500 Deductible Plan • $4,500 Deductible Plan

Your May 2017 – April 2018 U.S. Benefits Decision Guide | 13

Supplemental Yourself • You can purchase AD&D insurance for yourself.

Covered person Benefit