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Management Consulting Services

2013 Benefits Guide


TABLE OF CONTENTS
Welcome to the Infosys Limited Benefits Plan 3
Who Can Enroll 4
When You Can Enroll 6
How to Enroll 7
Medical and Prescription Drug Benefits 8
Dental Benefits 11
Aetna’s Discount Programs 13

Vision Benefits 14
Health Savings Account 16
Dependent Care Flexible Spending Account 18

Disability Income Benefits and Basic Life and AD&D Insurance 20

Other Benefits 23
ƒƒ Employee Assistance Program 24

ƒƒ Retirement Benefits 24

ƒƒ Commuter Benefits 25

ƒƒ Group Auto and Home Insurance Program 26

ƒƒ Relocation and Mileage Reimbursement 27


ƒƒ Paid Time Off and Holidays 28
Web Tools 30
Contact Information 31
NEW HIRE ENROLLMENT
Notices 33 You have 31 days from your eligibility date to make your elections. If your
enrollment is not completed during the enrollment period, your benefits will
be set to the default enrollment elections and you will have to wait until the
Disclaimer: next year’s Open Enrollment to change these elections.
This brochure provides only a brief summary of the benefits available under Infosys Limited’s plans. In the
Please Note: This is the only time you will be allowed to change your benefit
event of a discrepancy between this summary and the Plan Document, the Plan Document will prevail.
Infosys Limited retains the right to modify or eliminate these or any other benefits at any time and for elections without a qualifying life event.
any reason. More detailed information on a particular benefit plan may be found in the Summary Plan
Description for that plan. View page 6 for more information on qualifying life events.

Your 2013 Benefits Guide 2


WELCOME TO THE INFOSYS LIMITED BENEFITS PLAN

Infosys Limited offers you and your eligible family members a comprehensive array of
employee benefits to make sure you always have the benefits that best meet your needs.
ƒƒ Health Benefits – We understand that a comprehensive health program is the key to
maintaining a healthy workforce. We offer comprehensive health coverage which
includes medical, dental and vision that you may choose separately.
ƒƒ Dependent Care Flexible Spending Account – Our benefits plan allows you to participate in
a dependent care flexible spending account to pay for dependent daycare expenses with
pre-tax dollars, reducing your taxable income, resulting in a tax savings.
ƒƒ Life Insurance Benefits – Our benefits program includes basic life and accidental death
& dismemberment insurance coverage to protect you and your family in the event of
accidental injury or death. You also have the opportunity to elect optional life coverage
on yourself, spouse and children.
ƒƒ Disability Insurance Benefits – We provide you with long-term disability and the option
to purchase short-term income insurance benefits that would cover you in the event of
an accident or illness resulting in an extended absence from work.
ƒƒ Employee Assistance Program (EAP) – Our EAP program is a company provided benefit
that helps you and your family balance the demands of work, home and life.
ƒƒ Retirement Benefits – As a way of saving for retirement, eligible employees may
contribute pre-tax dollars to the Infosys Limited 401(k) plan.
ƒƒ Commuter Benefits – You may enroll in the commuter benefits if you utilize the train,
the bus or pay parking costs for your commute to work.
ƒƒ Group Auto and Home Insurance Program – To help you protect your property, MetLife
Auto & Home insurance is available to you at discounted rates.
ƒƒ Relocation Services and Mileage Reimbursement – We provide reimbursement for eligible
moving expenses in the event you are required to relocate as a result of business reasons
and for mileage if you use your personal vehicle for business purposes.
ƒƒ Vacation, Holidays and Sick Time – To help balance your work and personal life, we offer
a variety of programs and policies to meet your time-off needs. This includes vacation,
paid holidays and sick time.

Your 2013 Benefits Guide 3


WHO CAN ENROLL

You are eligible to enroll in the benefit plans described in this document if
you are a regular full-time employee working 30 hours or more per week,
unless otherwise indicated. If you enroll in the medical, dental or vision
plans you may also enroll your eligible dependents in the same benefits
you enroll in. If you are a new hire, your benefits become effective the first
day of regular full-time employment.

Short-term Assignments
If you are contracted for short-term assignments, you are eligible for the
following benefits:
ƒƒ Medical Plans (Standard Plan with HSA or Plus Plan)
ƒƒ Basic Life and Accidental Death & Dismemberment Insurance
WHAT HAPPENS IF ƒƒ 401(k) Plan
ƒƒ Dependent Coverage (Employee + 1 or Employee + Family)
I DON’T ENROLL?
If your enrollment is not completed within the Eligibility does not include:
enrollment period, you will automatically be enrolled ƒƒ Dental
in the Employee Only Standard Medical Plan, the ƒƒ Vision
Employee Only Basic Dental Plan, Employee Only basic ƒƒ Dependent Care FSA
life and accidental death & dismemberment insurance ƒƒ Commuter Benefits
and Employee Only long-term (paid by Infosys Limited)
and short-term disability (paid 100% by you). Your
vision coverage will be waived. You will have to wait
until next year’s Open Enrollment to change
your coverage, unless you experience a
qualifying life status event prior.

Your 2013 Benefits Guide 4


WHO CAN ENROLL

Eligible Dependents

Generally, for the purposes of Infosys Limited’s benefits programs,


dependents are defined as:
ƒƒ Legal spouse or registered domestic partner
ƒƒ Dependent children up to age 26 (disabled children up to any age),
regardless of student or marital status. Children include:
-- Your biological children
-- Your stepchildren
-- Your legally adopted children
-- Your foster children, including any children
placed with you for adoption
-- Any children for whom you are responsible under court order
-- Your grandchildren in your court-ordered custody
-- Any other child who lives with you in a parent-child relationship
-- Disabled children may be covered, regardless of age.
Coverage for disabled children requires completion and
submittal of a disabled child form, and approval by Aetna.
Documentation may be requested to support proof of dependent relationship.

Your 2013 Benefits Guide 5


WHEN YOU CAN ENROLL

New Hire Enrollment


You have 31 days from your eligibility date to make your elections. The
choices you make become effective your date of hire through March 31,
2014. This is your one chance during the year to make changes for the
upcoming year, unless you have a qualifying life event.

Qualifying Life Events


A qualifying life event, as defined by IRS regulations, allows you to make a
change to your benefit coverage if you experience any of the following:
ƒƒ Change In Life Status including but not limited to:
–– Marriage or divorce
–– Death of a dependent
–– Birth or adoption of a dependent (includes adoption assistance)
–– Loss of medical coverage associated with change in employment
status
–– Dependent satisfying or ceasing to satisfy plan’s eligibility
requirements
–– Loss of, or significant change to, your current coverage
ƒƒ Judgment, decree or court order
ƒƒ Enrollment/Ceasing to be enrolled in Medicare
ƒƒ The employee’s, spouse’s or dependent’s Medicaid or SCHIP coverage
is terminated as a result of loss of eligibility and the employee requests
coverage under the plan within 60 days after the termination; or the
employee, spouse, or dependent becomes eligible for a premium
assistance subsidy under Medicaid or SCHIP and the employee requests
coverage under the plan within 60 days after eligibility is determined
ƒƒ Family Medical Leave Act (FMLA) special requirements
You have 31 days from the date of the event to update your benefits or
your dependent’s benefit election in the web-based enrollment system.
For assistance with making changes due to your qualifying life event, call the
Benefits Desk at (877) 745-6303 or e-mail Infosys.benefits@hannaglobal.com.

Your 2013 Benefits Guide 6


HOW TO ENROLL

Web-Based Enrollment System Instructions


Follow the steps below to enroll in your benefits.

1 Review your enrollment materials carefully, including reviewing this guide

2 Evaluate your needs

3 Go to: www.infosys.benefits-desk.com
-- Select Online Enrollment
-- Enter your username and password:
If you are an Infosys Limited Employee,
your username is INFY_your employee ID number.
If you are an IPS Employee,
your username is IPS_your employee ID number.
Your password is known only to you. If you need assistance,
please click on the e-mail me my password link.
-- You will be taken through the disclosure, disclaimer and
acknowledgment screens. Please take time to review this information.

4 Follow the on-screen instructions which includes:


-- Entering your personal information. You will enter either your work
e-mail address or a personal e-mail address where you wish to
receive electronic correspondence from the enrollment system.
-- Once all required personal information is entered,
you will be taken through the benefit enrollment
screens where you will make your plan choices.
HELPFUL HINTS:
ƒƒ During the New Account Setup, review any information that is pre-
5 Upon completion of your plan selections, you must click on the “Submit” link populated for accuracy such as your first and last name.
on the benefit summary page to complete your enrollment. ƒƒ You may view and compare the plan choices by clicking on the “Benefits
-- After submitting your elections, you will receive an
Information Site” link located under “Enrollment Resources” in the
e-mail that will include your confirmation.
enrollment screens.
Additional assistance is available if you have questions regarding the benefits ƒƒ Remember, you must complete the enrollment process during Open
plans or how to enroll online. Contact the Benefits Desk at (877) 745-6303 or
Enrollment or within 31 days of date of hire by returning to the system
by e-mail at Infosys.benefits@hannaglobal.com. Representatives are available
and completing the process.
to answer your questions Monday through Friday between 6 a.m. to 6 p.m. PT.

Your 2013 Benefits Guide 7


MEDICAL and PRESCRIPTION DRUG BENEFITS

Medical and Prescription Drug Plans

You may choose to enroll in the Standard Medical Plan which includes
a Health Savings Account (HSA) or the Plus Medical Plan. If you elect to
participate in one of the medical plans, you may also enroll your eligible
dependents. An overview comparison on the following page provides a
brief outline of the in-network and out-of-network benefits for each plan.

The Standard Medical Plan and Plus Medical Plan use the same network
of Aetna health care providers. However, if you are a Plus Medical Plan
member and live in an area serviced by Aetna’s Aexcel network, you will
also be able to take advantage of no-referral access to Aexcel-designated
doctors in 12 selected categories of specialty care. As an Aexcel plan
member, you’ll generally pay the lowest out-of-pocket expense under the
terms of the plan when you visit an Aexcel-designated specialist.

All deductibles and out-of-pocket amounts accumulate on a plan year


(from April 1st through March 31st). Please refer to your SPD for a complete
list of benefits and any applicable limitations on the plan.

Your 2013 Benefits Guide 8


MEDICAL and PRESCRIPTION DRUG BENEFITS

Aetna Medical and Prescription Drug Plan


Group Number: 883499
Member Service Phone Number: (888) 219-9153
Web Site: www.aetnanavigator.com
Standard Plan Plus Plan
Plan Features In-Network Out-of-Network In-Network Out-of-Network
$1,500 EE Only $2,500 EE Only $600 Individual $2,000 Individual
Plan Year Deductible
$3,000 EE + 1 or more $5,000 EE + 1 or more $1,800 Family $6,000 Family

Member Coinsurance Aetna covers 80% after deductible Aetna covers 50% after deductible Aetna covers 80% after deductible Aetna covers 50% after deductible

$2,500 EE Only $3,500 EE Only $1,750 Individual $3,500 Individual


Out-of-Pocket Maximum
$5,000 EE + 1 or more $7,000 EE + 1 or more $5,250 Family $10,500 Family
Lifetime Maximum Unlimited Unlimited

Physician Office Visit


Primary Care Physician You pay $20 copay
Covered 80% after deductible Covered 50% after deductible Covered 50% after deductible
Designated Specialist You pay $35 copay
Non Designated Specialist You pay $50 copay
Preventive Care Covered 100%; no deductible Covered 50% after deductible Covered 100%; no deductible Covered 50% after deductible
Hospital Services Covered 80% after deductible Covered 50% after deductible Covered 80% after deductible Covered 50% after deductible

X-Ray and Lab Covered 80% after deductible Covered 50% after deductible Covered 80% after deductible Covered 50% after deductible

Emergency Room (Emergency Care) Covered 80% after deductible $150 copay, then covered 80%; no deductible
Emergency Room (Non Emergency Care) Covered 50% after deductible Covered 50% after deductible
Urgent Care Clinics (Non Emergency Clinic) Covered 80% after deductible Covered 50% after deductible $50 copay; no deductible Covered 50% after deductible
Prescription Drugs
Retail - Up to 30 Day Supply After Deductible Is Met No Deductible
Generic $10 copay $20 copay
Preferred Brand $20 copay Not Covered $40 copay Not Covered
Non-Preferred $35 copay $75 copay
Mail Order – 31 to 90 day supply After Deductible is Met No Deductible
Generic $20 copay $40 copay
Preferred Brand $40 copay Not Covered $80 copay Not Covered
Non-Preferred Brand $70 copay $150 copay
NOTES:
1. Out-of-pocket maximum includes the deductible. Unless otherwise indicated, any applicable deductible must be met before benefits are paid by the plan.
2. Out-of-pocket maximum does not include copays.
3. On the Standard Plan, if coverage is elected for one or more dependents, the entire family deductible ($3,000 in-network) must be met in full before any one member will receive coinsurance or prescription drug copayments under the plan. The EE + 1 or EE +
Family out-of-pocket maximum can be met with a combination of family members or any single individual within the family. Once met, the plan will pay 100% of the family’s covered expenses for the rest of the plan year.
4. The Standard Plan medical deductible must be met before prescription drugs will be covered at the stated copays. Until the deductible is satisfied, members are responsible for all Rx costs.

Your 2013 Benefits Guide 9


MEDICAL and PRESCRIPTION DRUG BENEFITS

Biweekly and Monthly Contribution Rates

Biweekly Standard Plan Contribution Rates Monthly Standard Plan Contribution Rates
PL EE EE + 1 EE + Family PL EE EE + 1 EE + Family
1&2 $15.37 $22.75 $26.44 1&2 $33.30 $49.29 $57.28
3 $48.33 $64.22 $72.17 3 $104.72 $139.15 $156.37
4&5 $51.43 $68.58 $75.43 4&5 $111.44 $148.58 $163.44
6 $70.05 $91.34 $101.98 6 $151.78 $197.90 $220.95
7 & up $80.70 $107.30 $117.94 7 & up $174.84 $232.48 $255.53
EE = Employee Only EE = Employee Only
EE + 1 = Employee + 1 Dependent EE + 1 = Employee + 1 Dependent
EE + Family = Employee + 2 or More Dependents EE + Family = Employee + 2 or More Dependents

Biweekly Plus Plan Contribution Rates Monthly Plus Plan Contribution Rates
PL EE EE + 1 EE + Family PL EE EE + 1 EE + Family
1&2 $41.81 $51.03 $60.87 1&2 $90.58 $110.57 $131.88
3 $101.97 $129.11 $139.71 3 $220.93 $279.74 $302.70
4&5 $114.52 $142.64 $153.61 4&5 $248.13 $309.05 $332.82
6 $118.71 $216.43 $244.56 6 $257.20 $468.94 $529.88
7 & up $118.71 $249.71 $296.89 7 & up $257.20 $541.04 $643.27
EE = Employee Only EE = Employee Only
EE + 1 = Employee + 1 Dependent EE + 1 = Employee + 1 Dependent
EE + Family = Employee + 2 or More Dependents EE + Family = Employee + 2 or More Dependents

Your 2013 Benefits Guide 10


DENTAL BENEFITS

Dental Benefits
Infosys Limited offers you a choice to enroll in Aetna’s Basic Dental PPO
Plan or the Premium Dental PPO Plan. If you elect to participate in the
dental plan, you may also enroll your eligible dependents.

Each plan includes Aetna’s Dental PPO. As an Aetna Dental PPO participant,
you may visit any dentist you choose. However, if the dentist you choose is
out-of-network, you may experience higher out-of-pocket costs. If possible,
try to use a provider in the network. If you choose to visit a provider
outside the network, you may be charged more than the Aetna Recognized
Charge (ARC) amount; you are responsible for paying any amount incurred
above the ARC.

All deductibles and out-of-pocket amounts accumulate on a calendar year


(from January 1st through December 31st). An overview of dental benefits
is on the following page. Please refer to your SPD for a complete list of
benefits and any limitations to the plan.

Your 2013 Benefits Guide 11


11
DENTAL BENEFITS

Aetna Dental
Group Number: 883499
Member Service Phone Number: (877) 238-6200
Web Site: www.aetnanavigator.com

Plan Features Basic Dental Plan PPO Plan Premium Dental Plan PPO Plan

In-Network Out-of-Network In-Network Out-of-Network

$50 Individual $50 Individual


Calendar Year Deductible
$150 Family $150 Family
Annual Maximum (per Individual) $2,500 $3,000
Diagnostic & Preventive
Covered 100%; no deductible 100% covered up to *ARC, no deductible 100% covered; no deductible 100% covered up to *ARC; no deductible
(Type A Expenses)
Basic Services (Type B Expenses) Covered 80% after deductible Covered 80% up to *ARC, after deductible Covered 90% after deductible Covered 90% up to *ARC after deductible
Major Services (Type C Expenses) Covered 60% after deductible Covered 60% up to *ARC, after deductible Covered 70% after deductible Covered 70% up to *ARC after deductible
Orthodontic Expenses Not Covered Covered 50% up to $3,000 lifetime
NOTES
1. Unless otherwise indicated, any applicable deductible must be met before benefits are paid by the plan.
2. For more information refer to the carrier’s document for complete details, including plan exclusions and limitations.
*ARC is the maximum amount Aetna will pay for a covered expense from an out-of-network provider.

Bi-weekly and Monthly Contribution Rates


Basic Dental Plan PPO Plan Contribution Rates Premium Dental Plan PPO Plan Contribution Rates
EE EE + 1 EE + Family EE EE + 1 EE + Family
Bi-weekly Contribution $4.64 $9.74 $13.92 Bi-weekly Contribution $5.23 $10.98 $15.68
Monthly Contribution $10.06 $21.10 $30.16 Monthly Contribution $11.34 $23.78 $33.98
EE = Employee Only EE = Employee Only
EE+1 = Employee + 1 Dependent EE+1 = Employee + 1 Dependent
EE + Family = Employee + 2 or More Dependents EE + Family = Employee + 2 or More Dependents

Your 2013 Benefits Guide 12


AETNA DISCOUNT PROGRAMS

Aetna Discount Programs


Any member enrolled in an Aetna medical or dental plan is eligible for
Aetna’s Discount Programs. Aetna’s Discount Programs help you be well
and save you money on gym memberships, eyeglasses, contacts, weight-
loss programs, chiropractor visits and more.

Aetna’s Discount Programs include:


ƒƒ Aetna VisionSM discount program
ƒƒ Aetna FitnessSM discount program
ƒƒ Aetna Natural Products and ServicesSM discount program
ƒƒ Aetna HearingSM discount program
ƒƒ Aetna Weight ManagementSM discount program

To learn more about Aetna’s Discount Programs:


ƒƒ Log in to www.aetna.com
ƒƒ Choose “Health Programs,” then “See the savings”

Your 2013 Benefits Guide 13


13
VISION BENEFITS

Vision Plan
Infosys Limited offers you a choice to enroll in a voluntary vision plan
administered through VSP. If you elect to participate in the vision plan, you
may also enroll your eligible dependents.

Finding the right eyecare provider is important to your eye health and
overall wellness. That’s why you can see a VSP doctor, retail chain affiliate
provider or any other provider. However, if the provider you choose is out-
of-network, you may experience higher out-of-pocket costs.

The vision plan covers eye exams, frames, lenses and more. You can order
contact lenses online and have them delivered to your home. If you are
enrolled in the Standard Medical Plan with HSA, keep in mind that most
vision care expenses are eligible for reimbursement through a health
savings account.

Using your VSP benefit is easy.


Note: Any member enrolled in an Aetna medical or dental plan is eligible ƒƒ You can choose any eyecare provider—your local VSP doctor, a retail
chain affiliate, or any other provider. To find a VSP doctor or retail chain
for the Aetna Vision Discount Program at no additional cost. You do not
affiliate, visit vsp.com or call (800) 877-7195.
have to be enrolled in the VSP plan to be eligible for discounts.
ƒƒ Review your benefit information — visit vsp.com to review your plan
ƒƒ The Aetna Vision Discount Program includes discounts on eye exams,
coverage before your appointment.
glasses, contact lenses, and Lasik surgery.
ƒƒ At your appointment, tell your provider you have VSP. There are no ID
ƒƒ You can visit many doctors in private practice plus, these national
cards.
chains:* JCPenney® Optical, LensCrafters®, Target Optical®, Sears
Optical® and Pearle Vision®.
That’s it! VSP handles the rest —there are no claim forms to complete
ƒƒ The Aetna Vision Discount Program requires no claim forms, the
when you see a VSP doctor or retail chain affiliate.
discount is given at the time of service.
ƒƒ Show your Aetna ID card to a participating vision provider for
An overview of vision benefits is on the following page. Please refer to your
immediate savings. A list of participating providers can be found on the
SPD for a complete list of benefits and any limitations to the plan.
Aetna web site.
*EyeMed Select Network and Provider List, 1/12

Your 2013 Benefits Guide 14


14
VISION BENEFITS

VSP Vision 2013 PLAN ENHANCEMENTS


Group Number: 30020863 Discounts and coverage are now available with VSP retail chain affiliate providers
Member Service Phone Number: (800) 877-7195 (includes Costco). Contact VSP for details on your vision coverage and exclusive
Web Site: www.vsp.com savings and promotions for VSP members.

Benefit Description of Your Coverage with VSP Doctors and Affiliate Providers* Copay Frequency
WellVision Exam Focuses on your eyes and overall wellness $0 Every 12 months
Prescription Glasses
Frame $200 allowance for a wide selection of frames; 20% off amount over your allowance $0 Every 12 months
Lenses Single vision, lined bifocal, and lined trifocal lenses; polycarbonate lenses for dependent children $0 Every 12 months
Lens Options Progressive lenses; average 35-40% off other lens options $0 Every 12 months
Contacts
(instead of glasses) $200 allowance for contacts; contact lens exam (fitting and evaluation up to $60 copay ) Up to $60 Every 12 months
Primary Eyecare Treatment and diagnosis of eye conditions like pink eye, vision loss and monitoring of cataracts, glaucoma, and diabetic retinopathy $20 As needed
Computer Vision Care
Computer Vision Exam Evaluates your needs related to computer use $0 Every 12 months
Frame $90 allowance for a wide selection of frames; 20% off amount over your allowance $0 Every 12 months
Lenses Single vision, lined bifocal, lined trifocal, and occupational lenses $0 Every 12 months
*You coverage provides you access to the VSP Signature Doctor Network. Coverage with a retail chain affiliate may be different. Once your benefit is effective, visit vsp.com for details.
Coverage information is subject to change. In the event of a conflict between this information and your organization’s contract with VSP, the terms of the contract will prevail.

Your Coverage with Other Providers


Extra Savings and Discounts Using the VSP Signature Network
Exam up to $50 Single Vision Lenses up to $50 Lined Trifocal Lenses up to $100 Contacts up to $105
Glasses and Sunglasses
Frame up to $70 Lined Bifocal Lenses up to $75 Progressive Lenses up to $75
ƒƒ 30% off additional glasses and sunglasses, including lens options from the same
Visit vsp.com for details, if you plan to see a provider other than a VSP doctor. VSP doctor on the same day as your WellVision Exam, or get 20% off from any VSP
doctor within 12 months of your last WellVision Exam.

Bi-weekly and Monthly Contribution Rates Retinal Screening


ƒƒ Guaranteed pricing on retinal screening as an enhancement to your WellVision Exam.
VSP Vision Plan Contribution Rates
EE Only EE +1 EE + Family Laser Vision Correction
Bi-weekly Contribution $3.55 $7.09 $11.42 ƒƒ On an average, receive 15% off the regular price or 5% off the promotional price;
Monthly Contribution $7.69 $15.36 $24.74 discounts only available from contracted facilities.
ƒƒ After surgery, use your frame allowance (if eligible) for sunglasses from any VSP
EE = Employee Only
doctor.
EE+1 = Employee + 1 Dependent
EE + Family = Employee + 2 or More Dependents

Your 2013 Benefits Guide 15


HEALTH SAVINGS ACCOUNT

Health Savings Account (HSA)


When enrolling in the Standard Medical Plan, you may have the option
of setting up a Health Savings Account (HSA) through JP Morgan Chase
(Aetna’s HSA vendor partner) should you meet the eligibility requirements.
Eligibility requirements are as follows: you must be enrolled in a high
deductible health plan; you must not be covered by any other health plan;
you must not be enrolled in Medicare; and you must not be claimed as a
dependent on another individuals tax return.

An HSA is a special tax-advantaged account that you and your family


members can use to pay for qualified medical expenses – ranging from
deductibles and co-insurance to pharmacy bills, dental care, vision care
and much more. You can make pre-tax contributions to your HSA via
payroll deduction. Once deposited, your money grows tax-free year after
year, much like an IRA. And it’s yours to keep, even if you change jobs.

Features of an HSA:
ƒƒ An HSA account is an individually owned account.
ƒƒ HSA contributions are made on a pre-tax basis and can be used for
future qualified medical expenses.
ƒƒ Funds you withdraw tax-free must be used to pay for qualified medical
expenses, as defined by Section 213(d) of the Internal Revenue Code
(“Code”).
ƒƒ Funds carry over year after year.
ƒƒ You can withdraw the money on a taxable basis for any purpose after
age 65 – your unused HSA funds can help fund your retirement.
ƒƒ You can create a balanced HSA portfolio tailored to your specific needs
and risk preferences.

Your 2013 Benefits Guide 16


16
HEALTH SAVINGS ACCOUNT

JP Morgan Chase Health Savings Account (HSA) When you pay for qualified medical expenses with your HSA, the funds you
Member Services Phone Number: (866) 524-2483 withdraw are tax-free, provided they:
Investments: (866) 774-7129 ƒƒ Are qualified medical expenses as generally described in IRS publication
Web Site: www.chase.com/health-savings-account 502 titled, “Medical and Dental Expenses,” Catalog Number 15002Q. You
can order the publication by calling (800) TAX-FORM or view it online at
IRS Annual Maximum Plan Year Contributions to Your HSA www.irs.gov/pub/irs-pdf/p502.pdf .
Individual $3,250 ƒƒ Have not been compensated or reimbursed by insurance or otherwise.
Family $6,450

Over 55 catch up contributions $1,000 Examples of Qualified Medical Expenses


ƒƒ Deductibles and coinsurance for medical and dental care
Establishing Your HSA ƒƒ Prescription drugs (some over the counter drugs with a prescription)
When you enroll in the Standard Medical Plan you will receive a welcome kit ƒƒ Vision care, including glasses and Lasik eye surgery
in the mail from JP Morgan Chase with instructions on how to set up your ƒƒ Smoking cessation treatment and prescriptions
HSA account and complete the enrollment process. ƒƒ Some insurance premiums, such as long-term care, COBRA and health
care coverage premiums while receiving unemployment income
MONTHLY HSA ACCOUNT FEES: * For a detailed list, visit the IRS web site at: www.irs.gov/pub/irs-pdf/p502.pdf
ƒƒ No fee to establish the HSA account
Examples of Non-Qualified Medical Expenses
ƒƒ Monthly service charge of $3.75
ƒƒ Air purifiers
ƒƒ A complete list of account fees will be included in the welcome kit and
ƒƒ Cosmetic surgery and related expenses
posted on the web site
ƒƒ Health club dues (unless prescribed by a physician to treat illness)
ƒƒ Illegal operations and treatments
ƒƒ Massages for general well-being
ƒƒ Transportation, unless specifically for and essential to medical care
ƒƒ Toothpaste, cosmetics and toiletries
ƒƒ Vitamins and nutritional supplements
ƒƒ Weight loss programs (unless for a specific illness)

Please Note: For questions regarding your HSA, first call Aetna’s medical
member services at (888) 219-9153 or log on to www.aetnanavigator.com.

Your 2013 Benefits Guide 17


DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT

Dependent Care Flexible Spending Account (FSA)


This account enables you to pay for out-of-pocket, work-related
dependent daycare cost with pre-tax dollars. Dependent care expenses
must be incurred during the coverage period so you (and your spouse, if
married) can work or look for work, or in some cases if your spouse is a full-
time student.

The care must be provided by a dependent care center or by an individual


who can provide a name, address, and taxpayer identification number.
Although you may not take the childcare tax credit if you choose this
option, you may save more depending on your income level.

The dependent care FSA should only be considered for anticipated


expenses. You should be conservative when estimating the amount to
contribute to your account. If you overestimate your expenses and have
money left in the account at the end of the year, it will be forfeited.

Your 2013 Benefits Guide 18


18
DEPENDENT CARE FLEXIBLE SPENDING ACCOUNT

Flex-Plan Dependent Care Flexible Spending Account


Member Service Phone Number: (800) 669-3539
Web Site: www.flex-plan.com

Plan Contribution
You may contribute between $900 (annual
Dependent Care FSA
minimum) and $5,000 (annual maximum).

Eligible dependent care facilities:


ƒƒ A dependent (day) care center, provided that if care is provided by the
facility for more than six individuals, the facility complies with applicable
state and local laws;
ƒƒ An educational institution for pre-school children. For older children, only
expenses for non-school care are eligible; and
ƒƒ An “individual” who provides care inside or outside your home. The
“individual” may not be a child of yours under age 19 or anyone you claim
as a dependent for federal tax purposes.

Eligible expenses must be for the care of:


ƒƒ A dependent child who is under age 13 and whom you claim as an
exemption on your income tax return.
ƒƒ A dependent child, elderly parent or relative who is physically or mentally
incapable of caring for him - or herself.

Eligible expenses include those to cover:


ƒƒ Licensed day care center
ƒƒ Nursery school
ƒƒ In-home care for dependents unable to care for themselves (children or
adults) “Use It Or Lose It Rule”
ƒƒ Daytime summer recreational camp
The IRS mandates that any amount not spent in the
ƒƒ Adult day care center
ƒƒ Adult private sitter (nanny or home care companion)
FSA plan year will be forfeited.

Your 2013 Benefits Guide 19


DISABILITY INCOME BENEFITS and BASIC LIFE and AD&D INSURANCE

Disability Income Benefits


You are eligible for short-term and long-term disability income benefits if
you are a regular full-time employee. In the event you become disabled
from a non work-related injury or sickness, disability income benefits are
provided as a source of income. Infosys Limited pays the full cost of long-
term benefit – there is no cost to you. You also have the opportunity to
elect optional short-term disability coverage on yourself.

Basic Life and Accidental Death & Dismemberment


(AD&D) Insurance
Regular, full-time employees are provided with company paid life insurance
and AD&D insurance. Eligible employees are automatically enrolled in life
insurance and AD&D insurance of $75,000. Infosys Limited pays the full cost
of this benefit – there is no cost to you. You also have the opportunity to
elect optional life coverage on yourself, spouse and children.

Your 2013 Benefits Guide 20


20
DISABILITY INCOME BENEFITS and BASIC LIFE and AD&D INSURANCE

Disability Benefits
Aetna Disability Benefits Aetna Basic Life and AD&D Benefits
Member Service Phone Number: (877) 832-8241 Member Service Phone Number: (800) 523-5065
Web Site: www.aetnadisability.com Web Site: www.aetna.com/group/aetna_life_essentials

Plan Features Short-term Disability Long-term Disability Plan Features


Benefits Begin On the 8th day of approved On the 91st day of approved claim Life Benefit Amount $75,000
claim for illness or injury for illness of injury
AD&D Amount Pays an additional one times the life insurance amount
Benefit Duration Up to 13 weeks Up to age 65 if totally disabled.
should you die by accidental means
Limitations for specific conditions.
Age Reduction Reduce by 50% at age 70
Percentage of 66.67% of basic weekly 66.67% of basic monthly earnings
Income Replaced earnings (minus other income benefits) Accelerated Death Included up to $25,000 of your life benefit if you are
Benefit diagnosed with a terminal illness and have a life expectancy
Maximum Benefit $2,000 per week $10,000 per month
of 12 months or less.
Eligibility Approved claim paperwork 1 year of US Infosys Limited employment Conversion Included - 31 days to convert to individual policy in most
Employee Cost Employee Paid None - Infosys Limited pays all costs cases
Employee Cost None - Infosys Limited pays all costs
Short-term Disability
Regular, full-time employees have the opportunity to purchase short-term
disability coverage. This coverage provides eligible employees with up to Use the
66.67% of base pay in the event of a qualified disability which renders the online enrollment
employee unable to work. Short-term disability payments are applicable for system to update your
up to 13 weeks, with a maximum of $2,000 per week. Short-term disability
beneficiary!
payments are subject to a seven day waiting period.

Short-term Disability Premium Long-term Disability


Your short-term disability premium cost is $.18 per month per $10 dollars Regular, full-time employees are provided with company paid long-term
of weekly covered benefit. Below is an example of how a premium for an disability coverage after one year of employment. This coverage provides
employee with a $75,000 salary would be calculated: eligible employees with up to 66.67% of their base pay in the event of a
ƒƒ $75,000 ÷ 52 * 66.7% = $962 qualified disability which renders the employee unable to work as defined by
ƒƒ ($962 * $.18) ÷ $10 = $17.31 (monthly premium) the summary plan documents. Long-term disability payments pay out at a
ƒƒ ($17.31 * 12) ÷ 26 = $7.99 (biweekly premium) maximum of $10,000 per month and are subject to a 90 day waiting period.

Your 2013 Benefits Guide 21


DISABILITY INCOME BENEFITS and BASIC LIFE and AD&D INSURANCE

Voluntary Life and AD&D Insurance Voluntary Life Insurance Rates


You have opportunity to elect optional life and AD&D coverage on yourself. If Age Banded Employee (Voluntary Life)
you elect coverage on yourself, you may also elect coverage on your spouse Spouse (Dependent Life)
and children. See the chart below for plan features. Cost per $1,000 of Coverage
Plan Features Under 25 $0.05

Employee Life and AD&D 25 - 29 $0.06


Benefit Increments 1x, 2x, 3x, 4x, 5x or 6x base annual earnings 30 - 34 $0.08

Benefit Maximum $1,000,000 35 - 39 $0.09

Guarantee Issue Amount 3x annual earnings up to $500,000 40 -44 $0.10

Age Reduction Schedule 50% at age 70 45 - 49 $0.15

Spouse Life and AD&D 50 -54 $0.26


Benefit Increments $5,000 55 - 59 $0.52

Benefit Maximum $250,000 or 50% of employee election 60 - 64 $1.04

Guarantee Issue Amount $30,000 65 - 69 $1.84

Age Reduction Schedule 50% at age 70 70 - 74 $2.68

Child(ren) Life and AD&D 75+ $3.47


Benefit Increments $1,000 Dependent Child $0.05
Benefit Maximum $10,000 or 50% of employee election

Please Note: Evidence of Insurability (EOI) is required unless you elect voluntary life insurance
within 31 days of your benefit eligibility date. EOI is also required for amounts above the
Guarantee Issue. Voluntary AD&D Insurance Rates
You must be enrolled in optional life in order to elect spouse and/or child dependent life.
Employee (Voluntary AD&D) Cost per $1,000 of Coverage
Employee + 1 or more
(Dependent AD&D)
Employee Only $0.040

Employee + 1 or More $0.050

Your 2013 Benefits Guide 22


OTHER BENEFITS

Your 2013 Benefits Guide 23


23
EMPLOYEE ASSISTANCE PROGRAM and RETIREMENT BENEFITS

Employee Assistance Program (EAP) Retirement Benefits


Aetna EAP Fidelity 401(k) Plan Benefits
Member Service Phone Number: (888) 238-6232 Member Service Phone Number: (800) 294-4015
Web Site: www.aetnaeap.com Web Site: www.401kxpress.com
Company Code: EAP4INFY

The EAP is a company paid benefit that is available to all eligible employees. If you are an employee in Personal Level 6 or below and are not defined as a
This program offers confidential telephonic counseling services around Highly Compensated Employee (HCE) per IRS regulations, you may contribute
the clock by licensed clinical staff to help you, members of your household pre-tax dollars to the Infosys Limited 401(k) plan, exclusively through payroll.
and your adult children up to age 26 balance the demands of work, life and Infosys Limited does not provide a matching contribution. The maximum
personal issues. annual employee deferral in the 401(k) plan is governed by the IRS limits
specified for the plan year. You have a choice of investing your salary deferrals
The EAP can assist with topics such as: in funds from different families of mutual funds. You may enroll in this plan
ƒƒ Marital distress starting the first calendar month after date of hire.
ƒƒ Relationship issues
ƒƒ Substance abuse
ƒƒ Workplace conflict Infosys Executive Rewards Plan
ƒƒ Stress
ƒƒ Personal and family issues Similar to the 401(k), the IERP - MCS is a vehicle for long-term savings through
the investment of premiums paid on an employee-owned life insurance or
Balancing the demands of work, home and life can lead to improved annuity policy using post tax-dollars in a variety of investment accounts. The
productivity, increased employee satisfaction and better managed health IERP - MCS works in a manner similar to a Roth IRA and the Firm provides
costs. a matching contribution on investments up to a specified limit to help
offset the loss of pre-tax investment benefits. There is no limit on employee
contributions and the policy is fully portable. The plan includes disbursement
strategies to enable income tax-free withdrawal upon retirement and
customized plan design is provided for each employee. Eligibility is based on
401(k) IRS Maximum Deferrals for 2013 whether or not you are the JL 7 or above.

ƒƒDeferral Limit: $17,500 The company match is equal to 43% of employee contribution subject to a
ƒƒCatch-up Limit $5,500 maximum of $538.00 per month.

Your 2013 Benefits Guide 24


COMMUTER BENEFITS

Flexi-Commuter Benefits Plan


Member Service Phone Number: (800) 669-3539
Web Site: www.flex-plan.com

The Flexi-Commuter Benefit Plan enables you to use pre-tax dollars to pay for Eligible Mass Transit & Parking Expenses
transportation and parking expenses spent on your commute to work. You ƒƒ Bus vouchers and passes used to commute to and from work.
may purchase tickets online every month for the following month. You can ƒƒ Vanpooling in a “commuter highway vehicle” to and from work as long
save anywhere between 20-40% on these expenses depending on your tax as 80% of the mileage is for transportation of employees between work/
bracket. home and the vehicle is at half the maximum adult seating.
ƒƒ Ferry passes used to commute to and from work.

Here’s How it Works


ƒƒ Register on Flexi-Commuter Plan web site, and go through the three-step Mass Transit FSA Non-Allowable Expenses
ordering process. Your passes will be mailed to your home address. ƒƒ Mass transit costs not associated with the commute to work.
ƒƒ Registration and orders must be completed via the Flexi-Commuter Plan ƒƒ Mass transit costs from an employee bought voucher or bus pass when a
web site by the 8th of the month for the following month benefit access. voucher system is already sponsored or available by the employer.
ƒƒ A minimum monthly contribution of $75 is required or a $3.50
administration fee will be assessed. Parking FSA Eligible Expenses
ƒƒ Purchases are made a month in advance for the following month’s transit. ƒƒ Parking costs associated with a lot at or near the place of business.
ƒƒ Mass Transit Expenses (i.e. Train or Bus) are subject to a $245/month ƒƒ Parking costs from a lot that is at or near the place of commute (i.e.
maximum contribution. rideshare, carpool, vanpool).
ƒƒ Parking Expenses are subject to a $245/month maximum contribution.

Parking FSA Non-Allowable Expenses


ƒƒ Parking costs incurred at your residence.
ƒƒ Parking costs at a lot that is owned or sponsored by the employer.

Please Note: Parking lot fees arising from a company owned lot are not
eligible under the Parking Reimbursement Account. These costs are deducted
through the Parking Conversion Plan.

Your 2013 Benefits Guide 25


GROUP AUTO and HOME INSURANCE PROGRAM

MetLife Auto & Home®


Call MetLife Auto & Home at 800 GET-MET 8 ((800) 438-6388) for your FREE
quote anytime after March 1, 2013
Web Site: www.metlife.com/mybenefits

MetLife Auto & Home’s group insurance program will be available to you
beginning March 1, 2013 as a voluntary benefit made available by your
employer. As part of the program you will have access to value-added
features and benefits, including special group discounts on auto and home*
insurance, as well as a variety of other insurance policies including: condo,
renter’s, motor home, motorcycle, recreational vehicle, boat and personal
excess liability policies.

You could also benefit from these program features:


ƒƒ 24-hour claim reporting
ƒƒ Extended customer service hours, including weekday evenings and
Saturdays
ƒƒ Coverage you can take with you, should you retire or leave the company
for another reason
ƒƒ Enhanced product coverages that are built into every auto policy**

You can also choose from a variety of flexible and convenient payment
options to make paying for your insurance easier. You can choose an
automated payment option and receive added-savings or select direct bill as
your preferred payment option.

*Home insurance is not part of MetLife Auto & Home’s benefit offering in Florida and
Massachusetts. Since everyone’s insurance policies renew at different times during the year,
**See policy for restrictions. you may apply for group auto and home insurance at any time after
March 1, 2013.
Additional information about this NEW Employee Benefit will be coming your way
soon, so be on the lookout for more details.

Your 2013 Benefits Guide 26


RELOCATION and MILEAGE REIMBURSEMENT

Relocation and Mileage Reimbursement

In the event that you are required to relocate as a result of business reasons All reimbursements will be based on actuals upon submission of bills.
and with prior written approval by management, you may be eligible for You will be reimbursed for expenses against bill towards accommodation
reimbursement under Infosys Limited’s relocation policy. Relocation is (hotel expense) and conveyance for their initial stay. The entitlement towards
defined as the transfer of work to a new location which is 50 miles or more the reimbursement would be as per your Base Location and Personal Level.
from the existing work location of the employee post joining or location as You will be entitled for the reimbursement of Initial Settlement Expense of
captured in the application form for a new joinee. USD.

Expenses for which you may be eligible for reimbursement include travel Please Note: The above mentioned Initial Settlement Expense eligibility
to the new location for yourself and applicable family members (spouse is applicable only for Bellevue, WA, USA. In case there is a change in your
and children) via air, personal car or rental car, transportation of goods location, please discuss Initial Settlement Expense eligibility with the
and movement of one vehicle within the US. You will also be eligible for Recruitment Manager or the Human Resource Manager upon your joining.
reimbursement of Lease Breakage expenses due to relocation as per the
Policy on Relocation within USA or Policy on Reimbursement of Relocation All transit expenses (bus, train, and airfare) will be reimbursed on submission
Expenses for Inter-Country Movements, whichever is applicable. of bills and reimbursement is limited to economy fare only. For claims
purposes, please keep all original tickets and boarding passes.
Maximum allowable reimbursement towards the transportation of goods:
ƒƒ Up to $3,000 for relocations of less than or equal to 1,500 miles or $4,000 Mileage Reimbursement
for relocations more than 1,500 miles. Employees who use their personal vehicles for business purposes may be
ƒƒ All employees will be eligible for transportation of one vehicle and will eligible for mileage reimbursement. For more information contact the Human
be reimbursed at actuals on submission of bills up to $1,000. This is Resources Department.
applicable only for domestic relocation i.e., within the US.
Mileage Reimbursement Rates
Travel by personal car will be eligible for mileage reimbursement as per the Particulars Rate (per mile)
chart on the right. If a rental car is used, rental charges and fuel expenses Business travel 56.5 cents
are reimbursable upon submission of bills up to a maximum limit of airfare
Using your own car for relocation purposes 24.0 cents
between the two locations; the exact amount applicable at a time can be
confirmed with the Human Resource Department. Driving options are
available only if airfare is not utilized.

Your 2013 Benefits Guide 27


PAID TIME OFF and HOLIDAYS

Paid Time Off and Holidays


HR Helpdesk: (888) 237-8763 Option 4
Web Site: AHD > HR Helpdesk

Paid Time Off Holidays


Recognizing that individuals have diverse needs for time off from work, the All employees will be eligible for 10 paid holidays in a calendar year. The dates
Company provides Paid Time Off (“PTO”) to regular, full-time employees. of the holidays will depend on whether the employee is assigned to a client or
Employees may draw upon accrued PTO days for vacation, sick leave, medical works out of an Infosys Limited location or another non-client location.
appointments, family illness or other needs requiring time away from work.
Holiday Policy – Effective 1/1/13
Employees begin accruing PTO on their first day of employment, on a bi-weekly ƒƒ All employees who are in the US from January 1st – December 31st of each
basis. Employees will accrue 20 days per year. Additional approved time off will year will get 10 holidays on January 1st to be applied as per the Infosys
be treated as unpaid leave. Limited or client holiday calendar. Employees joining onsite for part of the
year will get holidays pro-rated based on the number of days at onsite for
Employees may take an advance of PTO up to a maximum of 2 days with their that year. A “year” is based on the calendar year.
manager’s prior written approval. This option is available only if an employee ƒƒ Employees working in Infosys Limited offices have to follow the Infosys
has exhausted his / her PTO allotment completely and has no accrued PTO. Limited holiday calendar. All 10 holidays are fixed and must be applied
through the leave system.
PTO accruals are capped at 160 hours. When the accrual cap is reached, an ƒƒ Employees working in client locations should follow the client holiday
employee will cease accruing additional PTO until the employee has used calendar. Employees can only apply for holidays as per the list of holidays in
enough PTO such that the accrued amount falls below the cap. the Leave System.
ƒƒ All holidays, statutory or otherwise, need to be applied for through the
At separation, all accrued, unused PTO will be encashed. Leave System.
ƒƒ If an employee (either working in an Infosys Limited office or at a client
In addition to PTO, the Company also provides 1 day of bereavement leave location) is unable to take a holiday as designated by Infosys Limited or the
because of the death of a family or household member. client due to project requirements, he/she may take an “alternate holiday”
and apply for the same through the Leave System. Alternate holidays are
additional days designated in the Leave System in the same month in which
that holiday applies and are listed in the leave system.
ƒƒ Legacy Infosys Consultants (IC) employees, please note: All Legacy IC
employees need to continue to follow the current process to apply for
holiday leaves as you have been doing last year. If you have any specific
questions, you may reach out to your MCS HRBP.

Your 2013 Benefits Guide 28


PAID TIME OFF and HOLIDAYS

During Client Shutdowns:


ƒƒ Employees must either use their available holidays and apply for the leave
through the Leave System, or
ƒƒ They may work from home wherever possible, with their Manager’s
approval.
ƒƒ If working from home is not an option, the employee can create a task
in iTime for “On duty” or any other non-billable project code and enter 8
hours in their time sheet for every holiday that the client is closed and the
employee does not have sufficient leave to apply. In this circumstance,
employees are not required to use their vacation leave or LOP.

Your 2013 Benefits Guide 29


WEB TOOLS

Aetna Navigator - www.aetnanavigator.com


It’s the one place to go for coverage, claims, costs and more.
Aetna Navigator is easy to use. Aetna Navigator is your secure web site for
planning and managing your health and health care. It’s organized to help
you do what you want to do.

Register for Aetna Navigator to:


ƒƒ Check claim status
ƒƒ Find doctors, dentists, hospitals and pharmacies
ƒƒ View and print temporary ID cards
ƒƒ Request replacement Aetna member ID cards
ƒƒ Contact Aetna Member Services
ƒƒ Utilize tools to manage your health care:
-- Simple Steps – Health and Wellness
-- Moms to Babies Program
-- Access expert sources of medical and dental health information
-- Review coverage details
-- Estimate health care costs
-- Find doctors, dentists, hospitals and pharmacies
ƒƒ Get explanation of benefits statements and much more...

INSURANCE ID CARDS
ƒƒ ID cards will be mailed to your home address within 30 days of
enrollment.
ƒƒ Providers will be able to verify your coverage with Aetna even if you
have not received your ID card.
ƒƒ You will be able to print a temporary ID card from the
Aetna Navigator site.
ƒƒ There are no ID cards issued for the VSP vision plan.

Your 2013 Benefits Guide 30


30
CONTACT INFORMATION

Your 2013 Benefits Guide 31


31
CONTACT INFORMATION

Check with the plan’s administrator directly for specific information about the plan for 2013.

Carrier Phone Number Web Site


Medical Benefits
Aetna Medical and Prescription Drugs (888) 219-9153 www.aetnanavigator.com
Aetna Dental (877) 238-6200 www.aetnanavigator.com
Aetna Discount Vision Plan (888) 219-9153 www.aetnanavigator.com
VSP Vision (800) 877-7195 www.vsp.com
JP Morgan Chase HSA (866) 524-2483 www.chase.com/health-savings-account
JP Morgan Chase HSA Investments (866) 774-7129 www.chase.com/health-savings-account
Flexible Spending Account
Flex-Plan Dependent Care Flexible Spending Account (800) 669-3539 www.flex-plan.com
Insurance
Aetna Disability Income (Short-term and Long-term) (877) 832-8241 www.aetnadisability.com
Aetna Basic Life and AD&D (800) 523-5065 www.aetna.com/group/aetna_life_essentials
Other Benefits
Aetna Employee Assistance Program (EAP) (888) 238-6232 www.aetnaeap.com
Fidelity 401(k) Plan a (800) 294-4015 www.401kxpress.com
Flexi-Commuter Plan (800) 669-3539 www.flex-plan.com
MetLife Auto & Home® (800) 438-6388 www.metlife.com/mybenefits
Vacation, General and Floating Holidays, and Sick Leave (888) 237-8763 Option 4 AHD > HR Helpdesk

Still have questions about your benefits?


ƒƒ Go online to www.Infosys.benefits-desk.com
ƒƒ Call the Benefits Desk at (877) 745-6303. Representatives are available Monday through Friday
between 6 a.m. to 6 p.m. Pacific Time.
ƒƒ E-mail Infosys.benefits@hannaglobal.com
ƒƒ Call or visit a specific plan administrator’s web site

Your 2013 Benefits Guide 32


NOTICES

Your 2013 Benefits Guide 33


33
NOTICES

MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP)

Medicaid and The Children’s Health Insurance Program (CHIP)


Offer Free or Low-Cost Health Coverage to Children and Families

If you are eligible for health coverage from your employer, but are unable to these programs, you can contact your State Medicaid or CHIP office or dial
afford the premiums, some States have premium assistance programs that 1-877-KIDS-NOW or www.insurekidsnow.gov to find out how to apply. If you
can help pay for coverage. These States use funds from their Medicaid or CHIP qualify, you can ask the State if it has a program that might help you pay the
programs to help people who are eligible for employer-sponsored health premiums for an employer-sponsored plan.
coverage, but need assistance in paying their health premiums.
Once it is determined that you or your dependents are eligible for premium
If you or your dependents are already enrolled in Medicaid or CHIP and you live assistance under Medicaid or CHIP, your employer’s health plan is required to
in a State listed below, you can contact your State Medicaid or CHIP office to permit you and your dependents to enroll in the plan – as long as you and your
find out if premium assistance is available. dependents are eligible, but not already enrolled in the employer’s plan. This
is called a “special enrollment” opportunity, and you must request coverage
If you or your dependents are NOT currently enrolled in Medicaid or CHIP, within 60 days of being determined eligible for premium assistance.
and you think you or any of your dependents might be eligible for either of

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 April 16, 2010. You should contact your State for further information on eligibility.

ALABAMA – Medicaid ARIZONA – CHIP


Web Site: http://www.medicaid.alabama.gov Web Site: http://www.azahcccs.gov/applicants/default.aspx
Phone: 1-800-362-1504 Phone: 1-877-764-5437

ALASKA – Medicaid ARKANSAS – CHIP


Web Site: http://health.hss.state.ak.us/dpa/programs/medicaid/ Web Site: http://www.arkidsfirst.com/
Phone (Outside of Anchorage): 1-888-318-8890 Phone: 1-888-474-8275
Phone (Anchorage): 907-269-6529

Your 2013 Benefits Guide 34


NOTICES

CALIFORNIA – Medicaid KENTUCKY – Medicaid


Web Site: http://www.dhcs.ca.gov/services/Pages/ Web Site: http://chfs.ky.gov/dms/default.htm
TPLRD_CAU_cont.aspx Phone: 1-800-635-2570
Phone: 1-866-298-8443
COLORADO – Medicaid and CHIP LOUISIANA – Medicaid
Medicaid Web Site: http://www.colorado.gov/ Web Site: http://www.la.hipp.dhh.louisiana.gov
Medicaid Phone: 1-800-866-3513 Phone: 1-888-342-6207
CHIP Web Site: http:// www.CHPplus.org
CHIP Phone: 303-866-3243

FLORIDA – Medicaid MAINE – Medicaid


Web Site: http://www.fdhc.state.fl.us/Medicaid/index.shtml Web Site: http://www.maine.gov/dhhs/oms/
Phone: 1-866-762-2237 Phone: 1-800-321-5557
GEORGIA – Medicaid MASSACHUSETTS – Medicaid and CHIP
Web Site: http://dch.georgia.gov/ Medicaid & CHIP Web Site: http://www.mass.gov/MassHealth
Click on Programs, then Medicaid Medicaid & CHIP Phone: 1-800-462-1120
Phone: 1-800-869-1150
IDAHO – Medicaid and CHIP MINNESOTA – Medicaid
Medicaid Web Site: www.accesstohealthinsurance.idaho.gov Web Site: http://www.dhs.state.mn.us/
Medicaid Phone: 1-800-926-2588 Click on Health Care, then Medical Assistance
CHIP Web Site: www.medicaid.idaho.gov Phone: 800-657-3739
CHIP Phone: 1-800-926-2588
INDIANA – Medicaid MISSOURI – Medicaid
Web Site: http://www.in.gov/fssa/2408.htm Web Site: http://www.dss.mo.gov/mhd/index.htm
Phone: 1-877-438-4479 Phone: 573-751-6944
IOWA – Medicaid MONTANA – Medicaid
Web Site: www.dhs.state.ia.us/hipp/ Web Site: http://medicaidprovider.hhs.mt.gov/clientpages/clientindex.shtml
Phone: 1-888-346-9562 Telephone: 1-800-694-3084
KANSAS – Medicaid NEBRASKA – Medicaid
Web Site: https://www.khpa.ks.gov Web Site: http://www.dhhs.ne.gov/med/medindex.htm
Phone: 800-766-9012 Phone: 1-877-255-3092

Your 2013 Benefits Guide 35


NOTICES
NEVADA – Medicaid and CHIP OREGON – Medicaid and CHIP
Medicaid Web Site: http://dwss.nv.gov/ Medicaid & CHIP Web Site: http://www.oregonhealthykids.gov
Medicaid Phone: 1-800-992-0900 Medicaid & CHIP Phone: 1-877-314-5678
CHIP Web Site: http://www.nevadacheckup.nv.org/
CHIP Phone: 1-877-543-7669
NEW HAMPSHIRE – Medicaid PENNSYLVANIA – Medicaid
Web Site: http://www.dhhs.state.nh.us/DHHS/MEDICAIDPROGRAM/default.htm Web Site: http://www.dpw.state.pa.us/partnersproviders/medicalassistance/
Phone: 1-800-852-3345 x 5254 doingbusiness/003670053.htm
Phone: 1-800-644-7730
NEW JERSEY – Medicaid and CHIP RHODE ISLAND – Medicaid
Medicaid Web Site: http://www.state.nj.us/humanservices/dmahs/clients/medicaid/ Web Site: www.dhs.ri.gov
Medicaid Phone: 1-800-356-1561 Phone: 401-462-5300
CHIP Web Site: http://www.njfamilycare.org/index.html
CHIP Phone: 1-800-701-0710
NEW MEXICO – Medicaid and CHIP SOUTH CAROLINA – Medicaid
Web Site: http://www.nyhealth.gov/health_care/medicaid/ Web Site: http://www.scdhhs.gov
Phone: 1-800-541-2831 Phone: 1-888-549-0820
NEW YORK – Medicaid TEXAS – Medicaid
Web Site: http://www.nyhealth.gov/health_care/medicaid/ Web Site: https://www.gethipptexas.com/
Phone: 1-800-541-2831 Phone: 1-800-440-0493
NORTH CAROLINA – Medicaid UTAH – Medicaid
Web Site: http://www.nc.gov Web Site: http://health.utah.gov/medicaid/
Phone: 919-855-4100 Phone: 1-866-435-7414
NORTH DAKOTA – Medicaid VERMONT– Medicaid
Web Site: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Web Site: http://ovha.vermont.gov/
Phone: 1-800-755-2604 Telephone: 1-800-250-8427
OKLAHOMA – Medicaid VIRGINIA – Medicaid and CHIP
Web Site: http://www.insureoklahoma.org Medicaid Web Site: http://www.dmas.virginia.gov/rcp-HIPP.htm
Phone: 1-888-365-3742 Medicaid Phone: 1-800-432-5924
CHIP Web Site: http://www.famis.org/
CHIP Phone: 1-866-873-2647

Your 2013 Benefits Guide 36


NOTICES

WASHINGTON – Medicaid WISCONSIN – Medicaid


Web Site: http://hrsa.dshs.wa.gov/premiumpymt/Apply.shtm Web Site: http://dhs.wisconsin.gov/medicaid/publications/p-10095.htm
Phone: 1-877-543-7669 Phone: 1-800-362-3002
WEST VIRGINIA – Medicaid WYOMING – Medicaid
Web Site: http://www.wvrecovery.com/hipp.htm Web Site: http://www.health.wyo.gov/healthcarefin/index.html
Phone: 304-342-1604 Telephone: 307-777-7531

To see if any more States have added a premium assistance program since April 16, 2010, or for more information on special enrollment rights, you can contact
either:
U.S. Department of Labor U.S. Department of Health and Human Services
Employee Benefits Security Administration Centers for Medicare & Medicaid Services
www.dol.gov/ebsa www.cms.hhs.gov
1-866-444-EBSA (3272) 1-877-267-2323, Ext. 61565

Your 2013 Benefits Guide 37


NOTICES

MEDICAID AND THE CHILDREN’S HEALTH INSURANCE PROGRAM (CHIP)

Notice of HIPAA Special Enrollment Rights

This notice is being provided to ensure that you understand your rights to Medicaid or CHIP
apply for group health insurance coverage. You should read this notice even if If you or your dependents lose eligibility for coverage under Medicaid or the
you plan to waive coverage at this time. Children’s Health Insurance Program (CHIP) or become eligible for a premium
assistance subsidy under Medicaid or CHIP, you may be able to enroll yourself
Loss of Other Coverage and your dependents. You must request enrollment within 60 days of the loss
If you are declining enrollment for yourself or your dependents (including your of Medicaid or CHIP coverage or the determination of eligibility for a premium
spouse) because of other health insurance or group health plan coverage, you assistance subsidy.
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 To request special enrollment or obtain more information, contact the Benefits
contributing toward your or your dependents’ other coverage). However, you Desk at (877) 745-6303.
must request enrollment within 31 days or any longer period that applies
under the plan after your or your dependents’ other coverage ends (or after the
employer stops contributing toward the other coverage).

Marriage, Birth, or Adoption


In addition, if you have a 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 31 days or any
longer period that applies under the plan after the marriage, birth, adoption, or
placement for adoption.

Your 2013 Benefits Guide 38


NOTICES

Medicare Part D – Standard Plan and Plus Plan

Important Notice From Infosys Limited About Your Prescription Drug (a penalty) if you later decide to join a Medicare drug plan.
Coverage and Medicare When Can You Join A Medicare Drug Plan?
You can join a Medicare drug plan when you first become eligible for Medicare
Please read this notice carefully and keep it where you can find it. This notice and each year from October 15th to December 7th.
has information about your current prescription drug coverage with Infosys
Limited Health & Welfare Plan and about your options under Medicare’s However, if you lose your current creditable prescription drug coverage,
prescription drug coverage. This information can help you decide whether or through no fault of your own, you will also be eligible for a two (2) month
not you want to join a Medicare drug plan. If you are considering joining, you Special Enrollment Period (SEP) to join a Medicare drug plan.
should compare your current coverage, including which drugs are covered
at what cost, with the coverage and costs of the plans offering Medicare What Happens To Your Current Coverage If You Decide to Join A Medicare
prescription drug coverage in your area. Information about where you can get Drug Plan?
help to make decisions about your prescription drug coverage is at the end of If you decide to join a Medicare drug plan, your current Standard Plan and Plus
this notice. Plan coverage will not be affected. If you do decide to join a Medicare drug
plan and drop your current Infosys Limited coverage, be aware that you and
There are two important things you need to know about your current coverage your dependents may be able to get this coverage back.
and Medicare’s prescription drug coverage:
When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?
1. Medicare prescription drug coverage became available in 2006 to You should also know that if you drop or lose your current coverage with
everyone with Medicare. You can get this coverage if you join a Medicare Standard Plan and Plus Plan and don’t join a Medicare drug plan within
Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO 63 continuous days after your current coverage ends, you may pay a higher
or PPO) that offers prescription drug coverage. All Medicare drug plans premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous
provide at least a standard level of coverage set by Medicare. Some days or longer without creditable prescription drug coverage, your monthly
plans may also offer more coverage for a higher monthly premium. premium may go up by at least 1% of the Medicare base beneficiary premium
2. Infosys Limited has determined that the prescription drug coverage per month for every month that you did not have that coverage. For example,
offered by the Standard Plan and Plus Plan is, on average for all if you go nineteen months without creditable coverage, your premium
plan participants, expected to pay out as much as standard Medicare may consistently be at least 19% higher than the Medicare base beneficiary
prescription drug coverage pays and is therefore considered premium. You may have to pay this higher premium (a penalty) as long as you
Creditable Coverage. Because your existing coverage is Creditable have Medicare prescription drug coverage. In addition, you may have to wait
Coverage, you can keep this coverage and not pay a higher premium until the following October to join.

Your 2013 Benefits Guide 39


NOTICES

For More Information About This Notice Or Your Current Prescription Drug Remember: Keep this Creditable Coverage notice. If you decide to join
Coverage… one of the Medicare drug plans, you may be required to provide a copy
Contact the department listed below for further information. NOTE: You will of this notice when you join to show whether or not you have maintained
get a notice each year. You will also get it before the next period you can join a creditable coverage and, therefore, whether or not you are required to pay a
Medicare drug plan, and if this coverage through Infosys Limited changes. You higher premium (a penalty).
also may request a copy of this notice at any time.
Date: April 1, 2013
For More Information About Your Options Under Medicare Prescription Drug Name of Entity/Sender: Hanna Global Solutions
Coverage… Contact--Position/Office: Benefits Desk
More detailed information about Medicare plans that offer prescription Address: 1390 Willow Pass Road, Suite 940
drug coverage is in the “Medicare & You” handbook. You’ll get a copy of the Concord, CA 94520
handbook in the mail every year from Medicare. You may also be contacted Phone Number: (877) 745-6303
directly by Medicare drug plans.

For more information about Medicare prescription drug coverage:


ƒƒ Visit www.medicare.gov
ƒƒ Call your State Health Insurance Assistance Program (see the inside back
cover of your copy of the “Medicare & You” handbook for their telephone
number) for personalized help
ƒƒ Call 1-800-MEDICARE (1-800-633-4227). TTY users should call
1-877-486-2048.

If you have limited income and resources, extra help paying for Medicare
prescription drug coverage is available. For information about this extra help,
visit Social Security on the web at www.socialsecurity.gov, or call them at
1-800-772-1213 (TTY 1-800-325-0778).

Your 2013 Benefits Guide 40


NOTICES

Notice Of Privacy Practices


This Notice Describes How Medical Information About You May Be regarding your health treatment, the Plan may disclose medical information
Used and Disclosed and How You Can Get Access to this Information. it has created or received for treatment purposes. For example, the Plan may
Please Review It Carefully. disclose your medical information to your doctor, at the doctor’s request, for his
or her treatment of you.
As a participant in the Infosys Limited Health and Welfare Plan (the “Plan”),
you are eligible for certain health care benefits. In the course of providing For payment. The Plan or one of its Business Associates may use or disclose
these benefits to you, the Plan may receive and maintain some of your medical your medical information to pay claims for medical services provided to you
information. Federal law requires that the Plan protect the privacy of, generally, or to provide eligibility information to your doctor when you receive medical
medical information that identifies you and relates to your past, present or treatment.
future health or condition, the provision of health care to you, or the payment
for health care received by you. The Plan may hire other companies (“Business For health care operations. The Plan may provide your medical information to
Associates”) to help provide health care benefits to you. These Business our accountants, attorneys, consultants, and others in order to make sure we
Associates may also receive and maintain your medical information. are complying with federal law. Also, your medical information may be used or
disclosed to assess the quality of health care that you receive or to assist the
Federal law requires that the Plan provide you with this Notice about its privacy Plan in the management of its performance of administrative activities.
practices and its legal duties regarding your medical information. The Plan is
required to abide by the terms of the Notice currently in effect. To you, your personal representative, or others involved in your healthcare.
The Plan may provide your medical information to you and your legal
The Plan may change its privacy practices and the terms of this Notice at any representative. The Plan may also provide medical information to a person,
time. Changes will be effective for all of your medical information received or including family members, other relatives, friends or others identified by you
created by the Plan. If the Plan changes its policies regarding the protection and acting on your behalf, so long as you do not object and the information
of your medical information, the Plan will mail you a new notice of privacy is directly relevant to such person’s involvement in your health care. For this
practices that incorporates any changes within 60 days. The Plan will also will purpose, a person acts on your behalf by being involved in the provision and/or
post a new notice on its internet web site. payment of your health care.

How the Plan May Use and Disclose Your Medical Information As required by law. For example, the Plan may disclose your medical
The Plan may use and disclose your medical information without your written information to comply with workers’ compensation laws or other similar laws.
permission for the following purposes:
To Business Associates. The Plan may disclose your medical information to its
For treatment. While the Plan does not directly participate in decisions Business Associates so that they may perform the services that the Plan has

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NOTICES

asked them to perform. The Plan requires that these entities appropriately For any other use or disclosure of your medical information, the Plan must have
safeguard your medical information. your written authorization. You may cancel your written authorization for the
use and disclosure of any or all of your medical information, unless the Plan has
For health-related benefits. The Plan or one of its Business Associates may taken action in reliance on your permission.
contact you about treatment alternatives or other health benefits or services Your Rights
that may be of interest to you. You may make a written request to the Plan to do one or more of the following
concerning your medical information received or created by the Plan and/or
For other uses and disclosures permitted by law such as: the Plan’s Business Associates:

ƒƒ To public health authorities for public health purposes (e.g. the reporting of ƒƒ The right to request restrictions on certain uses and disclosures of medical
communicable diseases); information; however, the Plan is not required to agree to such request.
ƒƒ To state agencies handling cases of abuse, neglect, or domestic violence; ƒƒ The right to receive confidential communications of medical information by
ƒƒ To a government agency authorized to oversee the health care system or alternative means or at alternative locations.
government programs (e.g. determining eligibility for public benefits); ƒƒ The right to inspect and copy medical information.
ƒƒ To law enforcement officials for limited law enforcement purposes (e.g. to ƒƒ The right to amend medical information.
locate a missing person or suspect); ƒƒ The right to receive an accounting of disclosures of medical information.
ƒƒ To a coroner, medical examiner, or funeral director about a deceased person ƒƒ The right, even if you have agreed to receive this notice electronically, to
(e.g. to identify a person); obtain a paper copy of this from the Plan upon request.
ƒƒ To an organ procurement organization under limited circumstances;
ƒƒ For research purposes in limited circumstances (e.g. if identifying Although the Plan will utilize its best efforts to comply with your request, the
information is removed or a research board has approved the use of the Plan may legally deny your request under certain circumstances. The Plan will
information); notify you of the reason for the denial and you will get a chance to respond.
ƒƒ To avert a serious threat to your health or safety or the health or safety of The Plan may not deny a request to communicate with you in confidence by a
others; different means or location if the current means or location used by the Plan
ƒƒ To military authorities if you are a member of the armed forces or a veteran endangers you. The Plan may, however, request payment for any additional
of the armed forces; expenses it incurs to comply with your request. Your request to communicate
ƒƒ To federal officials for lawful intelligence, counterintelligence, and other by a different means or location must be in writing, include a statement that
national security purposes; disclosure of all or part of the medical information by the current means could
ƒƒ To an executor or administrator of your estate; and endanger you, specifically state the different means or location by which you
ƒƒ To any other persons and/or entities authorized under law to receive would like the Plan to communicate with you, and continue to allow the Plan to
medical information. pay claims.

Your 2013 Benefits Guide 42


NOTICES

Complaints
If you feel as if your privacy rights have been violated, you may file a written
complaint with:
Angie Reese, SPHR
Practice Lead – Compensation & Benefits
Privacy Inquiries
6100 Tennyson Parkway
Suite 200
Plano, Texas 75024

You may also send a written or electronic complaint to the Secretary of the
Department of Health and Human Services. The complaint must state the
name of the entity that is the subject of the complaint and describe the act or
omissions believed to be in violation of law. A complaint must be filed within
180 days of when you knew or should have known that the act or omission
complained of occurred. The Plan may not retaliate against you if you file a
complaint.

More Information
If you would like more information about this Notice, please contact:
Angie Reese, SPHR
Practice Lead – Compensation & Benefits
(469) 229-9530

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NOTICES

The Women’s Health and Cancer Rights Act of 1998

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:

ƒƒ All stages of reconstruction of the breast on which the mastectomy was


performed;
ƒƒ Surgery and reconstruction of the other breast to produce a symmetrical
appearance;
ƒƒ Prostheses; and
ƒƒ Treatment of physical complications of the mastectomy, including
lymphedema.

This coverage will be provided in consultation with the attending physician


and the patient, and will be subject to the same annual deductibles and
coinsurance provisions which apply for the mastectomy. For deductibles and
coinsurance information applicable to the plan in which you enroll, please refer
to the summary plan description.

If you would like more information on WHCRA benefits, call your plan
administrator’s Benefits Desk at (877) 745-6303.

Your 2013 Benefits Guide 44


NOTICES

Notice Regarding Electronic Disclosure


To: Infosys Limited Employees

From: Infosys Limited

Date: April 1, 2013

Re: Important Information About the Infosys Limited Employee Benefit Plan
(the “Plan”)

A Summary of Material Modification/revised Summary Plan Description


describes important changes in the benefits provided to you and/or your
dependents under the Plan.

It can be accessed electronically through the Infosys Americas portal at


http://usahrapp01/americas/.

You have a right to request and obtain a paper version of the document at no
charge. Contact the Benefits Desk at (877) 745-6303 or
Infosys.benefits@hannaglobal.com to request a paper version.

Your 2013 Benefits Guide 45

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