BENEFITS PLAN VALUATION COMPARISON - imercer

BENEFITS PLAN VALUATION COMPARISON

US REPORT

© Mercer LLC All rights reserved. Mercer, 400 West Market Street, Suite 700, Louisville, KY 40202 Survey materials and the data contained therein are copyrighted works owned exclusively by Mercer and may not be copied, modified, sold, transformed into any other media, or otherwise transferred in whole or in any part to any party other than the named subscriber, without prior written consent from Mercer.

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2013 Benefits Plan Valuation Comparison

Contents

1. Overview ......................................................................................................Section 1 Introduction 1 - 1 If You Have Questions 1 - 1 About the Report 1 - 2

2. Executive Summary ....................................................................................Section 2 Total Benefits 2 - 1 Retirement/Savings 2 - 1 Health/Group 2 - 1 Time Loss 2 - 1

3. Plan Value Comparisons ............................................................................Section 3 Points of Comparison 3 - 1 Plans Covered 3 - 1 Plan Value Comparison Charts 3 - 2

4. Summary of Plan Features .........................................................................Section 4 How the Plan Features are Organized 4 - 1 Where Information is Obtained 4 - 1

5. Participant List ............................................................................................Section 5

6. Methodology................................................................................................Section 6 ©2013 Mercer LLC

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©2013 Mercer LLC 1 - 1

Overview Introduction The Benefits Plan Valuation Comparison (BPVC) is a custom, comparative, benchmarking report of benefit plan values and features of the Manufacturing industry. The BPVC allows you to analyze how benefit plans in the peer group compare in degrees of increasing specificity ⎯ by all plans together, by plan groupings (i.e., Retirement/Savings, Health/Group, and Time Loss), and by individual plans. For each degree of specificity noted above, the BPVC displays the values and comparative results for a composite workforce. The Benefits Plan Valuation Comparison is organized into six sections.

Overview: Provides an overview of the report purpose.

Executive Summary: Overview of the plan provisions that represent the median value the industry is providing for each benefit.

Plan Value Comparisons: Illustrate the quantitative benefits information consisting of calculations and statistics for the national composite workforce. The first and third quartile along with the median plan values are shown relative to the peer group.

Summary of Plan Features: Provides the features of the benefit plans for the peer organization(s) that represent the 25th, 50th and 75th percentiles.

Participant List: Provides the names of the organizations whose plans have been valued and make up the peer group.

Methodology: Details the methods used to value the benefit plans included in the Plan Value Comparisons.

If You Have Questions… If you have any questions about this report, please call our customer service line for assistance. Customer Service Line 800 333 3070

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About the Report Primary Function This new report is a hybrid of values and prevalence data, which will give you an overview of what benefit package the industry is offering to their employees. By focusing on the plan designs at the 1st, median and 3rd quartiles you will be able to assess the level of benefit provided in the industry. This easy-to-read report contains true plan designs from organizations and a graphical representation to help visualize the comparative level of the plan design through employee values. Tying all of the information together, the executive summary interprets the findings of the report. Use this as a spring board to initiate a conversation regarding your benefits.

Benefit Plans The report illustrates competitive information and assessment for each of the following benefit categories:

Retirement/Savings: Includes defined benefit, defined contribution, and stock purchase plans.

Health/Group: Includes medical, dental, life insurance, flexible spending accounts, and post-retirement medical plans.

Time Loss: Includes vacation, holiday, personal leave, PTO banks, sick leave, and short- and long-term disability plans.

Objective Comparisons The focus of BPVC value calculations is on plan design. Other factors such as geographic differentials, claims experience, and negotiating power that can affect the cost or the perceived value of benefit plans are removed. As a result, the BPVC helps you assess your overall plan design.

Calculations and Statistics The following key values and statistics are displayed:

Benefit values: The estimated dollar value of pretax pay an employee would need in order to replace the employer-provided benefit.

For quick orientation, a representative section will be emphasized to reflect the benefit plans under review. In this example, the total Health/Group plan values are graphically illustrated.

Health/Group

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

1st Quartile Mean Median 3rd Quartile

Valu

es

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National Composite Workforce The BPVC values compares benefit plans of the peer group based on a hypothetical national composite workforce. The composite workforce is a set of generic employee profiles that represents a typical employee population. The workforce composite profiles are derived and calculated from a national cross-section of representative organizations that vary by industry, size, and geography.

The national composite workforce is described in greater detail in the Methodology section.

Benefits Valuation Analysis As you review the results of this report and evaluate the implications of change, you may commission Mercer to calculate the full value of your benefits. The BVA report will be discounted by 25% if you decided to take advantage of this offer.

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Executive Summary Retirement/Savings Combined Retirement Benefit: The median

value is represented by one organization that provides a defined contribution plan only. The plan provides an employer match of 100% on the first 8% of employee contributions. The plan includes bonus within the salary definition.

Defined Benefit: The median value is represented by one organization that offers a Retirement Equity plan to all employees and a Final Average Pay plan to executives only. The Retirement Equity plan uses the employee’s highest 3 of the final 10 years pay. Employer contributions are based on age and range from 5% - 15%. Bonus pay is included in the calculation of benefits. The executive plan is determined by using the high 36 consecutive month’s base plus bonus pay.

Defined Contribution: The median value is represented by one organization that offers a 401(k) plan to all employees and an additional savings plan for executives only. The 401(k) provides an employer matching contribution of 90% on the first 6% of employee’s base contributions. The executive plan provides no employer contributions.

Stock Purchase: The median plan provides a 15% discount on employer stock and allows employees to defer up to 10% of pay. This plan does not include bonus within the salary definition.

Health/Group Medical: The median plan is generated through

an HMO. It is a 2 tiered HMO plan where tier 1 represents services provided at the home facility and tier 2 is inside network. This plan has a deductible of $200 per individual coverage and $400 per family coverage for both tier 1 and tier 2. The tier 1 out-of-pocket limit is $2,200 for employee only and $4,400 for family; tier 2 is $2,500 for employee only and $5,000 for family. Under tier 1, inpatient and outpatient hospital services are covered at 90% after the annual deductible is met. For tier 2, inpatient and outpatient services are covered at 70% after the deductible. Office visits are covered in full after a copayment of $15/visit. Employees pay approximately 20% of the cost of for all levels of coverage.

Dental: The median plan has a deductible for Basic/Major and Orthodontia services of $75 per individual and $225 per family. Preventive services are covered at 100%, Basic services are covered at 80%, Major and Orthodontia services are covered at 50%. There is an annual limit of $1,200 for Preventive, Basic, and Major services and a $1,200 lifetime limit for Orthodontia. Employees pay approximately 22% of the cost of for all levels of coverage.

Life Insurance: The median plan provides a 1 times pay benefit with no minimum and no maximum coverage amounts. Bonus is included in the salary definition.

Flexible Spending Accounts: The employee contribution limits on these plans exceed the projected need such that all organizations that offer the plans have the same value for all employee profiles.

Post-retirement Medical: The median plan provides a subsidy of 60% of the premium for pre-65 and post-65 retirees.

Time Loss Paid Time Off: The median plan provides a

range of days from 20 days at date of hire to 32 days after 15 years of service. Paid Time Off includes vacation, holidays, personal days and sick days.

Vacation: The median value is generated by a plan that provides a range from 10 days upon hire to 25 days after 20 years of service for salaried employees below Director Level. Employees that are Director Level and above are provided a range of days from 15 days at date of hire to 25 days at 20 years of service.

Holidays: The median plan provides 10 holidays.

Personal Leave: The median plan provides 3 days.

Sick Leave: The median plan provides 10 sick days with no carryover days allowed.

STD: The median plan provides 13 weeks at 100% and 13 weeks at 75% for salaried employees with a 14 day waiting period. The weekly maximum payment amount is unlimited.

LTD: The median plan provides a 60% benefit for salaried employees with a $10,000 monthly maximum.

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Plan Value Comparisons Plan Value Comparisons are a series of charts that show you how the peer groups benefit plans’ market replacement value compares, by plan grouping, and by plan based on a national composite workforce. Market replacement value is the estimated amount of pretax salary an employee would need in order to replace the employer-provided benefits. The national composite workforce is a set of generic employee profiles that represents a typical employee population. These profiles were developed from a national cross-section of representative organizations that vary by industry, size, and geography. The national composite workforce is described in greater detail in the Methodology section.

Points of Comparison To compare the competitive position relative to the peer group, the following Plan Value Comparison charts show the peer group’s 1st quartile, median, mean and 3rd quartile values:

Quartile: Shows the distribution of the peer group’s plan values by showing the 1st and 3rd quartiles, mean and median dollar values.

Plans Covered Benefit value comparisons are shown for the following plan groupings and individual plans:

Total Benefits ⎯ All benefit components

Retirement/Savings ⎯ Defined Benefit ⎯ Defined Contribution ⎯ Stock Purchase

Health/Group ⎯ Medical ⎯ Dental ⎯ Life Insurance ⎯ Health Care Spending Accounts ⎯ Dependent Care Spending

Accounts ⎯ Post-retirement Medical

Time Loss ⎯ Paid Time Off ⎯ Vacation ⎯ Holiday ⎯ Personal Leave ⎯ Sick Days ⎯ Short-term Disability ⎯ Long-term Disability

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Plan Value Comparisons Benefit Plan Groupings

©2013 Mercer LLC 3 - 2 Sample

Total Benefits

0

5,000

10,000

15,000

20,000

25,000

30,000


Val

ues

Retirement/Savings

01,0002,0003,0004,0005,0006,0007,0008,0009,000


Val

ues

Health/Group

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000


Val

ues

Time Loss

01,0002,0003,0004,0005,0006,0007,0008,000


Val

ues

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Defined Benefit

01,0002,0003,0004,0005,0006,0007,0008,0009,000

10,000


Val

ues

Defined Contribution

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000


Val

ues

Stock Purchase

0

200

400

600

800

1,000

1,200

1,400


Val

ues

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Medical

01,0002,0003,0004,0005,0006,0007,0008,0009,000

10,000


Val

ues

Dental

0200400600800

1,0001,2001,4001,6001,800


Val

ues

Life Insurance

0

50

100

150

200

250

300

350


Val

ues

Dependent Care FSA

0102030405060708090

100


Val

ues

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Health Care FSA

01020304050607080


Val

ues

Post-retirement Medical

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000


Val

ues

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Paid Time Off

0

1,000

2,000

3,000

4,000

5,000

6,000


Val

ues

Personal Leave

0100200300400500600700800900


Val

ues

Holiday

0

500

1,000

1,500

2,000

2,500


Val

ues

Vacation

0500

1,0001,5002,0002,5003,0003,5004,000


Val

ues

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Long-term Disability

0

50

100

150

200

250

300

350


Val

ues

Short-term Disability

0100200300400500600700800


Val

ues

Sick Leave

0100200300400500600700800900


Val

ues

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Summary of Plan Features How the Plan Features are Organized The table records (or rows) consist of individual plan features. The columns consist of the 1st quartile, the median and 3rd quartile plan features for each individual benefit. The plan feature may or may not have the exact value as the quartiles shown in the employee profile comparison section. Also note that the plan for each benefit will not always represent the same peer and could represent a number of different peers for each benefit. The plan details display qualitative descriptions and values. Take, for example, a single record from the Retirement/Savings Plan Features — “Maximum employee contribution as a percentage of compensation”. By scanning across the record, you can quickly assess how this feature in your Retirement/Savings plan differs from your retirement plan.

Where Information is Obtained Participant data displayed in the Plan Features is imported from Mercer’s national benefits database. To populate our national benefits database, we annually gather data from a broad cross section of industries ranging from 500 to over 30,000 employees. Our database tracks extensive information on the major types of employee benefit plans, including Retirement/Savings, Health/Group Benefits, and Time Loss Benefits.

The 25th, 50th and 75th plan designs are determined by assigning an actuarial value to each plan, sorting the plans by value, then picking the corresponding value. When a percentile value does not match a peer’s value within the peer group, then the closest two peers to the percentile value (one above and one below the value) are selected. Each plan value is based on the cost to the employee of replacing the benefit outside of employment.

Quick and easy comparisons: The Retirement/Savings Plan Features table setup allows you to quickly and easily compare individual plan features among the participants.

Plan Feature Median Plan

Maximum employee contribution as a percentage of compensation:

Effective immediately, 10.00% of pay

Such comparisons may serve a variety of uses from evaluating drivers that influence results, to annual monitoring, to providing the information needed for creating “what if” scenarios and analysis.

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DEFINED BENEFITDEFINED BENEFITOrganization Name: Organization A Organization B Organization C

Plan Number: N/A DBG010 DB0010Employees covered: All employees, including highly

compensated, minimum hours 1,907.0 per year.

All employees, including highly compensated, minimum hours 1,000.0 per year.Some sites are not eligible.

Part-time are eligible: Not specified. Yes.Collectively bargained eligible: Excluded. Excluded.Participants are eligible for social security benefits:

Yes. Yes.

Formula type: Final average. Cash balance.Plan Status: Grandfathered. Active.Service definition: Service accrual pattern is hours

counting: total hours for full credit year = 1,907.

Service for benefit accruals is unlimited.

Service accrual pattern is hours counting: total hours for full credit year = 1,000.


Employee Contributions: None. None.Salary component used in formula definition:

DP1= High 3 consecutive of final 10 years pay.

Pay is defined as: Total.

Pay is defined as: Total pay.

Formula definition (Annual): This plan offers 2 formulas for Post 1994 benefits 1995-2005 = 1.67% x final average pay x years of service. Post 2005 = 1% x final average up to 50% of Social Security Wage Base + 1.5% final average salary over 50% of Social Security wage base x years of service.

Accrued benefit is determined by using service at calculation date.

Maximum benefit is the IRS maximum.

Age + service to 39, 3.00% of pay, to breakpoint TWB, 6.00% of excess.Age + service to 49, 4.00% of pay, to breakpoint TWB, 8.00% of excess.Age + service to 59, 5.00% of pay, to breakpoint TWB, 10.00% of excess.Age + service to 69, 6.50% of pay, to breakpoint TWB, 11.50% of excess.Then, 8.50% of pay, to breakpoint TWB, 13.50% of excess.

Investment credit rate is a variable rate announced periodically.Average yield on a 1 year Treasury constant maturities during the month of June plus 1%.Guaranteed minimum investment credit rate is 4.83%.

Cost-of-living adjustments are: None. Not applicable.

© Mercer LLC DB - 1 Summary of Plan Features

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Plan Number: N/A DBG010 DB0010Excess plan for salaries and benefits in excess of legislated limits:

There is an excess plan for salaries in excess of legislated limits.

There is an excess plan that pays benefits in excess of legislated limits.



Target income replacement percentage:

Not specified. Not specified.

Plan's normal retirement age: Age 65.0. Age 65.0.

Plan's earliest retirement age: Age 55.0, with 10 years of service.

Age 55.0, with 5 years of service.

Early retirement percentages and special criteria for unreduced benefits:

Age 64: 97.50%.Age 63: 95.00%.Age 62: 92.50%.Age 61: 90.00%.Age 60: 87.50%.Age 59: 85.00%.Age 58: 82.50%.Age 57: 80.00%.Age 56: 77.50%.Age 55: 75.00%.

Special criteria for unreduced benefits: Age 55.0 with a minimum of 85 years age/service combination.

Not applicable.

Special criteria for unreduced benefits: Not applicable.

Temporary supplement for early retirees:

None. None.

Employee 100% vests at: 5 years.

Automatic vesting occurs at age 65.

3 years.



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Plan Number: N/A DBG010 DB0010Disability benefit is: Not specified. Continued accrual - deferred.

For actives, death benefit is more than the required minimum:

Not specified. Yes, 100% of accrued, unreduced, payable immediately.

Normal form of payment for single employee:

Life. Life.

Normal form of payment for married employee:

J&S 50. J&S benefit = actuarial equivalent of single life benefit.


Condition for election of lump sum payment form:

Limited - based on value of accrued, not to exceed $7,500.

Lump sums unlimited.

Comments: Participation Freeze: If employee was hired on or after October 10, 2005; in addition employee must have 5 years of service or reached age 65 on or before October 10, 2005. Effective December 31, 2007, employee cannot become a new participant unless employee had 16 years of vesting service.


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DEFINED BENEFITDEFINED BENEFITOrganization Name:

Plan Number:Employees covered:

Part-time are eligible:Collectively bargained eligible:Participants are eligible for social security benefits:Formula type:Plan Status:Service definition:

Employee Contributions:Salary component used in formula definition:

Formula definition (Annual):

Cost-of-living adjustments are:

Organization C Organization D Organization DDBG020 DB0020 DBF010

Executives, only highly compensated.Officers. Employees hired prior to January 1, 2008 continue to participate.

Executives, only highly compensated, minimum hours 1,000.0 per year.Officers only.

All employees, including highly compensated, minimum hours 1,000.0 per year.

Not specified. No. Yes.Not applicable. Not applicable. Not applicable.Not specified. Yes. Yes.

SERP, Final average. SERP, Final average. Career average.Grandfathered. Active. Frozen.Service accrual pattern is elapsed time.

Service for benefit accruals is limited to 20 years.





None. None. None.DP1= High 3 consecutive of final 10 years pay.


DP1=Final 3 years pay.

Pay is defined as: Base plus highest bonus over final 3 years.

DP1= Career average of pay.

Pay is defined as: Base + overtime + shift differential.

.015 * DP1 * (CSE up to 20).



.65 * DP1 - .50 * PIA.

Benefit is offset by other Defined Benefit plan.



.0115 * (DP1 up to 200.0000 * 100) * (CSE up to 35) + .0175 * (DP1 in excess of 200.0000 * 100) * (CSE up to 35) + .0175 * DP1 * (CSE in excess of 35).

Minimum benefit for retiree age 65 with at least 15 years of service = $2,400/year. If years of service are between 5 and 15, benefits are prorated.



None. None. None.


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Plan Number:Excess plan for salaries and benefits in excess of legislated limits:

Target income replacement percentage:Plan's normal retirement age:

Plan's earliest retirement age:



Employee 100% vests at:







There is not an excess plan that pays benefits in excess of legislated limits.

Not specified. Not specified. Not specified.



Age 65.0, with 1 year of service.


Age 60.0 with a minimum of 90 years age/service combination, or age 65.0, with 10 years of service.


Age 64: 100%.Age 63: 100%.Age 62: 100%.Age 61: 98.00%.Age 60: 96.00%.Age 59: 94.00%.Age 58: 92.00%.Age 57: 90.00%.Age 56: 88.00%.Age 55: 86.00%.


Age 64: Not specified.Age 63: Not specified.Age 62: Not specified.Age 61: Not specified.Age 60: Not specified.Age 59: Not specified.Age 58: Not specified.Age 57: Not specified.Age 56: Not specified.Age 55: Not specified.


Benefit is reduced 1%/year of service less than 25 years.



None. Social Security benefit.Temporary benefit is payable to age 62.Increases by 0%.

None.

Upon date of hire. Not specified. 5 years.


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Plan Number:Disability benefit is:


Normal form of payment for single employee:Normal form of payment for married employee:


Comments:


Not specified. Reduced accrued - immediate.

Employee vested at 100% at age 60 and 25 years of service.

Reduced accrued - immediate.

Not specified. No. No.

Lump sum. Life. Life.

Lump sum.J&S benefit calculation is not specified.



Lump sums unlimited. Lump sums are not allowed above IRS mandatory limits.

Lump sums are not allowed above IRS mandatory limits.

Offset by lump sum value of all other company provided retirement benefits.

The last two upgrades were in 1986 & 1998. This plan is frozen to new members effective 2009.


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Organization E Organization E Organization FDB0010 DBG010 DBF020

Executives, only highly compensated.

Salaried employees, including highly compensated.


Not specified. Yes. Yes.Not applicable. Excluded. Excluded.Yes. Yes. Yes.

SERP, Final average. Cash balance. Career average.Active. Grandfathered. Frozen.Service accrual pattern is elapsed time.


Service accrual pattern is elapsed time.




None. None. None.DP1=Final 5 years pay.

Pay is defined as: Base + bonus.

Pay is defined as: Base + bonus + special payments.


Pay is defined as: Base + bonus + commission + overtime + shift differential + special payments.

.016 * DP1 * CSE.

This plan is offset by the grandfathered defined benefit plan.



Age to 29, 3.00% of pay.Age to 34, 4.00% of pay.Age to 39, 5.00% of pay.Age to 44, 7.00% of pay.Age to 49, 9.00% of pay.Then, 11.00% of pay.Maximum interest = 10%.

Investment credit rate is a variable rate announced periodically.Variable rate basis is 30-year Treasury.Guaranteed minimum investment credit rate is 5.25%.

.001 * (DP1 up to TWB) * (CSE up to 35) + .001 * (DP1 in excess of TWB) * (CSE up to 35).



None. Not applicable. None.


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Age 65.0, with 1 year of service. Age 65.0. Age 65.0, with 5 years of service.

Age 55.0, with 5 years of service. Age 55.0, with 10 years of service, or age 62.0, with 1 year of service.




Not applicable.




Reduction prior to January 1, 2000; 4%/year prior to age 60.

None. None. Other - Plan Defined.Temporary supplement = .4% of average earnings based on service through 2004, plus .3% of average earnings based on service on or after 2005. Plan is frozen as of December 31, 2006.Increases not specified.

5 years. 5 years.


5 years.


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Comments:


None.

One hundred percent vested the later of 36 months on executive payroll or vesting in qualified defined benefit plan.

Accrued - immediate.

Automatic vesting at age 62 with 1 year of service while still active.

None.

No. No. No.

Life. Life. Life.




Limited - based on value of accrued, not to exceed $15,000.



Grandfathered as of December 31, 2008.

Frozen to new employees as of June 1, 2009. Benefit accrued through 2004 are payable as a lump sum.


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Organization G Organization H Organization IDBG020 DBG010 DB0010

All employees, including highly compensated, minimum hours 1,000.0 per year.For employees hired before July 1, 2008.

Salaried employees, including highly compensated.Corporate and IS and GS employees only; hired before January 1, 2006.

All employees, including highly compensated.Excludes employees at one subsidiary.

Yes. Not specified. Yes.Not applicable. Not applicable. Not applicable.Yes. Yes. Yes.

Cash balance. Final average. Cash balance.Grandfathered. Grandfathered. Active.Service accrual pattern is elapsed time.






None. None. None.Pay is defined as: Total pay. DP1= High 3 nonconsecutive of

final 10 years pay.

Pay is defined as: Base + certain management incentive compensation + certain merit payments + certain commissions.


Age + service to 24, 3.50% of pay, to breakpoint TWB, 7.50% of excess.Age + service to 34, 4.00% of pay, to breakpoint TWB, 8.00% of excess.Age + service to 44, 4.50% of pay, to breakpoint TWB, 8.50% of excess.Age + service to 54, 5.00% of pay, to breakpoint TWB, 9.00% of excess.Age + service to 64, 5.50% of pay, to breakpoint TWB, 9.50% of excess.Age + service to 74, 6.50% of pay, to breakpoint TWB, 10.50% of excess.Age + service to 84, 7.50% of pay, to breakpoint TWB, 11.50% of excess.Then, 9.00% of pay, to breakpoint TWB, 13.00% of excess.

Investment credit rate is a variable rate announced periodically.Variable rate basis is 30-year Treasury.

.0125 * (DP1 up to CC) * (CSE up to 35) + .015 * (DP1 in excess of CC) * (CSE up to 35) + .015 * DP1 * (CSE in excess of 35).



3.00% of pay.

Investment credit rate is a variable rate announced periodically.Variable rate basis is 30-year Treasury.

Not applicable. None. Not applicable.


SAMPLE









There is not an excess plan for salaries in excess of legislated limits.

There is not an excess plan that pays benefits in excess of legislated limits.






Age 65.0, with 5 years of service. Age 65.0. Age 65.0, with 5 years of service.


Age 55.0, with 5 years of service. Age 55.0, with 5 years of service.

Not applicable.


Age 64: 100%.Age 63: 100%.Age 62: 100%.Age 61: 100%.Age 60: 100%.Age 59: 95.00%.Age 58: 90.00%.Age 57: 85.00%.Age 56: 80.00%.Age 55: 75.00%.


Not applicable.


None. Other - Plan Defined.Temporary benefit is payable to age 62.Increases not specified.

None.

3 years. 5 years.


3 years.


SAMPLE






Comments:


Continued accrual - deferred. None. Continued accrual up to 24 months.

No. Yes, 100% of accrued, reduced same as early retirement, payable deferred.

Benefit paid is the actuarial equivalent Joint and 100% Survivor Option (Spouse's portion).

Yes, 100% of accrued, unreduced, payable immediately.

Life. Life. Life.






Lump sums unlimited.

To be eligible for early retirement supplement, employee must be at least age 60 with at least 10 years service. Benefit is equal to $200 per month plus an additional $25 per month for each year of credited service (maximum of 25 years). The maximum supplement is $825 per month or the amount of projected Social Security benefit, whichever is less.

Employees must work 1000 hours within one year to be eligible for the plan.


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Organization I Organization J Organization JDBG020 DBF010 DBF020

All employees, including highly compensated, minimum hours 1,000.0 per year.Excludes employees at one subsidiary.

Salaried employees, including highly compensated.Limited to certain divisions. Frozen as of September 30, 2006 and all employees will be 100% vested.

Salaried employees, including highly compensated.Employees hired prior to January 1, 1993. Employee will receive the higher of this or the other pension plan.

Yes. Yes. Yes.Not applicable. Excluded. Excluded.Yes. Yes. Yes.

Final average. Final average. Final average.Grandfathered. Frozen. Frozen.Service accrual pattern is elapsed time.






None. None. None.DP1= High 60 consecutive of final 120 years pay.








.01 * (DP1 up to CC) * (CSE up to 35) + .015 * (DP1 in excess of CC) * (CSE up to 35).



Greater of 1 or 2.

#1 = .015 * DP1 * (CSE up to 35) - .0048 * (DP1 up to CC) * (CSE up to 35).

#2 = .015 * DP2 * CSE.

Employee receives the greater of Formula 1, 2, or 3. #3 = .015 * (DP1 up to 28,000) * CSE. The percentage of offset in formula one varies with birth date: before 1938 = .0048, 1938-1954 = .00455, 1955 and later = .0043.



Greater of 1 or 2.

#1 = .026667 * DP1 * (CSE up to 15) + .005 * DP1 * (CSE in excess of 15 up to 35) - .00425 * PIA * (CSE up to 15) - .0025 * PIA * (CSE in excess of 15 up to 35).

#2 = .015 * DP2 * CSE.

Employee receives the greater of Formula 1, 2, or 3. #3 = .015 * (DP1 up to 28,000) * CSE. The percentage of offset in formula one varies with birthdate: before 1938 = .0048, 1938-1954 = .00455, 1955 and later = .0043.



None. None. None.


SAMPLE
















Age 65.0, with 5 years of service. Age 65.0. Age 65.0.

Age 55.0, with 5 years of service. Age 55.0. Age 55.0.



If age + service > 80, ERFs are adjusted 1% for each year by which the sum of age + service exceeds 80, up to 100%.



Early Reduction Factors are for employees hired after January 1, 1993.

Age 64: 100%.Age 63: 100%.Age 62: 100%.Age 61: 100%.Age 60: 100%.Age 59: 94.00%.Age 58: 88.00%.Age 57: 82.00%.Age 56: 76.00%.Age 55: 70.00%.


Early Reduction Factor for employees hired prior to January 1, 1993.

None. Flat annual amount = $3,900.Employees hired after September 30, 2006 receive a prorated supplement. Temporary benefit is payable to 62 if employee is at least age 60 with 15 years service or age 55 with 30 years of service.Increases not specified.

Flat annual amount = $3,900.Employee hired prior to September 30, 2006 receive supplement if at least age 60 with 15 years vested service or age 55 with 30 years vested service. After September 30, 2006, supplement is prorated.Increases not specified.

3 years. 5 years.


5 years.



SAMPLE






Comments:


Continued accrual up to 24 months.

None. None.

Yes, 100% of accrued, unreduced, payable immediately.

Yes, 60% of accrued, unreduced, payable deferred.

For single employees, benefit = 1x salary; married employees, benefit is in the form of an annuity.

Yes, 60% of accrued

For single employees benefit = 1x salary, married employees benefit is in the form of an annuity.

Life. Life. Life.


J&S 60%: Pensioner = 95% of single life annuity; Surviving spouse = 60% of pensioner's benefit.J&S benefit = simple reduction.

J&S 60%: Pensioner = 95% of single life annuity, Surviving spouse = 60% of pensioner's benefit.J&S benefit = simple reduction.

Lump sums unlimited. Lump sums are not allowed above IRS mandatory limits.


Grandfathered as of February 1, 2010. Service accrual not capped at 35 years for employees hired prior to September 1, 1994.


SAMPLE







Organization K Organization LDBG010 N/A

All employees, including highly compensated.

Yes.Excluded.Yes.

Final average.Grandfathered.Service accrual pattern is elapsed time.


None.DP1= High 3 nonconsecutive of final 10 years pay.


.01165 * (DP1 up to CC) * (CSE up to 35) + .015 * (DP1 in excess of CC) * (CSE up to 35) + .015 * DP1 * (CSE in excess of 35).



None.


SAMPLE











40.00%





Above reduction factors apply to those with 30+ years of service. With 29 years = 3.64%/year, 28 = 3.87%, 27 = 3.92%, 26 = 4.06%, 25 = 4.20%, 24 = 4.34%, 23 = 4.48%, 22 = 4.62%, 21 = 4.76%, 20 = 4.90%, 19 5.04%, 18 = 5.18%, 17 = 5.32%, 16 = 5.46%, 15 = 5.60%, 14 = 5.74%, 13 = 5.88%, 12 = 6.02%, 11 = 6.16%, 10 = 6.30%, 9 = 6.44%, 8 = 6.58%, 7 = 6.72%, 6 = 6.86%, 5 = 7%.

Other - Plan Defined.Temporary benefit is payable to age 62; with at least 10 years of service, eligible for $100 per month plus $20/month for each year of service up to a maximum of 25 years.Increases not specified.

5 years.


SAMPLE






Comments:


Continued accrual - deferred.

No.

Life.

J&S 50. J&S benefit = simple reduction.

Grandfathered lump sum provision permitted (unlimited).

Employees hired prior to January 1, 2007.


SAMPLE

DEFINED CONTRIBUTIONDEFINED CONTRIBUTIONOrganization Name: Organization A Organization A Organization B

Plan Number: DC0010 DC0020 DC0010Employees covered: All employees, including highly

compensated, minimum hours 1,000.0 per year.



Part-time are eligible: Not specified. Not specified. Not specified.Collectively bargained eligible: Not applicable. Not applicable. Included.Participants are eligible for social security benefits:

Yes. Yes. Yes.

Plan type: 401(k). Money purchase. 401(k).Plan Status: Active. Active. Active.Rollover contributions allowed: Yes. No. Yes.

For plan participation, employee contributions are required, allowed, or not allowed?

Allowed. Not allowed. Allowed.


After 1 year,MATCHED: none.UNMATCHED: 50.00% pretax, 50.00% maximum.

Not applicable. Upon age 18.0, effective immediately,MATCHED: 6.00% pretax, 6.00% after tax, 6.00% maximum.TOTAL: 30.00% pretax, 30.00% after tax, 30.00% maximum.Employee is automatically enrolled at a deferral rate of 3%.

Percent of eligible NHCE participating, average deferral %, and average contribution %:

% participating is not specified. ADP is not specified. ACP is not specified.

Not applicable. % participating is not specified. ADP is not specified. ACP is not specified.

Percent of eligible HCE participating, average deferral %, and average contribution %:



Compensation definition: Pay is defined as: Base + bonus + overtime.

Pay is defined as: Base + bonus + commission + overtime.


Employer matching contribution and maximum amount (other than by law):

None. Not applicable. First 2.00% of employee contribution = 100.00% employer match.Next 4.00% of employee contribution = 50.00% employer match.

Maximum amount unlimited.

© Mercer LLC DC - 19 Summary of Plan Features

SAMPLE


Plan Number: DC0010 DC0020 DC0010Employer nonmatching contributions (profit sharing, ESOP, money purchase, etc.):

Fixed, 3.00% of salary. Fixed, 10.25% of salary. Fixed, 3.00% of salary.

Employer contributions are greater of 3% or $45/week.

Excess plan for salaries in excess of legislated limits:

Yes. Yes. Yes.

Employee 100% vests: Immediately. Immediately. 2 years.

Employee contribution investment options:

Employee directed with 21 options. Company stock fund information not specified.

Not applicable. Employee directed with 11 options. Company stock is not an investment fund.

Employee contribution stock trades allowed:

Not specified. Not applicable. Not specified.

Employee contribution stock buying/selling allowed:

Not applicable. Not applicable. Not applicable.

Employee contribution mutual funds outside the normal plan offering allowed:


Employer contribution investment options:



Employee directed with 11 options. Company stock is not an investment fund.

Employer contribution stock trades allowed:


Employer contribution stock buying/selling allowed:


Employer contribution mutual funds outside the normal plan offering allowed:


Inservice Withdrawals: Non-hardship withdrawals not allowed.

Hardship withdrawals are allowed for employee pre-tax contributions.

Withdrawals of employer non-match and rollover contributions are not specified.

Non-hardship withdrawals not allowed.

Hardship withdrawals are not allowed.

Non-hardship withdrawals allowed before reaching age 59 1/2 for after-tax and rollover contributions.Non-hardship withdrawals are not allowed for employer non-match and employer match contributions.


Hardship withdrawals are not allowed for employer non-match and employer match contributions.


SAMPLE


Plan Number: DC0010 DC0020 DC0010Loans allowed? Yes, from employee and

employer accounts.Yes, from employer accounts only.

Yes, from employee and employer accounts.

Final distribution methods: Lump sum. Lump sum, installment payments, or annuity.

Lump sum.

Comments: This is a Safe Harbor Plan.


SAMPLE

DEFINED CONTRIBUTIONDEFINED CONTRIBUTIONOrganization Name:


Part-time are eligible:Collectively bargained eligible:Participants are eligible for social security benefits:Plan type:Plan Status:Rollover contributions allowed:





Compensation definition:


Organization C Organization C Organization DDC0010 DC0040 DC0010


All employees, only highly compensated, minimum hours 1,000.0 per year.Officers and Vice Presidents.


Yes. Yes. Yes.Included. Not applicable. Not applicable.Yes. Yes. Yes.

401(k). 401(k). 401(k).Active. Active. Active.Yes. Yes. Yes.

Allowed. Allowed. Allowed.

Effective immediately,MATCHED: 5.00% pretax, 5.00% maximum.TOTAL: 40.00% pretax, 40.00% maximum.Automatic enrollment at 3%. Highly compensated employees are limited to 6% deferral.

Effective immediately,MATCHED: none.UNMATCHED: 25.00% pretax, 25.00% maximum.

Effective immediately,MATCHED: 2.00% pretax, 2.00% maximum.TOTAL: 40.00% pretax, 40.00% maximum.







Pay is defined as: Total pay. Pay is defined as: Total pay. Pay is defined as: Base + overtime + shift differential + special payments.

First 3.00% of employee contribution = 100.00% employer match.Next 2.00% of employee contribution = 50.00% employer match.Union employees are not eligible for the company match.


None. First 2.00% of employee contribution = 25.00% employer match.



SAMPLE


Plan Number:Employer nonmatching contributions (profit sharing, ESOP, money purchase, etc.):

Excess plan for salaries in excess of legislated limits:Employee 100% vests:


Employee contribution stock trades allowed:Employee contribution stock buying/selling allowed:Employee contribution mutual funds outside the normal plan offering allowed:Employer contribution investment options:

Employer contribution stock trades allowed:Employer contribution stock buying/selling allowed:Employer contribution mutual funds outside the normal plan offering allowed:Inservice Withdrawals:


Discretionary. Allocation basis is based on participant compensation for entire year.

The discretionary contribution is made in company stock. Union employees are not eligible for the company contribution.

2006 = 1%, 2007 = 1%, 2008 = 1%, 2009 = 0%, 2010 = 0%.

Discretionary. Allocation basis is based on participant compensation for entire year.

The discretionary contribution is made in company stock. Union employees are not eligible for the company contribution.

2006 = 1%, 2007 = 1%, 2008 = 1%, 2009 = 0%, 2010 = 0%.

Fixed, amount not specified. Allocation basis is age weighted. Retirement contribution: under 30 = 3% of covered pay, 30-39 = 4%, 40-49 = 5%, 50-59 = 7%, 60+ = 9%.

There have been no discretionary contributions.

Yes. Yes. No.

Immediately. Immediately. 3 years.

Retirement contribution vesting coded above. Employer match vested 100% immediately.

Employee directed with 23 options. Company stock is an investment fund.



Yes. Yes. No.

No. No. Not applicable.

Yes. Yes. Not applicable.

Employee directed on a limited basis with 1 options. Company stock is an investment fund.



No. No. No.



Non-hardship withdrawals allowed before reaching age 59 1/2 for rollover contributions.




Hardship withdrawals are allowed for employee pre-tax and rollover contributions.

Hardship withdrawals are not allowed for employer non-match contributions.



Hardship withdrawals are not allowed for employer match contributions.

Withdrawals of employer non-match contributions are not specified.


SAMPLE


Plan Number:Loans allowed?

Final distribution methods:

Comments:


Yes, from employee accounts only.



Lump sum. Lump sum. Lump sum, or transfer of company shares.

Employee must have 1,000 hours/year for each year of service in the Retirement Contribution plan.


SAMPLE










Organization E Organization E Organization EDC0010 DCG010 DCG020

All employees, including highly compensated.Employees hired on or after January 1, 2009.

All employees, including highly compensated.Employees hired prior to January 1, 2009.


Yes. Yes. Not specified.Excluded. Included. Not applicable.Yes. Yes. Yes.

401(k). 401(k). SERPActive. Grandfathered. Grandfathered.Yes. Yes. No.

Allowed. Required. Required.

Effective immediately,MATCHED: 8.00% pretax, 8.00% after tax, 8.00% maximum.TOTAL: 25.00% pretax, 25.00% after tax, 25.00% maximum.


Effective immediately,MATCHED: 8.00% pretax, 8.00% maximum.TOTAL: 50.00% pretax, 50.00% maximum.May defer 100% of bonus and incentive awards.







Pay is defined as: Base + shift differential.


Pay is defined as: Base + bonus.

First 4.00% of employee contribution = 100.00% employer match.Next 4.00% of employee contribution = 50.00% employer match.


First 8.00% of employee contribution = 75.00% employer match.





SAMPLE








Fixed, amount not specified. Allocation basis is age weighted. Less than age 40 = 3%, 40-49 = 4%, 50+ = 5%.

None. None.

Yes. Yes. Yes.

Immediately. Immediately. Immediately.



Not specified.

No. No. Not specified.





Not specified.

No. No. Not specified.



Non-hardship withdrawals allowed before reaching age 59 1/2 for after-tax, employer match and rollover contributions.





Non-hardship withdrawals not specified.

Hardship withdrawals are not specified.


SAMPLE




Comments:




Not specified.

Lump sum, installment payments with a maximum of 10 years, annuity, transfer of company shares.

Rollover, Partial distributions, Deferred receipt. Annuity option is only available if requested within 30 days of retirement; it's not allowed for terminated participants.


Rollover, Partial distributions, Deferred receipt. Annuity option is only available if requested within 30 days of retirement; it's not allowed for terminated participants.

Lump sum, or installment payments with no maximum number of years.

Grandfathered as of January 1, 2008.


SAMPLE










Organization F Organization G Organization HDC0010 DC0010 DC0010

All employees, including highly compensated.Limited to certain locations.


Salaried employees, including highly compensated, minimum hours 1,000.0 per year.Includes Corporate, OS, IS, and GS employees. Certain hourly and collectively bargained are eligible.

Yes. Yes. Yes.Excluded. Not applicable. Not applicable.Yes. Yes. Yes.

401(k). 401(k). 401(k).Active. Active. Active.Yes. Yes. Yes.

Required. Allowed. Required.

Effective immediately,MATCHED: none.UNMATCHED: 97.00% pretax, 97.00% after tax, 97.00% maximum.After 1 year,MATCHED: 6.00% pretax, 6.00% after tax, 6.00% maximum.TOTAL: 97.00% pretax, 97.00% after tax, 97.00% maximum.Roth 401(k) contributions up to 97% of salary, after tax contributions = 10%.

Upon age 18.0, effective immediately,MATCHED: 8.00% pretax, 8.00% after tax, 8.00% maximum.TOTAL: 75.00% pretax, 75.00% after tax, 75.00% maximum.Highly compensated limited to 35%. Automatic enrollment = 2% pretax.




% participating is 80.00%. ADP is 7.20%. ACP is 2.94%.



% participating is 80.00%. ADP is 7.20%. ACP is 2.94%.

Pay is defined as: Base + overtime + shift differential + bonus + commission + overtime + shift differential + bonus + commissionspecified special payment only.

Pay is defined as: Base + bonus + commission + overtime + shift differential + special payments.

Pay is defined as: Base pay.

After 1.00 year, first 6.00% of employee contribution = 100.00% employer match.


First 2.00% of employee contribution = 100.00% employer match.Next 2.00% of employee contribution = 50.00% employer match.Next 4.00% of employee contribution = 25.00% employer match.





SAMPLE








None. Fixed, amount not specified. Allocation basis is age weighted. For employees hired after July 1, 2008: age < 35 = 3%, 35-49 = 4%, 50+ = 5%.

None.

Yes. No. Yes.

Immediately. 3 years.

Match is vested immediately; non-match vesting indicated above.

Immediately.




No. Yes. No.

Not applicable. Yes. Not applicable.




Employer directed. Company stock is an investment fund.

No. Yes. No.



Non-hardship withdrawals allowed before reaching age 59 1/2 for after-tax and rollover contributions.Non-hardship withdrawals are not allowed for employer match contributions.

Hardship withdrawals are allowed for employer match and employee pre-tax contributions.




Non-hardship withdrawals allowed before reaching age 59 1/2 for after-tax contributions.Non-hardship withdrawals are not allowed for employer match and rollover contributions.




SAMPLE




Comments:





Lump sum. Lump sum, or transfer of company shares.


Direct rollover.

This plan has a Roth 401(k) feature. This is a Safe Harbor plan for pre-tax and matching contributions. Loans exclude Company stock and Roth. Inservice withdrawals are not allowed for Roth 401(k) contributions. Hardship withdrawal of Roth 401(k) contributions are not allowed.

This plan has a Roth feature.


SAMPLE










Organization H Organization H Organization IDC0020 DC0030 DC0010

Executives, only highly compensated, minimum hours 1,000.0 per year.Corporate, IS, and GS employees only. Annual base pay must be at least $150,000 on November 1 of any year.

Salaried employees, including highly compensated, minimum hours 1,000.0 per year.Corporate, IS, and GS employees only; hired on or after January 1, 2006.

All employees, including highly compensated, minimum hours 1,000.0 per year.Excludes employees at one subsidiary.

Yes. Yes. Yes.Not applicable. Not applicable. Included.Yes. Yes. Yes.

SERP Money purchase. 401(k).Active. Active. Active.No. No. Yes.

Required. Not allowed. Required.


Not applicable. Effective immediately,MATCHED: none.UNMATCHED: 75.00% pretax, 75.00% after tax, 75.00% maximum.Highly Compensated Employees are capped at 6% deferral limit.





Pay is defined as: Base + bonus + bonus+ Long Term Incentive Compensation.

Pay is defined as: Base pay. Pay is defined as: Base + overtime + bonus + commission + overtime + bonus + commissionplus Long Term Incentive Bonus.



Not applicable. None.


SAMPLE








None. Fixed, amount not specified. Allocation basis is based on service points. 0-9 years = 3%, 10-19 = 4%, 20-29 = 5%, 30+ = 6%.

None.

Yes. Yes. No.

Immediately. 3 years. Not applicable.



Yes. Not applicable. Not specified.

Not specified. Not applicable. Not applicable.

Not specified. Not applicable. Not applicable.



Not applicable.

Not specified. No. Not applicable.







Non-hardship withdrawals allowed before reaching age 59 1/2 for after-tax and rollover contributions.



SAMPLE




Comments:


No. No. Yes, from employee accounts only.

Lump sum, or transfer of company shares.


Direct rollover.

Lump sum.

Rollover.

This plan has a Roth feature.


SAMPLE










Organization J Organization K Organization KDC0010 DC0010 DCG010

All employees, including highly compensated.Commission employees excluded.



Yes. Yes. Yes.Excluded. Not applicable. Excluded.Yes. Yes. Yes.

401(k). 401(k). 401(k).Active. Active. Grandfathered.Yes. Yes. Yes.

Allowed. Allowed. Required.

Effective immediately,MATCHED: none.UNMATCHED: 50.00% pretax, 50.00% after tax, 50.00% maximum.After 0.50 years,MATCHED: 8.00% pretax, 8.00% after tax, 8.00% maximum.TOTAL: 50.00% pretax, 50.00% after tax, 50.00% maximum.Highly Compensated employees may contribute 20% of base salary in pre-tax and 30% in aftertax.









Pay is defined as: Base pay. Pay is defined as: Base + overtime.

Pay is defined as: Base + overtime.

After 0.50 years, first 8.00% of employee contribution = 75.00% employer match.




First 8.00% of employee contribution = 50.00% employer match.After 10.00 years, first 8.00% of employee contribution = 60.00% employer match.



SAMPLE








Fixed, amount not specified. Allocation basis is based on service points. Age + service points take effect in September 2006: < 35 = .5%, 35-44 = 1%, 45-54 = 2%, 55-64 = 3.5%, 65-74 = 5%, 75+ = 6%.

Fixed, amount not specified. Allocation basis is based on service points. Service Points: 0-4 years of service = 2%, 5-9 = 3%, 10+ = 4%.

None.

Yes. No. No.

3 years. 3 years.

Vesting schedule above reflects the employer non-matching contribution; employer match is vested immediately.

Immediately.




No. No. No.






Not specified. No. No.





Hardship withdrawals are not allowed for employer non-match contributions.

Non-hardship withdrawals allowed before reaching age 59 1/2 for after-tax contributions.Non-hardship withdrawals are not allowed for employer non-match and employer match contributions.



Withdrawals of rollover contributions are not specified.

Non-hardship withdrawals allowed before reaching age 59 1/2 for after-tax contributions.Non-hardship withdrawals are not allowed for employer match contributions.





SAMPLE




Comments:



Yes. Yes, from employee and employer accounts.

Lump sum, installment payments with a maximum of 10 years, or transfer of company shares.

Lump sum, or installment payments.

Lump sum, or installment payments.

Employees hired on or after January 1, 2007.

Grandfathered as of December 31, 2006.


SAMPLE










Organization L Organization L Organization LDC0010 DC0020 DC0030

Highly compensated, minimum hours 1,000.0 per year.Faculty and Key staff employees.

Staff employees, including highly compensated, minimum hours 1,000.0 per year.


Yes. Yes. Yes.Not applicable. Not applicable. Not applicable.Yes. Yes. Yes.

403b. 403b. 403b.Active. Active. Active.No. No. Yes.

Required. Not allowed. Required.

Effective immediately,MATCHED: none.UNMATCHED: 5.70% pretax, 5.70% maximum.Participant's mandatory contribution of 5.7% of salary is in excess of Social Security Taxable Wage Base. Approximately 66% of employee population is participating in this plan.

Not applicable. Effective immediately,MATCHED: none.UNMATCHED: 100% pretax, 100% maximum.


Not applicable. % participating is 15.00%. ADP is not specified. ACP is not applicable.


Not applicable. % participating is 50.00%. ADP is not specified. ACP is not applicable.

Pay is defined as: Base pay. Pay is defined as: W2 box 1 pay. Pay is defined as: Base pay.

None. Not applicable. None.


SAMPLE








Fixed, amount not specified. Allocation basis is integrated with Social Security. Benefit before age 55 is 8.3% below Social Security Taxable Wage Base and 14% above Social Security Taxable Wage Base; after age 55, 12.3% of annual salary up to Social Security Taxable Wage Base plus 18% above Social Security Taxable Wage Base.

Fixed, amount not specified. Allocation basis is based on service points. After 6 months through 9 years = 5%, 10+ years = 8%, 10+ years and age 50+ = 12%.

None.

No. No. No.

Immediately. Immediately. Not applicable.



No. Not applicable. Not specified.





Not applicable.












SAMPLE




Comments:



Yes, from employer accounts only.


Lump sum, installment payments with a maximum of 30 years, or annuity.

Lump sum, installment payments with a maximum of 30 years, or annuity.

Lump sum, installment payments with no maximum number of years, or annuity.

Participation is mandatory unless a one time irrevocable election not to participate is made.


SAMPLE










Organization LDC0040


Yes.Not applicable.Yes.

SERPActive.No.

Required.

Effective immediately,MATCHED: none.UNMATCHED: 100% pretax, 100% maximum.Approximately 47% of eligible employees participate.

% participating is not specified. ADP is not specified. ACP is not applicable.

% participating is not specified. ADP is not specified. ACP is not applicable.


None.


SAMPLE








None.

Yes.

Not applicable.

Not specified.

Not specified.

Not applicable.

Not applicable.

Not applicable.

Not applicable.

Not applicable.

Not applicable.




SAMPLE




Comments:


No.

Lump sum, installment payments, or annuity.


SAMPLE

STOCK PURCHASESTOCK PURCHASEOrganization Name: Organization A Organization B Organization C

Plan Number: N/A N/A DC0020Employees covered: All employees, including highly

compensated.Part-time are eligible: Yes.Collectively bargained eligible: Not applicable.Plan Status: Active.Rollover contributions allowed: No.


Required.


Not specified.

Compensation definition: Pay is defined as: Base pay.


No match or discount offered. Number of shares unlimited.

There are 12.00 purchase periods in a 12.00-month offering period.

Market value price between the 12th and 15th of each month. Minimum contribution = $5/paycheck.

Employee 100% vests: Not applicable.Comments:

© Mercer LLC SP - 43 Summary of Plan Features

SAMPLE

STOCK PURCHASESTOCK PURCHASEOrganization Name:


Part-time are eligible:Collectively bargained eligible:Plan Status:Rollover contributions allowed:





Employee 100% vests:Comments:

Organization D Organization E Organization FN/A N/A N/A


SAMPLE









Organization G Organization H Organization IN/A N/A DC0030

All employees, including highly compensated.Not specified.Not applicable.Active.No.

Required.

10.00% of pay, effective immediately.


Company discounts, 15.00%. Maximum number of shares = 10000 per offering period.

Market value determination method is price at the end of the purchase period.


Not applicable.


SAMPLE









Organization J Organization K Organization LDC0020 DC0020 N/A



Yes. Yes.Included. Not applicable.Active. Active.No. No.

Required. Required.



Pay is defined as: Base pay. Pay is defined as: Base + overtime.

Company discounts, 5.00%. Number of shares unlimited.



Maximum of 15% of pay up to $25,000.

Company discounts, 15.00%. Number of shares unlimited.


There is 1.00 purchase period in a 6.00-month offering period.

Maximum contribution is $21,250.

Not applicable. Not applicable.


SAMPLE

MEDICALMEDICALOrganization Name: Organization A Organization A Organization B

Plan Number: MD0010 MDR020 MD0010Employees covered: All employees, including highly

compensated, minimum hours 24.0 per week.

Retirees. All employees, including highly compensated, minimum hours 20.0 per week.

Part-time are eligible: Yes. Not specified. Yes.Collectively bargained eligible: Not applicable. Not applicable. Excluded.Plan type: PPO. PPO. PPO.

Plan Status: Active. Active. Active.Is this plan only for out-of-area participants:

No. No. No.

Is this plan a silent PPO: Not applicable. Not applicable. Not applicable.Percent of all employees participating:


Maximum age dependents receive coverage:

Non-student - 18Student - 22Disabled - unlimited.

Not specified. Non-student - 18Student - 24Disabled - unlimited.

Pre-existing condition policy: None. None. Not specified.Employee monthly contributions: None.

COBRA rates are: EE only: $559.52EE+child: $1,678.54EE+spouse: $1,678.54EE+family: $1,678.54

See retiree contributions. Contributions are: Pretax/payroll deduction.EE only: See below.EE+child: See below.EE+spouse: See below.EE+family: See below.

Contributions vary by salary.

Less than $25,000: employee only = $51.05, employee + children = $81.16, employee + spouse = $101.05, employee + family = $131.17; $25,000-$44,999 = $76.74/$122.03/$152.01/$196.86; $45,000-$54,999 = $91.87/$146.08/$181.91/$236.12; $55,000 and above = $102.05/$162.28/$202.15/$262.34.

COBRA rates are: EE only: $484.36EE+child: $770.15EE+spouse: $959.27EE+family: $1,245.05

© Mercer LLC MD - 47 Summary of Plan Features

SAMPLE


Plan Number: MD0010 MDR020 MD0010Plan deductible: Inside network - per individual =

None, per family = None.Outside network - per individual = $250, per family = $500.

Inside network - per individual = $200, per family = $600.Outside network - per individual = $200, per family = $600.

Inside network - per individual = $500, per family = $1,000.Outside network - per individual = $800, per family = $1,600.

Employee copayments: Inpatient Hospital - network = 0%; non-network = 20%*.Inpatient Surgery - network = 0%; non-network = 20%*.Physician Office Visit - network = 0%; non-network = 20%*.Specialist Office Visit - network = 0%; non-network = 20%*.Outpatient Surgery - network = 0%; non-network = 20%*.Routine Physicals - network = 0%; non-network = 20%*.Pap Smear - network = 0%; non-network = 20%*.Mammogram - network = 0%; non-network = 20%*.Well-child Care - network = 0%; non-network = 20%*.Inpatient Maternity - network = 0%; non-network = 20%*.Diagnostics, X-rays and Lab - network = 0%; non-network = 20%*.Emergency Room Care - network = 0%; non-network = 0%.Chiropractic - network = 0%; non-network = 20%*.

* - subject to deductible

Inpatient Hospital - network = 20%*; non-network = 40%, $250*.Inpatient Surgery - network = 20%*; non-network = 40%*.Physician Office Visit - network = $15; non-network = 40%*.Specialist Office Visit - network = $15; non-network = 40%*.Outpatient Surgery - network = 20%*; non-network = 40%, $250*.Routine Physicals - network = $15; non-network = 40%*.Pap Smear - network = 20%*; non-network = 40%*.Mammogram - network = 0%; non-network = 40%*.Well-child Care - network = $15; non-network = 40%*.Inpatient Maternity - network = 20%*; non-network = 40%, $250*.Diagnostics, X-rays and Lab - network = 20%*; non-network = 40%*.Emergency Room Care - network = 20%*; non-network = 20%*.Chiropractic - network = $15; non-network = 40%*.


Inpatient Hospital - network = 10%*; non-network = 40%*.Inpatient Surgery - network = 10%*; non-network = 40%*.Physician Office Visit - network = $25; non-network = 40%*.Specialist Office Visit - network = $45; non-network = 40%*.Outpatient Surgery - network = 10%*; non-network = 40%*.Routine Physicals - network = $25; non-network = 40%*.Pap Smear - network = $25; non-network = 40%*.Mammogram - network = $25; non-network = 40%*.Well-child Care - network = $25; non-network = 40%*.Inpatient Maternity - network = 10%*; non-network = 40%*.Diagnostics, X-rays and Lab - network = 10%*; non-network = 40%*.Emergency Room Care - network = 10%, $100*; non-network = 40%, $100*.Chiropractic - network = $25; non-network = 40%*.


Mental Health and Substance Abuse employee copayment:

Inpatient Mental Health - network = 0%; non-network = 20%*.Outpatient Mental Health - network = 0%; non-network = 0%.Inpatient Substance Abuse - network = 0%; non-network = 20%*.Outpatient Substance Abuse - network = 0%; non-network = 0%.


Inpatient Mental Health - network = 20%*; non-network = 40%, $250*.Outpatient Mental Health - network = 0%; non-network = 0%.Inpatient Substance Abuse - network = 20%*; non-network = 40%, $250*.Outpatient Substance Abuse - network = 0%; non-network = 0%.


Inpatient Mental Health - network = 20%; non-network = 50%.Outpatient Mental Health - network = 20%; non-network = 50%.Inpatient Substance Abuse - network = 20%; non-network = 50%.Outpatient Substance Abuse - network = 20%; non-network = 50%.

Healthcare Spending Accounts included with medical plan:

No. No. No.


SAMPLE


Plan Number: MD0010 MDR020 MD0010Healthcare Spending Accounts Plan details:


Healthcare Spending Account amount per year:


Healthcare Spending Account used at retirement:


Healthcare Spending Account at retirement plan detail:


Prescription benefits part of the medical plan:

Yes. Yes. No.

Prescription plan type (traditional, formulary):

Traditional. Formulary/Non-formulary. Formulary/Non-formulary.

Generic drug employee copayment: Inside network = $5.00, outside network = not covered, mail order = $5.00.

Inside network = $10.00, outside network = 50%, mail order = $20.00.

Inside network = not specified, outside network = not specified, mail order = not specified.

Brand Formulary/Single-source employee copayment:

Not applicable. Inside network = $20.00, outside network = 50%, mail order = $40.00.

Inside network = 35%, outside network = 35%, mail order = 35%.

Brand Non-formulary/Multi-source or Traditional employee copayment:

Inside network = $30.00, outside network = not covered, mail order = $30.00.



Separate deductible and prescription comments:

No separate deductible. No separate deductible. No separate deductible.Retail: Generic = 25% with $10 maximum; Preferred Brand, minimum = $20, maximum = $50; Non-preferred Brand = $60/$100. Mail Order: Generic = 25% with $25 maximum; Preferred Brand = $50/$125; Non-preferred Brand = $150/$250.


SAMPLE


Plan Number: MD0010 MDR020 MD0010Out-of-pocket limit (Includes deductibles):

Inside network = $800 per person, $1,600 per family.Outside network = $1,050 per person, $2,100 per family.

Inside network = $1,200 per person, $3,600 per family.Outside network = $1,200 per person, $3,600 per family.


Plan maximums: Lifetime Maximums: Base plan - inside network = unlimited, outside network = unlimited.

Skilled Nursing = 90 days/year. Chiropractic = $1,000/year. In-vitro Fertilization = $25,000/lifetime.

Lifetime Maximums: Base plan - inside network = $1,000,000, outside network = $1,000,000.

Preventive Care ages 3+ = $500/year. Skilled Nursing = 90 days/year. Chiropractic = $1,000/year. In-vitro Fertilization = $25,000/lifetime. Home Health Care = 100 days/year.


Infertility = $20,000/lifetime. Preventive Care age 5+ = up to a maximum of $500/year. Skilled Nursing = 60 days/condition. Chiropractic = $1,000/year. Mental Health/Substance Abuse inpatient = 60 days/year, outpatient = 60 visits/year. Substance Abuse = 2 Rehabilitation admissions.

Cost management features: Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Not specified.Large case management = Yes.Managed mental health = Not specified.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Not specified.Large case management = Yes.Managed mental health = Not specified.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Yes.Managed mental health = Yes.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

Retirement coverage: Age < 65 = separate plan.Age > 65 = separate plan.

Age < 65, type of coverage not specified.Age > 65 = medicare supplement.

None.

Retirement pre-65 eligibility for coverage:

Not applicable. Age 55.0, with 15 years of service.

Not applicable.


SAMPLE


Plan Number: MD0010 MDR020 MD0010Retiree pre-65 monthly contribution: Retired < age 65: Not applicable. Retired < age 65:

EE only: $205.71EE+1: $617.11EE+family: $617.11

Not applicable.

Retiree pre-65 employer portion of monthly retiree premium, including maximums:

Retired < age 65: Not applicable. Retired < age 65: EE only: $342.84EE+1: $1,028.52EE+family: $1,028.52Maximum: not specified.

Not applicable.

Retiree pre-65 employer reached the maximum:

Not specified. Not specified. Not applicable.

Retirement post-65 eligibility for coverage:


Not applicable.


SAMPLE


Plan Number: MD0010 MDR020 MD0010Retiree post-65 monthly contribution:

Retired > age 65: Not applicable. Retired > age 65:EE only: $205.71EE+1: $617.11EE+family: $617.11

Not applicable.

Retiree post-65 employer portion of monthly premium, including maximums:

Retired > age 65: Not applicable. Retired > age 65:EE only: $342.84EE+1: $1,028.52EE+family: $1,028.52Maximum: not specified.

Not applicable.

Retiree post-65 employer reached the maximum:


Comments: Mental Health/Substance Abuse outpatient = no charge for first 5 visits; visits 6-25 = 50%.

Mental Health/Substance Abuse outpatient = no charge for first 5 visits; visits 6-25 = 50%.

This plan has the largest percentage of participation.


SAMPLE

MEDICALMEDICALOrganization Name:


Part-time are eligible:Collectively bargained eligible:Plan type:

Plan Status:Is this plan only for out-of-area participants:Is this plan a silent PPO:Percent of all employees participating:Maximum age dependents receive coverage:

Pre-existing condition policy:Employee monthly contributions:

Organization B Organization B Organization CMD0020 MD0030 MD0010

All employees, including highly compensated, minimum hours 20.0 per week.



Yes. Yes. Yes.Excluded. Excluded. Not applicable.PPO. Consumer Driven Health Plan,

PPO.Consumer Driven Health Plan, PPO.

Active. Active. Active.No. No. No.

Not applicable. Not applicable. Not applicable.Not specified. Not specified. 12.00%.




Not specified. Not specified. None.Contributions are: Pretax/payroll deduction.EE only: See below.EE+child: See below.EE+spouse: See below.EE+family: See below.



COBRA rates are: EE only: $339.95EE+child: $540.53EE+spouse: $673.26EE+family: $873.84

Contributions are: Pretax/payroll deduction.EE only: See below.EE+child: See below.EE+spouse: See below.EE+family: See below.




Contributions are: Pretax/payroll deduction.EE only: $42.00EE+child: $109.00EE+spouse: $109.00EE+family: $165.00

Tobacco users pay an additional $15/month.



SAMPLE


Plan Number:Plan deductible:

Employee copayments:





Inside network - per individual = $1,250, per family = $2,500.Outside network - per individual = $2,500, per family = $5,000.


Inpatient Hospital - network = 20%*; non-network = 50%*.Inpatient Surgery - network = 20%*; non-network = 50%*.Physician Office Visit - network = $25; non-network = 50%*.Specialist Office Visit - network = $45; non-network = 50%*.Outpatient Surgery - network = 20%*; non-network = 50%*.Routine Physicals - network = 0%; non-network = 50%*.Pap Smear - network = 0%; non-network = 50%*.Mammogram - network = 0%; non-network = 50%*.Well-child Care - network = 0%; non-network = 50%*.Inpatient Maternity - network = 20%*; non-network = 50%*.Diagnostics, X-rays and Lab - network = 20%*; non-network = 50%*.Emergency Room Care - network = 20%, $100*; non-network = 50%, $100*.Chiropractic - network = $25; non-network = 50%*.


Inpatient Hospital - network = 20%*; non-network = 50%*.Inpatient Surgery - network = 20%*; non-network = 50%*.Physician Office Visit - network = 20%*; non-network = 50%*.Specialist Office Visit - network = 20%*; non-network = 50%*.Outpatient Surgery - network = 20%*; non-network = 50%*.Routine Physicals - network = 0%; non-network = 50%*.Pap Smear - network = 0%; non-network = 50%*.Mammogram - network = 0%; non-network = 50%*.Well-child Care - network = 0%; non-network = 50%*.Inpatient Maternity - network = 20%*; non-network = 50%*.Diagnostics, X-rays and Lab - network = 20%*; non-network = 50%*.Emergency Room Care - network = 20%*; non-network = 50%*.Chiropractic - network = 20%*; non-network = 50%*.


Inpatient Hospital - network = 20%*; non-network = 40%*.Inpatient Surgery - network = 20%*; non-network = 40%*.Physician Office Visit - network = 20%*; non-network = 40%*.Specialist Office Visit - network = 20%*; non-network = 40%*.Outpatient Surgery - network = 20%*; non-network = 40%*.Routine Physicals - network = 0%; non-network = 0%.Pap Smear - network = 0%; non-network = 0%.Mammogram - network = 0%; non-network = 0%.Well-child Care - network = 0%; non-network = 0%.Inpatient Maternity - network = 20%*; non-network = 40%*.Diagnostics, X-rays and Lab - network = 20%*; non-network = 40%*.Emergency Room Care - network = 20%*; non-network = 20%*.Chiropractic - network = 20%*; non-network = 40%*.


Inpatient Mental Health - network = 20%; non-network = 20%.Outpatient Mental Health - network = 20%; non-network = 20%.Inpatient Substance Abuse - network = 20%; non-network = 20%.Outpatient Substance Abuse - network = 20%; non-network = 20%.

Inpatient Mental Health - network = 20%*; non-network = 50%*.Outpatient Mental Health - network = 20%*; non-network = 50%*.Inpatient Substance Abuse - network = 20%*; non-network = 50%*.Outpatient Substance Abuse - network = 20%*; non-network = 50%*.




No. Yes. Yes.


SAMPLE


Plan Number:Healthcare Spending Accounts Plan details:

Healthcare Spending Account amount per year:Healthcare Spending Account used at retirement:Healthcare Spending Account at retirement plan detail:

Prescription benefits part of the medical plan:Prescription plan type (traditional, formulary):Generic drug employee copayment:





Not applicable. Employer contributions = $250/person, $500/family. Employee may contribute up to the IRS limits: 2009 = $3,000/person, $5,950/family.

Not specified.

Not applicable. $3,000.00/year. $3,050.00/year.

Not applicable. Yes. Yes.

Not applicable. Not specified. Employer contributes $250 if employee receives the Preventive Care Exam within the required period. Employee may contribute up t the IRS limit.

No. Yes. Yes.

Formulary/Non-formulary. Traditional. Formulary/Non-formulary.





Not applicable. Inside network = 20%, outside network = 40%, mail order = 20%.




No separate deductible.Retail: Generic = 25% with $10 maximum; Preferred Brand, minimum = $20, maximum = $50; Non-preferred Brand = $60/$100. Mail Order: Generic = 25% with $25 maximum; Preferred Brand = $50/$125; Non-preferred Brand = $150/$250.

No separate deductible.Retail: Generic = 25% with $10 maximum; Preferred Brand, minimum = $20, maximum = $50; Non-preferred Brand = $60/$100. Mail Order: Generic = 25% with $25 maximum; Preferred Brand = $50/$125; Non-preferred Brand = $150/$250.

Not specified.Medical deductible applies.


SAMPLE


Plan Number:Out-of-pocket limit (Includes deductibles):

Plan maximums:

Cost management features:

Retirement coverage:










Lifetime Maximums: Base plan - inside network = unlimited, outside network = unlimited.

Chiropractic Care = 25 visits/year. Skilled Care = 120 days/confinement. Hospice must have prior approval.



Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Yes.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

None. None. None.



SAMPLE


Plan Number:Retiree pre-65 monthly contribution:


Retiree pre-65 employer reached the maximum:Retirement post-65 eligibility for coverage:







SAMPLE


Plan Number:Retiree post-65 monthly contribution:


Retiree post-65 employer reached the maximum:Comments:






SAMPLE






Organization C Organization C Organization DMD0020 MD0030 MD0040




Yes. Yes. Not specified.Not applicable. Not applicable. Not applicable.PPO. PPO. Pt. of service.


Not applicable. Not applicable. Not applicable.67.00%. 21.00%. 65.00%.




None. None. Not specified.Contributions are: Pretax/payroll deduction.EE only: $74.00EE+child: $181.00EE+spouse: $181.00EE+family: $277.00







Employees who waive medical receive $600/employee only, employee + family = $1,200.



SAMPLE







Inside network - per individual = $500, per family = $1,000.Outside network - per individual = $1,000, per family = $2,000.


Inside network - per individual = None, per family = None.Outside network - per individual = $1,000, per family = $2,000.

Inpatient Hospital - network = 10%*; non-network = 30%*.Inpatient Surgery - network = 10%*; non-network = 30%*.Physician Office Visit - network = 0%; non-network = 30%*.Specialist Office Visit - network = 0%; non-network = 30%*.Outpatient Surgery - network = 10%*; non-network = 30%*.Routine Physicals - network = 0%; non-network = 0%.Pap Smear - network = 0%; non-network = 0%.Mammogram - network = 0%; non-network = 0%.Well-child Care - network = 0%; non-network = 0%.Inpatient Maternity - network = 10%*; non-network = 30%*.Diagnostics, X-rays and Lab - network = 10%*; non-network = 30%*.Emergency Room Care - network = 10%*; non-network = 10%*.Chiropractic - network = 0%; non-network = 30%*.


Inpatient Hospital - network = 10%*; non-network = 30%*.Inpatient Surgery - network = 10%*; non-network = 30%*.Physician Office Visit - network = 0%; non-network = 30%*.Specialist Office Visit - network = 0%; non-network = 30%*.Outpatient Surgery - network = 10%*; non-network = 30%*.Routine Physicals - network = 0%; non-network = 0%.Pap Smear - network = 0%; non-network = 0%.Mammogram - network = 0%; non-network = 0%.Well-child Care - network = 0%; non-network = 0%.Inpatient Maternity - network = 10%*; non-network = 30%*.Diagnostics, X-rays and Lab - network = 10%*; non-network = 30%*.Emergency Room Care - network = 10%*; non-network = 10%*.Chiropractic - network = 0%; non-network = 30%*.


Inpatient Hospital - network = $250; non-network = 25%*.Inpatient Surgery - network = 0%; non-network = 25%*.Physician Office Visit - network = $20; non-network = 25%*.Specialist Office Visit - network = $20; non-network = 25%*.Outpatient Surgery - network = $75; non-network = 25%*.Routine Physicals - network = $20; non-network = Not covered.Pap Smear - network = $20; non-network = 25%*.Mammogram - network = $20; non-network = 25%*.Well-child Care - network = 0%; non-network = 25%*.Inpatient Maternity - network = $250; non-network = 25%*.Diagnostics, X-rays and Lab - network = $20; non-network = 25%*.Emergency Room Care - network = $100; non-network = $100.Chiropractic - network = $20; non-network = 25%*.


Inpatient Mental Health - network = 10%*; non-network = 30%*.Outpatient Mental Health - network = 0%; non-network = 30%*.Inpatient Substance Abuse - network = 10%*; non-network = 30%*.Outpatient Substance Abuse - network = 0%; non-network = 30%*.


Inpatient Mental Health - network = 10%*; non-network = 30%*.Outpatient Mental Health - network = 0%; non-network = 30%*.Inpatient Substance Abuse - network = 10%*; non-network = 30%*.Outpatient Substance Abuse - network = 0%; non-network = 30%*.


Inpatient Mental Health - network = $250; non-network = 25%*.Outpatient Mental Health - network = $20; non-network = 25%*.Inpatient Substance Abuse - network = $250; non-network = 25%*.Outpatient Substance Abuse - network = $20; non-network = 25%*.


No. No. No.


SAMPLE













Yes. Yes. Not specified.

Formulary/Non-formulary. Formulary/Non-formulary. Formulary/Non-formulary.










No separate deductible.Retail, inside network: Brand Formulary minimum = $25, maximum $50, Non-Formulary Brand = $50/$75. Mail Order: Brand Formulary = $60/$125, Non-Formulary Brand = $125/$180.

No separate deductible.Retail, inside network: Brand Formulary = $25 minimum, $50 maximum; Non-Formulary Brand = $50/$75. Mail Order: Brand Formulary = $60/$125, Non-Formulary brand = $125/$180.

No separate deductible.


SAMPLE



Plan maximums:







Inside network = not applicable, family OPL not applicable.Outside network = $3,000 per person, $6,000 per family.


Chiropractic = 25 visits/year. Skilled Nursing = 120 days/confinement.


Chiropractic = 25 visits/year. Skilled Nursing = 120 days/confinement.


Hospice = 210 days/lifetime. Skilled Nursing = 50 days/year. Mental Health, inpatient = 30 days/year; outpatient = 20 visits/year. Substance Abuse, inpatient = 30 days/year; outpatient = 60 visits/year.

Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Yes.Outpatient review = Not specified.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

Hospital pre-certification = Not specified.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Not specified.Managed mental health = Not specified.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

None. None. Age < 65 = same coverage as active.

Not applicable. Not applicable. Age 62.0, with 25 years of service.


SAMPLE






Not applicable. Not applicable. Retired < age 65: EE only: 100.0%EE+1: 100.0%EE+family: 100.0%

Not applicable. Not applicable. None.

Not applicable. Not applicable. Not specified.



SAMPLE






Not applicable. Not applicable. Retired > age 65: No plan available

Not applicable. Not applicable. Retired > age 65: No plan available


This plan has the largest percentage of employee participation. Employee must participate in the Health Assessment to participate in this plan.

Office visits, including primary care, specialist care, mental health/substance abuse, and chiropractic care, inside network = 100% covered for first two visits/year, thereafter, coinsurance and deductible applies.

Employees may also participate in the Health Saving Account plan if they do not participate in the Health Assessment.

Office visits, including primary care, specialist care, chiropractic care, and mental health/substance abuse inside network= 100% covered for first two visits/year, thereafter, coinsurance and deductible apply.

Lab Testing, inside network = covered in full.


SAMPLE






Organization D Organization D Organization EMD0050 MDRG03 MD0010


Retirees. Salaried employees, including highly compensated, minimum hours 19.1 per week.

Not specified. Not specified. Yes.Not applicable. Not applicable. Excluded.Pt. of service. Indemnity. PPO.

Active. Grandfathered. Active.No. No. No.

Not applicable. Not specified. Not applicable.35.00%. Not specified. 57.00%.



Not specified. Not specified. None.Contributions are: Pretax/payroll deduction.EE only: $42.48EE+child: $97.90EE+spouse: $97.90EE+family: $144.27

Employees who waive medical receive $600/employee only, employee + family = $1,200.


See retiree contributions. None.



SAMPLE







Inside network - per individual = None, per family = None.Outside network - per individual = $500, per family = $1,000.

Individual = None, family = None. Inside network - per individual = not specified, per family = not specified.Outside network - per individual = not specified, per family = not specified.

Inpatient Hospital - network = $100; non-network = 20%*.Inpatient Surgery - network = 0%; non-network = 20%*.Physician Office Visit - network = $15; non-network = 20%*.Specialist Office Visit - network = $15; non-network = 20%*.Outpatient Surgery - network = $15; non-network = 20%*.Routine Physicals - network = $15; non-network = Not covered.Pap Smear - network = $15; non-network = 20%*.Mammogram - network = $15; non-network = 20%*.Well-child Care - network = 0%; non-network = 20%*.Inpatient Maternity - network = $100; non-network = 20%*.Diagnostics, X-rays and Lab - network = $15; non-network = 20%*.Emergency Room Care - network = $100; non-network = $100.Chiropractic - network = $15; non-network = 20%*.


Inpatient Hospital = 0%.Inpatient Surgery = 0%.Physician Office Visit = 0%.Specialist Office Visit = 0%.Outpatient Surgery = 0%.Routine Physicals = 0%.Pap Smear = 0%.Mammogram = 0%.Well-child Care = 0%.Inpatient Maternity = 0%.Diagnostics, X-rays and Lab = 0%.Emergency Room Care = 0%.Chiropractic = 0%.

Inpatient Hospital - network = 10%*; non-network = 40%*.Inpatient Surgery - network = 10%*; non-network = 40%*.Physician Office Visit - network = $20; non-network = 40%*.Specialist Office Visit - network = $30; non-network = 40%*.Outpatient Surgery - network = 10%*; non-network = 40%*.Routine Physicals - network = 0%; non-network = Not covered.Pap Smear - network = 0%; non-network = Not covered.Mammogram - network = 0%; non-network = Not covered.Well-child Care - network = 0%; non-network = Not covered.Inpatient Maternity - network = 10%*; non-network = 40%*.Diagnostics, X-rays and Lab - network = 10%*; non-network = 40%*.Emergency Room Care - network = $75*; non-network = 40%, $75*.Chiropractic - network = $30; non-network = 40%*.




Inpatient Mental Health = 0%.Outpatient Mental Health = 0%.Inpatient Substance Abuse = 0%.Outpatient Substance Abuse = 0%.

Inpatient Mental Health - network = 10%*; non-network = 40%*.Outpatient Mental Health - network = $20; non-network = 40%*.Inpatient Substance Abuse - network = 10%*; non-network = 40%*.Outpatient Substance Abuse - network = $20; non-network = 40%*.


No. No. No.


SAMPLE













Not specified. Not specified. Yes.




Inside network = 10%, outside network = not covered, mail order = $10.00.



Inside network = 20%, outside network = not covered, mail order = $50.00.



Inside network = not specified, outside network = not covered, mail order = $85.00.

No separate deductible. No separate deductible. No separate deductible.Generic = $5 minimum, $25 maximum; Brand Formulary = $20/$75; Brand Non-formulary = greater of 30% or $30.


SAMPLE



Plan maximums:





Inside network = not applicable, family OPL not applicable.Outside network = $2,500 per person, $5,000 per family.

Not applicable, family OPL not applicable.



Hospice = 210 days/lifetime. Skilled Nursing = 50 days/year. Mental Health, inpatient = 30 days/year; outpatient = 20 visits/year. Substance Abuse, inpatient = 30 days/year; outpatient = 60 visits/year.

Lifetime Maximums: Base plan = $50,000.


Routine Physicals, inside network = 1 exam/3 years through age 34, then 1 exam/year. Chiropractic = 26 visits/year, inside network and outside network are combined.



Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Yes.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = No.

Age < 65 = same coverage as active.

Age < 65 = separate plan.Age > 65 = medicare supplement.

None.




SAMPLE






Retired < age 65: EE only: 100.0%EE+1: 100.0%EE+family: 100.0%

Retired < age 65: Not applicable. Not applicable.

None. Retired < age 65: Not applicable. Not applicable.


Not applicable. Age 65.0. Not applicable.


SAMPLE






Retired > age 65: No plan available

Contributions vary by service.Retired > age 65:EE only: See below.EE+1: See below.EE+family: See below.

Retirees who retired after October 1,1989 pay $262.18/month with 20 years of service. Employees with less than 20 years of service pay an additional $4.00/month premium. Total premium = $304.18/month.

Not applicable.

Retired > age 65: No plan available

Retired > age 65:EE only: not specifiedEE+1: not specifiedEE+family: not specifiedMaximum: not specified.

Not applicable.

Not applicable. Not specified. Not applicable.

Lab Test, inside network = covered in full.

Grandfathered as of September 30, 1989.

Deductible, inside network: individual = $300, family = $900; outside network: individual = $600, family = $1,800; outside network deductible applies to inside network deductibles.


SAMPLE






Organization E Organization E Organization EMD0020 MD0030 MD0040

Salaried employees, including highly compensated, minimum hours 19.1 per week.



Yes. Yes. Yes.Excluded. Excluded. Excluded.HMO. Consumer Driven Health Plan,

PPO.EPO.






None. None. None.Contributions are: Pretax/payroll deduction.EE only: $35.65EE+child: $71.30EE+spouse: $71.30EE+family: $106.95


None.





SAMPLE







None. Inside network - per individual = $1,500, per family = $3,750.Outside network - per individual = $1,500, per family = $3,750.

Inside network - per individual = None, per family = None.

Inpatient Hospital - network = $250.Inpatient Surgery - network = 0%.Physician Office Visit - network = $20.Specialist Office Visit - network = $30.Outpatient Surgery - network = $30.Routine Physicals - network = 0%.Pap Smear - network = 0%.Mammogram - network = 0%.Well-child Care - network = 0%.Inpatient Maternity - network = $250.Diagnostics, X-rays and Lab - network = 0%.Emergency Room Care - network = $75.Chiropractic - network = $30.

Inpatient Hospital - network = 10%*; non-network = 40%*.Inpatient Surgery - network = 10%*; non-network = 40%*.Physician Office Visit - network = 10%*; non-network = 40%*.Specialist Office Visit - network = 10%*; non-network = 40%*.Outpatient Surgery - network = 10%*; non-network = 40%*.Routine Physicals - network = 0%; non-network = Not covered.Pap Smear - network = 0%; non-network = Not covered.Mammogram - network = 0%; non-network = Not covered.Well-child Care - network = 0%; non-network = Not covered.Inpatient Maternity - network = 10%*; non-network = 40%*.Diagnostics, X-rays and Lab - network = 10%*; non-network = 40%*.Emergency Room Care - network = 10%*; non-network = 10%*.Chiropractic - network = 10%*; non-network = 40%*.


Inpatient Hospital - network = $250.Inpatient Surgery - network = 0%.Physician Office Visit - network = $20.Specialist Office Visit - network = $30.Outpatient Surgery - network = 0%.Routine Physicals - network = 0%.Pap Smear - network = 0%.Mammogram - network = 0%.Well-child Care - network = 0%.Inpatient Maternity - network = $250.Diagnostics, X-rays and Lab - network = 0%.Emergency Room Care - network = $75.Chiropractic - network = $30.

Inpatient Mental Health - network = $250.Outpatient Mental Health - network = $20.Inpatient Substance Abuse - network = $250.Outpatient Substance Abuse - network = $20.




No. Yes. No.


SAMPLE









Not applicable. This is a Health Savings Account: Employer contributes as follows: employee only = $700, employee + 1 = $1,250, employee + family = $1,750; Employee may contribute additional funds up to the IRS maximum.

Not applicable.

Not applicable. $3,050.00/year. Not applicable.



Yes. Yes. Yes.



Inside network = 10%, outside network = not covered, mail order = 10%.








No separate deductible. No separate deductible. No separate deductible.


SAMPLE



Plan maximums:





$650 per person, $1,500 per family.



Lifetime Maximums: Base plan - inside network = unlimited.

Chiropractic = limited to 26 visits/year. Skilled Nursing = 90 days/year.


Employee + 1 out-of-pocket limit, inside network = $5,425; outside network = $8,225. Routine Physicals = 1 exam/3 years through age 34, then 1 exam/year. Chiropractic = 26 visits/year, inside and outside network combined. Child Preventive Care: 0-24 months = 8 exams, ages 2-5 = 1 exam/year, age 6+ = covered as recommended by doctor or AAP. TMJ = $3,500/lifetime. Hospice = 6 month maximum, Respite Care: 4 or more hours/day.


Chiropractic = 26 visits/year. TMJ = $1,000/year, $5,000/lifetime.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Yes.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.


Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Yes.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = No.

None. None. None.



SAMPLE











SAMPLE









Employee + 1, inside and outside network deductible = $2,625.


SAMPLE






Organization F Organization F Organization GMD0010 MD0020 MD0010




Yes. Yes. Not specified.Excluded. Excluded. Not applicable.Consumer Driven Health Plan, PPO.

Consumer Driven Health Plan, PPO.

PPO.


Not applicable. Not applicable. Not applicable.55.00%. 30.00%. Not specified.


Coverage ends at the end of the month in which maximum age is reached.


Coverage ends at the end of the month in which maximum age is reached.


Not specified. Not specified. None.Contributions are: Pretax/payroll deduction.EE only: $75.00EE+child: $136.83EE+spouse: $136.83EE+family: $196.50

This plan has a spousal surcharge. Tobacco users pay a higher contribution.



This plan has a spousal surcharge. Tobacco users pay a higher contribution rate.



If spouse is employed they must elect coverage with their employer if employer pays 50% or more of the cost of the plan.



SAMPLE














Inpatient Hospital - network = 10%*; non-network = 40%*.Inpatient Surgery - network = 10%*; non-network = 40%*.Physician Office Visit - network = $20; non-network = 40%*.Specialist Office Visit - network = $40; non-network = 40%*.Outpatient Surgery - network = 10%*; non-network = 40%*.Routine Physicals - network = $20; non-network = Not covered.Pap Smear - network = $20; non-network = Not covered.Mammogram - network = $20; non-network = Not covered.Well-child Care - network = $20; non-network = Not covered.Inpatient Maternity - network = 10%*; non-network = 40%*.Diagnostics, X-rays and Lab - network = 10%*; non-network = 40%*.Emergency Room Care - network = 10%*; non-network = 10%*.Chiropractic - network = $40; non-network = 40%*.






Inpatient Mental Health - network = 10%; non-network = 40%.Outpatient Mental Health - network = $15; non-network = 40%.Inpatient Substance Abuse - network = 10%; non-network = 40%.Outpatient Substance Abuse - network = $15; non-network = 40%.

Yes. Yes. No.


SAMPLE









Total employer and employee family contribution = $6,150. Employer contribution = $750/individual, $1,500/family.

This is an employer funded Health Reimbursement Account. Annual family contribution = $1,250; employee + 1 = $950.

Not applicable.

$3,050.00/year. $625.00/year. Not applicable.



Not specified. Yes. No.




Inside network = not specified, outside network = 50%, mail order = not specified.







No separate deductible.Medical plan deductible applies.

No separate deductible. No separate deductible.Deductible, outside network = $50/$100. Inside network and Mail Order: Generic = greater of 10% or $5 copay, Formulary Brand = greater of 10% or $20, Non-formulary Brand = 10% or $40. Annual out-of-pocket limit = $2,000/$4,000.


SAMPLE



Plan maximums:








Lifetime Maximums: Base plan - inside network = unlimited, outside network = $2,000,000.

Home Health Care, outside network = 120 days/year. Skilled Nursing = combined inside and outside network, 120 days/year. Chiropractic, inside and outside network = 1,300/year.


Home Health Care, outside network = 120 days/year. Skilled Nursing = combined inside and outside network, 120 days/year. Chiropractic, inside and outside network = $1,300/year. Out-of-pocket limit: employee + 1, inside network = $5,250; outside network = $9,000.


Infertility lifetime maximum = $25,000. Chiropractic = 40 visits/year. Mental Health/Substance Abuse, inpatient, outside network = 30 days/year; outpatient, outside network = 30 visits/year. Skilled Nursing = 120 days/year. Home Health Care = 120 visits/year. Substance Abuse, inside network = 3 admissions/lifetime, outside network = 1 admission/lifetime; inside and outside network combined.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Not specified.Outpatient review = Yes.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Not specified.Outpatient review = Yes.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = No.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

None. None. Age < 65 = same coverage as active.Age > 65 = separate plan.

Not applicable. Not applicable. Age 55.0, with 10 years of service.


SAMPLE






Not applicable. Not applicable. Retired < age 65: EE only: 100.0%EE+1: 100.0%EE+family: 100.0%

Not applicable. Not applicable. None.




SAMPLE






Not applicable. Not applicable. Retired > age 65: Not applicable.

Not applicable. Not applicable. Retired > age 65: Not applicable.


Deductible: employee + 1 = $2,250.

This plan has the largest percentage of employee participation.


SAMPLE






Organization G Organization G Organization GMD0030 MD0040 MDR050



Retirees.

Not specified. Not specified. Not specified.Not applicable. Not applicable. Not applicable.EPO. Consumer Driven Health Plan,

PPO.Indemnity.


Not applicable. Not applicable. No.Not specified. Not specified. Not specified.




None. Not specified. None.Contributions are: Pretax/payroll deduction.EE only: $176.00EE+child: $317.00EE+spouse: $387.00EE+family: $496.00


COBRA rates are: EE only: $565.28EE+child: $970.90EE+spouse: $1,122.06EE+family: $1,476.96




See retiree contributions.


SAMPLE









Individual = None, family = None.

Inpatient Hospital - network = $200.Inpatient Surgery - network = 0%.Physician Office Visit - network = $20.Specialist Office Visit - network = $40.Outpatient Surgery - network = 0%.Routine Physicals - network = $20.Pap Smear - network = $20.Mammogram - network = $20.Well-child Care - network = $20.Inpatient Maternity - network = $200.Diagnostics, X-rays and Lab - network = $20.Emergency Room Care - network = $250.Chiropractic - network = $40.



Inpatient Hospital = 0%.Inpatient Surgery = 0%.Physician Office Visit = 0%.Specialist Office Visit = 0%.Outpatient Surgery = 0%.Routine Physicals = 0%.Pap Smear = 0%.Mammogram = 0%.Well-child Care = 0%.Inpatient Maternity = 0%.Diagnostics, X-rays and Lab = 0%.Emergency Room Care = 0%.Chiropractic = 0%.




Inpatient Mental Health = 0%.Outpatient Mental Health = 0%.Inpatient Substance Abuse = 0%.Outpatient Substance Abuse = 0%.

No. Yes. No.


SAMPLE









Not applicable. This is an employer funded Health Reimbursement Account: employee only = $1,000, employee + spouse = $1,500, employee + child = $1,500, employee + family = $2,000. Employees completing the Health Risk Assessment receive an additional $100 towards the Health Reimbursement Account; participation in Health Coach program also earns the employee an additional $100 + $200 for successful completion.

Not applicable.

Not applicable. $1,000.00/year. Not applicable.



No. Yes. No.


Inside network = not specified, outside network = not covered, mail order = not specified.









No separate deductible.Inside network and Mail Order: Generic = $5 or 10% coinsurance whichever is greater, Brand Formulary = $20 or 10% coinsurance whichever is greater, Brand Non-formulary = $40 or 10% coinsurance whichever is greater. Out-of-Pocket maximum: individual = $1,500, family = $3,000.

No separate deductible.Medical plan deductible applies.

No separate deductible.Deductible, outside network = $50/$100. Inside network and Mail Order: Generic = greater of 10% or $5 copay, Brand = greater of 10% or $20, Non-formulary = 10% or $40. Annual out-of-pocket limit = $2,000/$4,000.


SAMPLE



Plan maximums:








Lifetime Maximums: Base plan - inside network = $2,000,000.

Mental Health/Substance Abuse, inpatient = 60 days/year, outpatient = 60 visits/year. Chiropractic = 40 visits/year. In-vitro Fertilization = $12,500/lifetime. Home Health Care = 120 days/year. Skilled Nursing = 120 days/year.


Out-of-pocket limit: employee + spouse = $9,000, employee + child = $9,000. Chiropractic = 40 visits/year. Hospice = up to 6 months. Home Health Care = 120 visits/year. In-vitro fertilization = $25,000 lifetime maximum. Mental Health/Substance Abuse, inpatient = 100 days/year, outpatient = 60 visits/year. Outside network: (60 visits/year maximum applies to outpatient Mental Health and Substance Abuse combined). Well-Child = 6 visits the first year, 3 visits the second year, and 1 thereafter. Skilled Nursing = 120 days/year.

Lifetime Maximums: Base plan = $2,000,000.

Routine Physicals = $300/year. Skilled Nursing = 100 days/year. Inpatient Mental Health = 190 days/lifetime.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Not specified.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Not specified.Large case management = Not specified.Managed mental health = Yes.Disease management = Not specified.Health risk assessment = Yes.Maternity programs = Not specified.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = No.Large case management = Yes.Managed mental health = Yes.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

Age < 65 = same coverage as active.Age > 65 = separate plan.

Age < 65 = same coverage as active.Age > 65 = medicare supplement.




Not applicable.


SAMPLE








Retired < age 65: Not applicable.

None. None. Retired < age 65: Not applicable.


Not applicable. Age 65.0, with 5 years of service. Age 65.0, with 5 years of service.


SAMPLE






Retired > age 65: Not applicable. Retired > age 65:EE only: 100.0%EE+1: 100.0%EE+family: 100.0%

Retired > age 65:EE only: 100.0%EE+1: 100.0%EE+family: 100.0%

Retired > age 65: Not applicable. None. None.


Inside and outside network deductible: employee + spouse = $2,700, employee + child = $2,700.


SAMPLE






Organization H Organization H Organization HMD0010 MDR010 MDR020

All employees, including highly compensated, minimum hours 20.0 per week.Includes Corporate, OS, IS, and GS employees.

Retirees, including highly compensated.Corporate retirees only, age 65 and above.

Retirees, including highly compensated.Corporate employees only, age less than 65.

Yes. Not specified. Not specified.Not applicable. Not applicable. Not applicable.PPO. Indemnity. PPO.


Not applicable. Not specified. Not applicable.Not specified. Not specified. Not specified.

Non-student - 26Student - 26Disabled - 64



None. Not specified. Not specified.Contributions are: Pretax/payroll deduction.EE only: See below.EE+child: See below.EE+spouse: See below.EE+family: See below.

Rates vary by divisions. Corporate employees: employee only = $70.50, employee + child = $141, employee + spouse = $141, employee + family = $222.08; COBRA = $479.40/$958.80/$958.80/$1,510.11. OS employees: $102.15/$204.30/$204.30/$321.78; COBRA = $416.78/$833.56/$833.56/$1,312.86. IS and GS employees: $80.80/$161.59/$161.59/$254.51; COBRA = $412.06/$824.11/$824.11/$1,297.98 and varies by region. Deposits earned by completing Healthy Actions, Personal Health Assessment: employee = $250, spouse or domestic partner = $300; Physical Activity Program: employee = $50. Tobacco non-users: employee = $50, spouse or domestic partner = $50.

COBRA rates are: EE only: not specified.EE+child: not specified.EE+spouse: not specified.EE+family: not specified.

See retiree contributions. See retiree contributions.


SAMPLE








Individual = $100, family = None. Inside network - per individual = $500, per family = $1,500.Outside network - per individual = $1,500, per family = $4,500.

Inpatient Hospital - network = 15%*; non-network = 35%*.Inpatient Surgery - network = 15%*; non-network = 35%*.Physician Office Visit - network = 15%*; non-network = 35%*.Specialist Office Visit - network = 15%; non-network = 35%*.Outpatient Surgery - network = 15%; non-network = 35%*.Routine Physicals - network = 0%; non-network = 0%.Pap Smear - network = 0%; non-network = 0%.Mammogram - network = 0%; non-network = 0%.Well-child Care - network = 0%; non-network = 0%.Inpatient Maternity - network = 15%*; non-network = 35%*.Diagnostics, X-rays and Lab - network = 15%*; non-network = 35%*.Emergency Room Care - network = 15%*; non-network = 15%*.Chiropractic - network = 15%*; non-network = 35%*.


Inpatient Hospital = 20%*.Inpatient Surgery = 20%*.Physician Office Visit = 20%*.Specialist Office Visit = 20%*.Outpatient Surgery = 20%*.Routine Physicals = 20%.Pap Smear = 20%.Mammogram = 20%.Well-child Care = 20%*.Inpatient Maternity = 20%*.Diagnostics, X-rays and Lab = 20%*.Emergency Room Care = 20%*.Chiropractic = 20%*.


Inpatient Hospital - network = 15%*; non-network = 35%*.Inpatient Surgery - network = 15%*; non-network = 35%*.Physician Office Visit - network = 15%*; non-network = 35%*.Specialist Office Visit - network = 10%; non-network = 35%*.Outpatient Surgery - network = 10%; non-network = 35%*.Routine Physicals - network = 0%; non-network = 0%.Pap Smear - network = 0%; non-network = 0%.Mammogram - network = 0%; non-network = 0%.Well-child Care - network = 0%; non-network = 0%.Inpatient Maternity - network = 15%*; non-network = 35%*.Diagnostics, X-rays and Lab - network = 15%*; non-network = 35%*.Emergency Room Care - network = 15%*; non-network = 15%*.Chiropractic - network = 15%*; non-network = 35%*.




Inpatient Mental Health = 20%*.Outpatient Mental Health = 50%*.Inpatient Substance Abuse = 20%*.Outpatient Substance Abuse = 50%*.




No. No. No.


SAMPLE













No. Yes. Yes.



Inside network = $10.00, outside network = not specified, mail order = $20.00.








No separate deductible.Retail, inside network: Generic = lesser of 10% or $25, Brand Formulary = lesser of 30% or $75, Brand Non-formulary = lesser of 50% or $175. Mail Order, inside network: Generic = lesser of 10% or $50, Brand Formulary = lesser of 30% or $150, Brand Non-formulary = lesser of 50% or $350. Mail Order, outside network: not covered.

No separate deductible.Outside network: Generic = greater of 50% or $10.00, Brand = greater of 50% or $40.00.

No separate deductible.Retail, inside network: Generic = lesser of 10% or $25, Brand Formulary = lesser of 30% or $75, Brand Non-formulary = lesser of 50% or $175. Mail Order, inside network: Generic = lesser of 10% or $50, Brand Formulary = lesser of 30% or $150, Brand Non-formulary = lesser of 50% or $350. Mail Order, outside network: not covered.


SAMPLE



Plan maximums:






$5,000 per person, family OPL not applicable.



Chiropractic Care = 20 visits/year. Skilled Nursing = 120 days/year. Home Health Care = 120 visits/year. Routine Physicals: age and frequency limits apply. Employee + 1, out-of-pocket limits: inside network = $4,300; outside network = $13,000.

Lifetime Maximums: Base plan = $2,000,000.

Lifetime maximums are combined, up to $1,000 of lifetime maximum may be restored each year. Well Child Care: age < 1 = 6 visits, ages 1-2 = 2 visits. Routine Physical Exam: ages 2-6 = 1/year, ages 7-64 = 1 visit/2 years, ages 65+ = 1/year. Chiropractic = 15 visits/year. Skilled Nursing = 120 days/confinement. Home Health Care = 120 visits/year. Hospice = 210 days/year.


Skilled Care = 120 days/year. Home Health Care = 120 visits/year. Chiropractic = 20 visits/year.


Hospital pre-certification = No.Hospital concurrent review = No.Second surgical opinion = No.Outpatient review = No.Large case management = No.Managed mental health = No.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Not specified.Managed mental health = Yes.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

Age < 65 = separate plan.Age > 65 = separate plan.





SAMPLE






Retired < age 65: Not applicable. Retired < age 65: Not applicable. Retired < age 65: EE only: 100.0%EE+1: 100.0%EE+family: 100.0%

Retirees hired prior to January 1, 2006 contributions vary with service: 0-4 years of service = not eligible, 5-9 = 100%, 10 = 85%, 11 = 80%, 12 = 75%, 13 = 70%, 14 = 65%, 15 = 60%, 16 = 56%, 17 = 52%, 18 = 48%, 19 = 44%, 20 = 40%, 21 = 37%, 22 = 34%, 23 = 31%, 24 = 28%, 25 = 25%, 26 = 22%, 27 = 19%, 28 = 16%, 29 = 13%, 30+ = 10%. Maxmium employer contribution = $4,900.

Retired < age 65: Not applicable. Retired < age 65: Not applicable. None.




SAMPLE






Retired > age 65: Not applicable. Retired > age 65:EE only: 100.0%EE+1: 100.0%EE+family: 100.0%

Retirees hired prior to January 1, 2006: Retiree only = 60%, retiree + spouse = 80%.

Retired > age 65: Not applicable.

Retired > age 65: Not applicable. None. Retired > age 65: Not applicable.


This is a three tiered plan where tier 1 = inside network, tier 2 = Aexcel network, and tier 3 = outside network.

Out-of-area coverage: 20% coinsurance. Deductibles: employee + 1, inside network = $1,300; outside network = $3,000. Tier 2: Specialist Office Visits and Outpatient Surgery is covered 90% if employee uses the Aexcel network.

Out-of-area plan provisions = 80% coverage after deductible. Specialist Office Visits and Outpatient Surgery is covered 90% if employee uses the Aexcel network. Other network providers = 85% coverage after deductible.


SAMPLE






Organization I Organization I Organization IMD0010 MD0020 MD0030




No. No. No.Excluded. Excluded. Excluded.PPO. PPO. PPO.


Not applicable. Not applicable. Not applicable.Not specified. Not specified. Not specified.




None. None. None.Contributions are: Pretax/payroll deduction.EE only: $143.00EE+child: $268.00EE+spouse: $268.00EE+family: $323.00

Participation in the Health Risk Assessment = $20/month credit.









SAMPLE







Inside network - per individual = None, per family = None.Outside network - per individual = $500, per family = $1,000.

Inside network - per individual = $150, per family = $300.Outside network - per individual = $500, per family = $1,000.

Inside network - per individual = $325, per family = $650.Outside network - per individual = $1,000, per family = $2,000.

Inpatient Hospital - network = 10%; non-network = 40%*.Inpatient Surgery - network = 10%; non-network = 40%*.Physician Office Visit - network = $20; non-network = 40%*.Specialist Office Visit - network = $20; non-network = 40%*.Outpatient Surgery - network = 10%; non-network = 40%*.Routine Physicals - network = 0%; non-network = Not covered.Pap Smear - network = 0%; non-network = 40%*.Mammogram - network = 0%; non-network = 40%*.Well-child Care - network = 0%; non-network = 40%*.Inpatient Maternity - network = 10%; non-network = 40%*.Diagnostics, X-rays and Lab - network = 10%; non-network = 40%*.Emergency Room Care - network = $150; non-network = $150.Chiropractic - network = $20; non-network = 40%*.


Inpatient Hospital - network = 20%*; non-network = 40%*.Inpatient Surgery - network = 20%*; non-network = 40%*.Physician Office Visit - network = $25; non-network = 40%*.Specialist Office Visit - network = $25; non-network = 40%*.Outpatient Surgery - network = 20%*; non-network = 40%*.Routine Physicals - network = 0%; non-network = Not covered.Pap Smear - network = 0%; non-network = 40%*.Mammogram - network = 0%; non-network = 40%*.Well-child Care - network = 0%; non-network = 40%*.Inpatient Maternity - network = 20%*; non-network = 40%*.Diagnostics, X-rays and Lab - network = 20%*; non-network = 40%*.Emergency Room Care - network = $150; non-network = $150*.Chiropractic - network = $25; non-network = 40%*.


Inpatient Hospital - network = 30%*; non-network = 50%*.Inpatient Surgery - network = 30%*; non-network = 50%*.Physician Office Visit - network = $30; non-network = 50%*.Specialist Office Visit - network = $30; non-network = 50%*.Outpatient Surgery - network = 30%*; non-network = 50%*.Routine Physicals - network = 0%; non-network = Not covered.Pap Smear - network = 0%; non-network = 50%*.Mammogram - network = 0%; non-network = 50%*.Well-child Care - network = 0%; non-network = 50%*.Inpatient Maternity - network = 30%*; non-network = 50%*.Diagnostics, X-rays and Lab - network = 30%*; non-network = 50%*.Emergency Room Care - network = $150; non-network = $150*.Chiropractic - network = $30; non-network = 50%*.


Inpatient Mental Health - network = 10%; non-network = 40%*.Outpatient Mental Health - network = $25; non-network = 40%*.Inpatient Substance Abuse - network = 10%; non-network = 40%*.Outpatient Substance Abuse - network = 50%; non-network = 50%*.


Inpatient Mental Health - network = 20%*; non-network = 40%*.Outpatient Mental Health - network = $25; non-network = 50%*.Inpatient Substance Abuse - network = 20%*; non-network = 40%*.Outpatient Substance Abuse - network = 50%*; non-network = 50%*.


Inpatient Mental Health - network = 30%*; non-network = 50%*.Outpatient Mental Health - network = $30; non-network = 50%*.Inpatient Substance Abuse - network = 30%*; non-network = 50%*.Outpatient Substance Abuse - network = 50%*; non-network = 50%*.


No. No. No.


SAMPLE













No. No. No.


Inside network = not specified, outside network = not specified, mail order = none.



Inside network = 30%, outside network = 30%, mail order = not specified.






No separate deductible.Retail: Generic and Brand Name selected Preventive = lesser of 10% or $10; Formulary = $10 minimum, $40 maximum; Non-Formulary = $10/$50. Mail Order: Formulary = lesser of 25% or $80; Non-Formulary = lesser of 35% or $100.




SAMPLE



Plan maximums:








Lifetime Maximums: Base plan - inside network = unlimited, outside network = $1,000,000.Substance abuse - inside network = $50,000, outside network = $50,000.

Skilled Care = 60 days/year. Chiropractic = 30 days/year. Hospice = 90 days/year. Mental Health/Substance Abuse, inpatient = 30 days/year; outpatient = 30 visits/year. Substance Abuse, inpatient = 30 days/year; outpatient = 20 visits/year. Home Health Care = 60 days/year.





Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Yes.Large case management = Yes.Managed mental health = Yes.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.



None. None. None.



SAMPLE











SAMPLE






Organization J Organization J Organization JMD0010 MD0020 MD0030




Yes. Yes. Yes.Not applicable. Not applicable. Not applicable.HMO. Consumer Driven Health Plan,

PPO.EPO.






Not specified. None. None.Contributions are: After tax and pretax/payroll deduction.EE only: $68.00EE+child: $160.00EE+spouse: $177.00EE+family: $258.00

Full-time employees can opt out and receive $50/month, part-time = $25/month. Contributions above are for participation in PHA with Biometrics and 2 wellness activities, otherwise, employee only = $93, employee + child = $160, employee + spouse = $202, employee + family = $258.


None.

Rates are 100% employer paid with completion of PHA with Biometrics and 2 wellness activities, otherwise, employee only = $25, employee + child = $25, employee + spouse or family = $50. Opt out credit = $50/month for full-time employees, $25/month for part-time.


Contributions are: After tax and pretax/payroll deduction.EE only: $68.00EE+child: $135.00EE+spouse: $140.00EE+family: $207.00

Contributions above are for participation in PHA with Biometrics and 2 wellness activities, otherwise, employee only = $93, employee + child = $160, employee + spouse = $190, family = $257. Full-time employees can opt out and receive $50/month, part-time = $25/month.



SAMPLE







None. Inside network - per individual = not specified, per family = not specified.Outside network - per individual = not specified, per family = not specified.


Inpatient Hospital - network = $250.Inpatient Surgery - network = 0%.Physician Office Visit - network = $25.Specialist Office Visit - network = $25.Outpatient Surgery - network = $25.Routine Physicals - network = 0%.Pap Smear - network = 0%.Mammogram - network = 0%.Well-child Care - network = 0%.Inpatient Maternity - network = $250.Diagnostics, X-rays and Lab - network = 0%.Emergency Room Care - network = $150.Chiropractic - network = Not covered.

Inpatient Hospital - network = 20%*; non-network = 40%*.Inpatient Surgery - network = 20%*; non-network = 40%*.Physician Office Visit - network = 20%*; non-network = 40%*.Specialist Office Visit - network = 20%*; non-network = 40%*.Outpatient Surgery - network = 20%*; non-network = 40%*.Routine Physicals - network = 0%; non-network = 40%*.Pap Smear - network = 0%; non-network = 40%*.Mammogram - network = 0%; non-network = 40%*.Well-child Care - network = 0%; non-network = 40%*.Inpatient Maternity - network = 20%*; non-network = 40%*.Diagnostics, X-rays and Lab - network = 20%*; non-network = 40%*.Emergency Room Care - network = 20%*; non-network = 20%*.Chiropractic - network = 20%*; non-network = 40%*.


Inpatient Hospital - network = 20%, $200.Inpatient Surgery - network = 20%, $200.Physician Office Visit - network = $25.Specialist Office Visit - network = $50.Outpatient Surgery - network = 20%.Routine Physicals - network = 0%.Pap Smear - network = 0%.Mammogram - network = 0%.Well-child Care - network = 0%.Inpatient Maternity - network = 20%, $200.Diagnostics, X-rays and Lab - network = 20%.Emergency Room Care - network = 20%.Chiropractic - network = $50.




Inpatient Mental Health - network = 20%, $200.Outpatient Mental Health - network = $20.Inpatient Substance Abuse - network = 20%.Outpatient Substance Abuse - network = $20.

No. Yes. No.


SAMPLE









Not applicable. Employee can contribute any amount up to their annual deductible.

Not applicable.




Yes. Yes. Yes.











No separate deductible.Retail and Mail Order = up to 100 day supply. Brand Non-formulary and Mail Order Non-formulary = $95 or 40%, whichever is greater.

No separate deductible.Generic, Preventive Drugs = $5; Mail Order, Preventive Drugs = $10. Out-of-pocket maximum = $2,500. Formulary Brand: Retail = greater of $25 or 20%, Mail Order = greater of $55 or 20%. Non-formulary Brand: Retail = greater of $45 or 40%, Mail Order = greater of $95 or 40%. Non-preventive drugs are subject to the medical plan deductible and applicable copays. Mandatory for Generic substitution and penalty for maintenance drugs at retail.

Separate deductible = $150.Preventive generics covered at $5 for 30 day supply, $10 for 90 day at company pharmacy. Annual out-of-pocket maximum = $1,500/individual, $3,000/family. Formulary Brand: Retail = greater of $25 or 20%, Mail Order = greater of $55 or 20%. Non-formulary Brand: Retail = greater of $45 or 40%, Mail Order = greater of $95 or 40%. Separate deductible: $150/individual, $300/family. Mandatory generic substitution and mandatory Mail Order for maintenance drugs or penalties apply.


SAMPLE



Plan maximums:





$1,500 per person, $3,000 per family.

Inside network = per person not specified, family OPL not specified.Outside network = per person not specified, family OPL not specified.

Per person not specified, family OPL not specified.



Annual out-of-pocket is based on salary: $50,000 and under = $2,750/person, $5,500/family, $50,001-$75,000 = $3,300/$6,600, $75,001-$100,000 = $4,400/$8,800, $100,001+ = $5,500/$11,000. Chiropractic = 25 visits/year. Skilled Nursing = 90 days/year. Hospice, inpatient = $10,000/lifetime, outpatient = 60 days/lifetime. Home Health Care = 120 days/year.


Skilled Nursing = 90 days/year. Hospice, inpatient = 60 days; outpatient = $10,000/lifetime. Home Health Care = 120 days/year. Chiropractic = 25 visits/year. Annual out-of-pocket maximum is based on salary: $30,000 and under = $1,100/person, $2,200/family; $30,001-$50,000 = $1,800, $3,600; $50,001-$75,000 = $2,250/$5,100; $75,001-$100,000 = $3,500/$7,000; $100,000+ = $4,700/$9,400.

Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Not specified.Managed mental health = Yes.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

Hospital pre-certification = Yes.Hospital concurrent review = No.Second surgical opinion = No.Outpatient review = No.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = Yes.Maternity programs = Yes.

Age < 65 = same coverage as active.Age > 65 = medicare HMO.


Age < 65 = separate plan.Age > 65 = separate plan.



Not applicable.


SAMPLE






Retired < age 65: EE only: See below.EE+1: See below.EE+family: See below.

Total monthly premium: retiree = $651, family = $1,465. Retiree pays the full cost of coverage less the employer annual subsidy. Annual subsidy varies by service: < 10 years of service = $0, 10 = $3,082/retiree, $6,164/retiree + 1, 11 = $3,205/$6,410, 12 = $3,328/$6,656, 13 = $3,452/$6,904, 14 = $3,575/$7,150, 15 = $3,698/$7,396, 16 = $3,822/$7,644, 17 = $3,945/$7,890, 18 = $4,068/$8,136, 19 = $4,191/$8,382, 20 = $4,315/$8,630, 21 = $4,438/$8,876, 22 = $4,561/$9,122, 23 = $4,684/$9,368, 24 = $4,808/$9,616, 25+ = $4,931/$9,862.


Total premium: single = $696, retiree + 1 = $1,392. Retiree pays the full cost of coverage less the employer annual subsidy. Annual subsidy varies by service: < 10 years of service = $0, 10 = $3,082/retiree, $6,164/retiree + 1, 11 = $3,205/$6,410, 12 = $3,328/$6,656, 13 = $3,452/$6,904, 14 = $3,575/$7,150, 15 = $3,698/$7,396, 16 = $3,822/$7,644, 17 = $3,945/$7,890, 18 = $4,068/$8,136, 19 = $4,191/$8,382, 20 = $4,315/$8,630, 21 = $4,438/$8,876, 22 = $4,561/$9,122, 23 = $4,684/$9,368, 24 = $4,808/$9,616, 25+ = $4,931/$9,862.


Retired < age 65: EE only: not specifiedEE+1: not specifiedEE+family: not specifiedCap has not been met for single coverage but has been for family.

Retired < age 65: EE only: not specifiedEE+1: not specifiedEE+family: not specifiedMaximum: not specified.


No. Yes. Not specified.




SAMPLE







Total monthly premium: retiree = $114, family = $228. Retiree pays the full cost of coverage less the employer annual subsidy. Annual subsidy varies by service: < 10 years of service = $0/retiree, $0/retiree + 1, 10 = $1,043/$2,086, 11 = $1,085/$2,170, 12 = $1,127/$2,254, 13 = $1,168/$2,336, 14 = $1,210/$2,420, 15 = $1,252/$2,504, 16 = $1,293/$2,586, 17 = $1,335/$2,670, 18 = $1,377/$2,754, 19 = $1,419/$2,838, 20 = $1,460/$2,920, 21 = $1,502/$3,004, 22 = $1,544/$3,088, 23 = $1,586/$3,172, 24 = $1,627/$3,254, 25+ = $1,669/$3,338.

Retired > age 65: Not applicable. Retired > age 65: Not applicable.


Retired > age 65: Not applicable. Retired > age 65: Not applicable.

Yes. Not specified. Not specified.

Deductible is based on salary: $50,000 and under = $1,250/person, $2,500/family, $50,001-$75,000 = $1,500/$3,000, $75,001-$100,000 = $2,000/$4,000, $100,001+ = $2,500/$5,000.


SAMPLE






Organization J Organization J Organization JMDR010 MDR030 MDR040

Retirees. Retirees. Retirees.

Not specified. Not specified. Not specified.Not applicable. Not applicable. Not applicable.HMO. Indemnity. HMO.


Not applicable. Not specified. Not applicable.Not specified. Not specified. Not specified.

Non-student - 25Student - 25Disabled - not specified.


Non-student - 25Student - 25Disabled - not specified.

None. None. Not specified.See retiree contributions. See retiree contributions. See retiree contributions.


SAMPLE







None. Individual = not specified, family = not specified.

None.

Inpatient Hospital - network = $150.Inpatient Surgery - network = 0%.Physician Office Visit - network = $15.Specialist Office Visit - network = $25.Outpatient Surgery - network = $50.Routine Physicals - network = $25.Pap Smear - network = $25.Mammogram - network = $25.Well-child Care - network = $25.Inpatient Maternity - network = $150.Diagnostics, X-rays and Lab - network = 0%.Emergency Room Care - network = $50.Chiropractic - network = $25.

Inpatient Hospital = 20%*.Inpatient Surgery = 20%*.Physician Office Visit = 20%*.Specialist Office Visit = 20%*.Outpatient Surgery = 20%*.Routine Physicals = 0%.Pap Smear = 0%.Mammogram = 0%.Well-child Care = 0%.Inpatient Maternity = 20%*.Diagnostics, X-rays and Lab = 20%*.Emergency Room Care = 20%*.Chiropractic = 20%*.


Inpatient Hospital - network = 0%.Inpatient Surgery - network = 0%.Physician Office Visit - network = $10.Specialist Office Visit - network = $15.Outpatient Surgery - network = 0%.Routine Physicals - network = 0%.Pap Smear - network = 0%.Mammogram - network = 0%.Well-child Care - network = 0%.Inpatient Maternity - network = 0%.Diagnostics, X-rays and Lab - network = 0%.Emergency Room Care - network = $50.Chiropractic - network = $15.


Inpatient Mental Health = 20%*.Outpatient Mental Health = 20%*.Inpatient Substance Abuse = 20%*.Outpatient Substance Abuse = 20%*.


Inpatient Mental Health - network = 0%.Outpatient Mental Health - network = $15.Inpatient Substance Abuse - network = 0%.Outpatient Substance Abuse - network = $15.

No. No. No.


SAMPLE














Formulary/Non-formulary. Other: No coverage. Formulary/Non-formulary.

Inside network = $4.00, outside network = not covered, mail order = none.









Separate deductible = $200.Deductible = $200/person/year. Specialty drugs = 33% coinsurance. Once your true out-of-pocket cost reaches $4,050, you pay the greater of $2.25 generic and $5.60 for all other drugs or 5% coinsurance.

Not specified. No separate deductible.


SAMPLE



Plan maximums:






Per person not specified, family OPL not specified.



Chiropractic manipulations covered only.

Lifetime Maximums: Base plan = unlimited.

Annual out-of-pocket is based on salary: $25,000 and under = $750/person, $1,500/family, $25,001-$50,000 = $1,250/$2,500, $50,001-$75,000 = $1,750/$3,500, $75,001-$100,000 = $2,500/$5,000, $100,001+ = $3,250/$6,500. Chiropractic = 25 visits/year. Skilled Nursing = 90 days/year. Hospice, inpatient = $10,000/lifetime; outpatient = 60 days/lifetime. Home Health Care = 120 days/year.


Skilled Nursing = 100 days/year.






Age < 65 = separate plan.Age > 65 = medicare HMO.



SAMPLE






Retired < age 65: Not applicable. Retired < age 65: Not applicable. Retired < age 65: Not applicable.

Retired < age 65: Not applicable. Retired < age 65: Not applicable. Retired < age 65: Not applicable.






SAMPLE







Monthly premium: retiree only = $139, family = $278. Retiree pays the full cost of coverage less the employer annual subsidy. Annual subsidy varies by service: less than 10 years of service: retiree = $0, retiree + 1 = $0, 10 = $418/$836, 11 = $435/$870, 12 = $452/$904, 13 = $468/$936, 14 = $485/$970, 15 = $502/$1,004, 16 = $518/$1,036, 17 = $535/$1,070, 18 = $552/$1,104, 19 = $569/$1,138, 20 = $585/$1,170, 21 = $602/$1,204, 22 = $619/$1,238, 23 = $636/$1,272, 24 = $652/$1,304, 25+ = $669/$1,338.


Monthly premium: retiree only = $124, family = $248. Retiree pays the full cost of coverage less the employer annual subsidy. Annual subsidy varies by service: < 10 years of service = $0/retiree, $0/retiree + 1, 10 = $418/$836, 11 = $435/$870, 12 = $452/$904, 13 = $468/$936, 14 = $485/$970, 15 = $502/$1,004, 16 = $518/$1,036, 17 = $535/$1,070, 18 = $552/$1,104, 19 = $569/$1,138, 20 = $585/$1,170, 21 = $602/$1,204, 22 = $619/$1,238, 23 = $636/$1,272, 24 = $652/$1,304, 25+ = $669/$1,338.


Total monthly premium: retiree = $267, family = $534. Retiree pays the full cost of coverage less the employer annual subsidy. Annual subsidy varies by service: < 10 years of service = retiree = $0, retiree + 1, 10 = $418/$836, 11 = $435/$870, 12 = $452/$904, 13 = $468/$936, 14 = $485/$970, 15 = $502/$1,004, 16 = $518/$1,036, 17 = $535/$1,070, 18 = $552/$1,104, 19 = $569/$1,138, 20 = $585/$1,170, 21 = $602/$1,204, 22 = $619/$1,238, 23 = $636/$1,272, 24 = $652/$1,304, 25+ = $669/$1,338.




No. No. No.

Hospital requires $150/day for first 5 days then pays 100%. Mental Health/Substance Abuse, inpatient = $150/day for first 5 days then pays 100%; outpatient = $25-$50 copay based on where services are received.

Prescription drug plan was discontinued in 2008.

Deductible is based on final salary: $25,000 and under = $150/person, $300/family, $25,001-$50,000 = $250/$500, $50,001-$75,000 = $350/$700, $75,001-$100,000 = $500/$1,000, $100,001+ = $650/$1,300.


SAMPLE






Organization K Organization K Organization KMD0010 MD0020 MDR010



Retirees.

Yes. Yes. Not specified.Excluded. Excluded. Not applicable.Pt. of service. EPO. HMO.


Not applicable. Not applicable. Not applicable.85.00%. 5.00%. Not specified.



Not specified.

None. None. Not specified.Contributions are: Pretax/payroll deduction.EE only: See below.EE+child: See below.EE+spouse: See below.EE+family: See below.


Contributions based on salary: $0-$39,999: employee only = $82.33, employee + child = $151.66, employee + spouse = $164.66, employee + family = $260; $40,000-$59,999: $82.33/$160.33/$177.66/$281.66; $60,000-$79,999: $86.66/$173.33/$190.66/$303.33; $80,000-$99,999: $91/$186.33/$199.33/$325; $100,000-$124,999: $104/$208/$221/$346.66; $125,000+: $112.66/$229.66/$242.66/$368.33.


Contributions are: Pretax/payroll deduction.EE only: See below.EE+child: See below.EE+spouse: See below.EE+family: See below.


Contributions vary by salary: $0-$39,999: employee only = $69.33, employee + children = $117, employee + spouse = $134.33, employee + family = $182; $40,000-$59,999: $69.33/$125.66/$143/$190.66; $60,000-$79,999: $73.66/$134.33/$151.66/$216.66; $80,000-$99,999: $78/$143/$160.33.$234; $100,000-$124,999: $91/$147.33/$173.33/$238.33; $125,000+: $99.66/$156/$182/$247.


See retiree contributions.


SAMPLE







Inside network - per individual = None, per family = None.Outside network - per individual = 1.00%, per family = 1.00%.


None.

Inpatient Hospital - network = 0%; non-network = 30%*.Inpatient Surgery - network = 0%; non-network = 30%*.Physician Office Visit - network = $20; non-network = 30%*.Specialist Office Visit - network = $30; non-network = 30%*.Outpatient Surgery - network = 0%; non-network = 30%*.Routine Physicals - network = 0%; non-network = 30%.Pap Smear - network = 0%; non-network = 30%.Mammogram - network = 0%; non-network = 30%*.Well-child Care - network = 0%; non-network = 30%.Inpatient Maternity - network = 0%; non-network = 30%*.Diagnostics, X-rays and Lab - network = 0%; non-network = 30%*.Emergency Room Care - network = $100; non-network = $100.Chiropractic - network = $30; non-network = 30%*.


Inpatient Hospital - network = 10%, $100.Inpatient Surgery - network = 10%.Physician Office Visit - network = $20.Specialist Office Visit - network = $30.Outpatient Surgery - network = 10%.Routine Physicals - network = 0%.Pap Smear - network = 0%.Mammogram - network = 0%.Well-child Care - network = 0%.Inpatient Maternity - network = 10%.Diagnostics, X-rays and Lab - network = 10%.Emergency Room Care - network = $125.Chiropractic - network = $30.

Inpatient Hospital - network = $250.Inpatient Surgery - network = 0%.Physician Office Visit - network = $20.Specialist Office Visit - network = $25.Outpatient Surgery - network = 0%.Routine Physicals - network = $15.Pap Smear - network = $15.Mammogram - network = $15.Well-child Care - network = $15.Inpatient Maternity - network = $250.Diagnostics, X-rays and Lab - network = 0%.Emergency Room Care - network = $35.Chiropractic - network = Not covered.

Inpatient Mental Health - network = 0%; non-network = 50%*.Outpatient Mental Health - network = $20; non-network = 30%*.Inpatient Substance Abuse - network = 0%; non-network = 50%*.Outpatient Substance Abuse - network = $20; non-network = 30%*.


Inpatient Mental Health - network = 10%, $100.Outpatient Mental Health - network = $30.Inpatient Substance Abuse - network = 10%, $100.Outpatient Substance Abuse - network = $30.


No. No. No.


SAMPLE













Yes. Yes. Not specified.











No separate deductible. No separate deductible. No separate deductible.Copays apply through the first $2,700 of drug cost, generics available at $10 copay for next $4,350 of drug cost; 5% coinsurance after.


SAMPLE



Plan maximums:





Inside network = not applicable, family OPL not applicable.Outside network = 9.00% per person, 18.00% of salary for family.




Out-of-pocket maximum outside network: 9% of pay per covered person up to $9,000/person, $18,000/family. Mental Health/Substance Abuse, inpatient = 60 days/year. Mental Health, outpatient, outside network = 20 visits/year. Hospice = 6 months.



Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = No.Outpatient review = No.Large case management = Yes.Managed mental health = Yes.Disease management = Yes.Health risk assessment = No.Maternity programs = Yes.

Hospital pre-certification = Not specified.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Not specified.Managed mental health = Not specified.Disease management = Yes.Health risk assessment = Not specified.Maternity programs = Yes.

Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Not specified.Managed mental health = Not specified.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.



Age < 65 = separate plan.Age > 65 = medicare HMO.

After 5 years of service. After 5 years of service. Not applicable.


SAMPLE






Retired < age 65: EE only: $888.00, 100.0%EE+1: $1,776.00, 100.0%EE+family: not specified

Full premiums: retiree only = $888, retiree + 1 = $1,776. Employees hired after January 1, 2002 pay full premium.

Retired < age 65: EE only: $718.00, 100.0%EE+1: $1,436.00, 100.0%EE+family: not specified

Employees hired after January 1, 2002 pay the full premium.


Retired < age 65: EE only: $0.00, 0.0%EE+1: $0.00, 0.0%EE+family: not specifiedAnnual maximum is per person.

Retired < age 65: EE only: $0.00, 0.0%EE+1: $0.00, 0.0%EE+family: not specifiedMaximum: not specified.



Not applicable. Not applicable. Age 65.0.


SAMPLE






Retired > age 65: Not applicable. Retired > age 65: Not applicable. Retired > age 65:EE only: $225.00, 100.0%EE+1: $450.00, 100.0%EE+family: not specified

Retired > age 65: Not applicable. Retired > age 65: Not applicable. Retired > age 65:EE only: $0.00, 0.0%EE+1: $0.00, 0.0%EE+family: not specifiedMaximum: not specified.


Plan deductible outside network: 1% of pay per covered person up to $1,000/person, $3,000/family.


SAMPLE






Organization K Organization L Organization LMDR020 MD0010 MD0020



Not specified. Yes. Yes.Not applicable. Not applicable. Not applicable.Pt. of service. PPO. HMO.


Not applicable. Not applicable. Not applicable.Not specified. 17.00%. 53.00%.



None. None. None.See retiree contributions. Contributions are: Pretax/payroll

deduction.EE only: $324.00EE+child: $586.00EE+spouse: $652.00EE+family: $976.00





SAMPLE







Inside network - per individual = None, per family = None.Outside network - per individual = $500, per family = None.


None.

Inpatient Hospital - network = $750; non-network = 30%*.Inpatient Surgery - network = 0%; non-network = 30%*.Physician Office Visit - network = $25; non-network = 30%*.Specialist Office Visit - network = $30; non-network = 30%*.Outpatient Surgery - network = $100; non-network = 30%*.Routine Physicals - network = $25; non-network = 30%*.Pap Smear - network = $25; non-network = 30%*.Mammogram - network = $25; non-network = 30%*.Well-child Care - network = $25; non-network = 30%*.Inpatient Maternity - network = $750; non-network = 30%*.Diagnostics, X-rays and Lab - network = 0%; non-network = 30%*.Emergency Room Care - network = $50; non-network = 30%*.Chiropractic - network = Not covered; non-network = Not covered.


Inpatient Hospital - network = 20%*; non-network = 50%*.Inpatient Surgery - network = 20%*; non-network = 50%*.Physician Office Visit - network = $25; non-network = 50%*.Specialist Office Visit - network = $25; non-network = 50%*.Outpatient Surgery - network = 20%*; non-network = 50%*.Routine Physicals - network = $25; non-network = Not covered.Pap Smear - network = 20%; non-network = Not covered.Mammogram - network = 20%; non-network = Not covered.Well-child Care - network = $25; non-network = 50%.Inpatient Maternity - network = 20%*; non-network = 50%*.Diagnostics, X-rays and Lab - network = 20%*; non-network = 50%*.Emergency Room Care - network = 20%*; non-network = 20%*.Chiropractic - network = $25; non-network = 50%*.


Inpatient Hospital - network = 0%.Inpatient Surgery - network = 0%.Physician Office Visit - network = $15.Specialist Office Visit - network = $30.Outpatient Surgery - network = 0%.Routine Physicals - network = $15.Pap Smear - network = $15.Mammogram - network = $15.Well-child Care - network = $15.Inpatient Maternity - network = 0%.Diagnostics, X-rays and Lab - network = 0%.Emergency Room Care - network = $50.Chiropractic - network = $30.






No. No. No.


SAMPLE













Not specified. Yes. Yes.

Formulary/Non-formulary. Traditional. Traditional.


Inside network = $15.00, outside network = 50%, $15.00, mail order = $30.00.







No separate deductible.After $7,050 of drug cost, 5% coinsurance.

No separate deductible. No separate deductible.


SAMPLE



Plan maximums:





Inside network = not applicable, family OPL not applicable.Outside network = not applicable, family OPL not applicable.

Inside network = $2,500 per person, family OPL not applicable.Outside network = $8,500 per person, family OPL not applicable.




Skilled Nursing = 120 days/year. Chiropractic = 24 visits/year. Home Health Care = 120 visits/year. Preventive Care, age 7+ = $250/year. Outside network coverage up to age 7 = $20 copay/visit. Mental Health/Substance Abuse, inpatient = 60 days/year/2 years. Substance Abuse, outpatient = 50 visits/year. Mental Health, maximum benefit = $25/visit.


Skilled Nursing = 100 days/year. Chiropractic = 24 visits/year. Mental Health, inpatient = 30 days/year; outpatient = 20 visits/year. Substance Abuse, inpatient = 30 days/year; outpatient = 50 vists/year. Mental Health/Substance Abuse outpatient visits in excess of 12 must be pre-certified.

Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Not specified.Outpatient review = Not specified.Large case management = Not specified.Managed mental health = Not specified.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.

Hospital pre-certification = Yes.Hospital concurrent review = Yes.Second surgical opinion = Yes.Outpatient review = Yes.Large case management = Yes.Managed mental health = Not specified.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.








SAMPLE






Retired < age 65: Not applicable. Retired < age 65: EE only: See below.EE+1: See below.EE+family: See below.

Company contributes 3.8% for each year of service, with a maximum of 95% of the average cost of HMO plan, no matter which coverage is selected.



Retired < age 65: Not applicable. Retired < age 65: EE only: not specifiedEE+1: not specifiedEE+family: not specifiedMaximum: not specified.



Not specified. Age 65.0, with 10 years of service.



SAMPLE






Retired > age 65:EE only: $358.00, 100.0%EE+1: $716.00, 100.0%EE+family: not specified





Retired > age 65:EE only: $0.00, 0.0%EE+1: $0.00, 0.0%EE+family: not specifiedMaximum: not specified.




Skilled Nursing/Home Health, inside network copay = $25/day.

This is a two tiered HMO plan.

Tier 2, office copayment = $30. Copayments vary with which medical group selected lowest = $15, highest = $30.


SAMPLE






Organization LMD0030


Yes.Not applicable.HMO.

Active.No.

Not applicable.21.00%.


None.Contributions are: Pretax/payroll deduction.EE only: $102.00EE+child: $185.00EE+spouse: $205.00EE+family: $308.00



SAMPLE







None.

Inpatient Hospital - network = 0%.Inpatient Surgery - network = 0%.Physician Office Visit - network = $15.Specialist Office Visit - network = $15.Outpatient Surgery - network = $15.Routine Physicals - network = $15.Pap Smear - network = $15.Mammogram - network = $15.Well-child Care - network = 0%.Inpatient Maternity - network = 0%.Diagnostics, X-rays and Lab - network = 0%.Emergency Room Care - network = $35.Chiropractic - network = Not covered.


No.


SAMPLE









Not applicable.

Not applicable.

Not applicable.

Not applicable.

Yes.

Formulary/Non-formulary.



Not covered.

No separate deductible.Prescriptions = 100 day supply.


SAMPLE



Plan maximums:







Well Child to 23 months. Home Health Care = 100 visits/year. Skilled Nursing = 100 days/year. Mental Health, inpatient = 45 days/year; outpatient = 20 visits/year. Substance Abuse, inpatient = detoxification only; transitional residential recovery = 60 days/year, maximum of 120 days/5 year period.

Hospital pre-certification = Yes.Hospital concurrent review = Not specified.Second surgical opinion = Yes.Outpatient review = Not specified.Large case management = Not specified.Managed mental health = Not specified.Disease management = Not specified.Health risk assessment = Not specified.Maternity programs = Not specified.




SAMPLE







Company contributes 3.8% for each year of service, with a maximum of 95% of the average cost of the HMO plan, no matter which coverage is selected.


Not specified.



SAMPLE







Company contributes 3.8% for each year of service, with a maximum of 95% of the average cost of the HMO plan, no matter which coverage is selected.


Not specified.


SAMPLE

DENTALDENTALOrganization Name: Organization A Organization B Organization B

Plan Number: DE0010 DE0010 DE0020Employees covered: All employees, including highly




Part-time are eligible: Yes. Yes. Yes.Collectively bargained eligible: Not applicable. Excluded. Excluded.Plan Status: Active. Active. Active.Percent of all employees participating:


Maximum age dependents receive coverage:




Retirement coverage: Same coverage as active.

Retirees pay the full premium.

No coverage. No coverage.

NRA eligibility for coverage: Not specified. Not applicable. Not applicable.Employee monthly contributions: None.


Contributions are: Pre-tax/payroll deduction.

EE only: $4.90EE+child: $9.84EE+spouse: $9.84EE+family: $14.73





Deductibles: Preventive: none.Basic/Major: per person = $50, per family = $150.Orthodontia: per person = $50, per family = $150.

Deductibles are: basic/major and orthodontia combined.

Preventive: none.Basic/Major: per person = $25, per family = $50.Orthodontia: Not applicable.

Deductibles are: separate.

Preventive: none.Basic/Major: per person = $50, per family = $100.Orthodontia: per person = $50, per family = $100.


© Mercer LLC DE - 131 Summary of Plan Features

SAMPLE

DENTALDENTALOrganization Name: Organization A Organization B Organization B

Plan Number: DE0010 DE0010 DE0020Employee copayment: Preventive = 0%, basic = 20%,

major = 50%, orthodontia = 50%.Preventive = 0%, basic = 20%, major = 50%, orthodontia = Not applicable.

Preventive = 0%, basic = 20%, major = 50%, orthodontia = 50%.

Preventive coverage includes: Oral exam, x-rays, sealants, cleaning, polishing.

Oral exam, x-rays, cleaning, polishing.


Basic coverage includes: Fillings, extractions, periodontics, endodontics, oral surgery.

Sealants, fillings, extractions, periodontics, endodontics, oral surgery.


Major coverage includes: Dentures, bridges, crowns. Dentures, bridges, crowns. Dentures, bridges, crowns.Orthodontia eligibility (children and/or adults):

For children only. Not applicable. For children and adults.

Maximums: Plan annual: $2,000

Orthodontia: $1,000 lifetime.

Plan annual: $2,000

Orthodontia: Not applicable

Plan annual: $2,000


Reimbursement methodology: % Reimbursement.

Outside network = Reasonable and Customary.

% Reimbursement.


% Reimbursement.


TMJ: Not covered. Covered under medical plan. Covered under medical plan.Comments: This plan is network with non-

network option.

This is a Silent PPO plan.

This plan is network with non-network option.

This is a Silent PPO Plan. This plan has the largest percentage of participation.


This is a Silent PPO Plan.


SAMPLE

DENTALDENTALOrganization Name:


Part-time are eligible:Collectively bargained eligible:Plan Status:Percent of all employees participating:Maximum age dependents receive coverage:


NRA eligibility for coverage:Employee monthly contributions:

Deductibles:

Organization B Organization B Organization CDE0030 DE0040 DE0010




Yes. Yes. Yes.Excluded. Excluded. Excluded.Active. Active. Active.Not specified. Not specified. 64.00%.




No coverage. No coverage. No coverage.

Not applicable. Not applicable. Not applicable.Contributions are: Pre-tax/payroll deduction.









Preventive: none.Basic/Major: Not applicable.Orthodontia: Not applicable.

Preventive: none.Basic/Major: none.Orthodontia: none.

Preventive: none.Basic/Major: per person = $25, per family = $75.Orthodontia: none.



SAMPLE


Plan Number:Employee copayment:

Preventive coverage includes:

Basic coverage includes:

Major coverage includes:Orthodontia eligibility (children and/or adults):Maximums:

Reimbursement methodology:

TMJ:Comments:

Organization B Organization B Organization CDE0030 DE0040 DE0010

Preventive = 0%, basic = 100%, major = 100%, orthodontia = Not applicable.

Benefits are scheduled. Preventive = 0%, basic = 25%, major = 40%, orthodontia = 50%.


Oral exam, x-rays, sealants, cleaning, polishing.


Not applicable. Fillings, extractions, periodontics, endodontics, oral surgery.

Fillings, extractions, periodontics, endodontics, oral surgery.

Not applicable. Dentures, bridges, crowns. Dentures, bridges, crowns.Not applicable. For children and adults. For children only.

Plan annual: $500


Plan annual: No limit.

Orthodontia: unlimited lifetime.

Plan annual: $1,000


% Reimbursement.


Scheduled. % Reimbursement.


Covered under medical plan. Covered under medical plan. Covered under dental plan.This plan is network with non-network option.


This plan is network only. This plan is network with non-network option.


Sealents covered one time every three years for dependents up to age 16.


SAMPLE






Deductibles:

Organization C Organization D Organization EDE0020 DE0010 DE0010




Yes. Not specified. Yes.Excluded. Not applicable. Not applicable.Active. Active. Active.36.00%. 64.70%. 94.00%.











None.







Deductible, outside network, Basic/Major = $75/$225.


SAMPLE







TMJ:Comments:

Organization C Organization D Organization EDE0020 DE0010 DE0010



Outside network: Preventive = 0%, Basic = 20%, Major = 50%, Orthodontia = 50%.


Coinsurance, outside network: Preventive = 20%, Basic = 50%, Major = 50%, Orthodontia = 50%.







Dentures, bridges, crowns. Dentures, bridges, crowns. Dentures, bridges, crowns.Not applicable. For children and adults. For children and adults.

Plan annual: $1,000


Plan annual: $2,000


Plan annual: $2,000


Inside and outside network combined.

% Reimbursement.


R&C. R&C.

Covered under dental plan. Not covered. Covered under medical plan.This plan is network with non-network option.


Sealents covered one time every three years for dependents up to age 16.


Plan offered in one state.



SAMPLE






Deductibles:

Organization E Organization F Organization FDE0020 DE0020 DE0030




Yes. Yes. Yes.Excluded. Excluded. Excluded.Active. Active. Active.2.00%. 41.00%. 58.00%.



Coverage terminates at the end of the month in which maximum age is reached.


Coverage terminates at the end of the month in which maximum age is reached.


Not applicable. Not applicable. Not applicable.None.













Outside network = $100/$300.


SAMPLE







TMJ:Comments:

Organization E Organization F Organization FDE0020 DE0020 DE0030

Preventive = scheduled, basic = scheduled, major = scheduled, orthodontia = 50%.

There will be a $10 copayment/visit for all non-diagnostic/preventive visits.



Outside network: Preventive = 10%, Basic = 40%, Major = 50%, Orthodontia = 50%.







Dentures, bridges, crowns. Dentures, bridges, crowns. Dentures, bridges, crowns.For children and adults. For children and adults. For children and adults.



Annual and lifetime maximums vary by plan. Maximums: Crown = $180, Bridge = $180, Dentures = $277, Office Visit copay may also apply. Orthodontia: children to age 19 = $1,050, adults = $2,150, copay amount/lifetime.

Plan annual: $2,500


Plan annual: $1,500


Outside network: Orthodontia = $750/lifetime.

Scheduled. % Reimbursement. % Reimbursement.


Covered under medical plan. Not covered. Not covered.This plan is network only. This plan is network only. This plan is network with non-

network option.


SAMPLE






Deductibles:

Organization G Organization G Organization GDE0010 DE0020 DE0030




Not specified. Not specified. Not specified.Not applicable. Not applicable. Excluded.Active. Active. Active.Not specified. Not specified. Not specified.
















Deductible, tier 2 = $100/$200, tier 3 = $150/$250.

Preventive: none.Basic/Major: per person = $50, per family = $100.Orthodontia: per person = $50, per family = $100.


Tier 2 = $100/$200, Tier 3 = $150/$250.

Preventive: none.Basic/Major: Not applicable.Orthodontia: Not applicable.


SAMPLE







TMJ:Comments:

Organization G Organization G Organization GDE0010 DE0020 DE0030


Coinsurance, tier 2: Preventive = 0%, Basic = 25%, Major = 50%, tier 3 = 0%/30%/50%.


Coinsurance, tier 2: Preventive = 0%, Basic = 25%, Major and Orthodontia = 50%; tier 3: 0%/30%/50%.





Fillings, extractions, periodontics, endodontics, oral surgery, crowns.


Not applicable.

Dentures, bridges. Dentures, bridges. Not applicable.Not applicable. For children and adults. Not applicable.

Plan annual: $1,500


Tier 2 = $1,250, tier 3 = $1,000.

Plan annual: $2,000


Annual maximum, tier 2 = $1,500, tier 3 = $1,000. Orthodontia, outside network = $2,000.

Plan annual: $500


% Reimbursement.


% Reimbursement.


% Reimbursement.


Covered under dental plan. Covered under dental plan. Covered under medical plan.This plan is network with non-network option.

This is a 3-tier plan, where tier 1 = inside network, tier 2 = reduced network, and tier 3 = outside network.

Non-surgical treatment of TMJ, tier 1 = $500/lifetime maximum, tier 2 = $300, tier 3 = $250.


This is a 3-tier plan, where tier 1 = inside network, tier 2 = reduced network, and tier 3 = outside network. This plan has the largest percentage of employee participation.

Non-surgical treatment of TMJ, tier 1 = $500/lifetime maximum, tier 2 = $300, tier 3 = $250.




SAMPLE






Deductibles:

Organization G Organization H Organization HDE0040 DE0010 DE0020


Salaried employees, including highly compensated, minimum hours 20.0 per week.Includes Corporate, OS, IS, and GS employees.


Not specified. Yes. Yes.Not applicable. Excluded. Excluded.Active. Active. Active.Not specified. Not specified. Not specified.


Non-student - 26Student - 26Disabled - 64.







EE only: See below.EE+child: See below.EE+spouse: See below.EE+family: See below.

Rates vary by division: Corporate employees and OS employees: employee only = $6.76, employee + 1 = $13.56, employee + family = $21.36. IS and GS employees = $15.93/$31.86/$50.19.






Preventive: none.Basic/Major: per person = $50, for each family member.Orthodontia: none.




SAMPLE







TMJ:Comments:

Organization G Organization H Organization HDE0040 DE0010 DE0020

Preventive = scheduled, basic = scheduled, major = scheduled, orthodontia = scheduled.

Copayment required for sealants, some oral surgery, endodontics, dentures, bridges, crowns, and orthodontics.









Dentures, bridges. Dentures, bridges, crowns. Dentures, bridges, crowns.For children and adults. For children and adults. For children and adults.



Plan annual: $1,200


Plan annual: $1,500


Scheduled. R&C. R&C.

Covered under medical plan. Covered under dental plan. Covered under dental plan.This plan is network only. This plan is non-network only.


TMJ covered at 50% with no deductible, $300 lifetime maximum/person. Major includes inlays and onlays. .

This plan is non-network only.

TMJ covered at 80% with no deductible, $500 lifetime maximum/person. Major includes inlays and onlays.


SAMPLE






Deductibles:

Organization I Organization J Organization JDE0010 DE0010 DE0020




No. Yes. Yes.Excluded. Not applicable. Not applicable.Active. Active. Active.Not specified. 36.00%. 64.00%.








None.





Preventive: none.Basic/Major: per person = $50, per family = $150.Orthodontia: per person = not specified, per family = not specified.


Orthodontia lifetime maximum = $50/person.






SAMPLE







TMJ:Comments:

Organization I Organization J Organization JDE0010 DE0010 DE0020










Dentures, bridges, crowns. Dentures, bridges, crowns. Dentures, bridges, crowns.For children only. Not applicable. For children only.

Plan annual: $1,500


Plan annual: $1,000


Plan annual: $1,500


% Reimbursement.


R&C. R&C.

Not covered. Covered under dental plan. Covered under dental plan.This plan is network with non-network option.



Dental is a 2 year election. This is a Silent PPO plan.



TMJ = Lifetime maximum = $1,000.


SAMPLE






Deductibles:

Organization K Organization K Organization LDE0010 DE0020 DE0010




Yes. Yes. Yes.Excluded. Excluded. Not applicable.Active. Active. Active.15.00%. 75.00%. 81.00%.
















Preventive: none.Basic/Major: per person = $50, for each family member.Orthodontia: per person = $50, for each family member.



SAMPLE







TMJ:Comments:

Organization K Organization K Organization LDE0010 DE0020 DE0010










Dentures, bridges, crowns. Dentures, bridges, crowns. Dentures, bridges, crowns.For children only. For children only. For children only.

Plan annual: $2,000


Plan annual: $1,000


Plan annual: $1,250


% Reimbursement.


% Reimbursement.


% Reimbursement.


Covered under medical plan. Covered under medical plan. Covered under medical plan.This plan is network with non-network option.







SAMPLE






Deductibles:

Organization LDE0020


Yes.Not applicable.Active.13.00%.


No coverage.

Not applicable.Contributions are: Pre-tax/payroll deduction.





SAMPLE







TMJ:Comments:

Organization LDE0020

Preventive = 0%, basic = scheduled, major = scheduled, orthodontia = scheduled.

Oral exam, x-rays, cleaning, polishing.Sealants, fillings, extractions, periodontics, endodontics, oral surgery.Dentures, bridges, crowns.For children and adults.



Scheduled.

Covered under medical plan.This plan is network only.


SAMPLE

VISIONVISIONOrganization Name: Organization A Organization B Organization C

Plan Number: MD0010 MD0010 MD0010Employees covered: All employees, including highly




Part-time are eligible: Yes. Yes. Yes.Collectively bargained eligible: Not applicable. Excluded. Not applicable.Employee monthly contributions: None. Included with medical premiums. Contributions are: pretax/payroll

deduction.


COBRA rates are: EE only: $10.52EE+child: $14.81EE+spouse: $14.81family: $26.57

Employee pays 100% of the premium.

Benefit coverage exams: 1 every year, $60 maximum, 100.0% reimbursement.

1 every year, $250 maximum, 100.0% reimbursement.

1 every year, $10 copayment, 100.0% reimbursement.

Benefit coverage frames: 1 every year, $82 maximum, 100.0% reimbursement.

1 every year, $250 maximum, 100.0% reimbursement.

1 every 2 years, $20 copayment, $140 maximum, 100.0% reimbursement.

Benefit coverage lenses: Single vision: 1 every year, $78 maximum, 100.0% reimbursement.Bifocals: 1 every year, $160 maximum, 100.0% reimbursement.Trifocals: 1 every year, $190 maximum, 100.0% reimbursement.Lenticular: 1 every year, $215 maximum, 100.0% reimbursement.

Single vision: 1 every year, $250 maximum, 100.0% reimbursement.Bifocals: 1 every year, $250 maximum, 100.0% reimbursement.Trifocals: 1 every year, $250 maximum, 100.0% reimbursement.Lenticular: 1 every year, $250 maximum, 100.0% reimbursement.

Single vision: 1 every year, $20 copayment, 100.0% reimbursement.Bifocals: 1 every year, $20 copayment, 100.0% reimbursement.Trifocals: 1 every year, $20 copayment, 100.0% reimbursement.

Benefit coverage contacts: Necessary: 1 every year, $210 maximum, 100.0% reimbursement.Elective: 1 every year, $160 maximum, 100.0% reimbursement.

Necessary: 1 every year, $250 maximum, 100.0% reimbursement.Elective: 1 every year, $250 maximum, 100.0% reimbursement.

Necessary: 1 every year, $20 copayment, $140 maximum, 100.0% reimbursement.Elective: 1 every year, $20 copayment, $140 maximum, 100.0% reimbursement.

Benefit coverage laser correction: Not covered. Not covered. Not specified.

Coverage type: Structured plan.

Plan is network with non-network option.

Structured plan.

Plan is non-network only.

Structured plan.

Plan type is not specified.

© Mercer LLC VI - 149 Summary of Plan Features

SAMPLE

VISIONVISIONOrganization Name: Organization A Organization B Organization C

Plan Number: MD0010 MD0010 MD0010Comments: $250 is combined for all services. Laser is discounted inside

network. Outside network maximums: Exam = $46. Frames = $45. Lenses: single = $47, bifocal = $66, trifocal = $85. Contacts = $140. Copays apply.


SAMPLE

VISIONVISIONOrganization Name:


Part-time are eligible:Collectively bargained eligible:Employee monthly contributions:

Benefit coverage exams:

Benefit coverage frames:

Benefit coverage lenses:

Benefit coverage contacts:

Benefit coverage laser correction:

Coverage type:

Organization D Organization E Organization EMD0040 MD0010 MD0020




Not specified. Yes. Yes.Not applicable. Excluded. Excluded.Contributions are: pretax/payroll deduction.



Included with medical, but can be a free standing plan. Rates coded are for the free standing plan.

Included with medical premiums. Included with medical premiums.




1 every 2 years, $105 maximum, 100.0% reimbursement.



Single vision: 1 every year, 100.0% reimbursement.Bifocals: 1 every year, 100.0% reimbursement.Trifocals: 1 every year, 100.0% reimbursement.Lenticular: 1 every year, 100.0% reimbursement.

Single vision: 2 every 2 years, $50 maximum, 100.0% reimbursement.Bifocals: 2 every 2 years, $80 maximum, 100.0% reimbursement.Trifocals: 2 every 2 years, $95 maximum, 100.0% reimbursement.Lenticular: 2 every 2 years, $155 maximum, 100.0% reimbursement.


Necessary: 1 every year, 100.0% reimbursement.Elective: 1 every year, 100.0% reimbursement.

Necessary: 2 every 2 years, $120 maximum, 100.0% reimbursement.Elective: 2 every 2 years, $120 maximum, 100.0% reimbursement.

Necessary: 2 every 2 years, $105 maximum, 100.0% reimbursement.Elective: Not covered.

Not covered. Not covered. Not covered.

Structured plan.

Plan is network only.

Structured plan.


Structured plan.



SAMPLE


Plan Number:Comments:

Organization D Organization E Organization EMD0040 MD0010 MD0020

Maximums outside network: Exam = $50; Lenses, Frames, and Contacts covered up to maximum as inside network.


SAMPLE









Coverage type:

Organization E Organization E Organization FMD0030 MD0040 MD0010




Yes. Yes. Yes.Excluded. Excluded. Excluded.Included with medical premiums. Included with medical premiums. Contributions are: pretax/payroll

deduction.


COBRA rates are: EE only: not specified.EE+child: not specified.EE+spouse: not specified.family: not specified.

Employee pays 100% of the premium.



1 every year, 100.0% reimbursement.







Necessary: 2 every 2 years, 100.0% reimbursement.Elective: 2 every 2 years, $120 maximum, 100.0% reimbursement.


Necessary: 1 every year, 100.0% reimbursement.Elective: 1 every year, $130 maximum, 100.0% reimbursement.

Not covered. Not covered. Not covered.

Structured plan.


Structured plan.


Structured plan.



SAMPLE



Organization E Organization E Organization FMD0030 MD0040 MD0010

Outside network maximums = Exam = $50; Materials up to same maximum as inside network.

Outside network maximums: Exam = $40. Frames = $45. Lenses: single = $30, bifocal = $50, trifocal = $65, lenticular = $125. Contacts: elective = $130, medically necessary = $210.


SAMPLE









Coverage type:

Organization G Organization G Organization HMD0010 MD0030 MD0010



All employees, including highly compensated, minimum hours 20.0 per week.Includes Corporate, OS, IS, and GS employees.

Not specified. Not specified. Yes.Not applicable. Not applicable. Not applicable.Contributions are: pretax/payroll deduction.



Included with medical premiums. Contributions are: pretax/payroll deduction.

EE only: not specifiedEE+child: not specifiedEE+spouse: not specifiedEE+family: not specified


Rates vary by division. Corporate employees and LMOS employees: employee only = $.87, employee + 1 = $1.78, employee + family = $2.77. IS and GS employees: pay 20% of the cost..





Not covered. 1 every 2 years, 100.0% reimbursement.

Single vision: 1 every year, $10 copayment, 100.0% reimbursement.Bifocals: 1 every year, $10 copayment, 100.0% reimbursement.Trifocals: 1 every year, $10 copayment, 100.0% reimbursement.Lenticular: 1 every year, $10 copayment, 100.0% reimbursement.

Not covered. Single vision: 1 every year, 100.0% reimbursement.Bifocals: 1 every year, 100.0% reimbursement.Trifocals: 1 every year, 100.0% reimbursement.Lenticular: 1 every year, 100.0% reimbursement.

Necessary: 1 every year, 100.0% reimbursement.Elective: 1 every year, $105 maximum, 100.0% reimbursement.

Not covered. Necessary: 1 every year, 100.0% reimbursement.Elective: 1 every year, $105 maximum, 100.0% reimbursement.

Not specified. Not covered. Not specified.

Structured plan.


Structured plan.


Structured plan.



SAMPLE



Organization G Organization G Organization HMD0010 MD0030 MD0010

Laser is discounted 10-20% inside network. Frames and Lenses, inside network = copay combined. Frames = over $120, a 20% discount. Outside network maximums: Exam = $40. Lenses: single = $40, bifocal = $60, trifocal = $80. Frames = $45. Contacts: elective = $105.

Laser Surgery = 15% off retail or 5% off promotional price. Outside network: Exam = $25, Lenses: single = $40, bifocal = $80, trifocal = $80, Lenticular = $125. Frames = $45, Contacts: Elective = $85, Necessary = $170.


SAMPLE









Coverage type:

Organization I Organization J Organization JMD0010 MD0020 MD0030




No. Yes. Yes.Excluded. Not applicable. Not applicable.Contributions are: pretax/payroll deduction.



Contributions are: pretax/payroll deduction.



None.

Vision is a two year election.






Not specified.



Not specified.

Necessary: 1 every year, $25 copayment, 100.0% reimbursement.Elective: 1 every year, $130 maximum, 100.0% reimbursement.

Necessary: 1 every year, $20 copayment, 100.0% reimbursement.Elective: 1 every year, $120 maximum, 100.0% reimbursement.

Not specified.

Not covered. Not specified. Not covered.

Structured plan.


Structured plan.


Structured plan.



SAMPLE



Organization I Organization J Organization JMD0010 MD0020 MD0030

Outside network maximums: Exam = $45. Frames = $47. Lenses: single = $45, bifocal = $65, trifocal = $85, lenticular = $125. Contacts: medically necessary = $210, elective = $115.

Laser is discounted inside network. Outside network: $10 copay applies to all services except contacts. Copay for medically necessary contacts = $20. Outside network maximums: Exam = $35. Frames = $35. Lenses: single = $25, bifocal = $40, trifocal = $55, lenticular = $60. Contacts: elective = $50, medically necessary = $150.

Frames and Lenses = 20% discount, Contacts = 15% discount on Fittings, 20% on materials. Materials discount is only offered inside network. Outside network Exam = $20 copay, maximum = $35.


SAMPLE









Coverage type:

Organization K Organization K Organization LMD0010 MDR010 MD0010



Yes. Not specified. Yes.Excluded. Not applicable. Not applicable.Contributions are: pretax/payroll deduction.



Included with medical premiums. Included with medical premiums.

The Vision Plan is an automatic add-on to employees enrolled in Blue Cross PPO or Blue Cross Power Advantage Plans.









Single vision: 1 every 2 years, $5 copayment, 100.0% reimbursement.Bifocals: 1 every 2 years, $5 copayment, 100.0% reimbursement.Trifocals: 1 every 2 years, $5 copayment, 100.0% reimbursement.Lenticular: $5 copayment, 100.0% reimbursement.

Necessary: 1 every year, $135 maximum, 100.0% reimbursement.Elective: 1 every year, $135 maximum, 100.0% reimbursement.


Necessary: 1 every 2 years, $5 copayment, $120 maximum, 100.0% reimbursement.Elective: 1 every 2 years, $5 copayment, $120 maximum, 100.0% reimbursement.

Not specified. Not specified. Not covered.

Structured plan.


Structured plan.


Structured plan.



SAMPLE



Organization K Organization K Organization LMD0010 MDR010 MD0010

Laser discounted from 10%-30%. Frames in lieu of contacts.

Maximums are combined. Outside network maximums: Exam = $45. Lenses: single = $45, bifocal = $65, trifocal = $85. Frames = $47. Contacts = $120. Outside network service, copayment = $5.


SAMPLE









Coverage type:



Yes.Not applicable.Included with medical premiums.


Not covered.

Not covered.

Not covered.

Not covered.

Structured plan.



SAMPLE





SAMPLE

FLEXIBLE SPENDING ACCOUNTSFLEXIBLE SPENDINGOrganization Name: Organization A Organization B Organization C

Plan Number: N/A OM0010 OM0010Employees covered: All employees, including highly


Salaried employees, including highly compensated, minimum hours 30.0 per week.Salaried/Salaried Production employees.

Part-time are eligible: Yes. Yes.Collectively bargained eligible: Excluded. Not applicable.Accounts available: Health Care

Dependent CareHealth CareDependent Care

Employer contributions: None. None.

Employee maximum contributions: Health care = $4,992Dependent care = $4,992Total = $9,984

Health care = $3,500Dependent care = IRS limit ($5,000).Total = $8,500

Limited Health Care = $3,500.

Transportation account available: Parking = No.Transit passes = No.

Parking = No.Transit passes = No.

Employer contributions to transportation parking and pass accounts:


Employee maximum transportation parking and pass contributions:


Comments:

© Mercer LLC OM - 163 Summary of Plan Features

SAMPLE

FLEXIBLE SPENDING ACCOUNTSFLEXIBLE SPENDINGOrganization Name:


Part-time are eligible:Collectively bargained eligible:Accounts available:

Employer contributions:

Employee maximum contributions:

Transportation account available:



Comments:

Organization D Organization E Organization FOM0010 OM0010 OM0010




Yes. Yes. Yes.Not applicable. Excluded. Excluded.Health CareDependent Care

Health CareDependent Care


None. None. None.






Not specified.




SAMPLE









Comments:

Organization G Organization H Organization IOM0010 OM0010 OM0010




No. Yes. No.Not applicable. Excluded. Excluded.Health CareDependent Care



None.

.

None. None.




Parking = Yes.Transit passes = Yes.



Parking - noneTransit passes - none

Transportation accounts are allowed at some locations.


Parking = IRS limit.Transit passes = IRS limit.



SAMPLE









Comments:

Organization J Organization K Organization LOM0010 OM0010 OM0010




Yes. Yes. Yes.Included. Not applicable. Not applicable.Health CareDependent Care



None. None. None.





Parking = Yes.Transit passes = Yes.


Not applicable. Parking - noneTransit passes - none

Not applicable.

Not applicable. Parking = IRS limit.Transit passes = IRS limit.

Not applicable.


SAMPLE

LIFE AND AD4/14/2017LIFE INSURANCEOrganization Name: Organization A Organization B Organization C

Plan Number: LF0010 LF0010 LF0010Employees covered: All employees, including highly



All employees, including highly compensated, minimum hours 30.0 per week.Some unions are excluded.

Part-time are eligible: No. Yes. Yes.Collectively bargained eligible: Not applicable. Excluded. Excluded.Salary definition: Pay is defined as: Base pay. Pay is defined as: Base pay. Salary combination not found.

Employer paid group term: Employee coverage: multiple of pay = 2.00, minimum coverage = $10,000, maximum coverage = $1,000,000.

Spouse coverage not provided.

Dependent coverage not provided.

Employee coverage: flat amount = $50,000.



Employee coverage: multiple of pay = 2.00, no minimum, maximum coverage = $500,000. One group receives 1 times pay.



Employer paid AD&D: AD&D coverage is equal to group term.

Employee AD&D: flat amount = $25,000, minimum coverage = $25,000, maximum coverage = $25,000.

AD&D coverage is not provided.

Supplemental term for employees: Flat amount = $10,000 - $500,000

Overall maximum coverage = $1,500,000.

The employee pays the full cost of the supplemental coverage.

Cannot exceed 5 times pay.

Pay multiples = 1.00 - 8.00

Overall maximum coverage = $600,000.





© Mercer LLC LF - 167 Summary of Plan Features

SAMPLE

LIFE AND AD4/14/2017LIFE INSURANCEOrganization Name: Organization A Organization B Organization C

Plan Number: LF0010 LF0010 LF0010Supplemental term for spouse: Flat amount = $10,000 - $250,000


Flat amount = $10,000 - $50,000


Cannot exceed 50% of employee basic and optional coverage.

Flat amount = $25,000 - $50,000


Supplemental term for dependents: Flat amount = $2,000 - $10,000


Flat amount = $5,000 - $10,000


Flat amount = $12,500


Whole/universal for employees: Not provided. Not provided. Not provided.

Whole/universal for spouse: Not provided. Not provided. Not provided.

Whole/universal for dependents: Not provided. Not provided. Not provided.

Supplemental AD&D for employees: Provided, same as supplemental term.



Flat amount = $100,000 - $500,000


Benefit is limited to three times salary at one location.

Employer subsidized coverage while on disability:

Waiver. Waiver. Waiver.

Comments: Pay defined as: Fiscal year 8-1 to 7-31 total compensation.


SAMPLE

LIFE AND AD4/14/2017LIFE INSURANCEOrganization Name:


Part-time are eligible:Collectively bargained eligible:Salary definition:

Employer paid group term:

Employer paid AD&D:

Supplemental term for employees:

Organization D Organization D Organization ELF0010 LF0020 LF0010

All employees, including highly compensated.Excluding Managers.

Exempt employees, including highly compensated.Managers only.

Salaried employees, including highly compensated, minimum hours 19.1 per week.Excludes Executives.

Not specified. Not specified. Yes.Not applicable. Not applicable. Not applicable.Pay is defined as: Base pay. Pay is defined as: Base pay. Pay is defined as: Base pay.

Employee coverage: multiple of pay = 2.00, no minimum, maximum coverage = $200,000. Credit for reducing life coverage from 2x pay to 1x pay or to $50,000 only equal to premium savings.

Spouse coverage: flat amount = $2,000.

Dependent coverage: flat amount = $2,000 Benefit varies by age: 14 days-6 months = $200, 6 months-23 years = $2,000.

Employee coverage: minimum coverage = $155,000, maximum coverage = $1,026,500. Benefit varies by salary: $60,000-$64,999 = $155,000; $65,000-$69,999 = $167,500; $70,000-$74,999 = $180,000; $75,000-$79,999 = $192,500; $80,000-$84,999 = $205,000; $85,000-$89,999 = $217,500; $90,000-$94,999 = $230,000; $95,000-$99,999 = $242,500; $100,000-$109,999 = $250,000; $110,000-$119,999 = $266,000; $120,000-$129,999 = $286,500. For each additional $10,000 block of pay, benefit increases $20,000.


Dependent coverage: flat amount = $2,000 Benefit varies by age: 14 days-6 months = $200, 6 months-23 years = $2,000.

Employee coverage: multiple of pay = 2.25, no minimum, maximum coverage = $3,500,000.



AD&D coverage is equal to group term.







.





SAMPLE


Plan Number:Supplemental term for spouse:

Supplemental term for dependents:

Whole/universal for employees:

Whole/universal for spouse:

Whole/universal for dependents:

Supplemental AD&D for employees:

Employer subsidized coverage while on disability: Comments:

Organization D Organization D Organization ELF0010 LF0020 LF0010

Flat amount = $10,000 - $50,000


Flat amount = $10,000 - $50,000




Spouse's coverage cannot exceed 50% of the employee's coverage.

Flat amount = $5,000 - $25,000


Flat amount = $5,000 - $25,000




Can choose universal life in all locations except one. Individual policies are set up where costs vary by age and service.

Can choose universal life in all locations except one. Individual policies are set up where costs vary by age and service.

Not provided.

Not provided. Not provided. Not provided.


Not provided. Not provided. Flat amount = $25,000 - $500,000


Spouse flat amount $12,500-$250,000; child = $2,500-$50,000.

Not specified. Not specified. Employer pays.


SAMPLE





Employer paid AD&D:


Organization E Organization F Organization GLF0020 LF0010 LF0010

Executives, only highly compensated, minimum hours 19.1 per week.



Yes. Yes. Yes.Not applicable. Excluded. Excluded.Pay is defined as: Base pay. Pay is defined as: Base + bonus. Pay is defined as: Base pay.







Employee coverage: multiple of pay = 1.00, minimum coverage = $50,000, no maximum.




AD&D coverage is not provided. Employee AD&D: multiple of pay = 1.00, minimum coverage = $50,000, maximum coverage = $1,000,000.




Not provided. Pay multiples = 1.00 - 8.00



SAMPLE









Organization E Organization F Organization GLF0020 LF0010 LF0010



Spouse's coverage cannot exceed 50% of the employee's coverage.

Not provided. Flat amount = $25,000 - $50,000Pay multiples = 1.00 - 4.00


Spousal insurance cannot exceed 50% of employee's total life insurance.



Not provided. Flat amount = $10,000 - $30,000





Flat amount = $25,000 - $500,000


Spouse flat amount $12,500-$250,000; child = $2,500-$50,000.




Employer pays. Employer pays. Waiver.


SAMPLE





Employer paid AD&D:


Organization H Organization H Organization ILF0010 LF0020 LF0010

Salaried employees, including highly compensated, minimum hours 20.0 per week.Includes Corporate, OS, IS, and GS employees; excludes directors and elected officers.

All employees, including highly compensated.Includes Corporate, OS, IS, GS, Directors and elected officers.


Yes. Not specified. No.Excluded. Not applicable. Excluded.Pay is defined as: Base pay. Not applicable. Pay is defined as: Base pay.




Employee coverage: flat amount = $5,000,000.



Employee coverage: multiple of pay = 2.00, no minimum, maximum coverage = $800,000.



AD&D coverage is not provided. Employee AD&D: flat amount = $1,000,000, minimum coverage = $1,000,000, maximum coverage = $1,000,000.


Not provided. Not provided. Pay multiples = 1.00 - 5.00




SAMPLE









Organization H Organization H Organization ILF0010 LF0020 LF0010





Flat amount = $5,000 - $25,000






Not provided. Not provided.



Flat amount = $15,000 - $1,000,000


Not provided. Flat amount = $10,000 - $500,000Pay multiples = 1.00 - 10.00


Employer pays. Not specified. Waiver.


SAMPLE





Employer paid AD&D:


Organization J Organization K Organization LLF0010 LF0010 LF0010




Yes. Yes. Yes.Not applicable. Excluded. Not applicable.Pay is defined as: Base pay. Pay is defined as: Base pay. Pay is defined as: Base pay.

Employee coverage: multiple of pay = 1.00, minimum coverage = $40,000, maximum coverage = $1,000,000.


Dependent coverage: flat amount = $1,500.

Employee coverage: multiple of pay = 2.00, no minimum, maximum coverage = $1,000,000. Choice of $15,000,$50,000, 1x salary, 1.5x salary or 2x salary. Employee receives cash back if they elect a lesser benefit.



Employee coverage: multiple of pay = 1.00, no minimum, maximum coverage = $50,000.




AD&D coverage is not provided. AD&D not specified.




Not provided. Pay multiples = 1.00 - 5.00




SAMPLE









Organization J Organization K Organization LLF0010 LF0010 LF0010

Flat amount = $5,000 - $100,000




Spouses coverage can not exceed 50% of employee's Basic and Supplemental amount.

Flat amount = $10,000 - $15,000


Not provided. Flat amount = $10,000






Not provided.

Flat amount = $5,000 - $100,000




Not provided.

Flat amount = $10,000 - $15,000


Flat amount = $10,000 - $20,000


Not provided.

Flat amount = $25,000 - $750,000


Flat amount = $15,000 - $1,000,000


Flat amount = $10,000 - $500,000Pay multiples = 1.00 - 10.00


Employer pays. Employer pays. Waiver.


SAMPLE

EDUCATIONEDUCATIONAL ASSISTANCEOrganization Name: Organization A Organization B Organization C

Plan Number: EA0010 EA0010 EA0010Employees covered: All employees, including highly

compensated.All employees, including highly compensated.

All employees, minimum hours 30.0 per week.

Part-time are eligible: Not specified. Yes. Yes.Collectively bargained eligible: Not applicable. Not applicable. Not applicable.Percent of eligibles participating: Not specified. Not specified. Not specified.

Eligibility: Not specified. 90 days. Immediate.Covered members: Spouses are not covered.

Children are not covered.Domestic partners are not covered.Extended family members are not covered.

Spouses are not covered.Children are not covered.Domestic partners are not covered.Extended family members are not covered.


To be reimbursed, courses must be: Job related: Yes.Degree related: Yes.

Job related: Yes.Degree related: Yes.

Job related: Yes.Degree related: No.

Covered courses include: Undergraduate: Yes.Graduate: Yes.

Undergraduate: Yes.Graduate: Yes.


Associated costs coverage: Lab fees: Yes.Books: Yes.Parking: No.

Lab fees: Not specified.Books: Not specified.Parking: Not specified.

Lab fees: No.Books: No.Parking: No.

Maximum reimbursement percent: Undergraduate: 100.00%. Books are reimbursed at 50%.

Graduate: 100.00%. Books are reimbursed at 50%.

Undergraduate: 100.00%. Eighty percent at private institutions.

Graduate: 100.00%.

Undergraduate: 100.00%.

Graduate: 100.00%.

Maximum in-state reimbursement dollar amounts:

Undergraduate: Not specified per course, $5,250.00 per year.Graduate: Not specified per course, $5,250.00 per year.



Out-of-state reimbursement differences:

Not specified. Not specified. None.

How employee is taxed on this benefit:

IRS Guidelines. IRS Guidelines. IRS Guidelines.

Employee must pay back benefit on leaving within a specified period of time:

Yes.

Within one year.

Yes.

Within 1 year.

No.

Comments:

© Mercer LLC EA - 177 Summary of Plan Features

SAMPLE

EDUCATIONEDUCATIONAL ASSISTAOrganization Name:


Part-time are eligible:Collectively bargained eligible:Percent of eligibles participating:

Eligibility:Covered members:

To be reimbursed, courses must be:

Covered courses include:

Associated costs coverage:

Maximum reimbursement percent:



How employee is taxed on this benefit:Employee must pay back benefit on leaving within a specified period of time:

Comments:

Organization D Organization E Organization FEA0010 EA0010 N/A



No. Yes.Not applicable. Included.Not specified. Not specified.

Not specified. Not specified.Spouses are not covered.Children are not covered.Domestic partners are not covered.Extended family members are not covered.



Job related: No.Degree related: No.




Lab fees: Yes.Books: Yes.Parking: No.Books = $150/course; Thesis and Dissertation fees = $150; Cap and Gown = $200; Doctorial Cap and Gown = $500.


Graduate: 100.00%.


Graduate: 100.00%.

Undergraduate: Unlimited.Graduate: Unlimited.


None. None.

IRS Guidelines. IRS Guidelines.

No. No.


SAMPLE












Comments:

Organization G Organization H Organization IEA0010 EA0010 EA0010


All employees, including highly compensated.Includes Corporate, OS, IS, and GS employees.


No. Not specified. No.Not applicable. Included. Not applicable.Not specified. Not specified. Not specified.

Not specified. Not specified. Immediate.Spouses are not covered.Children are not covered.Domestic partners are not covered.Extended family members are not covered.





Job related: Yes.Degree related: Not specified.



Undergraduate: Yes.Graduate: Yes.Vocational school or state approved high school.

Lab fees: Yes.Books: Yes.Parking: No.Exam fees, software, tools, etc.

Lab fees: Yes.Books: Yes.Parking: No.

Lab fees: Yes.Books: No.Parking: No.


Graduate: 100.00%.

Undergraduate: 100.00%. Maximum of 2 courses/semester.

Graduate: 100.00%. Maximum of 2 courses/semester.


Graduate: 100.00%.


Maximum varies by sector.


Undergraduate: Not specified.Graduate: Not specified.

None. Out of state reimbursement is different.Details not specified.

Not specified.


Yes.

Within 12 months.

No. Yes.

Within one year.


SAMPLE












Comments:

Organization J Organization K Organization LEA0010 EA0010 EA0010



All employees, including highly compensated, minimum hours 40.0 per week.Part-time can attend undergraduate courses only.

Yes. Yes. Yes.Not applicable. Not applicable. Not applicable.Not specified. Not specified. Not specified.

Not specified. Immediate. 6 months.Spouses are not covered.Children are not covered.Domestic partners are not covered.Extended family members are not covered.





Job related: Yes.Degree related: Not specified.


Undergraduate: Yes.Graduate: Yes.Technical.


Lab fees: Yes.Books: No.Parking: No.

Lab fees: No.Books: Yes.Parking: No.Fees.


Undergraduate: 100.00%. Part-time = 50%.

Graduate: 100.00%. Part-time = 50%.


Graduate: 100.00%.


Graduate: 100.00%.


Two courses/term.


Two courses per term maximum.


Graduate = $5,250/year if career related, $10,000/year if job related.

Not specified. None. None.


Not specified. Yes.

Employee pays back within one year.

No.


SAMPLE

SEVERANCESEVERANCEOrganization Name: Organization A Organization B Organization C

Plan Number: N/A SV0010 SV0010Employees covered: All employees, including highly


Salaried employees, including highly compensated.Excludes grade lever T10 or E16 and above.

Part-time are eligible: Yes. Yes.Collectively bargained eligible: Excluded. Excluded.Eligibility: 6 months. Not specified.Prior service considered in eligibility:


Package offered: After 0.5 years, 2 weeks; minimum 2 weeks, maximum 2 weeks. After 3 years, 3 weeks; minimum 3 weeks, maximum 3 weeks. After 5 years, 4 weeks; minimum 4 weeks, maximum 4 weeks. After 7 years, 5 weeks; minimum 5 weeks, maximum 5 weeks.

Nine years = 6 weeks, 11 years = 7 weeks, 13 years = 8 weeks, 15 years = 9 weeks, 17 years = 10 weeks, 19 years = 11 weeks, 21 weeks = 12 weeks, 23+ = 13 weeks.

After 1 year, 1 week per year of service; minimum 4 weeks, maximum 26 weeks.

Salary definition: Pay is defined as: Base pay. Pay is defined as: Base pay.

How is benefit paid out: Lump Sum. Lump Sum.

Employee taxed: Yes. Yes. 0-10 years of service; COBRA coverage = 1 month, 10+ years of service = 2 months.

Medical COBRA subsidized: No. Yes. 0-10 years of service; COBRA coverage = 1 month, 10+ years of service = 2 months.

Dental COBRA subsidized: No. Yes.Employee pay back rules if rehired: Yes. No.

Outplacement services provided: Not specified. Yes.

How stock option is handled: Not specified. Extend the exercise period.Employees covered when change in control is involved:


Golden parachute excise tax for executives:


Non change in control months of salary paid:


Non change in control how is benefit paid out:


Non change in control calculation of bonus as part of severance:


Comments: Base severance = 2 weeks. Employees who sign a release will receive up to 11 additional weeks with 3 years service.

© Mercer LLC SV - 181 Summary of Plan Features

SAMPLE

SEVERANCESEVERANCEOrganization Name:


Part-time are eligible:Collectively bargained eligible:Eligibility:Prior service considered in eligibility:Package offered:

Salary definition:

How is benefit paid out:

Employee taxed:

Medical COBRA subsidized:

Dental COBRA subsidized:Employee pay back rules if rehired:

Outplacement services provided:

How stock option is handled:Employees covered when change in control is involved:Golden parachute excise tax for executives:Non change in control months of salary paid:Non change in control how is benefit paid out:Non change in control calculation of bonus as part of severance:

Comments:

Organization C Organization D Organization ESV0020 SV0010 SV0010

Salaried employees.MCP employees with grade level T10 or E16.


Salaried employees, including highly compensated.Non-union salaried (non-executive) and certain union employees.

Yes. Yes. Yes.Not applicable. Not applicable. Included.Not specified. Not specified. 12 months.Not specified. Yes. Yes.

After 1 year, 1 week per year of service; minimum 8 weeks, maximum 26 weeks.

Specified number of weeks for years of service. Varies by employee.

After 1 year, 1 week per year of service; minimum 1 week, maximum 26 weeks.

Pay is defined as: Base pay. Pay is defined as: Base pay. Pay is defined as: Base + special payments.

Lump Sum. Per scheduled pay period. Generally income continuation, but may elect lump sum.

Yes. 0-10 years of service; COBRA coverage = 1 month, 10+ years of service = 2 months.

Yes. Yes.

Yes. 0-10 years of service; COBRA coverage = 1 month, 10+ years of service = 2 months.

Yes. Yes.

Yes. Yes. Yes.No. No. No.

Yes. Not specified. No.

Extend the exercise period. Not specified. Not specified.Not specified. Not specified. Not specified.

Not specified. Not specified. No golden parachute.

Not specified. Not specified. 12 months.

Not specified. Not specified. Lump sum.

Not specified. Not specified. One times current year.

Formal plan not available. Part-time are prorated.


SAMPLE




Salary definition:


Employee taxed:





Comments:

Organization F Organization G Organization HN/A SV0010 SV0010

All employees, including highly compensated, minimum hours 20.0 per week.Employee must have received a cover memo signed by Vice President of Human Resources.

Salaried employees, including highly compensated, minimum hours 20.0 per week.Corporate, OS, IS, and GS employees.

Yes. Yes.Not applicable. Excluded.Immediately. 6 months.Varies by business sector. Not specified.

4 weeks + 1 week per year of service; minimum 5 weeks, maximum 26 weeks.

After 0.5 years, 2 weeks + 1 week per year of service; minimum 3 weeks, maximum 26 weeks.

Pay is defined as: Base pay. Pay is defined as: Base pay.

Lump Sum. Lump Sum.

Not specified. Yes.

Yes. No.

Yes. Varies by location. No.Not specified. Not specified.

Yes. Varies by business sector. Not specified.

Not applicable. Not specified.Not specified. No coverage.





Must sign Confidential Separation and General Release.

Benefits include supplemental severance if employee signs a Release of Claims form.


SAMPLE




Salary definition:


Employee taxed:





Comments:

Organization H Organization I Organization JSV0020 N/A N/A

Salaried employees, including highly compensated, minimum hours 20.0 per week.LMOS employees only.

Yes.Excluded.6 months.Not specified.

After 0.5 years, 2 weeks; minimum 2 weeks, maximum 2 weeks. After 2 years, 3 weeks; minimum 3 weeks, maximum 3 weeks. After 10 years, 4 weeks; minimum 4 weeks, maximum 4 weeks. After 15 years, 5 weeks; minimum 5 weeks, maximum 5 weeks.

20 years = 6 weeks.


Lump Sum.

Yes.

No.

No.Not specified.

Not specified.

Not specified.Not specified.

Not specified.

Not specified.

Not specified.

Not specified.


SAMPLE




Salary definition:


Employee taxed:





Comments:

Organization K Organization L Organization LSV0010 SV0020 SV0030


Exempt employees, including highly compensated.

Non-exempt employees.

Yes. Not specified. Not specified.Excluded. Not applicable. Not applicable.6 months. 6 months. 6 months.Yes. No. No.

Less than than 4 years of service = 2 weeks. Greater than than 4 years of service = 2 weeks + 1 week for every year of service in excess of 2 years. Maximum = 26 weeks.

Exempt employees receives pay for 21 days plus 5 days for each year of uninterupted service up to 26 weeks.

Non-exempt employees receives pay for 21 days plus five days for each year of uninterupted service up to 13 weeks.

Pay is defined as: Base pay. Pay is defined as: Base pay. Pay is defined as: Base pay.

Weekly or Lump Sum. Lump Sum. Lump Sum.

Yes. Yes. Yes.

Yes. Yes. Yes.

No. Yes. Yes.No. Yes. Yes.

Yes. Yes. Yes.

Accelerate vesting. Not specified. Not specified.Not specified. Not specified. Not specified.





Plan applies to layoffs. Employee must be benefit based.

Plan applies to layoffs. Employee must be benefit based.


SAMPLE

PAID TIME OFFPAID LEAVEOrganization Name: Organization A Organization B Organization C

Plan Number: PL0010 PL0010 PL0010Employees covered: All employees, including highly



Part-time are eligible: Not specified. Not specified. Yes.Collectively bargained eligible: Not applicable. Not applicable. Not applicable.Personal days per year: 0 0 0Holidays per year: 13.00 + 0.00 floating holiday

Holidays are not lost if they fall on a weekend.

15.00 + 0.00 floating holidayHolidays are not lost if they fall on a weekend.

8.00 + 3.00 floating holidaysHolidays are not lost if they fall on a weekend.

Option to buy or sell time-off days: Option to buy not specified. Employee may buy vacation days. Option not available.

Time-off accrual per years of service:

0.00 years = 10.0 days,1.00 year = 20.0 days.

0.00 years = 12.0 days,10.00 years = 15.0 days,20.00 years = 20.0 days.


Carryover policy: Allowed 50 days maximum accumulation.

Allowed 40 days maximum accumulation.

Not allowed.

Policy for handling paid leave in the event of plant shutdown:

Sabbatical leave: No. No. No.Sabbatical - employees covered: Not applicable. Not applicable. Not applicable.

Sabbatical - part-time are eligible: Not applicable. Not applicable. Not applicable.

Sabbatical eligibility: Not applicable. Not applicable. Not applicable.Sabbatical duration: Not applicable. Not applicable. Not applicable.Sabbatical granted: Not applicable. Not applicable. Not applicable.Sabbatical leave paid or unpaid: Not applicable. Not applicable. Not applicable.

© Mercer LLC PL - 186 Summary of Plan Features

SAMPLE

PAID TIME OFFPAID LEAVEOrganization Name: Organization A Organization B Organization C

Plan Number: PL0010 PL0010 PL0010Comments: Employee may use 3 sick days as

personal.

Employee may purchase up to 10 days/year.

Carryover maximum = 2 times accrual.

Corporate location.


SAMPLE

PAID TIME OFFPAID LEAVEOrganization Name:


Part-time are eligible:Collectively bargained eligible:Personal days per year:Holidays per year:

Option to buy or sell time-off days:


Carryover policy:


Sabbatical leave:Sabbatical - employees covered:

Sabbatical - part-time are eligible:

Sabbatical eligibility:Sabbatical duration:Sabbatical granted:Sabbatical leave paid or unpaid:

Organization C Organization D Organization EPL0020 PL0010 PL0010




Yes. No. Yes.Not applicable. Not applicable. Excluded.0 0 08.00 + 3.00 floating holidaysHolidays are not lost if they fall on a weekend.

One location.

9.50Holidays are not lost if they fall on a weekend.

Floating holidays vary by location, typically 1-2 floating days are given.


Employees receive 8 holidays/year plus Christmas shutdown.

Not specified. Employee may sell vacation days. Option not available.

0.00 years = 10.0 days,5.00 years = 15.0 days.


1.00 year = 10.0 days,5.00 years = 12.0 days,10.00 years = 15.0 days,12.00 years = 16.0 days,14.00 years = 17.0 days,16.00 years = 18.0 days,18.00 years = 20.0 days.

Not allowed. Allowed. Allowed 40 days maximum accumulation.

One to five days of Vacation is normally saved for plant shutdown.

Employees receive as part of holiday pay, the shutdown at Christmas.

No. No. Yes.Not applicable. Not applicable. Not specified.


Not applicable. Not applicable. Not specified.Not applicable. Not applicable. 24 months.Not applicable. Not applicable. Not specified.Not applicable. Not applicable. One educational leave of

absense/degree program.


SAMPLE



Organization C Organization D Organization EPL0020 PL0010 PL0010

Only days in excess of 10 may be cashed out at the end of the year beginning in the tenth year of service. Cash out subject to company approval.

Beginning the tenth year of service, employees receive their basic 10 days/year and seven additional weeks. These seven weeks have unlimited carryover and do not have to be used in one week increments. The seven weeks are earned on each fifth anniversary thereafter.

Carryover = 2 times annual accrual.


SAMPLE






Carryover policy:





Organization F Organization G Organization HPL0010 PL0010 PL0010



Salaried employees, including highly compensated, minimum hours 20.0 per week.Corporate employees only. Excludes elected officers.

Not specified. No. Yes.Not applicable. Not applicable. Not applicable.0 Not specified. 07.00Holidays are not lost if they fall on a weekend.



Option not available. Employee may buy vacation days. Option not available.

0.00 years = 10.0 days,3.00 years = 12.5 days,5.00 years = 15.0 days,10.00 years = 17.5 days,15.00 years = 20.0 days,20.00 years = 25.0 days.

1.00 year = 10.0 days,2.00 years = 10.5 days,3.00 years = 11.0 days,4.00 years = 11.5 days,5.00 years = 12.0 days,6.00 years = 12.5 days,7.00 years = 13.0 days,8.00 years = 13.5 days,9.00 years = 14.0 days,10.00 years = 14.5 days.

This is a paid time-off plan.

1.00 year = 15.0 days,15.00 years = 16.0 days,16.00 years = 17.0 days,17.00 years = 18.0 days,18.00 years = 19.0 days,19.00 years = 20.0 days.

Not allowed. Allowed 50 days maximum accumulation.

Not allowed.

Employees also receive 13 paid shutdown days.

Management discretion.

No. No. No.Not applicable. Not applicable. Not applicable.


Not applicable. Not applicable. Not applicable.Not applicable. Not applicable. Not applicable.Not applicable. Not applicable. Not applicable.Not applicable. Not applicable. Not applicable.


SAMPLE



Organization F Organization G Organization HPL0010 PL0010 PL0010

Vacation varies by location. Employee also receives 13 paid shutdown days.

Paid Time Off includes vacation, personal time, and sick days.

Accrual continues at 1/2 day increments until 30 years = 25 days. Employee allowed to carry over up to 2x annual accrual. Employee may purchase 3-5 days vacation/year on a pre-tax basis.


SAMPLE






Carryover policy:





Organization H Organization H Organization HPL0020 PL0030 PL0040

All employees, including highly compensated.Elected officers at corporate location only.

Salaried employees, including highly compensated, minimum hours 20.0 per week.OS, IS, and GS employees only. Excludes elected officers.

All employees, including highly compensated.Elected officers at IS and GS divisions only.

Not specified. Yes. Not specified.Not applicable. Not applicable. Not applicable.0 0 012.00 + 0.00 floating holidayHolidays are not lost if they fall on a weekend.



Option not available. Option not available. Option not available.

0.00 years = 20.0 days. 0.00 years = 10.0 days,4.00 years = 15.0 days,19.00 years = 20.0 days.

0.00 years = 20.0 days.

Not allowed. Not allowed. Not allowed.

Management discretion.





SAMPLE



Organization H Organization H Organization HPL0020 PL0030 PL0040


SAMPLE






Carryover policy:





Organization I Organization J Organization KPL0010 PL0010 PL0010




Not specified. Yes. Yes.Not applicable. Not applicable. Excluded.0 0 012.00 + 0.00 floating holidayHolidays are not lost if they fall on a weekend.


Specific number of holidays may vary from year to year due to Christmas shutdown, 13-14.


Not specified. Employee may sell vacation days. Option not available.



0.00 years = 10.0 days,4.00 years = 11.0 days,5.00 years = 15.0 days,10.00 years = 18.0 days,15.00 years = 20.0 days.

Not allowed. Allowed 25 days maximum accumulation.






SAMPLE



Organization I Organization J Organization KPL0010 PL0010 PL0010

Employee may sell 40 hours of accrued vacation and 40 hours of future accrual over the next 12 months.

Maximum accumulation of carryover is 1x the annual allotment of vacation days.


SAMPLE






Carryover policy:





Organization L Organization LPL0010 PL0020


Highly compensated, minimum hours 20.0 per week.Manager IIIs and above; Pay Grade 14 or Senior Research Scientists are eligible.

Yes. Yes.Not applicable. Not applicable.1 111.00 + 0.00 floating holidayHolidays are not lost if they fall on a weekend.

If holiday falls while employee is on vacation, employee receives holiday pay.


If holiday falls while employee is on vacation, employee receives holiday pay.

Option not available. Option not available.


0.00 years = 21.0 days.


Not allowed.

No. Yes.Not applicable. Highly compensated, minimum

hours 20.0 per week.Senior Research Scientists only.

Not applicable. Yes.

Not applicable. Not specified.Not applicable. 6 months.Not applicable. Not specified.Not applicable. Paid. Employee can receive 6

months at 100% of pay, or 12 months at 50% pay.


SAMPLE



Organization L Organization LPL0010 PL0020

Part-time employees receive a prorated schedule.

Part-time employees receive a prorated schedule.


SAMPLE

SICK / SHORT-TERM DISABILITYSHORT-TERM DISABILITYOrganization Name: Organization A Organization B Organization C

Plan Number: DI0010 DI0010 DI0010Employees covered: All employees, including highly


Non-exempt employees, including highly compensated, minimum hours 30.0 per week.

Sick days - part-time are eligible: Not specified. Not specified. Yes.

STD - part-time are eligible: Not applicable. Not specified. Not specified.Collectively bargained eligible: Not applicable. Excluded. Not applicable.Eligibility period: Not specified.

STD eligibility is not applicable.Date of hire. 3 months.

Sick days - period of coverage earned per year:

Carryover leave time is not allowed.

Benefits begin with the first reported work day of absence and continue for each day to a maximum of 65 days.

5 days.Carryover leave time is not allowed.

Employees may use up to 3 days for personal days.

10 days.Carryover leave time is allowed and limited, 30 days cumulative limit.

Employees receive three days during first year of service. One location provides 3 days of PTO. Sick Leave benefits vary by location.

Accumulated sick days are cashed-out upon termination:

No. No. No.

Accumulated sick days are cashed-out upon retirement:

No. No. No.

Salary definition: Sick days are defined as: Base pay. STD is not applicable.

Sick days are defined as: Base pay. STD pay is defined as: Base pay.

Sick days are defined as: Base pay. STD pay is defined as: W2 box 1 pay.

STD benefit waiting period: Not applicable. 5 days. 0 days.

Monthly employee STD contributions per $100 of pay:

Not applicable. None. None.

Self Funded Plan.

Monthly employer STD contributions per $100 of pay:

Not applicable. Rate not specified. Rate not specified.

© Mercer LLC ST - 198 Summary of Plan Features

SAMPLE

SICK / SHORT-TERM DISABILITYSHORT-TERM DISABILITYOrganization Name: Organization A Organization B Organization C

Plan Number: DI0010 DI0010 DI0010STD benefits: Not applicable. First 200 hours are paid at 100%,

then declining pay at 95% pay and decreases 5% every two weeks up to 20 weeks.

After 0 years of service: 26 weeks at 60%.

Maximum STD payment amount: Not applicable. Unlimited. Unlimited.

Maximum STD payment period: Not applicable. 26 weeks. 26 weeks.

Social Security Offset: Not applicable. None. Not specified.Comments:


SAMPLE

SICK / SHORT-TERM DISABILITYSHORT-TERM DISABILITOrganization Name:


Sick days - part-time are eligible:

STD - part-time are eligible:Collectively bargained eligible:Eligibility period:


Accumulated sick days are cashed-out upon termination:Accumulated sick days are cashed-out upon retirement:Salary definition:

STD benefit waiting period:



Organization C Organization D Organization DDI0020 DI0010 DI0020



Executives, only highly compensated.Executives, Managers, and Supervisors with less than 10 years of service.


Not specified. No. No.Not applicable. Not applicable. Included.3 months. Date of hire. Sick days eligibility is not

applicable.STD eligibility = date of hire.


Employees receive 3 days during first year of service.


Time may be used for sickness and other discretionary personal situations. Employees working 16-30 hours/week receive 3 days/year; < 16 hours/week receive 1.5 days/year.

Not applicable.



Sick days are defined as: Base pay. STD pay is defined as: W2 box 1 pay.

Sick days are defined as: Base + shift differential. STD pay is defined as: Base + shift differential.

Sick days are not applicable. STD pay is defined as: Base pay.

0 days. Accident = 0 days.Sickness = 3 days.Hospitalization = 3 days.

0 days.

None.

Self Funded Plan.

None. None.

Rate not specified. Rate not specified. Rate not specified.


SAMPLE


Plan Number:STD benefits:

Maximum STD payment amount:

Maximum STD payment period:

Social Security Offset:Comments:

Organization C Organization D Organization DDI0020 DI0010 DI0020

After 0 years of service: 13 weeks at 100%, 13 weeks at 75%.

After 0 years of service: 26 weeks at 66.67%.


Unlimited. $1,200.00 per week. Unlimited.

26 weeks. 26 weeks. 26 weeks.

Not specified. Individual benefit. Individual benefit.


SAMPLE










Organization D Organization E Organization FDI0030 DI0010 DI0010

Executives, only highly compensated.Officers and Executives with 10 or more years of service.



Not applicable. Yes. Not specified.

No. Yes. Yes.Not applicable. Excluded. Excluded.Sick days eligibility is not applicable.STD eligibility = date of hire.

Sick days = 1 month.STD eligibility = first of month following date of hire.

Date of hire.

Not applicable. 10 days.Carryover leave time is allowed with unlimited carryover.

Up to 50% of unused sick leave may be held over at the end of the year; 50% of unused sick leave will be paid out to employee at time of retirement. Part-time are prorated.


Employees take sick leave as needed at the discretion of management.

Not applicable. No. No.

Not applicable. Yes. No.


Sick days are defined as: Base pay. STD pay is defined as: Base + shift differential + special payments.


0 days. 7 days. Accident = 0 days.Sickness = 7 days.Hospitalization = 0 days.

None. None.

This is a self insured plan.

None.



SAMPLE






Organization D Organization E Organization FDI0030 DI0010 DI0010



After 0 years of service: 2 weeks at 100%, 24 weeks at 66.66%. After 3 years of service: 3 weeks at 100%, 23 weeks at 66.66%. After 4 years of service: 4 weeks at 100%, 22 weeks at 66.66%. After 5 years of service: 5 weeks at 100%, 21 weeks at 66.66%. After 6 years of service: 6 weeks at 100%, 20 weeks at 66.66%. After 7 years of service: 7 weeks at 100%, 19 weeks at 66.66%. After 8 years of service: 8 weeks at 100%, 18 weeks at 66.66%. After 9 years of service: 9 weeks at 100%, 17 weeks at 66.66%. After 10 years of service: 10 weeks at 100%, 16 weeks at 66.66%.

Unlimited. Unlimited. Unlimited.


Individual benefit. Family benefit. None.Coverage continues at one week for every year of service at 100% and the remainder of weeks up to 26 weeks = 66.66%. 26+ years of service = 26 weeks at 100%.


SAMPLE










Organization G Organization G Organization HDI0010 DI0020 DI0010

All employees, including highly compensated, minimum hours 20.0 per week.Limited to certain locations.


Salaried employees, including highly compensated, minimum hours 20.0 per week.Corporate employees only.


Not specified. Not specified. Yes.Excluded. Excluded. Excluded.Sick days eligibility is not applicable.STD eligibility = date of hire.

Sick days eligibility is not applicable.STD eligibility = date of hire.

Date of hire.

Sick days are combined with PTO.

Not applicable. Carryover leave time is not allowed.

Casual absence granted at management's discretion.

Not applicable. Not applicable. No.

Not applicable. Not applicable. No.




7 days. 7 days. 7 days.

None.

This is a self-insured plan.

$0.150, on an after-tax basis.

Employee pays total cost.

None.

Rate not specified. None. Rate not specified.


SAMPLE






Organization G Organization G Organization HDI0010 DI0020 DI0010




$8,100.00 per week. $1,250.00 per week. Unlimited.


None. None. None.


SAMPLE










Organization H Organization H Organization IDI0040 DI0050 DI0010

Salaried employees, including highly compensated, minimum hours 20.0 per week.OS employees only.

Salaried employees, including highly compensated, minimum hours 20.0 per week.IS and GS employees only.



Yes. Yes. No.Included. Included. Not applicable.Date of hire. Date of hire. Date of hire.


The OS contracts choose a paid absence plan which is an annual grant and the employees incidental absence time is deducted as the time is used. On average most contracts use the 40 hour plan, but they can select anywhere from 24, 40, 56, 80, or 400 hours annually. When an employee is out on medical LOA, they can choose to use all or any of their remaining hours at the start of their leave; sometimes it covers the waiting period prior to Short Term Disability benefits or if there is enough time, it can be used during the Short Term Disability period (the STD benefits are then reduced by hours paid).


Casual absense granted at management's discretion.


Occasional sick days are covered prior to Salary Continuation elimination period being met.

No. No. No.

No. No. No.




7 days. 7 days. Accident = 0 days.Sickness = 7 days.Hospitalization = 0 days.

None. None. None.



SAMPLE






Organization H Organization H Organization IDI0040 DI0050 DI0010



After 0 years of service: 2 weeks at 100%, 24 weeks at 60%. After 1 year of service: 4 weeks at 100%, 22 weeks at 60%. After 3 years of service: 6 weeks at 100%, 20 weeks at 60%. After 5 years of service: 10 weeks at 100%, 16 weeks at 60%. After 10 years of service: 14 weeks at 100%, 12 weeks at 60%. After 15 years of service: 18 weeks at 100%, 8 weeks at 60%. After 20 years of service: 22 weeks at 100%, 4 weeks at 60%. After 25 years of service: 26 weeks at 100%.

$1,500.00 per week. $1,500.00 per week. Unlimited.


None. None. Not specified.


SAMPLE










Organization J Organization K Organization LDI0010 DI0010 DI0010

Salaried employees, including highly compensated.Selected Hourly employees are included.


All employees, including highly compensated, minimum hours 20.0 per week.Only California employees are under State Disability; only employees outside of California (where there is no State Disability) are eligible for Short Term Disability.

No. Not applicable. Yes.

Yes. Yes. Yes.Not applicable. Excluded. Not applicable.Date of hire. Sick days eligibility is not

applicable.STD eligibility = date of hire.

Sick days = date of hire.STD eligibility = first of month following date of hire.


Unlimited short duration personal absences.

Not applicable. 12 days.Carryover leave time is allowed and limited, 120 days cumulative limit.

Retirees receive a "sick leave credit" based on their normal defined contribution plan monthly contribution. Retiree receive a lump sum payment equal to their normal defined contribution pension plan contribution for each month of accrued sick days.

No. Not applicable. No.

No. Not applicable. Yes.




Accident = 0 days.Sickness = 3 days.Hospitalization = 0 days.

0 days. Accident = 7 days.Sickness = 7 days.Hospitalization = 0 days.

None.

This is a self insured plan.

None.

Self-funded plan.

Rate not specified but is on an after-tax basis.


Employee pays 1.1% of wages to $93,316 or .48/$100 of pay.

Rate not specified. Rate not specified. None.


SAMPLE






Organization J Organization K Organization LDI0010 DI0010 DI0010

2 weeks minimum at 100%; 1 week at 100% for each full year of service with 60% for remaining weeks to a total of 26 weeks.



$1,385.00 per week. Unlimited. $987.00 per week.


None. None. None.


SAMPLE

LONG-TERM DISABILITYLONG-TERM DISABILITYOrganization Name: Organization A Organization B Organization B

Plan Number: DI0010 DI0010 DI0020Employees covered: All employees, including highly



Part-time are eligible: Not specified. Not specified. Not specified.Collectively bargained eligible: Not applicable. Excluded. Excluded.Eligibility: Not specified. Immediately. Immediately.

Monthly employee contribution per $100 of pay:

None. None. Rate not specified but is on an after-tax basis.


Monthly employer LTD contribution per $100 of pay:


Benefit waiting period: 90 days. 6 months. 6 months.Period of own occupation: Not specified. Not specified. Not specified.Level of benefit before offsets: Fixed = 60.00% of pay. Fixed = 50.00% of pay. Fixed = 15.00% of pay.

This is supplemental coverage.Salary definition: Pay is defined as: Base pay. Pay is defined as: Base pay. Pay is defined as: Base pay.

Maximum monthly benefit: $19,000 $10,000 $10,000 Maximum percent from all sources: 60%. 50%. 65%.

Social Security Offset: Family benefit. Family benefit. Family benefit.Comments:

© Mercer LLC DI - 210 Summary of Plan Features

SAMPLE

LONG-TERM DISABILITYLONG-TERM DISABILITYOrganization Name:


Part-time are eligible:Collectively bargained eligible:Eligibility:


Monthly employer LTD contribution per $100 of pay:Benefit waiting period:Period of own occupation:Level of benefit before offsets:

Salary definition:

Maximum monthly benefit:Maximum percent from all sources:


Organization C Organization C Organization DDI0010 DI0020 DI0010

Non-exempt employees, including highly compensated, minimum hours 30.0 per week.



Yes. Yes. No.Not applicable. Not applicable. Not applicable.First of month following date of hire.

First of month following date of hire.

12 months.

Rate not specified but is on an after-tax basis. Contributions vary by salary.

Employee and employer share the cost.

Rates = $.44/$100. Company pays the premium for a monthly benefit equal to $1,000. Employees pay premium for benefits > $1,000/month.


Employee and employer share the cost.

Rates = $.44/$100. Company pays the premium for a monthly benefit equal to $1,000. Employees pay premium for benefits > $1,000/month.

None.


180 days. 180 days. 6 months.2.0 years. 2.0 years. Not specified.Fixed = 60.00% of pay. Fixed = 60.00% of pay. Fixed = 50.00% of pay.

Pay is defined as: Base + overtime + bonus + commission + overtime + bonus + commissionPlus deferred bonuses.

Pay is defined as: Base + overtime + bonus + commission + overtime + bonus + commissionPlus deferred bonuses.


$10,000 $10,000 $15,000 60%. 60%. 50%.

Family benefit. Family benefit. Individual benefit.Eligible employees are those paid weekly.


SAMPLE






Salary definition:



Organization D Organization D Organization DDI0020 DI0030 DI0040

Executives, only highly compensated.Executives, Managers, and Supervisors with less than 10 years of service.

Executives, only highly compensated.Officers and Executives with 10 or more years of service.


No. No. No.Included. Not applicable. Not applicable.12 months. 12 months. 12 months.

None. None. Rate not specified but is on a pre-tax basis.



6 months. 6 months. 6 months.Not specified. Not specified. Not specified.Fixed = 60.00% of pay. Fixed = 70.00% of pay. Fixed = 10.00% of pay.

This is supplemental coverage.Pay is defined as: Base pay. Pay is defined as: Base pay. Pay is defined as: Base + shift

differential.

$22,000 $22,000 $15,000 60%. 70%. 60%.

Individual benefit. Individual benefit. Individual benefit.Eligible employees are those paid semi-monthly and monthly.

Eligible employees are those paid monthly.


SAMPLE






Salary definition:



Organization E Organization E Organization FDI0010 DI0020 DI0010




Yes. Yes. Yes.Excluded. Not applicable. Excluded.First of month following date of hire.

First of month following date of hire.

Immediately.

None. $0.089, on an after-tax basis.


None.

$0.14 None. Rate not specified.

26 weeks. 26 weeks. 180 days.2.0 years. 2.0 years. 1.0 year.Fixed = 50.00% of pay. Fixed = 10.00% of pay.

This is supplemental coverage.

Fixed = 40.00% of pay.

Pay is defined as: Base pay. Pay is defined as: Base pay. Pay is defined as: Base + bonus.

$15,000 $15,000 Unlimited.50%. 60%. 40%.

Family benefit. None. Family benefit.


SAMPLE






Salary definition:



Organization F Organization G Organization GDI0020 DI0010 DI0020


All employees, including highly compensated, minimum hours 20.0 per week.Limited to certain locations.


Yes. No. No.Excluded. Excluded. Excluded.Immediately. Immediately. Immediately.



None. Rate not specified but is on an after-tax basis.


None. Rate not specified. None.

180 days. 6 months. 6 months.1.0 year. 2.0 years. 2.0 years.Fixed = 20.00% of pay.


Fixed = 50.00% of pay. Fixed = 10.00% of pay.

This is supplemental coverage.Pay is defined as: Base + bonus. Pay is defined as: Base pay. Pay is defined as: Base pay.

Unlimited. $15,000 $15,000 60%. 50%. 60%.

Family benefit. Individual benefit. Individual benefit.


SAMPLE






Salary definition:



Organization G Organization H Organization HDI0030 DI0020 DI0030




No. Yes. Yes.Not applicable. Excluded. Excluded.Immediately. Immediately. Immediately.







None. None. None.

6 months. 6 months. 6 months.2.0 years. 2.0 years. 2.0 years.Fixed = 20.00% of pay.


Fixed = 50.00% of pay. Fixed = 60.00% of pay.


$15,000 $25,000 $30,000 70%. 50%. 60%.

Individual benefit. Family benefit. Family benefit.


SAMPLE






Salary definition:



Organization I Organization J Organization JDI0010 DI0010 DI0020


Salaried employees, including highly compensated.Selected Hourly employees are included.

Salaried employees, including highly compensated.Selected Hourly employees.

No. Yes. Yes.Not applicable. Not applicable. Not applicable.Immediately. Immediately. Immediately.

None. None. $0.151, on an after-tax basis. Contributions vary by salary.


Rate not specified. $0.20 None.

180 days. 6 months. 26 weeks.2.0 years. Age 65. Age 65.Fixed = 60.00% of pay. Fixed = 50.00% of pay. Fixed = 16.67% of pay.

This is supplemental coverage.Pay is defined as: Base pay. Pay is defined as: Base pay. Pay is defined as: Base pay.

$12,500 $6,000 $7,500 60%. 50%. 66.67%.

Individual benefit. Family benefit. Family benefit.In 2008 this company implemented a 24 month limitation for non-organic mental and nervous disorders.

In 2008 this company implemented a 24 month limitation for non-organic mental and nervous disorders.


SAMPLE






Salary definition:



Organization J Organization K Organization KDI0030 DI0010 DI0020




Yes. Yes. Yes.Not applicable. Excluded. Excluded.Immediately. Immediately. Immediately.





$0.20 None. None.

6 months. 6 months. 6 months.Age 65. Age 65. Age 65.Fixed = 50.00% of pay. Fixed = 50.00% of pay. Fixed = 60.00% of pay.


Unlimited. $25,000 $25,000 50%. 50%. 60%.

Family benefit. Individual benefit. Individual benefit.


SAMPLE






Salary definition:



Organization L Organization LDI0010 DI0020

All employees, including highly compensated, minimum hours 20.0 per week.Only California employees are under State Disability; only employees outside of California (where there is no State Disability) are eligible for Short Term Disability.


Yes. Yes.Not applicable. Not applicable.First of month following date of hire.

Immediately.



$0.22 None.

180 days. 180 days.2.0 years. 2.0 years.Fixed = 40.00% of pay. Fixed = 20.00% of pay.

This is supplemental coverage.Pay is defined as: Base pay. Pay is defined as: Base pay.

$10,000 $15,000 40%. 60%.

Family benefit. Family benefit.


SAMPLE

NON-TRADITIONAL BENEFITSNON-TRADITIONAL BENEFITSOrganization Name: Organization A Organization B Organization C

Pre-Retirement Counseling No. Yes. No.Life Insurance-Business Travel/Accident


Wellness Program Not specified. Yes. No.Onsite Fitness Facility Not specified. Yes. No.Paid/Subsidized Offsite Fitness Facility


Parental/Family Leave Not specified. Yes. Yes.Employee Assistance Plan Not specified. Yes. Yes.Free/Subsidized Parking Not specified. Yes. Yes.Telecommuting Not specified. No. No.Satellite Workplace Not specified. No. No.Job Sharing Not specified. No. No.Home Computer Offered Not specified. No. No.College Scholarships Not specified. Yes. Yes.Financial Planning Assistance Not specified. Yes. Yes.Subsidized Eating Facility Not specified. No. Yes.Formal Training/Professional Development


Gambling Addiction Counseling Not specified. No. No.

Legal Counseling Not specified. Yes. No.Child/Elder Care Assistance Not specified. No. No.Flextime Not specified. Yes. No.Business Casual Policy Not specified. Yes. Yes.Funeral Leave Not specified. Yes. Yes.Adoption Benefits Not specified. No. No.Lactation Rooms Not specified. No. Yes.Work at Home Policy Not specified. No. No.Discount Purchasing Not specified. No. No.Onsite Child Care Not specified. No. No.Relocation Allowance Not specified. Yes. Yes.Executive Co. Car Not specified. Yes. Yes.Non Executive Co. Car Not specified. Yes. No.Sales Employee Co. Car Not specified. No. Yes."Other" Employee Co. Car Not specified. No. No.

© Mercer LLC NB - 219 Summary of Plan Features

SAMPLE

NON-TRADITIONAL BENEFITSNON-TRADITIONAL BENOrganization Name:

Pre-Retirement CounselingLife Insurance-Business Travel/AccidentWellness ProgramOnsite Fitness FacilityPaid/Subsidized Offsite Fitness FacilityParental/Family LeaveEmployee Assistance PlanFree/Subsidized ParkingTelecommutingSatellite WorkplaceJob SharingHome Computer OfferedCollege ScholarshipsFinancial Planning AssistanceSubsidized Eating FacilityFormal Training/Professional DevelopmentGambling Addiction Counseling

Legal CounselingChild/Elder Care AssistanceFlextimeBusiness Casual PolicyFuneral LeaveAdoption BenefitsLactation RoomsWork at Home PolicyDiscount PurchasingOnsite Child CareRelocation AllowanceExecutive Co. CarNon Executive Co. CarSales Employee Co. Car"Other" Employee Co. Car

Organization D Organization E Organization FYes. Yes. Yes.Yes. Yes. Yes.

Yes. Yes. Yes.No. Yes. Yes.No. Yes. No.

Yes. No. Yes.Yes. Yes. Yes.No. Yes. Yes.No. Yes. Yes.No. No. No.No. Yes. Yes.No. No. No.No. No. No.No. Yes. Yes.No. No. No.Yes. Yes. Yes.

No. Yes. Yes.

Yes. Yes. Yes.Yes. Yes. Yes.No. Yes. Yes.No. Yes. Yes.Yes. Yes. Yes.No. No. No.No. Yes. Yes.No. No. No.No. Yes. Yes.Not specified. Yes. No.Yes. Not specified. Yes.No. Yes. Yes.No. Not specified. No.No. Not specified. Yes.No. Not specified. No.


SAMPLE




Organization G Organization H Organization IYes. Not specified. Not specified.Yes. Yes. Yes.

Yes. Yes. Not specified.Yes. Yes. Not specified.Not specified. Yes. Not specified.

Yes. Yes. Not specified.Yes. Yes. Yes.Yes. Yes. Not specified.Yes. Yes. Not specified.Yes. No. Not specified.No. No. Not specified.No. Not specified. Not specified.Yes. No. Yes.No. No. Not specified.Yes. Yes. Not specified.Yes. Not specified. Not specified.

Yes. Not specified. Not specified.

Yes. Not specified. Yes.No. Not specified. Not specified.Yes. Yes. Not specified.Yes. Yes. Not specified.Yes. Yes. Not specified.Yes. Yes. Not specified.Yes. Not specified. Not specified.Yes. Not specified. Not specified.Yes. Not specified. Not specified.Yes. Not specified. Not specified.Yes. Not specified. Not specified.Yes. No. Yes.Not specified. No. Not specified.Not specified. Not specified. Not specified.Not specified. Not specified. Not specified.


SAMPLE




Organization J Organization K Organization LYes. No. Yes.Yes. Yes. Yes.

Yes. Yes. Yes.Yes. Yes. Yes.No. No. No.

Yes. Yes. Yes.Yes. Yes. Yes.Yes. Yes. Yes.Yes. No. Yes.No. No. No.Yes. No. No.Yes. No. No.No. No. No.Yes. Yes. No.No. No. No.Yes. Yes. Yes.

Yes. Yes. No.

Yes. Yes. No.Yes. Yes. Yes.Yes. Yes. No.Yes. Yes. Yes.Yes. Yes. Yes.Yes. Yes. No.Yes. No. Yes.Not specified. No. No.Yes. Yes. Yes.Yes. No. No.Yes. Yes. Yes.Yes. No. No.Not specified. No. No.Not specified. No. No.Not specified. No. No.


SAMPLE

© Mercer LLC

Peer Participant List The following organizations are included in the statistics shown in this report. Peer A Peer B Peer C Peer D …

© Mercer LLC 6 - 1

Methodology This section details the methods used by Mercer to value the benefit plans included in the Plan Value Comparisons and Employee Profile Comparisons sections. For each item discussed, we provide an example illustrating how each plan is valued. Note: Your organization’s plan features may vary somewhat from the examples provided. However, we have applied these techniques, with adjustments where necessary, to the actual features of your plan.

Section Contents The Methodology contains the following sections: Principles Basic methodology Market or actuarial valuation Gross salary equivalent Mean use Participation Personal substitution National Composite Workforce Workforce demographics Target bonuses Position classification

Cash Compensation Annual Salary Bonus Time Loss Benefits Paid Time Off Vacation Holidays Personal Leave Sick Leave Short-term Disability benefits Long-term Disability benefits Retirement/Savings Defined Benefit plans Defined Contribution plans Stock Purchase plans Health/Group Benefits Medical benefits Dental benefits Life Insurance benefits Dependent Care Spending Accounts Health Care Spending Accounts Impact of Taxation Marginal tax rate Calculation of taxable pay Calculation of T1 and T2

© Mercer LLC 6 - 2

Principles Basic methodology Benefits are valued using the "walkaway" method. The values represent the cost to the employee of employer provided benefits if he or she left the employer and were to duplicate them in the marketplace. In many instances, these amounts will be greater than the cost to the employer. For example, an individual medical plan that is identical to the employer’s medical plan will cost more because of the greater marketing, administrative, and underwriting costs associated with an individual plan. Market or actuarial valuation Valuation reflects market pricing wherever possible. If there is a market yardstick which employees are likely to use to determine the personal value attributed to an employee benefit, this is used. Where market pricing does not exist, an actuarial valuation using standard assumptions and pricing techniques will be used. For example, although individual medical or dental policies containing provisions matching an employer plan would typically not be available in the open market, the value of the employer plan is estimated by valuing the employer plan using the same rate methodology as is used for individual benefit.

Gross Salary Equivalent Values normally reflect the amount of salary that would be required to purchase the equivalent benefit. Thus, the value of a benefit that enjoys a tax-preferred status in relation to salary (e.g., medical plans) will include a tax "gross-up" to equate it to taxable salary required to purchase a similar benefit. Mean use Two organizations with the same benefit plan will each have the same value attributed to their plan irrespective of the costs of the plan to the employers. Participation Values are calculated assuming that all employees participate in the primary plans offered even when they are voluntary and certain employees may have opted out. For example, it is assumed that all employees participate in medical, 401(k), and Stock Purchase plans (where offered). This gives a measure of the opportunity value to the employee. Personal substitution Values reflect as close substitution as possible to the benefit provided by the employer. For example, it has been assumed that employees will replace their life insurance benefit with the same amount of coverage. We understand that, in reality, this may not always be the case.

© Mercer LLC 6 - 3

National Composite Workforce Workforce Demographics Benefits are valued using a national composite workforce. The same workforce is used for all employers, so the effect of varying employee demographics is removed from the value comparison. The national composite workforce is a set of generic employee profiles that represents a typical employee population. These profiles were developed from a national cross-section of representative organizations that vary by industry, size, and geography. The workforce consists of 30,578 incumbents distributed over 115 employee profiles. Associated with each employee profile are number of incumbents, age, service, annual salary, target bonus, gender, and family status. The workforce demographics are shown below. The average value for a data item is obtained by multiplying the value for each employee profile by the number of incumbents in that profile, summing the results, and dividing the sum by the total number of incumbents in the workforce. Average Age - 39 Average Service - 8 Average Annual Salary - $49,990 Average Target Bonus - $9,004 Percent Male - 42% Percent Married - 48% Percent With Children - 52% Average Number of Children - 2

Target Bonuses A target bonus is assumed for each employee profile in the national composite workforce. Target bonus percentages vary with annual salary as follows: Less than $30K - 4% $30K < $40K - 7% $40K < $50K - 13% $50K < $90K - 20% $90K < $125K - 23% $125K < $150K - 28% $150K < $200K - 34% $200K < $250K - 42% $250K < $300K - 48% $300K and over - 61% Position Classification The employee profiles in the national composite workforce do not have job titles. As a result, assumptions are made when benefits vary by job title or employee classification. These assumptions are applied uniformly across all employers. When benefits vary by exempt vs. non-exempt status, it is assumed that employees with annual salaries below $35,000 are non-exempt and that employees with annual salaries of $35,000 and over are exempt. When benefits vary by manager vs. non-manager classification, it is assumed that employees with annual salaries of $75,000 and over are managers. When benefits vary by executive vs. non-executive classification, it is assumed that employees with annual salaries of $150,000 and over are executives.

© Mercer LLC 6 - 4

Cash Compensation Annual Salary The annual base salary for any given profile is assumed and held constant across all organizations. Bonus The annual bonus for any given profile is assumed and held constant across all organizations.

Time Loss Benefits Vacation/Paid Time Off The amount of vacation or paid time off is based on years of service and the organization's vacation or paid time off plan. The number of days is translated into equivalent annual salary by multiplying the number of days by the value of one day. This value is equal to 1/260th of annual salary.

EXAMPLE: VACATION

1. Profile information: 10 Years Service, Annual Salary $50,000

2. Vacation entitlement: 10 days plus 5 additional days for each full 5 years service to a maximum of 25 days

3. Basic entitlement: 10 days 4. For first 5 years of service: 5 days 5. For next 5 years of service: 5 days 6. Total entitlement: 20 days 7. Value of one day ($50,000 / 260):

$192.31

Vacation: 20 x $192.31 = $3,846

© Mercer LLC 6 - 5

Public Holidays As for vacation, the number of public holidays recognized by each organization is translated into equivalent annual salary. If an organization indicates that holidays that fall on a weekend are lost, then the value of those days is 1/365th of annual salary. Floating holidays are also valued in this category.

EXAMPLE: PUBLIC HOLIDAYS 1. Annual Salary: $50,000 2. Number of holidays not

subject to loss: 4 days

3. Value of one day not subject to loss: ($50,000 / 260) $192.31

4. Number of holidays subject to loss: 6 days

5. Value of one day subject to loss: ($50,000 / 365) $136.99

Public Holidays: (4 x $192.31) + (6 x $136.99) = $1,591

Personal Leave As for vacation, the number of personal days granted by each organization is translated into equivalent annual salary.

EXAMPLE: PERSONAL LEAVE 1. Annual Salary: $50,000 2. Number of personal days: 3 days 3. Value of one day ($50,000 / 260): $192.31 Personal Leave: 3 x $192.31 = $577

Sick Leave As for vacation, the number of sick leave days granted by each organization is translated into equivalent annual salary. A 35% utilization rate is applied to plans that do not allow for cash-out upon termination of employment. If an organization allows carryover of unused sick leave, the value of any assumed unused accumulated sick leave is included in the short-term disability value.

EXAMPLE: SICK LEAVE 1. Annual Salary: $50,000 2. Number of sick days: 10 days 3. Value of one day ($50,000 / 260): $192.31 Sick Leave: 10 x $192.31 x .35 = $673

© Mercer LLC 6 - 6

Short-term Disability Benefits The value of the short-term disability benefit is the amount needed to purchase insurance to provide short-term income replacement payable for the first 6 months of disability. The reason for this definition of short-term disability benefits is to provide a consistent period of disability for the comparison. Assuming disabilities occur evenly throughout the year, the mean length of new benefit payments in a one-year time span would be 6 months. Thus, on average, the payments during the first 6 months of disability would be paid in that year. These payments are considered to be salary continuation benefits in that they are substitutes for that cash compensation in the same manner that sick pay or vacation pay is a substitute for cash compensation.

We determine the waiting period, the benefit percentage, the benefit period and any maximum benefit per day. Present value calculations are done for benefit payment streams resulting from disabilities lasting 11, 22, 33, 65 and 130 days. The age-based weighted-mean of these five results constitutes the benefit value. If an organization allows carryover of unused sick leave, the value of any assumed unused accumulated sick leave is included in the short-term disability value. If an organization provides a long-term disability benefit that commences within six months of disability, the value of any long-term disability benefits payable during the first six months of disability is included in the short-term disability value. Underwriting risk factors: age and sex. Impacts on claim amount: benefit period and amount insured.

EXAMPLE: SHORT-TERM DISABILITY BENEFITS 1. Plan Benefit: 100% of pay payable for four months,

followed by 75% of pay payable for two months

2. Pay: $50,000 $50,000 3. Daily benefit – first four months: $50,000/260 $192 4. Daily benefit – next two months .75 x$50,000/260 $144 5. Maximum daily benefit Unlimited 6. Employee’s age and sex: age 35, male 7. Value for one year to insure coverage (tax neutral benefit): $604 Short-term Disability Benefit Value: $604

© Mercer LLC 6 - 7

Long-term Disability Benefits The value of the long-term disability benefit is the amount needed to purchase insurance to provide the long-term income replacement payable beginning after 6 months of disability. The reason for this definition of long-term disability benefits is to provide a consistent period of disability for the comparison. We value the first six months of disability as short-term disability.

It is assumed that 70% of disabled individuals qualify for Social Security benefit payments. If an organization provides short-term disability benefits that extend beyond the first six months of disability, the value of any short-term disability benefits payable after the first six months of disability is included in the long-term disability value. Underwriting risk factors: age and sex. Impacts on claim amount: benefit period, actual elimination period of long-term disability benefit, social security offsets, amount insured.

EXAMPLE: LONG-TERM DISABILITY BENEFITS

1. Plan Benefit: 60% of pay reduced by Family Social Security

2. Pay: $50,000 $50,000 3. Family Social Security: $23,000 $23,000 4. Benefit amount: (.6 x $50,000) - (23,000 x .7) $13,900 5. Employee’s age and sex: age 35, male 6. Insurance rate for employee’s age/sex $.564/$100 of

benefit .00564

7. Value for one year to insure coverage (tax neutral benefit):($13,900 x .564) ÷ $100

$78

Long-term Disability Benefit Value: $78

SAMPLE LONG-TERM DISABILITY PREMIUMS

Age Male Female Annual Premium Rate per $100 Annual Benefit

25 30 35 40 45 50 55

$0.322 0.397 0.564 0.829 1.424 2.577 4.214

$0.499 0.564 0.999 1.405 2.046 3.146 4.174

© Mercer LLC 6 - 8

Retirement/Savings Defined Benefit Plans The approach taken determines the present value of the target retirement pension based on total expected service and allowing for projected salary increases to retirement date. Then the value of future benefit accruals is determined by multiplying by the ratio of future service to total service. For cash balance plans, the value of future benefit accruals is determined by projecting an account balance at retirement resulting from future employer contributions and the interest credited to those contributions. This resulting lump sum can be considered as the additional value attributable to staying with the organization to retirement, which is then spread as an even percentage of the employee's projected annual salary over the future working years until retirement. This gives a value which reflects the percentage of salary one would need to place in a retirement account in each future year to substitute for the benefits expected to emerge from the retirement plan owing to future years of continued employment. The annuity factor used to discount the future cash flow from the retirement annuity is determined at net interest rates (after federal tax). This represents the terms on which such a benefit could be replicated by the individual employee in the external market. Retirement age is a key factor when determining the value of the benefit because it affects both the accumulation period and the pay-out period. Early retirement subsidies such as unreduced benefits or bridge supplements are also a factor. In order to produce values which differ based on plan provisions, we use a single set of retirement probabilities. The following table shows the assumed distribution of retirements:

Age

Likelihood of Retirement

55 60 62 65

5% 15% 20%

60% 100%

Integration using Social Security is fully accounted for. To complete the valuation, the following assumptions are made.

Financial assumptions underlying the valuation: Rate of investment return: Rate of salary increase: Rate of increase in Social Security Wage base: Rate of increase in prices:

7.0%/year 4.0%/year

3.5%/year 2.5%/year

Demographic assumptions underlying the valuation: Preretirement mortality rates: Postretirement mortality rates: Withdrawal rates: Disability rates:

None

Retired Pensioners Mortality Table f/males and females projected to 2000, no collar, fully generational None None

© Mercer LLC 6 - 9

Comments Pension indexing after retirement is

assumed to be at the guaranteed rate of increase (where applicable). Ad-hoc increases, if reported with some frequency, result in an assumed indexing percentage equal to the reported rate divided by the frequency in years.

Temporary supplements payable at an early retirement age are included in calculations for organizations that reported such provisions.

© Mercer LLC 6 - 10

EXAMPLE: DEFINED BENEFIT PLANS 1. Membership statistics Age nearest: 35, male Service completed to date: 10 years Current Annual Salary: Current Mean Salary:

$50,000 $48,102

2. Plan details Retirement Pension: 2% x Mean Salary x Service Mean Salary: Mean of last three years’ Annual Salary Normal Retirement Age:

65 3. Calculation of benefit amounts Expected pension at age 65 Formula base pension: .02 x 40 x $48,102 x 1.0430

$124,811 4. Calculation of present value of benefit amounts

a. Present value of pension payable from age 65 Tax rate: Net discount rate: .07 x (1 - .25) Annuity factor at age 65 (calculated at 5.25%): Value = $124,811 x 10.94 ÷ 1.052530

25% 5.25% 10.94

$294,176 4. Calculation of present value of benefit amounts

b. Present value of future benefit accruals Service from now to age 65: 30 years Total service at age 65: 40 years Value = $294,176 x 30 ÷ 40

$220,632 5. Equivalent level rate of contribution over next 30 years

Spread factor for 30 years (calculated at 5.25% interest and 4.0% salary scale): Benefit value spread = $220,632 ÷ 25.20

25.20 $8,755

6. Assume that the value in (5) is taxed at rate t65, i.e., multiply by (1 - t65).

7. Gross up the value in (5) by dividing by (1 - t1) where t1 is the marginal rate of tax at the current date.

8. Assume t65 = t1 and therefore steps (6) and (7) neutralize each other.

Defined Benefit Value: $8,755


Defined Contribution Plans This category of benefit plans includes several common types of capital accumulation arrangements, including: 401(k) 403(b) (Tax Sheltered Annuity) After-Tax Savings Deferred Profit Sharing ESOP/LESOP Valuation is performed as follows: 1. Calculate the expected fund at

retirement, taking into account the payment of future contributions and assumed investment return. (Gross rate of 7.0% assumed.)

2. Spread this amount over the period to retirement yielding the annual level percentage contribution required to provide the benefits expected to emerge at retirement, due to continued years of future employment. For this purpose, the spread factor is calculated using a net discount rate (e.g., 5.25% = 7.0% x (1 - 25%)). We use discount rate net of tax because the employee is only able to achieve an "after-tax" accumulation rate outside the organization plans.

3. The principle of utilizing four probable retirement ages applies, just as for defined benefit plans.

Age

Likelihood of Retirement

55 60 62 65

5% 15% 20%

60% 100%

4. In all instances, the matched and unmatched employee contributions are constrained by plan rules and any government maximums, provided no "excess" plan or SERP exists.

Comments For plans with employee contributions, we assume the maximum percent of salary an employee is willing to contribute. These percentages are based on the employee pay level. Employer contributions are limited by the maximum amount that an employer will match. Following are specimen rates:

Mean Contribution Rate For Participating Employees

Salary Level Mean Contribution

Up to $25,000 $25,001 - $35,000 $35,001 - $45,000 $45,001 - $60,000 $60,001 - $75,000 $75,001 - $100,000

$100,001+

5.50% 6.50% 7.00% 7.75% 8.50% 8.25% 6.50%


Valuation of employer contributions to qualified plans The value of the benefit to the employee is the equivalent amount he/she would need to receive in pay in order to accumulate a similar benefit after tax without the existence of a qualified plan. The employee does not pay tax on the employer contributions until maturity.

It is assumed that the tax rate at maturity is equal to the employee's current marginal tax rate (the rate that would be applied to extra cash pay) and thus no additional value is calculated for a change in tax status. The employee is only able to achieve an after-tax accumulation rate outside the plan and thus discounting is at after-tax rates.

EXAMPLE: EMPLOYER CONTRIBUTIONS

1. Current annual employer contribution: $100.00 2. Gross accumulation factor for 20 years:

(at 7.0% interest and 4.0% salary scale)

57.91 3. Net accumulation factor:

(at 5.25% interest and 4.0% salary scale)

48.56 4. Equivalent cash value to employee

100 x 57.91 ÷ 48.56

$119.25 Employer Contribution Value: $119.25


Valuation of pretax employee contributions Pretax employee contributions may be accumulated in the organization plan at a gross rate. Tax deferral provides additional value. Therefore, the entire accumulation is taxable at maturity. For simplicity, the tax rate at maturity is assumed to be the same as the current tax rate.

The benefit to the employee, then, is the accumulated value of the pretax contributions, minus the tax payable when the benefit is received, and minus the value which could have been accumulated outside of a plan that allows pretax contributions.

EXAMPLE: PRETAX EMPLOYEE CONTRIBUTIONS

1. Employee contribution: ($100 pretax; $75 after-tax)

2. Gross accumulation at 7.0% for 20 years: $100 x 57.91

$5,791

3. Net accumulation at 5.25% for 20 years: $75 x 48.56

$3,642

4. Tax rate: 25% 5. Tax: $5,791 x .25 $1,448 6. Gain to employee:

$5,791 - $1,448 - $3,642

$701 7. Equivalent cash value to employee

(equivalent cash pay, pretax): $701 ÷ (48.56 x (1 - .25))

$19.25 Note: See previous comments regarding amounts in excess of IRS limitations. Pretax Employee Contribution Value: $19.25


Valuation of after-tax employee contributions After-tax employee contributions may be accumulated in the organization plan at a gross rate. There is no tax deferral benefit, but the earnings generated by the after-tax contributions are tax-deferred. Only a portion of the accumulation is taxable at maturity. For simplicity, the tax rate at

maturity is assumed to be the same as the current rate. The benefit to the employee, then, is the accumulated value of the after-tax contributions minus the tax payable at maturity, and minus the employee's contributions accumulated as if invested outside the plan at external rates and tax conditions.

EXAMPLE: AFTER-TAX EMPLOYEE CONTRIBUTIONS

1. Employee contribution: $100 2. Gross accumulation at 7.0%:

$100 x 57.91

$5,791 3. Net accumulation at 5.25%:

$100 x 48.56

$4,856 4. Capital accumulation (i.e., no interest)

$100 x 29.78

$2,978 5. Tax rate: 25% 6. Tax: ($5,791 - $2,978) x .25 $703 7. Gain to employee:

$5,791 - $4,856 - $703

$232 8. Equivalent cash value to employee

$232 ÷ (48.56 x (1 - .25))

$6.37 After-Tax Employee Contribution Value: $6.37


Stock Purchase Plans We assume that employees sell their stock immediately after the offering period. Each organization's offering period and discount rate are factored into the valuation. Where applicable, employees are assumed to "lock in" to the lowest possible stock price during the offering period. Therefore, the value is taken as the amount of the gain available to the employee on the basis that the stock could be bought and sold on the same day. For valuation purposes, the employee contribution is determined in a similar manner to other defined contribution "matched" plans. We assume the stock price growth rate to be 7.0%. The contribution assumption is as follows:

Contribution Rate: Pay % of Maximum Rate < $30,000 75% grading to > $80,000 100% For example, an employee earning $50,000 will contribute 85% of the maximum contribution rate allowed by the plan.

EXAMPLE: STOCK PURCHASE

Plan Details 1. Employee contribution: up to 10% of Pay 2. Frequency: Twice a year 3. Discount: 4. Growth 5. Defined Pay:

15% 7.0%

$50,000

Calculation 6. Assume employee buys and sells on the same day 7. Employee’s contribution: Contribution Rate: 85% of

max Contribution: .10 x .85 x $50,000 Assume one-half is used for each period.

$4,250

8. Market value of shares purchased: ($2,125 ÷ .85) x 1.07.5 ($2,125 ÷ .85) x 1.07

$2,586 $2,675

9. Total value of shares: $2,586 + $2,675 Total amount paid: Total value for the employee: $5,261 - $4,250

$5,261 $4,250 $1,011

Stock Purchase Value: $1,011


Health/Group Benefits Medical Benefits Medical benefits are valued utilizing actual claims experience from a sample distribution. POS and PPO plans are valued assuming the majority of claims occur In Network and a lesser percentage Out of Network. HMO and EPO plans are valued to recognize some claims are Out of Network and, therefore, unpaid. These values are then normalized to market rates.

% OF TOTAL CLAIMS

Plan Inside

Network Outside Network

HMO EPO POS PPO

Indemnity

95% 95% 95% 90% N/A

N/A N/A 5% 10%

100%

Where employee contributions are required, either for individual or family coverage, the value is adjusted for the employee contributions, which are assumed to be made on a pretax basis. Valuation is based on global parameters and specific covered charges. The global parameters available for use are: Deductible - Individual and Family Coinsurance percentage Out-of-Pocket Maximums - Individual

and Family Annual Maximum Lifetime Maximum Carve-Out Outpatient Mental Health Deductible Coinsurance Maximum Benefit Carve-Out Outpatient Chemical

Dependency Deductible Coinsurance Maximum Benefit

The specific covered charges are: Inpatient Hospital Admissions

Medical Surgical Maternity Mental Health Chemical Dependency

Outpatient Facilities Medical Surgical Maternity Mental Health Chemical Dependency

Inpatient Physician Medical Surgical Maternity Mental Health Chemical Dependency

Outpatient Physician Medical Surgical Mental Health Chemical Dependency

Wellness Benefits Newborn Nursery Well Baby Immunizations Physical Exams

Outpatient Miscellaneous X-rays Medical Supplies Chiropractor Outpatient Department - No

Other Specification Laboratory Other


Each of these twenty-eight covered charges can be either included or excluded from the value. Per incidence charges, such as a charge per admission to a hospital or a per visit copay for an office visit to a doctor, can be applied either additionally to the coinsurance percent or instead of the coinsurance percent. For each covered charge application of the coinsurance amount and/or deductible can be specified. Annual trends for utilization and price increases (decreases) are also applied. Utilization rates and mean prices per utilization for each covered charge are determined from a sample claims distribution. A value for each covered charge is determined by first subtracting from the mean price per utilization any per utilization copays and then adjusting for trending in utilization and price changes from the date of determination of the data. The values for each covered charge are summed three ways: total included charges, charges subject to the deductible, and charges subject to coinsurance.

Total annual charges per enrollee and the associated number of enrollees are distributed into 48 ranges on both an in-network and an out-of-network basis: $0 - $0 0 - 50 50 - 100 100 - 150 200 - 250 250 - 300 300 - 400 500 - 600 600 - 800 800 - 1,000 1,000 - 1,500 1,500 - 2,000 2,000 - 2,500 2,500 - 3,000 3,000 - 4,000 4,000 - 5,000 5,000 - 6,000 6,000 - 8,000 8,000 - 10,000 15,000 - 20,000 20,000 - 25,000 25,000 - 30,000 30,000 - 40,000 40,000 - 50,000 50,000 - 60,000 60,000 - 80,000 80,000 - 100,000 100,000 - 150,000 150,000 - 200,000 200,000 - 250,000 250,000 - 300,000 300,000 - 400,000 400,000 - 500,000 500,000 - 500,000 600,000 - 600,000 800,000 - 1,000,000 1,000,000 - 1,500,000 1,500,000 - 2,000,000 2,000,000 - 2,500,000 2,500,000 - 3,000,000 3,000,000 - 4,000,000 4,000,000 - 5,000,000 5,000,000 - 6,000,000 6,000,000 - 8,000,000 8,000,000+


From these distributions, adjustments for deductible, coinsurance, and out-of-pocket maximum are determined. The method used to calculate the adjustments is to, first, for each range in the distribution, calculate a mean annual charge, apply the deductible, and calculate the amount that is then payable from the plan, subject to the coinsurance level and out-of-pocket maximum. These amounts are multiplied by the number of employees in each range and totaled. The mean percentage of total cost over the deductible and mean percent saved from coinsurance (subject to the out-of-pocket maximum) are then calculated. The adjustments for deductible and coinsurance are then applied to the previously determined charges subject to deductible and charges subject to coinsurance. An adjustment for annual maximum is similarly calculated. Additional costs associated with carve-out provisions for outpatient mental health and chemical dependency are determined based on similar distributions of charges. For each of the forty-eight ranges, a mean charge is computed. These means are then subjected to the deductible, coinsurance, and maximum. The resulting amounts are then weighted by the number of enrollees and totaled to determine the adjustment amount. Adjustments for age/sex, geographical region, administrative expenses, and individual premium are then applied.

For postretirement coverage, retirement age assumptions are the same as for the defined benefit retirement plans. Current premium rates are projected and an increasing annuity (reflecting the plan's coordination with Medicare) is valued using the same techniques as are used for the defined benefit retirement plans. Medicare benefits are valued on the same manual rating basis and projected. It is assumed that there will be no cost shifting from Medicare to the employer plan. No assumption is made to take into account future caps on the level of benefits that can be provided to retirees. Therefore, the values that are shown for postretirement health may overstate the values of the benefits for employers with caps. However, given the current uncertainty in the health care system in the U.S. and the lack of regulatory guidance regarding benefit changes for retirees, we feel this is a reasonable assumption. These benefits are assumed to accrue with service. Thus an employee who is age 50 with 10 years of service who is retiring at age 65 will have earned 10/25 of the postretirement health benefit. Assumptions for Postretirement Medical: Discount rate: 7.0% Preretirement increases in medical

costs and Medicare: 9.0% for the first two years 7.5% for the next eight years 6.0% thereafter Postretirement increases in medical

costs and Medicare: Annual increase - 6.0% Aging - 1.5%


Dental Benefits Dental benefits are valued using a standard insurance organization manual rating technique. These values are then normalized to market rates. Where employee contributions are required, either for individual or family coverage, the value is adjusted for the employee contributions, which are assumed to be made on a pretax basis. The resulting amount is then grossed-up to recognize the tax-free status of benefits. Scheduled dental plans present unique challenges in the determination of value given our chosen methodology. We have valued these types of plans as if they are indemnity plans with the following characteristics: no deductibles, 80% coinsurance for preventive treatments, 60% coinsurance for basic treatments, 40% coinsurance for major treatments, and 40% coinsurance for orthodontic treatments, where applicable. Manual rating adjustment factors: age, marital/dependency status.

Life Insurance Benefits Death benefits are valued as the amount of insurance premium an individual would need to pay to provide the same level of coverage. For valuation purposes, the value determined is based on the expected coverage in the year following the valuation date. The coverage amount valued is equal to the amount of coverage which is provided (i.e. paid for) by the employer. The value reported is net of any required employee contributions. The tax-favored status of the first $50,000 of organization-provided coverage is factored into the benefit value. Underwriting risk factors: age, sex. Underwriting classification: standard non-medical, nonsmoking.

EXAMPLE: LIFE INSURANCE BENEFITS

Group Life Coverage Lump-Sum Death Benefit

1. Plan Benefit: 2 x Pay 2. Defined Pay: $50,000 3. Employee’s age and sex: age 35, male 4. Insurance rate for employee’s age/sex: $1.81/$1,000 .00181 5. Value for one year to insure coverage (before tax effect):

(2 x 50,000 x 1.81) ÷ 1,000

$181 6. Marginal tax rate: 25% 7. U.S. tax table premium rate: $.09 per month/$1,000 .00009 8. U.S. tax table premium: ($100,000 - $50,000) x .09 x 12 ÷

$1,000

$54 9. Value after gross-up: [181 - (54 x .25] ÷ (1 - .25) $223 Life Insurance Benefit Value: $223


Dependent Care and Health Care Spending Accounts Dependent care and health care spending accounts provide a means for employees to pay for these expenses on a tax-favored basis. Where no employer contributions are made, the value of the benefits is the tax advantage enjoyed by the employee. Because the employee is at risk of losing any monies not used, the valuation method assumes a conservative level of use of the accounts. The value determined for these benefits is generally small relative to other benefits, but is being determined and included due to the current high visibility of such plans. Employer contributions to spending account plans are fully tax effective. For dependent care, the amount of salary assumed to be deferred into the plan is determined as follows: $2,000 per child family member for

an employee under age 50 ($1,300 for a male employee with a spouse), up to the maximum specified by the plan.

Where employer contributions exist, the resulting total is provided first from the employer and supplemented by the employee; if there are no employer contributions, the entire amount is contributed by the employee.

This amount is adjusted based on pay levels to recognize the availability of the child care tax credit. The adjustment is a linear interpolation between 0% at $25,000 pay to 100% at $45,000 pay for a married employee and 0% at $18,000 pay to 100% at $33,000 pay for an unmarried employee.

This amount is multiplied times 25% to recognize the proportion of children who require care.

For medical spending accounts, the amount of salary assumed to be deferred into the plan is determined as follows: $125 per adult family member plus

$175 per child family member, up to the maximum specified by the plan.

Where employer contributions exist, the resulting total is provided first from the employer and supplemented by the employee; if there are no employer contributions, the entire amount is contributed by the employee.

This sum is adjusted based on pay levels to recognize the risk of losing unused amounts in the account (lower paid employees receive a lesser tax advantage and so cannot afford the risk that higher paid employees can). The adjustment is a linear interpolation between 0% at a $25,000 pay to 100% at a $75,000 pay.

SAMPLE LIFE PREMIUMS Life Insurance Age Male Female Annual Premium Rate per $1,000 Lump Sum

25 30 35 40 45 50 55

$1.73 1.76 1.81 2.11 2.77 3.93 5.68

$1.57 1.62 1.67 1.83 2.23 2.96 4.01


Impact of Taxation When performing valuations we take into account taxability of the benefit provided. If the benefit provided by the organization is taxed beneficially compared with how an externally purchased benefit would be taxed, the difference is recognized in the calculation. For example, a Medical Insurance plan may be provided to an employee with no tax consequences. If the organization did not provide the plan, an employee would have had to buy Medical Insurance out of after-tax income. In this case, the value of the organization plan is grossed-up by dividing by (1-MTR) where MTR is the Marginal Tax Rate of the employee. Marginal tax rate The Marginal Tax Rate is generally computed using the following formula: Marginal Tax Rate = (T2 - T1)/(P2 - P1) Where: P1 = current taxable pay

P2 = current taxable pay + $1,000 T1 = The tax on P1 T2 = The tax on P2

That is to say, the Marginal Tax Rate is the effective rate of tax on the next $1,000 of remuneration. The remuneration may be in the form of cash or benefits that receive either a beneficial tax treatment in the current year or on which tax is deferred to a later date. Calculation of taxable pay Taxable Pay is computed based on single or married status rates, assuming standard deduction and dependents in accordance with the employee profile. Calculation of T1 and T2 Tax is determined using the United States federal tax rate schedule. P2 changes as the marginal tax rate changes so the process is iterative. A sufficient number of iterations are performed to determine the final marginal tax rate.

©2012 Mercer LLC

About Mercer Mercer is a leading global provider of consulting, outsourcing and investment services, with more than 25,000 clients worldwide. Mercer consultants help clients design and manage health, retirement and other benefits and optimize human capital. The firm also provides customized administration, technology and total benefit outsourcing solutions. Mercer’s investment services include global leadership in investment consulting and multi-manager investment management. Mercer’s global network of 17,000 employees, based in more than 40 countries, ensures integrated, worldwide solutions. Our consultants work with clients to develop solutions that address global and country-specific challenges and opportunities. Mercer is experienced in assisting both major and growing, mid-size companies. The company is a wholly owned subsidiary of Marsh & McLennan Companies, Inc., which lists its stock (ticker symbol: MMC) on the New York, Chicago and London stock exchanges. The information contained in this document (including any attachments) is not intended by Mercer to be used, and it cannot be used, for the purpose of avoiding penalties under the Internal Revenue Code that may be imposed on the taxpayer. Mercer is providing this survey information to its clients to permit them to make independent decisions regarding salaries and benefits. Because the exchange of salary and benefit information among competitors may be construed in certain circumstances as a means to facilitate an antitrust violation, Mercer has taken appropriate steps in collecting and disseminating this information in order to avoid such perceptions.

©2013 Mercer LLC

About Mercer Mercer is a leading global provider of consulting, outsourcing and investment services, with more than 25,000 clients worldwide. Mercer consultants help clients design and manage health, retirement and other benefits and optimize human capital. The firm also provides customized administration, technology and total benefit outsourcing solutions. Mercer’s investment services include global leadership in investment consulting and multi-manager investment management. Mercer’s global network of 17,000 employees, based in more than 40 countries, ensures integrated, worldwide solutions. Our consultants work with clients to develop solutions that address global and country-specific challenges and opportunities. Mercer is experienced in assisting both major and growing, mid-size companies. The company is a wholly owned subsidiary of Marsh & McLennan Companies, Inc., which lists its stock (ticker symbol: MMC) on the New York, Chicago and London stock exchanges.

The information contained in this document (including any attachments) is not intended by Mercer to be used, and it cannot be used, for the purpose of avoiding penalties under the Internal Revenue Code that may be imposed on the taxpayer. Mercer is providing this survey information to its clients to permit them to make independent decisions regarding salaries and benefits. Because the exchange of salary and benefit information among competitors may be construed in certain circumstances as a means to facilitate an antitrust violation, Mercer has taken appropriate steps in collecting and disseminating this information in order to avoid such perceptions.

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