Compliance Notices for Health Coverage

Compliance Notices You may cover your dependents up to age 26 on the medical, dental and vision plans. Special Enrollment Rights If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance coverage, you may in the future be able to enroll yourself or your dependents in this plan, provided that you request enrollment within 30 days after your other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents, provided that you request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption. Provider Networks A complete provider directory for services is available to all employees at cost upon request. These directories are also available online at the respective carrier websites and would only be applicable to the medical and dental coverages. The current available network for your medical plan is a national network. Please see the directory for further information. Uniformed Services Employment and Reemployment Rights Act (USERRA) If you are going into or returning from military service, you may have special rights to health care coverage under the Uniformed Services Employment and Reemployment Rights Act of 1994. These rights can include extended health care coverage. If you may be affected by this law, ask your plan Administrator for further details. Women's Health & Cancer Rights Act of 1998 If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women's Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: • All stages of reconstruction of the breast on which the mastectomy was performed; • Surgery and reconstruction of the other breast to produce a symmetrical appearance; • Prostheses; • Treatment of physical complications of the mastectomy, including lymphedema. These benefits will be provided subject to the same deductibles and coinsurance or copays applicable to other medical and surgical benefits provided under this Plan. Therefore, the deductibles and coinsurance for your health plan apply. If you would like more information on WHCRA benefits, call your Plan Administrator at 603-594-6171. Newborns' and Mothers' Health Protection Act of 1996 Group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn child to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, federal law generally does not prohibit the mother's or newborn's attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable). In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours). Summary of Benefits and Coverage ("SBC") and Uniform Glossary The Affordable Care Act requires that employers must provide an SBC to all eligible employees and beneficiaries with any application for enrollment (including annual open enrollment) and upon request. A copy of the Plan's SBC is contained with your annual enrollment materials. If you have any questions, or did not receive one, please contact Human Resources. Family Medical Leave Act (FMLA) Job protection and limited benefits for up to 12 weeks if you are seriously ill or injured, for the birth, adoption or foster care placement of a child, to care for the child, or to care for a sick spouse, child or parent. Job protection for up to 26 weeks for Covered Service Member Entitlement Leave. See HR for additional information.