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UNIVERSAL MANAGEMENT COMPANY2016 Renewal Presentation

TABLE OF CONTENTS1 HEALTH CARE REFORM

2 FINANCIAL ANALYSIS & MEDICAL PLAN OPTIONS

3 DENTAL & VISION PLAN OPTIONS

4 LIFE AND DISABILITY OPTIONS

5 SPECIALTY BENEFIT PLAN OPTIONS

SMART BENEFIT SOLUTIONS

CARRIERS CONTACTED

MEDICAL – BCBSM

• BCN: Presented• Priority Health: Presented• AHL / HAP: Presented

DENTAL – NEW LINE

• Delta Dental: Presented• Guardian: Presented• Principal Financial: Presented• Ameritas: Presented

VISION – NEW LINE

• Heritage: Presented• Ameritas: Presented• Guardian: Presented• Principal: Presented

LIFE & DISABILITY – Reliance Standard

• Guardian: Presented• Mutual of Omaha: Presented• Sun Life: Presented• MMA / MetLife: Presented• The Hartford: Requested• UNUM: Presented

Detailed below is a categorical listing of carriers that were contacted regarding assumingcoverage for Universal Management Company. Noted below are the responses that were

received per carrier.


3

HEALTH CARE REFORM


4

Health Care Reform 2-50 Checklist

Mandated Benefit Changes StatusMapped to new HCR compliant plan PASS

Cover Essential Health Benefits PASS

Implement True Out of Pocket Maximums PASS

Pediatric Dental / Pediatric Vision Coverage PASS

New Hire Waiting Period can not exceed 90 days PASS

Minimum hours for eligibility can not exceed 30 PASS

Required Action:

NONE

Universal Management Company

5

2016 ACA/Regulatory Renewal Checklist For Small Groups (1-50)

The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the law was enacted in 2010.

This checklist provides a brief overview of the ACA’s key reforms that are in effect or will take effect in 2016. Employers should review this checklist to help confirm they are ready to comply with the ACA’s current reforms. Please contact Austin Benefits Group if you would like more information about any of the following.

Plan Design Changes

ACA Requirement Action Items

Grandfathered Plan Status

A grandfathered plan is one that was in existence when the ACA was enacted on March 23, 2010. If you make certain changes to your plan that go beyond permitted guidelines, your plan is no longer grandfathered.

□ If you have a grandfathered plan, determine whether it will maintain its grandfathered status for the 2016 plan year.

□ If your plan will lose its grandfathered status for 2016, confirm that the plan has all of the additional patient rights and benefits required by the ACA for non-grandfathered plans.

Health FSA Contributions

Effective for plan years beginning on or after Jan. 1, 2013, the ACA placed an annual limit on an employee’s pre-tax salary reduction contributions to a health flexible spending account (FSA). The health FSA limit was $2,550 in 2015 and will remain the same in 2016.

□ If you had a health FSA in 2015, there are no changes.

□ If you start a health FSA in 2016, the annual limit will be $2,550.

Essential Health Benefits (EHBs)


EHBs and Pediatric Dental and Vision Certain health benefits that are deemed “essential” must be covered. The minimum package of items and services that must be covered by these plans generally defined by each state’s EHB benchmark plan. Grandfathered plans don’t have to cover EHBs but, if they do, they can’t set any annual or life dollar limits on those EHBs. ACA requires that each employee and dependent (enrolled in an applicable medical plan) must have pediatric dental and vision EHB coverage. The law requires pediatric dental and vision coverage as an EHB for non-grandfathered fully insured small group and non-grandfathered individual plans with plan/policy years beginning on or after Jan. 1, 2014.

□ Ensure your health care plan covers EHBs

□ Ensure you offer pediatric dental and vision EHB coverage (excluding grandfathered plans)

6


Out-of-pocket Maximums for EHBs

For plan years beginning on or after Jan. 1, 2016, member cost sharing for in-network EHBs, across all service providers, cannot exceed the OOPM set by ACA. The OOPM cannot exceed $6,850 for individual coverage, and $13,700 for family coverage in the 2016 plan year. Generally, member cost sharing that is considered part of the OOPM includes:

Deductibles for in-network EHBs Coinsurance for in-network EHBs Copayments for in-network EHBs Any other expenditure required by, or on behalf

of, an enrollee for in-network EHBs including out-of-network emergency services and member liability on reference-based pricing (RBP) claims

□ Confirm that the OOPM for your 2015 plan with EHBs does not exceed $6,850 for individual, or $13,700 for family coverage

Minimum Value Coverage


A plan provides minimum value if the plan’s share of total allowed costs of benefits provided under the plan is at least 60 percent of those costs. The IRS and HHS provided the following approaches for determining minimum value: a Minimum Value Calculator; design-based safe harbor checklists; and actuarial certification. In addition, any plan in the small group market that meets any of the “metal levels” of coverage (that is, bronze, silver, gold or platinum) provides minimum value.

□ Determine whether your health plan provides minimum value by using one of the four available methods (minimum value calculator, safe harbor checklists, actuarial certification or metal level).

Taxes & Fees


Reinsurance Fee

Health insurance issuers and self-funded group health plans that provide major medical coverage must pay fees to a reinsurance program for the first three years of the Exchanges’ operation (2014-2016). Certain self-insured plans are exempt from the reinsurance fees, such as health FSAs and health reimbursement arrangements (HRAs) that are integrated with major medical coverage. For 2015 and 2016, self-insured health plans are exempt from the reinsurance fees if they do not use a third-party administrator in connection with the core administrative functions of claims processing or adjudication or plan enrollment. Health insurers and third-party administrators (TPAs) are responsible for paying the reinsurance program fees on behalf of insured and self-insured plans, respectively.

□ Taking into account the new exception for self-insured, self-administered health plans, review the health coverage you provide to your employees to determine the plan(s) subject to the reinsurance fees for 2016.

□ For 2016, HHS announced a national contribution rate of $27 per enrollee per year (about $2.25 per month). The reinsurance fee is calculated by multiplying the number of covered lives (employees and their dependents) for all of the entity’s plans and coverage that must pay contributions by the national contribution rate for the year.

7


Health Insurer Fee

The premium in a group’s bill will be adjusted to reflect the effects of the Health Insurer Fees, which will be inclusive of any additional federal and state taxes applicable to these fees. This provision requires covered entities providing health insurance (health insurers) to pay an annual fee to the federal government. These fees are designed to support programs that will stabilize premiums and provide subsidies to qualified individuals to help them purchase coverage. The Health Insurer Fee does apply to stand-alone vision and dental plans.

□ The fee is already built into your premium, so you do not have to take any additional steps.

PCORI

The Patient-Centered Outcomes Research Institute (PCORI) fee funds patient-centered outcomes (also referred to as the comparative clinical effectiveness) research. The fee is multiplied by the average number of lives covered under the plan or policy for plan years ending on or after Oct. 1, 2015, and before Oct. 1, 2016. For fully insured groups, the insurer responsible for reporting and paying these fees to the federal government or other entity based on the number of covered lives of its member base. For self-funded groups or products such as an HRA, the health plan sponsor is responsible for remitting the payment.

□ Pay PCORI fees by filing a Form 720, the quarterly Federal Excise Tax Returns to report and pay the annual fees.

□ Fees are due on July 31, 2016 for plan years ending in 2015.

□ The fee for the plan years ending on or after Oct. 1, 2015 and before Oct. 1, 2016 is $2.17

HIPAA Certification


Health plans must file a statement with HHS certifying their compliance with HIPAA’s electronic transaction standards and operating rules. The first certification deadline is Dec. 31, 2015.

Controlling health plans (CHPs) are responsible for providing the initial HIPAA certification on behalf of themselves and their subhealth plans, if any. Based on HHS’ definition of CHPs, an employer’s self-insured plan will likely qualify as a CHP, even if it does not directly conduct HIPAA-covered transactions. For employers with insured health plans, the health insurance issuer will likely be the CHP responsible for providing the certification.

It is likely that HHS will issue additional guidance on the HIPAA certification requirement in the future.

□ Confirm whether your health plan is a CHP that is required to provide the initial HIPAA certification.

o If you have a self-insured plan, work with your third-party administrator (TPA) to complete the certification by the deadline.

o If you have an insured plan, confirm that the issuer will be providing the HIPAA certification on your behalf.

□ Work with your advisors to monitor additional guidance from HHS on the HIPAA certification requirement.

8


Health Plan Identifier (HPID) - DELAYED


The HPID, along with the national provider identifier implemented in 2004, is a standard identifier that was required by the original Health Insurance Portability and Accountability Act of 1996 (HIPAA). The original deadline required by the Centers for Medicare and Medicaid services has since been delayed indefinitely until further notice.

No action items at this time, but should a new deadline be provided, the following actions should be taken:

□ To apply for an HPID, go to the CMS Enterprise Portal to obtain a user ID and password (verification process).

□ Then select the link to register in the HIOS (this may take up to 48 hours).

□ After registering, select the HPOES and follow the prompts.

Wellness Incentives


ACA changes the maximum reward that can be provided under HIPAA’s health factor-based wellness program from 20 to 30 percent. The reward under such a program can be up to 30 percent of the cost of employee coverage. Additionally, the secretaries of Health and Human Services, Labor and Treasury can expand the reward up to 50 percent of cost coverage if deemed appropriate.

□ Consider offering wellness incentives as part of a corporate wellness program, which Austin Benefits Group can assist with putting together.

Employer Penalty Rules For employers that are considered large (50 or more employees – including full-time equivalents), there are penalty rules that come into effect, such as:

Employer Shared Responsibility (ESR)

-Affordability test

-Minimum value coverage

-Full-time equivalent tracking

6055/6056 Reporting

Employer Responsibilities

Marketplace Notices – As of Oct. 1, 2013, employers have to provide employees with written notice of the Marketplace. For 2014 and beyond, an employer has to provide the notice to new employees within 14 days of an employee’s start date. The notice is required to be provided automatically, free of charge. It can be provided in writing either by first-class mail, or electronically (www.dol.gov/ebsa/) if the Department of Labor’s electronic disclosure safe harbor requirements are met.

9

http://www.dol.gov/ebsa/


Plans Losing Grandfathered Status Plans losing grandfathered status must implement changes that went into effect prior to 2015.

Changes to implement

Appeals and Reviews – Amend process for appeals by implementing appeals and external review requirements.

Clinical Trials – Requires that if a “qualified individual” is in an “approved clinical trial,” the plan may not: (1) deny the individual

participation in the clinical trial; (2) deny the coverage of routine patient costs for items and services furnished in connection with

the trial; and (3) discriminate against the individual on the basis of the individuals participation in such trial.

Community Rating – Health insurance issuers can only use the following rating factors: geographic area, family demographics, age and tobacco use.

Direct Access – Allow direct access to OB/GYNs for female enrollees without pre-authorization or referral.

Emergency Services – Cover emergency room (ER) services without pre-authorization, even for out-of-network providers, and apply

prudent layperson definition of an emergency medical condition. If services are rendered out of network, ACA cost- sharing

requirements apply. This is for the initial ER services in the emergency room, including the emergency room physicians fee – and

does not include ambulance or facility/professional fees for follow-up medical treatment.

Non-discrimination Regarding Health Care Providers – Health care providers can participate in an insurer’s provider network as long

as they follow the terms and conditions for participation and act within the limits of their medical license or certification.

Physician Choice – Allow members to choose any participating primary care physician or pediatrician.

Pre-existing Conditions Exclusions – Eliminate pre-existing condition limitations for enrollees of all ages.

Preventive Services – Remove cost-sharing requirements on certain recommended preventive services.

The information in this handout is subject to change based on subsequent federal and state laws, regulations and guidance. This information is a high-level summary and for general informational purposes only. The information is not comprehensive and does not constitute legal, tax, compliance or other advice or guidance.

austinbenefits.com | 248-594-5550

10

http://www.austinbenefits.com/

FINANCIAL ANALYSIS


11

Age Medical Premium Employer Contribution EE Contribution Medical Premium Employer Contribution EE Contribution

Byrd, Cantrese 43 $389.13 $272.39 $116.74 $393.31 $275.32 $117.99

Naab, Antoinette 30 $320.88 $224.62 $96.26 $328.97 $230.28 $98.69

Parks, Elizabeth 59 $746.44 $522.51 $223.93 $754.45 $528.12 $226.34

Rougeau, Sonya 47 $448.21 $313.75 $134.46 $453.02 $317.11 $135.91

Whiren, Kimberly 40 $366.48 $256.54 $109.94 $370.42 $259.29 $111.13

Monthly Grand Total $2,271.14 $1,589.80 $681.34 $2,300.17 $1,610.12 $690.05Yearly Grand Total $27,253.68 $19,077.58 $8,176.10 $27,602.04 $19,321.43 $8,280.61

$ Employer Monthly Increase / Decrease $29.03 $20.32 $8.71% Employer Monthly Contribution Increase / Decrease 1.28% 1.28% 1.28%

*Rates may change slightly upon enrollment* Rates and contributions include federal taxes and fees.* All Rates and contributions illustrated are displayed on a monthly basis

Current - BCN HMO $2000 Renewal - BCN HMO $2000

Medical Premium - Employer pays 70% of The Single Rate.Employees Pay 100% For All Dependents.

Medical Premium - Employer pays 70% of The Single Rate.Employees Pay 100% For All Dependents.

Universal Management Company| Financial Analysis12

MEDICAL PLAN OPTIONS


13

AGECurrent Plan

BCN HMO 2000Renewal Plan

BCN HMO 2000 BCN HMO Silver $3000 (20%) BCN HMO Silver $4000 (30%)Grand Total $2,271.14 $2,300.17 $2,112.87 $1,930.67

Byrd, Cantrese $389.13 $393.31 $361.29 $330.13Byrd, Cantrese 43 $389.13 $393.31 $361.29 $330.13

Naab, Antoinette $320.88 $328.97 $302.18 $276.12Naab, Antoinette 30 $320.88 $328.97 $302.18 $276.12

Parks, Elizabeth $746.44 $754.45 $693.02 $633.26Parks, Elizabeth 59 $746.44 $754.45 $693.02 $633.26

Rougeau, Sonya $448.21 $453.02 $416.13 $380.25Rougeau, Sonya 47 $448.21 $453.02 $416.13 $380.25

Whiren, Kimberly $366.48 $370.42 $340.25 $310.91Whiren, Kimberly 40 $366.48 $370.42 $340.25 $310.91

BCN HMO Medical Plan

Universal Management Company | Medical Analysis14

Universal Management Company | Medical Analysis

$-

$500.00

$1,000.00

$1,500.00

$2,000.00

$2,500.00

CurrentRates

RenewalRates

BCN HMOSilver$3000(20%)

BCN HMOSilver$4000(30%)

SB Silver$2000

SB PPOSilver$3000

HAP 2000HMO II

HAP 3000HMO

HAP 2000PPO II

HAP 3000PPO

PH HMO2000

PH HMO3000

PH PPO2000

PH PPO3000

15

00279884-0001

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

$2,000 N/A $2,000 N/A $3,000 N/A $4,000 N/A$4,000 N/A $4,000 N/A $6,000 N/A $8,000 N/A


70% N/A 70% N/A 80% N/A 70% N/A30% N/A 30% N/A 20% N/A 30% N/A





Elective Abortion

Prescription Formulary

$2,271.14 $27,253.68 $2,300.17 $27,602.04 $2,112.87 $25,354.44 $1,930.67 $23,168.04

$29.03 $348.36 ($158.27) ($1,899.24) ($340.47) ($4,085.64)

Included

$40

Included

$ Change from Current% Change from Current 1.28%

Monthly / Annual Premium

Specialist Visit

EE Coinsurance Liability

EE True Out of Pocket Max:

Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40

Non-Preferred Specialty

$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

20% ($300 Maximum) 20% ($300 Maximum)

SingleFamily

30% after Deductible 30% after Deductible

Urgent Care $50 $50

Hospital Admission

$150 $150Emergency Room

Embedded Coinsurance Max:

Renewal Option - GoldBCN HMO 2000

Current PlanBCN HMO 2000

(Current Billed Ages)

Generic

20% ($300 Maximum)

Not Included Not Included

Custom Select

Silver

BCN HMO $3000 Deductible

Silver

BCN HMO 70% $4000 Deductible

Pediatric Dental

Preferred Specialty 20% ($200 Maximum)

$6 or $25 $6 or $25$50

$8020% ($200 Maximum)

Medical Riders:

Imaging $150 after Deductible $150 after Deductible

Included Included on DentalIncluded

Employee RX Copay:

$20 $35$45$50

Family

In-Network Employee Copay:

Coinsurance Percentage:

Carrier Coinsurance Liability

$40

Medical Policy #:

Employee Deductible:

Renewal Date: 9 / 1 / 2016

SingleFamily

$150 after Deductible30% after Deductible

Included on Dental

-6.97%

$30$50$50

$250$150 after Deductible20% after Deductible

$50

$250

-14.99%

$8020% ($200 Maximum)

Custom Select Custom Select Custom Select

$4 or $15


00279884-0001

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

$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily

Custom Select Custom Select

$4 or $15


$2,700 N/A $3,000 N/A$5,400 N/A $6,000 N/A


80% N/A 100% N/A20% N/A 0% N/A


N/A N/A N/A N/AN/A N/A N/A N/A


$5,000 N/A $6,300 N/A$10,000 N/A $12,600 N/A

$2,039.56 $24,474.72 $2,082.96 $24,995.52

($231.58) ($2,778.96) ($188.18) ($2,258.16)


Silver (Embedded)

BCN HMO HSA $3000 Deductible

Silver (Embedded)

BCN HMO HSA $2700 Deductible

20% ($300 Maximum)

0% after Deductible

Included on DentalIncluded on Dental

-8.29%

20% after Deductible20% after Deductible20% after Deductible20% after Deductible20% after Deductible20% after Deductible

Custom Select

Rx Copays After Deductible

$4 or $15$40


$10 or $30$60$80

20% ($200 Maximum)20% ($300 Maximum)

0% after Deductible0% after Deductible0% after Deductible0% after Deductible0% after Deductible

-10.20%

$8020% ($200 Maximum)

Custom Select


00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$2,000 $4,000 $3,000 $6,000$4,000 $8,000 $6,000 $12,000


70% 50% 80% 60%30% 50% 20% 40%




$6,600 $13,200 $6,350 $12,700$13,200 $26,400 $12,700 $25,400

$2,185.58 $26,226.96 $2,172.72 $26,072.64

($85.56) ($1,026.72) ($98.42) ($1,181.04)-4.33%

Not Included

Custom Select

Not Included

30% after Deductible

25% ($300 Maximum) 25% ($300 Maximum)Custom Select

Included on Dental

50% ($80 Min, $100 Max)

$20$60

-3.77%

20% ($200 Maximum)

$15020% after Deductible20% after Deductible

$50$60

Silver

BCBSM Simply Blue PPO $2000

Silver

BCBSM Simply Blue PPO $3000

$30

20% ($200 Maximum)

30% after Deductible$250

$40

$60$60

Included on Dental

$20$60

50% ($80 Min, $100 Max)


00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$2,700 $5,400 $3,250 $6,500$5,400 $10,800 $6,500 $13,000


80% 60% 100% 80%20% 40% 0% 20%




$5,000 $10,000 $5,500 $11,000$10,000 $20,000 $11,000 $22,000

$2,125.89 $25,510.68 $2,152.41 $25,828.92

($145.25) ($1,743.00) ($118.73) ($1,424.76)

Custom Select

Not Included

25% ($300 Maximum)

-5.23%

50% ($70 Min, $100 Max)

-6.40%

0% after Deductible

$15$50

0% after Deductible

Not Included


Silver $3250 (Embedded)

BCBSM Simply Blue PPO HSA ($250)

0% after Deductible0% after Deductible


20% ($200 Maximum)





Included on Dental

0% after Deductible

Silver $2700 (Embedded)

BCBSM Simply Blue PPO HSA ($0)

Included on Dental


$20$60

50% ($80 Min, $100 Max)20% ($200 Maximum)25% ($300 Maximum)

Custom Select


00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$2,000 N/A $3,000 N/A$4,000 N/A $6,000 N/A


80% N/A 80% N/A20% N/A 20% N/A




$6,850 N/A $6,850 N/A$13,700 N/A $13,700 N/A

$2,077.88 $24,934.56 $2,018.13 $24,217.56

($193.26) ($2,319.12) ($253.01) ($3,036.12)

$30 $40


$20 $15

$65


Included on Dental Included on Dental

$60 $50

HAP HMO II 2000 HAP HMO 3000

$50 $60$65

$200 $20020% after Deductible 20% after Deductible

50% ($250 Maximum) 50% ($250 Maximum)

50% ($500 Maximum) 50% ($500 Maximum)N/A N/A

-8.51% -11.14%

50% ($500 Maximum) 50% ($500 Maximum)


00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$2,000 N/A $2,000 $5,000$4,000 N/A $4,000 $10,000


80% N/A 80% 50%20% N/A 20% 50%




$6,000 N/A $6,850 $15,000$12,000 N/A $13,700 $30,000

$2,004.55 $24,054.60 $2,289.77 $27,477.24

($266.59) $24,054.60 $18.63 $223.56

HAP PPO II 2000

50% ($250 Maximum)

0.82%

$30$50$65

$200

Included on Dental

$20

50% ($500 Maximum)

$60

50% ($500 Maximum)

Not Included



HAP HSA HMO 2000


20% after Deductible20% after Deductible20% after Deductible


Included on DentalNot Included


-11.74%


N/AN/A


00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$3,000 $6,000 $2,000 $5,000$6,000 $12,000 $4,000 $10,000


80% 50% 80% 50%20% 50% 20% 50%




$6,850 $15,000 $6,000 $12,000$13,700 $30,000 $12,000 $24,000

$2,236.84 $26,842.08 $2,220.49 $26,645.88

($34.30) ($411.60) ($50.65) $26,645.88

HAP PPO 3000

$5050% ($250 Maximum)50% ($500 Maximum)

$65$200


Included on Dental

HAP HSA PPO 2000

$40$60

Not IncludedNot IncludedIncluded on Dental


20% after Deductible$15

-2.23%

20% after Deductible20% after Deductible50% ($500 Maximum)

-1.51%

N/A N/A



00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$2,000 N/A $3,000 N/A$4,000 N/A $6,000 N/A


70% N/A 70% N/A30% N/A 30% N/A




$6,250 N/A $6,250 N/A$12,500 N/A $12,500 N/A

$2,138.82 $25,665.84 $2,062.32 $24,747.84

($132.32) ($1,587.84) ($208.82) ($2,505.84)

Priority Health HMO 2000 Priority Health HMO 3000

$30$45$75

$30

$250$150



$20$60$80

$60$80

20% ($200 Maximum)20% ($400 Maximum)

N/A

-5.83%

$45$75

$250$150



$20

20% ($200 Maximum)20% ($400 Maximum)

N/A

-9.19%


00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$2,000 N/A $3,550 N/A$4,000 N/A $7,100 N/A


70% N/A 50% N/A30% N/A 50% N/A




$5,000 N/A $6,550 N/A$10,000 N/A $13,100 N/A

$1,986.46 $23,837.52 $1,720.21 $20,642.52

($284.68) ($3,416.16) ($550.93) ($6,611.16)


Included on Dental

30% after Deductible30% after Deductible30% after Deductible30% after Deductible30% after Deductible

-12.53%

Priority Health HSA HMO $3550



Rx copays after Deductible

$20$75

$10020% ($200 Maximum)20% ($400 Maximum)

N/A

-24.26%

Not Included


$20$60$80

20% ($200 Maximum)20% ($400 Maximum)

N/A

Priority Health HMO HSA 2000


00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$2,000 $4,000 $3,000 $6,000$4,000 $8,000 $6,000 $12,000


70% 50% 70% 50%30% 50% 30% 50%




$6,250 $12,500 $6,250 $12,500$12,500 $25,000 $12,500 $25,500

$2,221.21 $26,654.52 $2,131.61 $25,579.32

($49.93) ($599.16) ($139.53) ($1,674.36)

Priority Health PPO 2000

$30$45$75

$250$150



$20

$80$60

20% ($400 Maximum)N/A

20% ($200 Maximum)

N/A

-2.20% -6.14%

Priority Health PPO 3000

$30$45$75

$250$150



$20$60$80

20% ($200 Maximum)20% ($400 Maximum)


00279884-0001


$2,000 N/A $2,000 N/A$4,000 N/A $4,000 N/A


70% N/A 70% N/A30% N/A 30% N/A


$1,000 N/A $1,000 N/A$2,000 N/A $2,000 N/A


$6,600 N/A $6,600 N/A$13,200 N/A $13,200 N/A

Elective Abortion


$2,271.14 $27,253.68 $2,300.17 $27,602.04

$29.03 $348.36

Included

$40

Included



Specialist Visit



Single

Office Visit $20

$40$80

20% ($200 Maximum)

Preferred Brand $40


$4 or $15

Non-Preferred Brand

20% ($300 Maximum)

$80

SingleFamily


Urgent Care $50 $50

Hospital Admission






Generic

20% ($300 Maximum)

Pediatric Dental


Medical Riders:


IncludedIncluded

Employee RX Copay:

$20

Family




$40

Medical Policy #:



SingleFamily


$4 or $15


$2,000 $4,000 $3,550 $7,100$4,000 $8,000 $7,100 $14,200


70% 50% 50% 40%30% 50% 50% 40%




$5,000 $10,000 $6,550 $13,100$10,000 $20,000 $13,100 $26,200

$2,114.47 $25,373.64 $1,786.70 $21,440.40

($156.67) ($1,880.04) ($484.44) ($5,813.28)



$20$60$80

20% ($200 Maximum)20% ($400 Maximum)

30% after Deductible30% after Deductible30% after Deductible30% after Deductible

N/A

-6.90%

Priority Health HSA PPO $3550



Rx copays after Deductible

$20$75

$10020% ($200 Maximum)20% ($400 Maximum)

-21.33%

Priority Health PPO HSA 2000



1) Employee headcounts obtained from May 2016 census.2) Final premium cost subject to change based on employee enrollment.3) Medical plan premiums shown above exclude Pediatric Dental EHBs and may increase if a ACA Compliant Dental plan is NOT purchased.4) The benefits shown in this section are not an insurance contract. The information provided is for illustrative purposes only. Please refer to the contractfor the exact description and details.5) The Embedded Coinsurance Maximum excludes the deductible, office visit copay, prescription drug copays and private duty nursing coinsurance.

HMO Plan Disclaimers

Benefit Improvements Benefit Reductions


DENTAL PLAN OPTIONS


28

Universal Management Company | Dental Analysis

$0.00

$500.00

$1,000.00

$1,500.00

$2,000.00

$2,500.00

$3,000.00

Principal 100/75/50 Ameritas 100/75/50 Guardain 100/75/50 Principal Plan 2100/80/50

Ameritas Plan 2100/80/50

Delta Dental100/80/50

Guardian Plan 2100/80/50

29

Dental Policy #

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

$50 $50 $50 $50 $50 $50$150 $150 $150 $150 $150 $150

100% 100% 100% 100% 100% 100%100% 100% 100% 100% 100% 100%100% 100% 100% 100% 100% 100%100% 100% 100% 100% 100% 100%

75% 75% 75% 75% 75% 75%50% 50% 50% 50% 50% 50%50% 50% 50% 50% 50% 50%50% 50% 50% 50% 50% 50%

50% 50% 50% 50% 50% 50%50% 50% 50% 50% 50% 50%50% 50% 50% 50% 50% 50%

N/A N/A N/A N/A N/A N/A

Single 5EE & Spouse 0EE & Child 0Family 0Total Enrolled 5

$162.55 $1,950.60 $163.00 $1,956.00 $234.00 $2,808.00

$1,000N/A

To Age 26 EOMVoluntary - Greater of 20% or 5 Lives

Included in DentalIncluded in Dental

Included in Rates Below

Principal

The Principal Plan Dental90th

Not IncludedIncluded

$1,000N/A




Ameritas

Ameritas Classic Passive PPO Network90th

IncludedIncluded

12 Month waiting period if less than 25 enrolled

Rate Guarantee | Duration:

Annual Max per Person

Included in Dental

12 MonthsIncluded in Rates BelowEHB's Monthly Total Cost

Headcounts | Rates:


$32.60$66.84$84.80

$119.04

12 Months12 Months

$32.51$64.42$64.42

$114.66

Onlays

Orthodontics

Ortho Lifetime Max Per Person

Pediatric Dental:

Additional Cost per Dep(s)Essential Health Benefits

X-Rays

Fluoride TreatmentsCleanings (Oral Prophylaxis)

FillingsOral SurgeryPeriodontics

Participation RequirementDependent Age

Additional Details:

Plan Maximums:

Crowns


Plan Deductible:

Proposed Plan

Dental Plan Features:

Type IV - Orthodontics:

Bridges / Dentures

In-Network / UCR

Endodontics

Type III - Major Services:

Type I - Preventative Services:

Exams

Type II - Basic Services:

Preventative AdvantageOut of Network UCR

Maximum Rollover

SingleTwo Person / Family

Guardian

DentalGuard Preferred90th

IncludedIncluded

$46.80$95.01

$116.98$175.99

$1,000N/A

To Age 26 EOYVoluntary - Assumes 50% of Eligible

Included in Dental

Universal Management Company | Dental Analysis30

Dental Policy #



Annual Max per Person

EHB's Monthly Total Cost

Headcounts | Rates:


Onlays

Orthodontics

Ortho Lifetime Max Per Person

Pediatric Dental:

Additional Cost per Dep(s)Essential Health Benefits

X-Rays

Fluoride TreatmentsCleanings (Oral Prophylaxis)

FillingsOral SurgeryPeriodontics

Participation RequirementDependent Age

Additional Details:

Plan Maximums:

Crowns


Plan Deductible:

Proposed Plan

Dental Plan Features:

Type IV - Orthodontics:

Bridges / Dentures

In-Network / UCR

Endodontics

Type III - Major Services:

Type I - Preventative Services:

Exams

Type II - Basic Services:

Preventative AdvantageOut of Network UCR

Maximum Rollover

SingleTwo Person / Family

In-Network Out-of-Network In-Network Out-of-Network Delta PPO Premier Nonparticipating In-Network Out-of-Network

$50 $50 $50 $50 $50 $50$150 $150 $150 $150 $150 $150

100% 100% 100% 100% 100% 80% 80% 100% 100%100% 100% 100% 100% 100% 80% 80% 100% 100%100% 100% 100% 100% 100% 80% 80% 100% 100%100% 100% 100% 100% 100% 80% 80% 100% 100%

80% 80% 80% 80% 80% 60% 60% 80% 80%50% 50% 50% 50% 50% 50% 50% 50% 50%50% 50% 50% 50% 50% 50% 50% 50% 50%50% 50% 50% 50% 50% 50% 50% 50% 50%

50% 50% 50% 50% 50% 50% 50% 50% 50%50% 50% 50% 50% 50% 50% 50% 50% 50%50% 50% 50% 50% 50% 50% 50% 50% 50%

N/A N/A N/A N/A N/A N/A N/A N/A N/A

$165.10 $1,981.20 $165.20 $1,982.40 $193.80 $2,325.60 $237.75 $2,853.00

Principal

The Principal Plan Dental90th

IncludedIncluded

Delta Dental PPO | PremierOut of Network Fee Schedule

Not Included

12 Months 12 Months12 Months

Not IncludedIncluded

$1,000N/A N/A


$1,000

Ameritas Classic Passive PPO Network90th

GuardianAmeritasDelta Dental

(Plan A - Area 1 Standard)



$1,000

$65.38

$75 Per Person

12 Months

Included in Dental

To Age 26 EOM

$1,000


Voluntary - 50% of Eligible

Included in DentalIncluded in Rates Below



Voluntary - Greater of 60% or 5 Lives


$38.76$71.74

$120.84$71.74

$123.67 $179.28

$47.55$96.52

$119.27

Not Included

N/A N/A

To Age 26 EOYVoluntary - Assumes 50% of Eligible

To Age 26 EOY

DentalGuard Preferred90th

IncludedIncluded

12 month waiting period for new enrollees12 Month waiting period if less than 25 enrolled

$65.38$116.40

$33.02 $33.04$67.68$86.20


1) Employee headcounts obtained from May 2016 census.2) Rates are contingent on a packaged sale.3) Final premium cost subject to change based on employee enrollment (age banded rates only).4) Some carriers offer multi-product discounts, if you move a line of coverage it may increase cost to other lines if this discount is in place.5) If the pediatric essential health benefits are not included in the dental plan, the medical plan premium may increase. No one currently enrolled under age 19.6) Mutual of Omaha: Late Entrant Waiting Period for Type B, C and Ortho is 12 Months.7) MMA/MetLife: Late Entrant Waiting Period for Type B is 6 months (fillings)/12 months (other services), C and Ortho is 24 Months.8) Principal: Late Entrant Waiting Period for Type B is 6 months (fillings)/12 months (other services), C and Ortho is 24 Months.9) The benefits shown in this section are not an insurance contract. The information provided is for illustrative purposes only. Please refer to the contractfor the exact description and details.

Dental Plan Disclaimers



VISION PLAN OPTIONS


33

Universal Management Company | Vision Analysis

$0.00

$100.00

$200.00

$300.00

$400.00

$500.00

$600.00

$700.00

$800.00

Heritage24/24/24

Ameritas12/24/24

Heritage12/24/24

Guardian VSP12/12/24

Heritage12/12/24

Principal12/12/24

Ameritas12/12/12

Heritage12/12/12

Guardian VSP12/12/12

Principal12/12/12

34

Vision Policy #


$10 Reimbursed up to $35 $10 Reimbursed up to $45 $10 Reimbursed up to $35

$15

Member responsiblefor difference

between approvedamount and providers

charge, after $15copay

$25

Member responsible fordifference between

approved amount andproviders charge, after $25

copay

$15




Paid-in-Full4 $25 Paid-in-Full4 $30 Paid-in-Full4 $25Paid-in-Full4 $35 Paid-in-Full4 $50 Paid-in-Full4 $35Paid-in-Full4 $45 Paid-in-Full4 $65 Paid-in-Full4 $45Paid-in-Full4 $60 Paid-in-Full4 $100 Paid-in-Full4 $60

$130 $45 $130 $70 $130 $45

Paid-in-Full4 $210 Paid-in-Full4 $210 Paid-in-Full4 $210$130 $105 $130 $105 $130 $105


$31.55 $378.60 $36.20 $434.40 $38.30 $459.60

$9.68$9.68

$16.99

$11.67$11.67$20.71

Heritage

Once Every:

24242424

Up to:

Up to:

Up to:

On Medical Plan

Yes

36 Months

On Medical Plan

Yes

To Age 26 EOY

Heritage

Once Every:

12242424

Up to:

Up to:

Up to:

12 Months

$7.24$14.40$12.68$19.84

On Medical Plan

Yes

To Age 26 EOY

Voluntary - The Greater of 60% or 5 Lives

Ameritas

Once Every:

12242424

Up to:

Up to:

Up to:


Headcounts | Rates:

$6.31 $7.66

Rate Guarantee | Duration: 36 Months

Participation Requirement

Dependent Age

Voluntary - Under 10 Employees

To Age 26 EOY

Voluntary Under 10 Employees

Additional Details:

Contact Lenses in Lieu of Frames

Elective

Vision Plan Features:

Pediatric Vision for Under Age 19Essential Health Benefits

Medically Necessary

ExaminationsLenses

Proposed Plan

Plan Co-Payments:

Examinations

Materials


Contact Lenses 4:

Frames

Single Vision

Lenticular

Frequency (Number of Months):

FramesContact Lenses

Lenses 4:

BifocalTrifocal

Frames 4:

Universal Management Company | Vision Analysis35

Vision Policy #



Headcounts | Rates:



Dependent AgeAdditional Details:


Elective



Medically Necessary

ExaminationsLenses

Proposed Plan

Plan Co-Payments:

Examinations

Materials


Contact Lenses 4:

Frames

Single Vision

Lenticular



Lenses 4:

BifocalTrifocal

Frames 4:


$10 Reimbursed up to $39 $10 Reimbursed up to $35 $10 Reimbursed up to $45

$25


approved amount andproviders charge, after

$25 copay

$15




$25




Paid-in-Full4 $23 Paid-in-Full4 $25 Paid-in-Full4 $30Paid-in-Full4 $37 Paid-in-Full4 $35 Paid-in-Full4 $50Paid-in-Full4 $49 Paid-in-Full4 $45 Paid-in-Full4 $65Paid-in-Full4 $64 Paid-in-Full4 $60 Paid-in-Full4 $100

$130 $46 $130 $45 $150 $70

Paid-in-Full4 $210 Paid-in-Full4 $210 Paid-in-Full4 $210$130 $100 $130 $105 $150 $105

$42.35 $508.20 $44.35 $532.20 $45.85 $550.20

Heritage

Once Every:

12122412

Up to:

Up to:

Up to:

On Medical Plan

Yes

To Age 26 EOY

$13.51$23.97

24 Months

On Medical Plan

Principal(VSP)

Once Every:

12122412

Up to:

Up to:

Up to:

$29.77

Yes

To Age 26 EOM

Voluntary - Greater of 20% or 5 Lives

$23.01

$8.47$14.26$14.54

$9.17$17.83$18.72

$8.87$13.51

12 Months36 MonthsVoluntary - Under 10 Employees

Guardian(VSP)

Once Every:

12122412

Up to:

Up to:

Up to:

On Medical Plan

Yes

To Age 26 EOYVoluntary

50% of elgible employees - Sold with Dental


Vision Policy #



Headcounts | Rates:



Dependent AgeAdditional Details:


Elective



Medically Necessary

ExaminationsLenses

Proposed Plan

Plan Co-Payments:

Examinations

Materials


Contact Lenses 4:

Frames

Single Vision

Lenticular



Lenses 4:

BifocalTrifocal

Frames 4:


$10 Reimbursed up to $45 $10 Reimbursed up to $35 $10 Reimbursed up to $39 $10 Reimbursed up to $45

$25




$15




$25


approved amount andproviders charge, after

$25 copay

$25




Paid-in-Full4 $30 Paid-in-Full4 $25 Paid-in-Full4 $23 Paid-in-Full4 $30Paid-in-Full4 $50 Paid-in-Full4 $35 Paid-in-Full4 $37 Paid-in-Full4 $50Paid-in-Full4 $65 Paid-in-Full4 $45 Paid-in-Full4 $49 Paid-in-Full4 $65Paid-in-Full4 $100 Paid-in-Full4 $60 Paid-in-Full4 $64 Paid-in-Full4 $100

$130 $70 $130 $45 $130 $46 $150 $70

Paid-in-Full4 $210 Paid-in-Full4 $210 Paid-in-Full4 $210 Paid-in-Full4 $210$130 $105 $130 $105 $130 $100 $150 $105

$44.60 $535.20 $49.65 $595.80 $51.30 $615.60 $56.65 $679.80

On Medical Plan

Yes

To Age 26 EOY

Contributory Under 10 Employees

Heritage

Once Every:

12121212

Up to:

Up to:

Up to:

Guardian(VSP)

24 Months

Once Every:

12121212

Up to:

Up to:

Up to:

Yes

To Age 26 EOYVoluntary

50% of elgible employees - Sold with Dental

$9.93$15.28$15.28$26.11 $27.86

$10.26$17.27$17.61

36 Months

On Medical Plan

Principal(VSP)

Once Every:

12121212

Up to:

Up to:

Up to:

On Medical Plan

Yes

To Age 26 EOM

Voluntary - Greater of 20% or 5 Lives12 Months

$11.33$22.02$23.15$36.80

Ameritas

Once Every:

12121212

Up to:

Up to:

Up to:

On Medical Plan

Yes

To Age 26 EOY

Voluntary - The Greater of 60% or 5 Lives12 Months

$8.92$17.76$15.92$24.76


1) Employee headcounts obtained from May 2016 census.2) Rates are contingent on a packaged sale.3) Final premium cost subject to change based on employee enrollment (age banded rates only).4) Applicable copayments apply.5) Some carriers offer multi-product discounts, if you move a line of coverage it may increase cost to other lines if this discount is in place.6) The benefits shown in this section are not an insurance contract. The information provided is for illustrative purposes only. Please refer to the contractfor the exact description and details.

Vision Plan Disclaimers



BASIC LIFE PLAN OPTIONS


39

Universal Management Company | Basic Life Analysis

$995

$995

$1,002.37

$1,039.23

$1,223.49

$1,289.82

$1,307.84

$1,378.26

$1,470

$1,474

$0

$200

$400

$600

$800

$1,000

$1,200

$1,400

$1,600

Current Renewal Hartford SunLife MoO Principal MMA Guardian MetLife Unum

Carrier by Annual Premium

40

GL150607

Class Description Class 1:

Benefit Amount Guarantee Issue Benefit Amount Guarantee Issue Benefit Amount Guarantee Issue Benefit Amount Guarantee Issue

Amount Class 1: 1x BAE up to 50(k) $50(k) 1x BAE up to 50(k) $50(k) 1x BAE up to 50(k) $50(k) 1x BAE up to 50(k) $50(k)

Domestic Partner

Volume $614,200Total Lives $20

$82.92 $995.00 $82.92 $995.00 $83.53 $1,002.37 $86.60 $1,039.23

Rate per $1(k)

Not Included

75% of Benefit Amount to $500(k)

$0.136

$3.69

Rate per $1(k)

$0.141

SunLife2

Included, prior to Age 65IncludedIncluded

Not Included

Non-Contributory

All Employees Working 40+ Hours / Week

Basic Life Plan Features:

Reduction Schedule

Basic Life / AD&D EE Eligibility:

65% at 65, 40% at 70, 20% at 75

All Employees Working 40+ Hours / Week All Employees Working 40+ Hours / Week

Accelerated (Living) Benefit

Basic Life Policy #

Earnings Definition

Additional Plan Features:

IncludedConversion

Waiver of PremiumIncludedIncluded



CurrentReliance Standard

Spouse / Child BenefitNot Included

Base Salary

Basic Life Benefit:

Not Included

Monthly Premium Info:

Not Included

IncludedPortability Not Included

Not IncludedNot Included

24 Months

$0.135 $0.135

% Change from Current (Monthly)

Monthly Premium Total

$ Change from Current (Monthly)0.00%

Rate per $1(k) ofCovered Benefit:

Rate per $1(k)

$0.00

Included, prior to Age 60

Base Salary65% at 65, 40% at 70, 20% at 75


Non-Contributory

Active Full-Time Employees Working 30 Hours /

65% at 65, 50% at 70Base Salary

Non-Contributory


Included

Rate per $1(k)

12 Months

Included

Headcounts | Rates:

RenewalReliance Standard

Hartford

IncludedIncluded


24 Months

4.44%$0.610.74%

Universal Management Company| Basic Life Analysis41

GL150607


Benefit Amount Guarantee Issue Benefit Amount Guarantee Issue

Amount Class 1: 1x BAE up to 50(k) $50(k) 1x BAE up to 50(k) $50(k)

Domestic Partner


$82.92 $995.00 $82.92 $995.00


Reduction Schedule


65% at 65, 40% at 70, 20% at 75



Basic Life Policy #

Earnings Definition


IncludedConversion






Base Salary

Basic Life Benefit:

Not Included


Not Included



$0.135 $0.135





Rate per $1(k)

$0.00


Non-Contributory

Included

Rate per $1(k)

12 Months

Included

Headcounts | Rates:



1x BAE up to 50(k) $50(k) 1x BAE up to 50(k) $50(k)

$101.96 $1,223.49 $107.49 $1,289.82

65% at 65, 40% at 70, 25% at 75Base Salary

Non-Contributory

Not Included


Included

24 Months

Rate per $1(k)

Not Included

$19.0422.96%

$0.166


Not Included

50% of Benefit Amount to $100(k)Included, prior to Age 65 Included

Mutual of Omaha2


Base Salary

Included

Not Included

$0.175

24 Months

Principal


65% at 65, 40% at 70, 20% at 75

Non-Contributory

$24.5729.63%


GL150607




Domestic Partner


$82.92 $995.00 $82.92 $995.00


Reduction Schedule


65% at 65, 40% at 70, 20% at 75



Basic Life Policy #

Earnings Definition


IncludedConversion






Base Salary

Basic Life Benefit:

Not Included


Not Included



$0.135 $0.135





Rate per $1(k)

$0.00


Non-Contributory

Included

Rate per $1(k)

12 Months

Included

Headcounts | Rates:




$108.99 $1,307.84 $114.86 $1,378.26

31.44%

65% at 65, 50% at 70Base Salary


$26.07


21 Months (Renews June 1, 2018)

MMA2

($240 Mandatory Membership Fee)


80% to a Maximum of $500(k)

Rates Based on Package Sale

24 Months

Included

38.52%


Non-Contributory

65% at 65, 40% at 70, 20% at 75

Not Included

$31.94


Included, prior to Age 65Included w/EOI

Guardian

Base Salary

Non-Contributory


Included

Rate per $1(k)

$0.187

Rate per $1(k)

$0.154


GL150607




Domestic Partner


$82.92 $995.00 $82.92 $995.00


Reduction Schedule


65% at 65, 40% at 70, 20% at 75



Basic Life Policy #

Earnings Definition


IncludedConversion






Base Salary

Basic Life Benefit:

Not Included


Not Included



$0.135 $0.135





Rate per $1(k)

$0.00


Non-Contributory

Included

Rate per $1(k)

12 Months

Included

Headcounts | Rates:




$122.50 $1,469.99 $122.84 $1,474.08

$0.176

$39.5847.74%


24 Months

MetLife2


65% at 65, 40% at 70, 20% at 75Base Salary

Non-Contributory

50% to a Maximum of $500(k)Not Included

IncludedIncluded

Rate per $1(k) Rates per $1(K)

24 Months

Not Included

Base Salary


Not Included

$0.200


Non-Contributory

65% at 65, 40% at 70, 20% at 75

48.15%$39.92

Unum

Included, prior to Age 60Included w/out EOI

Included


1) Employee headcounts obtained from May 2016 census.2) Rates are contingent on a packaged sale.3) Some carriers offer multi-product discounts, if you move a line of coverage it may increase cost to other lines if this discount is in place.4) The benefits shown in this section are not an insurance contract. The information provided is for illustrative purposes only. Please refer to the contractfor the exact description and details.

Basic Life Plan Disclaimers



OPTIONAL LIFE PLAN OPTIONS


46

Proposed Plan


Age BracketEmployee

Age BandedVolume

Spouse AgeBandedVolume

Age Banded Rates per$1(k)

EmployeeMonthlyPremium

Age Banded Ratesper $1(k)

Spouse MonthlyPremium









20-24 $0 $0 $0.037 $0.00 $0.037 $0.00 $0.035 $0.00 $0.058 $0.00 $0.076 $0.00 $0.076 $0.0025-29 $0 $0 $0.037 $0.00 $0.037 $0.00 $0.031 $0.00 $0.052 $0.00 $0.076 $0.00 $0.076 $0.0030-34 $0 $0 $0.044 $0.00 $0.044 $0.00 $0.035 $0.00 $0.058 $0.00 $0.084 $0.00 $0.084 $0.0035-39 $0 $0 $0.068 $0.00 $0.068 $0.00 $0.053 $0.00 $0.082 $0.00 $0.126 $0.00 $0.126 $0.0040-44 $0 $0 $0.096 $0.00 $0.096 $0.00 $0.081 $0.00 $0.121 $0.00 $0.204 $0.00 $0.204 $0.0045-49 $0 $0 $0.141 $0.00 $0.141 $0.00 $0.134 $0.00 $0.195 $0.00 $0.314 $0.00 $0.314 $0.0050-54 $0 $0 $0.256 $0.00 $0.256 $0.00 $0.215 $0.00 $0.309 $0.00 $0.512 $0.00 $0.512 $0.0055-59 $0 $0 $0.414 $0.00 $0.414 $0.00 $0.312 $0.00 $0.444 $0.00 $0.805 $0.00 $0.805 $0.0060-64 $0 $0 $0.707 $0.00 $0.707 $0.00 $0.399 $0.00 $0.565 $0.00 $1.117 $0.00 $1.117 $0.0065-69 $0 $0 $2.020 $0.00 $2.020 $0.00 $0.580 $0.00 $0.818 $0.00 $2.061 $0.00 $2.061 $0.0070-99 $0 $0 $3.300 $0.00 $3.300 $0.00 $1.031 $0.00 $1.447 $0.00 $3.443 $0.00 $3.443 $0.00TOTAL $0 $0 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00

EE's EnrolledSP's Enrolled

Rates higher for anyone 70+

Spouse Coverage

$0$0.040$0.00

Not Included

39% of Eligible with a Minimum of 8 lives

24 Months

75% of coverage to a maximum of $250(k)Included, prior to Age 60

IncludedIncluded

Employee Coverage

Hartford

All Full Time Employees Working 30 Hours

Increments of $10(k), to a max of 3x BAE or $250(k)Increments of $5(k), to a max of $25(k) not to exceed 50%

15 days to 6 months - $500, 6 months to 19 (Age 25 IFS) - $10(k)

65% at 65, 50% at 70

$10(k) not to exceed 100% of Employee's amount

Employee Coverage Spouse Coverage

65% at 65, 50% at 70

Under Age 70: $20(k) Over Age 70: $10(k)$10(k)

Included

$0

$0.00

0.025

Greater of 20% or 5 Lives

24 Months

$0$5(k) for $1.00 per family / $10(k) for $2.00 per family

$10(k)

75% to a Maximum of $250(k)Included, prior to Age 60

Under Age 70: $70(k) Over Age 70: $10(k)$100(k)$25(k)

IncludedIncluded


Increments of 10(k) up to a max of 300(k)Increments of 5(k) up to a max of 100(k)

Children under 14 days of age: $1(k), 14 days or older: $5(k) or $10(k)Not to Exceed 100% of EE Amount

Under Age 65: $20(k) Over Age 70: $10(k)Under Age 65: $0(k) Over Age 70: $0(k)

Monthly Premium

VolumeRate per $1(k)

Employee Rate Change Occurs

Employee and Spouse Product Cost

Cost

Child(ren) Product Cost: Enrolled


Additional Plan Details:

True Open Enrollment

AD&D Plan Features:


24 Months

IncludedPortability

Voluntary Life Employee Eligibility:Class Description

Employee AmountSpouse Amount

Child

Guarantee Issue Amounts:

Child Amount

Employee Reduction Schedule

Spouse Employee

Voluntary Life Benefit Amounts:

30% Minimum of 4 Enrolled LivesMinimum Participation

$10(k) not to exceed 100% of Employee's amount

Conversion

Voluntary Life Plan Features:

Waiver of PremiumAccelerated (Living) Benefit

$0.00



$10(k) to a max of $20(k)

$0.171$0


65% at 65, 40% at 70, 20% at 75

0.04

Principal

Voluntary Life Policy #

Guardian

Universal Management Company | Voluntary Life Analysis

47

Proposed Plan


Age BracketEmployee

Age BandedVolume


20-24 $0 $025-29 $0 $030-34 $0 $035-39 $0 $040-44 $0 $045-49 $0 $050-54 $0 $055-59 $0 $060-64 $0 $065-69 $0 $070-99 $0 $0TOTAL $0 $0


Rates higher for anyone 70+Monthly Premium




Cost





AD&D Plan Features:

Portability



Child


Child Amount


Spouse Employee


Minimum Participation

Conversion
















$0.057 $0.00 $0.084 $0.00 $0.060 $0.00 $0.060 $0.00 $0.065 $0.00 $0.064 $0.00$0.068 $0.00 $0.101 $0.00 $0.060 $0.00 $0.060 $0.00 $0.071 $0.00 $0.070 $0.00$0.091 $0.00 $0.134 $0.00 $0.070 $0.00 $0.070 $0.00 $0.095 $0.00 $0.094 $0.00$0.102 $0.00 $0.151 $0.00 $0.090 $0.00 $0.090 $0.00 $0.142 $0.00 $0.142 $0.00$0.113 $0.00 $0.168 $0.00 $0.140 $0.00 $0.140 $0.00 $0.216 $0.00 $0.216 $0.00$0.170 $0.00 $0.252 $0.00 $0.230 $0.00 $0.230 $0.00 $0.336 $0.00 $0.336 $0.00$0.260 $0.00 $0.387 $0.00 $0.390 $0.00 $0.390 $0.00 $0.496 $0.00 $0.496 $0.00$0.487 $0.00 $0.723 $0.00 $0.600 $0.00 $0.600 $0.00 $0.709 $0.00 $0.710 $0.00$0.747 $0.00 $1.109 $0.00 $0.940 $0.00 $0.940 $0.00 $0.912 $0.00 $0.912 $0.00$1.437 $0.00 $2.134 $0.00 $1.690 $0.00 $1.690 $0.00 $1.297 $0.00 $1.298 $0.00$2.331 $0.00 $0.00 $3.020 $0.00 $3.020 $0.00 $2.454 $0.00 $2.454 $0.00

$0.00 $0.00 $0.00 $0.00 $0.00 $0.00

Included


Birth to 14 days old: $0(k), 14 days to 6 months: $500,6 months to age 19 (23 IFS) months to 19 (26 IFS) increments of $2(k)

Lesser of current amount or $50(k)

0.028

$0.00

20% of Eligible

24 Months

$0


$0.250


IncludedIncluded

50% of employee coverage

65% at 70, 45% at 75, 30% at 80, 20% at 85, 15% at 90


Increments of $5(k), to a max of 5x BAE or 100(k)

65% at 65, 40% at 70, 20% at 75

Increments of $5(k) up to a max of $10(k)

Greater of 50% or 10 lives

$50(k)$25(k)

Increments of $10(k), to a max of 5x BAE or $300(k)

$0.140$0.00

$10(k)

50% of coverage to a maximum of $100(k)

Included

$0



24 Months

Not Included

Live birth to 14 days old: $1(k), 14 days to 6 months: $1(k),6 months to 19 (26 IFS) increments of $2(k) up to $10(k)

SunLife2 Mutual of Omaha2

Increments of $10(k), to a max of 5x BAE or $300(k)Increments of $5(k) to the lesser of 100% or up to a max of $50(k)

IncludedIncluded

Unum


Increments of $10(k), to a max of 5x BAE or $500(k)

65% at 65, 50% at 70

Increments of $5(k) to the lesser of 100% or Employee amount or $500(k)

Employee Coverage

$50(k)$15(k)$10(k)

Spouse Coverage

100% of coverage to a maximum of $250(k)Included

Not Included

$0$0.500$0.00

Greater of 20% or 10 lives

36 Months


48

Proposed Plan


Age BracketEmployee

Age BandedVolume


20-24 $0 $025-29 $0 $030-34 $0 $035-39 $0 $040-44 $0 $045-49 $0 $050-54 $0 $055-59 $0 $060-64 $0 $065-69 $0 $070-99 $0 $0TOTAL $0 $0


Rates higher for anyone 70+Monthly Premium




Cost





AD&D Plan Features:

Portability



Child


Child Amount


Spouse Employee


Minimum Participation

Conversion








$0.044 $0.00 $0.044 $0.00$0.044 $0.00 $0.044 $0.00$0.056 $0.00 $0.056 $0.00$0.074 $0.00 $0.074 $0.00$0.100 $0.00 $0.100 $0.00$0.150 $0.00 $0.150 $0.00$0.230 $0.00 $0.230 $0.00$0.400 $0.00 $0.400 $0.00$0.533 $0.00 $0.533 $0.00$1.000 $0.00 $1.000 $0.00$1.607 $0.00 $1.607 $0.00

$0.00 $0.00

Child 15 days to 6 months old: $1,000, 6 months to 19 (23 IFS): Options of$1,000, $2,000, $4,000, $5,000, or $10,000


Increments of $10(k), to a max of 5x BAE or $500(k)Increments of $5(k) to a max of $100(k) not to exceed 50% of EE amount

24 Months

None

$50(k)$25(k)

48% and at least 10 covered lives

$10(k)


IncludedIncluded

MetLife2

$0.00


$0$0.240

$0.017 Spouse / $0.051 / Child


49

1) Employee headcounts obtained from May 2016 census.2) Some carriers offer multi-product discounts, if you move a line of coverage it may increase cost to other lines if this discount is in place.3) The benefits shown in this section are not an insurance contract. The information provided is for illustrative purposes only.Please refer to the contract for the exact description and details.

Optional Life Plan Disclaimers



50

SHORT TERM DISABILITY PLAN OPTIONS


51

Universal Management Company|ER Paid STD Analysis

$1,504.44

$2,683.80 $1,794.24

$1,794.24

$2,005.92

$2,348.64

$2,671.20

$3,528.00

$0.00

$500.00

$1,000.00

$1,500.00

$2,000.00

$2,500.00

$3,000.00

$3,500.00

$4,000.00

MetLife $150 Plan Gurdian $150 Plan MMA $200 Plan MoO $200 Plan MetLife $200 Plan SunLife $200 Plan Principal $200 Plan Unum $200 Plan


52

Employee Lives 20Volume $4,200

$125.37 $1,504.44 $223.65 $2,683.80 $149.52 $1,794.24 $159.60 $1,915.20

24 Months

$3,150.00 $3,150.00

NoneIncluded

Rate per $10$0.356

$4,200.00 $4,200.00

Not Included

18

$75Base Salary

MMA2

($240 Mandatory Membership Fee)

All Active Full-Time Employees

$200

Monthly Premium

W2 Preparation IncludedRate Guarantee| DurationMonthly Premium Information:

Not Included21 Months (Renews June 1, 2018)

Volume

Pre-Existing Condition Limitation NoneMaternity Benefit

FICA Match

Payment for Partial Disability IncludedAdditional Carrier Offerings:

Included

Payment for Sickness (First Day) 8Benefit Duration (Weeks) 1313

STD Plan Features:Payment for Accident (First Day) 11

Minimum Benefit Amount NoneEarnings Definition Base Salary

$20Prior Year W2 Earnings

Percentage of BWE 60%Amount up to $200

60%

Class Description All Active Full-Time EmployeesSTD Benefit:

ER Paid STD Policy #

STD Employee Eligibility:

Proposed PlanRenewal Date: 9 / 1 / 2016

Mutual of OmahaMetLife


60%$150

813

Included

NoneIncluded


Volume

Rate per $10$0.398

None

Guardian


60%$150None

Base Salary

$0.710

Not Included

$0.380

VolumeRates Based on Package Sale

Rate per $10 Rate per $10

88

12Included

Included

Included24 Months

Not Included

24 Months

Universal Management Company|ER Paid STD Analysis53


Monthly Premium

W2 PreparationRate Guarantee| DurationMonthly Premium Information:

Pre-Existing Condition LimitationMaternity Benefit

FICA Match

Payment for Partial DisabilityAdditional Carrier Offerings:

Payment for Sickness (First Day)Benefit Duration (Weeks)

STD Plan Features:Payment for Accident (First Day)

Minimum Benefit AmountEarnings Definition

Percentage of BWEAmount up to

Class DescriptionSTD Benefit:

ER Paid STD Policy #

STD Employee Eligibility:

Proposed PlanRenewal Date: 9 / 1 / 2016

$167.16 $2,005.92 $195.72 $2,348.64 $222.60 $2,671.20 $294.00 $3,528.00

$4,200.00 $4,200.00

60%$200

24 MonthsVolume

Included

Rate per $10$4,200.00 $4,200.00

NoneIncluded

Not Included

13Included

13Included

18

$20Prior Year W2 Earnings

$200$200

Base SalaryNone

Base Salary

Included

$0.700

MetLife


Included

Volume

Rate per $10Rate per $10 Rate per $10

Included24 Months

Volume

Not Included

3/12

24 Months

Sun Life


None

1

Included

Unum


$0.530$0.466

60%

$25

$0.398

Volume

Included

Not Included

8

60%

Principal


60%

Treated as Any Other Disability

Included

None

IncludedIncluded

$200$15

Base Salary

18

13

88

12

24 Months

Universal Management Company|ER Paid STD Analysis54


STD Plan Disclaimers


Universal Management Company |ER Paid STD Analysis55

LONG TERM DISABILITY PLAN OPTIONS


56

Universal Management Company|ER Paid LTD Analysis

$1,892.74

$2,424.86

$3,906.72

$1,993.77

$3,004.13

$3,300.50

$3,704.65

$3,906.72

$4,054.90

$0.00

$500.00

$1,000.00

$1,500.00

$2,000.00

$2,500.00

$3,000.00

$3,500.00

$4,000.00

$4,500.00

Hartford $3(k) Mutual of Omaha$3(k)

Guardian $3(k) Hartford Option 2$4(k)

SunLife $4(k) Principal $4(k) Unum $(k) Guardain Option 2$4(k)

SunLife Option 2 $4(k)


57

Proposed Plan


Contributory Status Class 1:

Definition of Dis. Class 1:

Earnings Test Class 1:


$157.73 $1,892.74 $202.07 $2,424.86 $325.56 $3,906.72

Rates Based on Package Sale

Direct / Family3x GMB

Rate per $1000.580%

24 Months LifetimeNone

24 Months

Not Included

6 / 24

110% for first 12 MonthsGreater of Direct Reduction or Proportionate Loss

Lesser of 10% or CPI

Yes, in Excess of 100%None

24 Months Lifetime

Not Included

$3(k)Base Salary

Tax Choice /100% Participation Required90

UnlimitedSSNRA

2 Year Own Occupation

80% / 80%

Guardian

All Full Time Active Employees Working 30

60%$3(k)

Not Included

None

None

Rate per $100

3x GMB

Rate per $100

None3 / 12

$3(k)

Full Family

180RBD to SSNRA


99% / 85%

Guarantee Issue Amount $3(k) $3(k)

ER Paid LTD Policy #

LTD Employee Eligibility:

All Full Time Active Employees Working 30 All Full Time Active Employees Working 30

Percentage of BME

Tax Choice /100% Participation RequiredLTD Plan Features:

Earnings Definition Base Salary Base Salary

60% 60%$3(k)Amount up to

Tax Choice /100% Participation Required

Benefit Period90

LTD Benefit:

Elm. Period (# of Days) 180Accum. Period (# of Days)

90


Not Included

24 Months Lifetime

Revenue Protection Benefit

ADEA 1 with SSNRA

Residuals after First 12 Mos.

Integration

Mutually Progressive Partial

Infectious / Contagious Rider Not Included

Rate Guarantee| Duration 24 Months 24 Months


Monthly Premium0.28% 0.36%

Not Included

24 Months Lifetime

Direct / FamilySurvivor Benefit

Pre-Existing Condition Limit

Additional Carrier Offerings:

6 / 12

Dollar for Dollar

Drug / Alcohol Limit

Offsets for Individual DisabilityMental / Nervous Limit

NoneOffsets for Salary Cont.

Proportionate LossIndexing Lesser of 10% or CPI

24 Months Lifetime

80% / 80%Return to Work Benefit


Headcounts | Rates:

Hartford Mutual of Omaha

3x GMB

Yes, in Excess of 100%

100% for first 12 Months

LTD Plan Offsets & Limitations:

NoneSelf-Reported Symptoms Limit

100% to End of Max Benefit Period

24 Months Lifetime

Universal Management Company | LTD Analysis58

Proposed Plan






Guarantee Issue Amount



Percentage of BME

LTD Plan Features:

Earnings Definition

Amount up to

Benefit Period

LTD Benefit:

Elm. Period (# of Days)Accum. Period (# of Days)



Integration

Infectious / Contagious Rider

Rate Guarantee| Duration


Monthly Premium

Survivor Benefit





Offsets for Salary Cont.

Indexing

Return to Work Benefit


Headcounts | Rates:


Self-Reported Symptoms Limit

$166.15 $1,993.77 $250.34 $3,004.13 $275.04 $3,300.50 $308.72 $3,704.65

24 Months

Rate per $1000.30%

24 Months LifetimeNone6 / 12


Direct / Family3x GMB

Dollar for DollarNone

24 Months Lifetime

ADEA 1 with SSNRA2 Year Own Occupation

80% / 80%100% for first 12 Months

Proportionate LossLesser of 10% or CPI

$4(k)Base Salary


Hartford Option 2


60%$4(k)

3 / 3 /12

Not Included

SunLife

60%$4(k)$4(k)

Rate per $1000.446%


Not Included

24 Months

IncludedDirect

3x GMB

Base Salary

24 Months Lifetime

Non-Contributory90

180SSNRA

Extended Own Occupation

80% / 80%

Yes, in Excess of 100%

100% for first 12 Months

None

24 Months LifetimeNone

Zero Day Residual


24 Months

Rate per $100

24 Months LifetimeAs Any Other Disability

None3 / 12

0.55%

IncludedPrimary and Family

3x GMB

NoneNone

SSNRA / RBD2 Year Own Occupation


Zero Day Residual

$4(k)Base Salary


Unum2

60%$4(k)


Principal


60%

180SSNRA

To End of Benefit Duration

80% / 80%

$4(k)$4(k)

Base Salary

Contributory90

None3 / 12

100% for first 12 MonthsZero Day Residual

Lesser of 10% or CPIDirect

3x GMB


24 Months

Rate per $1000.490%

NoneNone

24 Months Lifetime24 Months Lifetime


Proposed Plan






Guarantee Issue Amount



Percentage of BME

LTD Plan Features:

Earnings Definition

Amount up to

Benefit Period

LTD Benefit:

Elm. Period (# of Days)Accum. Period (# of Days)



Integration

Infectious / Contagious Rider

Rate Guarantee| Duration


Monthly Premium

Survivor Benefit





Offsets for Salary Cont.

Indexing

Return to Work Benefit


Headcounts | Rates:


Self-Reported Symptoms Limit

$325.56 $3,906.72 $337.91 $4,054.90

0.580%


24 Months

Rates Based on Package SaleRate per $100



None6 / 24

110% for first 12 MonthsGreater of Direct Reduction or Proportionate Loss

Lesser of 10% or CPIDirect / Family

3x GMB


UnlimitedSSNRA


80% / 80%

Guardian Option 2


60%$4(k)$4(k)

Base Salary

SunLife Option 2


60%$4(k)$4(k)

Base Salary


180SSNRA

Extended Own Occupation


Zero Day ResidualIncluded

Direct3x GMB



None3 / 3 /12


24 Months

Rate per $1000.602%



LTD Plan Disclaimers


Universal Management Company| LTD Analysis61

SPECIALTY BENEFITS


62

Service

CancerInvasive Cancer

Carcinoma in SituBenign Brain Tumor

Skin Cancer

VascularHeart Attack

StrokeHeart Failure

Arteriosclerosis

OtherOrgan FailureKidney Failure

Group 2 Covered Conditions

Group 3 Childhood Covered Conditions

Cancer VaccinePre-Existing Conditions

Wellness Benefit

Dependent Age Limits

Benefit Reduction Schedule

Contribution / Participation

EE Critical Illness Benefit Amounts

Dependent Critical Illness Benefit Amount

Underwriting Requirements

2-24 Eligible Lives25 - 99 Eligible Lives Guarantee Issue

25 - 99 Lives Conditional Issue

Benefit Amounts Under 30 Ages 40 - 49 Ages 50 - 59 Ages 60 - 69$5,000 $7.38 $15.07 $25.42 $37.78

$10,000 $13.08 $28.22 $48.57 $72.88$15,000 $18.78 $41.37 $71.72 $107.98$20,000 $24.48 $54.52 $94.87 $143.08$25,000 $30.18 $67.67 $118.02 $178.18

Benefit Amounts Under 30 Ages 40 - 49 Ages 50 - 59 Ages 60 - 69$2,500 $4.53 $8.50 $13.85 $20.23$5,000 $7.38 $15.07 $25.42 $37.78$7,500 $10.23 $21.65 $37.00 $55.33

$10,000 $13.08 $28.22 $48.57 $72.88$12,500 $15.93 $34.80 $60.15 $90.43

1) The Critical Illness plan is Voluntary.

2) Premiums Listed are for Issue Age and will not increase due to Insured's Age. Child Cost is Included with Employee Elections

3) Spouse Rate is Based on employee's age bracket

4) 2 Year Rate Guarantee

5) Not Available for All Industries

2016 Critical Illness

$31.74$39.24

$70.92$138.52$206.12

Employee May Choose a lump sum benefit of $5(k) to $25(k) In increments of $5(k)

Ages 70 +Ages 30 - 39

Spouse: Up to 50% of EE Benefit Child: 25% of EE Benefit

$16.74$24.24

$250 per Lifetime

Employee < 70 Spouse < 70 Child

Health Questions Required on All Amounts

All Amounts Guaranteed

100%30%

50%

First Occurrence of these additional illnesses: Addison's Disease 30%, ALS (Lou Gehrig's Disease) 100%, Alzheimer's Disease 50%, Coma 100%, Huntington'sDisease 30%, Multiple Sclerosis 30%, Loss of Speech, Sight or Hearing 100%, Parkinson's Disease 100%, Permanent Paralysis 50% for 1 limb, 100% for 2 Limbs,

Severe Burns 100%100% of Child Benefit for the First Occurrence of Cerebral Palsy, Cleft Lip/palate, Club Foot, Cystic Fibrosis, Down's Syndrome, Muscular Dystrophy, Spina Bifida,

Type 1 Diabetes

Groups 2 - 99 Employees

First Occurrence Second Occurrence

Covered Conditions(Lump Sum Payments)

100%30%75%

50%100%100%

50%0%0%

Not Included

50%

Plan # 1

0%50%50%

100%100%

$50 per lifetime for receiving Cancer Vaccine3 Months Look Back Period, 12 Month Exclusion Period

Provides a per year benefit for completing certain routine wellness screenings or procedures (refer to plan highlights for listing)Employee $50; Spouse $50; Child $50

Child Birth to 26 years

50% at 70(If Actively at Work)

Ages 30 - 39 Ages 70 +

Voluntary - 2 - 9 Eligible Employees Must Have a Minimum of 2 Enrolled, 10 - 24 Eligible Employees Must Have a Minimum of 5 Enrolled, 25+ Eligible Employees Must Have Greater of10 Enrolled or 15%

Employee & Spouse Ages 70 +

Health Questions Required

$5.49 $37.12

Employee

Spouse

$273.72

$2,500 GI

Health Questions Required on All Amounts Above Guarantee Issue

$5(k) GI

$341.32

$9.24

$20.49 $172.32

$9.24 $70.92$12.99 $104.72$16.74 $138.52

This outline is intended only as a source of reference. Official benefits, conditions, limitations and exclusions are documented in plan contracts .63

GuardianValue Plan

GuardianAdvantage Plan

GuardianPremier Plan

$150(Accident Emergency Treatment)



$25 up to 6 Treatments(Doctor Visit)



Ground: $100Air: $500

Ground: $150Air: $1(k)

Ground: $200Air: $1,500

Hospital Admission: $750Hospital Confinement: $175 / Day, up to 1 Year

ICU Admission: $1,500ICU Confinement: $350 / Day, up to 15 Days

Hospital Admission: $1(k)Hospital Confinement: $225 / Day, up to 1 Year

ICU Admission: $2(k)ICU Confinement: $450 / Day, up to 15 Days

Hospital Admission: $1,250Hospital Confinement: $250 / Day, up to 1 Year

ICU Admission: $2,500ICU Confinement: $500 / Day, up to 15 Days

Employee: $10(k)Spouse / Child: $5(k)

(As a Result of Accidental Death) ;

Percentage of Benefit is Paid for Dismemberment orLoss of Sight, Speech, Hearing, & Cognitive Function

due to Accidental Injury

Employee: $25(k)Spouse: $12,500

Child: $5(k)(As a Result of Accidental Death) ;



Employee: $50(k)Spouse: $25(k)

Child: $5(k)(As a Result of Accidental Death) ;



$50 $75 $100

$1,500/$750/$750 $2,500/$1,250/$1,250 $3,500/$1,750/$1,750

$150 $250 $350

$25 / Day for up to 10 Days $25 / Day for up to 10 Days $35 / Day for up to 10 Days


$100 $125 $125

1: $5002 or More: $1(k)

1: $5002 or More: $1(k)

1: $7502 or More: $1,500

$300 $300 $300

$400(3 Times per Accident)




$13.35 $17.28 $21.30$22.86 $29.24 $35.72$23.30 $29.42 $35.39$32.81 $41.38 $49.81

1) Accident Coverage is Off-the-Job.2) Accident Coverage is Voluntary.

4) 2 Year Rate Guarantee5) Portability Included without EOI

3) Guardian's Accident Coverage also includes benefits for Catastrophic Loss, Common Carrier, Common Disaster, Seatbelt / Airbag Use, Reasonable Accommodation to Home / Vehicle, Burns, ChildOrganized Sports, Chiropractic Visits, Coma, Concussions, Dislocations, Major Diagnostic Exams, Emergency Dental Work, Epidurals, Eye Injury, Family Care, Fractures, Initial Office / UC Treatment, KneeCartilage, Hip/Knee/Shoulder Joint Replacement, Laceration, Surgical Repair for Ruptured Disc, Cranial/Open Abdominal/Thoracic/Exploratory/Arthroscopic Surgery, Tendon/Ligament/Rotator Cuff, and X-Rays

EmployeeEE & Spouse

EE & Child(ren)Family

Surgery - Exploratory or Arthroscopic

Monthly Premium

Prosthesis Benefit

Occupational / Physical Therapy Benefit

Minimum Participation 2 - 9 Eligible Lives Minimum 2 Enrolled / 10 - 999 Eligible Lives Minimum 5 Enrolled Employees

Provides a $50 per year benefit for completing certain routine wellness screenings or procedures (refer to plan highlights for listing)

Hospital / ICU

AD&D Death Benefit

Initial Physicians Office / Urgent Care FacilityTreatment

Blood / Plasma / Platelets Benefit

Transportation Benefit

Wellness benefit

Appliances Benefit

Universal Management Company2016 Accident Coverage Comparison

Rehabilitation Unit Confinement Benefit

Joint Replacement(Hip/Knee/Shoulder)

Family Lodging Benefit

Service

Accident Medical Expense

Accident Follow Up Treatment

Ambulance Benefit

This outline is intended only as a source of reference. Official benefits, conditions, limitations and exclusions are documented in plan contracts.64

DISCLOSUREThe material contained herein includes a descriptive summary of current and / orproposed benefit plans and estimated associated costs. The benefit plandescription should not be construed as a substitution for the insurance policy butas a synopsis thereof. Costs are based upon available census data and may vary atplan implementation in accordance with the actual enrollment.

IMPORTANT NOTICE:All employees must be “ACTIVELY-AT-WORK” and dependents not disabled onthe effective date to be eligible for coverage.

The Austin Benefits Group may not bind coverage. Existing coverage should notbe canceled until written confirmation of coverage from the new insurancecompany is received. Written confirmation will generally be received in two tothree weeks following the application to the insurance company.

AUSTIN BENEFITS GROUP

65

38500 Woodward Ave., Suite 360, Bloomfield Hills, MI 48304 Phone: 248.594.5550 Fax: 248.594.5533 www.austinbenefits.com

66

2016 renewal presentation universal …macademyk8.com/adobeforms/school reports/umc 10,1,2016.pdfa...

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