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Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

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Page 1: Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

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Employee Benefits Open Enrollment Effective: January 1, 2012

Page 2: Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

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Filice Insurance:

Broker Overview - EBI Partnership

Dedicated Account Management Team Melanie Beranek: Client Services Manager

Charlie Weckel: Broker

Dawn Alvarez: Compliance/Wellness Director

Patrick Arnold: CEO - Lafayette, CA Division

New Enrollments/Benefits Orientation

Assistance with Claims, Eligibility, Carrier Issues…

Customized Benefits Website: www.filice.com/benefits/EBI

Page 3: Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

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EBI Employee Benefits 2012:

Insurance Carrier Selection: – Kaiser Permanente and MetLife

Employee Premium Contributions:– Full-Time Eligible Employees: $40 per Month– Part-Time Eligible Employees: $75 per Month

Plan Availability - Effective January 1, 2012:– Medical: Kaiser – Deductible HMO (Base Plan) & HMO 15 – Dental: Met Life PPO– Vision: Discount Program (MetLife dental participants only) – Flexible Spending Accounts (FSA): Optum Health Financial– 401K: John Hancock

Page 4: Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

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Kaiser 2012 Plan Options:

aega Kaiser Permanente HMO for EAST BAY INNOVATIONS, INC. Purchaser ID: 72129 HMO Deductible HMO

Annual Deductible: Individual / Family per calendar year(s) None / None $1000 / $2,000

Maximum Out-Of-Pocket $1,500 per member, $3,000 per family

$3,000 per member, $6,000 per family

Maximum Lifetime Benefit None / None None / None

* Benefit applies to deductible

Hospital Inpatient (all services rendered while hospitalized) $100 per day 20% per admit *

Outpatient (specialty, routine, eye/hearing exams, and urgent care) $15 per visit $20 per visit Well-child preventive care visits (23 months or younger) No charge No charge Scheduled prenatal care and first postpartum visit No charge No charge Outpatient surgery $100 per procedure 20% per procedure * Allergy Injections / Immunizations $3 per visit No charge X-rays and Lab tests No charge $10 per encounter Ambulance services $75 per trip $150 per trip Emergency department visits $100 per visit 20% per visit *

Outpatient Prescription Drugs (pharmacy and mail order) $10 gen / $25 brand, $20 gen / $50 brand MOI $10 gen / $30 brand, $20 gen / $60 brand MOI

Days supply 30 days, 100 days MOI 30 days, 100 days MOI

Mental Health Services Inpatient psychiatric care / days per calendar year $100 per day 20% per admit * Outpatient individual therapy visits $15 per visit $20 per visit Outpatient group therapy visits $7 per visit $10 per visit

Chemical Dependency Services Inpatient detoxification $100 per day 20% per admit * Outpatient individual therapy visits $15 per visit $20 per visit Outpatient group therapy visits $5 per visit $5 per visit Transitional Residential Recovery Services $100 per admit $100 per admit

Infertility Services Covered services related to the diagnosis and treatment of infertility 50% per visit 50% per visit

Additional Benefits Supplemental Durable Medical Equipment 20% per item 20% per item Skilled Nursing, Home and Hospice Care No charge 20% per admit Optical eyewear (frames, lenses, contact lenses) $150 per 24 months Not covered Hearing aids Not covered Not covered Chiropractic Not covered Not covered Dental Not covered Not covered

The information presented in this chart is a summary only. For a complete understanding of benefits, please read this chart in conjunction with the Evidence of Coverage (EOC). The EOC contains a detailed explanation of benefits, exclusions, and limitations. We reserve the right to modify the rates and benefits if we receive further clarification of Federal Health Reform requirements, or to incorporate other applicable Federal Health Reform requirements. In addition, Kaiser Permanente reserves the right to make any change in these rates and benefits due to changes in State or Federal legislation or regulatory action.

Page 5: Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

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Medical Plan Alternative:

Alameda Alliance for Health (Public Authority)

– Medical, Dental and Vision Benefits for In Home Supportive Services (IHSS) workers in Alameda County

– Eligibility: 160 hours of paid employment (issued checks) for two consecutive months.

– Benefits: Alameda Alliance Group Care HMO based medical services administered by contracted medical providers with

Alameda County (Medical groups and Hospitals). Two Dental Options: HMO and PPO plan designs Vision: Exam and Eyewear coverage.

– Monthly Premiums: $20: Medical and Dental (HMO) $45: Medical and Dental (PPO)

– Enrollment Process: Contact #: 510-777-4201 (Additional Info/Enrollment Packet Request)

Page 6: Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

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Dental:

MetLife Dental PPO

Deductible:

In Network: $50/Individual - $150/Family (Waived for Preventive) Out of Network: $50/Individual - $150/Family (Waived for Preventive)

Annual Maximum: $1,500 per Person

Co-Insurance : In Network Out of Network (90th % UCR) Preventive 100% 100% Basic 80% 80% Major 50% 50% Ortho 50% 50%

Orthodontics Maximum: $2,000 Lifetime (Child Only)

Page 7: Confidential Employee Benefits Open Enrollment Effective: January 1, 2012

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Flexible Spending Accounts (FSA)

Administered by Optum Health Financial

Medical and Dependent Care Reimbursement

Pre-tax payroll deductions to pay for un-reimbursed medical and dependent care expenses.

Annual Maximums Medical Reimbursement Account - $2,500

Dependent Care Reimbursement Account - $5,000 (IRS limit)

To enroll, complete the required election forms: Cannot change enrollment election during plan year

Funds leftover at the end of the year will be lost. Plan carefully!

For questions and eligible expenses: www.optumhealthfinancial.com