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Etori U.S.A., Inc. Presented by:

Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Page 1: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

Etori U.S.A., Inc.

Presented by:

Page 2: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Effective May 1, 2011:

• Insurance carrier remained the same:

Medical – Nippon Life Insurance

• Insurance carrier changed:

Dental – Nippon Life Insurance

Life/AD&D – Nippon Life Insurance

Disability - Nippon Life Insurance

Page 3: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Aging population who are staying in the work place longer;

Advances in medical technology;

Inflation or Health Care Trend;

Government regulations; health care reform changes in 2010 including extension of dependent age to age 26, 100% coverage for preventive services, no pre-existing condition exclusions for children to age 19 and no longer any lifetime benefit maximum.

Larger volumes of prescription drugs and expensive bio-tech drugs;

Over-utilization of health care services (e.g. office visits, ER visits, etc.);

Changes in Health Status – More Chronic Diseases (e.g. Cancers, Diabetes, Heart Disease, Asthma, Obesity)

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Page 4: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Plan Type Employee Premium

Medical Employee onlyEE+SP and / or Dependants

10%50%

Dental Employee onlyEE+SP and / or Dependants

10%50%

Short Term Disability

Employee only 50%

Basic term Life

Employee only(All Employee are Eligible Automatically)

0%

AD & D Employee only(All Employee are Eligible Automatically)

0%

An employee will be eligible for the insurance benefits after 3 months of his/ her hire date . Insurance plans and the contribution percentages offered for employee at Etori USA , Inc. are as follows

Page 5: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Monthly premium

MEDICAL

Monthly premium

DENTAL

Monthly premium

SHORT TERMDISABILITY

Monthly premium

BASIC TERMLIFE

Monthly premium

AD&D

MonthlyPremium

Total

Employee Only

$29 $2.9 Weekly salary / $10 X $0.40 x 12 /52 = -50%

$0 $0 $31.90 +

STD

Employee + Spouse

$86 $6.9 N/A N/A $92.90 +

STD

Employee + Child(ren)

$66 $5.6 N/A N/A $71.60 +

STD

Family $122 $9.2 N/A N/A $131.20 +

STD

Page 6: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Page 7: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

What you can do to save MONEY!What you can do to save MONEY!

Use IN-NETWORK providers whenever possible – Medical & Dental

Request GENERIC DRUGS

Utilize MAIL ORDER PRESCRIPTION DRUGS

PRECERTIFY all inpatient visits & procedures

Request DENTAL PREDETERMINATION LETTER

Ask your doctor about ALTERNATIVE TREATMENTS & MEDICINES

Ask what services cost and become a more KNOWLEDGEABLE CONSUMER

Lead a HEALTHIER LIFESTYLE

Page 8: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Medical Coverage – Nippon Life InsuranceMedical Coverage – Nippon Life Insurance

Page 9: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

PREFFERED PROVIDER ORGANIZATION…

This plan allows you to see any service provider, either in-network or out-of-network, and still receive benefits. However, in most cases benefits for services from out-of-network providers are paid at a reduced benefit level and will not contain a discount. You and the company end up paying more for medical services.

Find a Participating Doctor or Hospital

www.nipponlifebenefits.com

1-877-210-5518 (English / Spanish)

1-800-447-8208 (Japanese)

Page 10: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

In-Network Out-of-Network

Office Visits

Primary Care

Specialist

$30 Copayment

$30 Copayment

70% after Deductible

70% after Deductible

Deductible

Individual Maximum

Family Overall Max

$1,500

$4,500

$3,000

$9,000

Coinsurance Plan pays 80% Plan pays 60%

Out-of-Pocket Maximum

Individual

Family

$2,000 after deductible is met

$4,000 after deductible is met

$4,000 after deductible is met

$8,000 after deductible is met

Emergency Room $50 Copayment + 80% Coinsurance $100 Copayment + 60% Coinsurance

Inpatient Services

Facility Charges

Physician Charges

80% after Deductible

80% after Deductible

60% after Deductible

60% after Deductible

Outpatient Services

Facility Charges

Physician Charges

Diagnostic Services

80% after Deductible

80% after Deductible

80% after Deductible

60% after Deductible

60% after Deductible

60% after Deductible

Medical Plan Design (summary)

Certain exclusions and limitations apply. Complete details are contained in the Plan Document. If there is any conflict between this exhibit and the actual plan provisions, the terms of the Plan Document will govern.

Page 11: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Dental Coverage – Nippon Life InsuranceDental Coverage – Nippon Life Insurance

Page 12: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Dental Plan Summary - Nippon Life Dental Plan Summary - Nippon Life Insurance Insurance

Certain exclusions and limitations apply. Complete details are contained in the Plan Document. If there is any conflict between this exhibit and the actual plan provisions, the terms of the Plan Document will govern.

In-Network Out-of-Network

Calendar Year Deductible

$50 per Person$150 per Family Maximum

Calendar Year Max $1,500 per Person

Preventive Care Cleaning  Exam  X-Rays

Plan pays 100% of Contracted Fee

Plan pays 100% of Reasonable &

Customary

Basic Care  Extraction  Filling  Periodontic Endodontic

After you pay Deductible,

Plan pays 80% of Contracted Fee

After you pay Deductible,

Plan pays 80% of Reasonable &

Customary

Major Care  Crown  Bridge  Dentures

After you pay Deductible,

Plan pays 50% of Contracted Fee

After you pay Deductible,

Plan pays 50% of R&C

Page 13: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Basic Life & AD&D Coverage Basic Life & AD&D Coverage Nippon Life InsuranceNippon Life Insurance

Page 14: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Basic Life & AD&D Summary - UNUMBasic Life & AD&D Summary - UNUM

Basic Life and AD&D InsuranceMitsukoshi offers life and accident benefits to give your family a financial cushion and peace of mind if anything should happen to you. All full-time Employees receive benefits in the amount of $15,000.

Example

Life Insurance Benefit = $60,000  ( = $30,000 x 2 )

AD&D Benefit = $60,000

Death due to Illness - >  $60,000

Death due to Accident   - > $120,000

Have you designated or

updated a

Beneficiary?

THIS COVERAGE IS PROVIDEDAT NO COST TO YOU.

Certain exclusions and limitations apply. Complete details are contained in the Plan Document. If there is any conflict between this exhibit and the actual plan provisions, the terms of the Plan Document will govern.

Page 15: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Short Term Disability Coverage Short Term Disability Coverage Nippon Life InsuranceNippon Life Insurance

Page 16: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Disability Plan Summary Disability Plan Summary Nippon Life Insurance Nippon Life Insurance

Short-Term DisabilityBenefits will begin on the 1st day for injury and 8th day for sickness. Your STD benefits substitute 60% of your eligible weekly pay up to $1500 per week up to 26-weeks.

Please refer to your plan booklet for additional details.

Certain exclusions and limitations apply. Complete details are contained in the Plan Document. If there is any conflict between this exhibit and the actual plan provisions, the terms of the Plan Document will govern.

Remember your disability benefits are NOT meant to replace your income. They only

partially SUBSTITUTE income until you are able to return to work.

Page 17: Etori U.S.A., Inc. Presented by:. 2 Sumitomo Life Insurance Agency America, Inc. Effective May 1, 2011: Insurance carrier remained the same: Medical –

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Sumitomo Life Insurance Agency America, Inc.

Questions and Comments

Thank You for Attending!!Thank You for Attending!!