2010 Open Enrollment HomeCare 4 23 2010

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CHRISTUS CONTINUING CARE ASSOCIATE BENEFIT PLANS JULY, 2010 r. 4/24/10 ADMINISTERED BY:

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PRE-TAX BENEFITS Health Including Vision & Pharmacy Dental Flexible Spending Accounts Fidelity Matched Savings Plan POST-TAX BENEFITS Optional Life (4 X salary) Voluntary AD&D Dependent Life Voluntary Short Term Disability (4 plans) Long Term Disability (buy-up to 60% benefit) FREE BENEFITS LTD (40% benefit) BASIC CORE LIFE & AD&D – ANNUAL SALARY MAXIMUM OF $100,000 Employee Assistance Program Retirement - Cash Balance Plan PTO/EIB Willpower Wellness Program

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THE NEW PLAN YEAR IS FROM JANUARY 1st TO DEC 31st EACH YEAR. YOUR DEDUCTIBLES WILL BEGIN ON JULY 1 and start again on JANUARY 1 for this period only due to the transition of plans. The new Third Party Administrator paying all claims is GILSBAR, INC. You will receive new insurance ID cards before July 1st. After effective date, please provide new ID card to your providers Networks are either Beechstreet or PHCS (formerly Amer Lifecare.) Location determines network. You still receive a higher benefit for using CHRISTUS facilities. There are no salary tiers for premiums. Medical Plan Differences for YOU

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The standard Medical PPO Plans offered are $350 and $500 deductibles. There is no consumer PPO Plan. The $500 deductible plan offers a lower premium than the $350 deductible plan, with same office visit and pharmacy copays as $350 plan; The $500 deductible plan pays 10% less benefits on other services than the $350 deductible plan. The “Low Cost” plan is still available with a $2,500 individual deductible. This plan will pay no more than $25,000 total in a year per individual covered. Medical Plan Differences for YOU (continued)

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The office copay on all plans is $25 each visit including Vision. Pharmacy copays are $12/$25/$50; and deductibles each year are either $150 or $300 per person depending upon plan chosen. Vision Plan is included in medical plan, but similar benefits to your former options. Some Similar Medical Plan Provisions

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Dental Plan is almost identical to your former plan. As an option, CIGNA HMO plan is offered for dental except in Corpus Christi and New Braunfels. Long Term Disability is still FREE. A 40% benefit is payable after 150 days of qualifying absence (former plan paid 40% after 180 days.) Associate may still purchase buy-up option to equal 60% benefit. Short Term Disability options are the same. Associate still pays full cost. Free life insurance is 1 X annual salary up to $100,000. You are taxed on any premiums paid on your behalf in excess of $50,000 of benefit. Dependent life insurance includes both spouse ($25,000) and eligible children ($10,000 each.) A new Employee Assistance Plan is in effect with similar benefits. Your flexible spending account includes a debit card for immediate use upon receipt. There will be no Voluntary Benefit plans offered by on-site vendors last year. You will receive information in June regarding your ability to transfer these to individual policies. Non-Medical Plan Comparisons

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Only current Part-Time associates will be allowed to remain in Medical and Dental Plans No new Part-Timers will be allowed to enroll Current Part-timers will only have med/dental (There will be portability of other products for those part-timers currently enrolled in life insurance and disability) Part-time eligibility for Benefits will change to: Between 20 < 36 hours per week Full-time associates working between 32 – 36 hours per week will revert to Part-time effective July 1st (Portability provisions will apply if currently enrolled in life insurance and disability) Part-Time Associates

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All current eligible associates will move to new plans effective July 1st All future transfers into HomeCare will be effective upon transfer from CHRISTUS All future new hires will be eligible on the first of month after 60 days of employment New hires May 6th and later, will not have coverage before August 1st New hires before May 6th will have be covered by the current CHRISTUS plan prior to July 1st, and will obtain new plans effective July 1st. (Two open enrollments.) Coverage Periods

MEDICAL PLAN : 

MEDICAL PLAN 2010

2010 MEDICAL/DENTAL COSTS Per Pay Period - Pre-Tax : 

2010 MEDICAL/DENTAL COSTS Per Pay Period - Pre-Tax

2010 MEDICAL PLAN BENEFITS : 

2010 MEDICAL PLAN BENEFITS

$350 Deductible Plan 2010 DEDUCTIBLES & OUT-OF-POCKET : 

$350 Deductible Plan 2010 DEDUCTIBLES & OUT-OF-POCKET

$500 Deductible Plan 2010 DEDUCTIBLES, PERCENTAGES & OUT-OF-POCKET : 

$500 Deductible Plan 2010 DEDUCTIBLES, PERCENTAGES & OUT-OF-POCKET

Low Cost Plan 2010 DEDUCTIBLES, PERCENTAGES & OUT-OF-POCKET : 

Low Cost Plan 2010 DEDUCTIBLES, PERCENTAGES & OUT-OF-POCKET NOTE: MOST BENEFITS WILL BE PAID AT 10% LESS THAN THE $350 DEDUCTIBLE PLAN. THE MAXIMUM ANNUAL BENEFIT PER PERSON ON THIS PLAN IS $25,000 OFFICE VISIT COPAYMENTS WILL BE $25. EMERGENCY VISIT COPAY IS $150 PHARMACY ANNUAL DEDUCTIBLE IS $300 PER PERSON. PHARMACY COPAYS ARE THE SAME ON ALL PLANS.

PHARMACY CHARGES2010 : 

PHARMACY CHARGES2010

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Vision Exam & Supplies Paid before annual deductible 100% after $25 Co-Pay Routine Exam & Refraction One per 24-month period Hardware (also paid before annual deductible) 80% ($200 maximum per 24 month period) VISION PLAN With All Medical Plans2010

DENTAL PLAN : 

DENTAL PLAN 2010

GILSBAR DENTAL PLAN : 

GILSBAR DENTAL PLAN

MONTHLY MEDICAL/DENTAL COSTSCONTINUATION COVERAGE 2010 OPTIONAL AFTER TERMINATION/RESIGNATION : 

MONTHLY MEDICAL/DENTAL COSTSCONTINUATION COVERAGE 2010 OPTIONAL AFTER TERMINATION/RESIGNATION

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ELIGIBILITY COVERAGE PARAMETERS Medical/Vision*: GILSBAR – Available to all eligible employees with Employer subsidizing cost. Dental*: GILSBAR– Available to all eligible employees with Employer subsidizing cost. CIGNA DHMO – Available to all employees with Employer subsidizing cost. (Unavailable at Corpus Christi and New Braunfels) Basic Life & Basic AD&D (up to $100,000) & Long-Term Disability (40%): Provided by Employer to all eligible employees at no charge. Supplemental Life, Dependent Life, AD&D, & Short-Term Disability and extra Long-Term Disability buy-up to 60%): Available to all eligible employees at their own expense. NOTE: AD& D amounts must be equal to or higher than Life Insurance amounts of coverage. No additional life insurance can be purchased above previous year coverage unless and Evidence of Insurability Form is completed. New amount is not effective until the Evidence of Insurability Form is approved by The Hartford. * Employees can choose dental carriers. Separate choices can be made regarding whether to choose dental and/or medical coverage. Associates can choose different dependent coverages if enrolled in both medical and dental.

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PRE-EXISTING CONDITIONS LIMITATION – GILSBAR Definition: A sickness or injury for which an individual received medical treatment, consultation or prescription drugs 6 months prior to the “effective date” (first day of waiting period, if applicable). Limitation: Only the first $500 will be payable for a “pre-existing condition”. This exclusion will not apply, however, to covered expenses incurred: 12 months insured after the enrollment date HIPAA: The period of the Pre-existing Conditions Limitation can be reduced by the length of the combined periods of “creditable coverage” from another carrier (if any) applicable to the participant as of the enrollment date, however there can not be more than a 63 day break between coverage not including waiting period.

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PRECERTIFICATION – GILSBAR Review is required: Before being admitted as a hospital inpatient AND If the doctor feels the hospital stay must be longer than originally certified AND Before any inpatient or outpatient surgery is performed. Notification will be required as follows: Emergency admissions – GILSBAR must be notified of an emergency admission by telephone or any other means within 48 hours or on the first business day following the admission or as soon as reasonably possible. (Insurance ID card has phone contact numbers to call.) Non-emergency admissions – GILSBAR must be notified ASAP prior to admit. Proposed surgery – Attending physician should provide GILSBAR details. Penalty: If the original admission is not certified or the surgical review program not met, benefits will be reduced to 50%, but by not more than $300 per occurrence. A deductible applies if it would have normally been applied. If a later request to extend is not certified, benefits for hospital expense will be reduced by $50 for each day the patient remains in the hospital, up to $300 per occurrence. A deductible applies if it would have normally been applied.

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SECOND SURGICAL OPINIONS – GILSBAR If the surgical proposal by the attending physician is not certified, a second opinion must be obtained from an eligible doctor. The covered person must use one of the eligible doctors available in the area where he lives. If the second opinion does not certify the need for surgery, a third opinion is needed. Once the third opinion is obtained, regardless of the result, the requirements of the surgical review program have been met. Second and third opinions will be covered at 100% if required by GILSBAR.

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DEPENDENT ELIGIBILITY “Dependent” means any one of the following: Your lawful spouse, provided no judicial decree or separation has been obtained, even if the spouse is employed elsewhere and covered under another group plan. Your unmarried child under age 19. (birth to 14 days, no Dependent Life coverage) Your unmarried child under age 25, attending an accredited school full-time and primarily supported by the employee. (Texas residents are not required to be in enrolled in school but must be eligible dependents.) Your unmarried child age 19 or more years of age, primarily supported by the employee and incapable of self-sustaining employment by reason of mental or physical handicap.

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DEPENDENT ELIGIBILITY (CON’T) Any of your unmarried grandchildren under age 19 as long as you claim such dependent on your federal income tax return or for whom you are required to provide medical support under a court order. Any of your unmarried grandchildren under age 25, attending an accredited school full-time as long as you claim such dependent on your federal income tax return or for whom you are required to provide medical support under a court order. (Texas residents need not be enrolled in school.) “Child” includes your stepchild who resides in your household. “Child” also includes an adopted child from the date a petition is filed, provided the employee is party in that petition. No child eligible for coverage as an employee under any group benefit plan can be covered hereunder as a dependent. No spouse eligible for coverage as an employee of your employer can be covered hereunder as a dependent. No person may be the dependent of more than one employee under this plan. It is the employee’s responsibility to provide proof of dependent eligibility.

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CHANGING BENEFIT CHOICES Normally you may change your medical and/or dental benefit choices and/ dependent coverage each year at “Open Enrollment” only. Changes in The Hartford non-medical are only at “Annual Re-solicitation” period. (Life Insurance and Disability provisions.) During the year, changes in medical/dental are allowed only if considered an eligible “Family Status” change with request notice within 31 days of event: Marriage, divorce, or other change in the employee’s legal marital status Birth, adoption, or other change in the number of dependents A change in employment status of the employee, spouse, or dependent A change in work schedule of the employee, spouse, or dependent An unmarried dependent gaining or losing eligibility; or child A change of residence or worksite of the employee, spouse, or child

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HEALTH CARE SPENDING ACCOUNT DEBIT CARD – FULLY LOADED WITH ELECTIONS - Maximum contribution is $4,800 annually - Helps you pay for unreimbursed medical, dental, vision, hearing and other health care expenses including deductibles, copays. For 2010, you will only have a six month plan. DEPENDENT CARE SPENDING ACCOUNT - Maximum contribution is $4,800 annually - Helps you pay for day care expenses for your children < 13 yrs and qualified older dependents including parents. FLEXIBLE SPENDING ACCOUNTS(Pre-Tax Dollars)

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You may include health care costs for any immediate family member - not just limited to those covered by Dubuis Med/Dental Plans. “Debit card” feature allows you to charge expenses to your card “as you go.” GRACE PERIOD: IRS requires you to forfeit any money that you do not use by year end. IRS will allow an exception to the “Use It or Lose It” provision. IRS Notice 2005-42 offers a grace period to allow associates additional time to incur Health Care or Dependent Care expenses against the previous year’s unused balance. The grace period cannot be any longer than 2 ½ months (March 15th deadline) following the end of the preceding plan year. FLEXIBLE SPENDING ACCOUNTS(Continued)

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LIFE INSURANCE DEPENDENT LIFE INSURANCE ACCIDENTAL DEATH AND DISMEMBERMENT LONG TERM DISABILITY SHORT TERM DISABILITY FLEX PLAN EMPLOYEE ASSISTANCE PLAN RETIREMENT PLAN (CASH BALANCE) MATCHED SAVINGS PLAN (FIDELITY) MISCELLANEOUS PLANS

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LIFE INSURANCE PREMIUM CALCULATION & EOI (Evidence of Insurability) GUIDELINES Salaries are frozen throughout year at April 1st Ages are frozen throughout year at April 1st Supplemental Life benefits are determined by rounding salaries up to next $1000 then multiplying by option Guarantee Issue Limit is the Lesser of “Two Times Annual Salary” or $250,000 Increases in Supplemental Life benefits during Annual Re-solicitation period and during Family Status Changes for current insureds require completion of Evidence of Insurability Form. Increased coverage is not effective until notice of approval is received from The Hartford. EOI is required for all enrollees who waived coverage initially offered.

LONG-TERM DISABILITY BENEFITS : 

Employer will continue to provide free Long-Term Disability insurance with benefits up to 40% of base salary (with some cap limitations.) Employee may purchase an additional 20% benefit for a total 60% benefit (with some cap limitations.) Benefits do not begin until after 150 days of eligible disability (this is an improvement from prior coverage) LONG-TERM DISABILITY BENEFITS

SHORT-TERM DISABILITY BENEFITS : 

The benefits are optional and fully paid by the Employee (4 choices): - 50% benefit after 42 days - 50% benefit after 84 days - 70% benefit after 42 days - 70% benefit after 84 days SHORT-TERM DISABILITY BENEFITS

2010 REMINDERS : 

2010 REMINDERS All deductions are for 26 pay periods each year Except for the flexible benefits which are 24 pay period per year It is not suggested that you reduce to the “Low Cost” Medical Plan until you speak with a representative of the HR team to fully understand limitations

EMPLOYEE ASSISTANCE PROGRAM : 

EMPLOYEE ASSISTANCE PROGRAM Ability Assist- Available to you and your family to address daily challenges including stress, parenting, aging, financial and legal questions, addiction and recovery and emotional health. 24-hour access to professionals and face-to-face visits when needed. 800-964-3577 (800-96-HELPS)

CHRISTUS Cash Balance PlanRetirement Savings : 

CHRISTUS Cash Balance PlanRetirement Savings Funded by Employer - no cost to you Automatically enrolled after 1 yr. employment Each year must work 1500+ hours to benefit Employer contributes amount equal to 6% base pay Your accounts earns variable interest annually Begin vesting at 2 years; fully vested at 5 years Vested portion of your account paid to you when you leave EMPLOYMENT

FIDELITY MATCHED SAVINGS PLAN : 

FIDELITY MATCHED SAVINGS PLAN Can enroll for payroll deduction immediately Pretax savings up to 50% of pay (other limits apply) Cap raised to $16,500 annual contributions. Employer will match your contributions up to 4% of your pay (at $.50 on each dollar.) Matching funds only begin after one year of service in which you worked at least 1,500 hours Partial vesting in match after 2 years; fully vested after 5 years of service You are always fully vested in your contributions

IMPORTANT CONTACTS : 

IMPORTANT CONTACTS OPEN ENROLLMENT ASSISTANCE 713-630-5532 OR 713-277-2359 Toll Free: 1-877-339-7034 HUMAN RESOURCES For all HomeCare locations other than Houston contact: Stan Richardson – 210-785-5296 Lori Pesina – 210-785-5297 For HomeCare Houston location contact: Sherry McKinney - 713-630-5532 Lydia Diaz  - 713-630-5531 GILSBAR MEDICAL/DENTAL 888-472-4352 www.mygilsbar.com WALGREENS HEALTH INIATIVES 800-207-2568 WHI MAIL SERVICE PHARMACY 800-999-2655 P.O. Box 62800, Orlando, FL 32862-8001 CIGNA DENTAL HMO 800-367-1037 GILSBAR (FSA ACCTS) claims 866-635-1329 email: flex@gilsbar.com questions 800-445-7227 X 883 HEWITT RETIREMENT (CASH BALANCE) 888-255-4500 FIDELITY (MATCHED SAVINGS) 800-343-0860 www.fidelity.com EMPLOYEE ASSISTANCE (HARTFORD) 800-964-3577 http://www.guidanceresources.com 800-96-HELPS WILLPOWER WELLNESS PLAN 800-321-7011 www.mygilsbar.com