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Dear Alpine Access Employee, Alpine Access continually seeks to provide benefits that deliver excellent coverage and

valuable options for you and your families. With that in mind, we are pleased to offer a Limited Medical Benefit Program through Standard Security Life Insurance Company of New York. Now is your time to enroll in this exciting program! Employees are eligible to enroll 30 days after date of hire and employees must complete enrollment within 60 days from hire date. We consider your hire date to be your first day of training. After the 60 days has passed, you will not be able to enroll until our next Open Enrollment period without a qualifying life event. Coverage begins on the first Friday in which you have a payroll deduction, after 30 days of employment.

Call 1-800-656-4577 to Enroll. Be sure to mention you are an Alpine Access employee!
The enclosed program brochure provides an overview of the available health plans. There are medical plans from which to choose as well as optional Dental, Life Insurance and Short Term Disability insurance so that you can select the program(s) that best suits your needs. Please call the Enrollment Center for more information at 1-800-656-4577. The Enrollment Center can answer your specific questions about the plan and coverage. ID Cards and plan information will be mailed to your home address. When calling to enroll, please identify the option you wish to elect and provide Social Security Numbers and birth dates for you and any dependents you wish to cover. Please see the information below before you call to make your elections.

Enrollment Instructions
Enrollment must be done through the Enrollment Center; you cannot enroll online. When you call the Enrollment Center, please be prepared to answer the following questions. A representative will take your information and answer any questions you may have regarding your benefits. The Enrollment Center is available from 7:00 AM to 7:00 PM Central Time, Monday through Friday. When you call the Enrollment Center, be ready to provide them the name of your employer (Alpine Access), along with your name, social security number, date of birth and full address. If you are enrolling dependents, please be prepared to provide your dependents full name, date of birth, social security number, and relationship (spouse or child). What level of coverage? __ Employee Only __ Employee Plus Child(ren) __ Employee Plus Spouse __ Family Would you like to elect a medical plan? Optional Coverage? __ Select Plan __ Dental Coverage __ Select Buy-Up Plan __ Vision Coverage __ Short Term Disability __ Life Insurance

When you are ready to enroll, or if you have questions about your coverage choices, call the Enrollment Center at 1-800-656-4577. If you decide to enroll, please save this brochure for future reference along with the plan information you will be receiving.
Si usted necesita la informacin o ayuda en espaol, llame por favor el centro de la inscripcin al 1-800-656-4577.

1120 Lincoln Street, Suite 1400, Denver, CO 80203 l phone 303.279.0585 l fax 303.279.0584 l www.alpineaccess.com

Benefit Summary for Non-Corporate Employees

PLAN YEAR |

January 6, 2012 January 3, 2013

PLAN YEAR

| [current_year

Our employees are our most valuable asset.


Thats why at Alpine Access we are committed to a comprehensive employee benefit program that helps our employees stay healthy, feel secure, and maintain a work/life balance. Stay Healthy Medical, Dental, and Vision Care

Feeling Secure Disability Insurance Life and Accidental Death & Dismemberment

Work/Life Balance Time Off

Contact Information
Refer to this list when you need to contact one of your benefit vendors. For general information contact Human Resources at benefits@alpineaccess.com. MEDICAL/RX: Page 4 First Health/Select Plan - Doctors only/Select Plus Plan - Doctors and Hospitals/Standard Security Life Insurance Company -Member Services 800-822-3906 WWW.YOURMEDBENEFITS.COM DENTAL: Standard Security Life Insurance Company - Member Services 800-822-3906 VISION: Standard Security Life Insurance Company - Member Services 800-822-3906 SHORT-TERM DISABILITY: Standard Security Life Insurance Company Member Services 800-822-3906 LIFE & ACCIDENTAL DEATH & DISMEMBERMENT: Standard Security Life Insurance Company - Member Services 800-822-3906 BENEFIT PREMIUMS: Page 6

Page 6

Page 7

P age 7

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Medical Reimbursement Plan


Select Plan
Services Doctors Office Visit Outpatient Diagnostic X-ray and Lab Preventive Care Inpatient - Surgical Benefit Outpatient - Surgical Benefit Emergency Room Indemnity Benefit for Illness Only Daily In-patient Hospital Benefit Hospital Confinement Mental Illness Disorder Plan pays:* $75 per visit $450 calendar year maximum $75 per day $450 calendar year maximum $50 per visit $150 calendar year maximum $1,000 lump sum $500 lump sum $100 per visit; $400 calendar year maximum $300 per day $500 per confinement $150 per day $5,000 calendar year maximum, $30,000 lifetime maximum $150 per day 30 day calendar year maximum, $30,000 lifetime maximum 100% of charges up to $1,000 annual maximum per accident $10,000 for Employee Only No Benefit Tier I: $10 / Tier II: $20 / Tier III $40 or less for preferred drugs

Substance Abuse

Accident Coverage Accidental Death & Dismemberment Critical Illness Benefit **Prescription Drug (Discount Plan)

* Employee is responsible for the remainder of the cost ** These benefits are not underwritten by Standard Security Life Insurance Company of New York

Medical Reimbursement Plan

Select Buy-Up Plan


Services Doctors Office Visit Outpatient Diagnostic X-ray and Lab Preventive Care Inpatient - Surgical Benefit Outpatient - Surgical Benefit Emergency Room Indemnity Benefit for Illness Only Daily In-patient Hospital Benefit Hospital Confinement Mental Illness Disorder Plan pays: * $75 per visit $450 calendar year maximum $75 per day $450 calendar year maximum $50 per visit $150 calendar year maximum $1,000 lump sum $500 lump sum $100 per visit; $400 maximum $500 per day $500 per confinement $250 per day $5,000 calendar year maximum, $30,000 lifetime maximum $250 per day 30 day calendar year maximum, $30,000 lifetime maximum 100% of charges up to $1,000 annual maximum per accident $10,000 for Employee Only $5 Generic: $25 Brand $100 monthly max

Substance Abuse

Accident Coverage Accidental Death & Dismemberment **Prescription Drug (Discount Plan)

* Employee is responsible for the remainder of the cost ** These benefits are not underwritten by Standard Security Life Insurance Company of New York

Dental Insurance
Dental Care Benefit
$50 deductible, $500 calendar year maximum This table provides a brief overview of the Dental Benefit. Exclusions and limitations apply.
Type of Service Percent paid by plan 80% 80% 50% Waiting period Deductible Applies No Yes Yes

Type I Type II Type III

None 6 months 6 months

Type IV (Ortho)

50%

12 months

Yes

Vision
Vision Care Benefit
Covered Vision Care expenses are paid at 80%. $300 maximum benefit per person per calendar year. One exam every 12 months. One pair of glasses/contacts every 24 months.

Disability Insurance
In the event you become disabled from a non work related injury or sickness, disability income benefits are provided as a source if income. You are not eligible to receive short term disability benefits if you are receiving workers compensation benefits.

Short-term Disability Benefits Begin Benefits Payable Percentage of Income Replaced Maximum Benefit After 15th day of sickness or injury $150 per week 66% of salary Pays up to 26 weeks

*12 month pre-existing condition applies

Life and AD&D Insurance/Voluntary Life


Life Insurance/Accidental Death and Dismemberment Benefit Additional $20,000 employee coverage. The Life Insurance Benefits reduce by 35% of the original amount upon attainment of Age 65, and by an additional 35% each five year period thereafter. Dependent Life Insurance $2,500 Spouse; $1,250 Child (from 6 months to 19 years, 26 years if a Full Time Student); $200 Child (from 10 days to 6 months).

Benefit Premiums
Limited Medical Rates
Select Plan Rates Bi-Weekly Employee Only Employee + Spouse Employee + Child(ren) Family $52.60 $128.55 $80.35 $136.75 Select Buy Up Plan Rates Bi-Weekly $69.25 $172.26 $106.22 $188.95

Dental and Vision Rates


Dental Employee Only $7.68 Vision $2.79

Employee + Spouse

$20.21

$7.33

Employee + Child(ren)

$13.06

$4.46

Family

$22.44

$7.67

Life and Disability Rates


Life Employee Only Employee + Spouse Employee + Child(ren) Family $5.55 $7.21 $6.44 $8.09 Short Term Disability $6.07 Not Available Not Available Not Available

Employees are eligible for insurance benefits after completing 30 days of employment.

The information in this Benefits Summary is presented for illustrative purposes and is based on information provided by the employer. The text contained in this Summary was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies, or errors are always possible. In case of discrepancy between the Benefits Summary and the actual plan documents the actual plan documents will prevail. All information is confidential, pursuant to the Health Insurance Portability and Accountability Act of 1996. If you have any questions about this summary, contact Human Resources.

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