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2010 UnitedHealthcare Benefits Summary

Medical
Deductible In-network: $400 per person (up to two family members)
Out-of-network: $800 per person (up to two family members)
Coinsurance In-network: 85%
Out-of-network: 65%
Out-of-pocket maximum In-network: $2400 per person (up to two family members; includes deductible)
Out-of-network: $4800 per person (up to two family members; includes deductible)
Office visit (no referrals required) Primary care physician: $20; specialist: $25
Urgent care visit $35 co-pay
Emergency room $75 co-pay
Prescription drug co-payment Tier 1: $20 for a 31 day supply, $40 for mail order 90 day supply
Tier 2: $35 for a 31 day supply, $70 for mail order 90 day supply
Tier 3: $65 for a 31 day supply, $130 for mail order 90 day supply
Note: To determine which drugs are in each tier, refer to the Prescription Drug List
Reference Guide on www.myuhc.com/groups/tribune

Dental
Deductible Single: $50 in and out of network
Family: $150 in and out of network
Annual maximum $1,500
Lifetime maximum None
Preventive & diagnostic care 100%
Restorative care 80%
Major care 50%
Orthodontia 50% up to $1,500 lifetime maximum (children up to age 19)
Note: If you receive services out-of-network, benefits are subject to reasonable and customary charges and balance billing.

Vision
In-network Out-of-network
Exam 100% after $10 co-pay Up to $40
Single vision lenses 100% after $20 co-pay Up to $40
Bifocals 100% after $20 co-pay Up to $60
Trifocals 100% after $20 co-pay Up to $80
Frames 100% after $20 co-pay Up to $45
Contacts 100% after $20 co-pay Up to $105

Short-term Disability
Benefit 40% of pay (employer paid) up to weekly maximum of $2,000; employee may buy
additional 20% of pay up to weekly maximum of $2,000

Long-term Disability
Benefit 60% of pay (employee paid) to $15,000 monthly maximum

Life Insurance
Benefit Basic life: 1 times pay (employer paid)
Supplemental coverage: 1-8 times pay (employee paid)
Spouse/Domestic partner coverage: $10,000 - $150,000; employee paid
Dependent coverage: $5,000 - $25,000 per child; employee paid
Note: AD&D insurance is also available to you and your dependents.

Flexible Spending Accounts (FSAs)


The UHC FSA debit card can be used to pay for healthcare or dependent day care expenses. The commuter reimbursement
account also will be coordinated by UnitedHealthcare in conjunction with WageWorks.

The purpose of this summary is to provide highlights of Your Tribune Company Benefits plan. Eligibility and benefit payment determinations
will be governed by the plan documents. In the event of a discrepancy between the information provided in this material and the plan
documents, the plan documents will govern. Tribune Company reserves the right to change, amend or terminate the benefit plans at any time
for any reason. Your eligibility for benefits does not guarantee continued employment at Tribune Company or any of its entities. Benefits for
union-represented employees are subject to collective bargaining and the benefits summarized in this material may not currently apply. Local
Human Resources or Tribune Benefits Service Center representatives can answer any questions about benefits for union-represented
employees.

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