B E N E F I T S AT A G L A N C E

October 1, 2016

Benefits Enrollment Guide

Effective: July 1, 2017 - June 30, 2018

 
B E N E F I T S A T A G L A N C E
Dear Associate:

WGI is committed to employee health and welfare and understands how important your benefits are to you and your
family. As a full time associate, you are eligible for a wide range of valuable benefits designed to:

Promote the health and wellness of you and your family;

Protect your income if you are ill or injured and unable to work;
Provide financial protection to your survivors;
Build financial security for retirement and help you take advantage of tax savings opportunities;
Help you balance your personal responsibilities and work life and;
Teach you many ways to save money while using your employee benefits

Some benefits are provided automatically, while you must actively choose others. You are provided with many benefit
options enabling you to choose the package that best meets your needs. This guide gives you an overview of the bene-
fits available to you, and it also includes explanations on eligibility, benefits, cost and carrier contact information.

Please take the time to review each section and discuss with your family members before making your benefit elec-
tions.

Sincerely,

Your Management Team

Table of Contents
Contact Information B E N E F I T S A T A G L ………………………………………….5
A N C E

Who is Eligible to Enroll …………………………………………. 6

Dependent Eligibility Verification …………………………………………. 7
Medical Health Plans …………………………………………. 8
Medical - HDHP HSA Information ………………………………………….9
HSA Eligible & Ineligible Expenses …………………………………………..10
Saving Money …………………………………………..11
United Healthcare Member Site Information …………………………………………..12
Healthiest You …………………………………………..13
Care24 …………………………………………..14
Dental Plan ………………………………………….15
Vision Plan …………………………………………..16
Life & Disability …………………………………………..17
401(k) .………………………………………….18
Long Term Care .………………………………………….18
Additional Perks - Plum and Employee Perks .………………………………………….18
Employee Assistance (EAP) …………………………………………..19
Travel Assist …………………………………………..19
Will & Document Preparation …………………………………………..19
Preferred Legal …………………………………………..20
Pet Assure …………………………………………..20

Important Notices ………………………………………….21

Report Eligibility Changes …………………………………………..22

HIPAA Privacy Notice Reminder …………………………………………..23
HIPAA Special Enrollment Rights …………………………………………..23
Marketplace Notice …………………………………………..23
Expanded Women’s Preventative Health Benefits …………………………………………..24
Continuation Coverage Rights under COBRA …………………………………………..25-26
Medicaid and the Children’s Health Insurance Programs …………………………………………..27
Women’s Health and Cancer Rights …………………………………………..28
Newborn and Mother’s Health Protective Act …………………………………………..28
Prescription Drug Coverage under Medicare Part D …………………………………………..29-31
Contact/ResourcesFLEXIBLE BENEFIT PLAN
Benefit Provider Phone Website/Email

Medical United Healthcare 888-363-7731 www.myuhc.com

Download App at the AppStore

Healthiest You United Healthcare 866-703-1259
(IPhone) or Google Play (Android)

Care24 Services United Healthcare 888-887-4114 www.myuhc.com

https://
myhealth.bankofamerica.com/
Health Savings Account Bank of America 800-718-6710
Login.aspx?sec=BSB-1017, group
number BSB-1017

Dental United Healthcare 877-816-3596 www.myuhc.com

Vision VSP 800-852-7600 www.vsp.com

Life, AD&D & Disability Principal 800-843-1371 www.principal.com

401(k) Plan John Hancock See HR

www.magellanhealth.com/member
Employee Assistance Plan Principal/Magellan 800-450-1327

In US: 888-647-2611
Travel Assistance Principal/ARAG Outside: 630-766-7696 www.principal.com/travelassistance
(call collect)

www.aragwills.com/principal, enter
Will & Legal Documents Principal/Arag N/A
group number 1045106

Legal Preferred Legal 888-577-3476 www.preferredlegal.com

Pet Insurance PetAssure 888-789-7387 www.petassure.com

Kelly Sundermeier CBIZ 561-900-9112 ksundermeier@cbiz.com

dlyons@cbiz.com
Dana Lyons CBIZ 561-900-9105

Jackie Moran Jackie.moran@wginc.com

WGI Human Resources 561-687-2220

Cindy Sachnoff
WGI Human Resources 561-687-2220 Cindy.Sachnoff@wginc.com

5
Who is Eligible to Enroll?

ELIGIBILITY FOR BENEFITSB E N E F I T S A T A G L A N C E

To be eligible for benefits described in this Benefit Enrollment Guide if you are a Full Time
Associate working at least 30 hours or more per week. Benefits are effective the first of the
month following 30 days from date of hire.

Eligible Dependents for all plans:

 Your legally married spouse
 Your natural child, stepchild, legally adopted child, or eligible foster Child until their 26th birthday
 Child placed in your home for purpose of adoption
 Child for whom legal guardianship has been awarded to the Participant or the Participant's spouse
 Your child for whom health care coverage is required through a Qualified Medical Child Support Order
(QMCSO) or other court or administrative order

Child Dependent Limitations:

 Medical Plans:
Dependent child: Birth to age 26 (covered through the end of the month the dependent turns 26)

 Dental & Vision Plans

Dependent child: Birth-26 years (covered through the end of the month the dependent turns 26).
Unmarried; and Dependent upon Associate for support

CHANGING YOUR COVERAGE

Coverage elections you made at Open Enrollment are effective through June 30, 2018 as long you remain eligi-
ble for the plans. In return, for the tax savings advantage IRS regulations restrict your ability to change, unless
you experience a Qualifying Event . A qualifying event includes, but is not limited to:

 Marriage / Divorce;
 Birth, or adoption
 Death of your spouse or covered child;
 Change in work status that affects yours or spouse benefits;
 Receiving Qualified Medical Child Support Order
 Your child no longer qualifying as an eligible dependent under the plan(s)

If you experience one of these events during the year and would like to make a change to your benefits, you
must contact Human Resources within 31 days of the qualifying event. Otherwise, you will have to wait until
the next annual open enrollment period to make changes.

6
Dependent Eligibility Verification

We are required to verify the eligibility of any dependent who you choose to enroll in coverage on a WGI benefit
plan. When we request this information, it is simply to ensure compliance with the insurance carrier rules and to
help manage ever-increasing benefit plan costs.

Eligible dependents in our benefit plans include: Legal Spouse, and Children (biological, legally adopted, stepchild,
foster child or child under other legal guardianship). Please refer to Page 6 for more details.

From time to time, we may request documentation from you to confirm the eligibility.

Sample, acceptable documentation includes copies of the following:

 Proof of Marital Status - Marriage Certificate

 Proof of Parent/Child Relationship
 Birth Certificate showing child’s parents
 Court-approved document (for adoption, custody, or legal guardianship)
 Most current Federal Tax Return – can be used for proof of either; please provide first page only, with
all financial information marked out

Human Resources will contact you if documentation is required.

77
 Medical Plans & Prescription Drugs Benefits
WGI’s Medical Plan Options are designated to provide you and your eligible dependents with
comprehensive benefits giving you’re the options to choose the plan that best meets your healthcare needs. You also
have the option to “waive” coverage if you have coverage under another plan.

Hospital Supplement
Your medical options offer good, comprehensive coverage but there are out-of-pocket expenses you may incur should you
require hospitalization. Hospitalization expenses can add up quickly. To help offset some of the expenses, we are pleased
to offer a Hospital Supplemental plan through Sun Life Financial. A Hospital Indemnity policy can help to cover deductibles,
co-insurance and other expenses for hospital stays. This benefit provides a specified payment for the First Hospital
Confinement (up to $5,000 for a covered sickness or injury) during the calendar year based on the total number of days
of Hospital Deductibles
Confinement.areThe
perbenefit is not
person, notcumulative
to exceed and
the will not maximum
family exceed $5,000. Subsequent Hospital Confinements due
to a covered injury or sickness will be paid at $30 per day beginning with the first day up to 180 days. Please note that this
plan does not provide benefits where you may be hospitalized for “observation.” See your Sun Life Financial enrollment pack-
age for additional information.
Finding a Network Provider 
Prescription
Cost per Pay Period (bi‐weekly)   Benefits
  
United Healthcare HDHP QF3 POS QE8 POS
To locate a Network Provider: 
Medical Plans ABJ1Plan Plan Plan
Call Customer Service at (888)363‐7731, or 
Employee Only $ 10.00 $ 84.00 $127.00 Log on:  www.myuhc.com  
Employee + Spouse $ 75.00 $214.00 $253.00 Select “Find a Doctor” . Select “Choice Plus” network 
and enter your search parameters from there.  
Employee + Child(ren) $ 60.00 $152.00 $223.00 Tips:  Of course you can choose to receive care from a 
provider who is not in network.  If you do your out‐of‐
Family $100.00 $276.00 $373.00 network expenses will be higher.  
 

8
Health Savings Account
B E N E F I T S A T A G L A N C E

Health Savings Account (HSA)

October 1, 2016
With Our High Deductible Health Plan (HDHP)
If you are enrolled in our high deductible health plan (HDHP), you may choose to contribute to a Health Savings
Account. A Health Savings Account (HSA), when combined with our high deductible insurance plan, offers you
an opportunity to establish a tax-favored savings account. The money you contribute to your HSA will be de-
ducted from your pre-tax earnings and accumulate on a tax-free basis.

What is a high deductible health plan (HDHP)? The IRS determines the requirements of a qualifying high de-
ductible health plan. Plans must have a high deductible and a maximum out-of-pocket amount that meets cer-
tain limits.

How do I open a Health Savings Account (HSA)? If you enroll in the HDHP plan, then you can open a Health
Savings Account with Bank of America (group ID BSB-1017).

How do I make contributions to my HSA? You will make your election online at Benetrac. Each pay period, your
pre-tax contribution will be direct deposited into your HSA bank account. (you must open the bank account
through Bank of America)

How much can I contribute to my HSA? The 2017 annual H S A contribution maximum limit for employee only
coverage is $3,400 ($6,750 for family coverage). The 2017 catch-up contribution limit (for individuals who are
55 or older) is $1,000.

When can I start using funds in my HSA? Once your H S A bank account is open and a deposit has been made
to your account, you can start using your H S A funds when the bank says funds are available. Please keep in
mind there is a 20% penalty on taxable, non-medical distributions.

Reminder regarding Over-the-Counter Medications and your HSA: Effective January 1, 2011, un-prescribed over
the counter medications are no longer considered an eligible medical expense through the Health Savings Ac-
count unless you have a prescription from your provider. This would include items such as aspirin, Benadryl,
Tylenol, etc.

Sample Expenses:

Acupuncture Oral Surgery Orthopedist

Ambulance Service Eyeglasses (including exam fees) Pediatrician and/or Physician

Contact Lenses Non-prescription Medicine - with a

Vision Correction Surgery
(incl cost of materials) Prescription (e.g., insulin)

Braces Dermatologist Obstetrician/Prenatal Care

9
Eligible & Ineligible Expenses
FLEX—BENEFIT PLAN
QUALIFIED MEDICAL EXPENSES

Abortion Disabled Dependent Care Oral Surgery

Acupuncture Drug Addiction Therapy Orthopedist

Ambulance Service Eyeglasses (including exam fees) Pediatrician and/or Physician

Anesthetists Fertility Treatments Prescription Drugs

Artificial Teeth Gynecologist Registered Nurse

Bandages Hearing Aids Psychologist/Psychiatric Care

Hospital Services/Operating Room
Stop Smoking Programs (except
Birth Control Pills Expenses/Operations (except
non-prescription drugs)
Cosmetic)
Blood Tests Insulin Therapy
Transportation (essential to medi-
Braces Laboratory Tests
cal care)
Cardiographs Medical Services Vaccines
Insurance Premiums (only if
Chiropractor Neurologist
receiving unemployment benefits)
Non-prescription Medicine
Contact Lenses
(e.g., insulin, Tylenol, Benadryl) Vasectomy
(incl cost of materials)
MUST HAVE PRESCRIPTION
Contraceptives Nursing Services Vision Correction Surgery
Dental Treatment Out-of-pocket Expenses for your
Weight Loss Programs
(except cosmetic treatments) Spouse/Dependent
Dermatologist Obstetrician/Prenatal Care X-rays
Diagnostic Devices & Fees Ophthalmologist

INELIGIBLE MEDICAL EXPENSES

Advance Payments for Future

Medical Expenses
Athletic Club Membership & Dues
Babysitting (for healthy children)
Boarding School Fees
Bottled Water
Breast Reconstruction Surgery
(cosmetic)
Car Expenses Associated with
Operating a Specially Equipped Car
Child Care
Commuting Expenses for the
Disabled
Controlled Substances
Cosmetic Surgery
Cosmetics & Hygiene Products Illegal Operations & Treatments
Dancing Lessons Illegally Procured Drugs
Dental Treatment (cosmetic
treatments such as teeth whiten- Maternity Clothes
ing)
Insurance Premiums (unless
Driving Lessons
receiving unemployment benefits)
Diaper Service Medigap Premiums
Domestic Help Nutritional Supplements
Premiums for Life, Disability,
Electrolysis or Hair Removal
or other Accident Insurance
Funeral Expenses Special Foods or Beverages
Hair Transplants Swimming Lessons
Health Programs at Resorts, Gyms
Tuition for Problem Children
or Health Clubs
Household Help Vitamins

Go to IRS.Gov for complete listing of eligible and ineligible expenses

10
Saving Money
SAVING MONEY ON PRESCRIPTION COSTS
There are numerous ways you can help manage the cost of prescription benefits and utilization. Exploring and find-
ing options may save you money in two ways:

 Short term – costing you less out of pocket every time you fill your prescription, and;
 Long term – helping keep our group’s medical claims expenses down.

We encourage you to be an educated consumer and consider all options available to you. Some of those ways in-
clude:

Use Generic Prescription programs: These retail stores provide discounted medications for all customers, regard-
less of whether or not you have medical insurance. If you use one of these programs, do not provide their Pharma-
cist with your UHC ID card. If your family member does not have medical insurance, these pharmacies are a great
value.

 Wal-Mart – you pay $4 per prescription for a 30-day supply, and $10 per prescription for a 90-day supply

 Publix – offers some antibiotics for $0 (Amoxicillin, Ampicillin, Cephalexin, Ciprofloxacin and Penicillin),
as well as FREE Metformin, FREE Lisinopril and FREE Amlodipine

 K-Mart – you pay $5 per prescription for a 30-day supply, and $10-$15 per prescription for a 90-day supply

Remember – do NOT provide the Pharmacist with your UHC ID card, and the prescription costs do not become part
of our group’s claims.

Speaking with your prescribing physician: Are there any less costly medications that I can take? Taking generic
drugs can be less expensive than brand-name drugs.

Free Samples: Ask your doctor for samples when trying a new drug or even for existing prescriptions. Drug repre-
sentatives often provide your doctor’s office with free samples of various drugs they represent. Always remember to
ask your doctor about samples and you might be surprised how much they can provide.

Drug Manufacturers Coupons: Many times the drug manufacturers offer additional coupons online or through your
doctor’s office. We suggest you also google your medication to find out if there are any additional offers available.

Mail order pharmacy program: Are you currently enrolled in the UHC mail order program? If not and you are taking
maintenance medications, contact UHC to see how you can enroll and start saving in co-pays & time.

SAVING MONEY ON HEALTHCARE COSTS

You can also help better manage your health and your costs:

 Schedule your wellness exams (well-woman, annual physical, etc). Your cost = $0
 Schedule your preventative screenings (mammogram, colonoscopy, PSA, etc). Your cost = $0
 Utilize Participating Labs for all laboratory testing.
 Visit your PCP before seeing a Specialist.
 Use an Urgent Care or take advantage of Healthiest You instead of an Emergency Room.
 Use a free-standing Imaging Center for X-rays and complex imaging instead of a hospital.
 Use an Ambulatory Surgical Center for outpatient surgery instead of a hospital.

11
United Healthcare Resources
B E N E F I T S A T A G L A N C E

October 1, 2016

Register at www.myuhc.com

12
United Healthcare - Healthiest You

Connect with a doctor 24/7/365

using Healthiest You. Doctors are
licensed and can handle a lot of
common ailments. In addition to
providing prescriptions.

You can download the app on your

SmartPhone or call for help:

866-703-1259

13
United Healthcare - Care24

Care24 provides a wide range of services

and support available 24/7/365. You can
access:
 Registered Nurse
 Master’s level counselors
 Legal & Financial Professionals
 Community Resources
 Access Audio library on various topics

14
 Dental DHMO Plan
Dental Plan Highlights
WGI offers you the benefit of selecting dental coverage through United Healthcare. Both PPO dental plans offer
in and out-of-network benefits. By utilizing in-network PPO dentists, you will reduce your out-of-pocket expenses
for dental services. You also have the option to “waive” coverage if you have coverage under another plan.

The PPO 1211 has a late entrant waiting period– if you have waived dental coverage previously and elect this plan, major services
will have a 12-month waiting period.

SAVING MONEY ON DENTAL costs

Pre-determination of Benefits:
A predetermination of benefits is a way for you to find out what your cost will be prior to having the services per-
formed by your dentist. Have your dentist fax your treatment plan to United Healthcare for review. United will let
your dentist know what services would be payable under your dental plan and provide an estimate of your cost
for these services. Out of Network dental providers will be reimbursed on a fee schedule. They may bill you
the difference between what United allows for services and what they actually charge. Although you have the
option of using out-of-network dentists, keep in mind that an out-of-network provider may balance bill you, in
addition to what they are paid by United.

Finding a Network Provider 
To locate a United Healthcare Dental Provider: 
Call Customer Service at (877)816‐3596, or Log 
onto www.myuhcdental.com,  
Select "Find a Den st", 
Select your Network “PPO Na onal Network”   
Enter your search parameters 

15
 Vision Plan Highlights
WGI offers you the option of selecting vision coverage through VSP. The VSP vision care plan provides benefits for
eye health examinations, frames, eyeglass lenses and contact lenses. In addition, as a member, you will enjoy dis-
counts for LASIK surgery and preferred member pricing. You also have the option to “waive” coverage if you have
verage under another plan.

Benefit In-Network Non Network Providers

Deductible / Copay
Exams (Non-Contact Exam) $10 Co-pay Reimbursed up to $45
Exam - Contact Lens Fitting Up to $60 Co-pay NA

Lenses / Frames $25 Co-pay NA

Lenses / Frames After Co-pay
Single Vision Paid In Full Reimbursed up to $30
Bifocal Paid In Full Reimbursed up to $50
Trifocal Paid In Full Reimbursed up to $65
Frames $130 Retail Allowance Reimbursed up to $70
Contact Lenses
Elective Elective: Up to $130
Elective: Reimbursed up
Allowance
to $105
Med Necessary:
Med Necessary:
Paid in Full, After $25 Co-
Reimbursed up to $210
pay
Laser Vision Correction
Laser Vision Correction Discount Provided N/A
Frequency of Services
Exams Once every 12 Months
Lenses Once every 12 Months
Contact Lenses
Once every 12 Months*
(*in lieu eyeglasses)
Frames Once every 24 Months

SAVING MONEY ON VISION costs

The VSP vision plan provides significant benefits and cost savings for routine eye exams as well as a complete pair
of eyeglasses (*or contact lenses in lieu of eyeglasses). You can receive care from a contracted Network eye care
professional or an out-of-network provider, your out-of-pocket expenses will be higher and you will be responsible
for paying the provider directly and submitting a claim form.

Cost per Pay Period (bi-weekly) Finding a Network Provider 

To locate a VSP Provider, retail & private practice
Vision Plan
Optometrists:
Employee Only $ 2.88
Call VSP at 800-852-7600 or Log onto www.vsp.com
Employee + Spouse $ 4.98
Employee + Child(ren) $ 5.15 Select "Find a Doctor"

Family $ 7.95 Enter your Zip code or other parameters

Choose your network: VSP Choice

16
Life and Disability Benefits Highlights
Employer Paid Life/AD&D Insurance
Through Principal, WGI provides basic insurance coverage to full-time active associates. The Basic Life cover-
age provides each eligible associate a benefit amount of $50,000 with a matching Accidental Death and Dis-
memberment (AD&D) benefit. This benefit provides for an accelerated life benefit subject to certain condi-
tions. (Note: Age reduction schedule applies beginning at age 65 years, see certificate for full schedule)

Voluntary Life/AD&D Insurance

Through Principal, you have the ability to purchase additional Life/AD&D insurance.

For You: You can purchase a minimum benefit of $10,000 up to a maximum of $500,000. Guarantee Issue
amount for associates is offered in the amount of $80,000 for new hires only, up to age 69. For those age
70 and older, the Guarantee Issue amount is $10,000. For higher coverage amounts, you will need to com-
plete a Change Form and Evidence of Insurability form and will be subject to medical underwriting.

(Note: Age reduction applies beginning at Age 65, see certificate for full schedule).

For Your Spouse: If you elect optional life for yourself, then you have the opportunity to elect optional
life for your spouse. You can purchase up to 50% of employee amount to a maximum of $150,000. Guar-
antee Issue for spouse coverage is offered at $30,000 for new hires only under age 69, or $10,000 for
those age 70 and older.

For Your Child(ren): Offered at $10,000 for children age 6 months - 19 years (to age 23 if a f/time student).
For children age 14 days to 6 months, the benefit is $1,000.

Your Voluntary benefits may be portable or convertible to an individual policy if your employment ends. You
must have been enrolled for at least 12 consecutive months and will need to complete an Evidence of Insura-
bility form and will be subject to carrier approval. Please contact the carrier within 30 days of your termina-
tion if interested.

Shared Cost Disability Plans

Short Term Disability (STD) provides short-term disability benefits beginning on the 1st day of accident or the
8th day of an illness and provides 60% of your weekly pay to a maximum of $1,500 per week. The benefits will
be paid for up to 13 weeks minus the elimination period.

Long Term Disability (LTD) provides long-term disability benefits beginning after 90 consecutive days of disabil-
ity and provides 60% of monthly earnings to a maximum benefit of $10,000 (per month) as a result of an ill-
ness or off-the-job injury. This benefit is payable to age 65. It provides pay for two years for your own occupa-
tion and for any occupation thereafter.

Completing an Evidence of Insurability Form (EOI) - Both a Change Form and an Evidence of Insurability Form is
required for disability as well as life, if electing over the Guarantee Issue amount as a new hire or electing for
the first time as a Late Entrant. Principal reviews the EOI once received and determines if they will approve or
deny the requested coverage. Please obtain Change Form and EOI form online at Benetrac.com.

Cost per Pay Period (bi-weekly)

Payroll deduction rates are calculated

based on age-band and/or salary within
Benetrac as you enroll.
17
Profit Sharing and 401K Savings/Retirement Plan

WGI provides a 401(k) savings/retirement plan through John Hancock for its associates’ designed to help
you secure a financial future. Associates age 21 years or older are eligible to participate after completing
90 days of employment. Enrollment will take place during the first open quarter after eligibility. WGI match-
es 50 cents on every dollar up to a maximum of 6% of your salary. There is a 6-year vesting schedule.

WGI will be offering a Roth IRA in addition to the 401k savings/retirement plan. Additional information will
be available from your HR department.

Long Term Care Insurance

Through Long Term Care Financial Partners, you can purchase a policy that provides extended chronic care
services. Services can be provided at home, in an assisted living facility, an adult day care center or in a
nursing home. Pre-qualification is required, see HR for details.

Additional Employee Perks

Discount Programs

 Plum Benefits
Logon at http://www.perksatwork.com/index/index/usource/lgnrdt
Register with your personal email and company code: wantmangroup07

 Employee Perks
Logon at www.plumbenefits.com/signup
Use your Wantman Group Inc. email address to get started
Create and confirm a password. Password must be at least 8 characters
Read and follow the steps on the site
If you do not have work email address, use this code with your own email account: wgi

See HR for additional details.

18
 Life
Employee Assistance & Disability
Program
Value Added Benefits
Magellan Employee Assistance Program - Available 24/7 this benefit provides self-service support on educa-
tional materials on work /life topics such as caregiving, daily living and working smarter.

Licensed professionals can provide confidential support and guidance with such issues as family, relation-
ship and parenting
 Basic child and elder care needs
 Conflicts at work or home
 Alcohol and drug dependencies
 Personal development and general wellness issues

In addition to the phone based support, there is a wealth of information available on-line such as self-
assessment tools, interactive databases, health and wellness calculators, webinars and podcasts. You can
access these online at www.magellanhealth.com/member.

Travel Assist
Travel Assistance is available to you and your family as a resource you can access when you travel for medi-
cal, legal and financial assistance and emergency medical evacuation benefits when traveling domestically
and internationally 100 or miles away from home for up to 120 consecutive days.

Information and assistance provided include pre-trip and cultural information services such as Visa and
Passport requirements, travel advisories & customs information, immunization/inoculation requirements,
currency exchange rates and more.

For Personal Assistance Services - they can help with lost/stolen documents such as passports, drivers li-
censes and credit cards and lost luggage. They can also provide legal referrals and political evacuation.

Under Medical Assistance services include medical/dental referrals, hospital admission guarantee and dis-
charge planning, lost prescription and eyeglass/contact assistance, medical monitoring, replacement of
medical devices, etc.

The Assistant Services are available at no cost; the participant will be responsible for any fees related to an
actual service obtained through the Assistant.

For Assistance within the US, call 888-647-2611. Outside the US, call collect 630-766-7696.

Will & Legal Document Preparation

As a member covered by group term life through Principal, you have free access to resources from the Will &
Legal Document Center. With this free online resource, you or your spouse can draft a Will, a Living Will, cre-
ate a Healthcare Power of Attorney, a Durable Power of Attorney or Medical Treatment Authorization for mi-
nors. There are a wide variety of services available through this online tool.

Log on at www.aragwills.com/principal
Enter your group number: 1045106
Complete forms or download materials.

19
Preferred Legal Plan
FLEXIBLE BENEFIT PLAN
Preferred Legal Plan

The Preferred Legal Plan is a licensed legal expense organization providing its members with full service and
representation on all types of legal services, including divorce, traffic tickets, buying, selling or refinancing a
home, wills, probate, DUI, immigration, credit report issues, child support, custody and visitation, garnishments,
defense of collections, foreclosures, criminal defense, lawsuits, small claims court, personal injury, landlord-
tenant disputes, domestic violence and more.

Member Benefits Include:

 Free unlimited legal advice via phone consultation
 Free review of legal documents ( real estate contracts, lease agreements, etc.)
 Free face-to-face initial consultations with attorneys
 Free letters and phone calls on your behalf to resolve disputes
 Free credit report analysis and repair and settling accounts in collection
 Free notary services
 Free simple wills for member and spouse
 40-70% reduced legal fees for all types of legal services
 Spouse and dependent children and entire household covered
 All communications strictly confidential
 Tri-lingual attorneys. Se habla español. Nou pale Creol.
 No long-term contracts. You may cancel at any time.
 Identity theft protection and restoration

Legal statistics in this country are staggering. Don’t wait for legal problems to come up. Protect yourself ahead
of time. For just pennies a day, Preferred Legal Plan provides you with comprehensive, affordable LEGAL PRO-
TECTION AND PEACE OF MIND for you and your entire family.

Call 888-577-3476 for Customer Service

www.preferredlegal.com Cost per Pay Period (bi-weekly)
$4.59

Pet Assure
Pet Insurance, Veterinary Discount

Have a Pet? Consider a Pet Discount Program with PetAssure.

Pet Assure: Discount Program at In-Network Vets

As a PetAssure member:
 Save 25% on ALL medical services
 Covers office visits, shots, x-rays, dental care, etc.
 Covers every kind of pet - absolutely no exclusions Cost per Pay Period (bi-weekly)
 Includes the Pet Assure locator service Single Pet $3.69
 To find a vet near you, search www.petassure.com
 Includes other pet discount offers & lost pet recovery service Unlimited Pets $5.08

Call 1-888-789-7387 for Customer Service

www.petassure.com
20
 FLEXIBLE BENEFIT PLAN

Important Notices

21
 FLEXIBLE
Important BENEFIT PLAN
Notices
About your rights as a participant in the WGI Benefits Program

There are certain important notices regarding your benefits that WGI is required by law to provide to
you. We encourage you to read the following pages of this 2017 Benefit Guide carefully and share it
with your family members. If you have any questions about your benefits, please contact Human Re-
sources.

Report Eligibility Changes in a Timely Manner

 

It is your responsibility to notify Human Resources when a dependent becomes eligible or ceases to be eligible for
coverage under our benefit plans. All eligibility changes should be reported within 31 days of the event. Failure to
report changes in a timely manner can impact your ability to add newly eligible dependents or discontinue pre-tax
premium contributions on ineligible dependents.

In addition, failure to report a loss of eligibility due to legal separation or divorce or a dependent that has otherwise
ceased to be eligible, such as a child reaching the maximum dependent child age limit, can impact your dependent’s
right for group health plan coverage under the federal law known as COBRA. If you fail to report the loss of eligibility
within 60 days of the event, your dependents may be left with no continuation coverage under our plan. Please see
your COBRA notice or your group health plan summary plan description for additional information.
There are

22
 FLEXIBLE
HIPAA Privacy Notice Reminder BENEFIT PLAN

Protecting the confidentiality of your personal medical information has always been an important priority. The Group
Health Plans sponsored by WGI maintain policies to safeguard the privacy of your medical information and to comply
with federal law (specifically, “HIPAA” and the privacy rules issued under HIPAA). We are required by federal law to
protect the privacy of your individual health information (referred to in this reminder as “Protected Health Infor-
mation”). We are also required to provide you with this reminder regarding our policies and procedures on your Pro-
tected Health Information. For more information about your privacy rights or to request a copy of the Health Plan’s
Notice of Privacy Practices please contact the Human Resources Department.

HIPAA Special Enrollment Rights

Loss of other Coverage
If you are declining enrollment for yourself and/or your dependents (including your spouse) because of
other health insurance coverage or group health plan coverage, you may be able to enroll yourself and/or
your dependents in this plan if you or your dependents lose eligibility for that other coverage or if the em-
ployer stops contributing towards your or your dependent’s coverage. You will be required to submit a
signed statement that this other coverage as the reason for waiving enrollment originally. To be eligible for
this special enrollment opportunity you must request enrollment within 31 days after your other coverage
ends or after the employer stops contributing towards the other coverage.

New Dependents as a result of Marriage, Birth, Adoptions or Placement for Adoption

If you have a new dependent as a result of marriage, birth, adoption or placement for adoption, you may
be able to enroll yourself and/or your dependent(s). To be eligible for this special enrollment opportunity
you must request enrollment within 31 days after the marriage, birth, adoption or placement for adoption.

Marketplace Notice

The Health Insurance Marketplace was developed as part of Health Care Reform. The Marketplace is de-
signed to help you find insurance outside of your workplace in the event group coverage is not available to
you. Since your employer provides you with coverage that meets the requirements, you would not be eligi-
ble for a subsidized plan through the Marketplace. People who may not have coverage available to them
or lose coverage through their group plans, may save on premium by exploring their options through the
Marketplace. The Marketplace holds open enrollment every year beginning in October. Visit
www.healthcare.gov for additional information.

23
Expanded Women’s Preventive
FLEXIBLE Health Benefits
BENEFIT PLAN
The Affordable Care Act (ACA or Health Care Reform) requires some health plans to cover certain preventive health
services for women at no cost to the member, when they are provided in-network.

The following preventive care services for women will generally be covered at no cost, when provided by an in-
network doctor/facility:

 Anemia screening on a routine basis for pregnant women

 Breast cancer genetic test counseling (BRCA) for women at higher risk for breast cancer

 Breast cancer mammography screenings every one to two years for women over age 40

 Breast cancer chemoprevention counseling for women at higher risk

 Breast feeding comprehensive support and counseling from trained providers and access to breast feeding
supplies, for pregnant and nursing women
 Cervical cancer screening for sexually active women

 Chlamydia infection screening for younger women and other women at higher risk

 Contraception for FDA-approved contraceptive methods, sterilization procedures, and patient

education and counseling, as prescribed by a health care provider for women with reproductive capacity (not
including abortifacient drugs). This does not apply to health plans sponsored by certain exempt religious employ-
ers
 Domestic and interpersonal violence screening and counseling for all women

 Folic acid supplements for women who may become pregnant

 Gestational diabetes screening for women 24 to 28 weeks pregnant and those at high risk of developing gesta-
tional diabetes

 Gonorrhea screening for all women at higher risk

 Hepatitis B screening for pregnant women at their first prenatal visit

 HIV screening and counseling for sexually active women

 Human Papillomavirus (HPV) DNA test every three years for women with normal cytology results who are 30 or
older

 Osteoporosis screening for women over age 60 depending on risk factors Rh incompatibility screening for all
pregnant women and follow-up testing for women at higher risk

 Sexually transmitted infections counseling for sexually active women

 Syphilis screening for all pregnant women or other women at increased risk

 Tobacco use screening and interventions for all women, and expanded counseling for pregnant tobacco users

 Urinary tract or other infection screening for pregnant women

 Well-woman visits to get recommended services for women under age 65

24
Continuation Coverage Rights under
FLEXIBLE COBRA
BENEFIT PLAN
Introduction You are receiving this notice because you have recently become covered under a group health plan
(WGI) This notice contains important information about your right to COBRA continuation coverage, which is a tem-
porary extension of coverage under the Plan. This notice generally explains COBRA continuation coverage, when it
may become available to you and your family, and what you need to do to protect the right to receive it.

The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Recon-
ciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you when you would other-
wise lose your group health coverage. It can also become available to other members of your family who are cov-
ered under the Plan when they would otherwise lose their group health coverage. For additional information about
your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan De-
scription or contact Human Resources.

What is COBRA Continuation Coverage? COBRA continuation coverage is a continuation of Plan coverage when cov-
erage would otherwise end because of a life event known as a “qualifying event.” Specific qualifying events are
listed later in this notice. After a qualifying event, COBRA continuation coverage must be offered to each person
who is a “qualified beneficiary.” You, your spouse, and your dependent children could become qualified beneficiar-
ies if coverage under the Plan is lost because of the qualifying event. Under the Plan, qualified beneficiaries who
elect COBRA continuation coverage must pay for COBRA continuation coverage.

If you are an employee, you will become a qualified beneficiary if you lose your coverage under the Plan because
either one of the following qualifying events happens:

Your hours of employment are reduced, or

Your employment ends for any reason other than your gross misconduct.

If you are the spouse of an employee, you will become a qualified beneficiary if you lose your coverage under the
Plan because any of the following qualifying events happens:

Your spouse dies;

Your spouse’s hours of employment are reduced;
Your spouse’s employment ends for any reason other than his or her gross misconduct;
Your spouse becomes entitled to Medicare benefits (under Part A, Part B, or both); or
You become divorced or legally separated from your spouse.
Your dependent children will become qualified beneficiaries if they lose coverage under the Plan because
any of the following qualifying events happens:
The parent-employee dies;
The parent-employee’s hours of employment are reduced;
The parent-employee’s employment ends for any reason other than his or her gross misconduct;
The parent-employee becomes entitled to Medicare benefits (Part A, Part B, or both);
The parents become divorced or legally separated; or
The child stops being eligible for coverage under the plan as a “dependent child.”

When is COBRA Coverage Available? The Plan will offer COBRA continuation coverage to qualified beneficiaries
only after Human Resources has been notified that a qualifying event has occurred. When the qualifying event is
the end of employment or reduction of hours of employment, death of the employee, commencement of a proceed-
ing in bankruptcy with respect to the employer, or the employee's becoming entitled to Medicare benefits (under
Part A, Part B, or both), the employer must notify the Human Resources of the qualifying event.

You Must Give Notice of Some Qualifying Events: For the other qualifying events (divorce or legal separation of the
employee and spouse or a dependent child’s losing eligibility for coverage as a dependent child), you must notify
the Human Resources within 60 days after the qualifying event occurs.

25
Continuation Coverage Rights under
FLEXIBLE COBRA
BENEFIT (Continued)
PLAN
How is COBRA Coverage Provided? Once Human Resources receives notice that a qualifying event has occurred,
COBRA continuation coverage will be offered to each of the qualified beneficiaries. Each qualified beneficiary will
have an independent right to elect COBRA continuation coverage. Covered associates may elect COBRA continua-
tion coverage on behalf of their spouses, and parents may elect COBRA continuation coverage on behalf of their
children. COBRA continuation coverage is a temporary continuation of coverage. When the qualifying event is the
death of the employee, the employee's becoming entitled to Medicare benefits (under Part A, Part B, or both), your
divorce or legal separation, or a dependent child's losing eligibility as a dependent child, COBRA continuation cov-
erage lasts for up to a total of 36 months. When the qualifying event is the end of employment or reduction of the
employee's hours of employment, and the employee became entitled to Medicare benefits less than 18 months
before the qualifying event, COBRA continuation coverage for qualified beneficiaries other than the employee lasts
until 36 months after the date of Medicare entitlement. For example, if a covered employee becomes entitled to
Medicare 8 months before the date on which his employment terminates, COBRA continuation coverage for his
spouse and children can last up to 36 months after the date of Medicare entitlement, which is equal to 28 months
after the date of the qualifying event (36 months minus 8 months). Otherwise, when the qualifying event is the end
of employment or reduction of the employee’s hours of employment, COBRA continuation coverage generally lasts
for only up to a total of 18 months. There are two ways in which this 18-month period of COBRA continuation cov-
erage can be extended.

Disability extension of 18-month period of continuation coverage: If you or anyone in your family covered under
the Plan is determined by the Social Security Administration to be disabled and you notify Human Resources in a
timely fashion, you and your entire family may be entitled to receive up to an additional 11 months of COBRA con-
tinuation coverage, for a total maximum of 29 months. The disability would have to have started at some time be-
fore the 60th day of COBRA continuation coverage and must last at least until the end of the 18-month period of
continuation coverage.

Second qualifying event extension of 18-month period of continuation coverage: If your family experiences anoth-
er qualifying event while receiving 18 months of COBRA continuation coverage, the spouse and dependent chil-
dren in your family can get up to 18 additional months of COBRA continuation coverage, for a maximum of 36
months, if notice of the second qualifying event is properly given to the Plan. This extension may be available to
the spouse and any dependent children receiving continuation coverage if the employee or former employee dies,
becomes entitled to Medicare benefits (under Part A, Part B, or both), or gets divorced or legally separated, or if
the dependent child stops being eligible under the Plan as a dependent child, but only if the event would have
caused the spouse or dependent child to lose coverage under the Plan had the first qualifying event not occurred.

If You Have Questions: Questions concerning your Plan or your COBRA continuation coverage rights should be
addressed to the contact or contacts identified below. For more information about your rights under ERISA, includ-
ing COBRA, the Health Insurance Portability and Accountability Act (HIPAA), and other laws affecting group health
plans, contact the nearest Regional or District Office of the U.S. Department of Labor’s Employee Benefits Security
Administration (EBSA) in your area or visit the EBSA website at www.dol.gov/ebsa. Addresses and phone numbers
of Regional and District EBSA Offices are available through EBSA’s website.

Keep Your Plan Informed of Address Changes: In order to protect your family’s rights, you should keep Human Re-
sources informed of any changes in the addresses of family members. You should also keep a copy, for your rec-
ords, of any notices you send to Human Resources.

Plan Contact Information: Information about the plan and COBRA continuation coverage can be obtained on re-
quest from WGI’s, Human Resources Department at 561-687-2220.

26
 FLEXIBLE
Medicaid and the Children’s BENEFIT
Health Insurance PLAN
Program (CHIP) Offer
Free or Low-Cost Health Coverage to Children and Families

If you are eligible for health coverage from WGI, but are unable to afford the premiums, some States have premium
assistance programs that can help pay for coverage. These States use funds from their Medicaid or CHIP programs to
help people who are eligible for employer-sponsored health coverage, but need assistance in paying their health premi-
ums.

If you or your dependents are already enrolled in Medicaid or CHIP and you live in Florida, you can contact your State
Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents
might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or visit
www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help
you pay the premiums for an employer-sponsored plan.

Once it is determined that you or your dependents are eligible for premium assistance under Medicaid or CHIP, the WGI
health plan is required to permit you and your dependents to enroll in the plan – as long as you and your dependents
are eligible, but not already enrolled in the employer’s plan. This is called a “special enrollment” opportunity, and you
must request coverage within 60 days of being determined eligible for premium assistance.

If you live in Florida, you may be eligible for assistance paying WGI health plan premiums. You should contact Florida
Medicaid for further information on eligibility.

FLORIDA – Medicaid
Website: https://www.flmedicaidtplrecovery.com/
Phone: 1-877-357-3268

To see if any more States have added a premium assistance program since January 31, 2012, or for more information
on special enrollment rights, you can contact either:

U.S. Department of Labor U.S. Department of Health and Human Services

Employee Benefits Security Administration Centers for Medicare & Medicaid Services
www.dol.gov/ebsa www.cms.hhs.gov

1-866-444-EBSA (3272) 1-877-267-2323, Ext. 61565

Pre-existing Conditions Exclusion Period

As a result of the Patient Protection & Affordable Care Act, pre-existing condition exclusions will not apply to dependent
children under 19 years of age. A pre-existing medical condition is an illness or any related condition for which a mem-
ber received services, supplies or medication in the 6 months prior to enrollment under this medical plan.

A pre-existing condition does not include:

A pregnancy existing on the enrollment date
Genetic information

Unless you have maintained continuous medical insurance coverage without a break of more than 63 days prior to
your eligibility for this medical plan, benefit coverage for services, supplies and medication(s) received for a pre-existing
condition(s) will be excluded (not covered) for the first 12 months of coverage.

27
 FLEXIBLE
Women’s Health and BENEFIT PLAN
Cancer Rights
In October 1998, Congress enacted the Women’s Health and Cancer Rights Act of 1998. This notice explains some
important provisions of the Act. Please review this information carefully.

As specified in the Women’s Health and Cancer Rights Act, a plan participant or beneficiary who elects breast reconstruc-
tion in connection with a mastectomy is also entitled to the following benefits:

 Reconstruction of the breast on which the mastectomy was performed;

 Surgery and reconstruction of the other breast to produce a symmetrical appearance; and

 Prostheses and treatment of physical complications at all stages of the mastectomy, including lymph edemas.

Health plans must determine the manner of coverage in consultation with the attending physician and the patient. Cover-
age for breast reconstruction and related services may be subject to deductibles and coinsurance amounts that are con-
sistent with those that apply to other benefits under this plan.

For more information, you can visit this U.S. Department of Health and Human Services website
http://www.dol.gov/ebsa/publications/whcra.html and the U.S. Department of Labor at: https://www.dol.gov/ebsa/
consumer_info_health.html

Newborns’ and Mothers’ Health Protection Act of 1996

The Newborns’ and Mothers’ Health Protection Act of 1996 prohibits group and individual health insurance policies
from restricting benefits for any hospital length of stay for the mother or newborn child in connection with child-
birth; following a normal vaginal delivery, to less than 48 hours, and following a cesarean section, to less than 96
hours.

Health insurance policies may not require that a provider obtain authorization from the health insurance plan or the
issuer for prescribing any such length of stay. Regardless of these standards an attending health care provider may
in consultation with the mother, discharge the mother or newborn child prior to the expiration of such minimum
length of stay. Further, a health insurer or health maintenance organization may not:

 Deny to the mother or newborn child eligibility, or continued eligibility, to enroll or to renew coverage under the
terms of the plan, solely to avoid providing such length of stay coverage;

 Provide monetary payments or rebates to mothers to encourage such mothers to accept less than the minimum
coverage;

 Provide monetary incentives to an attending medical provider to induce such provider to provide care incon-
sistent with such length of stay coverage;

 Require a mother to give birth in a hospital; or

 Restrict benefits for any portion of a period within a hospital length of stay described in this notice.

These benefits are subject to the plan’s regular deductible and copay. For further details, refer to your SPD. Keep
this notice for your records and call Human Resources for more information.

28
 Prescription Drug Coverage
FLEXIBLEUnder Medicare
BENEFIT Part D
PLAN
Important Notice From WGI About Your Prescription Drug Coverage And Medicare

Please read this notice carefully and keep it where you can find it. This notice has information about your
current prescription drug coverage with WGI and about your options under Medicare’s prescription drug cov-
erage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are
considering joining, you should compare your current coverage, including which drugs are covered at what
cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area.
Information about where you can get help to make decisions about your prescription drug coverage is at the
end of this notice.

There are two important things you need to know about your current coverage and Medicare’s prescription drug
coverage:

1. Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can
get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like
an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a
standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher
monthly premium.
2. WGI has determined that the prescription drug coverage offered by U n i t e d H e a l t h c a r e are, on aver-
age for all plan participants, expected to pay out as much as standard Medicare prescription drug
coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is
Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later
decide to join a Medicare drug plan.

When Can You Join A Medicare Drug Plan?

You can join a Medicare drug plan when you first become eligible for Medicare and each year from Octo-
ber 15th to December 7th. However, if you lose your current creditable prescription drug coverage, through
no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a
Medicare drug plan.

What Happens To Your Current Coverage If You Decide To Join A Medicare Drug Plan?

If you decide to join a Medicare drug plan, your current WGI coverage will not be affected. If you do decide to
join a Medicare drug plan and drop your current WGI coverage, be aware that your dependents will not be
able to get this coverage back until the next enrollment period unless you experience a qualified life event.
Note that your current coverage pays for other health expenses in addition to prescription drugs, and you
will still be eligible to receive all of your current health and prescription drug benefits if you choose to enroll in
a Medicare prescription drug plan and keep your coverage under the WGI Plan.

29
Prescription Drug Coverage
FLEXIBLEUnder Medicare
BENEFIT Part D (Continued)
PLAN

Important Notice From WGI About Your Prescription Drug Coverage And Medicare (Continued)

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?

You should also know that if you drop or lose your current coverage with WGI and don’t join a Medicare
drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a
penalty) to join a Medicare drug plan later.
If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly pre-
mium may go up by at least 1% of the Medicare base beneficiary premium per month for every month
that you did not have that coverage. For example, if you go nineteen months without creditable cover-
age, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium.
You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug cov-
erage. In addition, you may have to wait until the following October to join.
& You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be
contacted directly by Medicare drug plans.

Summary Of Options For Medicare Eligible Team Members (and/ or Dependents)

Medical and prescription drug coverage are offered as a package under the WGI plan (you cannot elect
medical coverage without prescription drug coverage).
Continue medical and prescription drug coverage under the WGI Plan and do not elect Medicare D cov-
erage. Impact – your claims continue to be paid by the WGI’s plan.
Continue medical and prescription drug coverage under the WGI plan and elect Medicare D coverage.
Impact - As an active team member (or dependent of an active team member) the WGI plan contin-
ues to pay primary on your claims (before Medicare D).
Drop the WGI plan coverage and elect Medicare Part D coverage. Impact – Medicare is your primary
coverage. You will not be able to rejoin the WGI plan until the next open enrollment period unless you
experience a qualified life event.
For More Information About This Notice Or Your Current Prescription Drug Coverage…
Contact the person listed below for further information. NOTE: You’ll get this notice each year. You will also
get it before the next period you can join a Medicare drug plan, and if this coverage through WGI changes.
You also may request a copy of this notice at any time.
For More Information About Your options Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare
& You” handbook. You’ll get a copy of the handbook in the mail every year from Medicare. You may also be
contacted directly by Medicare drug plans.
For more information about Medicare prescription drug coverage: Visit www.medicare.gov Call your State
Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You”
handbook for their telephone number) for personalized help. Call 1-800-MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048.
If you have limited income and resources, extra help paying for Medicare prescription drug coverage is
available. For information about this extra help, visit Social Security on the web at
www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

30
Prescription Drug Coverage
FLEXIBLEUnder Medicare
BENEFIT Part D (Continued)
PLAN

Important Notice From WGI About Your Prescription Drug Coverage And Medicare Part D contin-
ued

For more information about Medicare prescription drug coverage: Visit www.medicare.gov Call your State
Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” hand-
book for their telephone number) for personalized help. Call 1-800-MEDICARE (1-800-633-4227). TTY us-
ers should call 1-877-486-2048.

If you have limited income and resources, extra help paying for Medicare prescription drug coverage is avail-
able. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or
call them at1-800-772-1213 (TTY 1-800-325-0778).

Remember: This is your annual Medicare part D Notification. You will also receive this notice if this cover-
age through United Healthcare changes. You may also request copy of this notice at anytime. Keep this
Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to
provide a copy of this notice when you join to show whether or not you have maintained creditable cover-
age and, therefore, whether or not you are required to pay a higher premium (a penalty).

Date: July 1, 2017

Name of Entity/Sender: WGI
Contact--Position/Office: Human Resources
Phone Number: 561-687-2220

31
 FLEXIBLE BENEFIT PLAN

The information in this Benefits Guide is presented for illustrative purposes and is based on information provided by the insurer to the
employer. The text contained in this guide 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
Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential, pursuant to the Health In-
surance Portability and Accountability Act of 1996. If you have any questions about this summary information, please contact Human
Resources.