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UNDENIABLY YOURS

2019 OPEN ENROLLMENT

BENEFITS INFORMATION

OCT 15 –NOV 2, 2018

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2019 Open Enrollment Benefits Information Oct. 15, 8:00 a.m. – Nov. 2, 2018, 4:59 p.m.

www.kent.edu/hr/benefits

WELCOME .................................................................................................................. 2

WHAT’S NEW FOR 2019 .................................................................................................... 5-6 OPEN ENROLLMENT PORTAL ACCESS ..................................................................................... 6-7 HEALTHCARE PLANS ......................................................................................................... 7-16 OPT OUT INCENTIVE ............................................................................................................ 16 FLEXIBLE SPENDING ACCOUNTS ........................................................................................ 17-19 VOLUNTARY INDEMNITY PLANS ........................................................................................ 19-21 RETIREMENT PLANS ............................................................................................................. 22 DEPENDENT ELIGIBILITY ........................................................................................................ 23 ADULT DEPENDENT CHART ................................................................................................... 24 EMPLOYEE WELLNESS ..................................................................................................... 25-28 NON-BARGAINING MEDICAL PLAN COMPARISON CHART ....................................................... 29-30 EMPLOYEE CONTRIBUTION RATES – NON-BARGAINING .............................................................. 31 AFSCME MEDICAL COMPARISON CHART .......................................................................... 32-33 EMPLOYEE CONTRIBUTION RATES - AFSCME .......................................................................... 34 AAUP MEDICAL COMPARISON CHART............................................................................... 35-36 EMPLOYEE CONTRIBUTION RATES - AAUP .............................................................................. 37 DELTA DENTAL PLAN SUMMARY DOCUMENTS ..................................................................... 38-41 DEFINITION OF A DEPENDENT ........................................................................................... 42-43 IMPORTANT NOTICES ........................................................................................................... 44 WOMEN’S HEALTH AND CANCER RIGHTS NOTICE...................................................................... 44 NEWBORNS’ AND MOTHERS’ HEALTH PROTECTION ACT ............................................................. 44 PRESCRIPTION DRUG COVERAGE AND MEDICARE NOTICE ...................................................... 45-46 SUMMARY OF BENEFITS AND UNIFORM GLOSSARY TERMS .......................................................... 47 NOTICE OF PRIVACY PRACTICES ........................................................................................ 47-51 HEALTHCARE PROVIDER CONTACT INFORMATION ...................................................................... 52 NEW HEALTH INSURANCE MARKETPLACE COVERAGE OPTIONS ............................................... 53-54

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DISCLAIMER: This Open Enrollment booklet and its contents provide an informational summary not intended to be a summary plan description (SPD) or plan document. If there are differences between the booklet and the SPD or plan document, the terms of the SPD and plan document shall be definitive. Kent State University may amend or terminate its benefit plans at any time in accordance with the law and any applicable collective bargaining agreement. The description of the program, the plan itself or participation in the plan is not an employment contract or any type of employment guarantee and should not be construed as such. The university makes no endorsements, warranties, promises, representations and/or guarantees regarding the performance, use, interpretation, application, correctness or accuracy of any of the vendors’ plans and programs summarized in this booklet. Individuals should consult with the vendor(s) as well as their personal legal, medical, insurance and/or financial, etc., advisor/professional concerning the application of any plan or program to their own circumstance to answer any questions and/or concerns related to their participation in the plan(s) and program(s). Kent State University, Kent State and KSU are registered trademarks and may not be used without permission. Kent State University, an equal opportunity, affirmative action employer, is committed to attaining excellence through the recruitment and retention of a diverse workforce. 15-HR-00157-049

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A Welcome Note from Medical Mutual Medical Mutual is pleased to be the exclusive healthcare partner for Kent State University (KSU) effective January 1, 2019. Each of our 2,300 employees working in Ohio is dedicated to providing the highest level of service to KSU employees and their families. As a mutual insurance company, we are owned by and operated for the benefit of our policyholders and thus our business objectives are aligned with those of our customers. Medical Mutual has one of the strongest networks in Northeast Ohio, including Akron Children’s Hospital, Akron General, Aultman, Cleveland Clinic Foundation, EMH Regional Medical Center, Lake Health System, Mercy Health, Metro Health, Summa Hospitals, University Hospitals and UPMC. To view a complete list of providers and facilities, please visit MedMutual.com/FindADoctor. We look forward to our continued partnership!! WHAT DO I NEED TO DO FOR OPEN ENROLLMENT? The annual Open Enrollment period is an opportunity for you to review your current health care plan elections to ensure they continue to meet your needs and those of your family. Every benefits-eligible employee is strongly encouraged to log into the Open Enrollment portal, beginning Monday, Oct. 15, 8:00 a.m. through Friday, Nov. 2, 4:59 p.m. to verify your elections or make changes. Changes to your coverage will be effective January 1, 2019 – December 31, 2019.

WHAT’S NEW IN 2019 Beginning January 1, 2019, the university has selected Medical Mutual of Ohio as its sole medical plan vendor. In terms of benefit plan year 2019, the 85/60 PPO plan is available for non-represented employees as well as employees represented by AFSCME. The 90/70 PPO Plan, available to AFSCME employees, continues through Plan Year 2019 at a revised employee contribution schedule. WHAT’S NOT CHANGING The University continues to offer both HDHP and PPO plan options to all of its employees The High Deductible Health Plan (HDHP) will give you greater control and flexibility on how your healthcare dollars are spent. It will also provide access to a university-funded, tax advantaged Health Savings Account (HSA). The university will once again contribute to your HSA account - $1,000 for single coverage and $2,000 for family coverage. See Page 9 for more details.

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A PREFERRED PROVIDER ORGANIZATION (PPO) plan gives you freedom of choice and greater flexibility. You are not required to choose a primary care physician and do not need a referral to see a specialist. It is important to note that, with all of the plan choices, you have ready access to quality healthcare. Both the HDHP and PPO plans offer a large network of contracting doctors and hospitals to choose from when care is needed. When a contracting network provider is used, the care is considered “in-network,” your out-of-pocket costs may be less and the highest level of benefits is received. If a doctor outside the network is used, the care is considered “out-of-network” and coverage may still be provided, but the out-of-pocket costs will be significantly higher. In addition, members have access to care anywhere they live, work or travel across the country and around the world. Please visit the Open Enrollment website at www.kent.edu/hr/benefits/2019-open-enrollment for additional information regarding your plans. The 90/70 and 80/60 PPO grandfathered plans remain options for AAUP bargaining unit employees. For more information, please see the comparison chart on Page 35. Also, visit the open enrollment website at www.kent.edu/hr/benefits/2019-open-enrollment. WILL I NEED TO ACCESSS THE OPEN ENROLLMENT PORTAL? Yes, you will want to access the Open Enrollment portal to verify your benefits and to ensure that you are enrolled in benefit plans that best meet the needs of you and your family. Remember that the Open Enrollment portal is available from Oct. 15, 8:00 a.m. to Nov. 2, 2018, 4:59 pm. Login to the university’s secure Flashline web portal at http://login.kent.edu to enroll. Once there, you will be able to access the 2019 Open Enrollment portal through the Employee Dashboard where the link will be featured during the open enrollment period within the Top Employee Resources section. Once you complete your changes, it is important that you print the confirmation statement for your records. Any changes you make during Open Enrollment will take effect on Jan. 1, 2019. Decisions made during Open Enrollment are binding through Dec. 31, 2019, unless you have a qualified life event, such as a marriage, divorce or birth or adoption of a child.

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WHAT IF I EXPERIENCE A QUALIFIED LIFE EVENT IN 2019? If you experience a qualified life event during the year, you must notify the Human Resources Benefits Office within 31 days of the event to make changes, or to add/delete dependents, etc. Documentation will be required when you add or drop a dependent. Contact the Benefits department at 330-672-3107 or email benefits@kent.edu. for more information.

HEALTHCARE PLANS OFFERED The university offers five healthcare plans, all of which provide coverage for pre-existing conditions, prescription drugs, mental health and substance abuse with no lifetime maximum. Choosing and personalizing your benefits depends on your specific healthcare needs, doctor preferences, budget and the type of plan you prefer. Please use the comparison charts beginning on Pages 29-36 to determine which of the following plans best suits your medical needs. Also note that plan participation differs by employee group eligibility. The following 2019 plan options are available for non-bargaining unit employees:

• Medical Mutual PPO 85/60 • Medical Mutual High Deductible Health Plan (HDHP)

The following 2019 plan options are available for AFSCME bargaining unit employees:

• Medical Mutual PPO 90/70 • Medical Mutual PPO 85/60

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• Medical Mutual High Deductible Health Plan (HDHP) The following 2019 plan options are available for AAUP bargaining unit employees:

• Medical Mutual PPO 90/70 • Medical Mutual PPO 80/60 • Medical Mutual High Deductible Health Plan (HDHP)

COST OF COVERAGE You and Kent State University share the monthly cost for healthcare coverage. The university pays the majority of the costs. Your cost is based on:

• The plan you choose; • The coverage level you choose (single or family) • Your annual salary; and • Whether you are a full-time or part-time employee

85/60 Plan for Non-Bargaining-Unit and AFSCME employees The 85/60 plan is a non-grandfathered healthcare plan. This means that the plan covers preventive annual exams, immunizations, preventive screenings and preventive medications at no cost to the employee. Other in-network inpatient, outpatient, and diagnostic services are covered at 85% after the deductible is satisfied. Out-of-network coverage for these services is covered at 60% after the deductible has been satisfied. The PPO 85/60 plan has a $300 individual deductible and a $600 family deductible each calendar year. For more information, please review the Non-Bargaining Unit Medical Plan Comparison Charts on Pages 29-30, and the AFSCME Medical Plan Comparison Charts on Pages 32-33.

90/70 Plan for AFSCME employees The 90/70 plan covering AFSCME represented employees is a non-grandfathered healthcare plan. This means that the plan covers preventive annual exams, immunizations, preventive screenings and preventive medications at no cost to the employee. Other in-network inpatient, outpatient, and diagnostic services are covered at 90% after the deductible is satisfied. Out-of-network coverage for these services is covered at 70% after the deductible has been satisfied. The PPO 90/70 plan has a $250 individual deductible and a $500 family deductible each calendar year. For more information, please review the AFSCME Medical Plan Comparison Charts on Pages 32-33.

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The 90/70 and 80/60 PPO plans remain for AAUP Employees The PPO 90/70 plan for AAUP represented employees is a grandfathered healthcare plan and has a $250 individual calendar year deductible and a $500 family deductible. Under this plan in-network inpatient, outpatient, and diagnostic services are covered at 90% after the deductible is satisfied. Out-of-network coverage for these services is covered at 70% after the deductible has been satisfied. Services such as preventive annual exams, immunizations, and preventive screenings may be covered at 100% or subject to a copayment. For more information, please review the AAUP Medical Plan Comparison Charts on Pages 35-36. The PPO 80/60 plan for AAUP represented employees is grandfathered healthcare plan and has a $350 individual calendar year deductible and a $700 family deductible. Under this plan, in-network inpatient, outpatient, and diagnostic services are covered at 80% after the deductible is satisfied. Out-of-network coverage for these services is covered at 60% after the deductible has been satisfied. Services such as preventive annual exams, immunizations, and preventive screenings may be covered at 100% or subject to a copayment. For more information, please review the AAUP Medical Plan Comparison Charts on pages 35-36.

Highlights of the High Deductible Health Plan The university will again be offering a consumer-driven health plan option called the High Deductible Health Plan (HDHP). This plan will give you greater control and flexibility over how your healthcare dollars are spent. It will also provide access to a university-funded, tax advantaged Health Savings Account (HSA). With the HDHP, you pay a low monthly premium contribution in conjunction with a higher deductible. But the one feature that makes the HDHP special is that it’s compatible with a Health Savings Account. A Health Savings Account or (HSA) is like a savings plan for your healthcare. The combination of the new HDHP and an HSA gives you greater flexibility and control over how you pay for and save for healthcare. When you elect the HDHP Plan:

* The network will be the same preferred provider organization (PPO) administered by Medical Mutual of Ohio. The plan will offer the same broad network of physicians and care providers currently available with all of the plans.

* Like the 85/60 PPO plan option, preventive care is covered at 100%. This means when you receive annual physicals, mammograms, colonoscopies, and well-child care, there is no deductible or coinsurance.

* This plan is a non-grandfathered health plan, and it must cover screening and immunizations required by healthcare reform (the Affordable Care Act (ACA). If these services are performed by an in-network provider, members cannot be charged a copayment, coinsurance or deductible.

* Out-of-network charges may apply if the services are performed by a non-network provider.

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* In the case of non-preventive care, the plan provides coverage after the deductible is met. The annual deductible for this plan is:

• $2,700 in-network/$3,100 out-of-network for those enrolled as an individual • $5,400 in-network/$6,200 out-of-network for those enrolled with a spouse and

dependents.

* After the deductible is met, medical claims are covered by the plan at 100%. Pharmacy benefits, as in the case of the PPO plans have its own coinsurance provisions.

* Additional plan features can be found on the Medical Plan Comparison Charts on Pages 29-36.

Low Monthly Premium You probably noticed right away that the HDHP monthly premium cost is relatively low. If you typically choose your health plan by monthly premium alone, be sure you understand all aspects of any plan you consider. With the HDHP, the annual deductible is higher than with the other medical plan options. Like with all plans, you have to satisfy the deductible with money out of your own pocket before the HDHP begins to cover the cost of healthcare services. To Understand How the HDHP and HSA Works, Consider the Plan’s Three Components:

1. The Health Insurance Plan – Your Medical Benefits

Medical Mutual of Ohio (MMO) When you enroll in the HDHP plan, you can choose the provider network that works best for you and your family. You can select Medical Mutual of Ohio, Preferred Provider Organization (PPO) networks. Both networks feature powerful resources and information to help you take control of your healthcare and make the most of your benefits dollars. Regardless of the provider network you select, the plan levels and coverage are the same, as well as the monthly premium contributions. Enrollment in medical includes prescription drug coverage provided by CVS Caremark, and vision coverage provided by EyeMed, at the level of coverage you elected (single or family). This plan is a non-grandfathered health plan and covers routine immunizations and other services required by healthcare reform (the Affordable Care Act (ACA). If these services are performed by an in-network provider, members cannot be charged a copayment, coinsurance or deductible. Out-of-network charges may apply if the services are performed by a non-network provider.

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Your healthcare plan includes an out-of-pocket maximum – a cap that limits the amount you pay for covered medical services in a given year. When your costs reach the limit, remaining qualified medical expenses are covered by the plan at 100 percent. In the case of the HDHP, this maximum is the same as the deductible, i.e., after this amount is met, medical claims are covered at 100%.

Single – $2,700 in-network Single – $4,500 out-of-network

Family – $5,400 in-network Family – $ 9,000 out-of-network

HOW DOES AN HDHP WORK AT THE PHYSICIAN’S OFFICE?

HDHP WITH HSA OVERVIEW

Go to doctor and present your Medical ID card and receive services. Note – you should not pay

anything at the time of service.

If services are billed as preventive, office visit will be covered

at 100%.

If services are not billed as preventive, discount charges will be applied to your plan year deductible.

You will receive an Explanation of Benefits (EOB) in the mail

explaining charges for which you are

responsible.

You will use your HSA debit card, cash or checkbook to

pay your doctor the charges for which you are responsible.

Doctor submits claims to provider – MMO

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HSA Eligibility – IRS Qualifying Requirements: In order to be an eligible individual and qualify for an HSA, you must meet the following requirements:

• You have to be covered by a qualified High Deductible Health Plan (HDHP) • You must not have other medical coverage • Age 18 or older • You cannot be enrolled in Medicare • You cannot be claimed as dependent on someone else’s 2019 tax return. • You cannot be enrolled in a Flexible Spending Account (FSA) or Health Reimbursement

Arrangement (HRA). When you enroll in the HDHP plan, an HSA account is established which works with your medical and prescription drug insurance plan. The Health Savings Account (HSA) is administered by our financial partner, PNC Bank.

Prescription Drug Coverage with an HDHP Your Prescription Drug Benefits Enrollment in any healthcare plan option automatically includes prescription drug coverage, which is provided through CVS Caremark. Under this plan, you can receive periodic prescriptions through your local retail pharmacy for up to three refills. For maintenance prescriptions (prescriptions taken on a regular basis for an extended period of time), you will then need to use CVS Caremark mail-order pharmacy service. You pay the full cost of prescription drugs until your deductible is met unless it is a preventive drug. Once your annual deductible has been met, the same coinsurance featured under the PPO plans applies. For preventive drugs, you may receive your prescriptions at little or no out of pocket costs. Once your deductible has been met: Your share of the cost for prescriptions is: • 10 percent - Co-insurance for generic drugs • 20 percent - Co-insurance for brand name drugs • 40 percent - Co-insurance for brand name drugs when a generic is available

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Kent State University Provides Funding Into Your Health Savings Account: One significant benefit of enrolling in the HDHP Plan is the opportunity to offset your deductible with an HSA that is partially funded by the university. Kent State University will contribute the following into your HSA account:

KSU’s HSA Contribution – January 2019 IRS Limits for HSA-2019

Single Coverage $1,000 Single Coverage $3,500 Family Coverage $2,000 Family Coverage $7,000

Notes: * Catch-up Contributions: Employees 55 years of age or older can contribute an additional

$1,000 to their HSA. * Contributions include monies you deposit plus employer contributions; you cannot exceed

the annual IRS limits. * Employees can elect not to contribute their own dollars to an HSA. * Married couples both with HSAs – if either has family coverage (at KSU or anther employer),

their max contribution is $7,000 combined. * HSA contributions are prorated over 12 months. For example, an individual who enrolls in

the HDHP plan on June 1 will be allowed to contribute up to 7/12th of the annual allowable contribution.

* You are responsible for informing PNC Bank if you are enrolled in an HDHP and become ineligible for an HSA.

Each year, you can choose the amount you wish to contribute to your HSA. Contributions you make to your HSA through payroll deduction are made using pre-tax dollars (money that has not been subject to income tax). Then, you can use your PNC Visa debit card to get instant access to your HSA dollars to pay for qualified out-of-pocket expenses quickly and easily. Or, if you pay your expenses out-of-pocket until you reach your deductible, you can still reduce your taxable income for the year involved. Best of all, you own your HSA so you keep it, even if you change healthcare plans or jobs. And, at the end of the year, money left in the account rolls over to the next year. Unlike, the flexible spending account there is no “use it or lose it.” From job to job, plan to plan, your HSA goes with you. For additional information, please visit the Open Enrollment website at www.kent.edu/hr/benefits/2019-open-enrollment.

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Prescription Drug Coverage Prescription Drug coverage is provided by CVS Caremark

PRESCRIPTION DRUG COVERAGE WITH YOUR PPO PLAN Enrollment in any healthcare plan option automatically includes prescription drug coverage, which is provided through CVS Caremark. Under this plan, you can receive periodic prescriptions through your local retail pharmacy for up to three refills. For maintenance prescriptions (prescriptions taken on a regular basis for an extended period of time), you will then need to use CVS Caremark mail-order pharmacy service. Your share of the cost for prescriptions is: • 10 percent - Co-insurance for generic drugs • 20 percent - Co-insurance for brand name drugs • 40 percent - Co-insurance for brand name drugs when a generic is available As another layer of protection, the maximum you will pay out-of-pocket for any prescription is $60 ($80 in the case of the 85/60 option). The maximum applies to both retail and mail order programs and caps your prescription cost regardless of whether your co-insurance is 10, 20 or 40 percent. The exception to the $60 ($80) maximum is if you receive a brand name medication when a generic equivalent is available. In this case, the maximum co-insurance is $100, unless your physician has specified that the prescription be dispensed as written (DAW). The mail-order prescription drug program continues to be a great way to save both you and the university money on your prescriptions. Mail-order prescriptions may be picked up at any CVS pharmacy. Smoking cessation products available through CVS Caremark: Our Commitment to a Smoke- and Tobacco-Free University Nicotine Replacement Therapy (NRT) and prescription medication coverage is included in the CVS prescription drug plan 2019 for all employees and their covered dependents (18 and over). No copay or coinsurance will be applied to NRT or prescription medications to support the smoking cessation program. CVS MINUTE CLINICS OFFER REDUCED OFFICE-VISIT COPAY TO KSU MEMBERS. Minute Clinic is a division of CVS Health, the largest pharmacy healthcare provider in the United States. It has 1,100 locations that offer convenient, high-quality care for common family illnesses. The clinic practitioners can evaluate, diagnose and treat a variety of minor illnesses and injuries, including bronchitis, flu, strep throat, bladder infections, minor burns and cuts,

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insect stings and more. Kent State University’s healthcare plan members can visit any participating clinic for a $10 copay per office visit, that’s a savings of $5. Additional plan features concerning the prescription drug coverage for each plan can be found on the Medical Plan Comparison Chart on pages 29-36.

Vision Plans Vision Insurance Kent State University offers vision coverage through EyeMed Vision When you elect medical coverage through Medical Mutual, you are automatically enrolled for vision coverage at the same level of coverage as your medical election (single or family). EyeMed has added ContactsDirect.com and Glasses.com as new in-network providers. So now you can use your in-network benefits online. You can order contact lenses and glasses using a 3D virtual try-on app. Use your in-network vision benefits for this transaction. To purchase contacts or glasses, you’ll need a valid prescription from within the last 12 months. Your contact lenses and glasses will be shipped for free, once the prescription is verified. EyeMed Vision provides access to more than 37,000 independent practitioners and optical retail providers at more than 17,000 locations nationwide. Retail locations include Lens Crafters, Pearle Optical, Sears Optical, Target Optical and JC Penney Optical. Eye exams are an important part of overall health care for the entire family. The plan offers comprehensive coverage, including eye exams and discounts on eyewear. With open access to see any eye-care provider, you can use the one who is right for you. Type of Service In Network * Out Of Network Eye Examination Covered in full $90 Single Vision $240 + discount $240 Bi-focal Vision $240 + discount $240 Tri-focal Vision $240 + discount $190 Contacts $190 + discount up to $190 Laser Vision Correction 15% off retail price or 5% off promotional price N/A Additional Pair Benefit 15% to 40% discount N/A Employees are now able to receive exams, eyeglasses/contact lenses on a calendar year basis (Jan. 1 – Dec. 31). The Employee Group Vision Care Plan is administered through EyeMed and is

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automatic when you elect healthcare coverage. Also note that Medical Mutual members may elect to use their benefit allowance for eyeglasses or contact lenses. The full benefit allowance must be used at time of service (i.e., when you purchase a pair of glasses or contact lenses); any remaining balance will not roll over to a future purchase. How to receive benefits: You may receive service from any vision care provider. If you use an in-network provider, you do not need to submit a claim form. If you are using an out-of-network provider, you must submit a claim form to EyeMed for reimbursement of covered expenses in accordance with the above schedule. The EyeMed vision claim form is available in the Human Resources forms library at: www.kent.edu/hr/benefits-forms-and-information. The booklet describing the vision program is also available on the same website. Dental Coverage Kent State University offers four different types of dental plans, including a preferred provider organization (PPO) plan through Delta Dental of Ohio. DENTAL PLANS OVERVIEW Regular visits to the dentist do more than just brighten your smile — they can be important to your overall health. Many diseases produce oral signs and symptoms. The university’s dental insurance plans provide coverage for preventive care, basic care, major care, and orthodontia (if applicable). Choosing and personalizing your benefits depends on your specific dental care needs, budget and the type of plan you prefer. Under the plans, you are free to visit any licensed dentist you choose. The dental plans offer a large network of contracting providers to choose from when dental care is needed. All plans offer in-network and out-of-network providers; when using an in-network provider, out of pocket costs will be less and the highest level of benefits is received. If a provider is out-of-network, coverage may still be provided but at a lower benefit level. Opt-Out Incentive Option Opt-Out Incentive Option Overview Employees have the choice of opting out of medical coverage. In order to be eligible for the opt-out incentive, employees cannot be enrolled in any university healthcare-related plan. This applies to medical, prescription, dental and vision coverage.

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The incentive for opt-out is $100 per month. To receive the opt-out incentive, proof of healthcare coverage must be provided and an opt-out affidavit must be submitted. If you do not complete a new 2019 opt-out affidavit, you will not receive the monthly incentive. View the opt-out form at: https://www.kent.edu/hr/benefits/2019-opt-out-affidavit-0.

Health and Dependent Care Flexible Spending Accounts Flexible Spending Accounts provided by PNC Bank PNC BANK ADMINISTRATOR FOR FLEXIBLE SPENDING ACCOUNTS The university continues to partner with PNC Bank, the sixth-largest commercial bank in the United States for administering Flexible Spending Accounts (Healthcare, Dependent Care) and Health Savings Accounts. Participants enrolling will receive new debit cards by Dec. 31, 2018. Flexible Spending Accounts Flexible Spending Accounts will be administered by PNC Bank for all accounts- (Healthcare, Dependent Care New debit cards will be sent out to all enrolled employees by Dec. 31, 2018. IRS regulations require re-enrollment into the FSAs each year. If you are enrolled in a health and/or dependent care FSA during calendar year 2018, your elections will not automatically be continued for calendar year 2019. HEALTHCARE FSA The Health Care Flexible Spending Account (HCFSA), administered by PNC Bank is an easy way to prepare for expenses not covered by your healthcare plan. An HCFSA allows you to pay for eligible healthcare expenses such as co-pays, prescriptions, hearing aids, etc. You may contribute up to $2,600 annually on a tax-free basis to the HCFSA. For more information concerning eligible medical and dental expenses, please review IRS Publication 502 at https://www.irs.gov/pub/irs-pdf/p502.pdf or contact PNC Bank at 844-356-9993 Covered Expenses Include

• Medical, dental, and vision deductibles, coinsurances and office visits • Prescription • Certain over-the-counter drug expenses • Unreimbursed vision expenses

DEPENDENT CARE FSA The Dependent Care Flexible Spending Account allows you to pay for eligible dependent care (day care for ages 13 and under). The maximum amount a married couple can contribute to the DCFSA is $5,000 if filing a joint return and $2,500 per spouse for separate returns.

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Employees with Flexible Spending Accounts will need to enroll each year and indicate their annual contribution elections. For more information concerning child and dependent care expenses, please review IRS Publication 503 at https://www.irs.gov/pub/irs-pdf/p503.pdf or contact PNC Bank at 844-356-9993. Eligible dependent care expense may include items such as:

• Before- and after-school care • Extended day programs • Summer day camp • Elder daycare

HOW FLEXIBLE SPENDING ACCOUNTS WORK You elect an annual contribution, which will be deducted on a pre-tax basis from each of your paychecks in equal amounts. As a pre-tax contribution, the amount will be deducted from your salary before federal income tax and, in most cases, state and local taxes. Your health and/or dependent care FSA contribution elections for 2019 must remain in effect through December 31, 2019. IRS regulations do not allow you to increase, decrease or stop your contributions during a plan year unless you have a qualified life event, such as marriage, divorce, or birth of a child. Any FSA contribution changes you make must be consistent with the type of life event. Proof of the event is required and must be submitted within 31 days of the change effective date. Qualified health and dependent care expenses incurred from Jan. 1 to Dec. 31, 2019, will be eligible for reimbursement from your FSA accounts. However, you can also use money remaining in your healthcare and dependent care FSAs as of Dec. 31, 2019 for qualified expenses incurred from Jan. 1, 2019, through March 15, 2020. This means you have until March 15, 2020, to use your 2019 remaining account balance before it is forfeited. All claims must be submitted by June 30, 2019. For more information, visit the PNC website at pncbenefitplus@healthaccountservices.com. Plan carefully. Any balance not used by March 15, 2020, will be forfeited. College Advantage Ohio 529 Savings Plan Saving for college is an investment for a lifetime. College Advantage, Ohio’s 529 college savings plan is offered and administered by the Ohio Tuition Trust Authority, a state agency. The plan provides you with a tax-advantaged way to save for college. Funds can be used at any college in the country for tuition, room and board or books. College Advantage has many benefits that make saving for college easy and affordable: • Earnings are tax-free • Contributions may be used as a deduction on your Ohio income tax return ($2,000 annually) • Funds may be used at any college in the country

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• Funds may be used to pay for tuition, room, board or books • Contribute as little as $25 at a time • Benefit from professional money management by leading financial firms • Save with FDIC-insured bank products • Funds may be transferred from one child to another • Funds may be withdrawn at any time • Investment options may be changed You can learn more about the College Advantage plan at www.collegeadvantage.com. When enrolling online, please use the following codes for Kent State: Bi-weekly employee code: CO-6280 Semi-monthly employee code: CO-6281 Payroll contact: Lisa Heilman

GROUP LIFE, PERSONAL ACCIDENT, LONG-TERM DISABILITY, and LONG TERM CARE INSURANCE Whether you’re just getting started or preparing for what’s next in life, someone is depending on you. Adequate protection means

your loved ones can pursue their plans and dreams, even if something happens to you. Life Insurance Kent State offers a variety of insurance plans for all full-time employees. An overview of each plan, offered by the Standard Insurance Co., is listed below. An Evidence of Insurability (EOI) questionnaire is a medical questionnaire that must be completed to determine approval for many of the voluntary insurance plans offered. The EOI is also required if you did not enroll within 31 days of starting your employment at Kent State or you are requesting an increase in coverage. You will receive a notice from Standard Insurance indicating approval or denial of your request. Basic Life/Accidental Death and Dismemberment Insurance Life insurance is provided by the university to all full-time employees at a level of three times the annual base salary with a maximum coverage level of $225,000. Employees age 65 or older will have a reduced coverage level based on their age. This benefit continues to be provided by the university at no cost to employees, and the level of coverage is automatically updated when your salary level changes. You can obtain a copy of the life insurance booklet in the HR Forms Library at: www.kent.edu/hr/benefits-forms-and-information. Voluntary Accidental Death and Dismemberment Insurance (AD&D) This insurance is intended to supplement the basic AD&D insurance provided to you by the university, and gives you the opportunity to purchase coverage for your legally married spouse or eligible, registered domestic partner (same or opposite gender) and your dependent children.

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This insurance helps provide financial protection by promising to pay a benefit in the event of an insured individual’s covered death or dismemberment as the result of an accident. The cost for you, your spouse/domestic partner and/or your children is based on the amount of coverage you choose (the rates will be provided when you go through the online open enrollment process). Voluntary Supplemental Life Insurance Supplemental life insurance provides extra life insurance protection for you, a legally married spouse or eligible, registered domestic partner (same or opposite gender) and/or dependent children. Coverage for dependent children only costs $1 per month for $10,000 of coverage. The cost for you and your spouse or domestic partner is based on the amount of coverage you choose, your salary and your age (the rates will be provided when you go through the online open enrollment process). Voluntary Long-Term Disability Insurance (LTD) LTD insurance provides financial protection for eligible employees by paying a percentage of monthly earnings in the event of a covered disability. Your cost is based on which option you choose, your salary and your age (the rate will be provided when you go through the online open enrollment process). Evidence of good health will be required during this enrollment period. Voluntary LTD insurance will become effective Jan. 1, 2019, for new enrollees and current participants who elect to increase their level of coverage (i.e., move from Option 1 to Option 2). For eligible employees with less than five years of service or enrolled in the Alternative Retirement Plan, Voluntary LTD Insurance provides gap coverage. For eligible employees with five or more years of service who are enrolled in OPERS/STRS, this insurance provides a valuable supplement to the OPERS/STRS benefits. For example: • OPERS/STRS has a 365-day benefit waiting period; Voluntary LTD has a 180-day

benefit waiting period. • In most cases, OPERS/STRS requires you to become disabled before age 60 to qualify

for benefits; Voluntary LTD has no age requirement. • Voluntary LTD insurance benefits are not subject to federal taxes; OPERS/STRS

benefits are. Note: It is important for employees to update beneficiary designations for any life insurance policies. You can verify your beneficiary designations by contacting the Benefits office. You can also complete the Beneficiary Change Form at http://www.kent.edu/hr/benefits/beneficiary-change-form and return it to the Benefits Office in Heer Hall. *You must purchase coverage for yourself in order to purchase coverage for your spouse/domestic partner and dependent children. Voluntary Indemnity Plans AFLAC offers a variety of voluntary indemnity plans. These plans provide protection for you and your family members when an unexpected accident or illness occurs.

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Plan Options: • Aflac Group Accident Insurance – helps with the costs that arise when you have a

covered accident such as a fracture, dislocation or laceration. Covered at home and at work.

• Aflac Group Critical Illness Insurance – provides cash benefits if you’re diagnosed with or treated for a covered illness, such as cancer, a heart attack or a stroke. Guaranteed issue coverage is available for all employees up to $30,000 and up to $15,000 for the spouses.

• Aflac Group Hospital Indemnity Insurance – helps pay the out-of-pocket costs associated with a hospital stay including benefits for inpatient and outpatient services including an emergency room/physician office benefit and more.

• Aflac Short-Term Disability Insurance – provides cash benefits in the case of illness or injury to help you maintain your standard of living and help you pay your bills. Guaranteed issue coverage up to $3,000.

Additional information about these plans can be found at: https://www.kent.edu/hr/benefits/voluntary-indemnity-plans A contact for an Aflac representative is Derrick Fellows at 216-382-9500. Voluntary Long-term Care (LTC) Long-term care insurance pays for home healthcare, assisted living and nursing home care to help people with the functions of day-to-day living (bathing, dressing, toileting, transferring and eating) as well as services related to rehabilitation, chronic illness and cognitive impairment. Many working age people are buying LTC insurance to avoid the risk of becoming uninsurable. Once accepted, changes to your health do not affect your coverage or premiums. In addition, note that Medicare, disability insurance and other types of health insurance are not designed for long-term care coverage; and Medicaid won’t pay until after recipients have “spent down” their assets to low levels. The state of Ohio Long Term Care Partnership Program provides dollar-for-dollar asset protection. Each dollar that your partnership policy pays out in benefits entitles you to keep a dollar of your assets if you ever need to apply for Medicaid. Legacy Services is an independent agency that offers individual policies from the major carriers with a wide range of options that allow you to customize coverage to fit your needs and budget. Certain health conditions may affect eligibility. Any coverage selected will be paid for entirely by the employee and will not be eligible for payroll deduction. To schedule a one-on-one consultation or for any other questions, contact Legacy at 800-230-3398, ext. 101 or email custsvc@4groupltci.com.

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Retirement Plans Invest in your financial future by taking advantage of the supplement retirement options.

Supplemental Retirement Plans There are two supplemental retirement plans available to Kent State employees on a tax-deferred basis: a 403(b) account and a 457 account. These two plans allow you to make pretax contributions by convenient payroll reduction and save that money for your retirement. For calendar year 2018, the maximum contribution was $18,500. If you are age 50 or older in 2019, you can direct an additional $6,000 into each plan. The IRS will announce the contribution limits for 2019 in late October. The 403(b) and the 457 plans were created to encourage long-term savings. Distributions are available when you reach age 59 1/2; certain distributions are mandated beginning at 70 1/2 years of age. As you consider these plans, you may wish to speak with your financial advisor about distribution options when you leave employment. Contributing to either one of these supplemental retirement plans can help you take control of your future. Other sources of retirement income, including state pension plans and, if applicable, Social Security, rarely fully replace a person’s final salary upon retirement. Roth A Roth option is also available in connection with the 403(b) and 457 plans. Roth participants can make supplemental retirement contributions on an “after-tax” basis; and when taken, distributions from accounts are non-taxable. For some individuals, this may be a significant advantage. A list of providers for both plans, including the list of Roth providers, is available online at www.kent.edu/hr/benefits-forms-and-information. Look for the 403(b) and 457 Provider list in the Retirement Program section Travel Assistance Assistance is available to full-time Kent State employees and their family members who travel more than 100 miles from home or internationally, for a maximum of 180 days. There is no fee; it is offered as part of the group life insurance from the Standard Co. Services are available 24/7 and include assistance with pre-trip planning, legal issues, emergency transportation, personal security, medical assistance and travel. For more information, contact UHC Global at 1-800-527-0218 or www.uhcglobal.com.

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Dependent Eligibility As healthcare costs rise, proper management and financial control of health plans have become increasingly important. As a part of this process, the university must verify that the dependents enrolled under the medical and pharmacy plans meet the university’s eligibility rules. If you previously submitted documentation to the Benefits Office and are not adding any dependents, no further action is required on your part. However, if you are adding a new dependent or going from single to family coverage, you must provide the proper documentation, see Page 42, to the Benefits Office by the end of the Open Enrollment period. Questions should be directed to University Benefits. You may contact them at (330) 672-3107, (330) 672-MYHR (6347) or benefits@kent.edu. Definition of a Dependent Listed below are the definitions of a dependent based upon the guidelines of Kent State University’s benefit plans. Spouse: Your legal spouse. Domestic Partner: The employee’s same-gender or opposite-gender registered domestic partner. Child: A biological child, stepchild or adopted child of the employee, employee’s spouse or registered domestic partner who is under the age of 26. A dependent child for whom the employee, the employee’s spouse or registered domestic partner has legal guardianship or legal custody. Disabled Child: The maximum dependent age limits do not apply for a child who cannot hold a self-supporting job due to a permanent physical disability if: • The child becomes disabled prior to age 19 and remains disabled while covered under the healthcare plan(s). • The physical or mental impairment is a result of either a congenital or acquired illness or injury leading to the individual being incapable of independent living. Dependent Eligibility Rules and Documentation Requirements The chart below shows each category of a dependent as defined by the Kent State Healthcare Plan and lists the supporting documentation that you are required to submit along with the completed form.

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Adult Dependent Eligibility Adult dependent children, between the ages of 26-28, who meet the eligibility requirements may be enrolled for coverage up to age 28. Domestic Partner Benefits Kent State University offers domestic partner benefits to eligible employees. The benefits extend to both same-gender and opposite-gender partners of university faculty, unclassified and classified employees. The benefits offered to eligible domestic partners are: • Medical, prescription, vision and dental insurance • Dependent life insurance • Voluntary Accidental Death and Dismemberment Insurance (AD&D) • Tuition fee waiver To initiate the domestic partner benefits process, the employee must complete an Affidavit of Domestic Partnership form, which includes supporting documentation attesting that the domestic partners meet the conditions listed below: • Are at least 18 years of age and have the capacity to enter into a contract; • Share a permanent residence (unless residing in different cities, states or countries on a temporary basis); • Are the sole domestic partner of each other, having been in the relationship for at least six months and intending to remain in the relationship indefinitely; • Are not currently married to, or legally separated from, another person under statutory or common law; • Are responsible for each other’s welfare; • Are not related by blood to a degree that would bar marriage in the state of Ohio; and • Are financially interdependent on each other. This includes documentation of at least three of the following: • Joint ownership of real estate property or joint tenancy on a residential lease; • Joint ownership of an automobile; • Joint bank account or credit account; • Will, designating the domestic partner as the primary beneficiary; • Retirement plan or life insurance policy designating the domestic partner as the primary beneficiary; • Durable power of attorney, signed to the effect that powers are granted to one another.

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Information and the affidavit form can be found online at www.kent.edu/hr/benefits/domestic-partners

Employee Wellness Program The university is committed to helping faculty and staff live a healthy lifestyle. The Employee Wellness program, Wellness Your Way, provides a robust menu of health education resources and activities that

support healthy lifestyle choices. EMPLOYEE WELLNESS – Healthy Choices That Pay! EARN $300 WELLNESS REWARD Wellness has even greater rewards! As part of the Wellness Your Way program, all full-time, benefits-eligible employees may earn up to $300 in wellness rewards by simply participating in healthy lifestyle activities. Many, you may be doing already, so why not enjoy some additional benefits to living a healthy lifestyle? Examples include completing your health risk assessment, getting your annual physical, or participating in a worksite or physician screening to “Know Your Numbers.” Visit our employee wellness reward web page at https://www.kent.edu/hr/benefits/wellness and get a head start earning your reward dollars for 2019! Our Strategic Partners in Wellness

• Be Well Solutions Be Well Solutions (BWS) is a physician-owned and operated comprehensive wellness company staffed by professionals experienced in patient care and education. BWS offers physicians, nurses, dietitians, health educators, diabetes educators, certified wellness coaches, personal trainers, nutrition specialists and freedom from smoking facilitators. There is no cost to the employee for these services. For individuals participating in the voluntary Wellness Your Way

employee wellness program, BWS will track and verify all employee reward points. You may check your points anytime at portal.bewelldata.com. The Be Well Web portal can be accessed at https://portal.bewelldata.com. If you have not yet set up your Be Well login, please follow the instructions at http://www.kent.edu/hr/benefits/partners-bewellsolutions for initial set up of your Be

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Well account. Once logged in, you can check out the Employee Wellness Program and start earning your $300 wellness reward.

• Impact Solutions – Kent State University’s Employee Assistance and Work/Life program. The IMPACT program can assist with problems such as stress, anxiety, depression, child management, marital concerns or substance abuse. They can also provide assistance for child or elder care, financial or legal matters. All resources are available 24 hours a day, 365 days a year. IMPACT services are confidential and provided by credentialed professionals. All services are offered to Kent State faculty and staff, their household members, dependents living away from home, and parents and parents-in-laws. IMPACT provides up to six confidential counseling sessions at no cost. To access IMPACT resources, visit www.Impactemployeeassistance.com. The login to the site is “kent.” You may also reach IMPACT directly at 1-800-227-6007. Kent State University, along with IMPACT Solutions, is partnering with Right Direction, an

initiative addressing depression in the workplace. The goal is to spread awareness that depression is treatable, and help to reduce the stigma surrounding depression. Resources can be found at http://www.rightdirectionforme.com/ksu.

Wellness Resource Guide The Employee Wellness Office collaborates with and is supported by several wellness partners. With 8 health priorities identified, we have developed our online resource guide capturing university resources that support these priorities. Visit our Wellness Resource Guide to learn more at www.kent.edu/hr/benefits/wellness-resource-guide.

• Weight Watchers at Work is offered weekly on the Kent Campus; and employees at all locations can take advantage of a discount on the Weight Watchers monthly pass to attend meetings in their community or for the online program. Details can be found on our Wellness Partner website at http://www.kent.edu/hr/benefits/our-partners-wellness. Medical Mutual of Ohio participants are eligible for partial reimbursement. • The Chef’s Garden (through Medical Mutual) brings vegetable, herbs and other produce straight from the garden to your home. You can also get recipes and view instructional videos featuring the produce you receive.

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• University Health Services (UHS) is a full-service, primary care medical facility on the Kent Campus. UHS treats chronic and short-term medical conditions and offers a range of wellness services. The services are available to faculty and staff, as well as students, and most major medical insurance plans are accepted. Visit www.kent.edu/uhs for more information. • The Student Recreation and Wellness Center offers a wide variety of cardio and strength equipment, access to the natatorium, racquetball and basketball courts, climbing wall and many other recreational and fitness opportunities. Employees receive a membership discount. • The Nutrition Outreach Program offers its services to all Kent State employees. The Nutrition Outreach Program provides nutrition education on weight control, cardiovascular/hypertension, digestive disorders, diabetes, eating disorders, general nutrition/wellness, pediatric nutrition, childhood obesity, sports nutrition, vegetarian, food allergies and food safety. For more information on how to schedule an appointment, please visit www.kent.edu/ehhs/hs/nutr/center-nutrition-outreach • The School of Health Sciences offers the Fit for Life program. This program is specifically designed to assist individuals who may benefit from a more structured and personal exercise program due to a sedentary lifestyle or for individuals who may have some risk factors that require more supervision, such as hypertension, diabetes, family history of heart or coronary disease, metabolic disease, etc. The program is located in the MACC Annex off of Midway Drive on the Kent Campus and is overseen by Angela Ridgel, Ph.D. Dr. Ridgel is an associate professor in Exercise Science/Physiology at Kent State. For more details on the program, visit our Wellness Partnerships webpage at http://www.kent.edu/hr/benefits/our-partners-wellness. • Nurseline - available 24 hours a day, seven days a week. The nurse line is staffed by registered nurses (RNs) who provide around-the–clock guidance and answers to your healthcare questions. Medical Mutual of Ohio Nurse Line can be reached at 888-912-0636 or accessing the program’s secure email system at https://www.medmutual.com/, then logging on to My Health Plan and select Nurse Line under Resources & Tools.

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Stay in the Know - To stay informed, visit our site Employee Wellness regularly at www.kent.edu/hr/benefits/wellness. To see a comprehensive calendar of all wellness offerings, go to tinyurl.com/WYWCalendar.

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Important Notices Women’s Health and Cancer Rights Notice This Congressional Act of 1998 requires benefit plans to provide coverage for reconstructive surgery and related services following a mastectomy. All terms and conditions (including deductibles and coinsurance) of your medical plan apply to this coverage. Specifically, the benefits include: • Coverage for reconstructive surgery of the breast on which a mastectomy has been performed. • Coverage for surgery and reconstruction of the other breast to produce a symmetrical appearance. • Coverage for prostheses and physical complications through all stages of a mastectomy, including swelling associated with the removal of lymph nodes. Treatment will be in a manner that is determined in consultation with the attending physician and patient. In addition, the plan may not:

• Interfere with a woman’s rights under the plan to avoid these requirements. • Offer inducements to the health provider, or assess penalties against the health

provider, in an attempt to interfere with the requirements of the law. This law requires written notice of the availability of the coverage be delivered to all plan participants upon enrollment and annually thereafter. This notice serves to fulfill this requirement. Newborns’ and Mothers’ Health Protection Act The Newborns’ and Mothers’ Health Protection Act of 1996 provides protections for mothers and their newborn children with regard to hospital lengths of stay following childbirth. All terms and conditions (including deductibles and coinsurance) of your medical plan apply to this coverage. Specifically, the benefits include:

• Coverage must provide benefits for hospital lengths of stay in connection with childbirth to cover the minimum length of stay for all deliveries.

• Group Health Plans may not restrict mothers’ and newborns’ benefits for a hospital length of stay in connection with childbirth to less than

• 48 hours following a vaginal delivery or 96 hours following a delivery by cesarean section.

• Determination of whether an admission is in connection with childbirth is a medical decision to be made by the attending provider. An example clarifies that delivery does not have to occur inside a hospital in order for an admission to be “in connection with childbirth.”

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• Exception to the interim rules permits an exception to the 48-hour (or 96-hour) general rule if the attending provider decides, in consultation with the mother, to discharge the mother or her newborn earlier.

Important Notice from Kent State University 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 Kent State University and about your options under Medicare’s prescription drug coverage. 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. Kent State University has determined that the prescription drug coverage offered by the Kent State University Health Plan is, on average 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 October 15 to December 7. 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 Kent State University coverage will not be affected. You can keep this coverage if you elect Medicare Part D and this plan will coordinate with Part D coverage. A description of the prescription drug benefits available to Kent State employees is available at www.kent.edu/hr/benefits/Prescription-cvs-health. See pages 7- 9 of the CMS Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance (available at www.cms.hhs.gov/CreditableCoverage/), which outlines the prescription

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drug plan provisions/options that Medicare eligible individuals may have available to them when they become eligible for Medicare Part D. 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 Kent State University 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 premium may go up by at least 1 percent of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go 19 months without creditable coverage, your premium may consistently be at least 19 percent 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 coverage. In addition, you may have to wait until the following October to join. For More Information About This Notice Or Your Current Prescription Drug Coverage: Contact the person listed below. 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 Kent State University 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). Remember: 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 coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

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Date: Oct. 9, 2019 Name of Entity/Sender: Kent State University Contact--Position/Office: Sheba N. Marshall, Director, University Benefits Address: Kent State University Heer Hall - Human Resources, P.O. Box 5190, Kent OH 44242-0001 Phone Number: 330-672-3107 Summary of Benefits and Uniform Glossary of Terms Federal legislation requires employers to provide employees with a Summary of Benefits Coverage (SBC) and a Uniform Glossary of Terms for each health plan. You can view the SBC for each Kent State health plan online at www.kent.edu/hr/benefits/medical-insurance. If you have questions about any of the plans, contact the Benefits Office at 330-672-MyHR (6947) or benefits@kent.edu. These documents are designed to provide health plan information in a uniform format to allow consumers to compare the terms of plans offered and to assist consumers in understanding the benefits provided. NOTICE OF PRIVACY PRACTICES FOR KENT STATE UNIVERSITY EMPLOYEE GROUP HEALTH PLAN THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) requires health plans to notify plan participants and beneficiaries about its policies and practices to protect the confidentiality of their health information. This document is intended to satisfy HIPAA’s notice requirement with respect to all health information created, received, or maintained by the Kent State University group health plan (the plan), as sponsored by Kent State University (the university). Your Personal Health Information The plan needs to collect, create, receive and maintain records that contain health information about you to administer the plan and provide you with health care benefits. This notice describes the plan’s health information privacy policy with respect to your medical, prescription drug, dental, vision, health care flexible spending account (FSA), and wellness benefits. The notice tells you the ways the plan may use and disclose health information about you, describes your rights, and the obligations the plan has regarding the use and disclosure of your health information. However, it does not address the health information policies or practices of your healthcare providers.

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Kent State University’s Pledge Regarding Health Information Privacy The privacy policy and practices of the plan protects confidential health information that identifies you or could be used to identify you and relates to a physical or mental health condition or the payment of your health care expenses. This individually identifiable health information is known as protected health information (PHI). Your PHI will not be used or disclosed without a written authorization from you, except as described in this notice or as otherwise permitted by federal and state health information privacy laws. Privacy Obligations of the Plan The plan is required by law to: • Make sure that health information that identifies you is kept private; • Give you this notice of the plan’s legal duties and privacy practices with respect to health information about you; • Follow the terms of the notice that is currently in effect; and • Notify affected individuals following a breach of unsecured PHI. How the Plan May Use and Disclose Health Information About You • Your Authorization. Except as outlined below, the plan will not use or disclose your PHI for any purpose, unless you have signed a form authorizing the use or disclosure of such PHI. Most uses and disclosures of psychotherapy notes, as applicable, require your authorization. Subject to certain limited exceptions, the plan may not use or disclose PHI for marketing without your authorization. The plan will not sell your PHI without your authorization. You have the right to revoke that authorization in writing unless the plan has taken any action in reliance on the authorization. • For Treatment. The plan may disclose your PHI to a healthcare provider who renders treatment on your behalf. For example, if you are unable to provide your medical history as the result of an accident, the plan may advise an emergency room physician about the types of prescription drugs you currently take. • For Payment. The plan may use and disclose your PHI so claims for health care treatment, services, and supplies you receive from healthcare providers may be paid according to the plan’s terms. For example, the plan may receive and maintain information about surgery you received to enable the plan to process a hospital’s claim for reimbursement of surgical expenses incurred on your behalf. • For Health Care Operations. The plan may use and disclose your PHI to enable it to operate or operate more efficiently or make certain all of the plan’s participants receive their health benefits. For example, the plan may use your PHI for case management or to perform population-based studies designed to reduce healthcare costs. In addition, the plan may use or disclose your PHI to conduct compliance reviews, audits, actuarial studies, and/or for fraud and abuse detection. The plan may also combine health information about many plan participants and disclose it to the university in summary fashion so it can decide what coverages the plan should provide. The plan may remove information that identifies you from health information disclosed to the university so it may be used without the university learning the identity of the individual. The plan is prohibited from using or disclosing PHI that is genetic information for underwriting purposes.

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• To the university. The plan may disclose your PHI to designated university personnel so they can carry out their plan-related administrative functions, including the uses and disclosures described in this notice. Such disclosures will be made only to the university’s manager of university benefits (the plan administrator) and/or the members of the university’s benefits department. These individuals will protect the privacy of your health information and ensure it is used only as described in this notice or as permitted by law. Unless authorized by you in writing, your health information: (1) may not be disclosed by the plan to any other university employee or department, and (2) will not be used by the university for any employment-related actions and decisions or in connection with any other employee benefit plan sponsored by the university. • To a business associate. Certain services are provided to the plan by third party administrators known as “business associates.” For example, the plan may input information about your healthcare treatment into an electronic claims processing system maintained by the plan’s business associate so your claim may be paid. In so doing, the plan will disclose your PHI to its business associate so it can perform its claims payment function. However, the plan will require its business associates, through contract, to appropriately safeguard your health information. • Treatment Alternatives. The plan may use and disclose your PHI to tell you about possible treatment options or alternatives that may be of interest to you. • Health and wellness-related benefits and services. The plan may use and disclose your PHI to tell you about health-related benefits or services that may be of interest to you. For example, we may send health care information to you on topics such as women’s health, diabetes, asthma, heart disease, etc. We may also work with other agencies, health care providers, and pharmaceutical companies to provide good health and disease management and prevention programs. • Individual involved in your care or payment of your care. The plan may disclose PHI to a close friend or family member involved in or who helps pay for your healthcare. The plan may also advise a family member or close friend about your condition, your location (for example that you are in the hospital) or death. • As required by law. The plan will disclose your PHI when required to do so by federal, state or local law, including those that require the reporting of certain types of wounds or physical injuries. Special Use and Disclosure Situations The plan may also use or disclose your PHI under the following circumstances: • Lawsuits and disputes. If you become involved in a lawsuit or other legal action, the plan may disclose your PHI in response to a court or administrative order, a subpoena, warrant, discovery request, or other lawful due process. • Law enforcement. The plan may release your PHI if asked to do so by a law enforcement official, for example, to identify or locate a suspect, material witness, or missing person or to report a crime, the crime’s location or victims, or the identity, description, or location of the person who committed the crime.

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• Workers’ compensation. The plan may disclose your PHI to the extent authorized by and to the extent necessary to comply with workers’ compensation laws or other similar programs. • Military and veterans. If you are or become a member of the U.S. armed forces, the plan may release medical information about you as deemed necessary by military command authorities. • To avert serious threat to health or safety. The plan may use and disclose your PHI when necessary to prevent a serious threat to your health and safety, or the health and safety of the public or another person. • Public health risks. The plan may disclose health information about you for public health activities. These activities include preventing or controlling disease, injury or disability; reporting births and deaths; reporting child abuse or neglect; or reporting reactions to medication or problems with medical products or to notify people of recalls of products they have been using. • Health oversight activities. The plan may disclose your PHI to a health oversight agency for audits, investigations, inspections, and licensure necessary for the government to monitor the health care system and government programs. • Research. Under certain circumstances, the plan may use and disclose your PHI for medical research purposes. • National security, intelligence activities and protective services. The plan may release your PHI to authorized federal officials: (1) for intelligence, counterintelligence, and other national security activities authorized by law, and (2) to enable them to provide protection to the members of the U.S. government or foreign heads of state, or to conduct special investigations. • Organ and tissue donation. If you are an organ donor, the plan may release medical information to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank to facilitate organ or tissue donation and transplantation. • Coroners, medical examiners and funeral directors. The plan may release your PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine the cause of death. The plan may also release your PHI to a funeral director, as necessary, to carry out his/her duty. Your Rights Regarding Health Information About You Your rights regarding the health information the plan maintains about you are as follows: • Right to inspect and copy. You have the right to inspect and copy your PHI. This includes information about your plan eligibility, claim and appeal records, and billing records, but does not include psychotherapy notes. The plan must make PHI available in electronic format upon request and where available. You may request that copies of your PHI be sent to a third party. • To inspect and copy health information maintained by the plan, submit your request in writing to the plan Administrator. The plan may charge a fee for the cost of copying and/or mailing your request. In limited circumstances, the plan may deny your request to inspect and

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copy your PHI. Generally, if you are denied access to health information, you may request a review of the denial. • Right to amend. If you feel that health information the plan has about you is incorrect or incomplete, you may ask the plan to amend it. You have the right to request an amendment as long as the information is kept by or for the plan. If a requested amendment or correction is made by the Plan, notification may be made to others who work with us and have copies of the uncorrected record if such notification is necessary. To request an amendment, send a detailed request in writing to the plan administrator. You must provide the reason(s) to support your request. The plan may deny your request if you ask the plan to amend health information that was: accurate and complete; not created by the plan; not part of the health information kept by or for the plan; or not information that you would be permitted to inspect and copy. • Right to an accounting of disclosures. You have the right to request an “accounting of disclosures.” This is a list of disclosures of your PHI that the plan has made to others, except for those necessary to carry out health care treatment, payment, or operations; disclosures made to you; or in certain other situations. The first list you request within a 12-month period is free of charge, but the plan may charge you for additional lists within the same 12-month period. The Plan will notify you of the costs involved with additional requests, and you may withdraw your request before you incur any costs. To request an accounting of disclosures, submit your request in writing to the plan administrator. Your request must state a time period, which may not be longer than six years prior to the date the accounting was requested. • Right to request restrictions. You have the right to request a restriction on the health information the Plan uses or discloses about you for treatment, payment, or health care operations. You also have the right to request a limit on the health information the plan discloses about you to someone who is involved in your care or the payment of your care, like a family member or friend. For example, you could ask that the plan not use or disclose information about a surgery you had. To request restrictions, make your request in writing to the plan administrator. You must advise us: 1) what information you want to limit; (2) whether you want to limit the plan’s use, disclosure, or both; and (3) to whom you want the limit(s) to apply. Note: The plan is not required to agree to your request. • Right to request confidential communications. You have the right to request that the plan communicate with you about health matters in a certain way or at a certain location. For example, you can ask that the plan send you explanation of benefits (EOB) forms about your benefit claims to a specified address. To request confidential communications, make your request in writing to the plan administrator. The plan will make every attempt to accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. • Right to a paper copy of this notice. You have the right to a paper copy of this notice. You may write to the plan administrator to request a written copy of this notice at any time.

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Changes to this Notice The Plan reserves the right to change this notice at any time and to make the revised or changed notice effective for health information the plan already has about you, as well as any information the plan receives in the future. The plan will post a copy of the current notice in the university’s benefits office at all times. Complaints If you believe your privacy rights under this policy have been violated, you may file a written complaint with the plan administrator at the address listed below. Alternatively, you may complain to the Secretary of the U.S. Department of Health and Human Services, generally, within 180 days of when the act or omission complained of occurred. Note: You will not be penalized or retaliated against for filing a complaint. Other Uses and Disclosures of Health Information • Other uses and disclosures of health information not covered by this notice or by the laws that apply to the plan will be made only with your written authorization. If you authorize the plan to use or disclose your PHI, you may revoke the authorization, in writing, at any time. If you revoke your authorization, the plan will no longer use or disclose your PHI for the reasons covered by your written authorization; however, the plan will not reverse any uses or disclosures already made in reliance on your prior authorization. Contact Information If you have any questions about this notice, please contact: University Benefits Kent State University, Heer Hall, PO Box 5190, Kent OH 44242-0001 330-672-3107 or benefits@kent.edu. NEW HEALTH INSURANCE MARKETPLACE COVERAGE OPTIONS AND YOUR HEALTH COVERAGE PDF. (Covers 2 pages, PART A AND PART B)

Healthcare Provider Contact Information Provider Customer Service Contact Website Medical Mutual 1-866-811-9727 www.medmutual.com CVS Caremark 1-888-202-1654 www.caremark.com Delta Dental 1-800-524-0149 www.deltadental.com EyeMed 1-866-939-3633 www.eyemedvisioncare.com PNC Bank 1-844-356-9993 www.pnc.com/pncbenefitplus AFLAC 1-216-382-9500 www.aflac.com Legacy Long Term Care 1-800-230-3398 http://www.legacyltci.com

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