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NXP 2021 Summary Plan Description

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NXP 2021 Summary Plan Description NXP 2021 Summary Plan Description NXP Benefits: Health, Wellness, Life and More U.S. Benefits Effective January 1, 2021 Introduction A Rewards Package to Fit Your Lifestyle As an employee of NXP USA, Inc. (NXP), you drive the innovation that sets our company apart – and fuels our success in the market. To reward your dedication and commitment, we offer a competitive and comprehensive rewards program – including benefits to protect your health and enhance your life. About this SPD While at NXP, you will make many important decisions regarding you, your family, wellness and health care. This Summary Plan Description (SPD) provides you with useful information to help you make your choices along with tips on taking full advantage of your NXP reward programs. In addition, this document is your official SPD for the NXP Employee Health Benefit Plan, as described in and required under the Employee Retirement Income Security Act (ERISA). This SPD is divided into the following sections: • Participation includes information about who is eligible for the benefits described in this SPD, how to enroll, when coverage begins, when you can make changes and when coverage ends. You will also find information about continuing some coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA); • Health and Wellness includes: — Medical coverage, including behavioral health and prescription drug for the following medical options: • UnitedHealthcare Medical Plan 1 (HSA-eligible); • UnitedHealthcare Medical Plan 2 (PPO); • UnitedHealthcare Medical Plan 3 (EPO); • UnitedHealthcare Out-of-Area (OOA) Plan; and • Kaiser Permanente HMO; — Dental coverage; — Vision coverage; — Wellness programs; and — Flexible spending accounts, describing how you can save on taxes when you pay certain health care and dependent care expenses; • Disability Income Benefits, including short- and long-term disability; • Life, Accidental Death and Dismemberment and Business Travel Accident Benefits, addressing life insurance plans for you and your dependents, as well as accidental death and dismemberment and business travel accident coverage; • Legal services, including information about NXP’s Legal Services Plan; Introduction i • Work/Life Programs and Life Events, which include information on programs that assist with daily needs and describe what to do when you experience various life events, such as marriage, divorce or birth of a child; • A claims and appeals section, including information about how benefits are coordinated, your privacy rights; • A plan information section with other important information and your ERISA rights under the Employee Health Benefit Plan; • A definitions section with explanations of terms and phrases commonly used throughout this SPD; • An index to help you put your finger on the exact information you need; and • A contact information reference, conveniently located at the back of the SPD, of telephone numbers, websites and other resources available for additional benefit claims and appeals information. Each section includes, as applicable: • Explanations of the benefit plans, with helpful charts and tables; • Tips on getting the most from your benefits; and • Important facts, resources, dates and deadlines. Throughout the SPD, you will see references to where you can find additional information through various websites, toll-free numbers, addresses and other helpful sources. These are great tools to get the latest rewards news. Keep this SPD handy, and refer to it often as your resource for information on the many benefits of NXP’s Rewards package. Introduction ii NXP Benefits An “X” in the column indicates that the benefit or program described in this SPD applies to you. Domestic U.S. Expatriates U.S. Inpatriates Benefit or Program Employees Interns on U.S. Payroll on U.S. Payroll Adoption Assistance X X X X Program Behavioral Health Program X X Eligible through Eligible through global medical global medical plan plan COBRA Continuation X X Limited eligibility Limited eligibility Coverage (Medical, Dental, through global through global Vision and Health Care medical plan medical plan Flexible Spending Account (FSA)) Dental Plan X X Eligible through Eligible through global medical global medical plan plan Dependent Care Flexible X X X X Spending Account (DCFSA) Disability Income Benefits X X X X Health Care/Limited Use X X X X Health Care Flexible Spending Account (FSA) Health Savings Account X X (HSA) Travel Assistance X X X X Legal Services Plan X X X X Medical Plan X X Eligible through Eligible through global medical global medical plan plan Prescription Drug Program X X Eligible through Eligible through global medical global medical plan plan EAP, Live and Work Well X X X X Program Vision Plan X X Eligible through Eligible through global medical global medical plan plan Life Insurance Plans X X X X Activity Centers X X X X * Assumes you are working 30 or more hours per week. Introduction iii U.S. Expatriates and U.S. Inpatriates • A U.S. Expatriate or U.S. Inpatriate is defined as an NXP employee on the payroll of an NXP entity based in the United States, regardless of where the employee actually performs work. • U.S. Expatriates are employees of NXP or a participating entity that are on assignment outside the U.S. as determined by NXP Global Mobility. The benefits described in this SPD are available to you as outlined if you are a U.S. Expatriate on U.S. payroll. • U.S. Inpatriates are employees of NXP or a participating entity that are transferred from their home country to the U.S. for an assignment as determined by NXP Global Mobility. The benefits described in this SPD are available to you as outlined if you are a U.S. Inpatriate on U.S. payroll. See NXP Benefits chart above for a summary of your benefits and watch for the outlined, shaded boxes like this one that contain important information specifically for you. This information will help you identify which programs apply and assist you in taking full advantage of all the benefits available to you. Introduction iv NXP 2021 Summary Plan Description This SPD represents general information regarding provisions of the NXP Rewards Plans. You should not rely on this information other than as a summary of the features of the Plans. Your rights are governed by the terms of the respective Plan documents. Refer to the Plan documents for complete information on your Plan rights and responsibilities. Also, any questions concerning the Plans are determined according to the terms of the Plan documents and not this SPD. You may get a copy of any Plan document governed by ERISA upon written request to the NXP Benefits Service Center. In the event of any difference between the terms of this SPD and the Plan documents, the Plan documents’ terms control. No person has the authority to make any oral or written statement or representation of any kind that is legally binding upon NXP or that alters the Plan documents, or any contracts or other documents maintained in conjunction with the Plans. NXP, the sponsor of the Plans, has reserved the sole right at any time to amend, modify or terminate one or more of the Plans described in the SPD. You will be notified of any changes. This SPD describes the Plans, as each has been amended to date. Summaries of Material Modifications (SMMs) or new SPDs will be provided to advise you of changes in the Employee Health Benefit Plan, as required by ERISA. NXP and the NXP logo are trademarks of NXP Semiconductors in the U.S. and other countries. All other product or service names are the property of their respective owners. ©NXP Semiconductors 2021 Introduction v Table of Contents Participation ........................................................................................................ 1 Eligibility .................................................................................................................................... 2 Enrolling in NXP Rewards ......................................................................................................... 8 Paying for Coverage ................................................................................................................ 12 When Coverage Begins .......................................................................................................... 15 When You May Change Your Coverage ................................................................................. 18 When Coverage Ends ............................................................................................................. 26 COBRA Continuation Coverage .............................................................................................. 33 Health and Wellness Benefits ........................................................................... 38 NXP Medical Plan ................................................................................................................... 41 Health Savings Account (HSA).............................................................................................. 112 Prescription Drug Program .................................................................................................... 120 Activity Centers ..................................................................................................................... 132 NXP Dental Plan ................................................................................................................... 136 NXP Vision Plan ...................................................................................................................
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