A GUIDE TO UNDERSTANDING THE CONSUMER-DIRECTED HEALTH PLAN (CDHP) AND HEALTH SAVINGS ACCOUNT (HSA) WELCOME

CDHP AND HSA BASICS A GUIDE TO THE USING THE HSA CDHP AND HSA TO PAY FOR CARE At The Hartford, we offer competitive benefits and programs to help you live well—and coverage options that give you control over how you spend LEARN MORE your health care dollars. The Consumer-Directed Health Plan (CDHP) options and the Health Savings Account (HSA) give you more power to

manage your health care—and encourage you to make informed health care decisions. If you enroll in a CDHP, it’s important to understand how the plan works before you need care, so when the time comes you know what to do. Click the tabs to the left to learn more about the CDHP, and how it works together with the HSA—and how using the plan wisely can save you money on health care expenses today and in the future.

This guide is intended to provide a general overview of certain benefits. Details about those benefits are provided in official plan documents, which govern eligibility for the benefits and the operation of the plans. Any differences between this guide and the plan documents are not intended, but if any differences are found to exist, the plan documents will govern.

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CDHP AND HSA BASICS CDHP AND HSA BASICS CDHP at a Glance A Consumer-Directed Health Plan (CDHP) is a little different than a traditional health plan How Your Medical that you may be used to, but taking time to get to know the plan could mean extra money in Care Is Covered your pocket. CDHPs are designed to give you more control over how you spend your health care dollars. Paying for In-Network Care These plans cost less per pay period, but have higher deductibles than other plans. CDHPs allow you to contribute to a special tax-advantaged Health Savings Account (HSA) you can use What Happens to pay for qualified health care expenses—like doctor’s bills, hospital charges and pharmacy When You Visit expenses. Your HSA funds can also be used for dental and vision expenses. Any remaining Your Health Care funds in your HSA carry forward from year to year, so you can build your savings. You own Provider? your HSA, not The Hartford, so the money is yours to take with you—wherever you go! Prescription Drug Coverage Get to Know Your HSA

USING THE HSA TO PAY FOR CARE

LEARN MORE

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CDHP AND HSA BASICS THE CDHP OPTIONS AT A GLANCE CDHP at a Glance Here are some highlights of how the CDHP options work: How Your Medical • In-network preventive care services are covered at 100%, so you pay Care Is Covered nothing. Paying for • You have access to both in-network and out-of-network providers—you’ll In-Network Care pay less when you stay in-network. What Happens • You pay 100% of eligible medical and prescription drug expenses (except When You Visit for preventive care expenses) until you satisfy the annual deductible. Your Health Care Provider? • After you satisfy the deductible the Plan pays a portion of eligible expenses and you pay the rest (the coinsurance). If you cover Prescription Drug dependents, you must satisfy the family deductible. Coverage • An out-of-pocket maximum protects you from the high cost of a major Get to Know illness or injury. Your HSA In addition, the CDHP options offer you the unique ability to save tax-free USING THE HSA money through an HSA to pay for health care expenses now—or save for TO PAY FOR CARE the future.

LEARN MORE A NOTE ABOUT HOW DEDUCTIBLES WORK UNDER THE CDHPs If you cover dependents, you must meet the family deductible, not the individual deductible, before the CDHP options begin paying benefits. One family member, or all family members combined, can satisfy the deductible. So, for example, if you elect family coverage under the CDHP Standard option and you have a $3,000 expense in February, you and your family must incur an additional $2,000 in expenses to satisfy the $5,000 family annual deductible (even though you personally have exceeded the $2,500 individual deductible). Let’s suppose you incur an additional $2,000 of expenses in March. Then, the annual deductible has been satisfied for you and all of your covered family members for the remainder of the year.

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CDHP AND HSA BASICS HOW YOUR MEDICAL CARE IS COVERED CDHP at a Glance CDHP Value CDHP Standard CDHP Basic* How Your Medical Out-of- Out-of- Out-of- Care Is Covered In-Network Network In-Network Network In-Network Network Preventive care Plan pays 100%, Plan pays 60% Plan pays 100%, Plan pays 60% Plan pays 100%, Plan pays 60% Paying for no deductible after deductible no deductible after deductible no deductible after deductible In-Network Care Deductible $1,500 individual $3,000 individual $2,500 individual $5,000 individual $3,500 individual $7,000 individual What Happens $3,000 family $6,000 family $5,000 family $10,000 family $7,000 family $14,000 family When You Visit Office visits Plan pays 90% Plan pays 60% Plan pays 80% Plan pays 60% Plan pays 80% Plan pays 60% Your Health Care (non-preventive care after deductible after deductible after deductible after deductible after deductible after deductible Provider? visits with primary care physician/specialist) Prescription Drug Coverage Coinsurance (Your share 10% 40% 20% 40% 20% 40% after deductible for Get to Know other covered services) Your HSA Out-of-pocket $4,000 individual $8,000 individual $5,000 individual $10,000 individual $6,450 individual $12,900 individual maximum (includes $8,000 family $16,000 family $10,000 family $20,000 family $12,900 family $25,800 family USING THE HSA deductible)** TO PAY FOR CARE *This option does not provide creditable prescription drug coverage under Medicare Part D; if you or your spouse will be over age 65 any time during the plan year, at the time you apply for Medicare Part D coverage you may be subject to a premium penalty if enrolled in this LEARN MORE plan. See the Notice of Creditable Coverage for more details. **After a family member reaches the individual maximum, all eligible expenses for that family member are covered 100% by the plan even if the family maximum has not been met.

TIP: SAVE MONEY BY USING IN-NETWORK PROVIDERS Keep in mind that you will generally pay less when you use in-network providers, rather than providers who are out-of-network. The plan pays 100% of the cost of in-network preventive care for you and your covered family members, so be sure to take advantage of preventive care screenings and wellness visits. To find an in-network provider, check the online provider directory at anthem.com.

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CDHP AND HSA BASICS PAYING FOR IN-NETWORK CARE CDHP at a Glance When considering cost, remember that you’ll need to meet your deductible before the plan starts sharing any How Your Medical non-preventive care or prescription drug costs. Once you satisfy the deductible, you and the plan share in the cost Care Is Covered of covered services (your coinsurance). If you reach the out-of-pocket maximum, the plan pays the full cost of covered services for the remainder of the year. Paying for In-Network Care PREVENTIVE ELIGIBLE MEDICAL AND What Happens CARE PRESCRIPTION DRUG EXPENSES When You Visit Your Health Care Provider? YOU Prescription Drug THE PLAN THE PLAN Coverage YOU THE PLAN 100% 100% UP TO 100% Get to Know DEDUCTIBLE } MAXIMUM Your HSA DEDUCTIBLE OUT-OF-POCKET OUT-OF-POCKET USING THE HSA TO PAY FOR CARE FREE TO YOU! COINSURANCE

LEARN MORE Remember, you may use your HSA funds to help offset your out-of-pocket expenses—or save them for future health care expenses.

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CDHP AND HSA BASICS WHAT HAPPENS WHEN YOU VISIT YOUR HEALTH CARE PROVIDER? CDHP at a Glance When you visit an in-network provider, you will generally pay nothing at the time of your visit. So, when and how do you How Your Medical pay for care? Just follow these steps: Care Is Covered 1. Present your Anthem health plan ID card. Generally, you do not need to pay anything at the time of your visit. Paying for 2. After your visit, your provider will send a bill to Anthem. In-Network Care 3. You will receive your Explanation of Benefits (EOB) from Anthem—the amount listed under “Member Responsibility” What Happens is the amount you owe your provider. When You Visit Your Health Care 4. You will receive a separate bill from your provider. You have a choice to: Provider? — Pay the bill using funds from your HSA—Use your HSA debit card or check to pay your bill, if you have money in Prescription Drug your account, or pay out-of-pocket and get reimbursed later. Learn more about how to use your HSA to pay for Coverage eligible expenses. Get to Know OR Your HSA — Pay out-of-pocket and save your HSA funds for future use—You may decide that you prefer to save your HSA funds for a future expense. For example, maybe you are saving your funds for a planned surgery next year—or you USING THE HSA prefer to use your HSA as a way to save for medical expenses after retirement. TO PAY FOR CARE ALWAYS CHECK YOUR EOB CAREFULLY LEARN MORE FOR ACCURACY It’s important to check your EOB carefully to be sure your health services were billed correctly. For example, preventive care services are generally covered at 100%; if you think you were billed for what should have been a preventive care service, be sure to contact your provider. Sometimes health care services can be miscoded by providers resulting in billing errors. Checking your statements may save you from overpaying.

Questions about coverage or bills? Call Anthem at 1-800-801-6308 for assistance.

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CDHP AND HSA BASICS THE CHOICE IS YOURS

CDHP at a Glance When you incur an eligible expense—for example, a bill from your doctor before you’ve met your deductible, How Your Medical or prescription drug costs at the pharmacy—you can choose to use your HSA funds to pay the expense. Care Is Covered Or, you can pay out-of-pocket and save your HSA funds for later. The choice is yours: Paying for USE YOUR FUNDS TO In-Network Care

What Happens When You Visit Your Health Care Provider? COVER EXPENSES PLAN FOR THE Prescription Drug Coverage THIS YEAR FUTURE Get to Know Before you satisfy the annual deductible Do you have a chronic condition and aren’t Your HSA to pay for: sure how much care you’ll need each year? • Provider visits and other health care Are you thinking of retiring soon and want USING TH HSA TO services to set aside money for medical expenses? PAY FOR CARE • Prescription drugs at the pharmacy Do you expect to have a surgery in the LEARN MORE After you satisfy the annual deductible: next few years? 2016 • To pay your share of the 2017 2018 2019 2020 2021 coinsurance

ACCESS TO THE HARTFORD’S HSA CONTRIBUTION BEGINS RIGHT AWAY… Remember, the company makes an annual contribution to your HSA if you enroll in either the Value or Standard CDHP options ($400 for individual coverage/$800 for family coverage). You’ll receive the full deposit as of the first pay period after you open your account, so you can begin using these funds immediately to help offset your deductible. Keep in mind, the annual company contribution is prorated if you enroll in the CDHP after January 1st.

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CDHP AND HSA BASICS MAKE THE MOST OF YOUR VISIT TO THE DOCTOR

CDHP at a Glance Your primary care physician plays a key role in diagnosing health problems, How Your Medical discussing options for care including screening and disease prevention strategies Care Is Covered and health promotion, and making referrals as needed for quality care. Be Prepared for a Medical Appointment Paying for In-Network Care When you go to the doctor, there’s usually a lot to consider in a short amount of time. It’s easy to overlook a symptom you meant to bring up or a question you What Happens meant to ask. It helps to be well prepared for your appointment. Here’s how. When You Visit Your Health Care • Know your medical history, including: allergies, family health history, drug, Provider? alcohol, and tobacco use, and current exercise program. Prescription Drug • Write down any current prescription medications, over-the-counter medications, Coverage vitamins, herbal or natural remedies, and supplements you’re taking, including the dosage. Get to Know Your HSA • Have there been any major life changes or stresses you’re currently experiencing? • Take a few minutes before your appointment to make a list of your questions, USING THE HSA concerns, and symptoms, and refer to the list during your appointment. TO PAY FOR CARE Feel Confident about Asking Questions LEARN MORE Asking questions, lots of questions, is the number one best step you can take towards getting better health care, and having greater peace of mind about the care you get. Here are some tips to help you ask questions and get more answers: • If possible print out or write down all of your questions and bring them to your appointment. • Bring a family member or friend with you to take notes so that you can concentrate on what the doctor is saying. If you can’t bring someone, write down or record the discussion, with your doctor’s permission, so you can review it later. • If you don’t understand something, anything, ask the doctor or nurse to explain it again. It’s their responsibility as medical professionals to make sure you are well informed about your care.

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CDHP AND HSA BASICS After Your Appointment

CDHP at a Glance Stay In Touch with Your Doctor • Be sure to check in with your doctor when planned even if you are feeling better. How Your Medical Care Is Covered • Call your doctor immediately if you experience an unexpected side effect from the treatment or prescription. Paying for • Make sure you go to your follow-up appointments In-Network Care • If you don’t hear back on any laboratory results, make sure to follow up with your doctor’s office What Happens • Contact ConsumerMedicalTM if you have any medical claims questions or problems When You Visit Your Health Care Whether you have a newly-diagnosed condition or have been living with a chronic illness for many years, important Provider? treatment decisions will need to be made. Knowing the benefits, risks and any possible complications will help you make the best choices for you and your loved ones. Here are some things to do when faced with a treatment decision: Prescription Drug Coverage • Think about what’s important to YOU in terms of quality. Get to Know • Know where to find the information that you need. Your HSA • Visit websites, make phone calls, ask questions, and BE INFORMED.

USING THE HSA • Be an active participant in your care! TO PAY FOR CARE CONSUMERMEDICAL™ LEARN MORE If you need care, be sure you are receiving the right care, from the right provider, at the right cost. ConsumerMedical™, a benefit available to all employees and dependents at no cost, helps you obtain reliable, current and personalized information and support with any health-related concern or issue.

Helpful tools from ConsumerMedical • Questions to Ask Your Physician Questions developed by ConsumerMedical physicians and research teams to help you become an informed consumer. Questions can be used as a guide when speaking to your own doctor. • Best Websites for a Condition ConsumerMedical physicians and research teams have carefully reviewed and identified credible websites on a variety of medical diagnoses. These websites can get you started on accessing high quality online resources. • ConsumerMedical™ Price Transparency Tool, powered by Healthcare Bluebook, can provide the fair price of specific tests and procedures in your area, as well as color-coded cost and quality ratings for providers in your area. Visit the ConsumerMedical website or call 1-888-361-3944 for more information.

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CDHP AND HSA BASICS PRESCRIPTION DRUG COVERAGE UNDER THE CDHP OPTIONS CDHP at a Glance When you participate in The Hartford’s health plan, you automatically receive prescription drug coverage through How Your Medical Express Scripts. With the CDHP options, you must satisfy the combined medical/prescription drug annual Care Is Covered deductible before prescription drug coverage begins. This means you will pay 100% of the cost of eligible prescription drugs until you meet the deductible. Your out-of-pocket prescription drug expenses count toward the Paying for combined medical/prescription drug out-of-pocket maximum. Keep in mind, however, that preventive drugs (as In-Network Care mandated by the Affordable Care Act) are covered at 100% with no deductible. You may also use your HSA funds to What Happens pay for your out-of-pocket prescription drug costs. When You Visit All of The Hartford’s health plan options include a formulary feature, which is a list of commonly prescribed Your Health Care medications that have been shown to be clinically effective and cost effective, and includes four drug types: Provider? • Generic Prescription Drug • Preferred brand Coverage • Non-preferred brand Get to Know • Patient Choice Your HSA You can purchase these medications through a participating retail pharmacy or by mail through the home delivery program. USING THE HSA TO PAY FOR CARE HOW PRESCRIPTION DRUGS ARE COVERED LEARN MORE Retail Pharmacy Mail Order (up to a 30-day supply) (up to a 90-day supply) After meeting the combined medical/prescription drug deductible, you pay… Generic 20% up to a maximum of 20% up to a maximum of $200 per prescription $400 per prescription Preferred Brand 20% up to a maximum of 20% up to a maximum of $200 per prescription $400 per prescription Non-Preferred Brand 40% up to a maximum of 40% up to a maximum of $200 per prescription $400 per prescription mail Patient Choice Drugs* 50% up to a maximum of 50% up to a maximum of $200 per prescription $400 per prescription Annual Prescription Drug Included in combined medical/prescription drug out-of-pocket maximum Out-of-Pocket Maximum *Patient choice drugs include non-sedating antihistamines, weight loss drugs and drugs used to treat infertility and erectile dysfunction.

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CDHP AND HSA BASICS WHAT HAPPENS WHEN YOU NEED TO FILL A PRESCRIPTION?

CDHP at a Glance You have two ways to fill a prescription: How Your Medical Care Is Covered PAYING FOR PRESCRIPTIONS Paying for BEFORE YOU In-Network Care MEET YOUR What Happens DEDUCTIBLE RETAIL PHARMACY (up to a 90-day supply) When You Visit MAIL ORDER You’ll pay the full (up to a 30-day supply) Your Health Care You can have prescriptions you take cost of all of your Provider? When you need a regularly (maintenance drugs) delivered prescriptions until prescription right to your home through the mail order you reach your Prescription Drug away, you can get your program. You can conveniently manage your deductible. For Coverage prescription filled at one prescriptions online while saving time and example, if your Get to Know of the thousands money. Enroll online at express-scripts.com. doctor writes a of Express Scripts Your HSA Note: For maintenance medications, the prescription that participating pharmacies Plan requires that you use the mail order costs $150, you’ll around the country. Visit USING THE HSA program beginning after the third fill. pay the full $150 express-scripts.com to TO PAY FOR CARE Otherwise, even after you have met your at the pharmacy if locate a participating deductible, you will have to pay 100% of the you haven’t met the pharmacy. LEARN MORE discounted cost of the drug. combined medical/ prescription drug deductible for the year. If you Whether You Are Using A Retail Pharmacy or Mail Order, Remember: have, you’ll only 1. You will need to present your Express Scripts ID card when you pick up your prescription at a pay a percentage retail pharmacy. Remember, your prescription drug card is separate from your Anthem health of the cost. You plan ID card. can use your HSA to pay for any of 2. The health plan annual deductible applies to all prescriptions, so you’ll need to meet the these prescription deductible before the Plan begins to share the cost. This means you pay 100% of the cost of your expenses. prescriptions until you satisfy the deductible. 3. Once you’ve met the deductible, you’ll pay your share of the discounted cost of the drug (based on the type of prescription drug: Generic/Preferred, Non-Preferred or Patient Choice). 4. Use your HSA to pay your pharmacist by debit card or with your HSA checkbook, or pay out-of- pocket and get reimbursed later. Learn more about using your HSA to pay for eligible expenses.

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CDHP AND HSA BASICS GET TO KNOW YOUR HEALTH SAVINGS ACCOUNT (HSA) CDHP at a Glance One of the best things about the CDHP is that it gives you access to a Health Savings Account (HSA). How Your Medical HOW YOUR HSA IS FUNDED Care Is Covered You contribute to an HSA with pre-tax dollars. Depending on the CDHP option you elect, Paying for The Hartford may contribute to your account, too: In-Network Care • Contributions from You. You can contribute to your HSA on a pre-tax basis, up to the annual What Happens IRS maximum. If you are age 55 or older, you can make an additional annual catch-up contribution. When You Visit Your Health Care • Contributions from The Hartford. If you enroll in either the Value or Standard option, Provider? The Hartford will contribute either $400 if you have individual coverage or $800 if you cover family members each year (prorated if you enroll after January 1)—provided you have opened your Prescription Drug account. Be sure to visit NetBenefits to open your account. Coverage

Get to Know HSAs OFFER A TRIPLE TAX ADVANTAGE Your HSA • You can contribute on a pre-tax basis.

USING THE HSA • The withdrawals you make to pay for qualified TO PAY FOR CARE health care expenses are tax-free. • And, any investment earnings are tax-free!* LEARN MORE

*All references to “tax-free” refer to federal income tax. State tax laws may vary. Also keep in mind that investing involves risk. The value of your investment will fluctuate over time, and you may gain or lose money.

13 WELCOME HOW THE HSA WORKS FOR HEALTH CARE EXPENSES CDHP AND HSA BASICS Health Savings Accounts are used to pay for current and future health care expenses. They never expire; unused balances automatically carry over year-to-year, and the money is yours even if you go to a new employer, retire or transfer it to another HSA. If you enroll in a CDHP option, CDHP at a Glance consider using your premium savings to invest in a pre-tax HSA. Here’s how it works: How Your Medical Care Is Covered Paying for Money goes in Money In-Network Care 1 2 3 tax-free carries over What Happens When You Visit Your Health Care Use it to pay qualified health Provider? Money care expenses comes out You never forfeit Prescription Drug for you or tax-free unused funds Coverage your covered dependents There is no carry Get to Know over limit Your HSA Your balance OR stays with you USING THE HSA when you retire TO PAY FOR CARE or leave for any You and the company Pay for care out- reason combined can Money LEARN MORE stays in of-pocket and contribute, up to the allow your HSA annual IRS maximum. and may balance to grow, grow, You can make a with investment $1,000 annual catch- tax-free earnings up contribution if you are age 55 or older.

Only the CDHP with an HSA offers a triple-tax advantage and the ability to plan for health costs over the long term— not just year-to-year.

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CDHP AND HSA BASICS BUILDING YOUR HSA BALANCE

CDHP at a Glance See below for the maximum amount you can contribute on a pre-tax basis for 2016 based on the CDHP option you How Your Medical elect. Remember, you can change the amount of your HSA contributions any time during the year as your needs Care Is Covered change, so you may want to keep the IRS maximums in mind. To change your contributions, visit NetBenefits.

Paying for CDHP Basic CDHP Standard CDHP Value In-Network Care The Hartford’s Contribution None $400 individual $400 individual What Happens $800 family $800 family When You Visit Your Maximum HSA Contribution for 2016 $3,350 individual $2,950 individual $2,950 individual Your Health Care $6,750 family $5,950 family $5,950 family Provider? IRS Maximum HSA Contribution for 2016 $3,350 individual $3,350 individual $3,350 individual (Your contributions + The Hartford’s $6,750 family $6,750 family $6,750 family Prescription Drug contributions) Coverage Additional Catch-Up Contribution $1,000 $1,000 $1,000 Get to Know (If you are age 55 or older) Your HSA

USING THE HSA USING HSA FUNDS FOR FAMILY MEMBERS TO PAY FOR CARE Funds from your HSA can be used to pay for expenses incurred by your tax dependents, including your spouse and children. However, generally you cannot use your HSA funds to pay for expenses LEARN MORE of family members whom you cannot claim as tax dependents on your tax return—for example, a domestic partner or your adult child who is covered under your health plan but is not considered a tax dependent according to IRS regulations.

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CDHP AND HSA BASICS USE YOUR HSA FOR FUTURE CDHP at a Glance HEALTH CARE EXPENSES How Your Medical The money in your HSA is yours to use now and in the future— Care Is Covered it’s your choice. So, if you don’t use all of the money in your HSA during the year, it will carry over to the next year and you will Paying for build savings to use for future health care expenses. You own your In-Network Care HSA, not The Hartford, so the money is yours to take with you. The CDHP offered in conjunction with an HSA gives you greater What Happens control of your health care spending. When You Visit Your Health Care • You can take your HSA balance with you—wherever you go! Provider? If you switch to another high deductible health plan—such as your spouse’s plan—or if you leave The Hartford, you can Prescription Drug continue to use your HSA balance to pay for qualified expenses. Coverage • Investment options. Once your HSA balance reaches a certain Get to Know amount ($2,500 for most investment options), you can choose to Your HSA invest your balance among a broad range of investment options managed by Fidelity. The minimum balance may be lower for USING THE HSA some investment options. For more details, go to NetBenefits, TO PAY FOR CARE select “Health Savings Account” and choose “Contributing and Investing.” You will be notified by Fidelity once your account LEARN MORE reaches the $2,500 minimum.

CHECKING YOUR HSA BALANCE IS EASY… When you open an HSA, you can check your balance at any time. Log on to NetBenefits, Click on Health & Insurance, then click on your Health Savings Account benefit.

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CDHP AND HSA BASICS USING THE HSA TO PAY FOR CARE USING THE HSA HOW MUCH SHOULD YOU SET ASIDE IN YOUR HSA? TO PAY FOR CARE When you enroll in a CDHP and HSA, it’s very important to understand the cost for care and how How Much Should the plan works so you can accurately budget for your health care expenses. Knowing the general cost You Set Aside in of your medical care can help you ensure that you set aside enough money to cover any upcoming Your HSA? expenses. You’ll need to cover your plan’s deductible with out-of-pocket funds or the money in your Using Your HSA HSA. So you’ll want to make sure to budget and plan ahead. A good place to start is by reviewing your past expenses. You can access this information on your claims administrators’ websites (Anthem, LEARN MORE Express Scripts or Delta Dental). Remember, when you have an HSA, you can change your contributions during the year if your health care or financial needs change by visiting NetBenefits.

REMEMBER TO OPEN YOUR HSA You must visit NetBenefits to open your HSA. You can access HSA information by clicking on Health Savings Account under Featured Resources on the NetBenefits home page. Remember, you must establish an account online to be eligible to contribute your own money and receive The Hartford’s contribution—so don’t miss out!

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CDHP AND HSA BASICS USING YOUR HSA

USING THE HSA You have four options to choose from when paying for qualified medical expenses from your HSA: TO PAY FOR CARE 1. USE THE FIDELITY HSA® 2. PAY ONLINE WITH FIDELITY BILLPAY® FOR HSAs How Much Should DEBIT CARD You Set Aside in This convenient service enables you to make online payments Your HSA? The HSA debit card is a signature-based for qualified medical expenses to health care providers, 1card and does not require a personal 2companies and individuals. Additionally, you can set up an Using Your HSA identification number (PIN). Funds come automatic schedule for recurring payments, keep track of directly from the cash available in your all bill payments and reimburse yourself for out-of-pocket LEARN MORE HSA and payment details show up on qualified medical expenses. your account statement so you can track You can also choose to go paperless by signing up to receive the expenses paid from your account. an eBill with providers who offer electronic billing. You’ll If you request an HSA debit card receive an email notification when your online bill is available when you open your HSA, you and posted to your HSA BillPay account. This free online will automatically receive it within service lets you pay bills electronically as long as you have approximately two weeks. To request Internet access. Visit NetBenefits to enroll. one at a later time, visit NetBenefits to complete the Debit Card Application for yourself or the Supplemental Debit Card 4. PAY OUT OF POCKET AND REQUEST Application to obtain an HSA debit card A REIMBURSEMENT for your spouse or dependent. If you pay out of pocket for a qualified health care expense, 4you can get reimbursed from your HSA in one of four ways: 3. WRITE A FIDELITY HSA CHECK • Transfer money from your HSA into an existing Fidelity account or an outside bank account. Like the debit card, a Fidelity HSA check pays directly from the cash available in • Request a check for yourself electronically through Fidelity 3your HSA and records the transaction BillPay for HSAs. on your monthly account statement. • Write yourself a check using your HSA checkbook. Additional fees may apply. To request an HSA checkbook please complete • Contact Fidelity to request that a withdrawal check be the Checkwriting Form available on mailed to you or to transfer money from your HSA to NetBenefits. another account.

Remember, money left in your HSA is yours—money will carry over from year to year allowing you to build savings for future eligible expenses.

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CDHP AND HSA BASICS USING HSA FUNDS FOR OTHER KINDS OF EXPENSES USING THE HSA TO PAY FOR CARE You can withdraw money from your HSA for any reason. But keep in mind that there are tax implications if you use the funds How Much Should for non-eligible expenses. If you withdraw money before you You Set Aside in reach age 65 and don’t use it for eligible health expenses, you will Your HSA? pay a 20% penalty. Also, the money will be treated as ordinary income and subject to taxes (regardless of your age). To avoid Using Your HSA paying unnecessary taxes, be sure to think carefully at the time of purchase. For example, if you grab a pack of gum at the pharmacy LEARN MORE while picking up your prescription, use your HSA for the prescription only and pay for the gum with other money.

After the calendar year ends, your W-2 will show any contributions made by you or The Hartford to your HSA. In addition, you will receive a 1099-SA, which shows the withdrawals from your HSA. It’s important to keep all of your Explanation of Benefits forms and receipts throughout the year in case you’re audited. You’ll also receive a Form 5498-SA from Fidelity. This form is used to report distributions made from a health savings account (HSA). Keep this form with your tax return copies in case you’re audited.

DO YOUR PART TO MANAGE YOUR HEALTH CARE COSTS One of the best ways to manage your costs is by preventing serious and costly conditions in the future. Be sure to have preventive exams and screenings, and take advantage of The Hartford’s wellness programs to help you stay healthy, reduce your risks and, if applicable, manage a chronic condition. Learn more by viewing the Wellness eBook.

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CDHP AND HSA BASICS LEARN MORE USING THE HSA For information about the CDHP, visit NetBenefits to review the Summary Plan Description (SPD) or watch the short TO PAY FOR CARE descriptive CDHP and HSA videos on the Benefits Resource Site.

LEARN MORE MANAGING YOUR HSA Managing After you open your HSA, visit Your HSA NetBenefits to: Contact • View your account balance. Information • Access investment information and Important Terms make investment transactions. • Find forms and applications (debit card application, check writing form, automated BillPay, etc.). • Access tools and information. • Maintain beneficiary information. • Change your address.

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CDHP AND HSA BASICS CONTACT INFORMATION

USING THE HSA For… Contact… At… TO PAY FOR CARE General benefit questions HR Service Center 1-877-HR-AT-WORK (877-472-8967), say and and help using your HSA ‘Health Care, Savings or Retirement,’ or LEARN MORE www.netbenefits.com/thehartford Managing Health plan coverage Anthem 1-800-801-6308 Your HSA questions or online at www.anthem.com Prescription drug coverage Express Scripts 1-800-233-7840 Contact questions or online at www.express-scripts.com Information HSA information HR Service Center 1-877-HR-AT-WORK (877-472-8967), say Important Terms ‘Health Care, Savings or Retirement,’ or www.netbenefits.com/thehartford

Health-related information ConsumerMedical 888-361-3944, Monday through Friday, 8:30 a.m. to 5 p.m. ET or online at www.myconsumermedical.com/TheHartford Wellness program information My Wellness at Work 1-855-651-2910 or online at www.mywellnessmywork.com

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CDHP AND HSA BASICS IMPORTANT TERMS

USING THE HSA Annual Deductible TO PAY FOR CARE The amount you pay for covered services each calendar year before the plan begins to pay benefits. The amount paid toward the deductible also applies toward the out-of-pocket maximum. LEARN MORE Coinsurance The percentage you pay for most covered expenses after you’ve met the annual deductible. Managing Your HSA Generic Drug A drug product that is comparable to a brand/reference listed drug product in dosage form, strength, Contact route of administration, quality and performance characteristics, and intended use—yet, is available at a Information lower cost than brand equivalents. Important Terms In-Network Refers to doctors or healthcare facilities that are part of your medical plan’s network. Your deductible, coinsurance, and out-of-pocket maximums are generally lower for in-network care compared to out-of- network care. Out-of-Pocket Maximum The most you pay each calendar year for covered services. Your deductible and coinsurance count toward your out-of-pocket maximum. Once you meet the out-of-pocket maximum, the plan pays 100% for covered expenses for the rest of the year (excluding expenses above the Maximum Allowed Amount, if out-of-network or penalties). Patient Choice Drugs Express Scripts classifies patient choice drugs as drugs taken by choice, rather than medical necessity, such as non-sedating antihistamines, weight loss drugs and drugs used to treat infertility and erectile dysfunction. Preventive Care Routine physical exams and health screenings (like routine blood tests, immunizations, Pap smears, prostate screenings, and other age-appropriate health screenings), as defined by Health Care Reform. Such Preventive Care services are generally covered at 100% when received through an in-network provider. Tax Dependent All dependents you can claim on your tax form. Please see IRS regulations at www.irs.gov for specific examples.

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