Stryker Benefits Summary Stryker is pleased to provide you with this summary plan description For More (“SPD” or “Benefits Summary”) describing the healthcare, welfare and Information retirement benefits available to eligible Stryker employees as of January 1, Administrative details 2021. and procedures for Stryker’s healthcare When the unexpected occurs—a serious illness, a long absence from work, and welfare plans can even death—we count on Stryker-sponsored healthcare and welfare be found in the Your Rights and benefits for financial protection. In addition, Stryker Corporation sponsors Responsibilities the Stryker Corporation 401(k) Savings and Retirement Plan so that you section. and other employees of Stryker and its participating subsidiaries (all (Administrative information about the referred to in this Summary as the “Company”) may save for retirement on 401(k) Savings and a “before-tax” basis. The benefits provided under the 401(k) Plan are in Retirement Plan is addition to Social Security. included within the 401(k) Retirement To get the maximum value from your benefit plans, you need to Plan section.) See Contacts for phone understand how they work: what’s covered, what’s not, who is eligible and numbers and web when. This Stryker Benefits Summary provides information about the plan addresses you can use provisions and guidelines governing your healthcare, welfare and for answers to your retirement benefits. questions. If you have questions The information presented in the Benefits Summary makes it easy to about the information in this Benefits understand your benefits. Consider this handbook, which is available in Summary, you can print and online at http://totalrewards.stryker.com/spd, your first also contact your resource whenever you have a question about what is covered, how to file Benefits claims or your rights as a plan participant. The benefits described are representative. summaries of the official plan documents and contracts, which govern the plans. They are written in plain language to help you understand how the plans work. When you have questions that are not answered here, please refer to the section called Contacts. The information provided in the Contacts section includes toll-free phone numbers and web site addresses for Stryker’s claims administrators and insurance carriers. Please contact the claim administrators or insurance carriers first when you have questions about coverage or claim status. As always, your Benefits representative is also available to assist you with complex questions or situations that require special handling. Stryker Benefits Summary - Effective 1/1/21 i Stryker Benefits Summary Table of Contents Stryker Benefits Summary ............................ i Clinical Trials ..................................... 53 About this Summary .................................... 1 Diabetes Services ................................ 54 Healthcare Benefits ..................................... 3 Enteral Nutrition ................................ 54 Participating in Healthcare Benefits .................... 5 Home Healthcare ............................... 54 Eligibility .................................................... 5 Skilled Nursing Facility/ Inpatient Ongoing Eligibility ............................... 6 Rehabilitation Facility Services ......... 55 Dependents ........................................... 6 Mental Health, Substance-Related and Enrollment ................................................. 8 Addictive Disorder and Neurobiological Making Changes ........................................ 9 Disorder Services ............................... 56 HIPAA Special Enrollment Rights ..... 10 Organ Transplant Benefits ................. 57 Life Event Guide—Healthcare .............12 Ambulance Services ........................... 58 Your Cost for Healthcare Benefits ............ 15 Durable Medical Equipment (DME).. 58 Tobacco Surcharge .............................. 15 Gender Dysphoria .............................. 59 Non-Grandfathered Status ...................... 16 Hearing Aids ....................................... 60 When Coverage Begins ............................ 16 Hyperhidrosis Treatment ................... 61 When Coverage Ends ............................... 16 Fertility Services and Fertility Solutions COBRA: Continuing Healthcare Coverage17 (FS) Program ...................................... 61 Continuing Healthcare Coverage upon Lab, X-ray and Diagnostic - Outpatient62 Military Leave .......................................... 20 Nutritional Counseling ....................... 63 If You Have Other Coverage .....................21 Obesity Surgery .................................. 63 Medical Benefits ................................. 22 Prosthetic Devices .............................. 63 Dental Benefits ................................... 24 Specialty Pharmacy ............................ 64 Medical Benefits ................................................. 25 Urinary Catheters ............................... 64 Stryker’s Medical Options ....................... 25 Virtual Visits ....................................... 65 How the UnitedHealthcare Plans Work .. 26 Expenses Not Covered ............................. 65 Your Choices for Receiving Care ........ 26 How to Obtain Medical Benefits ............. 69 Participating Providers ...................... 26 How to Reach UnitedHealthcare ....... 70 Medical Plan Definitions ......................... 70 UnitedHealth Premium℠ Program .... 27 Eligible Expenses ..................................... 27 Prescription Drug Benefits ........................ 79 Your Deductible ....................................... 29 How Prescription Drug Benefits Work ... 79 Your Share in the Cost of Covered Services30 How Prescription Drug Coverage Your Out-of-Pocket Maximum ................ 30 Works with the PPO Plans ................. 79 Your Medical Benefits .............................. 31 How Prescription Drug Coverage Benefit Maximums .................................. 33 Works with the Basic and Premium Special Services and Procedures ............. 34 HSA Plans ........................................... 80 UHC Health Advantage Program ...... 34 Expenses Covered at 100% under All Prior Authorization Requirements for UHC Plans .......................................... 81 the UnitedHealthcare Plans ............... 35 Covered Expenses for All UHC Plans 81 Special Note: Mental Health and Expenses Not Covered under All UHC Substance-Related and Addictive Plans ......................................................... 82 Disorder Services ............................... 37 How to Obtain Prescription Drug Benefits83 Second Surgical Opinions .................. 37 Medical and Rx Claims Procedures ............ 87 Clinical Programs and Resources ............ 37 Medical and Rx Benefits .......................... 87 Consumer Solutions and Self-Service Required Information ........................ 87 Tools ................................................... 38 Payment of Benefits ........................... 88 Condition Management Services ....... 39 Submitting Medical or Rx Benefit Claims88 Covered Medical Expenses ...................... 41 Initial Claim Determinations ............. 89 Maternity Benefits .............................. 50 If You Receive an Adverse Benefit Benefits for Outpatient Rehabilitation Determination .................................... 90 Services ............................................... 50 Review of an Adverse Benefit Preventive Care Benefits ..................... 51 Determination: What to Do First ....... 91 Cancer Resource Center (CRS) .......... 52 How to Appeal a Claim Decision ............. 91 Cancer Support Program ................... 53 Appeal Process ................................... 92 Cellular and Gene Therapy ................ 53 Vision Benefits ........................................... 97 How Vision Benefits Work ...................... 97 ii Stryker Benefits Summary - Effective 1/1/21 Stryker Benefits Summary When You Use Participating EyeMed Day Care (Child and Adult) Flexible Providers ............................................ 97 Spending Account (DCFSA) ................... 137 If You Use Non-Participating Providers98 How Much You Can Contribute ........ 137 Benefit Frequency .............................. 99 Eligible Expenses ............................. 138 Expenses Not Covered ............................. 99 Expenses Not Covered ..................... 138 How to Obtain Vision Benefits ................ 99 Failure to Cash Reimbursement Checks139 Time Frames for Processing Out-of- The Federal Tax Credit ..................... 139 Network Claims ..................................... 100 How to Obtain DCFSA Benefits ....... 139 Time Frames for Responding to Appealed Health Savings Account ........................... 143 Claims .................................................... 100 Health Savings Account (HSA) Member Grievance Procedure ............... 100 Participation .......................................... 143 How to Reach EyeMed .......................... 100 Eligibility .......................................... 144 Dental Benefits ......................................... 101 Enrolling in an HSA ......................... 144 How Dental Benefits Work ..................... 101 When Contributions Begin ............... 145 Schedule of Benefits .............................. 102 When HSA Contributions Stop ......... 145 Covered Dental Expenses ................. 102 How HSAs Work ....................................