Cigna Health Savings Account (HSA) Summary Plan Description

include laser vision correction, acupuncture, chiropractic care, weight loss programs, fitness club and equipment discounts, and more. The Basics Who is eligible? You are eligible to open a Health Savings Account only if you are covered under a federally qualified high deductible health plan, such as the one described in this booklet. You cannot be covered by Medicare or any other individual or group health plan that is not a federally qualified high deductible health plan. You can no longer contribute to the HSA once you: become entitled to Medicare due to age; or are no longer covered under a high deductible health plan. However, you will still be able to use the HSA funds for qualified health care expenses. How does it work? The Health Savings Account combines a health care plan with a tax-free savings account. 1. You, your employer or both may contribute to your account. Contributions are tax-free up to federal limits. 2. You choose how to pay for qualified health care expenses:  You may pay for qualified expenses on your own using a debit card, checkbook (if purchased) or online bill pay that draws from your health savings account.  You may choose the Automatic Claim Forwarding option, allowing qualifying medical expenses to be paid directly to your doctor, hospital, or other facility from your HSA. You can change your election at any time during the year.  You may choose to cover your expenses using other personal funds. This allows you to save the money in your HSA for qualified health care expenses in future years or at retirement. The balance in your savings account will earn interest. 3. Once you meet your deductible, you and your plan share the costs . Depending on your plan, you pay pre- determined coinsurance for certain services. Your employer determines the maximum amount of out-of- pocket expenses you pay each year. Once you meet the maximum, the plan pays covered expenses at 100%. Your HSA can be a tax-sheltered savings tool. Because your HSA rolls over year after year, and unused money accumulates tax-deferred interest, you have the option to pay for current qualified health care expenses out of your pocket and use the account to save for future qualified expenses. Please note: Your HSA contributions are not taxable under federal and most state laws. However, your contributions to

What You Should Know About Cigna Choice Fund ® – Health Savings Account Cigna Choice Fund is designed to give you: Control You decide how much you’d like to contribute (up to federal limits) to your Health Savings Account. You decide how and when to access your account. And the money in the account is yours until you spend it. Unused dollars remain in your account from year to year and earn interest. Choice You have the freedom to choose any licensed doctor, even those who do not participate with Cigna. Your costs are lower for services from Cigna contracted health care professionals and facilities because they have agreed to accept discounted payments to help you make the most of your health care dollars. Easy Access to your HSA Dollars You can draw money directly from your health savings account using your HSA debit card, checkbook (if purchased) or online bill pay. Or, you may choose automatic claim forwarding, which allows qualified medical claims to pay directly from your account to your doctor or hospital. Flexibility and Tax Savings You can also choose to pay for medical expenses out of your pocket until you reach the deductible, allowing you to save for qualified health care expenses in future years or retirement. You are not taxed on your HSA withdrawals unless you use the money to pay for nonqualified expenses. Health Information and Education Call the toll-free number on your ID card to reach Cigna's 24- Hour Health Information Line SM , giving you access to trained nurses and an audio library of health topics 24 hours a day. In addition, the Cigna Healthy Pregnancies, Healthy Babies ® program provides prenatal education and support for mothers- to-be. Tools & Support We help you keep track of your health and coverage with online benefits information, transactions, and account activity; medical and drug cost comparisons; monthly statements; and more. You also have 24/7/365 toll-free access to a dedicated Customer Service team, specially trained to answer your questions and address your needs. Savings on Health and Wellness Products and Services Through Cigna Healthy Rewards ® , you can save money on a variety of health-related products and services. Offerings

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