RSM 2024 Benefit Guide

Michelle ’ s Law Notice When a dependent child over the age of 26 loses student status under the eligibility policy of RSM Electron Power, Inc. group health plan coverage, as a result of a medically necessary leave of absence from a post-secondary educational institution, the RSM Electron Power, Inc. group health plan will continue to provide coverage during the leave of absence for the earlier end date of up to one year, or until coverage would otherwise terminate under the RSM Electron Power, Inc. group health plan.

To maintain eligibility and continue coverage as a dependent during such leave of absence:

• The RSM Health & Welfare Plan must receive written certification by a treating physician of the dependent child which states that the child is suffering from a serious illness or injury and that the leave of absence (or other change of enrollment) is medically necessary; and

• The dependent must be established as a disabled dependent as defined by the medical carriers.

To obtain additional information, please contact:

Susan Panagopoulos Director, Human Resources (631) 586-7600 Susan.panagopoulos@sensitron.com Women’s Health and Cancer Rights Act (WHCRA) Notice Enrollment Notice If you have had or are going to have a mastectomy, you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for:

• All stages of reconstruction of the breast on which the mastectomy was performed;

• Surgery and reconstruction of the other breast to produce a symmetrical appearance;

Prostheses; and

• Treatment of physical complications of the mastectomy, including lymphedema.

These benefits will be provided subject to the same deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. Therefore, the following deductibles and coinsurance apply:

Meritain Health HSA $600/$1,200; 80%

• Meritain Health Buy-Up $1,000/$2,000; 90%

If you would like more information on WHCRA benefits, contact your plan administrator:

Susan Panagopoulos

Director, Human Resources

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