IMC Enrollment Guide 2022

Dental Maximum RolloverSave Your Unused Claims Dollars For When You Need Them MostGuardian will roll over a portion of your unused annual maximum into your personal Maximum Rollover Account (MRA). If you reach your PlanAnnual Maximum in future years, you can use money from your MRA. To qualify for an MRA, you must have a paid claim (not just a visit) andmust not have exceeded the paid claims threshold during the benefit year. Your MRA may not exceed the MRA limit. You can view yourannual MRA statement detailing your account and those of your dependents on www.GuardianAnytime.com.Please note that actual maximum limitations and thresholds vary by plan. Your plan may vary from the one used belowas an example to illustrate how the Maximum Rollover functions.* If a plan has a different annual maximum for PPO benefits vs. non‐PPO benefits, ( 1500 PPO/ 1000 non‐PPO for example) thenon‐PPO maximum determines the Maximum Rollover plan.Here’s how the benefits work:YEAR ONE: Jane starts with a 1,000 Plan Annual Maximum. Shesubmits 150 in dental claims. Since she did not reach the 500Threshold, she receives a 250 rollover that will be applied to Year Two.YEAR TWO: Jane now has an increased Plan AnnualMaximum of 1,250. This year, she submits 50 in claims andreceives an additional 250 rollover added to her Plan Annual Maximum.YEAR THREE: Jane now has an increased Plan Annual Maximumof 1,500. This year, she submits 1,200 in claims. All claimsare paid due to the amount accumulated in her Maximum Rollover Account.YEAR FOUR: Jane’s Plan Annual Maximum is 1,300 ( 1,000 PlanAnnual Maximum 300 remaining in her Maximum Rollover Account).NOTES:You and your insured dependents maintain separate MRAs based on your own claim activity. Each MRA may not exceed the MRAlimit.Cases on either a calendar year or policy year accumulation basis qualify for the Maximum Rollover feature. For calendar yearcases with an effective date in October, November or December, the Maximum Rollover feature starts as of the first full benefityear. For example, if a plan starts in November of 2013, the claim activity in 2014 will be used and applied to MRAs for use in2015.Under either benefit year set up (calendar year or policy year), Maximum Rollover for new entrants joining with 3 months or lessremaining in the benefit year, will not begin until the start of the next full benefit year. Maximum Rollover is deferred for memberswho have coverage of Major services deferred. For these members, Maximum Rollover starts when coverage of Major servicesstarts, or the start of the next benefit year if 3 months or less remain until the next benefit year. (Actual eligibility timeframe mayvary. See your Plan Details for the most accurate information.)Guardian's Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America or its subsidiaries,New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features mayincur additional costs. Plan documents are the final arbiter of coverage.The service categories and plan limitations shown above represent an overview of your Plan of Benefits. Please see your Plan description/Insurancecertificate for complete details. In the event of a conflict with this summary, the terms of your insurance certificate will govern.9 2018 Brown & Brown, Inc. All rights reserved.

WELCOME TO OPEN ENROLLMENTIberia Medical CenterLONG TERM DISABILITY INCOME BENEFITS(RELIANCE STANDARD)Iberia Medical Center provides full‐time employees with long‐term disability income benefits. Without disabilitycoverage, you and your family may struggle to get by if you miss work due to an injury or illness.At Iberia Medical Center, we want to do everything we can to protect you and your family. That’s why IberiaMedical Center pays for the full cost of long‐term disability insurance—meaning that you owe nothing out ofpocket. This coverage is provided by Reliance Standard Life Insurance Company.In the event that you become disabled from a non‐work‐related injury or sickness, disability income benefits willprovide a partial replacement of lost income. The waiting period for this benefit is the first of the monthfollowing 6 months of continuous employment.Class 1 EmployeeClass 2 EmployeeBenefits BeginAfter 90 DaysAfter 180 DaysBenefits PayableTo Age 652 YearsPercentage of IncomeReplaced60% of Monthly Income60% of Monthly IncomeMaximum MonthlyBenefit 10,000 10,000Your class is dependent upon your job title. Class can be verified on yourbenefit summary or with someone on the NetEnroll team during your enrollment.BASIC LIFE INSURANCE(RELIANCE STANDARD)Iberia Medical Center provides full‐time employees group life and accidental death and dismemberment(AD&D) insurance and pays the full cost of this benefit. This coverage is insured through Reliance StandardInsurance Company. Job class determines the amount of coverage with the minimum initial amount being 12,500 for active employees. There are reductions at age 65, age 70 and at age 75. This coverage is providedby Reliance Standard Insurance Company. The waiting period for this benefit is the time from hire to the first ofthe month after 90 days of continuous employment.10

WELCOME TO OPEN ENROLLMENTIberia Medical CenterHEALTH SAVINGS ACCOUNTSHealth savings accounts (HSAs) are a great way to save money and budget for qualified medical expenses. HSAsare tax‐advantaged savings accounts that accompany high deductible health plans (HDHPs). HDHPs offer lowermonthly premiums in exchange for a higher deductible (the amount you pay before insurance kicks in).WHAT ARE THE BENEFITS OF AN HSA?There are many benefits of using an HSA, including the following: It saves you money. HDHPs have lower monthly premiums, meaning less money is being taken out of yourpaycheck.It is portable. The money in your HSA is carried over from year to year and is yours to keep, even if youleave the company.It is a tax‐saver. HSA contributions are made with pre‐tax dollars. Since your taxable income is decreasedby your contributions, you’ll pay less in taxes.The maximum amount that you can contribute to an HSA in 2022 is 3,600 for individual coverage and 7,200for family coverage.Additionally, if you are age 55 or older, you may make an additional “catch‐up” contribution of 1,000. You maychange your contribution amount at any time throughout the year as long as you don’t exceed the annualmaximum.11

WELCOME TO OPEN ENROLLMENTIberia Medical CenterVOLUNTARY LIFE INSURANCE(RELIANCE STANDARD)Employees who want to supplement their group life insurance benefits may purchase additional coverage.When you enroll yourself and/or your dependents in this benefit, you pay the full cost through bi‐weekly payrolldeductions. You can purchase coverage on yourself in 10,000 increments. Minimum coverage is 10,000 andmaximum coverage is 190,000 (GI). Coverage on your spouse is in 5,000 increments up to 50,000 (GI).Coverage on children is in 2,000 increments up to 10,000. This coverage is insured through Reliance StandardLife Insurance Company. Amounts above Guaranteed Issue (GI) can be applied for with medical questions andfull underwriting. It may or may not be approved depending on health.Premiums depend on your age and amount of insurance requested. The waiting period for this benefit is thefirst of the month after 90 days of continuous employment.Employee RatesSECTION 125 PREMIUM ONLY PLANThe Internal Revenue Service will allow you to pay for health, dental, and vision insurance premiums before taxes,thus resulting in a TAX SAVINGS to you!Spouse Rates12

WELCOME TO OPEN ENROLLMENTIberia Medical CenterADDITIONAL BENEFIT OFFERINGSThe following Voluntary Workforce Benefits are being offered by Iberia Medical Center. These benefits will bepaid by you through bi‐weekly payroll deductions. Iberia Medical Center does not contribute to the cost ofthese benefits.CANCER INSURANCE(COLONIAL)Chances are someone you know has been diagnosed with cancer.When those medical emergencies occur, people are suddenly faced with lengthy medical treatment, drasticlifestyle changes, and uncertain futures. At the same time, most people are also not equipped to handle themountain of medical bills and associated expenses that their medical insurance may not cover. You canprepare for such an occurrence by having a cancer insurance policy that will pay benefits directly to you thatwill help cover the costs of you or your dependents treatment.Per Paycheck RatesEmployeeFamily 10.41 17.30ACCIDENT COVERAGE(RELIANCE STANDARD)Accidents and unexpected injuries are a fact of life.Even the healthiest and most safety‐conscious people can find themselves on the wrong end of a mishap.Accident Insurance is a way for you to help pay for medical bills and other out of pocket expenses that oftenarise after an unexpected injury that occurs off‐the‐job – from the football field to the ski slope and the highwayin‐between.EmployeeEmployee & SpouseEmployee & ChildrenFamily 5.99 10.23 11.59 15.9613

WELCOME TO OPEN ENROLLMENTIberia Medical CenterEmployee . 3.47Employee & 1 Dependent (either a Spouse or 1 Child) 6.74Employee & 2 or more Dependents . 9.88(can be a combination of Spouse & Child(ren)14

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WELCOME TO OPEN ENROLLMENTIberia Medical CenterPET INSURANCE (NATIONWIDE) Get 90% / 70% / or 50% (your choice) back on Vet Bills (some exclusions apply)Open to all agesMore than just accident and illness coverageEasy EnrollmentOption to cover WellnessGet a Quote and Enroll online at: www.petinsurance.com/iberiamedicalcenter ORCall to get a Quote and Enroll ‐ 877‐738‐1874YOU MUST TELL THEM YOU WORK FOR IBERIA MEDICAL CENTERID THEFT PLAN (IDSHIELD) Every two seconds someone becomes a VICTIM OF IDENTITY THEFT#7 Reported Fear by AmericansHaving and ID Theft Plan can help stop criminals before substantial damage is doneIDShield Plan PricingEmployeeFamily 4.13 per paycheck 8.75 per paycheckLEGAL PLAN (LEGALSHIELD)Under the protection of LegalShield, you don’t have to worry about high hourly costs, or about figuring outwhich attorney to use.LegalShield Plan PricingEmployeeFamily 7.82 per paycheck 8.75 per paycheckCOMBINATION IDSHIELD & LEGALSHIELDCombination IDShield AND LegalShield Plan PricingIndividual IDShield and LegalShield 11.95 per paycheckFamily IDShield and LegalShield 15.65 per paycheckFamily LegalShield plus Individual IDShield 12.88 per paycheckFamily IDShield plus Individual IDShield 16.57 per paycheckEnrollment will be online at the following address: www.legalshield.com/info/iberiamedicalcenter21

WELCOME TO OPEN ENROLLMENTIberia Medical CenterIf you do not make changes to your current elections, those elections will remain the same forthe plan year Jan. 1 to Dec. 31, 2022. Premiums for age or salary rated benefits may change.QUESTIONS & ANSWERSWHAT CHANGES ARE EFFECTIVE JAN. 1, 2022?1.) MEDICAL RATES ARE CHANGING2.) VISION RATES ARE CHANGING3.) THE DENTAL PLAN AND DENTAL RATES ARE CHANGINGWHAT FORMS MUST BE COMPLETED TO ENROLL OR MAKE CHANGES?You can enroll online (on Netchex) for most benefits this year. The exceptions are Cancer Insurance, PetInsurance, IDTheft, and LegalShield. You can also call Net Enroll. For Cancer, you must contact Net Enroll (Combined Benefit Administrators). They can be reached at844‐760‐5570. For Pet, IDTheft, and LegalShield, you must use their website or call them. For Pet Insurance Enroll online at: www.petinsurance.com/iberiamedicalcenter OR Call to get aQuote and Enroll ‐ YOU MUST TELL THEM YOU WORK FOR IBERIA MEDICAL CENTER ‐ 877‐738‐1874 For IDTheft and LegalShield go online to www.legalshield.com/info/iberiamedicalcenterThe information in this Enrollment Guide is presented for illustrative purposes and is based on informationprovided by the employer and coverage providers. The text contained in this guide was taken from varioussummary plan descriptions and benefit information. While every effort was taken to accurately report yourbenefits, discrepancies or errors are always possible. In case of discrepancy between the guide and actual plandocuments, the actual plan documents will prevail. All information is confidential, pursuant to the HealthInsurance Portability and Accountability Act of 1996. If you have any questions about the guide, please contactHR.22

WELCOME TO OPEN ENROLLMENTIberia Medical CenterNON‐INSURANCE EMPLOYER PROVIDED BENEFITSPAID TIME OFF PTO Time accrues according to status and hours paid each pay period. If hours worked for Full TimeEmployees total less than 72, or for Part Time Employees, less than 56 for a pay period, PTO will accrueaccording to a proportionate amount per hour for hours actually worked. Vacation and Holiday (PTO)o Full time and Part Time employees are eligibleo Iberia Medical Center pays for this benefito Employees are eligible after 90 days of employmento Includes Vacation and Holiday* payFull Time Employees1–4 yrs 144 hours (5.54 per pay period)80 hours paid vacation5‐9 yrs 184 hours (7.08 per pay period)120 hours paid vacation10‐19 yrs 224 hours (8.61 per pay period)160 hours paid vacation20 yrs 264 hours (10.15 per pay period)200 hours paid vacationPart time Employees 1–4 yrs 72 hours (2.77 per pay period)40 hours paid vacation5‐9 yrs 92 hours (3.43 per pay period)60 hours paid vacation10‐19 yrs 112 hours (4.31 per pay period)80 hours paid vacation20 yrs 132 hours (10.15 per pay period)100 hours paid vacationHoliday Payo Full time employees receive 8 (8 hour) paid holidays per yearo Part time employees receive 8 (4 hour) paid holidays per yearo The accrual is included in Paid Time Offo If an employee is required to work on a major holiday (*), time and one half will be paid forhours worked from 12:01 am to midnight on the specified day. If employee is already inovertime, double overtime will not be paid. Department Manager must approve overtimehours.23

WELCOME TO OPEN ENROLLMENTIberia Medical CenterHolidaysNew Year’s Day*Mardi Gras*Good Friday*Independence Day*Memorial DayLabor DayThanksgiving Day*Christmas Day* Sick Payo Full Time and Part Time employees are eligible.o Iberia Medical Center pays for this benefit.o Employees are eligible after 90 days of employment. Full time employees are eligible for 3.39 hours per pay period or 88 hours per year. Part time employees are eligible for 1.7 hours per pay period or 44 hours per year. Sick Pay accrues according to status and hours paid each pay period. If hours paid forFull Time Employees total less than 72, or for Part Time Employees, less than 56 for apay period, Sick Time will accrue according to a proportionate amount per hour foractual hours paid. Jury Dutyo Full Time and Part Time employees are eligible.o Iberia Medical Center pays for this benefit.o Employee are eligible immediately.o IMC pays base pay for regularly schedule hours missed due to jury duty. Bereavement Payo Full Time and Part Time employees are eligible.o Iberia Medical Center pays for this benefit.o Employees are eligible after 90 days of employment.o Up to three days off with pay for a death in the immediate family (up to 24 hours for full time,up to 12 hours for part time).24

WELCOME TO OPEN ENROLLMENTIberia Medical CenterADDITIONAL BENEFITS Family Medical Leave Acto Qualified employees are eligible.o Iberia Medical Center pays for this benefit.o Employees are eligible after 12 months of employment encompassing 1250 hours of work.o Up to 12 weeks of unpaid leave per year for serious health conditions of yourself or immediatefamily member, or birth or adoption of a child, with a guarantee that you can return to yourjob, or a similar one at the end of the 12 weeks. Additional leave available for military familymembers. Eligible accrued time (PTO and Sick if applicable) must be taken first.o Employees must continue paying the employee portion of benefit premiums to continue theirbenefits while out on leave. Workers Compensationo All employees.o Iberia Medical Center pays for this.o Employees are eligible immediately.o Medical payments and lost time will be paid in accordance with state regulations.o There is a waiting period of seven days before indemnity benefits apply. Liability Coverageo All employees receive.o Iberia Medical Center pays for this benefit.o Employees are eligible immediately.o Iberia Medical Center provides at no cost to the employee, professional liability coverage andmaintains continuing professional liability insurance, as well as general liability insurance. (IMCrecommends enrollment in private professional liability insurance). Medicareo All employees.o Iberia Medical Center and the employee contribute.o Hospital matches the amount withdrawn from payroll (1.45%).o Employee is eligible upon reaching the Medicare eligibility age. Social Securityo IHR, PRN, and Relief Employeeso Iberia Medical Center and the employee contribute.o Hospital matches the amount withdrawn from payroll (6.2%).o Employee is eligible upon reaching the eligibility age which varies by date of birth.25

WELCOME TO OPEN ENROLLMENTIberia Medical Center Deferred Compensation (LA State Deferred Compensation Plan and Voya)o All Employeeso Employee pays for thiso Eligible immediatelyo Employees contribute up to the annual limit on a pre‐tax basis with personal investmentchoices and withdrawal of funds available upon termination or retirement Unemployment Compensationo All Employeeso Iberia Medical Center and the employee contributeo Eligible in accordance with state regulationso Weekly benefits Continuing Educationo All employeeso Iberia Medical Center pays for this benefito Eligible immediatelyo In‐house continuing education through the CareLearning online training program Employee Discountso All employeeso Iberia Medical Center pays for this benefito Eligible immediatelyo Discounts in Jim’s Bayou Bistro and the Gift Shop when weari

IMC Done Elsewhere Tier 4 Out of Network ‐ Individual 2,500 3,000 6,000 6,000 0 1,500 4,000 5,000 ‐ Family 5,000 6,000 12,000 12,000 No Family Deductible Out‐of‐Pocket Max Tier 1 IMC Tier 2 In Network Tier 3 Available at IMC Done Elsewhere Tier 4 Out of Network