JP Morgan Chase PDF Flip Book

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january 2011 highlights of the jpmorgan chase u.s benefits program

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what s inside about the jpmorgan chase u.s benefits program the health care and insurance plans medical plan dental plan vision plan spending accounts health care child/elder care transportation long-term disability ltd plan life and accident insurance plans long-term care insurance plan group personal excess liability insurance plan group legal services plan the retirement savings program 401k savings plan retirement plan employee stock purchase plan additional employee programs services important definitions appendix special notice for employees who have been reinstated by jpmorgan chase within 31 days additional reminders page 2 6 6 13 15 16 19 20 21 21 22 23 23 24 24 24 25 26 26 27 about eligibility the jpmorgan chase u.s benefits program described in this brochure is generally available in whole or in part to most employees on a u.s payroll who are g paid salary draw commissions or production overrides g employed by jpmorgan chase co or one of its subsidiaries to the extent that such subsidiary has adopted the jpmorgan chase u.s benefits program and g regularly scheduled to work 20 or more hours per week you are considered a full-time u.s benefits-eligible employee if you are regularly scheduled to work 40 hours per week you are considered a part-time benefits-eligible employee if you are regularly scheduled to work at least 20 but less than 40 hours per week have you worked for jpmorgan chase or any of its predecessor organizations in the past if yes then your prior service may count toward your eligibility and vesting for certain jpmorgan chase benefits plans for more specific information please see page 25 generally your health care and insurance plan benefits elections remain in effect throughout the calendar year in the case of most benefits plans you re not allowed to make changes to your elections until the next annual enrollment period unless you experience a qualified change in status if you experience a qualified status change such as marriage divorce the birth or adoption of a child you must make any eligible health care and insurance plan benefits changes within 31 days of the qualifying event if you miss the 31-day deadline coverage for certain benefits i.e medical dental vision and the health care spending account will be effective as of the date you contact the benefits call center and you may be required to pay for your coverage on an after-tax basis for the period prior to the date you first contact the benefits call center in order to have retroactive coverage otherwise you will not be able to make the change in coverage until an annual benefits enrollment period the jpmorgan chase u.s benefits program is available to most employees on a u.s payroll who are regularly scheduled to work 20 hours or more a week and who are employed by jpmorgan chase co or one of its subsidiaries to the extent that such subsidiary has adopted the jpmorgan chase u.s benefits program this information does not include all of the details contained in the applicable insurance contracts plan documents and trust agreements if there is any discrepancy between this information and the governing documents the governing documents will control jpmorgan chase co expressly reserves the right to amend modify reduce change or terminate its benefits and plans at any time the jpmorgan chase u.s benefits program does not create a contract or guarantee of employment between jpmorgan chase and any individual jpmorgan chase or you may terminate the employment relationship at any time 1 th ejpmorgancha se u s benefi ts program

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about the jpmorgan chase u.s benefits program jpmorgan chase is committed to providing a comprehensive set of benefits choices to meet different employee needs and life styles in return we ask our employees to take an active role in designing a personal strategy to help meet their short-term and long-term health care and insurance and retirement savings objectives this brochure provides an overview of the jpmorgan chase u.s benefits program for the definitions of eligible compensation pay credit service total annual cash compensation and total service used in the following table and throughout this brochure please see page 25 jpmorgan chase benefits at a glance benefit medical cov eragesummarygwhen pa rt i c i pat ionb eg i n s for new hires ggggggggghea lt hcareandinsuranceplans four coverage options depending on your home zip code point-of-service pos high option point-of-service pos low option exclusive provider organization epo option/health maintenance organization hmo option consumer driven health option plus tax-deferred health savings account in-network preventive care covered at 100 under most options all options include prescription drug coverage no exclusions for pre-existing conditions employee and dependent coverage including domestic partner coverage jpmorgan chase and employee cost sharing smoker/non-smoker rates apply employee contributions on a before-tax basis are generally determined based on your level of total annual cash compensation excluding overtime the medical option chosen where you live the number and type of dependents covered and your covered dependents smoker/non-smoker status three coverage options depending on your home zip code preferred dentist program pdp option dental maintenance organization dmo option dental health maintenance organization dhmo option traditional indemnity dental option employee and dependent coverage including domestic partner coverage jpmorgan chase and employee cost sharing employee contributions on a before-tax basis coverage for eligible vision expenses like eye exams lenses including contacts and eyeglass frames employee and dependent coverage including domestic partner coverage employee contributions on a before-tax basis health care spending account contributions up to $8,000 annually child/elder care spending account contributions generally up to $5,000 annually transportation spending accounts contributions for work commuting expenses for mass transit up to $120 monthly in 2011 and parking up to $230 monthly in 2011 employee contributions on a before-tax basis employee contributions on an after-tax basis for transportation spending accounts when expenses exceed before-tax limits referenced above for employees earning less than $60,000 in total annual cash compensation company-provided employee coverage of 60 of your total annual cash compensation fully paid for by jpmorgan chase for employees whose total annual cash compensation is $60,000 or more replacement of 50 of total annual cash compensation replacement of 60 of total annual cash compensation $20,000 maximum monthly ltd benefit employee contributions on an after-tax basis for employees whose total annual cash compensation is $400,000 or more ability to purchase additional ltd coverage under a fully portable individual disability insurance idi policy idi policy provides an additional maximum monthly ltd benefit of up to $15,000 fully portable smoker/non-smoker rates apply full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire dental g g g full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire g g g vision ggggg full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire spending accounts health care child/elder care transportation transit/parking long-term disability ltd insurance ggggggggggg full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire g g continued the anthem pos high or low option may be referred to as a preferred provider organization ppo indicates when participation begins if you enroll when first eligible if you do not enroll when you are first eligible your participation will not begin unless you enroll due to a qualified status change or during subsequent annual benefits enrollment periods this does not apply to long-term disability for employees whose total annual cash compensation is less than $60,000 transportation spending accounts long-term care basic life business travel accident insurance the retirement plan or the 401k savings plan th ejpmorgancha se u s benefi ts program 2

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jpmorgan chase benefits at a glance continued benefit basic life insurance cov eragesummaryggwhen pa rt i c i pat ionb eg i n s for new hires g g g company-provided employee coverage equal to one times eligible compensation rounded up to next $1,000 to a maximum of $100,000 additional features of the basic life insurance plan include survivorsupport® financial counseling service identity id theft assistance program travel assistance and emergency evacuation services funeral concierge services fully paid for by jpmorgan chase company-provided employee coverage equal to six times annual base salary minimum of $50,000 and maximum of $3 million fully paid for by jpmorgan chase employee coverage up to 10 times eligible compensation in $10,000 increments up to a maximum of $3 million spouse/domestic partner coverage from $10,000 to $300,000 in $10,000 increments child coverage equal to $5,000 or $10,000 per child employee and adult dependent smoker/non-smoker rates apply employee contributions on an after-tax basis employee coverage up to 10 times eligible compensation in $10,000 increments up to a maximum of $3 million spouse/domestic partner coverage from $10,000 to $600,000 in $10,000 increments child coverage from $10,000 to $100,000 in $10,000 increments per child employee contributions on an after-tax basis full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire business travel accident insurance g g first day of work with jpmorgan chase h e a lt hcareandinsuranceplans employee and dependent supplemental term life insurance employee and dependent accidental death and dismemberment ad&d insurance long-term care insurance ggggggggggg full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire ggggg employee and dependent coverage including spouse/domestic partner and employee s/spouse s/domestic partner s parents and grandparents choice of five daily benefit options with optional forfeiture protection feature employee contributions on an after-tax basis g g g full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire coverage for dependents becomes effective the first day of the month following date of approval by insurance carrier full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire group personal excess liability insurance g g g provides additional liability coverage in excess of the limits carried on your personal insurance policies such as homeowners or renters automobile watercraft etc you choose from among three levels of coverage $2 million $5 million $10 million employee contributions on an after-tax basis coverage for attorneys fees for routine legal services related to personal and family legal issues employee and dependent coverage including domestic partner coverage employee contributions on an after-tax basis g g group legal services ggggg full-time employees first day of the month following your date of hire part-time employees first day of the month following 90 days from your date of hire continued indicates when participation begins if you enroll when first eligible if you do not enroll when you are first eligible your participation will not begin unless you enroll due to a qualified status change or during subsequent annual benefits enrollment periods this does not apply to long-term disability for employees whose total annual cash compensation is less than $60,000 transportation spending accounts long-term care basic life business travel accident insurance the retirement plan or the 401k savings plan 3 th ejpmorgancha se u s benefi ts program

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jpmorgan chase benefits at a glance continued benefit 401k savings cov eragesummarygggwhen pa rt i c i pat ionb eg i n s for new hires gretirement sav ingsprogramggg before-tax and/or roth after-tax 401k contributions up to the legal limit 16,500 for 2011 up to 50 of eligible compensation up to the legal limit 245,000 for 2011 participants age 50 and over as of december 31 of any calendar year may be eligible to make catch-up contributions up to the legal limit 5,500 for 2011 matching contributions dollar-for-dollar on 5 of eligible compensation contributed to the plan for participants who have completed one year of total service and have total annual cash compensation of less than $250,000 calculated and credited to a participant s account annually following the end of each calendar year participants generally must be employed on december 31 of that year to be eligible to receive any matching contribution 100 vested after three years of total service if hired on or after may 1 2009 participants direct the investment of matching contributions 24 investment funds when you leave jpmorgan chase vested account balances are payable in the form of a single lump sum rollover to an ira or another qualified plan or installment payments jpmorgan chase and employee contributions g g full-time employees may enroll as of your first day of employment with jpmorgan chase part-time employees first day of the month following 90 days from your date of hire participants become eligible for matching contributions on the first day of the month following completion of one year of total service if eligibility criteria is met retirement cash balance pension plan gggggggg generally the first day of the month after participation begins automatically after one year of total service a n0tional account established in your name that grows with pay credits and interest credits completing one year of total service monthly pay credits from 3 to 5 of eligible compensation depending on completed years of pay credit service eligible compensation capped at $100,000 annually monthly interest credits 100 vested after three years of total service when you leave jpmorgan chase vested account balances are payable in the form of a single lump sum rollover to an ira or another qualified plan or a variety of annuity options fully paid for by jpmorgan chase purchase jpmorgan chase common stock quarterly at a 5 discount with dividend reinvestments no brokerage or commission fees employee contributions on an after-tax basis from $240 to $25,000 per year up to 20 of eligible compensation employees with total annual cash compensation of $250,000 or more are not eligible to participate g employee stock purchase ggggg must be hired on or before september 30 to participate in the following year election to participate only during an annual benefits enrollment period indicates when participation begins if you enroll when first eligible if you do not enroll when you are first eligible your participation will not begin unless you enroll due to a qualified status change or during subsequent annual benefits enrollment periods this does not apply to transportation spending accounts long-term care basic life business travel accident insurance the retirement plan or the 401k savings plan th ejpmorgancha se u s benefi ts program 4

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wellness program nothing is more important than the health of you and your family that s why jpmorgan chase offers a wellness program for you and your family our wellness program provides resources and services that can help you take charge of your health and make informed health care decisions for you and your family our wellness resources are also available to enrolled family members however the wellness rewards program is only available to employees at this time program wellness screening descri pt ionga health check that measures your blood pressure blood sugar cholesterol total hdl and ldl triglycerides and body mass index these numbers are indicators of your overall health so it s important to know them jpmorgan chase periodically offers free onsite wellness screenings at major locations or you can get one free through the jpmorgan chase medical plan when you go to an in-network doctor for your annual physical it s a confidential online health and lifestyle questionnaire that will take about 15 minutes to complete once completed you can then print your wellness profile a report that identifies what you re doing well provides recommended actions for improving your health and identifies potential health issues to discuss with your doctor health coaches can help you set goals to address certain potential health risks like creating an exercise program developing a healthy eating plan or building a plan to lower your blood pressure or cholesterol if weight or stress is affecting your ability to live an active and productive life you can enroll in one of the lifestyle management programs available either via the telephone or online these programs can support you through each step of a plan to set you on a path toward weight loss or stress management if you or a family member has a chronic condition such as asthma diabetes heart conditions or low back pain you can take advantage of the smart steps condition management program which uses nationally-recognized resources and industry-leading guidelines to help you manage your condition nurses and other health professionals are available 24 hours a day seven days a week to answer your health questions health advocate can help you find solutions to your health care or insurance-related issues such as locating and researching treatments for a medical condition resolution for your benefits claims scheduling appointments with hard-to-reach specialists and more the employee assistance and work-life program is a professional counseling consultation and referral service available to help our employees and their family members find solutions to the many challenges faced in managing work and personal lives the program includes referrals for professional confidential and free counseling assistance with adoption services adult and elder professional care management parenting resources and information financial and legal counseling relocation resources pet care and more eap services are free confidential and available 24 hours a day seven days a week at major locations jpmorgan chase provides health services clinics seasonal flu shots cafeterias offering healthy dining and backup childcare wellness assessment gwellne ss program careallies programs gggg health advocate g employee assistance worklife program g onsite support g earn wellness rewards you can earn up to $200 for completing healthy activities identified as part of the program like getting a wellness screening completing your wellness assessment exercising regularly and getting preventive care services the wellness assessment is your entry way to the wellness rewards program and is a required step to earn and redeem wellness rewards 5 th ejpmorgancha se u s benefi ts program

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the health care and insurance plans maintaining good health and protecting your income in case you re unable to work are important priorities in your life that s why jpmorgan chase offers a variety of options under our health care and insurance plans such as the medical dental vision spending accounts long-term disability life and accident insurance long-term care insurance group personal excess liability and group legal services plans to provide you with the opportunity to select health care and insurance benefits that best suit your needs and those of your eligible dependents medical plan jpmorgan chase offers several different types of medical options that provide a range of quality and flexible coverage the number of options available to you is based on where you live all options generally cover the same medically necessary services and supplies including prescription drugs under most medical plan options in-network preventive care services are fully covered there is no annual deductible or copayment subject to age and frequency guidelines here s a brief overview of each medical plan option point of service pos high option per-pay-period contributions point of service pos low option exclusive provider organization epo option health maintenance organization hmo1 option consumer driven health option cdho depends on the level of your total annual cash compensation the medical option you choose the number and type of eligible dependents you cover where you live and your and/or your dependents smoker status please see page 25 for the definition of total annual cash compensation both in and out-of-network coverage2 available with higher benefits paid in-network 100 in-network coverage out-of-network benefits only available for an approved emergency both in and out-of-network coverage2 available with higher benefits paid in-network network in-network copayments physician office visit specialist office visit emergency room visit preventive care3 coinsurance after deductible or copayment surgery lab work etc annual deductible in-network $20 $30 $150 100 in-network $40 $50 $150 100 in-network $20 $30 $150 out-of-network benefits only available for an approved emergency 100 in-network 100 in-network coverage out-of-network benefits only available for an approved emergency 80 after deductible 100 in and out-of-network 80 in-network 60 out-of-network 90 in-network 70 out-of-network 80 in-network 60 out-of-network out-of-network deductible does not apply to office visits or emergency room charges in-network in-network out-of-network out-of-network $750 $1,500 $1,500 $2,250 $500 $1,000 $1,000 $1,500 $1,500 $3,000 $3,000 $4,500 $150 $300 $300 $450 out-of-network benefits available only for an approved emergency in-network out-of-network employee only employee plus one adult employee plus children employee plus family annual out-of-pocket maximums excludes deductible and copayments $250 $500 $500 $750 $1,50o $3,000 $3,000 $3,000 $1,500 $3,000 $3,000 $3,000 employee only employee plus one adult employee plus children employee plus family $1,500 $3,000 $3,000 $4,500 $3,000 $6,000 $6,000 $9,000 $2,500 $5,000 $5,000 $7,500 $5,000 $10,000 $10,000 $15,000 n/a n/a n/a n/a out-of-network benefits available only for an approved emergency $3,00o $6,000 $6,000 $6,000 $6,000 $12,000 $12,000 $12,000 please note this chart presents an overview of plan design features for more detailed information please contact your claims administrator or use the health plan comparison charts on the benefits web center with the health plan comparison charts you can easily compare specific features e.g costs deductibles coinsurance etc of up to three medical plan options at one time 1 medical plan coverage may vary for certain hmo and epo options for instance there is no in-network annual deductible for fully-insured hmo options for more information please refer to the health plan comparison charts on the benefits web center 2 coverage for an out-of-network provider under the pos high and low options and the cdho are subject to reasonable and customary charges the prevailing charge for most providers in the same or similar geographic area for the same or similar service or supply 3 eligible preventive services are subject to age and frequency guidelines the service must be submitted to the claims administrator as preventive medical care rather than as a diagnostic service in order to qualify for preventive care coverage for a complete list of eligible services please contact your claims administrator under the pos and epo options any deductibles and out-of-pocket maximums for prescription drug coverage are separate from those under the medical plan please see page 9 for additional details however under the cdho any deductibles and out-of-pocket maximums apply to both medical and prescription drug coverage th ejpmorgancha se u s benefi ts program 6

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p oint o f -s ervice p o s highand lo w o pt ions the pos high and low options give you the flexibility to use any licensed provider and receive benefits you do not need to select a primary care physician pcp you have the opportunity to get higher in-network benefits when you use preferred providers who belong to the pos network generally your out-of-pocket costs will be lower if you use network providers because these providers have agreed to offer their services for lower prenegotiated rates if you enroll in the pos high option you pay higher premiums but have lower deductibles out-of-pocket maximums and copayments for doctor s office visits and other services if you enroll in the pos low option you pay lower premiums but your deductibles out-of-pocket maximums and copayments for doctor s office visits and other services are higher in-network preventive medical care is covered at 100 with no deductible under both the pos high and low options please note the service must be submitted to the claims administrator as preventive medical care rather than as a diagnostic service in order to qualify for preventive care coverage eligible preventive services are subject to certain age and frequency guidelines the pos high and low options are administered by unitedhealthcare except in the following geographic areas in this geographic area california indiana kentucky louisiana michigan western new york west virginia arizona delaware maryland pennsylvania texas washington d.c the anthem pos high or low option may be referred to as a ppo 2011 administrator anthem aetna thee xc lu sivepr ov iderorganiz at i o n e p o h e a lt hmaintenanceorganiz at i o n h m o o pt i o n with epos and hmos most in-network services are fully paid after a copayment out-of-network services are generally not covered and there are no claim forms to file however there is one major difference between epos and hmos under an hmo prescription drug coverage is provided through the hmo under an epo prescription drug coverage is provided through the jpmorgan chase prescription drug plan administered by caremark please see page 9 for more information on the prescription drug plan the epo/hmo option available to you depends on where you live when you participate in an epo/hmo you receive all your care from the epo/hmo s network of providers hospitals and laboratories epo/hmos do not pay for treatment by non-epo/hmo providers except in an emergency in addition g there are no claim forms to file generally all eligible expenses are covered at 100 after you make a copayment and satisfy the annual deductible please note preventive medical care is generally covered at 100 with no deductible except for certain hmos the service must be submitted as preventive medical care rather than as a diagnostic service in order to qualify for preventive care coverage eligible preventive service are subject to certain age and frequency guidelines g if you receive care outside the network you re responsible for all charges except in an emergency generally your care within a epo/hmo network is coordinated through pcp if your plan requires one you must go through your pcp when you need medical care or a referral to a specialist check with your option administrator to determine if a pcp is required specific information on the epo/hmos available to you will be communicated during your designated enrollment period 7 th ejpmorgancha se u s benefi ts program

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co nsumerdrivenhea lt h o pt ionp lu s a ta x deferredhea lt h sav ingsa cco u n t the consumer driven health option administered by aetna is like the pos option in that it offers medical and prescription drug coverage with both in-network and out-of-network benefits you ll need to satisfy an annual deductible before the option begins to pay medical or prescription drug benefits 1,500 employee only $2,000 if you cover any family members it is important to note that preventive medical care will be covered at 100 even if the annual deductible isn t satisfied eligible preventive services are subject to age and frequency guidelines this option only offers employee and family levels for annual deductibles and annual out-of-pocket maximums this means that if you cover any dependents you will have to meet the entire family deductible before the plan begins sharing a portion of your eligible expenses through coinsurance the health savings account is a feature of the consumer driven health option that can help you save and pay for your out-of-pocket medical expenses now or in the future contributions are made on a before-tax basis through payroll deductions or direct contributions the maximum contribution for 2011 is $3,050 for employee-only coverage and $6,150 if you cover any dependents these amounts are indexed on an annual basis covered participants between the ages of 55 and 65 or who will reach age 55 on or before december 31 2011 are also eligible to make additional catch-up contributions of up to $1,000 each for 2010 however catch-up contributions for a spouse cannot be made through payroll deductions the balance in your account will roll over from year to year and can earn interest any interest earned is based on investment experience the health savings account is also portable meaning you can keep your account even if you leave jpmorgan chase for any reason distributions for qualified medical expenses are tax-free please note you are eligible to contribute to both the health savings account and the health care spending account however you can only use your contributions to the health care spending account for reimbursement of dental and vision expenses certain individuals are not eligible for the health savings account federal regulations limit eligibility for the health savings account to be eligible for the health savings account active employees must not be g covered by another group health plan e.g a spouse s employer coverage g enrolled in medicare g claimed as a dependent on another person s federal income tax return or g age 65 or older providers leaving networks the list of providers for any given health care network can change during the course of the plan year so you should check with your doctor to verify that he or she plans to continue participation in the medical plan option you choose if your health care provider does leave your network it does not qualify under federal law as an event that allows you to change coverage during the year high performance designation many of our medical plan options designate a select number of their participating providers as high performance these are physicians who have proven expertise in providing high-quality cost-effective care utilizing these providers can result in lower costs better outcomes or both visit your medical plan option administrator s web site for more information and consider utilizing a high performance provider when you need services get the best care and save money at centers of excellence for organ transplants and bariatric surgery organ transplants and bariatric surgery are complex procedures that require quality care as a result each medical plan option has in-network hospitals that have been designated as centers of excellence because of the high-quality care they consistently provide to encourage use of such facilities your hospital admission copayment will be waived if you choose a center of excellence as defined by your medical plan option for these procedures in addition if you use a center of excellence as designated by your health plan for an organ transplant your in-network deductible or any coinsurance e.g 10 will be waived and travel and lodging benefits will be provided to locate a center of excellence visit the web site of the medical plan option in which you are enrolled or contact the member services number on your health plan id card please note this does not apply to the hmo option or the cdho th ejpmorgancha se u s benefi ts program 8

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p rescri pt iondrug cov erage if you elect coverage under the pos high or low option or the epo option your prescription drug coverage is provided through the jpmorgan chase prescription drug plan administered by caremark you will receive two separate id cards one for medical services and one for your jpmorgan chase prescription drug coverage this coverage gives you the option of having prescriptions filled through a convenient mail-order program or at a cvs pharmacy please note if you elect medical plan coverage under either the hmo or consumer driven health option your prescription drug coverage is provided through your option administrator and you will receive only one id card for medical services and prescription drug benefits prescription drug coverage at a glance point-of-service pos high and low and exclusive provider organization epo options retail up to a 30-day supply1 annual deductible you pay $50 per employee only 100 employee plus one adult employee plus children $150 family $10 maximum copayment2 30 coinsurance to $100 max2 45 coinsurance to $150 max2 you pay none $20 maximum copayment2 30 coinsurance to $250 max2 45 coinsurance to $375 max2 health maintenance organization hmo option each hmo option offers its own prescription drug coverage for information about the prescription drug coverage under a specific hmo option please refer to the health plan comparison charts on the benefits web center consumer driven health option cdho retail up to a 30-day supply 80 in-network 60 out-of-network generic preferred brand non-preferred brand mail order up to a 90-day supply 1 annual deductible generic preferred brand non-preferred brand mail order up to a 90-day supply 80 in-network no mail-order coverage out-of-network amounts for both retail and mail order show the percent of eligible prescription drug expenses covered by the cdho after you satisfy the combined prescription/medical annual deductible see page 6 annual out-of-pocket maximum3 1 $2,000 employee only $4,000 employee plus one adult employee plus children 6,000 family out-of-pocket maximum applies to all charges including medical long-term medications limit of two 30-day fills before 90-day mail order required the 90-day supply may also be obtained through a cvs pharmacy maximum amounts shown are per prescription if the cost of a generic drug is less than the copayment you pay the lower amount 3 annual out-of-pocket maximum includes copayments and coinsurance for covered drugs but does not include the annual retail deductible or costs for non-covered drugs also it is not combined with jpmorgan chase medical plan out-of-pocket costs/limits 2 fill long-term prescription drugs through caremark s mail order program if you elect coverage in the jpmorgan chase medical plan s pos high or low option or the epo option your prescription drug coverage is provided through the prescription drug plan administered by caremark one of the best features of the plan is the discount available for long-term prescriptions purchased in bulk by caremark and fulfilled through the mail order pharmacy program this program saves both you and jpmorgan chase money long-term or maintenance medications are taken or prescribed on a regular recurring basis examples of these medications include those for high blood pressure and those meant for lowering cholesterol if you are taking a long-term medication you must receive your 90-day supply by mail through caremark s mail order program alternatively you have the option of picking up your 90-day supply at a cvs pharmacy where the same discounts are available the annual deductible applicable to retail prescriptions does not apply to long-term prescription medications filled at a cvs pharmacy 9 th ejpmorgancha se u s benefi ts program

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eligible dependents in addition to employee coverage your dependents are also generally eligible for coverage under the jpmorgan chase medical plan eligible dependents generally include g your spouse or domestic partner g you and/or your spouse/domestic partner s children up to the end of the month in which they reach age 26 please note you may continue coverage beyond age 26 for an unmarried child who is not capable of supporting himself or herself due to a mental or physical disability that began before the age limits described above and who is fully dependent on you for financial support for purposes of administration of jpmorgan chase s benefit plans the term spouse refers to any person to whom you are legally married as recognized by u.s federal law even if you are legally married under state law e.g in massachusetts and california or non-u.s law e.g canada spain etc to a person of the same sex your same sex spouse is considered to be your domestic partner for purposes of the administration of the jpmorgan chase benefits plans including the federal tax consequences for covering your domestic partner under your benefits i.e imputed income and the benefits that may not be available to that person e.g the health care spending account for more information regarding domestic partner coverage and the various federal and state tax consequences please refer to the domestic partner coverage guide on hr personal benefits you are responsible for understanding the dependent eligibility rules and abiding by them when you first enroll and each year during your designated enrollment period or within 31 days following a qualified status change it is important that you review both the dependent eligibility rules and the status of your covered dependents to ensure that you cover only eligible dependents jpmorgan chase conducts dependent eligibility audits on an annual basis such audits help ensure that dependents who have been certified for coverage during the enrollment process continue to meet plan rules for eligibility as a result you may be asked to provide documentation of eligibility for your covered dependents at any time e.g birth certificate or marriage certificate etc failure to either respond to a request for documentation or provide adequate proof of eligibility may result in termination of dependent coverage repayment of the cost of that coverage and/or disciplinary action up to and including termination of employment for a listing of acceptable documentation please see the dependent eligibility requirements on hr personal benefits cov eragec at eg ories the jpmorgan chase medical plan offers four coverage categories to help match your coverage needs g employee only g employee plus one adult spouse or domestic partner g employee plus children g employee plus family spouse or domestic partner plus child[ren domestic pa rt ners you and your domestic partner must g be age 18 or older g have lived together for at least six months and have a serious committed relationship g be financially interdependent g not be related to each other in a way that would prohibit legal marriage and g not be legally married to or the domestic partner of anyone else or g have registered as domestic partners pursuant to a domestic partnership ordinance or law of a state or local government or under the laws of a foreign jurisdiction important note the health savings account component of the consumer driven health option and/or the health care spending account does not apply to domestic partners unless you can claim him or her as a dependent on your federal tax return you may wish to contact a personal financial planner and/or tax advisor regarding the tax treatment of coverages related to your domestic partner and/or your domestic partner s children for additional information on covering domestic partners please review the domestic partner coverage guide on hr personal benefits contact each plan option directly or contact the benefits call center th ejpmorgancha se u s benefi ts program 10

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co stfor cov erage you and jpmorgan chase share the cost of coverage under the medical plan your contributions are deducted from your pay on a before-tax basis before federal and in most cases state and local income taxes are withheld the amount you pay depends on the level of your total annual cash compensation excluding overtime the medical option you choose where you live the number and type of eligible dependents you cover and your and/or your covered dependents smoker status you will have a higher cost for coverage if your total annual cash compensation is higher you cover more dependents under your medical option and/or costs in your geographic area are higher than average the following chart shows the total annual cash compensation levels currently used to determine employee before-tax contributions under the medical plan specific contribution rates for each of your available medical plan options will be communicated during your designated enrollment period please see page 25 for the definition of total annual cash compensation total annual cash compensation levels used to determine medical plan contributions level total annual cash compensation excluding overtime up to $39,999.99 $40,000 ­ $79,999.99 $80,000 ­ $149,999.99 $150,000 ­ $249,999.99 $250,000 ­ $349,999.99 $350,000 and above most employee pays 1 2 3 4 5 6 least co ntribution co stsforeach cov eredfami ly member to more accurately reflect the true cost of coverage and to fairly distribute that cost among employees you will pay for each family member that you cover under a jpmorgan chase medical plan option including each child you will be charged for a maximum of four children even if you cover more than that under your plan you can cover all of your children as long as they meet eligibility requirements you will only pay the per-child costs for the first four children you choose to cover this itemized pricing will not only help you evaluate the cost of each family member s coverage but will also give you information to more accurately compare your medical plan options and costs contributions will also vary based on your pay geographical location option you select and your and your covered family members smoker status here s how it works example 1 jack wants to cover himself his wife and their three children he will pay one price for himself one price for his wife and one price for each of his three children when combined this will equal his total contribution for medical coverage jack s employee-only rate wife s rate per child rate x 3 jack s total monthly contribution for medical coverage 90 $172 54 x 3 $424 example 2 barbara wants to cover herself her husband and their five children she will pay one price for herself one price for her husband and one price for each of the four of her children she will not pay an additional per-child price for her fifth child because per-child costs apply only up to four children even though she will have coverage for her five children barbara s employee-only rate husband s rate per child rate x 4 barbara s total monthly contribution for medical coverage 90 $172 54 x 4 $478 these examples are for illustrative purposes only your actual rates could be different from those represented here « 11 th ejpmorgancha se u s benefi ts program

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smoker and non-smoker rates for certain benefits coverage eligible employees and their covered dependents who don t smoke pay less for coverage under the following health care and insurance plans than those who smoke g medical plan employee adult and child coverage g long-term disability plan employee coverage and g supplemental term life insurance plan employee and adult coverage under the jpmorgan chase u.s benefits program a smoker for a plan year is any person who has smoked any type of tobacco products i.e cigarettes cigars or a pipe regardless of the frequency or location this includes daily occasionally socially at home only etc in the 12 months preceding any january 1 of the plan year this definition does not pertain to users of tobacco products that are not smoked such as chewing tobacco or snuff when you enroll as a newly eligible employee or during a subsequent annual enrollment period you will declare a non-smoker/smoker status for yourself and each applicable dependent that you elect to enroll the status you report will remain in effect for the calendar year after you and/or your covered dependents have been smoke-free for 12 months as of january 1 each year or completed a pre-approved smoking cessation course and certified attendance by the applicable deadline as part of the annual enrollment process you ll be eligible for lower non-smoker rates beginning january 1 of the following year if you are hired before october 1 you will be assigned non-smoker rates for the current calendar year if you are hired on or after october 1 for the current plan year and the following plan year you will be assigned non-smoker rates for your and your dependents coverage for certain benefits even if you declare yourself a smoker because you may not have had an opportunity to complete a smoking cessation program in order to qualify for the lower non-smoker rates you ll receive more information regarding the opportunity to update your smoker status during the annual benefits enrollment period more information on smoking cessation programs and requirements is available on hr personal wellness th ejpmorgancha se u s benefi ts program 12

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dental plan jpmorgan chase offers several different dental options based on where you live all options provide coverage for preventive care basic and major restorative care as well as orthodontia services for dependent children up to age 19 here s a brief overview of each dental plan option d e n ta l o pt ions at aglance preferred dentist program pdp option provision annual deductible preventive restorative basic and major orthodontia none $25 individual $75 family $50 individual lifetime 100 coverage none $75 individual $225 family $150 individual lifetime 70 coverage none none none none none none none $75 individual $225 family $150 individual lifetime 90 coverage in-network out-of-network dental health maintenance organization dhmo option cigna dental maintenance organization dmo option aetna traditional indemnity dental traditional option indemnity option preventive exams cleanings x-rays sealants no deductible basic restorative fillings extractions root canal periodontal oral surgery anesthesia 100 coverage 100 coverage with $0 copayment 80 coverage after deductible 60 coverage after deductible 80 coverage approximately 80 coverage with copayments ranging from $0 to $250 75 coverage after deductible major restorative 60 coverage after dentures bridges deductible inlays onlays crowns 50 coverage after deductible 60 coverage approximately 60 coverage with copayments ranging from $15 to $325 50 coverage after deductible orthodontia child up to age 19 adult maximum benefits combined annual for preventive and restorative lifetime for orthodontia maximum $1,500 maximum $1,500 no maximum no maximum maximum $1,500 50 coverage after deductible none 50 coverage after deductible none 50 coverage 50 coverage $2,400 copayment $2,900 copayment 50 coverage after deductible none maximum $2,500 maximum $2,000 limited to one course of treatment per lifetime 24 months of interceptive and/or comprehensive treatment cases beyond 24 months or atypical cases require additional payment by the patient maximum $2,000 all in-network percentages above apply to dentists negotiated fees all other percentages generally apply to reasonable and customary charges frequency limits may apply to certain services the cigna dhmo option is based on a copayment structure per procedure this coinsurance percentage reflects an approximation of copayments the actual copayment will vary more information will be available to you at the time of your benefits enrollment period combined in and out-of-network 13 th ejpmorgancha se u s benefi ts program

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p referreddentistprogramo pt i o n the preferred dentist program pdp option administered by metlife offers you the flexibility to choose between in-network and out-of-network dental care under this option networks of participating dental providers offer their services for lower prenegotiated rates here s how it works g when you need care you can choose to visit a network provider or go out of network g in general when you obtain care from an in-network dentist your out-of-pocket costs will be lower when you receive out-of-network care your out-of-pocket costs will be higher g once you pay a deductible you and the company share the reasonable and customary costs for covered expenses subject to plan maximums no deductibles apply to in-network or out-of-network preventive services d e n ta lmaintenanceorganiz at i o n d e n ta lhea lt hmaintenanceorganiz at iono pt i o n when you enroll in the dental maintenance organization dmo dental health maintenance organization dhmo option administered by aetna and cigna respectively g you receive care solely from dentists who are associated with the dmo/dhmo network g all of your care within the network is coordinated through a primary dentist you must go through your primary dentist to receive benefits from the plan and for specialist referrals g in most cases there are no deductibles traditionalindemni ty d e n ta l o pt i o n the traditional indemnity option administered by metlife allows you to visit any dentist and receive care this option also contains a preferred dentist feature reducing your overall costs when you use a network dentist because you will be charged lower negotiated fees generally the total cost of care under this option is higher than under the other options so the amount you pay for coverage will be higher if you enroll in the traditional indemnity dental option you pay a deductible and then you and the company share the reasonable and customary costs for covered expenses subject to plan maximums eligible dependents you can cover the same eligible dependents under the dental plan as under the jpmorgan chase medical plan please see page 10 co stfor cov erage you and jpmorgan chase share the cost of coverage under the dental plan your contributions are deducted from your pay on a before-tax basis the amount you pay depends on the option you choose and the number and type of eligible dependents you cover providers leaving networks when considering your options under the dental plan please remember that if your dentist leaves a network it does not qualify as an event that allows you to change coverage during the year please check with your provider to ensure that he or she plans to continue participation in the option of your choice th ejpmorgancha se u s benefi ts program 14

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