2019 U.S. Benefits Enrollment Guide - Enrollment Dates: December 3 to December 14, 2018 - Capital Power

2019 U.S. Benefits Enrollment Guide - Enrollment Dates: December 3 to December 14, 2018 - Capital Power
2019 U.S. Benefits
Enrollment Guide
Enrollment Dates: December 3 to December 14, 2018
2019 U.S. Benefits Enrollment Guide - Enrollment Dates: December 3 to December 14, 2018 - Capital Power
What’s in this guide
    The information contained in this enrollment guide                                                                        ...of your Health
    will help you determine the best benefit options
    for you and your family.

    Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  1          Core Employee Benefits . . . . . . . . . . . . . . . . . . . . . . . .  7
    How your Benefits program works . . . . . . . . . . . . . . . . . .  1                          Medical Insurance Options . . . . . . . . . . . . . . . . . . . . . . . .  7
    Benefits program. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2            Medical Opt-Out Benefit . . . . . . . . . . . . . . . . . . . . . . . . . 15
    Eligibility. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  2   Flexible Spending Accounts. . . . . . . . . . . . . . . . . . . . . . . 15
    Paying for your benefits . . . . . . . . . . . . . . . . . . . . . . . . . . .  2               Prior Authorization and Step Therapy. . . . . . . . . . . . . . .  17
    When coverage begins and ends. . . . . . . . . . . . . . . . . . .  3                           Telehealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
    When can I change my benefits? . . . . . . . . . . . . . . . . . . .  3                         Dental Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18
    Appealing a claim or coverage for a procedure. . . . . . . .  3                                 Vision Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
                                                                                                    Employer-Sponsored Benefits and Services. . . . . . . . . 20
    Enrolling in the 2019 Benefits Program. . . . . . . . . . .  4
    Benefits for living a well-balanced life. . . . . . . . . . . . . . . .  4                      Voluntary Benefits. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
    Choose your coverage and dependents. . . . . . . . . . . . . .  4                               Optional Life Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . 22
    Enroll online. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  5
                                                                                                    Discount Programs . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
    Who do I contact with online enrollment questions? . . .  5
                                                                                                    Guardian Vision Discount Program. . . . . . . . . . . . . . . . . 23
    What happens to my benefits if I don’t enroll?. . . . . . . . .  5
                                                                                                    Discount Prescription Programs. . . . . . . . . . . . . . . . . . . 23
    Changes to your Benefits Program . . . . . . . . . . . . . .  6
                                                                                                    Your 2019 Monthly Cost. . . . . . . . . . . . . . . . . . . . . . . . 24
    What’s new for 2019? . . . . . . . . . . . . . . . . . . . . . . . . . . . .  6
    What’s the same. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .  6             Carrier Contacts. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26
    Health Insurance Marketplaces – you have a choice . . .  6

2019 U.S. Benefits Enrollment Guide - Enrollment Dates: December 3 to December 14, 2018 - Capital Power
Your benefits program is an important and valuable part of     You have two choices for medical insurance: the Health
your total rewards at Capital Power Corporation. It provides   Savings Account option, which is a combination of a High
specific Capital Power-paid benefits as well as a range of     Deductible Health Plan (HDHP) and a Health Savings Account
benefit options to choose from to meet your unique needs       (HSA), or the Health Reimbursement Account option, which
and those of your dependents. The program offers coverage      combines a Preferred Provider Organization (PPO) plan with
that helps you:                                                a Health Reimbursement Account (HRA). The options treat
                                                               deductibles and co-pays differently and have different premium
 Take charge of your health                                   levels, enabling you to choose the one that’s right for you and
 Access appropriate treatment in the event of illness         your family. Refer to the Medical Insurance Options section
  or injury                                                    of this guide for more information on making your choice.
 Receive financial benefits in the case of accident           You also have the option to enroll in a Flexible Spending
  or death                                                     Account (FSA), through which you can set aside pre-tax
 Maintain income if you become disabled                       dollars for eligible health and dependent care expenses.
 Support your social, mental, physical and financial          Capital Power offers dental and vision insurance that covers
  well-being to reach your personal goals                      routine check-ups and help cover the cost of additional
                                                               services you may need, such as orthodontics, glasses
How your Benefits program works                                and contacts.
                                                               If you decide you need extra financial protection, you can
The Capital Power Benefits program is designed to provide
                                                               choose to purchase Optional Life insurance for you, your
employees with options and choice. Your core employee
                                                               spouse and your children.
benefits include medical, dental and vision insurance.
As a Capital Power employee, you are also automatically
protected by employer-sponsored benefits including Basic
Life insurance, Accidental Death & Dismemberment insurance,
                                                                 Opting out
and Short-Term and Long-Term Disability income benefits.         If you do not require medical insurance because you
Other benefits you have access to at no cost include the         are covered under another insurance program, you can
Employee Assistance Program (EAP), Travel Assistance,            choose to receive the annual opt-out benefit of $3,600,
and a range of counseling and support services.                  which is treated as taxable income. You must re-certify
                                                                 that you have alternate coverage every year during open
                                                                 enrollment in order to receive the opt-out benefit.

                                                                                    CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 1
2019 U.S. Benefits Enrollment Guide - Enrollment Dates: December 3 to December 14, 2018 - Capital Power
Benefits program
          Core Employee Benefits                                                                                Voluntary Benefits
                                                               Benefits and Services

            Cost shared between
                                                                100% Company-paid                              100% Employee-paid
         Capital Power and employee

                  Medical Insurance                                Basic Life Insurance                        Flexible Spending Accounts

                          Health Savings                Accidental Death & Dismemberment Insurance               Optional Life Insurance
                          Account Option
                                                                   Short-Term Disability
                       Health Reimbursement
                         Account Option
                                                                   Long-Term Disability
                   Dental Insurance
                                                               Employee Assistance Program
                   Vision Insurance

  Eligibility                                                                  Paying for your benefits
  To be eligible for the Capital Power Benefits program:                       Capital Power covers the majority of the cost of all medical
   You must be:                                                               premiums, and subsidizes out-of-pocket costs for both medical
     • a permanent, full-time employee residing in the                         plan options by contributing to both the Health Reimbursement
       United States, or                                                       Account and Health Savings Account. You will pay out of
     • a permanent, part-time employee residing in the                         pocket for the employee share of your annual medical premium,
       United States who works at least 30 hours per week                      as well as for any expenses up to the annual out-of-pocket limit.
   Your dependents must be residents in the United States.                    If you would like additional optional insurance benefits, you
     Dependents may include:                                                   can purchase Optional Life insurance through payroll deduction.
     • Your legally married spouse or domestic partner                         Whenever you have urgent medical needs, consider whether
     • Children who are:                                                       the services of an Urgent Care center are appropriate –
       – Your natural, adopted or step child(ren)                              Urgent Care is much less costly than a visit to the emergency
       – Unmarried and under age 26                                            room. You can also reduce benefits costs by getting prior
       – Unmarried, of any age, and incapable of self-sustaining               authorization from Cigna (Capital Power’s medical insurance
         employment by reason of mental or physical disability                 provider) for certain drugs and procedures to ensure the plan
         and depends on you for support, or                                    will cover them. More information about prior authorization
       – Your domestic partner’s child who is not your child                   is available in the Prior Authorization and Step Therapy
         and depends on you for support                                        section of this guide. By making smart choices, you can keep
  For full details, please refer to the Summary Plan Documents.                costs down for you and the benefits program, which will
                                                                               ultimately keep the program sustainable into the future.

2019 U.S. Benefits Enrollment Guide - Enrollment Dates: December 3 to December 14, 2018 - Capital Power
When coverage begins and ends                                       When can I change my benefits?
Coverage begins                                                     During open enrollment
   For new employees, coverage begins on the first day                Changes take effect on the first day of the benefit year
    of the month following the start date of your employment            (which runs from January 1 to December 31 each year),
    (except for Optional Life insurance, which starts on the            except for the Optional Life insurance, which takes effect
    approval date from the insurer, and the 401(k) plan,                when approved by the insurer.
    which requires three months of service).
                                                                    Within 31 days following a qualifying life event
   If your dependent (other than a newborn child) is in
                                                                    Qualifying life events include:
    hospital when you first enroll, coverage begins on
    the date he or she returns home from the hospital.                 Marriage or after 12 consecutive months
                                                                        in a common-law relationship
                                                                       Divorce, legal separation, or the end of
 Enrolling as a new hire                                                a common-law relationship
 As a new Capital Power employee, you will need to enroll
 within 31 days of your hire date. You will receive an email
                                                                       Adding a dependent child to your family through
                                                                        birth or adoption
 within the first 2 weeks of your employment from Morneau
 Sheppell with all the information you will need to enroll.            Your spouse becomes eligible for coverage or
 If you have questions about enrollment, please contact                 loses their coverage
 Morneau Sheppell at 1.866.856.2000.                                   The death of your spouse
 If you don’t enroll as a new hire, you will receive the               Your child is no longer an eligible dependent and the
 default coverage, which is employee only coverage,                     number of your eligible dependents decreases from
 as follows:                                                            “employee and family” or “employee and child(ren)” to
     Medical insurance: Health Savings Account option                  “employee plus spouse” or “employee only” coverage

     Dental insurance: Opt out                                     Change optional benefits at any time
     Vision insurance: Opt out                                     Your optional insurance choices, HSA deferrals, and 401(k)
     You automatically receive Basic Life and Basic                deferrals can be changed at any time. Optional insurance
      AD&D insurance, Short-Term and Long-Term                      changes may require proof of health and approval from the
      Disability coverage, and access to the Employee               provider before being effective.
      Assistance Program.
                                                                    Appealing a claim or coverage
                                                                    for a procedure
Coverage ends
                                                                    If Cigna denies coverage for a claim or procedure for you or
   At the end of the month following the date your
                                                                    one of your covered dependents, you must ask your doctor
    employment with Capital Power ends, except for life and
                                                                    to phone Cigna at 1.888.693.3297. Your doctor will conduct
    optional insurance, which end on your date of termination.
                                                                    a peer-to-peer review by speaking to a doctor at Cigna to
   For dependents, coverage ends when your coverage ends           determine the most effective treatment or drug for your
    or on the date they no longer qualify as eligible dependents.   condition. If a further appeal is required, please contact
   On termination, you will have 60 days to elect continuation     Daniel Heesing, Pension and Benefits Consultant,
    of coverage through COBRA.                                      at 780.392.5013 or DHeesing@capitalpower.com.

 Making tax-effective choices
     If you enroll in a Flexible Spending Account (FSA), you can set aside pre-tax dollars for eligible health and dependent
      care expenses.
     If you choose the Health Savings Account (HSA) option for medical insurance, Capital Power will contribute pre-tax dollars
      to an HSA in your name at the start of the benefit year as a lump sum, which you can use at any time, tax-free, to pay for
      eligible health care expenses. Or, leave the balance in the account and earn tax-free investment income within the HSA.
     Optional insurance can be purchased using after-tax income via payroll deduction.
     If you have medical insurance elsewhere, the annual opt-out benefit you receive is treated as taxable income.

                                                                                          CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 3
2019 U.S. Benefits Enrollment Guide - Enrollment Dates: December 3 to December 14, 2018 - Capital Power
Enrolling in the 2019 Benefits Program
  Capital Power Corporation provides an employee benefits
                                                                     Dental: Enroll in individual and/or dependent
  program that helps our employees stay healthy, feel secure          coverage, or opt out
  and maintain work/life balance. Our program represents
  a significant part of your total compensation.                     Vision: Enroll in individual and/or dependent
                                                                      coverage, or opt out

  Benefits for living a well-balanced life                           Flexible Spending Accounts (FSA): Choose how
                                                                      much you will contribute to your FSA(s) in 2019,
  As a Capital Power employee, your health and well-being are         if anything. Read more about eligibility requirements in
  important to us. That’s why our benefits program, a cornerstone     the Flexible Spending Accounts section of this guide
  of our Total Rewards program, helps ensure you and your
  loved ones live a well-balanced life. When choosing your           Optional Life insurance: Enroll in individual and/or
                                                                      dependent coverage (subject to approval), update your
  benefits coverage, take charge of your health: keep in mind
                                                                      beneficiaries, or opt out
  what fits your and your family’s needs and consider steps you
  can take to create balance for your mental, physical, financial    401(k): Update your 401(k) deferral at enrollment or
  and social health.                                                  any time during the year. Remember your 401(K) plan
                                                                      deferral, beneficiaries and investments can only be updated
                                                                      at www.oaretirement.com or by calling 1-800-858-3829.
  Choose your coverage and dependents
  You can choose different dependents for medical, dental,
  vision and Optional Life insurance plans.                                            Important dates
   Medical: Enroll in individual and/or dependent coverage                 December 3 to December 14, 2018
     and decide whether to:
                                                                      Open enrollment for Capital Power benefits for 2019
     • Choose the Health Savings Account option (and decide
       on your HSA contribution amount, keeping in mind that                            January 1, 2019
       Capital Power’s HSA contribution depends on how many                      Benefits coverage period begins
       dependents you enroll in medical insurance),
     • Choose   the Health Reimbursement Account option, or
     • Opt out and receive a $3,600 opt-out benefit (proof of
       medical coverage elsewhere required)

Enroll online                                                     Who do I contact with online
Go to https://cpcus.hroffice.com/ESS/ between                     enrollment questions?
9:00 a.m. EST on Monday, December 3, and 5 p.m. EST               Contact online enrollment administrator Morneau Shepell:
on Friday, December 14, 2018 to enroll:                           1.866.856.2000 or cpc@hroffice.com.
   Choose your medical, dental, vision and Optional Life
    insurance coverage (subject to approval), or opt out          What happens to my benefits
   Update beneficiary information                                if I don’t enroll?
   Make Health Savings Account Selections for 2019,              If you don’t enroll online by the deadline and have not contacted
    if you choose this medical coverage option                    the Capital Power Benefits Support Line (operated by
   Make Flexible Spending Account selections for 2019            Morneau Shepell), you will receive the same benefits and
                                                                  levels of coverage for the same dependents that you selected
To update your 401(k) deferral, go to www.oaretirement.com
                                                                  during 2018 enrollment.
or call 1-800-858-3829.
The coverage you select will take effect on January 1, 2019
and will be effective until December 31, 2019, unless you           During this open enrollment, you will make benefit
elect a level of Optional Life insurance for which you have         selections that will be effective from January 1 to
not yet been approved. Additional levels of optional insurance      December 31, 2019.
are effective on the day you are approved for coverage by
the insurer.
Outside open enrollment, you may only change coverage
due to a qualified life event and you must do so within 31 days
of the event. We encourage you to review all your benefits
and make your selections wisely. Optional insurance, HSA
elections (if eligible), and 401(k) deferrals can be updated
at any time.

                                                                                       CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 5
Changes to your Benefits Program
  What’s new for 2019?
     Each year the benefits program is reviewed to ensure it                 •   Improved vision care with more coverage for eye glass
      continues to be valuable and sustainable into the future.                   frames and contact lenses. For details on this improved
      Adjustments are made based on an annual market and                          coverage, please refer to the Vision Insurance section.
      program review. This year changes include:                                  Vision care costs will increase slightly this year, please
                                                                                  refer to the Your 2019 Monthly Cost section.
      •   An increase in the medical insurance premiums for the
          Health Savings Account (HSA) and Health Reimbursement              The HSA combined contribution limit set by the Internal
          Account (HRA) options paid by employees and Capital                 Revenue Services (IRS) will increase to $3,500 for
          Power to offset increases in plan costs. In 2019, premiums          Employee only and $7,000 for Families in 2019. These
          will increase in both options and both you and Capital              maximum amounts include Capital Power’s HSA contribution,
          Power will see these increases. The HSA option remains              as well as any additional money you contribute to this
          the lower-cost choice for medical coverage, and if you              account to support your overall well-being.
          choose this option, you will receive Capital Power’s full
          contribution to your HSA at the start of the benefit year.
                                                                             The Health Care Flexible Spending Account (HCFSA)
                                                                              employee contribution limit allowed under IRS regulations
          To learn more about which option may work best for you,
                                                                              will be increasing to $2,700 in 2019.
          please refer to the Core Employee Benefits section
          on the next few pages. For the new rates, please refer             The 401(k) annual limit for 2019 is increasing to $19,000.
          to the Your 2019 Monthly Cost section.                              There is no increase to the catch up annual limit of $6,000.

      •   The annual deductibles in the HRA option will increase
                                                                          What’s the same?
          in 2019. Both you and Capital Power will split absorbing
          the increase in these deductibles, with an equal increase          Capital Power’s annual contribution to the HSA will remain
          to your employee out-of-pocket portion and the amount               the same and be deposited at the start of the benefit year.
          Capital Power reimburses through your HRA. For                     There are no changes to deductibles or out of pocket
          the new HRA annual deductibles, please refer to the                 maximums under the HSA option.
          Health Reimbursement Account Option section.                       Your dental, Short-Term Disability, Long-Term Disability,
      •   The HRA option will also now feature an embedded                    Life insurance and Optional Life insurance rates will remain
          deductible. If you cover family members on your medical             the same.
          plan, each person will only be responsible for hitting his         Your providers remain the same for all benefits.
          or her own individual deductible before the plan starts
          to pay benefits for that person. Currently, the HRA option
                                                                             The Dependent Care FSA (DCFSA) maximum will remain
                                                                              at $5,000 per household ($2,500 if you are married and
          has an aggregate deductible that requires an employee
                                                                              file taxes separately).
          and their family to hit the entire deductible before the plan
          pays benefits. Generally, the embedded deductible is
          more advantageous because individuals cover the
                                                                          Health Insurance Marketplaces –
          deductible sooner.                                              you have a choice
      •   Individual and family out of pocket maximums are also              You have the option to compare Capital Power’s
          increasing under the HRA option. For these increased                coverage with plans available through the health
          amounts, please refer to How Your Core Medical                      insurance marketplaces at www.healthcare.gov. If you
          Insurance Works With Each Option section.                           choose Marketplace coverage, you can enroll beginning
                                                                              November 1, 2018 for coverage starting in 2019.

Core Employee Benefits
Medical Insurance Options
You have two choices for medical coverage:

Health Savings
Account option
                               Core Medical Insurance
                          High Deductible Health Plan (HDHP)      +                  Health Savings Account (HSA)
                                                                                 A tax-advantaged, portable savings account

Account option
                               Core Medical Insurance
                         Preferred Provider Organization (PPO)    +             Health Reimbursement Account (HRA)
                                                                          An employer-paid account that covers part of the deductible

Your core medical insurance will be a High Deductible Health       understand your own medical insurance needs before making
Plan (HDHP) or a Preferred Provider Organization (PPO)             your choice. An HSA is a tax-advantaged savings account that
depending on your choice of medical coverage. Both provide         remains yours, no matter where you work. Capital Power
traditional medical insurance that covers prescription drugs.      contributes the full amount to your account at the start
Your core medical insurance works in tandem with either the        of the benefit year. You can choose to contribute as well,
Health Savings Account (HSA) or the Health Reimbursement           up to specified limits, and use it when you want to – your
Account (HRA), depending on which option you choose.               balance never expires and there are no HSA forfeitures.
The HSA option offers several advantages that might be a           Premiums and the treatment of co-pays and deductibles
better fit for you than the HRA option, but it’s important to      differ between the two options.

  EXAMPLE: An employee with family coverage would have the following premiums and deductibles in 2019,
  depending on which medical insurance option is chosen:

                   Employee share      Annual          Annual
                   of monthly          deductible      deductible         Capital Power                  Prescription
                   premium             (in-network)    (out-of-network)   contributes (in 2019)          drug co-pay

   HSA option      $280.23             $6,000          $12,000            $3,000 (Deposited at           Pay for all drugs out of
                                                                          the start of the year and      pocket until you reach
                                                                          accessible right away)         deductible, then pay co-pay

   HRA option      $420.06             $7,500          $15,000            $5,250 (After satisfying       Pay co-pay only
                                                                          the $2,250 employee
                                                                          portion of the deductible)

                                                                                           CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 7
Choose which option works for you
  Your choice will depend on what makes the most financial
  sense for you and your family.
  The HSA and HRA options have different deductibles,
  out of pocket maximums and monthly premiums and operate
  differently in the way co-pays and expenses apply toward
  the deductibles.
  Here are a few of the differences between each option:

                       Health Savings Account option                                 Health Reimbursement Account option

    In most cases, you cover your deductible first,                      For most expenses, you cover co-pays first,
    then pay co-pays and coinsurance                                     then satisfy your deductible

    The deductible is an aggregate amount for you and your family        The deductible is embedded. Each covered individual must
    members and the total must be met before co-pays apply and           only meet the individual deductible amount before the plan
    the plan starts to pay coinsurance for any person                    starts to pay coinsurance for that person.

    You can use the HSA for any out-of-pocket costs associated           You can start using your HRA after you have satisfied your
    with your medical, dental, or vision coverage which includes         portion of the deductible
    your deductible

    Lower employee premiums                                              Higher employee premiums

    Capital Power contributes to your HSA; you have the option           Only Capital Power contributes to your HRA
    to contribute to your HSA

    HSA account balance can earn interest tax-free and can               Money in an HRA does not earn interest and cannot be invested
    be invested

    You can roll over your HSA account balance if you don’t use          Any remaining account balance at the end of the year
    it all in a single year                                              cannot be carried over to the following year

    You own the money in your HSA and can take it with you               If you leave Capital Power, you forfeit your Capital Power HRA
    if you leave Capital Power

    If you participate in an HSA, you can open a Dependent Care          You can participate in a Health Care Flexible Spending
    FSA; you cannot use an FSA for medical expenses if you               Account and a Dependent Care FSA
    have an HSA

    Use your HSA balance to pay for medical expenses tax-free            Use your HRA balance to pay for medical expenses
    now or in the future – if you leave Capital Power, take your         once you reach your portion of the deductible
    HSA with you

    You pay the full cost of prescription drugs up to your deductible,   You pay the co-pay only for prescription drugs
    then you pay the co-pay only. The money in your HSA can be
    used for prescription drug costs.

  If you and your covered dependents have typically low medical          In comparison, if you have high or frequent prescription drug
  and prescription costs, under the HSA option your medical              costs, you may find the HRA option more cost effective, as
  premiums would be lower, but you would pay the full cost of            you will only pay the co-pay each time you fill a prescription.
  all prescription drugs until you reach the annual deductible.
  After reaching the deductible, you would pay only the co-pay
  whenever you fill a prescription. You can use the money that
  you and Capital Power deposit into your HSA to help cover
  out-of-pocket expenses.

How your core medical insurance works
with each option
This chart gives a side-by-side look at the amounts payable                     Remember, you get the most out of your medical plan by using
under the Health Savings Account option or the Health                           an in-network provider. To see if your provider participates in
Reimbursement Account option when you use in-network                            the Cigna network – or to find one who does – log in to your
and out-of-network providers for each option.                                   plan member account at www.myCigna.com to see a directory
                                                                                of providers.

                                                    Health Savings Account option                        Health Reimbursement Account option
             Core medical                                  (HDHP + HSA)                                             (PPO + HRA)
                                                  In-network                Out-of-network                  In-network               Out-of-network

 • Individual*                                      $2,000                       $4,000                       $2,500                     $5,000
 • Family*                                          $6,000                       $12,000                      $7,500                     $15,000

 Out of pocket maximum
 (includes deductible)
 • Individual*                                      $2,500                       $5,000                       $3,000                     $6,000
 • Family*                                          $6,850                       $13,700                      $9,000                     $18,000

 Prescription drugs
 out of pocket maximum
 • Individual*                                   Included in                  Included in                      $500                        Not
 • Family*                                     maximum above                maximum above                     $1,000                    applicable

                                                 90% covered                 70% covered                   $25 co-pay;                70% covered
 Physician visit
                                                after deductible            after deductible              $50 specialist             after deductible

                                                                             70% covered
                                                100% covered                after deductible              100% covered
                                                                                                                                      70% covered
 Preventive care                                 (no co-pay,               (Labs and x-rays:               (no co-pay,
                                                                                                                                     after deductible
                                                no deductible)             100%, no co-pay,               no deductible)
                                                                             no deductible)

                                                 90% covered                 70% covered                  90% covered                 70% covered
                                                after deductible            after deductible             after deductible            after deductible

 Emergency room                                       90% covered after deductible                                       $150 co-pay

 Prescription drugs                            Deductible then
 (Retail/mail order)                              co-pay:                                                    Co-pay:
 Generic**                                       $10 / $20                                                  $10 / $20
                                                                              Not covered                                              Not covered
 Preferred***                                    $20 / $40                                                  $20 / $40
 Non-preferred †                                 $35 / $70                                                  $35 / $70
 Specialty §                                    $150 / N/A                                                  $150 / N/A

   * Per covered individual, up to a family/combined maximum as shown
  ** Generic: Drug will be the lowest cost alternative resulting in the lowest tier co-pay
 ***		 Preferred: Drug will be on Cigna’s formulary list. Drugs on this list will result in the middle tier co-pay
       Non-preferred: Drug will NOT be on the formulary list resulting in the highest tier co-pay
       Specialty: Specialty medications are typically high-cost drugs that are used to treat complex conditions

                                                                                                          CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 9
Which services are subject to the deductible?
   Below is a chart that shows examples of what is subject
   to the deductible and what is paid by your account based
   on the medical insurance option you select. Many services
   only require a co-pay at the time of service.

                                                 Health Savings Account option                  Health Reimbursement Account option
             Medical care
              provided                 Subject to            Co-pay            HSA           Subject to          Co-pay             HRA
                                      deductible?           applies?         eligible?      deductible?         applies?          eligible?

       In-network primary
                                           Yes                 No              Yes               No                Yes               No
       care office visit

       In-network specialist
                                           Yes                 No              Yes               No                Yes               No
       office visit

       Emergency room
                                           Yes                 No              Yes               No                Yes               No
       facility charge

       In-network lab work
       performed in an                     Yes                 No              Yes               Yes               No                Yes
       outpatient facility

       In-network inpatient
                                           Yes                 No              Yes               Yes               No                Yes
       hospital stay

                                                         (In-network only;                                         Yes
       Prescriptions                       Yes                                 Yes               No                                  No
                                                         After deductible                                    (In-network only)

   When you see an in-network provider:
                                                                                 You have access to the same in-network providers
   •   Your provider will file all claims directly with Cigna. If you
                                                                                 regardless of which medical insurance option
       chose the Health Savings Account option and you want
                                                                                 you select.
       to use your HSA to cover your expenses, present your
       HSA debit card at the time of payment.
   •   Cigna will review the claim submitted by the hospital or               If your provider is out-of-network
       other provider, and make any payment directly to them.                 If your provider is not currently in Cigna’s network, you
       This payment is based on the benefits in your health plan              can send your provider’s name, title, address, phone
       and the amount of funds in your HRA (if you chose the                  number and email address to Daniel Heesing at
       Health Reimbursement Account option).                                  DHeesing@capitalpower.com. Cigna will be asked to
   •   You will receive an Explanation of Benefits that breaks                review your provider to find out whether they meet the
       down how much of the bill you are responsible for. You                 in-network criteria.
       might have a deductible to cover, in which case the provider
       will bill you directly.

Health Savings Account option
PROVIDER: Cigna (core medical insurance)
and HSA Bank (Health Savings Account)
You may open and contribute to an HSA as long as you are                        •   Use the money in your HSA to pay for qualified health care,
not covered by any other health plan outside Capital Power                          dental, and vision expenses, including your deductible and
(including your spouse’s Health Care Flexible Savings                               coinsurance, for yourself and covered dependents. Or, leave
Account), not enrolled in Medicare A/B or TRICARE, and                              the balance in your HSA for as long as you wish – you’ll
not claimed as a dependent on another individual’s tax return.                      pay no tax on any investment income within the account.
If you choose this option:                                                      •   You can also use the HSA to pay for eligible medical
                                                                                    expenses not covered by your core medical insurance.
•    Capital Power will contribute pre-tax dollars as a lump sum
     at the start of the year to a Health Savings Account (HSA)                 •   If you opt out of coverage, change jobs or retire, you can
     in your name. If you are a new hire, your HSA deposit will                     take your HSA with you.
     be prorated based on your hire date.
•    You may also contribute to your HSA to put additional
     money aside for unexpected medical expenses now or
     in the future.


                       Capital Power’s contributions                                                     Your contributions

    Capital Power will deposit the company contribution into your              You may choose to contribute to your HSA via payroll deduction
    HSA as a lump sum at the start of the benefit year. The deposit            which will be deposited bi-weekly through normal pay.
    amount depends on how many dependents are covered under
    your core medical insurance.

Your contributions and Capital Power’s contributions count toward the Internal Revenue Service (IRS) HSA 2019 contribution
limit. In the following table, we have calculated the maximum contribution you can make to your HSA in 2019 to remain with
the IRS limits.

                                                                       HSA Contributions and Maximums for 2019
       Core medical insurance
           coverage level                Capital Power’s                m            Maximum employee                        Combined HSA
                                         contribution             deposit               contribution                        contribution limit *

    Employee                                           $1,000                               $2,500                                 $3,500

    Employee + spouse                                 $2,000                                $5,000                                 $7,000

    Employee + child(ren)                             $2,000                                $5,000                                 $7,000

    Employee + family                                 $3,000                                $4,000                                 $7,000

    * This limit is set by the Internal Revenue Service (IRS) each year. The limit includes employee and employer contributions.

It is your responsibility to remain within your IRS contribution limit. Capital Power does not monitor your contributions to ensure
you remain within the limit. For more information about IRS restrictions around HSAs, read the 2019 U.S. Benefits Frequently
Asked Questions document, available on the enrollment site.

                                                                                                        CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 11
Catch-up contributions
   If you are age 55 or older, you may make an additional $1,000           Common HSA-eligible expenses
   contribution each year to save for expenses during retirement.          • Office visits
   If your spouse has an HSA, your combined contributions                  • Surgery, lab work, radiology
   (minus the catch-up contributions) must not exceed the                  • Prescription drugs
   2019 family contribution limit of $7,000.                               • Dental and orthodontia
   Using your HSA                                                          • Vision
   You will receive an HSA debit card from Cigna to pay for                • Personal long-term care insurance premiums
   eligible expenses; you have the option to purchase an HSA               Visit www.Cigna.com/expenses for a full list of
   checkbook as well.                                                      eligible expenses.
   Use the money in your HSA tax-free for qualified out-of-pocket
   expenses you incur any time after the date your HSA was
   established – this year or in future years. Don’t worry about using
                                                                         Tax savings
                                                                         The HSA is tax-advantaged in several ways:
   the full contribution amount in your HSA in a single year: your
   HSA dollars roll over from year to year. If you use the account for   1. You won’t pay tax on money you or Capital Power
   non-eligible expenses, you will be subject to a 20% penalty if you       contribute to your HSA.
   are under age 65, and you will owe income tax on the expenses.        2. Any interest or investment income you earn in the
   Any HSA dollars you use for eligible medical expenses will count         account grows tax-free.
   toward your annual core medical insurance deductible. The dollars     3. Withdraw your account balance at any time tax-free
   you do not use remain in your account and earn interest tax-free.        to pay for eligible expenses.

     EXAMPLE: Gabrielle has a gross income of $70,000. She has no dependents and receives $1,000 from Capital Power
     in 2019 in her HSA. She decides to contribute $2,500 in 2019 to maximize her combined HSA contribution limit of $3,500,
     which is set by the IRS. By the end of 2019, she earned $170 in investment income and interest in her account, which she
     decides to withdraw tax-free at the end of the year to pay for medical expenses. The example below shows how contributing
     to an HSA can provide Gabrielle with more spendable income:
                                                                                                 Without HSA            With HSA

       Gross income                                                                                $70,000              $70,000

       Total HSA contributions (tax-free)                                                             $0               –$3,500

       Gross taxable income                                                                        $70,000              $66,500

       Estimated taxes on gross taxable income: Federal, State, FICA (assume 20%)                 –$14,000             –$13,300

       After-tax earnings                                                                          $56,000               $56,700

       Investment earnings within HSA (tax-free)                                                      $0                + $170

       Overall spendable income                                                                    $56,000               $56,870

       Increase in spendable income with HSA                                                         None                 $870

   Log in to www.myCigna.com to access an HSA calculator                 a monthly fee of $2.25 will be deducted from your balance.
   to determine your tax savings and potential future value              This fee is waived if your monthly balance exceeds $3,000.
   of your HSA based on the contributions you make today.                Log in to www.myCigna.com to make online transactions,
   Retain all your expense receipts in case you are audited              upload and save receipts, access a life stage modeling tool,
   by the IRS. Expense tracking tools are also available at              an online library of videos and education materials, an
   www.myCigna.com.                                                      interactive FAQ and IRS and tax resources.
   About HSA Bank and your account                                       Earning interest and investing your HSA balance
   If you choose the Health Savings Account option for your              HSA Bank offers two self-directed investing platforms for
   medical coverage, you will receive a welcome package from             investing your HSA balance: TD Ameritrade for stocks, bonds
   HSA Bank with more information.                                       and mutual funds, and Devenir for mutual funds. Some fees apply.
   Your account with HSA Bank will have many features of a standard      For more information about opening an investment account,
   bank account: you will receive regular account statements, and        log in to www.myCigna.com.

Health Reimbursement Account option
This option includes an HRA through Cigna. Under this                To receive reimbursement, all you need to do is show your
option, Capital Power subsidizes the Cigna Preferred Provider        provider your Cigna ID card. Any eligible deductible amount
Organization (PPO) in-network deductible. When you receive           will be applied automatically to your HRA.
care for any in-network services and after you have satisfied        The chart below shows the amount you are responsible to
your portion of the deductible, HRA dollars are used to pay          cover toward meeting the deductible, and what the HRA
for the remainder of your expenses.                                  will reimburse depending on your level of coverage:

                                                 Employee          Employee        Employee            Employee             Employee
                                                   only            & spouse        & one child         & children            & family

 Core medical insurance annual
                                                   $2,500            $5,000          $5,000              $7,500               $7,500
 in-network deductible

 Employee portion – annual                          $750             $1,500          $1,500              $2,250               $2,250

 Capital Power portion – annual
                                                   $1,750            $3,500          $3,500              $5,250               $5,250
 (HRA reimbursement amount)

The Health Reimbursement Account option comes
with an embedded deductible
If you enroll in the Health Reimbursement Account (HRA)
option and stay in the network, Capital Power will cost share
the deductible with you.

  EXAMPLE: Ken has family coverage, he covers himself, his wife and his daughter on the HRA option. While Ken’s wife and
  daughter have had minimal claims this year, Ken ends up seeing a specialist several times for consultations and surgery.
  The total in-network costs eligible for the deductible end up around $8,000. With the HRA option, his medical insurance
  includes a family in-network deductible of $7,500. Since the HRA is embedded, Ken has to satisfy the individual deductible
  of $2,500, and his portion of the deductible under the HRA is $750. Once Ken has paid $750 of his own claims towards
  the deductible, Capital Power’s HRA pays the next $1,750 until he fully satisfies the individual annual deductible of $2,500.
  He then is reimbursed at 90% until he is out of pocket another $500 at which point he reaches the $3,000 individual out
  of pocket maximum. Any further in-network costs he incurs would be covered 100% by the plan for the remainder of the year
  except for prescription drugs which have their own out of pocket maximum. Ken’s family members will each need to satisfy
  their own individual deductibles within their family coverage similar to Ken, up to the plan’s out of pocket maximum.

           Family and employee coverage                                                 $7,500 family in-network deductible
             $7,500 family deductible
              ($2,500 per individual)                  Ken has to satisfy this
                                                       embedded deductible
       $9,000 family out of pocket maximum                                            $2,500 individual in-network deductible
             ($3,000 per individual)
                                                                                      His portion             Capital Power’s portion

  Then…                                                                                  $750                          $1,750
  • The plan pays 90%, Ken pays 10% until he pays another $500.
  • He’s 100% covered when he reaches the individual out of pocket                    Paid $750               Capital Power pays
    maximum of $3,000.                                                                                            the rest of the
                                                                                                               $2,500 deductible –
  • His family members will each need to satisfy their own individual                                           no reimbursement
    in-network deductibles like Ken, up to the plan’s out of pocket maximum.                                     form necessary

                                                                                          CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 13
Which would you choose?
     JASON (mid-twenties)

                                             I’m single, healthy and I enjoy riding my motorcycle in my free time.
                                             I choose the Health Savings Account option because:
                                             I don’t visit the doctor very often, so I like that the HSA option has lower premiums. Also, I like
                                             that I receive the full amount of my HSA at the start of the benefit year because I can start
                                             paying for my first expense with this money and covering my annual deductible with company
                                             money right away. If something were to happen on one of my motorcycle trips, I could be
                                             on the hook for a large hospital bill. I like the fact that unlike an HRA, I don’t lose my HSA
                                             balance every year if I don’t use it. I can build it up year to year to year to help pay for an
                                             unexpected hospital bill. Plus, by choosing the HSA over the HRA, I can use the money
                                             I save on premiums to fund my HSA.

     CINDY (late thirties)

                                             I’m married with two kids, one of whom has a chronic illness.
                                             I choose the Health Reimbursement Account option because:
                                             Over the past few years, I have typically exceeded my portion of the core medical insurance
                                             deductible (mostly due to my daughter’s condition), so my family’s expenses have been
                                             mostly covered. I like the way the HRA works, especially because I pay only the prescription
                                             co-pays rather than having to pay for prescriptions in full until I meet the deductible, and
                                             then paying the co-pays, as I would if I chose the HSA option. For extra peace of mind, I will
                                             purchase Optional Life insurance for me and my husband to protect our family from financial
                                             hardship if something were to happen to either of us.

     DENNIS (early sixties)

                                             I’m divorced and nearing retirement.
                                             I choose the Health Savings Account option because:
                                             Since my divorce, it’s been tough to save enough for my medical expenses in retirement.
                                             I plan to make catch-up contributions to my HSA, and will use my accumulated HSA to
                                             supplement my medical expenses in retirement. In the meantime, I’m using my core medical
                                             insurance plan to cover my current medical expenses, although I may use some of my HSA
                                             dollars to pay my deductible. I also like the fact that I receive my lump-sum deposit at the
                                             beginning of the year because I start earning investment income sooner.

     JASMINE (mid-fifties)

                                             I’m married and I have coverage under my husband’s medical plan.
                                             I choose to opt out of medical coverage because:
                                             My husband’s medical plan provides benefits that are sufficient for the two of us, and I will
                                             receive $3,600 for opting out. However, I still have dental and vision coverage and I continue
                                             to receive access to great benefits like Basic Life Insurance, the Employee Assistance Plan
                                             and more.

Urgent Care versus ER – where to go?
  As a general rule, if your condition is a true emergency, in that it is life-threatening, trauma-related, requires x-rays, or requires
  a surgical procedure, go to the emergency room immediately or dial 911.
  However, because ER visits can be expensive (around three times the cost of a visit to Urgent Care), some conditions can
  be better suited to an Urgent Care center.
  If your condition is non-life threatening and you don’t have time to visit your doctor, you can visit an Urgent Care center for help
  with: fever, flu, cold, cough, sore throat, vomiting, diarrhea, stomach pain, cuts and severe scrapes, minor injuries and burns,
  sports injuries, and more.

Medical Opt-Out Benefit                                                Flexible Spending Accounts
No Coverage Option for medical and prescription                        Flexible Spending Accounts (FSAs) enable you to set aside
drug coverage                                                          money on a pre-tax basis for eligible expenses. Two types of
                                                                       FSA are available: a Health Care Flexible Spending Account
Capital Power offers an incentive payment if you choose
                                                                       (HCFSA), which you can use for eligible medical, dental
“No Coverage” under the medical plan. If you make this
                                                                       and vision care expenses, and a Dependent Care Flexible
election, your opt-out benefit will be added to your paycheck
                                                                       Spending Account (DCFSA) for eligible expenses related
in equal amounts over the course of the year if you provide
                                                                       to childcare and eldercare.
proof of medical insurance elsewhere.
The annual opt-out benefit is $3,600 and is treated as                 Eligibility
taxable income.                                                        All employees may contribute to a DCFSA.
Reminder: you must re-certify every year during open                   Your eligibility for a HCFSA depends on which core medical
enrollment to receive the opt-out benefit.                             insurance option you choose. If you choose the HSA option,
                                                                       you will not be able to use the FSA for medical expenses due
                                                                       to IRS restrictions.

                                                    Which types of FSA
 CORE MEDICAL INSURANCE OPTION                                                       Example of eligible expenses
                                                    can you choose?
                                                                                     •   Day care
 Health Savings                                                                      •   Summer day camps
                                                       Dependent Care FSA
 Account option                                                                      •   Babysitters
                                                                                     •   Eldercare expenses
 Health Reimbursement                                                                • Coinsurance, co-pays, deductibles
 Account option
                                                                                     • Eyeglasses, contact lenses, laser eye surgery
                                                         Health Care FSA             • Prescription drugs and some over the counter
                                                                                       medicines and supplies
                                                                                     • Dental treatments

For a full list of eligible expenses, visit www.payflex.com.

                                                                                               CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 15
Select your FSA contribution amount for 2019
   The amount you choose to contribute is taken out of your        Your only opportunity to make elections for your FSA is during
   paycheck in equal amounts each pay period. The maximum          open enrollment – you may not change your elections during
   HCFSA election is $2,700 per year; the maximum DCFSA            the benefit year. Any changes will be effective January 1, 2019.
   election is $5,000 per household per year. If your spouse
                                                                   How Flexible Spending Accounts help you save money
   contributes to a DCFSA and you file separate tax returns, the
   maximum you can each contribute to a DCFSA will be $2,500       The example below applies to the HCFSA, but the concept is
   in order to avoid IRS penalties. Money in an FSA does not       similar for the DCFSA. This example is for illustrative purposes
   rollover every year – any unused FSA amounts are forfeited at   only. Every situation varies and it is recommended you consult
   year end. You have access to the full amount of your election   a tax advisor for all tax advice.
   from January 1 each year – you don’t have to wait until your
   contributions have reached that amount to be able to use the
   balance in your account.

     EXAMPLE: Jason has a gross income of $100,000. He wears contact lenses, takes daily prescription medication and
     plans to have routine medical and dental checkups throughout the year. He chose the Health Reimbursement Account
     option for his core medical insurance, which means he is eligible to open a HCFSA. Jason plans to contribute the maximum
     $2,700 to his HCFSA because his expenses are eligible for reimbursement from the HCFSA.
     The example below shows how contributing to a HCFSA can provide Jason with more spendable income:

                                                                                           Without HCFSA          With HCFSA

       Gross income                                                                           $100,000             $100,000

       HCFSA contributions (tax-free)                                                            $0                –$2,700

       Gross taxable income                                                                   $100,000              $97,300

       Estimated taxes: Federal, State, FICA (assume 20%)                                    –$20,000              –$19,460

       After-tax earnings                                                                     $80,000               $80,540

       Increase in spendable income                                                             None                  $540

   By contributing $2,700 to his HCFSA, Jason has $540 more        The savings calculator at www.payflex.com can help you
   spendable income because any contributions to the HCFSA         calculate unreimbursed health and dependent care expenses
   (and the DCFSA) are made before tax is deducted.                to help you determine your FSA contributions. Click on the
                                                                   “individuals” tab, then “calculate your savings”, then scroll down
                                                                   to find the calculator.

Prior Authorization and Step Therapy
Prior authorization is a cost control process, supported by          As an example, if you are prescribed one of the Step Therapy
Capital Power, in which certain drugs and procedures require         drugs, you will try the most cost-effective, appropriate
Cigna’s approval before the cost of a treatment or procedure         medications available (typically, generics or lower-cost
is covered by the medical plan. This enables Cigna to review         brands) before more expensive brand-name versions are
your treatment before they will cover it to ensure it is medically   approved for coverage.
necessary and appropriate for your condition.                        The program includes medications used to treat the following
                                                                     medical conditions:
Cigna also operates a program that helps keep costs down
for everyone: Step Therapy. This is a program that requires
                                                                     • ADD/ADHD                • High cholesterol
less expensive prescriptions, most often generic drugs, are          • Allergies               • Mental health
tried before more expensive options are explored, unless it’s        • Breathing problems      • Osteoporosis
medically necessary to start with a more expensive alternative.      • Bladder  problems       • Pain (narcotic and non-narcotic
                                                                     • Depression                 pain relievers)
                                                                     • Emerging therapies      • Skin conditions
                      Step Therapy Process
                                                                     • Heartburn/ulcer         • Sleep disorders
  Step 1     Doctor prescribes you a new prescription drug           • High  blood pressure
                                                                     Whenever you fill a prescription for a medication included
                                                                     in this program, you and your doctor will receive a letter from
                                                                     Cigna describing the steps you need to follow before you
  Step 2        You fill the prescription at the pharmacy            refill your medication. If your doctor believes an alternative
                                                                     medication isn’t right for you for medical reasons, they can
                                                                     request that you seek Cigna’s prior authorization of your
                                                                     doctor’s prescribed drug for medications included in the
             You and your doctor receive a letter from Cigna
  Step 3                                                             Step Therapy program.
             stating that you must try a lower cost alternative
                 drug before filling your next prescription          To find out if your prescribed medication is part of the
                                                                     Step Therapy program, log in to www.myCigna.com and
                                                                     navigate to the prescription drug list. You will see a (ST)
                                                                     symbol next to all Step Therapy medications.
                                         Your doctor contacts
                                          Cigna through the
                                                                       It’s a good idea to check with Cigna before you have a
                Your doctor               peer-to-peer review
                                                                       medical procedure to ensure it is covered. However, if the
             prescribes a lower           process to explain
  Step 4                                                               prescribed drug or treatment is denied, you can appeal it
              cost alternative                why you are
                 treatment                 medically unable            – ask your doctor to contact Cigna (1.888.693.3297) to
                                           to take the lower           conduct a peer-to-peer review of your treatment plan with
                                            cost alternative           a physician from Cigna to determine the most effective
                                                                       treatment or drug for your condition.
                                                                       If a further appeal is required, please contact Daniel
If your doctor prescribes one of the medications included in           Heesing, Pension and Benefits Consultant, at
the program, you will be able to fill your prescription initially.     780.392.5013 or DHeesing@capitalpower.com.
However, you and your doctor will receive a mailed letter
saying you need to try a less expensive alternative the next time
your prescription is filled, unless there is a medically relevant
reason why the less expensive alternative cannot be taken.
While it may not be the process you are accustomed to,
this extra step helps ensure you and Capital Power only pay
for medically-necessary prescriptions, which allows Capital
Power to keep costs sustainable and to continue offering
the coverage you receive today. Without these provisions,
the benefits program would soon become unaffordable for
you and Capital Power.

                                                                                           CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 17
   If you are enrolled in one of the medical insurance options,
   you automatically receive access to MDLIVE, a service that                 To access medical advice through MDLIVE, call
   provides convenient, 24/7 remote medical advice 365 days                   1.888.726.3171 or visit www.mdlive.com/cignaselect .
   a year from a board-certified doctor by phone or online                    You can also download the MDLIVE App to visit with a
   video chat. Doctors at MDLIVE are available to talk to you –               doctor using your mobile device.
   no matter where you are located – about common conditions
   such as fevers, cold and flu, infections, allergies, pink eye,
   urinary tract infections and more. MDLIVE doctors can
   give you a diagnosis and prescribe medications if needed.

   Dental Insurance
   PROVIDER: Guardian
   Capital Power offers dental insurance that covers routine                To find out if your provider is in the Dental Guard Preferred
   check-ups and additional services needed for your health.                Network or to find one that is, call 1.800.627.4200 or go to
   There has been no change to the plan’s coverage, and Capital             www.guardiananytime.com and click on “Find a Provider”,
   Power continues to share the cost of dental premiums with                which is located on the homepage.
   you to keep our plan sustainable. You have the option to pay
   a monthly premium, or to opt out of dental coverage.

                                                             In-network Dental Guard
     BENEFIT                                                                                           Out-of-network*
                                                             Preferred Network

                                                             $50 for each covered person                $100 for each covered person
     Annual deductible
                                                             ($150 maximum per family)                 ($300 maximum per family)

     Preventive services (Exams, cleanings, x-rays)          100%                                      100%

     Preventive services (Deductible waived)                 Yes                                       No

     Basic services (Fillings, simple extractions)           100%                                      80%

     Major services (Root canals, crowns)                    60%                                       50%

     Annual maximum benefit                                  $2,000                                    $1,250

     Orthodontia                                             50%, up to $1,500 lifetime maximum

     * Out-of-network benefits are paid based on Maximum Plan Allowance (MPA) and you may be responsible for the difference between
       the provider’s usual fee and the MPA.

Guardian College Tuition Benefit
Rewards Program
Members that enroll in dental coverage with Guardian can               To learn more about the program, register and verify eligibility
register in the College Tuition Benefit Rewards Program and            requirements, go to www.Guardian.CollegeTuitionBenefit.com
earn 2,000 Tuition Rewards annually. You receive an additional         or call 215.839.0119. The registration UserName is your
bonus (2,500) after participating in the program for four years.       Guardian Plan Number 387665 and the password is
Each Tuition Reward is equivalent to a one dollar reduction on         Guardian. Please note, you must register within the next
the tuition to be paid. You can use your College Tuition Benefit       12 months to receive the first year of Tuition Rewards. Once
Rewards to reduce undergraduate tuition for your dependents            registered, you can add eligible dependents.
at SAGE Scholar Consortium colleges (over 380 private
Rewards can be given to children, grandchildren, nieces,
nephews and Godchildren.

Guardian PPO Dental Plan Rollover Feature
Members can save their annual maximum dollars for a time               In future years, if your dental expenses exceed the regular annual
when they need it. With the maximum rollover feature,                  maximum, Guardian will use your MRA to pay those additional
Guardian will roll over a portion of each insured dental               expenses. Even better, if a member uses only preferred providers
member’s unused annual maximum (amount is based on the                 during the benefit year (January 1 to December 31), Guardian
out-of-network maximum) into a personal Maximum Rollover               will increase the amount credited to your MRA.
Account (MRA).                                                         To find out your current rollover amount, call Guardian at

 Plan annual                                     Out-of-network/combo                 In-network maximum            Maximum rollover
 maximum*                                        maximum rollover amount              rollover amount               amount limit

 $1,250                      $600                $300                                 $450                          $1,250

 * If the plan has a different annual maximum for PPO benefits vs. non-PPO benefits, ($2,000 PPO/$1,250 non-PPO for example)
   the non-PPO maximum determines the maximum rollover plan.

 To be eligible for a Maximum Rollover, you must have at least one claim in the plan year, with total claims not exceeding
 the threshold amount.

 EXAMPLE A:                                     EXAMPLE B:                                     EXAMPLE C:

 Year 1 – Paid claims: $400                     Year 1 – Paid claims: $300                     Year 1 – Paid claims: $800
 (all in-network)                               (mixed in- and out-of-network)                 The paid claims exceed the $600
 The paid claims do not exceed the              The paid claims do not exceed the              threshold, therefore no additional
 $600 threshold and all the claims              $600 threshold, therefore $300 is              money is added to the MRA .
 were in-network, therefore $450 is             added to the MRA for use in year 2.
 added to the MRA for use in year 2.

                                                                                               CAPITAL POWER 2019 U.S. BENEFITS ENROLLMENT GUIDE | 19
Vision Insurance
   PROVIDER: Guardian – Vision Service Plan
   Eye care not only helps you see better, but routine check-ups               Capital Power offers eye care benefits through the Guardian
   can detect early signs of many different illnesses, including               Vision Service Plan, which includes routine vision exams,
   diabetes. There has been no change to the plan’s coverage.                  lenses, frames and contact lenses.
   Capital Power continues to share the cost of vision premiums
   with you to keep our plan sustainable. You have the option to
   pay a monthly premium, or to opt out of vision coverage.

     BENEFIT                                                           In-network                            Out-of-network

     Eye exam (every 12 months)                                        $10 co-pay                            Up to $50

                                                                       $25 co-pay; $150 allowance;
     Frames (every 24 months)                                                                                Up to $48
                                                                       20% discount over $130

                                                                                                             Up to $48 for single lenses,
                                                                       $25 co-pay for single, bifocal
     Lenses (every 12 months)                                                                                $67 for bifocal lenses and
                                                                       and trifocal lenses
                                                                                                             $86 for trifocal lenses

     Contacts (every 12 months, in lieu of frames and lenses)          Up to $150                            Up to $120

   Employer-Sponsored Benefits
   and Services
   PROVIDER: The Hartford (no change)                                          Disability Income Benefits
   All Capital Power employees automatically receive the                       Capital Power provides full-time employees with Short- and
   following employer-sponsored benefits, starting the day                     Long-Term Disability income benefits, and pays the full cost
   you meet eligibility for the Capital Power benefits program.                of this coverage. In the event you become disabled from a
                                                                               non-work-related injury or sickness, disability income benefits
   The following benefits are provided at no cost to you:
                                                                               are provided as a source of income. You are not eligible to
   Life Insurance                                                              receive Short-Term Disability benefits if you are receiving
   Basic Life Insurance is provided at two times your annual                   workers’ compensation benefits. Short-Term Disability is
   base salary or pay to a $500,000 maximum benefit.                           coordinated with other disability benefits you may be receiving,
                                                                               such as state-mandated programs and federal, state, and local
   Accidental Death & Dismemberment Insurance                                  government programs.
   Accidental Death and Dismemberment (AD&D) insurance
   is provided at two times your annual base salary or pay to
   a $500,000 maximum benefit.

                                                   Short-Term Disability                           Long-Term Disability

                                                   1st day of a non-work accident
     Benefits begin                                                                                After 90 days
                                                   8th day of illness

     Benefit duration                              13 weeks from date of disability                Until Social Security normal retirement age

     Percentage of income replaced                 100%                                            662/3 %

     Maximum benefit                               90 day coverage                                 $15,000 per month

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