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2018 Benefits NO RATES - UHC-WI · With either plan option, in-network preventive care is usually...

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BENEFITS GUIDE 2018
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Page 1: 2018 Benefits NO RATES - UHC-WI · With either plan option, in-network preventive care is usually covered with no cost sharing, including well child, routine physicals, OB/GYN exams,

BENEFITS

G U I D E

2018

Page 2: 2018 Benefits NO RATES - UHC-WI · With either plan option, in-network preventive care is usually covered with no cost sharing, including well child, routine physicals, OB/GYN exams,

Photos: We Challenge YOU!Many thanks to FLJ 07 for submitting this year’s cover photo! We love all your photos and want more. We challenge all regions to submit photos showing how you and your coworkers are the BEST! Will your photo be the cover next year? Selected photos may be used in any upcoming materials; make sure they are high quality and the best resolution your camera or phone can provide.

h Submit your photos in an email to [email protected].

h Make sure to include your name and region in the email.

h Start sending in YOUR photos today, and keep them coming!

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Dear Valued Employees,As members of the Discount Tire Family, we strive to take action in ensuring our customers receive the most information to make the right decision for them (aka the Customer Experience Strategy).

Taking an active role in your health is also important as it is the best way to prevent disease, get appropriate care, and reduce costs at the same time. A smart healthcare consumer doesn’t just ask the right questions of their doctor, but knows it’s also about prevention, self-care, and knowing where to find resources. By being a smart healthcare consumer you can make good decisions which will have a positive impact on your physical and financial health.

This guide is a tool to assist you in making the right benefit elections. After you have reviewed your choices, log in to Workday to make your benefit elections by Friday, October 27, 2017.

Sincerely,

Your Discount Tire Benefits Team

What’s in this guide?NOT Changing Your Benefit Elections for 2018? / Important Notes . . . . . . . . . . . . . . . 2

Benefit Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Medical Plan Choices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4

Medical Plans Compared . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Health Savings Plan with the Health Savings Account (HSA) . . . . . . . . . . . . . . . . . . . . 6

Prescriptions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7

Health & Wellness Features . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Flexible Spending Accounts (FSA) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Dental Plan / Vision Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Legal Insurance / Pet Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Employee Assistance / Tuition Assistance / Dependent Scholarships . . . . . . . . . . . . . 12

401(k) Retirement Plan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Life and Disability Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

For the most up-to-date information regarding

benefit choices during open enrollment or any time

throughout the year, visit www.discounttirefamily.com.

Online Resources for Employees and FamiliesHave you visited www.discounttirefamily.com yet? The Discount Tire Family website can be accessed from work or at home to keep you and your family informed and up-to-date on:

¾ Employee Benefits

¾ Financial Resources

¾ Health and Wellness

¾ Discount Tire In the News

¾ Healthy Recipes

¾ And more!

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NOT changing your benefit elections for 2018?

Log in at https://www.myworkday.com/tires during Open Enrollment to complete the following by Friday, October 27, 2017:

Review all of your important information, dependents and beneficiaries, including:

h Your dependent(s) on the plan (Ex-spouses and dependent children age 26 and older are not eligible for coverage.)

h Your chosen beneficiaries and their contact information, for both your life insurance and 401(k) account (Check your 401(k) beneficiaries at www.EmpowerMyRetirement.com)

h Your contact info, including your current mailing address, phone number and personal email

h Your emergency contacts

Tobacco Free Employees qualify for 2018 Wellness Rates.

h Remember, you must declare you are tobacco free every year to qualify for Wellness Rates for your medical plan contributions. To participate, follow the instructions in Workday to make your 2018 benefit elections.

Remember, you must enroll in Health Savings and Flexible Spending Accounts every year.

h Optum Bank Health Savings Account holders or those enrolling or re-enrolling in WageWorks’ Health Care and/or Dependent Care Flexible Spending Accounts for 2018 must elect and set payroll deduction amounts in Workday.

Important to Note:

Open Enrollment in Workday ends Friday, October 27, 2017.

After making your benefit choices, please review and verify your elections carefully. You are electronically signing that you are agreeing to the benefits you elect, so print the confirmation statement for your records.

2017 Open Enrollment for Austin J Dillon (000987)Initiated On: 10/01/2017Submit Elections By: 10/21/2017Event Date: 01/01/2018

Total Employee Cost/Credit$209.07 Weekly Cost

Select the print button below to print/save a pdf summary of your 2017 Open Enrollment elections.Elected Coverages

Benefit Plan Coverage BeginDate

Deduction BeginDate Coverage Calculated

Coverage Dependents Beneficiaries Employee Cost(Weekly)

EmployerContribution

(Weekly)Medical - UnitedHealthcare HealthSavings Plan

01/01/2017 12/25/2016 Employee +Family

Elizabeth RDillonLaura M Dillon

$70.47 $254.46

Dental - Delta Dental ofIllinois PPO

01/01/2017 12/25/2016 Employee +Family

Elizabeth RDillonLaura M Dillon

$8.67 $14.43

Health Savings Account- Optum Bank

01/01/2017 12/25/2016 $1,200.00Annual

$60.00

Healthcare FSA -WageWorks

01/01/2017 12/25/2016 $1,000.00Annual

$50.00

Basic Life - VoyaFinancial (Employee)

01/01/2017 12/25/2016 1.5 X Salary $50,000.00 Laura M Dillon $0.81

Additional Life - VoyaFinancial (Maximum 7xSalary) (Employee)

01/01/2017 12/25/2016 $350,000 $350,000.00 $12.92

Short Term Disability(STD) - Voya FinancialBASIC (Employee)

01/01/2017 12/25/2016 60% of Salary $1,200.00 $6.20

Short Term Disability(STD) ENHANCED -Voya Financial(Employee)

01/01/2017 12/25/2016 60% of Salary $704.55 $3.62

EAP - EAP AdvantagePlus

01/01/2012 01/01/2012

Total: $209.07 $272.51Waived Coverages

Plan TypeVisionDependent Care FSASpouse LifeChild LifeLong Term Disability (LTD)Long Term Disability (LTD) ENHANCED

Submit Elections Confirmation 12:50 PM10/01/2017Page 1 of 3

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Benefit Eligibility

Employees:Full-time employees are eligible for the Company’s benefit plans after 90 days of full-time employment. The 401(k) plan is open to employees age 21 and over, after completing 1,000 hours of service.

Eligible Dependents:Eligible dependents include your legal spouse and children up to age 26. The definition of “child” includes any of the following:

h Your child / stepchild

h A child placed with you for adoption

h Your legally adopted child

h A child for whom you have legal guardianship

h Your child for whom health coverage is required through a Qualified Medical Child Support Order (QMCSO)

Newly married or divorced? These events change your benefit eligibility.Below is an outline of benefit-related actions and their required documentation.

If you have experienced ... Documentation Required

MarriageMarriage certificate and new spouse’s Social Security card (original maiden name social security cards are accepted)

Divorce (you MUST remove your former spouse and/or former step-children)

Divorce decree

Death of spouse or dependent child Death certificate

Birth or adoptionBirth certificate or verification of birth / adoption agreement and Social Security card

Gain or loss of other coverageProof of other coverage or loss of coverage and effective date; applicable birth certificate(s), marriage certificate and Social Security cards if adding dependents

NOTE:

Information About Making Mid-year Changes: Once a qualifying life event occurs, you have 31 days from the date of the event to log in to Workday to submit the changes to your benefit elections and upload your supporting documents (i.e. birth certificate, marriage certificate, Social Security card, etc.). Changes will be effective on the date of the qualifying event.

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Medical Plan Choices

United Healthcare (UHC)Selecting the right medical plan takes careful consideration. The Company offers medical plan options through United Healthcare; review your choices and choose the plan which best meets your needs. You can manage all aspects of your medical plan at www.myuhc.com.

Options Plan h Coverage through the Options Plan is a more traditional health care option

with a deductible, set co-pays and coinsurance amounts.

h With the Options Plan, you have the option to elect the Flexible Spending Account (FSA). See details on page 9.

Health Savings Plan h The Health Savings Plan is a medical plan with a Health Savings Account (HSA).

h The Company contributes to your HSA once your medical benefits go into effect: $500 for individual / $1,000 for family. Plus, you can contribute to your HSA tax free. See details on page 6.

h Use your HSA money to pay your out of pocket health care expenses. All medical and prescription costs are applied to your deductible; after you meet the deductible, there are no co-pays and the plan covers 90% with 10% employee coinsurance.

h With the Health Savings Plan, you have the option to elect the Flexible Spending Account (FSA), but you may only use FSA funds to pay for dental and vision expenses. You cannot use FSA funds to pay for medical expenses when enrolled in the Health Savings Account.

h Your HSA goes where you go! Even if you change jobs, switch health plans, or retire, your HSA is yours—you own it, and the money carries over from year to year. See details on page 6.

Preventive Care at No CostWith either plan option, in-network preventive care is usually covered with no cost sharing, including well child, routine physicals, OB/GYN exams, mammograms and prostate exams. Costs will only be incurred if additional non-preventive lab work is requested. Also, many prescription medications are considered preventive and also covered with no cost sharing. Call the member number on your Medical Plan ID card to find out which preventive medications and services are covered at no cost.

2018 Weekly Employee and Employer Medical Contributions

See the Medical Rates in the Benefits Guide mailed to your home or contact the Benefits Team in Human Resources for more information at 1-800-347-4348 or [email protected].

Be a Smart Consumer! Choose from UHC’s

Premium providers for quality physicians who

offer more financial value.

Remember: you must declare you are tobacco free EVERY YEAR to qualify for Wellness Rates.

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Don’t wait until you throw your back out or have a 102° fever to sign up for Virtual Visits!

Sign up now to easily access virtual visits when you need them. To learn more and choose a virtual visit provider group, log in to www.myuhc.com.

• FREE for Options Plan participants

• Health Savings Plan participants: $40 per visit – use your HSA dollars!

Medical Plans ComparedBenefit

UHC Options Plan UHC Health Savings Plan

In-Network Out-of-Network ∆ In-Network Out-of-Network ∆

The Company’s Contribution

Individual/Family (Does not apply) $500/$1,000 ∑

Annual Deductible

Individual/Family $600/$1,800 $1,200/$3,600 $2,000/$4,000 Ω $4,000/$8,000 Ω

Maximums

Out-of-Pocket: Individual/Family $3,000/$7,000 $7,000/$18,000 $3,500/$6,850 $7,000/$14,000

Lifetime Maximum Unlimited Unlimited Unlimited Unlimited

Preventive Care

Routine physicals, immunizations, pap smear, mammogram, prostate screening, etc. Frequency limitations apply.

100% 70%* 100% 70%*

Physician’s Office Services: Sickness and Injury

Physician $20/visit 70%* 90%* 70%*

Specialist $40/visit 70%* 90%* 70%*

NEW Cost Savings: Virtual Visit via myuhc.com FREE N/A $40 N/A

NEW Cost Savings: Acupuncture (max 10 visits per year) $40/visit 70%* 90%* 70%*

Mental Health Services / Substance Related and Addictive Disorders

Inpatient 90%* 70%* 90%* 70%*

Outpatient $20/visit 70%* 90%* 70%*

NEW Cost Savings: Virtual Visit via myuhc.com FREE N/A $40 N/A

Maternity Care

Prenatal Visit $40 70%* 90%* 70%*

Postnatal Visits/Surgery 90%* 70%* 90%* 70%*

Emergency, Hospital, Tests

Urgent Care $40/visit 70%* 90%* 70%*

Emergency Room $200 $200 90%* 90%*

Hospital Care 90%* 70%* 90%* 70%*

Outpatient Surgery 90%* 70%* 90%* 70%*

Lab, X-Ray and Major Diagnostics (CT, PET, MRI, MRA and Nuclear Medicine) – Outpatient

90%* 70%* 90%* 70%*

* = After deductible ∑ = The Company funds your HSA on the day Medical Benefits go into effect. Ω = The Health Savings Plan also requires the FULL family deductible (e.g. $4,000 for in network) be met if you have enrolled any dependents at all. ∆ = When you receive out-of-network care, the plan covers its percentage up to the Reasonable

and Customary (R&C) limit, after you satisfy the Annual Deductible. You pay the remaining percentage up to the R&C limit plus any amount above the R&C limit.

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Health Savings Plan with the Health Savings Account (HSA)The Health Savings Account (HSA) is offered through Optum Bank to employees who enroll in the Health Savings Plan. Remember, you must set your weekly contribution amounts when you enroll, but you may also increase or decrease your weekly contribution amounts any time throughout the year in Workday. If you choose to enroll in the Health Savings Plan, you will receive a welcome kit and debit card from Optum Bank to pay for any out-of-pocket expenses.

Company HSA ContributionsThe Company will contribute $500 for individual coverage and $1,000 for family coverage on the day medical benefits go into effect. NOTE: If you change your Health Savings Plan enrollment from individual to family or family to individual based on a qualifying event in the middle of 2018, the Company’s contributions will remain at the plan coverage level at which you initially enrolled.

Your Pretax HSA ContributionsIn addition to the deposits the Company makes, you are able to contribute money on a pre-tax basis from your paycheck to your HSA up to the combined annual IRS limit of $3,450 for individual coverage and $6,900 for family coverage. (These limits include the Company’s contribution of $500 for individual and $1,000 for family.) If you are age 55 or older, you may contribute up to an additional $1,000 per year.

HSA Benefit: Triple Tax Advantage

NOTE: You must be enrolled in the Health Savings Plan to take advantage of the Health Savings Account.

Your contributions are made pre-tax, decreasing your overall taxable income.

Your account grows tax free through investments or interest payments.

Money is withdrawn tax free when you pay for qualified health care expenses.

Using your Health Savings Account

h Take advantage of the Health Savings Plan’s lower premiums and contribute the money you save on premiums into your HSA! Your HSA is a tax-free savings account which you own and the money carries over from year to year.

h Use your HSA to pay for visits to your physician or when you pick up a prescription, or other expenses such as, eye glasses, orthodontia, and chiropractic care. See other qualified expenses at www.optumbank.com.

h If you don’t use the money in your HSA, it will be there for unexpected medical expenses or additional retirement funds.

h If you have questions about your account, or want to learn more about your choices for using your HSA, contact Optum Bank’s customer service at 1-844-326-7967 or www.optumbank.com.

HSA Eligibility and Restrictions: To be eligible to contribute to the HSA, you cannot have other non-HSA compatible coverage (i.e. Traditional PPO, HMO, or HRA plans, including non-HSA compatible coverage through a spouse’s employer, your spouse enrolled in a non-limited FSA, Medicare, Medicaid, or Tricare), or have someone claim you as a dependent for tax purposes. If this is the case, you can still elect the Health Savings Plan for the lower premium contribution, but you may not receive the employer contributions or make your own pre-tax contributions to the HSA. If you are also enrolling in the Flexible Spending Account, you are limited to using your FSA only for vision and dental expenses for you and your family.

NEW for 2018:

Your pre-tax contribution limits to your HSA have increased this year:

h $3,450 for individual coverage

h $6,900 for family coverage

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Prescriptions

NEW! Mail Service Member SelectBeginning January 1, 2018, OptumRx® (the administrator of the pharmacy benefit on behalf of your United Healthcare medical plan) will make it easy for you to receive your maintenance medication(s) AND save you money. Mail Service Member Select (MSMS) gives you the choice to fill your maintenance medication at a retail pharmacy or take advantage of the cost savings and convenience of mail order.

What happens if I do nothing on January 1, 2018?United Healthcare will be mailing out member communications notifying you if you are eligible for this program. Before you reach your maximum number of two fills on your maintenance medication(s), you will need to either move your prescription to home delivery or continue filling at a retail pharmacy. If you do not choose a fill preference, you will pay the full cost for your medication until you make a decision.

What happens if I opt out of the Mail Service Member Select Program (MSMS)?If you chose not to enroll, you can continue filling your prescriptions at a retail pharmacy for the cost of your co-pays. However, you can switch back to OptumRx home delivery at any time.

Why choose home delivery?

h Cost savings: Average savings are 50% or more off of retail pharmacy pricing.

h Convenience: Receive home delivery of your medication with free standard shipping.

h 24/7 access: Speak to pharmacists who can answer your questions anytime.

h Helpful reminders: Set up text and email reminders to help you remember to take or refill your medication.

h Automatic refills: Some medications may be set up to refill automatically once you’ve enrolled.

It’s easy to get started!

h Online: Log in or register at www.myuhc.com and select Manage My Prescriptions.

h By phone: Call the member phone number on the back of your plan ID card to talk with a customer service representative. It’s helpful to have your plan ID card and medication bottle available. The representative can also contact your doctor directly if you need a new prescription.

h By fax / ePrescribe: Ask your doctor to call 1-800-791-7658 for instructions on how to fax your prescription directly to OptumRx Mail Service Pharmacy. Or your doctor can send an electronic prescription to OptumRx Mail Service Pharmacy.

Mail Service Member SelectSAVINGS:

Options Members: Get three months’ supply of prescription medications for the cost of two with Mail Service Member Select!

Health Savings Members: Mail Service is more cost effective AND you won’t pay dispensing fees charged in retail pharmacies.

PrescriptionsUHC Options Plan UHC Health Savings Plan

Retail (30 day supply)

Mail Order (90 day supply)

Retail (30 day supply)

Mail Order (90 day supply)

Tier 1 $10 $20 90%* 90%*

Tier 2 $30 $60 90%* 90%*

Tier 3 $60 $120 90%* 90%*

Tier 4 $90 $180 90%* 90%*

* = After deductible

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Health & Wellness FeaturesBy taking better care of ourselves, we have the opportunity to live healthier lives as well as reduce future medical costs. A variety of health and wellness features are available to you for free at www.myuhc.com as part of our comprehensive medical benefit plan through United Healthcare (UHC). Here are some examples:

Maternity Support ProgramIf you’re thinking about having a baby, or already have one on the way, the Maternity Support Program gives you access to an experienced maternity nurse to answer your questions and offer support throughout your pregnancy and after birth. Call 1-855-837-1612 and speak with a Health Advocate to register and learn more!

Check, Choose, Go >When you need care quickly, call your primary care physician or family doctor first. When seeing your physician is not possible, use the steps below to help you find the right place for you and avoid any financial surprises:

h 24/7 Nurse Line – Anytime expert advice. Call the number on your health plan ID card: FREE

h Virtual Visits on myuhc.com – Anytime online doctor visits. Options Plan: FREE; Health Savings Plan*: $40

h Urgent Care Center – For non-life-threatening immediate needs. Options Plan: $40; Health Savings Plan*: $190

h Emergency Room (ER) – For serious immediate needs. Options Plan: $200; Health Savings Plan*: $1,700

*Average cost shown; your responsibility until you’ve met your deductible, then 10% co-insurance.

Get a Physical, Get $50!Have your physician complete the Physician Affidavit, add your signature and return it to Human Resources by December 31, 2018, and you’ll receive a $50 gift card! Find the form in the front of this packet or on the Discount Tire Family website: www.discounttirefamily.com. Email completed forms to [email protected]. ALL full-time employees and their spouses are eligible!

Health4Me Smartphone AppUHC’s free Health4Me app provides mobile access to you and your family’s health information. Once you’re enrolled, download this app to find a physician, check the status of a claim, view your Medical Plan ID card, or use the Cost Estimator to help you make the best decisions regarding your care. Health4Me is available on the App Store and Google Play. Download the app for free today.

Advocate4MeFrom questions about benefits to help finding a doctor near you, Advocate4Me can provide support and resources to help you and your family make confident health care decisions. To contact a Health Advocate, call 1-855-837-1612 or email [email protected]. Advocates are available weekdays, 8 a.m. to 8 p.m. local time and nurses are available 24/7.

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FSA plans contain a “Use It Or Lose It” provision—please plan carefully!

If you are enrolled in the HSA, you cannot use your FSA dollars for anything other than dental and vision expenses.

Add Up Your Savings:

You save by reducing the amount of your earnings which are subject to federal income tax, FICA (Social Security) tax, and where applicable, state income tax. Exactly how much you save depends on how much you contribute each year and on your tax situation. Most people can save between $30 and $40 in taxes for every $100 contributed.

The bottom line: You keep more of your hard-earned money—instead of giving a portion to the IRS—by using tax-free dollars for expenses you face throughout the year. And with the various mobile and online resources available, spending your account funds couldn’t be any easier.

Health and Dependent Care Flexible Spending Accounts (FSA)

WageWorksThe Company’s Flexible Spending Accounts (FSA) can help you save money. By paying for eligible health care and dependent care expenses for you or your qualified dependent(s) with an FSA, you reduce your taxable income and pay no federal, state or social security taxes on the money used for those expenses. You must enroll each year to participate. FSA plans contain a “Use It Or Lose It” provision—please plan carefully! Should you leave the Company, benefits terminate on your last day of employment.

Health Care Flexible Spending AccountUse your health care FSA to pay for eligible medical, pharmacy, dental and vision expenses for you and your dependents, including, but not limited to, the cost of co-pays, coinsurance, eye glasses, orthodontia, chiropractic care, and eligible over-the-counter drugs. For plan year 2018, the maximum amount you can contribute to your health care FSA is $2,650. For a list of eligible expenses, visit www.wageworks.com.

Dependent Care Flexible Spending AccountUse your Dependent Care FSA to pay for eligible child care (up to age 13) and elder care expenses you incur because you and your spouse work. By law, the maximum amount you may contribute to any Dependent Care FSA for your family is $5,000 (or $2,500 if you are married and filing a separate return each calendar year). In addition, your provider of care must furnish you with either his/her Social Security Number or Tax Identification Number. For a list of eligible expenses, visit www.wageworks.com.

Flexible Spending Account ManagementManaging your account is easy. With a variety of payment and reimbursement options, your WageWorks FSA is easy to use. For Health Care FSAs, you’ll be provided with a convenient WageWorks Healthcare Card giving you swipe-and-go convenience. You also have the option to submit your receipts using the WageWorks EZ Receipts mobile app. Go to www.wageworks.com, to manage important aspects of your FSA, including:

¾ Submit claims

¾ Check your balance

¾ Access forms

¾ View claim status and history

¾ Add a dependent

¾ Sign up for electronic notifications

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Dental Plan: Delta Dental of ILDelta Dental of Illinois provides you access to a national network of preferred providers. Although you are not required to use these providers, benefits are enhanced when selecting providers within the preferred network. Find preferred providers at www.deltadentalil.com or download the Delta Dental mobile app.

Benefit PPO NetworkPlan Pays

Premier NetworkPlan Pays

Out-of-NetworkPlan Pays

Annual Deductible

Individual/Family $50/$150 $50/$150 $50/$150

Maximum Benefits – a pre-estimate is highly recommended to verify benefits prior to treatment:

Annual Max Per Individual $1,750 $1,750 $1,750

Lifetime Maximum Unlimited Unlimited Unlimited

Preventive Services Include:

Oral Evaluations, X-Rays and Clean-ings (2 cleanings/year)

100%* of reduced fee 100% ∑ of MPA 100% Ω of MPA

Basic Services Include:

Fillings, Extractions, Endodontics 80%* of reduced fee 80% ∑ of reduced fee 80% Ω of reduced fee

Major Services Include:

Implants, Inlays, Onlays, Crowns, Bridges and Prosthodontics

50%* of reduced fee 50% ∑ of reduced fee 50% Ω of reduced fee

Orthodontia Services:

Coverage Level 50% of reduced fee 50% of dentist’s fee 50% of dentist’s fee

Lifetime Maximum $2,000 $2,000 $2,000

* = You will not be “balance billed” for charges exceeding Delta Dental’s allowed PPO fees. ∑ = You will not be “balance billed” for charges exceeding Delta Dental’s maximum plan allowances (MPAs) Ω = You are responsible for charges exceeding Delta Dental’s maximum plan allowances (MPAs)

Vision Plan: Superior Vision Through Superior Vision, you can choose from a large number of in-network providers who will help you save money. Find an in-network provider, or confirm your current provider is in the network at www.superiorvision.com. The vision plan is a voluntary benefit, 100% employee paid.

Benefit In-NetworkPlan Pays

Out-of-Network Reimbursement

Exams (once every 12 months):

Exams/Screenings 100% $34

Lenses (once every 12 months):

Single Vision 100% $29

Bifocal 100% $43

Trifocal 100% $53

Frames (once every 12 months):

Retail Chain Provider $150 $75

Contacts - in lieu of eyeglasses (once every 12 months):

Elective $150 $100

Delta Dental To-go Feature:

You don’t have to leave your unused annual maximum behind. Discount Tire and Delta Dental are giving you more flexibility and helping you prepare for more extensive and costly dental treatment. Log in to www.deltadentalil.com for more information.

NO CHANGE TO PREMIUMS IN 2018

2018 Weekly Employee Dental Contributions

See the Dental Rates in the Benefits Guide mailed to your home or contact the Benefits Team in Human Resources for more information at 1-800-347-4348 or [email protected].

NO CHANGE TO PREMIUMS IN 2018

2018 Weekly Employee Vision Contributions

See the Vision Rates in the Benefits Guide mailed to your home or contact the Benefits Team in Human Resources for more information at 1-800-347-4348 or [email protected].

Remember: HSA and FSA dollars can be used for Dental and Vision Services.

No member card needed for your

Vision Plan!

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NEW! Legal Insurance: LegalGUARDLegalGUARD:Discount Tire has partnered with Nationwide to provide you with the LegalGUARD insurance plan, beginning January 1, 2018. Enrolling in LegalGUARD can help reduce stress and provide the support and protection you need when dealing with a legal or financial concern, or are preparing for an unexpected situation.

What does the LegalGUARD Plan provide?

h Access to over 18,000 attorneys nationwide with expertise specific to your personal legal matter

h Concierge help navigating common individual or family legal issues

h In- and out-of-network coverage

Coverage: h Home and residential: buying, selling, tenant disputes

h Financial and consumer: debts, tax audits, student loan refinancing

h Family: divorce, separation, name change, prenuptial agreement, adoptions (including international)

h Estate planning and wills: will, living will, power of attorney

h Auto and Traffic: license suspension, traffic ticket, vehicle repair and lemon laws

Visit www.legaleaseplan.com/discounttire or call 1-800-248-9000 for more information and complete definitions.

Limitations and exclusions may apply.

NEW! Pet Insurance: NationwideMy Pet Protection Plans: We understand how unexpected vet expenses can become stressful when your family pets get sick or injured. Starting in 2018, Discount Tire will offer My Pet Protection plans through Nationwide Pet Insurance.

Coverage:

h Reimbursement for vet bills up to 90%, with a $7,500 maximum per year, once you meet a $250 annual deductible

h Optional coverage for preventive care, like shots and flea medicine

h Boarding/kennel fees if a family member is hospitalized due to injury/illness

h Advertising/reward fees for pets that go missing during the policy term

h Pet replacement costs if a missing pet is not found within sixty(60) days

h Mortality coverage for euthanization due to illness/injury and cremation/burial fees

How does My Pet Protection Plan work?Simply take your pet to any vet, pay the invoice and submit your claim to Nationwide Pet Insurance. You’ll be reimbursed – by check or direct deposit – usually within ten days. Enroll NOW through Dec. 31, 2017 for coverage starting Jan. 1, 2018:

h Go to www.petinsurance.com/discounttire or call 1-877-738-7874. (NOTE: Pet insurance enrollment is NOT via Workday.) Mention DISCOUNT TIRE to get our exclusive plans with preferred pricing, based on the plan type and state you live in.

h You may enroll at any time in 2018. If you enroll after Jan. 1, there is a two-week set-up period before coverage starts.

h Make your monthly premium payments directly to Nationwide Pet Insurance.

See inserts on these great NEW benefits in the guide sent to

your home!

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Employee Assistance Program (EAP)

What is the EAP?The Employee Assistance Program (EAP) is a confidential, FREE resource to help with personal issues which might be affecting you and your dependents, such as:

h Personal/family issues

h Work concerns/work-related stress

h Relationship issues (at work or home)

h Substance abuse

h Financial concerns

h Legal issues

h Childcare referrals

h Elder care referrals

How Does the Program Work?When you call the EAP, a counselor will spend time with you or your family member on the phone to identify the issue, gather information and provide personal assistance. When appropriate, the EAP counselor will help schedule an appointment with an EAP affiliate for a face-to-face meeting. All of the EAP Plus counselors and affiliates are licensed by state governing agencies. Up to 6 sessions are provided free of charge to each employee or family member per issue.

GuidanceResources®

Our EAP is provided through GuidanceResources. To register, call 1-844-285-1067 or visit www.guidanceresources.com. For the Organization Web ID, see the Benefits Guide mailed to your home or contact the Benefits Team in Human Resources for more information at 1-800-347-4348 or [email protected].

Bruce T. Halle ScholarshipThe Bruce T. Halle Scholarship Program is available to college-age dependents, ages 17-24, of all full-time employees who have worked at the company for three consecutive years.

The scholarship is provided for undergraduate study only, and students must be enrolled full-time and successfully complete 12 credit hours each semester. The scholarship award is valued at $5,000 per year for students attending a four-year university, or $2,000 per year for students attending a two-year community college or vocational school. The scholarship is divided in two payments and will be paid directly to the school.

Contact the Diane and Bruce Halle Foundation at 480-515-7500 for information on obtaining scholarship application forms and to find out more about the program.

Tuition Assistance ProgramWe recognize your skills and knowledge are critical to the success of the Discount Tire Family. The Tuition Assistance Program encourages employees’ personal development through reimbursement of eligible education expenses—$5,250 per year for full-time employees, provided you pass with a “C” or better.

To participate, you must be employed continuously with the Company for at least one year. Tuition and books are expenses eligible for reimbursement; choose individual courses or courses which are part of a degree program through nationally recognized accredited colleges. Other restrictions may apply. Visit the Knowledge Center for the program rules and application form.

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401(k) Retirement Plan

Empower RetirementEmpower Retirement is the record keeper for the Company’s 401(k) plan. Employees age 21 or older are automatically enrolled in the plan at a pretax contribution rate of 5% after completing 1,000 hours of service. You may choose a different contribution amount, choose to make Roth 401(k) contributions, or opt out at any time.

Contribution MatchingThe Company makes contributing to the 401(k) Retirement Plan a win/win benefit. We encourage you to save by matching your contributions $1.00 for every $1.00 you contribute up to 3% of your compensation and $.50 for every $1.00 on the next 3%. By deferring 6% of your eligible compensation you maximize your match.

Based on an annual salary of $40,000:

If your weekly deferral is:

Your annual contribution would be:

The annual Company match would be:

Total annual account contribution would be:

3% $1,200 $1,200 $2,400

4% $1,600 $1,400 $3,000

5% $2,000 $1,600 $3,600

6% $2,400 $1,800 $4,200

The Company’s matching contributions are deposited in your account quarterly and you are 100% vested in the employer matching contributions after 3 years of service (with a minimum of 1,000 hours each calendar year).

You Control Your Investment StrategyYou can choose to create your own portfolio from an array of investment options or choose a single, pre-diversified target date fund based on your expected retirement date. Visit www.empowermyretirement.com to:

h Access your account

h Name your 401(k) beneficiary

h Set your communication preferences

h Roll over money from other retirement accounts

h Learn whether Roth 401(k) contributions are right for you

Or, contact Empower Retirement by phone at 1-844-372-8473 (1-844-DSC-TIRE) weekdays from 6:00 am to 8:00 pm MST.

Make sure your 401(k) beneficiary is up to date!Your 401(k) beneficiary is the person(s) or entity(ies) who receive(s) the cash benefit from your retirement account should you pass away. It’s important for you to designate a beneficiary and keep the information up to date. If you don’t choose one, your account will be passed on according to the default provisions in the plan, which may not be to the person(s) you prefer.

• You can change your 401(k) beneficiaries at any time at www.empowermyretirement.com.

• Even if you have a will, the Discount Tire Plan provisions will determine who receives your money when you don’t have a beneficiary on file.

• Be aware that proceeds will not be paid directly to minor beneficiaries; a trustee or guardian must receive the money on their behalf which requires additional time and arrangements. Consult a financial professional or call Empower Retirement for more information.

• Questions? Please contact [email protected].

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Life and Disability Insurance: VoyaThe Company’s insurance carrier is Voya. These benefits terminate when you leave the Company. See www.discounttirefamily.com for additional details.

Basic Life Insurance and AD&DBasic Life Insurance benefits offer you a way to protect your family’s financial security in case of your injury or death. The weekly cost is very inexpensive and the benefit is 1.5x your annual salary, up to a maximum of $50,000.

Additional and Dependent Life InsuranceEmployees may purchase Additional Life Insurance in $10,000 rounded-up increments up to 7x your base salary, capped at $500,000. If you elect Additional Life coverage for yourself, you may purchase Dependent Life Insurance for your spouse and child(ren). The Spouse Life benefit may be elected in $5,000 increments up to 50% of your additional life benefit election, capped at $100,000. The benefit amount reduces at age 65. The Child Life benefit covers all of your children up to age 26 in the amount of $5,000 or $10,000. (See the Insurance Rates in the Benefits Guide mailed to your home or contact the Benefits Team in Human Resources for more information at 1-800-347-4348 or [email protected].)

Note: Any new life and disability elections during Open Enrollment require evidence of insurability (EOI). An EOI form will be sent to you from Voya. Complete and return the form to Voya for review. Upon approval, benefits will go into effect.

Life Insurance Summary Table

Coverage Weekly Payroll Deduction

Basic Life and AD&D 1.5x annual salary, $50,000 max See the Insurance Rates in the Benefits Guide mailed to your home or contact the Benefits Team in Human Resources for

more information at 1-800-347-4348 or [email protected].

Additional Life Choose $10,000 increments up to 7x annual salary, $500,000 max

Spouse Life* Choose $5,000 increments up to 50% Additional Life election, $100,000 max

Child Life* Covers all your children; choose $5,000 or $10,000

*Requires Additional Life election.

IMPORTANT: Name Your Life Insurance BeneficiaryYour life insurance beneficiary is the person(s) or entity(ies) who receive(s) the cash benefit from your life insurance policy should you pass away. If you don’t choose one, your state’s laws determine who receives the proceeds. You can change your life insurance beneficiaries at any time by logging into Workday (www.myworkday.com/tires). NOTE: Proceeds will not be paid directly to minor beneficiaries and will be placed in an interest bearing account until the minor is of age, so select your life insurance beneficiaries carefully.

Voya Travel AssistanceAvailable to those who enroll in life and disability benefits: Voya Travel Assistance provides enhanced security for your leisure and business trips. When traveling more than 100 miles from home, Voya offers you and your dependents four types of services: Pre-Trip Information, Emergency Personal Services, Medical Assistance Services, and Emergency Transportation Services. Via web, toll-free or collect calling, you can access these services from anywhere in the world, 24 hours a day, 365 days a year. To learn more about this benefit and how to use it, visit www.discounttirefamily.com.

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Short Term Disability InsuranceThis benefit is designed to replace 60% of your income, up to a maximum of $1,200 per week, if you are unable to work due to a non-work related short term illness or injury. This benefit pays for up to 24 weeks. The cost for this benefit is based on your annual earnings.

Long Term Disability InsuranceThis plan provides 60% of your income, up to a maximum of $6,000 per month, beginning after 180 days of continuous disability. The cost for this benefit is based on your annual earnings and age.

Short Term Disability Weekly Deduction Rates

See the Short Term Disability Rates in the Benefits Guide mailed to your home or contact the Benefits Team in Human Resources for more information at

1-800-347-4348 or [email protected].

Disability Insurance Summary Table

Short Term Disability Plan Long Term Disability Plan

Benefits Begin 15th day of absence from work due to an illness/injury After 180 days of disability

Duration of Benefits Up to 24 weeks (after waiting period) As determined by the Plan

What You Will Receive 60% of basic weekly earnings* 60% of monthly earnings*

Up to a Maximum of $1,200/week $6,000/month*Earnings are defined based on your employment class. Preexisting condition limitation may apply.

Long Term Disability Weekly Deduction RatesSee the Long Term Disability Rates in the Benefits Guide mailed to your home or contact the Benefits Team in Human Resources for more information at

1-800-347-4348 or [email protected].

Funeral Planning ServicesAvailable to those who enroll in life and disability benefits: This funeral and concierge service is available to help you when dealing with funeral related issues. Everest Funeral Package, LLC, is a consumer advocate who works on your behalf—not a funeral home or a funeral services broker. While removed from a sales-focused environment, they will provide information to help you make informed decisions about all funeral related issues, and then put those wishes into action. For more information on this benefit, visit www.discounttirefamily.com.

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Benefits Team1-800-347-4348 [email protected]

Cara London Sr. Benefits Specialist / COBRA x66886

Jackie Logan Benefits for NMA, OKT, TXD, TXH, TXS / Military Leave x66104

Janice Whyte Benefits for Corp, DTD, Flight Dept., AZP, COD, ILC, KSK, MIA, MIW, WAS / 401(k) x65816

Karen Kuntz Benefits for CAL, CAN, CAS, CAR, FLO, GAA, INI, MNM, NVL, TNN, UTS, VAR x67104

Leave of Absence Team1-800-347-4348 [email protected]

Lisa Peterson Short Term Disability / FMLA / Light Duty for Non-Occupational Injuries x66489

Nina Scalzo Short Term Disability / FMLA / Light Duty for Non-Occupational Injuries x67128

Your teams for questions and assistance:


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