Page 2 - Sumitomo EE Guide 06-18.pub
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Welcome to Sumitomo Rubber North America, Inc!

         This guide provides a summary of your benefit op ons and is designed to help you make choices and enroll for coverage. If you
         would like more informa on about any of the benefits described here please contact the Human Resources Department.


         CONTENTS

         Important Informa on …………………………………………  2                   Travel Accident ……………………………………………………  15

         Enrollment Informa on ………………………………………..  3                 Disability Insurance ……………………………………………..  15
         Online Benefits Enrollment …………………………………..  4               Employee Assistance Program …………………………….  16

         Employee Contribu ons ……………………………………….  5                  Value‐Added Programs ……………………………………….  16
         Resources and Contacts ……………………………………….  6                 Flexible Spending Accounts …………………………………  17
         Medical Insurance ………………………………………………..  7                  Voluntary Benefits …………………….………………………..  18
         Dental Insurance ………………………………………………….  12                  Re rement Planning ……………………………………………  18

         Vision Insurance …………………………………………………..  13                 Paid‐Time Off ……………………………………………………...  19
         Life and AD&D Insurance ……………………………………..  14               Whistleblower Hotline ……….……………………………….  20



                               IMPORTANT INFORMATION




         THE AFFORDABLE CARE ACT AND YOU

         The Affordable Care Act (ACA) requires nearly every American to be enrolled in medical coverage or pay a penalty. This is referred
         to as the individual mandate. You have several op ons to sa sfy this requirement:
           Enroll in a medical plan offered by SRNA or another group plan
           Purchase coverage through a health insurance marketplace
           Enroll in coverage through a government sponsored program
           Have no coverage and incur a tax penalty

         Because  SRNA’s  medical  plans  are  considered  affordable  and  meet  minimum  value  under  Health  Care  Reform,  you  will  not
         generally see lower premiums or out‐of‐pocket costs through the marketplace. In addi on, employer contribu ons to your medical
         benefits will be lost if you choose to purchase coverage through the marketplace, and your por on of medical premiums will no
         longer be paid via payroll deduc ons on a pre‐tax basis.



                        FOR MORE INFORMATION
                        Go to www.healthcare.gov




         ANNUAL NOTICES

         Various state and federal laws require that employers provide disclosure and annual no ces to their plan par cipants. SRNA has
         posted all federally required annual no ces on Paycom for you to download and read at your convenience.

         The following is a list of the annual no ces:
           Medicare Part D No ce of Creditable Coverage        Medicaid & Children’s Health Insurance Program
           Women's Health and Cancer Rights Act (WHCRA)        HIPAA No ce of Privacy Prac ces
           Newborns’ and Mothers’ Health Protec on Act         Summary of Benefits and Coverage (SBC)
           Special Enrollment Rights


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