Page 2 - Sumitomo EE Guide 06-20 Final English

Welcome to Sumitomo Rubber North America, Inc!

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

CONTENTS

Important Information ………………………………………… 2 Travel Accident …………………………………………………… 15

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

Employee Contributions ………………………………………. 5 Value-Added Programs ………………………………………. 16
Resources and Contacts ………………………………………. 6 Flexible Spending Accounts ………………………………… 17
Medical Insurance ……………………………………………….. 7 Voluntary Benefits …………………….……………………….. 18
Dental Insurance …………………………………………………. 12 Retirement 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 Individual Mandate
Even though the Affordable Care Act (ACA)’s penalty for not having health coverage (known as the individual mandate) has been
reduced to zero, if you are a taxpayer in California, you will still be required to have health coverage (unless you qualify for an
exemption) or pay a penalty starting with the 2020 tax year. Several other states, including Massachusetts, New Jersey, and
Vermont, as well as the District of Columbia, have reinstated an individual mandate, and others are considering doing so in the
future. You may consider these options below to satisfy this requirement:
• Enroll in a medical plan offered by SNRA or another group medical plan meeting the requirements for minimum essential
coverage;
• Purchase coverage through a health insurance marketplace;
• Enroll in coverage through a government-sponsored program if eligible.
Because SNRA’s medical plans are considered affordable and meet minimum value under the Affordable Care Act, you will not
generally see lower premiums or out-of-pocket costs thorough the marketplace. In addition, employer contributions to your
medical benefits will be lost if you choose to purchase coverage through the marketplace, and your portion of medical premiums
will not longer be paid via payroll deductions 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 notices to their plan participants. SRNA has
posted all federally required annual notices on Paycom for you to download and read at your convenience.

The following is a list of the annual notices:
• Medicare Part D Notice of Creditable Coverage • HIPAA Special Enrollment Rights
• Women's Health and Cancer Rights Act (WHCRA) • Medicaid & Children’s Health Insurance Program
• Newborns’ and Mothers’ Health Protection Act • HIPAA Notice of Privacy Practices

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