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Important No ces (con nued)

Keep your Plan informed of address changes Women’s Health & Cancer Rights Act (WHCRA)
To protect your family’s rights, let the Plan Administrator know about If you have had or are going to have a mastectomy, you may be en tled
any changes in the addresses of family members. You should also keep a to certain benefits under the Women’s Health and Cancer Rights Act of
copy, for your records, of any no ces you send to the Plan 1998 (WHCRA). For individuals receiving mastectomy‐related benefits,
Administrator. coverage will be provided in a manner determined in consulta on with
the a ending physician and the pa ent, for:
Plan contact informa on  All states of reconstruc on of the breast on which the mastectomy
Confie Seguros Holding II Co. was performed;
Human Resources Department 
7711 Center Drive, 2nd Floor Surgery and reconstruc on of the other breast to produce a
Hun ngton Beach, CA 92647 symmetrical appearance;
714‐252‐2612  Prostheses; and
Benefits@confie.com  Treatment of physical complica ons of the mastectomy, including
lymphedema.

These benefits will be provided subject to the same deduc bles and
HIPAA Special Enrollment No ce
coinsurance applicable to other medical and surgical benefits provided
If you are declining enrollment for yourself or your dependents under the medical plan.
(including your spouse) because of other health insurance or group
health plan coverage, you may be able to enroll yourself or your To obtain more informa on on WHCRA benefits, please contact 7711
dependents in this plan if you or your dependents lose eligibility for that Center Drive, 2nd Floor, Hun ngton Beach, CA 92647; telephone: 714‐
other coverage (or if the employer stops contribu ng towards your or
252‐2612; email: benefits@confie.com.
your dependents’ other coverage). However, you must request

enrollment within 30 days a er your or your dependents’ other
coverage ends (or a er the employer stops contribu ng toward the Newborn and Mother’s Health Protec on Act
other coverage). Group health plans and health insurance issuers generally may not,
under Federal law, restrict benefits for any hospital length of stay in
In addi on, if you have a new dependent as result of marriage, birth,
connec on with childbirth for the mother or newborn child to less than
adop on, or placement for adop on, you may be able to enroll yourself
48 hours following a vaginal delivery, or less than 96 hours following a
and your dependents. However, you must request enrollment within 30 cesarean sec on. However, Federal law generally does not prohibit the
days a er the marriage, birth, adop on, or placement for adop on. mother’s or newborn’s a ending provider, a er consul ng with the

Special enrollment rights also may exist in the following circumstances: mother, from discharging the mother or her newborn earlier than 48
hours (or 96 hours as applicable). In any case, plans and issuers may not,
 If you or your dependents experience a loss of eligibility for
under Federal law, require that a provider obtain authoriza on from the
Medicaid or a state Children’s Health Insurance Program (CHIP)
plan or the insurance issuer for prescribing a length of stay not in excess
coverage and you request enrollment within 60 days a er that
of 48 hours (or 96 hours).
coverage ends; or
 If you or your dependents become eligible for a state premium To obtain more informa on, please call or email the contact listed on the
assistance subsidy through Medicaid or a state CHIP with respect to cover of this document.
coverage under this plan and you request enrollment within 60 days
a er the determina on of eligibility for such assistance.

Note: The 60 day period for reques ng enrollment applies only in these
last two listed circumstances rela ng to Medicaid and state CHIP. As
described above, a 30 days period applies to most special enrollments.
To request special enrollment or obtain more informa on, contact 7711
Center Drive, 2nd Floor, Hun ngton Beach, CA 92647; telephone: 714‐
252‐2612; email: benefits@confie.com.

Gene c Informa on Nondiscrimina on Act (GINA)
The Equal Employment Opportunity Commission (EEOC) has issued final
regula ons implemen ng Title II of the Gene c Informa on
Nondiscrimina on Act (GINA). Title II generally prohibits employment
discrimina on based on gene c informa on, as well as collec on, use
and disclosure of gene c informa on in connec on with employment.
President Bush signed GINA into law in May 2008 and it is currently in
effect. The EEOC’s new regula ons are effec ve January 10, 2011, and
employers may want to implement some compliance measures in
response to the regula ons.

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