This document provides a summary of employee benefits for 2012, including medical, dental, vision, life and disability insurance. It outlines the various plan options for medical coverage through Health Plus, including HMO, PPO, and high deductible plans. Details are provided on costs, networks, deductibles, and out-of-pocket maximums. Other benefits like dental through Assurant, vision through NVA, and life and disability through Mutual of Omaha are also summarized. Information is included on enrollment timelines and carriers' contact information.

1. 2012 Employee Benefits
Presented by:

2. 2012 Benefit Presentation
•Benefit Overview
•How Do I Choose the Right Medical Plan?
•Other Benefits
Vision, Dental, Life, AD&D & Disability
•Enrollment Timeframes
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3. 2012 Benefit Overview
• Medical Coverage – Health Plus - ww.healthplus.org
Cofinity PPO Network - www.cofinity.net
Cofinity is a large Network
• Health Savings Accounts - PNC Bank of Providers that Health Plus
offers to PPO Plan
participants, making it easier
to stay In-Network when
• Flexible Spending Accounts - TASC obtaining services.
• Vision – NVA (National Vision Administrators)
• Dental Coverage - Assurant
• Life and Disability Coverage - Mutual of Omaha
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4. How To Choose the Right Medical Plan?
e Cost per pay check (Pre-tax)
c Risk (Potential Out-Of-Pocket Cost), Plan Type & Design
a. Provider Network & Access to Care
 Health Plus (HMO)
 Cofinity (PPO)
b. Coverage Type & Plan Detail
 HMO (in-network ONLY)
 PPO (in and out-of-network coverage)
 High Deductible Health Plan (w/HSA)
 Standard Plan (w/FSA)
3. Health Care Spending Options (Pre-tax)
 HSA (Health Savings Account)
 FSA (Flexible Spending Account)
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5. How Much Does it Cost?
Standard HSA
2012 2012
Enrollment Health Plus Health Plus
HMO
Status Standard HMO HDHP HMO HSA
Cost Per Pay Cost Per Pay
Single $64.49 $21.26
2 Person $142.59 $45.33
Family $170.94 $54.22
2012 2012
Enrollment Health Plus Health Plus
PPO Status Standard PPO HDHP PPO HSA
Cost Per Pay Cost Per Pay
Single $73.91 $42.05
2 Person $163.78 $92.10
Family $196.36 $110.35
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6. Choosing the Right Plan:
PPO vs. HMO
PPO Coverage
Find providers at
Inand Out-of-network benefits available www.cofinity.net
No primary care physician required
Higher per pay check cost than HMO
HMO Coverage Find providers at
In-network www.healthplus.org
benefits ONLY
Must choose a primary care physician
Referrals Required (12 month option)
Less per pay check cost than PPO
Large provider network throughout Michigan
*Preventive care available in all plan options at no cost to the employee (no max; no copay)
*Adult children up to age 26 can be covered regardless of student, marital or earnings status.

7. Choosing the Right Plan:
HDHP w/HSA
 2 Options: HMO or PPO
 Plans require deductibles be met in full prior to coverage
(except for preventive care at 100%)
 Coinsurance & Rx co-pay begin AFTER deductible is met
 All out-of-pocket expenses accumulate to maximum out-of- pocket
 Contracts with two or more MUST meet full Family deductible amount
before coverage begins (except for preventive care).
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8. HDHP (w/HSA) Plans require copays for Rx, office visits,
ER visits, etc., AFTER Deductible that
PPO or HMO DO count to out-of-pocket maximum.
HMO (HealthPlus) PPO
In-Network In-Network Out-of-Network
Cofinity
Deductible $2000/$4000 $2,500/$5,000 $10,000/$20,000
Coinsurance 80% 90% 70%
Coinsurance $2,000/$4,000 $2,500/$5,000 $10,000/$20,000
Maximum
Preventive Health 100% 100% 70% of Reasonable and
Services Customary Charges
Office Visits $15 Copay $5 Copay 70%
After Deductible After Deductible After Deductible
Specialist Office $15 Copay 90% 70%
Visits After Deductible After Deductible After Deductible
Emergency Room $100 Copay 90% 90%
After Deductible After Deductible After Deductible
Urgent Care $50 Copay 90% 90%
Facility Services After Deductible After Deductible After Deductible
In-Patient 80% 90% 90%
Hospital After Deductible After Deductible After Deductible
*See Details in Access Point 8

9. HDHP(w/HSA)
PPO or HMO:
Prescription Drug Coverage
Prescription drug coverage is based on the use of a medication
formulary
Copays apply to each prescription you fill (AFTER deductible is met):
o $15 for Generic drugs
o $60 for Brand Name drugs
Contraceptive drugs and implantable contraceptive drugs are included
Prescription Mail Order
o $30 for Generic drugs/$120 for Brand Name
o Filled for up to 90 days
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10. What is a Health Savings Account?
Two components that work
together to meet our HDHP
personal healthcare needs. $$
Member
Preventive Care 100%
Deductible & Coinsurance
Responsibility
Health Deductible Health Plan
(HDHP) HSA
 Preventive care covered 100%
Health Savings Account (HSA)
 Employee allocates to HSA
 Employee controls HSA
 deposit balance to receive Olga’s
You must May roll$1/monthover at year-end 2012 HSA Limits
contribution of $20, $40, or $60 /month into your Single: $3,100
HSA, based on enrollment status. Family: $6,250
Age 55+: $1,000
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11. Eligible Expenses with HSA
Most out-of-pocket health care expenses:
•Deductibles & Coinsurance
•Medical, Dental and Vision
•Prescription drug costs
•Some over-the-counter medications
(with prescription)
•COBRA and Medicare premiums
•Qualified long-term care insurance and expenses
*Remember*
What is not used,
rolls over to the next year!
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12. HMO or PPO Plans require copays for Rx, office visits,
ER visits, etc., that do NOT count toward
maximum out-of-pocket.
Standard Plans
HMO (HealthPlus) PPO
In-Network In-Network Out-of-Network
Cofinity
Deductible $750/$1,500 $1,500/$3,000 $3,000/$6,000
Coinsurance 80% 80% 60%
Coinsurance Maximum $3,000/$6,000 $3,000/$6,000 $6,000/$12,000
Preventive Health 100% 100% 60% of Reasonable and
Services Customary Charges
Office Visits $20 Copay $20 Copay 60%
After Deductible
Specialist Office Visits $20 Copay $40 Copay 60%
After Deductible
Emergency Room $100 Copay $100 Copay 80%
After Deductible
Urgent Care Facility $35 Copay $50 Copay 60%
Services After Deductible
In-Patient Hospital 80% 80% 60%
After Deductible After Deductible After Deductible
Prescription Copay $10/$40 $15/$50 $15/$50
Mail Order 2X, 90 Day Pay & Receive Reim.
*See Details in Access Point 12

13. Flexible Spending Accounts
 Health Care Reimbursement Account - $4,000
These are “use it or lose
Funded with pre-tax payroll deductions
it” accounts, so please be
Covers medical, prescription drug, dental and vision. conservative with your
elections.
 Dependent Care Reimbursement Account - $5,000
Funded with pre-tax payroll deductions
You must deposit $1/month to receive Olga’s
contribution of $20, $40, or $60 /month into
your FSA, based on enrollment status.
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14. Vision Summary
National Vision Administrators
In-Network Out-of-Network
Exam Covered 100% (Reimbursed Amounts)
Once Every 12 Months After $10 Co-pay Up to $52
Lenses Standard Glass or Plastic Single Vision Up to $55
Once Every 12 Months Covered 100% Bi-focal Up to $75
After $25 Copay Tri-focal Up to $95
Lenticular Up to $125
Frame Covered up to $130 Up to $80
Once Every 24 Months Retail Allowance
(Additional discount on the balance may
apply at some providers)
Contact Lenses Elective: Elective:
Once Every 12 Months Covered Up to $130 Retail Allowance Up to $130
(Additional discount on the balance may
apply at some providers) Medically Necessary:
$210
Medically Necessary:
Covered at 100% Visit www.e-nva-com
To Find an NVA Provider:
https://www.e-nva.com/nva/content/tourist/JSFPEntryTouristPage.jsf
Sample Group/Sponsor Number: 50981000101
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15. Dental – Assurant PPO
HIGH PLAN In-Network Non-network
Deductible $0 $50/$150
Type I 100% 100% after deductible
Not Applied to Annual Max Not Applied to Annual Max
Type II 90% 80% after deductible
Type III* 60% 50% after deductible
Annual Maximum $1000 $700
Reasonable & Customary Fee Schedule 90th percentile
LOW MAC PLAN In-Network Non-network
Deductible $50/$150 $100/$300
Type I 100% 70%
No Deductible
Type II 80% after deductible 50% after deductible
Type III 60% after deductible 20% after deductible
Annual Maximum $700 $500
Reasonable & Customary PPO Fee Schedule 45% less than PPO Fee Schedule
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16. How Much Does it Cost?
2012 2012
Enrollment NVA Vision Plan Enrollment Assurant Dental
Status Cost Per Pay Status High Plan
Cost Per Pay
Single $2.75 Single $8.47
2 Person $4.95 2 Person $17.44
Family $7.15 Family $29.71
2012
Enrollment Assurant Dental
Status Low Mac Plan
Cost Per Pay
Single $3.10
2 Person $7.43
Family $15.43
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17. Life & Accidental Death &
Dismemberment – Mutual of Omaha
 Core Life & AD&D benefit provided
by Olga’s at no cost to you.
◦ Benefit is 1X annual salary to $50,000
 Voluntary Coverage (Life Only)
◦ Up to 5X base annual earnings in increments of $10,000
◦ All increases in coverage require evidence of insurability
 Voluntary Dependent Life Available
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18. Disability
Mutual of Omaha
Short-Term Disability
60% of weekly earnings to a maximum of $500
Payable on the 8th day for up to12 weeks
Company Paid
Long-Term Disability
60% of monthly earnings to a maximum of $5,000
Payable on the 90th day
Company Paid
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19. Access Point
Convenient Online Enrollment
ins:
t Beg re
men
E nroll te of Hi :
a ds
O n D ent E n s
llm k
Enro n 2 Wee
i
With
Benefits become active the first of the month following 30
days of full time employment.
An HR Representative will contact you with enrollment
details.
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20. Questions?
Please Contact:
Roni Pittiglio
roni.pittiglio@olgaskitchen.com
(248) 362-9398
Lisa Procter
lisa.procter@olgaskitchen.com
(248) 362-9377
Thank You!
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21. Carrier Contact Information
MEDICAL & RX VISION
NVA – National Vision Administrators
Health Plus
800-672-7723
(800) 332-9161 service@e-nva.comwww.e-nva.com
www.healthplus.org Claims Adress:
www.cofinity.net P.O. Box 2187
Clifton, NJ 07015
Claims Address:
P.O. Box 1700 LIFE & DISABILITY
Flint, MI 48501-1700 Mutual of Omaha
(800) 775-1000
Mail Order Drugs www.mutualofomaha.com
Express Scripts Claims Address:
(877) 322-8471 Mutual of Omaha Insurance Company
www.express-scripts.com Mutual of Omaha Plaza
Omaha, NE 68175
DENTAL
Assurant Employee Benefits
(800) 733-7879
www.assurantemployeebenefits.com
HEALTH SAVINGS ACCOUNTS Claims.dental@assurant.com
PNC Bank Claims Address:
(866) 622-3946 PO BOX 2940
www.pnc.com Clinton, IA 52733
Claims Address: FLEXIBLE SPENDING ACCOUNTS
PO BOX 1234 TASC
Pittsburgh, PA 52733 (800) 422-4661
www.tasconline.com
Claims Address:
FSA Reimbursement
PO BOX 7308
Madison, WI 53707-7308