/(*$/127,&(6  3UHPLXP$VVLVWDQFH8QGHU0HGLFDLGDQGWKH&KLOGUHQ¶V+HDOWK,QVXUDQFH3URJUDP &+,3  ,I\RXRU\RXUFKLOGUHQDUHHOLJLEOHIRU0HGLFDLGRU&+,3DQG\RX¶UHHOLJLEOHIRUKHDOWKFRYHUDJH IURP\RXUHPSOR\HU\RXUVWDWHPD\KDYHDSUHPLXPDVVLVWDQFHSURJUDPWKDWFDQKHOSSD\IRU FRYHUDJHXVLQJIXQGVIURPWKHLU0HGLFDLGRU&+,3SURJUDPV,I\RXRU\RXUFKLOGUHQDUHQ¶W HOLJLEOHIRU0HGLFDLGRU&+,3\RXZRQ¶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¶WDOUHDG\HQUROOHG7KLVLVFDOOHGD³VSHFLDOHQUROOPHQW´RSSRUWXQLW\DQG\RX PXVWUHTXHVWFRYHUDJHZLWKLQGD\VRIEHLQJGHWHUPLQHGHOLJLEOHIRUSUHPLXP DVVLVWDQFH,I\RXKDYHTXHVWLRQVDERXWHQUROOLQJLQ\RXUHPSOR\HUSODQFRQWDFWWKH 'HSDUWPHQWRI/DERUDWZZZDVNHEVDGROJRYRUFDOO(%6$    ,I\RXOLYHLQRQHRIWKHIROORZLQJVWDWHV\RXPD\EHHOLJLEOHIRUDVVLVWDQFHSD\LQJ\RXU HPSOR\HUKHDOWKSODQSUHPLXPV7KHIROORZLQJOLVWRIVWDWHVLVFXUUHQWDVRI-XO\ &RQWDFW\RXU6WDWHIRUPRUHLQIRUPDWLRQRQHOLJLELOLW\±  , %(1(),76*8,'( /(*$/127,&(6

Benefits Guide - Minimalist Template - Flipbook - Page 27 Benefits Guide - Minimalist Template - Flipbook Page 26 Page 28