New Employee Benefits Enrollment - Dow Corning

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ACCIDENTAL DEATH & DISMEMBERMENT (AD&D) In the case of a death, a number of additional benefits are also provided through the plan. Some examples are: � Survivor benefit – in addition to any other benefits payable, provided the employee has a surviving spouse, domestic partner and/or surviving dependent children. The benefit will be one percent of the principal amount, per month for six months. � Child care benefit – to assist with the costs related to a surviving child’s enrollment in a qualified child care center. The benefit will be five percent of the principal amount (up to $5,000 per year) for up to four years for each dependent child enrolled in a qualified child care center. � Education benefit – to assist with costs related to a surviving child’s enrollment in a qualified higher education program. The benefit will be five percent of the principal amount (up to $5,000 per year) for up to four years for each surviving child enrolled in a qualifying higher education program. � Seat belt and air bag benefits – if the insured person dies in an automobile accident in which a seat belt was in proper use and the automobile was equipped with an airbag for that location in the car. The benefit will be 20 percent of the principal amount, up to $50,000. You should know… � If your spouse or domestic partner is an Employee or Retiree of Dow Corning, your spouse or domestic partner may enroll for coverage under your plan, you may enroll for coverage under your spouse’s or domestic partner’s plan or you may both enroll individually for the maximum amount of coverage. However, you may not enroll for coverage under both plans to receive double coverage. If you both enroll individually, children are covered under the parent with the highest level of coverage. Annual Employee Contribution for 2008 AD&D Employee $ 2.16 per $10,000 of coverage Waiver - $ 0 AD&D Spouse or Domestic Partner* $ 2.16 per $10,000 of coverage Waiver - $ 0 * Per IRS regulations, Dow Corning cannot withhold benefit premiums for a domestic partner on a pre-tax basis. 19
HEALTH SAVINGS ACCOUNT (HSA) The feature that sets the new CDHP option apart from our other medical plan options is the Health Savings Account (HSA). An HSA is a tax-advantaged account that allows individuals and families, covered under a high-deductible health plan, to deposit pre-tax funds into an account to pay for IRSallowable qualified health care expenses (medical, prescription drug, over-the-counter medication/medical supplies, dental and vision). For your Dow Corning-sponsored HSA, an account will be set up for you through Wells Fargo. Attributes of an HSA � You must be enrolled in the CDHP option to be eligible to contribute to the HSA. � Per IRS guidelines, you are eligible to contribute and use HSA funds as of the first of the month following your hire date. � You control your HSA funds and how to spend those dollars. � Dow Corning will contribute $500 single/$1100 family into your HSA. � In addition to Dow Corning’s contribution, you can contribute up to $2,400/single or $4,700/family and if age 55, an additional $900 annually on a pre-tax basis. � Your contribution amount is on a per-pay-period-basis and can be changed at any time throughout the year. � Wells Fargo will provide a debit card to access your HSA funds. � Pay for any qualified health care expenses tax-free just like the Health Care FSA. o You are responsible for keeping a record of your account disbursements. The IRS may request documentation to substantiate tax-free distributions. � To use the funds from your HSA, you can: o Use your Wells Fargo debit card to pay your provider (doctor, hospital or pharmacy). o Pay the bill out of your own pocket then submit a claim for reimbursement to Wells Fargo. � The dollars in the account are invested. For information on investment options go to https://healthbenefits.wellsfargo.com/. � Any remaining HSA balance rolls over from year-to-year. � Contributions, investment earnings and disbursements are never federal-taxed if used for qualified health care expenses. � If funds are used for non-qualified expenses: o If before age 65, you pay taxes and 10% penalty. o If after age 65, you pay taxes only. � You take the dollars with you when you retire or leave the company. 20
Page 1 and 2: Dow Corning Corporation - Multibase
Page 3 and 4: INTRODUCTION Dear Fellow Employee:
Page 5 and 6: BENEFIT ENROLLMENT INFORMATION Dow
Page 7 and 8: DENTAL Coverage is effective on you
Page 9 and 10: MEDICAL Coverage is effective on yo
Page 11 and 12: Cost and Coverage Comparison Chart
Page 13 and 14: VISION Coverage is effective on you
Page 15 and 16: DEPENDENT LIFE Coverage is effectiv
Page 17 and 18: BASIC & OPTIONAL LIFE Coverage is e
Page 19: ACCIDENTAL DEATH & DISMEMBERMENT (A
Page 23 and 24: FLEXIBLE SPENDING ACCOUNTS (FSA) Do
Page 25 and 26: LONG TERM DISABILITY (LTD) Coverage
Page 27 and 28: BUSINESS TRAVEL ACCIDENT LIFE Busin
Page 29: BENEFIT ENROLLMENT WORKSHEET After

New Employee Benefits Enrollment - Dow Corning

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