MSD Benefits Overview

February 1, 2016 – January 31, 2017

Full-time employees are eligible for benefits upon 30 days of employment with the District.

Medical

The District offers two medical plan options to choose from.

Both plans include prescription drug coverage and one

annual refractive eye examination with an optometrist. The

District pays 80% of the cost for employee only coverage and 70% toward dependent coverage.

The costs of the medical plans are listed on the enclosed rate sheet. CIGNA Insurance

Company is our medical provider.

Preferred Provider Option (PPO) – Traditional Plan With the Traditional Plan, you have a higher payroll deduction and a lower annual deductible and out-of-pocket maximum. A summary of the plan is enclosed.

High Deductible Health Plan (HDHP) With the High Deductible Plan, you have a lower payroll deduction and a higher annual deductible and out-of-pocket maximum. A summary of the plan is enclosed.

MSD’s medical plans provide the following features:

Annual deductibles below the national average No referrals for in-network providers Low co-payments In and out-of-network coverage Vast range of in-network physicians to choose from

Dental

MSD offers comprehensive dental coverage through CIGNA

Insurance Company for services ranging from X-rays and routine cleanings, to fillings and orthodontic care. There are two dental plans to choose from. The District contributes $10 towards the monthly cost of coverage. The costs of the dental plans are listed on the enclosed rate sheet.

Dental Network (PPO) Plan In order to receive the greatest benefit of this plan, you must use a provider who is in- network. A summary of the plan is enclosed.

Dental Passive (PPO) Plan This plan allows you the flexibility of using a dentist who is in or out-of-network. However, staying in-network allows you to receive higher levels of benefits. A summary of the plan is enclosed.

MSD’s dental plans provide the following features:

Each family member has the freedom to go to a different dentist $0 Annual Deductible for the Network Plan Preventative and Diagnostic Services covered at 100%

In-Network Out-of-Network*$600 single/$1,200 family - **$1,500 single/$3,000 family * $1,800 single/$3,600 family - ** $4,500 single/$9,000 family

*$3,000 single /$6,000 family -**4,500 single/$9,000 family *$9,000 single/$18,000 family - **$13,500 single/$27,000 family

Coinsurance 80% 60%Lifetime Maximum Unlimited Unlimited

Physician Office Visits Primary Care: $20 copay / Specialist: $30 copay Covered at 60% of eligible expenses after deductibleRoutine Annual Physical Exams (one/ cal. yr.) Covered at 100% of eligible expenses Not CoveredAllergy Services -

Diagnostic Primary Care: $20 copay / Specialist: $30 copay Covered at 60% of eligible expenses after deductibleInjections No charge Covered at 60% of eligible expenses after deductible

From birth to five - 100% All other preventative services covered in network only

Maternity CarePre Natal and Post Natal $20 copay (Initial visit only)/ Specialist: $30 copay Covered at 60% of eligible expenses after deductibleSurgery and Related Services Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductibleMammograms Covered at 100% of eligible expenses Covered at 60% of eligible expenses after deductible

Lab, Xray, and other Diagnostic Services Covered at 100% of eligible expenses Covered at 60% of eligible expenses after deductibleOut-Patient Hospital Services

Surgery and related services Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductibleIn-Patient Hosptial Services

Unlimited days in a semi-private room including: Special care units Necessary ancillary services Covered at 80% of eligible expenses Maternity care including delivery after deductible Physician Services Surgery and related services Administration of anesthesia

Emergency ServicesHospital Emergency Room $200 copay; copay waived if admitted Benefits paid at in-network level

Urgent Care Facility $35 copay Covered at 60% of eligible expenses after deductible

Convenience Care Clinics $20 copay Covered at 60% of eligible expenses after deductible

CIGNA (OPEN ACCESS PLUS) PLAN (GENERAL SUMMARY ONLY) (*Traditional) (**High Deductible)

Covered at 60% of eligible expenses after deductible

Annual (Calendar Year) Deductible Includes copays - Separate in- and out-of network deductible

Maximum Out-Of-Pocket (Calendar Year)Maximums include deductibles and copays - Separate in- and out-of network maximums.

Immunizations No charge

100% coverage of eligible expenses for comprehensive annual physical

exams!

Hey - Get an annual physical

exam!

Using an Urgent Care Facility or

"convenience clinic" rather than an

Emergency Room will save you money.

In-Network Out-of-NetworkRefractive Eye Examinations -

One calendar year (optometrist)

Mental HealthOut-Patient $30 copay Covered at 60% of eligible expenses after deductible

In-Patient Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible

Substance Abuse

In-Patient Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible

Covered at 80% of eligible expenses after deductible Covered at 60% of eligible expenses after deductible

Physical, Speech, Occupational Therapy $20 copay Covered at 60% of eligible expenses after deductible(Out-patient) 60 visits physical therapy, 20 visits occupational

therapy, 20 visits speech therapy, 20 visits pulmonary rehabilitation, 20 visits cardiac rehabilitation.

60 visits physical therapy, 20 visits occupational therapy, 20 visits speech therapy, 20 visits pulmonary rehabilitation, 20 visits

cardiac rehabilitation.

Durable Medical Equipment Covered at 100% of eligible expenses Covered at 60% of eligible expenses after deductible

Covered at 60% of eligible expenses after deductible - up to 120 days per calendar year, combined in- and out-of-network

$30 copay Covered at 60% of eligible expenses after deductible

Ambulance Services Covered at 100% of eligible expenses Covered at 100% of eligible expenses

Prescription Drugs

Pharmacy - Tier 1 - $10 / Tier 2 - $30 / Tier 3 - $60 Up to a 31 day Supply (limited to CIGNA Network Pharmacy cost) Mail Order - Tier 1 - $25 / Tier 2 - $75 / Up to a 90 day Supply Tier 3 - $150

Covered at 100% after $20 copay Not covered

Chiropractic Care(Maximum 26 visits per calendar year - combined in- and out-of-network)

Home Health Care(Limited to 40 visits max. per cal. year in- or out-of-network)

Limits are per calendar year and combined in- and out-of network.

Out-Patient - Physician Office Services Covered at 60% of eligible expenses after deductible $30 per visit

REFER TO THE CIGNA SUMMARY OF BENEFITS FOR MORE SPECIFIC DETAILS ABOUT BENEFITS, LIMITS AND EXCLUSIONS

Skilled Nursing FacilityCovered at 80% of eligible expenses after deductible - up to 120 days per calendar year, combined in and out-

of-network

In-Network Benefits Only

Tier 1 - $10 / Tier 2 - $30 / Tier 3 - $60

The MSD plan offers a $0 Generic Mail Order Co-Pay Waiver Program for: Anti-Hypertension, Lipids, Asthma, Diabetic meds, Anti-Coagulants, Osteoporosis, Prenatal Vitamins

Don't forget the $100 a year for employee & spouse eyewear. That's a nice extra!

COMPARISON OF DENTAL PLAN OPTIONS GENERAL SUMMARY ONLY

Annual Deductible (calendar year)

Individual

Family

Preventitive / Diagnostic Services

Covered %

Office Visit for Oral Exam &

Teeth Cleaning

X-Rays Covered %

Bitewing X-Rays & Full

Mouth Series

Periapical

Basic Services Covered %

Minor Restorations

Root Canal Therapy with X-Rays

and Cultures

Anterior and Periapical

Molar Teeth

Major Services Covered %

Inlays, Onlays, Crowns, Full

& Partial Dentures

Orthodontic

Adults Dependent Children

Covered %

Orthodontic Deductible

Lifetime Maximum

Annual Benefit Maximum per

Person

Network Plan **** Passive PPO Plan

PARTICIPATING DENTISTS*

(In-Network)

PARTICIPATING DENTISTS*

(In-Network)

NON-PARTICIPATING

DENTISTS**

None None

100%

100%

100%

80%

80%

80%

50%

Covered Covered up to age 19

50%

None

$1,500

$2,000

$50***

$150***

100%

100%

100%

80%

80%

80%

50%

Not Covered Covered up to age 19

50%

None $1,500

$1,500

$50***

$150***

100%

100%

100%

80%

80%

80%

50%

Not Covered Covered up to age 19

50%

None $1,500

$1,500

* PPO participating dentists have agreed to provide care at a negotiated fee schedule. ** Non-network benefits are paid using the 90th percentile of Usual, Customary and Reasonable. *** The Annual Deductible is waived for Preventive / Diagnostic services. **** This is a network based plan with very reduced coverage when selecting a non-network provider. NOTE: Frequency and/or age limits may apply.

Life Insurance

CIGNA Insurance Company is our life insurance provider. The District provides company-paid Basic Life Insurance (term life) and Accidental Death and Dismemberment (AD&D) Insurance of 1 times your annual base salary rounded up to the next higher $1,000.

Voluntary Life Insurance

You can choose from multiples of 1 to 5 times your annual base salary rounded up to

the next higher $1,000, up to the maximum amount of $500,000.

You may also elect family life insurance – $10,000 for spouse and $5,000 coverage for

each dependent child (children are covered up to age 26). The costs of the AD&D plans

are listed on the enclosed rate sheet.

Voluntary Accidental Death and Dismemberment (AD&D) Insurance

You may purchase up to $500,000 in increments of $10,000 on an individual basis or a

family plan. For the AD&D benefit, the plan pays up to 100% for the employee, up to

50% for the spouse, and up to 10% of the child contingent on the type of claim. The

costs of the AD&D plans are listed on the enclosed rate sheet.

Reimbursement Accounts

Reimbursement Accounts (Flexible Spending)

allows you to have deductions from your paycheck

on a pre-tax basis to pay for out-of-pocket medical

and/or dental expenses or dependent care

expenses – SAVING YOU MONEY! Beneflex is

MSD’s Reimbursement Account Administrator.

There are two Reimbursement Accounts to choose

from.

Health Care Reimbursement Account (HCRA)

This account allows you to use funds to pay for medical and dental expenses, such as

co-pays, deductibles, and expenses not covered by your medical and/or dental plan.

You can use this account for any family members whom you claim as a dependent on

your taxes – even for family members not enrolled in the MSD medical and/or dental

plan(s). The maximum contribution amount to contribute is $2,550.

Dependent Care Reimbursement Account (DCRA)

This account allows you to use funds to pay for qualified dependent care expenses.

The maximum contribution amount to contribute is $5,000.

4

Pre-Paid Legal Plan

Hyatt Premier Legal Services is our Pre-Paid Legal Plan provider. Hyatt provides affordable and reliable legal counsel and telephone advice for everyday life matters such as debt predicaments, Wills and Estate planning, real estate matters, identity theft defense and much more. This plan provides assistance to you and covers most legal matters at 100% when you work with an in- network attorney. The cost of the Pre-Paid Legal plan is listed on the enclosed rate sheet.

Employee Assistance Program (EAP)

EAP is a free service provided by MSD. This service is administered by BJC. This program provides confidential assessments, counseling and referral services for all employees and their eligible dependents who may need help in areas such as the following:

Marital and family issues

Alcohol and other drug dependency

Stress-related issues Legal and financial

referrals

Vision Program

Beneflex is our Vision Program administrator.

This plan allows you and/or your spouse to use

Emotional problems

Health

Personal growth

$100 per fiscal year (07/01 – 06/30) towards your

prescription eyewear. The program allows for any unused

amounts to be rolled over up to the plan maximum of $300.

Long-Term Disability (LTD)

Liberty Mutual Insurance Company is our LTD administrator. MSD provides

company-paid coverage to you. This benefit provides

income replacement to you in the event you are unable to

work due to a qualified disability under the terms of the

plan, subject to approval by Liberty Mutual.

Retirement

The MSD Deferred Compensation Plan

(457) enables y o u t o s a v e a n d invest for

retirement without paying federal or state income taxes on the contributions until funds

are distributed. Vanguard is the plan administrator.

Convenient savings through payroll deduction!

You are 100% vested in the value of your account!

MSD pays the administrative fee for all participants!

The MSD Defined Contribution Plan (401a) enables you to save for retirement by

combining a Fixed Contribution of 7% contributed by the District with an opportunity for

you to make a voluntary contribution to your Deferred Compensation Plan of up to 4%

and receive a District Matching Contribution of 50% without paying federal or state income

taxes on the contributions or the earnings until it is distributed from the Plan. Vanguard is

the plan administrator.

Employees are 100% vested in the Employee Voluntary contribution and the District’s

Matching Contribution. The District’s Fixed Contribution is subject to a 20% per year

vesting schedule.

Wellness

The BALANCE Program: Promoting Better Health for MSD

Employees & Retirees

MSD and CIGNA partner to carryout the MSD Balance Wellness Program which is designed to improve the health and well-being of employees and retirees. The program offers resources to employees and retirees so they can learn how to be healthy and teach their families how to be healthy as well.

We have many well-being programs available to employees such as annual biometric

screenings, stress management programs, physical activity and nutrition programs. Also,

we have an Onsite Wellness Coordinator on staff.

MSD provides 7%

automatically for Defined

Contribution (401a)

If you make a contribution of

4% towards your Deferred

Compensation (457)

MSD will provide an additional 2%

towards your Defined

Contribution (401a)

You can receive 13% per

paycheck towards

retirement!

Dependent Eligibility Benefits coverage is available to all eligible dependents of

MSD Employees.

Dependent Criteria

WHO CAN BE COVERED UNDER YOUR

BENEFITS?

If you enroll yourself in MSD benefits, you may also enroll your eligible dependents who

include:

Your legal spouse

Your eligible children – up to age 26 for medical, voluntary life & AD&D insurance, pre-

paid legal, and reimbursement accounts; up to age 25 for dental insurance

An eligible child can be your:

Biological child

Legally adopted child

Child for whom you are the court-appointed legal guardian

Stepchild

Your incapacitated child who is unable to support themselves and depends on you for

support; the incapacity must have occurred before age 26 and be validated by the

vendor

WHO CANNOT BE COVERED UNDER YOUR BENEFITS?

Examples of ineligible dependents are:

Ex-spouse (even if court-ordered)

Common Law Spouse or Domestic Partners

Children (Grandchild, nieces, nephews, etc.) who are not the child of you or your

spouse, for whom you do not

Medical Rates*

Coverage Level

CIGNA PPO – Traditional Plan (bi-weekly rate)

CIGNA High Deductible Plan (bi-weekly rate)

Employee only $57.30 $34.39

Employee & spouse $183.08 $134.30

Employee & child(ren) $166.35 $122.02

Employee & family $253.74 $186.13

Dental Rates*

Coverage Level

CIGNA Passive PPO Plan (bi-weekly rate)

CIGNA Network Plan (bi-weekly rate)

Employee only $19.08 $5.47

Employee + one dependent $43.94 $16.05

Family $74.48 $29.04

Voluntary Employee Life Rates (monthly rate)

Age (as of February 1) Rate Per $1,000 Age Rate Per $1,000

Less than 25 $0.074 50 - 54 $0.379

25 - 29 $0.077 55 - 59 $0.678

30 - 34 $0.102 60 - 64 $0.952

35 - 39 $0.130 65 - 69 $1.799

40 - 44 $0.154 70 - 74 $2.915

45 - 49 $0.228 75 and over $2.915

Voluntary Family Life Rate (monthly rate)

Spouse & Child(ren) - $2.23 per family unit

Voluntary Accidental Death and Dismemberment (AD&D) Insurance Rates (monthly) rate)

Employee only Family

$0.03 per $1,000 $0.05 per $1,000

Pre-Paid Legal Plan Rate (bi-weekly rate)

$8.08

*Pre-tax deduction After-tax deduction

VOLUNTARY ACCIDENTAL DEATH AND DISMEMBERMENT INSURANCE

AMOUNT

INDIVIDUAL COVERAGE

EMPLOYEE & DEPENDENT

COVERAGE

AMOUNT

INDIVIDUAL COVERAGE

EMPLOYEE & DEPENDENT

COVERAGE

ELECTED (Monthly Premium: 3¢ / $1,000) (Monthly Premium: 5¢ / $1,000) ELECTED (Monthly Premium: 3¢ / $1,000) (Monthly Premium: 5¢ / $1,000)

$10,000 $0.30 $0.50 $260,000 $7.80 $13.00

$20,000 $0.60 $1.00 $270,000 $8.10 $13.50

$30,000 $0.90 $1.50 $280,000 $8.40 $14.00

$40,000 $1.20 $2.00 $290,000 $8.70 $14.50

$50,000 $1.50 $2.50 $300,000 $9.00 $15.00

$60,000 $1.80 $3.00 $310,000 $9.30 $15.50

$70,000 $2.10 $3.50 $320,000 $9.60 $16.00

$80,000 $2.40 $4.00 $330,000 $9.90 $16.50

$90,000 $2.70 $4.50 $340,000 $10.20 $17.00

$100,000 $3.00 $5.00 $350,000 $10.50 $17.50

$110,000 $3.30 $5.50 $360,000 $10.80 $18.00

$120,000 $3.60 $6.00 $370,000 $11.10 $18.50

$130,000 $3.90 $6.50 $380,000 $11.40 $19.00

$140,000 $4.20 $7.00 $390,000 $11.70 $19.50

$150,000 $4.50 $7.50 $400,000 $12.00 $20.00

$160,000 $4.80 $8.00 $410,000 $12.30 $20.50

$170,000 $5.10 $8.50 $420,000 $12.60 $21.00

$180,000 $5.40 $9.00 $430,000 $12.90 $21.50

$190,000 $5.70 $9.50 $440,000 $13.20 $22.00

$200,000 $6.00 $10.00 $450,000 $13.50 $22.50

$210,000 $6.30 $10.50 $460,000 $13.80 $23.00

$220,000 $6.60 $11.00 $470,000 $14.10 $23.50

$230,000 $6.90 $11.50 $480,000 $14.40 $24.00

$240,000 $7.20 $12.00 $490,000 $14.70 $24.50

$250,000 $7.50 $12.50 $500,000 $15.00 $25.00

Employees may purchase up to $500,000 maximum.

VACATION / HOLIDAYS / SICK LEAVE VACATION (Eligible to use upon successful completion of original probationary period. Accrual begins from date-of-hire.)

Length of Continuous Service

Monthly Accrual Rate

Annual Accrual

Max. Accumulation at End of Payroll Year

Less than 5 years .833 days 10 days 30 days

5 but less than 10 years 1.250 15 days 35 days

10 but less than 20 years 1.666 days 20 days 40 days

20 or more years 2.083 25 days 45 days

SICK LEAVE ACCRURAL (Eligible upon completion of three months of service. Accrual begins from date-of-hire.) There is no maximum accumulation for sick leave accrual.

MSD Service Accrual Rate / Mo. Annual Accrual

Up to 5 years .833 days per month 10 days

5 years to 20 years .916 days per month 11 days

20 years and longer 1 day per month 12 days

PERSONAL HOLIDAYS (Eligible upon successful completion of six months probationary period.) Employees are also entitled to two (2) Personal Holidays each new payroll year. Employees who are absent 3 days or less in a payroll year can earn up to three (3) additional personal holidays the following payroll year.

01/25/2016

HOLIDAYS (10 / year) – No waiting period

NEW YEARS’ DAY January 1

MARTIN LUTHER KING’S BIRTHDAY Third Monday in January

PRESIDENT’S DAY Third Monday in February

MEMORIAL DAY Last Monday in May

INDEPENDENCE DAY July 4

LABOR DAY First Monday in September

VETERAN’S DAY As designated by the Governor of Mo.

THANKSGIVING DAY As designated by the President of the US

THANKSGIVING FRIDAY The Friday following Thanksgiving

CHRISTMAS DAY December 25 SPECIAL HOLIDAYS

As designated by the Executive Director and approved by the Board of Directors

2015 MSD HOLIDAYS Friday, January 1

Monday, January 18

Monday, February 15

Monday, May 30

Monday, July 4

Monday, September 5

Friday, November 11

Thursday, November 24

Friday, November 25

Monday, December 26

As scheduled & approved in advance.