Argonne Retiree Health Reimbursement Account Summary Plan Description

Table of Contents Introduction

1

About the HRA

1

About the Aon Retiree Health Exchange

1

Participation in the HRA

2

Retiree Eligibility

2

General Rule

2

Eligibility Rules for Retiree Health Care Benefits

2

Deferred Enrollment

3

Opt-In Opportunity

3

Dependent Eligibility

3

If Residing Outside the Aon Retiree Health Exchange Area

3

Establishing an HRA

4

For You

4

For Your Medicare-Eligible Dependent

4

Contributions to Your HRA

5

Remaining HRA Balances

5

Forfeiting Your HRA Balance

6

Account Statements

6

Tax Information

6

Highly Compensated Individuals

6

Argonne, January 1, 2017

Eligible and Ineligible Expenses

7

Eligible Expenses

7

Ineligible Expenses

8

Catastrophic HRA

10

How the Catastrophic HRA Works

10

End of Participation

11

When Participation Ends

11

Retirees

11

Dependents

11

Reimbursement After Your Death

11

Survivor Participation in the HRA

12

Surviving Spouse Under Age 65

12

Continuing Coverage Under COBRA

13

Divorce

13

Dependent Child's Loss of Eligibility

13

COBRA Notification

13

Electing COBRA Coverage

14

When COBRA Coverage Ends

14

Claims Information

15

Deadline for Claims

15

How to Get Expenses Reimbursed

15

Auto-Reimbursement

15

Argonne, January 1, 2017

Filing a Form for Reimbursement

15

Information Required for Reimbursement

16

Receiving Reimbursements

17

Claims and Appeals Procedures

18

Responding to Your HRA Claim

18

If Your Appeal Is Denied

18

Appealing Your Adverse Determination

19

If Your Level II Appeal Is Denied

19

Deadline for Taking Legal Action

20

Administrative Information

21

Discretionary Authority of the Plan Administrator

21

Discretionary Authority of the Benefit Plans Committee

22

Clerical Error

22

Plan Funding and Administration

22

Electronic Media

23

Future of the HRA

23

Nonassignment of Benefits

23

Additional Administrative Details

23

Name of the Plan

23

Plan Sponsor

23

Plan Administrator

23

Appeals Reviewer

24

Claims Administrator

24

Plan Year

24

Employer Identification Number

24

Argonne, January 1, 2017

Plan Type

24

Plan Number

24

Agent for Service of Legal Process

24

Glossary

25

Active Service

25

Appeals Reviewer

25

Argonne Group Retiree Medical Plan

25

Child(ren)

25

Civil Union Partner

26

Claims Administrator

26

COBRA

26

Company

26

Consultants

26

Contribution

26

Dependent(s)

26

Eligible Former Employee

26

Highly Compensated Individual

27

HRA

27

Medicare

27

Medicare-Eligible

27

Participant(s)

27

Plan Year

27

Pre-Medicare Participant

27

Spouse

28

Surviving Spouse

28

Argonne, January 1, 2017

Your ERISA Rights

29

Your Rights Under ERISA

29

Receive Information About the HRA

29

Continue HRA Participation

29

Enforce Your Rights

29

Assistance with Your Questions

30

Argonne, January 1, 2017

About This SPD This Summary Plan Description (“SPD”) provides a summary of the Argonne Retiree Health Reimbursement Account (the “HRA” or “Plan”). Additional terms of the HRA may be found in other legal documents and instruments governing the Plan. This SPD, together with the other legal documents and instruments governing the Plan, comprise the HRA, effective January 1, 2017. If there are any discrepancies between this SPD and any of the other legal documents or instruments, the appropriate legal documents or instruments will govern. UChicago Argonne LLC (“Argonne” or the “Company”) reserves the right to modify, suspend, or terminate any of the benefits referenced in this SPD at any time and for any reason. The benefits described in this SPD are provided at the discretion of Argonne and do not create a contract of employment. Because of the many detailed provisions of the Plan, no one other than the office of the Plan Administrator and the delegated representatives indicated in this SPD are authorized to advise you as to your benefits. For this reason, Argonne cannot be bound by statements made by unauthorized personnel. The Plan is subject to the provisions of the Employee Retirement Income Security Act of 1974 (“ERISA”). Argonne intends the Plan to qualify as a “health reimbursement arrangement” as that term is defined under IRS Notice 2002-45 and a “medical reimbursement plan” under Sections 105 and 106 of the Internal Revenue Code of 1986, as amended. The Plan is also intended to be exempt from the Affordable Care Act as a separate “retiree-only” plan pursuant to ERISA Section 732(a) and IRC Section 9831(a)(2). The Plan will be interpreted at all times in a manner consistent with this intent.

Argonne, January 1, 2017

Introduction About the HRA Effective January 1, 2017, the Argonne Retiree Health Reimbursement Account (“HRA”) offers you and your eligible Dependents reimbursement for certain health care costs if you purchase individual medical plan coverage through the Aon Retiree Health Exchange. (The Aon Retiree Health Exchange is an independent medical plan exchange for Medicare-Eligible individuals.) The HRA reimburses expenses that you pay out of your pocket, such as premiums for coverage and your share of eligible health care expenses. The Contributions provided under the HRA replace the Company subsidy for Medicare-Eligible individuals provided by an Argonne group health plan and the Prescription Drug Plan for Post-65 Retirees as well as the contribution for post-65 retirees participating in the Argonne Group Dental Plan, which end December 31, 2016. If you have any questions about the HRA and how it works after reading this SPD, contact the Aon Retiree Health Exchange service center. Representatives are available from 8:00 a.m. to 8:00 p.m. Central Time. You can also obtain information directly on the Aon Retiree Health Exchange website. The Aon Retiree Health Exchange service center phone number and the website address are listed at the bottom of each page of this SPD for your convenience. Note: Certain terms are capitalized when they appear in this SPD. These terms are defined in the Glossary section.

About the Aon Retiree Health Exchange The Aon Retiree Health Exchange is an independent medical plan exchange that contracts with medical carriers to offer Medicare-Eligible individuals a variety of individual Medicare supplemental health care policies and offers assistance in helping you choose the one that best meets your health care coverage needs.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

1

Participation in the HRA Retiree Eligibility General Rule As an Argonne Retiree, you are eligible for the HRA if you meet all of the following conditions: 

You meet the Argonne eligibility rules for retiree health care benefits;



You are age 65 or over and enrolled in Medicare Part A and Part B;



You purchase an individual medical plan through the Aon Retiree Health Exchange effective as of the later of December 31, 2016, the first day of the month in which you become Medicare-Eligible, or a future deferred date as allowed by the rules of the Plan; and



You continue to otherwise be eligible for an HRA and continue to be enrolled in an individual Medicare supplemental medical plan through the Aon Retiree Health Exchange.

Eligibility Rules for Retiree Health Care Benefits Employees hired, rehired, or reclassified prior to October 1, 1995: Employees hired, rehired, or reclassified prior to October 1, 1995 into a position meeting the eligibility requirements for medical benefits must accumulate 10 years of Active Service in such positions. Employees hired, rehired, or reclassified on or after October 1, 1995 into a position meeting the eligibility requirements for medical benefits must accumulate 15 years of Active Service in such positions. Employees hired, rehired, or reclassified prior to October 1, 1994: Employees hired, rehired, or reclassified prior to October 1, 1994 into a position meeting the eligibility requirements for medical benefits will receive credit for all periods of Active Service in such positions toward the required accumulation of years of Active Service. Employees hired, rehired, or reclassified on or after October 1, 1994 into a position meeting the eligibility requirements for medical benefits will receive credit only for those years of Active Service in such positions consecutive with and immediately preceding retirement. For rehires and reclassifications, prior years of Active Service in medical benefitseligible positions will be credited at the time of rehire or reclassification if the break in Active Service in which the employee was eligible for medical benefits is less than 18 months; if 18 months or more, no prior accumulated Active Service will be credited. Employees in the 800 job series: Employees in the 800 job series who, between December 1, 1991 and November 1, 1997, were immediately hired from another federal laboratory and who were participating in that institution's medical plan will be eligible for Argonne's retiree medical benefits plan if these employees complete five years of eligible service at Argonne and attain age 55. Service time credited to critical skill new hires: Effective July 1, 2010, service time credited to critical skill new hires in accordance with criteria established by the U.S. Department of Energy will be counted as service time toward Argonne’s retiree medical benefits. The service credited to critical skill new hires plus the service in a medical benefits-eligible position with Argonne must total 15 years. If the critical skill new hire was previously employed with Argonne, a minimum of three of the 15 years of benefits-eligible service must be with Argonne since the most recent hire (rehire) date, unless the previous employment was with a non U.S. Department of Energy laboratory, in which case a minimum of five of the 15 years of benefits-eligible service must be with Argonne since the most recent hire (rehire) date.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

2

Deferred Enrollment At the time you become eligible to participate in the HRA, you may decide to delay enrollment to a future date of your choosing. For employees who retire on or after January 1, 2005, you do not need to be enrolled in a medical plan at the time you retire in order to preserve your ability to enroll at a later date. If you meet the eligibility criteria outlined above under “General Rule,” you or your unmarried Surviving Spouse may enroll at any time. Your Civil Union Partner must be an active participant in the medical plan immediately preceding your retirement in order to be eligible. For employees who retired before January 1, 2005, you must have been enrolled in an Argonne group health plan coverage as a retiree as of January 1, 2014 in order to defer enrollment to a later date.

Opt-In Opportunity If you are eligible for Argonne group health plan coverage as a retiree but waived Argonne group health plan coverage in the past (for example, you have coverage under your Spouse’s employer’s medical plan), you may have the opportunity to enroll for an individual medical plan through the Aon Retiree Health Exchange and have an HRA set up for you during the initial enrollment period (enroll by December 31, 2016) or you may delay enrollment until a later time. You are not eligible for the HRA during this opt-in opportunity if your coverage under an Argonne group health plan was cancelled due to non-payment of premiums.

Dependent Eligibility Your Dependent is eligible for the HRA if he or she: 

Meets the definition of “Dependent,” as defined in the Glossary section;



Is at least age 65 and, as a result, is eligible for Medicare due to age; and



Is enrolled in Medicare Part A and Part B.

Note: If you marry after you retire from the Company, your new Spouse may be eligible for the HRA. However, different rules apply as follows: 

An employee who retires in 2005 or later may add his or her new Spouse at any time; and



An employee who retired before 2005 must add his or her new Spouse within 30 days of the marriage or the Spouse will never be eligible again.

If Residing Outside the Aon Retiree Health Exchange Area If you and/or your eligible Dependent cannot enroll in an Aon Retiree Health Exchange individual Medicare supplemental medical plan because his or her primary residence is in a foreign country (including Puerto Rico, Guam, and USVI) or in an area in which the Aon Retiree Health Exchange does not offer individual Medicare supplemental health care policies, this individual will still be eligible for the HRA—as long as he or she meets the retiree medical plan age and service requirements.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

3

Establishing an HRA For You If you are eligible to participate in the HRA, an Argonne-funded HRA will be established automatically. 1

Your Spending Account™ administers the HRA through the Aon Retiree Health Exchange. You will receive enrollment information from the Aon Retiree Health Exchange about 90 days before the first day of the month in which you become Medicare-Eligible due to age. Since the medical plans offered are individual Medicare supplemental health care policies, the enrollment period is defined by Medicare. For an HRA to be established for you, you must enroll in an individual Medicare supplemental medical plan through the Aon Retiree Health Exchange by the deadline listed on the notification.

For Your Medicare-Eligible Dependent If you have a Medicare-Eligible Dependent age 65 or older, you will also receive a Contribution to your HRA for him or her effective as of the first day of the month in which your Dependent becomes MedicareEligible due to age. To be eligible for an HRA Contribution, your Medicare-Eligible Dependent must: 

Purchase an individual Medicare supplemental medical plan through the Aon Retiree Health Exchange;



Have been eligible to enroll in an Argonne group health plan immediately before becoming Medicare-eligible due to age; and



Continue to purchase an individual Medicare supplemental medical plan though the Aon Retiree Health Exchange in subsequent years.

If you are not Medicare-Eligible due to age, but your Dependent is Medicare-Eligible due to age and also meets the other eligibility requirements, an HRA in your name will be set up for your Dependent—whether or not you participate in an Argonne group health plan. If, after you purchase an individual Medicare supplemental medical plan for your Dependent, he or she terminates that coverage, the Contribution credited to your HRA for your Dependent will remain credited to your HRA. After that, no further Contributions for your Dependent who terminated coverage will be made to your HRA.

1

Your Spending Account is a trademark of Hewitt Associates LLC.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

4

Contributions to Your HRA Before annual enrollment each calendar year (January 1 through December 31), Argonne will designate the amount of the annual Contribution that will be credited to your HRA for the following calendar year. The annual Contribution credited to your HRA is based on your age as of December 31 of the year of the Contribution. Contribution amounts are included with the enrollment information you receive each year (or when you first become Medicare-Eligible due to age). For each calendar year that you are covered under an individual Medicare supplemental medical plan, the full year’s Contribution to your HRA as of that January 1 will be credited to your HRA. If you become Medicare-Eligible due to age during the year, the Contribution credited to your HRA will be prorated. For example, if your HRA is established on March 1, your Contribution will be 10/12ths of the amount that would have been contributed if the HRA had been established on January 1. The Contribution credited to your HRA for your Dependent is also based on his or her age as of December 31 of the year of the annual Contribution, and a separate Contribution will be made to your HRA on his or her behalf. If a retiree and his or her Dependent(s) are both eligible for an HRA Contribution, Contributions that Argonne makes on behalf of the eligible retiree and Dependent(s) will be combined into one HRA in the Argonne retiree’s name. Reimbursement of eligible expenses will be available to both the retiree and his or her eligible Dependent(s) as long as funds are available in the HRA. Call the Aon Retiree Health Exchange service center if you have questions about how your HRA Contribution is determined. Note: Argonne will review the Contribution amount annually and has the right to adjust or discontinue the Contribution at any time and for any reason.

Remaining HRA Balances If you do not use all of your HRA for reimbursement of eligible health care expenses during the calendar year, any unused remaining balance is automatically rolled into your next year’s HRA—as long as you continue to have coverage through the Aon Retiree Health Exchange and remain eligible for a Contribution.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

5

Forfeiting Your HRA Balance The Contributions credited to an HRA will be forfeited as described below. Contributions that are forfeited are not available to you, your Dependent, your Children, or your estate. 

If you have an HRA, die and, as of the date of your death, do not have a Surviving Spouse or partner eligible for an HRA before the date of your death, any balance remaining in the HRA as of the date of your death is forfeited and will not be paid out as a part of your estate; however, your estate will have six months from the date of your death to file claims for reimbursement of any eligible expenses incurred while coverage was in force.

Note: If you terminate your individual Medicare supplemental medical plan coverage purchased through the Aon Retiree Health Exchange, you may continue to be reimbursed for eligible expenses from Contributions remaining in your HRA until your HRA is depleted, as long as a request for reimbursement is filed within six months of your termination of coverage. Requests for reimbursements filed after the sixmonth period will be denied.

Account Statements You will receive an HRA Balance Reminder after January 1 of each year to confirm the annual funding has been made to your account for the year. You also will receive an HRA statement in the fourth quarter of each year showing your available balance and amounts paid to date. Your available balance and any Contribution or reimbursement history can be obtained at any time on the Aon Retiree Health Exchange website or by calling the Aon Retiree Health Exchange service center.

Tax Information Except as noted below, the Contribution credited to your HRA and any expense reimbursed generally is not taxable. Because your Civil Union Partner and his or her Children may not satisfy the definition of “dependent” under federal tax laws, Argonne is legally required to report the entire value of the HRA for your Civil Union Partner and his or her Children as taxable income to you for federal income tax purposes. The value is equal to the total Contribution by Argonne for your Civil Union Partner and his or her Children. If your Civil Union Partner and his or her Children meet the definition of a “dependent” under federal tax laws, you may not be required to report the Contributions as income for federal income tax purposes. You should consult a tax advisor regarding federal tax rules, to see if your Civil Union Partner and his or her Children meet the current definition of a “dependent” for federal income tax purposes, and about applicable state law.

Highly Compensated Individuals If you are a Highly Compensated Individual, HRA reimbursements may be limited or treated as taxable compensation to comply with Section 105(h) of the Internal Revenue Code (IRC), as determined by Argonne. Contact your tax advisor to determine if you are a Highly Compensated Individual and, if you are, how this impacts you.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

6

Eligible and Ineligible Expenses Eligible expenses that do not exceed the balance in your HRA can be reimbursed from your HRA if the expenses are incurred during the time you participate in the HRA. Expenses that exceed the balance in your HRA as of the date on which the claim is processed will not be reimbursed. Note: Expenses are eligible only to the extent that they are not paid for by health care coverage you have.

Eligible Expenses Examples of eligible expenses include, but are not limited to: 

Medical premiums (premiums paid on an after tax basis for individual medical coverage);



Dental premiums (premiums paid on an after tax basis for individual dental coverage);



Vision premiums (premiums paid on an after tax basis for individual vision coverage);



Prescription premiums (premiums paid on an after tax basis for individual prescription coverage);



Medicare Part B premiums;



Medicare Part D premiums;



Medicare Part B and Part D income and late enrollment penalties;



Acupuncture;



Alcoholism and drug abuse treatment;



Ambulance;



Artificial limb;



Blood pressure monitor;



Chiropractor;



Christian Science practitioners;



COBRA premiums;



Deductibles, copayments (copays), and coinsurance;



Dental treatment;



Hearing aids;



Heart defibrillators;



Hospital expenses;



Immigration immunizations;



Insulin;



Laboratory fees and X-rays;



Medical alert programs (when accompanied by a physician’s diagnosis letter);

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

7



Pill crushers;



Prescription drugs;



Psychiatric care;



Radial keratotomy;



Smoking drugs that require a prescription and programs to stop smoking;



Vaccines;



Vision care; and



Wheelchairs.

Note: Over-the counter (OTC) medication expenses, such as pain relievers and cold medications, will be eligible for reimbursement only with your health care provider’s prescription or statement of medical necessity. For a complete list of expenses allowed by the IRS and any special requirements for a service or supply (including those in the list above) to be reimbursable under the HRA, refer to Internal Revenue Service (“IRS”) Publication 502, available by calling 1.800.TAX.FORM (829.3676). You can also access IRS Publication 502 by logging on to the IRS website at www.IRS.gov.

Ineligible Expenses Examples of expenses not eligible for reimbursement from your HRA include, but are not limited to: 

Clothing;



Cosmetic procedures;



Cushions;



Dental bleaching or other teeth whitening;



Electric tooth brush replacement brushes;



Hair transplants;



Late payment interest;



Lens replacement insurance;



Missed appointment fees;



Over-the-counter medications without your health care provider’s prescription or statement of medical necessity;



Pill bags; and



Vitamins for general well-being.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

8

Note: If you terminate coverage purchased through the Aon Retiree Health Exchange, neither you nor your Dependent will be eligible for any reimbursement of expenses incurred after the date on which coverage is terminated. For a complete list of expenses not allowed for reimbursement by the IRS and any special requirements for a service or supply (including those in the list above) to be reimbursable under the HRA, refer to Internal Revenue Service (“IRS”) Publication 502, available by calling 1.800.TAX.FORM (829.3676). You can also access IRS Publication 502 by logging on to the IRS website at www.IRS.gov.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

9

Catastrophic HRA If you frequently require prescription drugs or use expensive drugs, there’s a chance that you will reach Medicare’s catastrophic coverage limit (“True Out-of-Pocket”). The annual Medicare True Out-of-Pocket is set yearly by Medicare. For 2017, the True Out-of-Pocket is $4,950. If you reach this limit, Medicare will pay 95% of the prescription cost, and you will pay the remaining 5%. If your purchase Medicare Part D coverage through the Aon Retiree Health Exchange, Argonne will reimburse you for your 5% of eligible Medicare Part D copayments or coinsurance for the remainder of the calendar year. The Catastrophic HRA is separate from your regular HRA. There is no limit to the 5% that Argonne will reimburse you and you do not have to deplete the funds in your regular HRA first. Note: A Medicare Part D copayment or coinsurance expense is only eligible for reimbursement from the Catastrophic HRA if it is an otherwise eligible prescription drug expense under your Medicare Part D coverage.

How the Catastrophic HRA Works The following steps are involved in receiving reimbursement under the Catastrophic HRA: 

You will receive a Medicare Part D Monthly Prescription Drug Summary Statement showing that you have reached True Out-of-Pocket. It will also identify you as being Catastrophic HRA eligible.



You must provide this EOB to Your Spending Account (“YSA”) when you submit your first prescription drug claim. You can obtain this form, upon request, from the Aon Retiree Health Exchange service center.



Once the claim and EOB are received, the YSA claims department will create the Catastrophic HRA and process the claim for reimbursement.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

10

End of Participation When Participation Ends Retirees Your participation in the HRA ends on the earliest of the date on which: 

You die;



You are rehired as an employee of Argonne;



You stop being eligible for the HRA for any reason;



You are no longer enrolled in a medical plan though Aon Retiree Health Exchange; or



The HRA is terminated.

Dependents Your Dependent’s participation in the HRA ends on the earliest of the date on which: 

You and your Spouse are divorced (subject to COBRA);



You and your Civil Union Partner dissolve your Civil Union;



Your Dependent dies;



Your Dependent no longer meets the HRA’s eligibility requirements;



You or your Dependent is no longer enrolled in a medical plan though the Aon Retiree Health Exchange; or



The HRA is terminated.

Reimbursement After Your Death If you die while a Participant in the HRA and you do not have a Spouse or Civil Union Partner participating in the HRA, reimbursement from your HRA is not available for expenses incurred after your death. However, your estate may request reimbursement of eligible health care expenses incurred before your death (up to your remaining HRA balance) and while you were participating in the HRA, as long as a request for reimbursement is filed within six months following the date of your death. Requests for reimbursement filed after the six-month period will be denied.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

11

Survivor Participation in the HRA If you die while participating in the HRA and your Medicare-Eligible Surviving Spouse or Civil Union Partner is participating in the HRA at the time of your death, he or she will become the HRA holder as long as he or she continues to meet eligibility requirements. Your Medicare-Eligible Surviving Spouse or Civil Union Partner will continue to receive a Contribution to the HRA until the earlier of his or her death or the termination of the Plan. If you have a Child who is Medicare-Eligible due to age, he or she will also continue to receive an annual Contribution under your Surviving Spouse’s or Civil Union Partner’s HRA for as long as the Child and your Surviving Spouse or Civil Union Partner are eligible for an HRA. Contributions for the Child will stop and he or she will cease to be eligible for the HRA when your Surviving Spouse or Civil Union Partner dies or ceases to be eligible for an HRA, even if the Child would be eligible for the HRA. Your surviving Medicare-Eligible Child is not permitted to be the HRA holder.

Surviving Spouse Under Age 65 If your Surviving Spouse or Civil Union Partner is not Medicare-Eligible due to age and is participating in an Argonne group health plan at the time of your death, he or she will be eligible to participate in the HRA when he or she becomes Medicare-Eligible due to age if he or she continues coverage under an Argonne group health plan as long as he or she: 

Is Medicare-Eligible due to age;



Enrolls, as of the later of December 31, 2016 or the first day of the month in which he or she becomes Medicare-Eligible, in one of the individual Medicare supplemental medical plans through the Aon Retiree Health Exchange; and



Otherwise remains eligible for participation in the HRA.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Continuing Coverage Under COBRA Divorce If you and your Spouse divorce or legally separate, your former Spouse has no right to the balance of the HRA as of the date of the divorce or to any future Contributions to your HRA, except to the extent required by COBRA. If your former Spouse elects COBRA, an HRA will be established for the former Spouse with a balance equal to the balance in your HRA as of the date of the divorce. For Civil Union Partners, Argonne may provide COBRA-like coverage if the Civil Union Partner was covered under the HRA at the time that coverage ended due to the dissolution of the Civil Union. To continue to participate in the HRA through COBRA, your former Spouse must elect COBRA continuation coverage during the required time frames. The cost for your former Spouse to continue to participate in the HRA will be the actuarial value of the average cost of the HRA plus 2% for administrative costs. With COBRA coverage, your former Spouse will have a separate HRA which may be continued for up to 36 months or as long as the former Spouse is eligible to participate in the HRA and pays for the cost of coverage. The former Spouse also must purchase an individual Medicare supplemental medical plan through the Aon Retiree Health Exchange during the COBRA period. Failure to do so will cause the former Spouse to lose eligibility for coverage under the HRA. If, after the divorce, you or your former Spouse requests reimbursement for expenses incurred before the divorce, the amount of the reimbursement will be deducted from the HRA the claim is submitted to.

Dependent Child's Loss of Eligibility A Child will cease to be a Dependent and lose eligibility to participate in the HRA when the Child loses coverage following the death of both parents (that is, the death of the Participant and his or her Surviving Spouse or Civil Union Partner). The Child may continue to participate in the HRA under COBRA, as long as the COBRA election is made within the required time frame. The cost for the Child to continue to participate in the HRA will be the actuarial value of the average cost of the HRA plus 2% for administrative costs. COBRA coverage for the Child may be continued for up to 36 months—as long as the Child remains eligible to participate in the HRA and pays for the cost of coverage. The Child also must purchase an individual Medicare supplemental medical plan through the Aon Retiree Health Exchange. Failure to do so will cause the Child to lose eligibility for coverage under the HRA.

COBRA Notification A notice regarding COBRA rights will be sent to you when you become eligible under the HRA. Your former Spouse and/or Child will also receive this notice at the time of divorce or loss of eligibility as a Dependent and again at the end of the COBRA continuation coverage period. In addition, a copy of the COBRA continuation notice is available upon request to the Aon Retiree Health Exchange service center.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Electing COBRA Coverage The COBRA administrator will notify your former Spouse and Child that continuation coverage under COBRA is available. Upon notification, they will receive a more detailed explanation of COBRA rights and an application form. Your former Spouse and Child will have 60 days to elect continued coverage from the later of the date they are notified of their eligibility or the date their eligibility to participate in the HRA ends. They will then have 45 days from the date they submit their application to make their first payment. Note: HRA participation and required payments will be retroactive to the date your former Spouse’s and Child’s participation under the HRA was terminated.

When COBRA Coverage Ends COBRA continuation coverage under the HRA will end on the earliest of the following: 

The date on which the payment is due (except for the first premium) if the payment is not made within 30 days of the due date;



The last day of the COBRA coverage period;



The date on which Argonne terminates the HRA; or



The date on which the individual obtains coverage under another group health plan.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Claims Information Deadline for Claims If you terminate your individual Medicare supplemental medical plan coverage purchased through the Aon Retiree Health Exchange, you may continue to be reimbursed eligible expenses from Contributions remaining in your HRA until your HRA is depleted, as long as a request for reimbursement is filed within six months following the date you terminated participation in the Plan. Requests for reimbursements filed after the six-month period will be denied.

How to Get Expenses Reimbursed Aon Hewitt (the “Claims Administrator”) administers the HRA for Argonne through Your Spending Account (“YSA”). Reimbursements are issued from a YSA bank account operated by UMB Bank.

Auto-Reimbursement In most cases, you are automatically enrolled in “auto-reimbursement” when you initially purchase an individual Medicare supplemental medical plan through the Aon Retiree Health Exchange. (See note below.) Once you have paid your premium, your premium will automatically be reimbursed to you from your HRA—up to the current HRA balance. Note: Most individual Medicare supplemental medical plan providers offer the auto-reimbursement option. If you enroll with a health care provider that does not offer this option, you will be responsible for submitting claims for reimbursement of your premiums. If you do not want the auto-reimbursement feature when you enroll in an individual Medicare supplemental health care policy through the Aon Retiree Health Exchange for the first time or you would like to decline auto-reimbursement at a later date, contact the Aon Retiree Health Exchange service center.

Filing a Form for Reimbursement When you have eligible expenses under the HRA that are not reimbursed through auto-reimbursement, go on line to the Aon Retiree Health Exchange website and print and complete the Your Spending Account Claim Form. If you do not have online access, contact the Aon Retiree Health Exchange service center. Through the Your Spending Account program, you benefit from many conveniences that make submitting claims and getting reimbursed as effortless as possible.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Here is how: 

Reimbursement requests are processed daily;



You can receive your money even faster by faxing your claim form and copies of receipts to the dedicated fax number at 1.888.211.9900 (although you do have the option of mailing the claim form and copies of receipts to the address listed on the claim form and below) or by uploading your claims on the site; and



You will be reimbursed by check. However, for faster reimbursement, you may sign up to have reimbursements electronically deposited to your bank account. With electronic reimbursement, these funds are immediately available to you; you do not need to wait for a check to clear.

Note: Banking laws do not permit electronic deposit (direct deposit) to international bank accounts. (This does not apply to U.S. territories such as Puerto Rico.)

Information Required for Reimbursement To make a claim for reimbursement, complete the Your Spending Account Claim Form. You must sign and date the form verifying the expenses have not been reimbursed by another policy or plan. You need to include supporting documentation with your claim form, showing the following: 

Premium amount(s) paid;



Coverage period start date; typically the first day of the month; and



Proof of payment.

Common documents may include: 

Bank statements;



Copies of mailed checks; and



Statements provided by your insurance carrier.

When submitting a claim for reimbursement of your out-of-pocket health care expenses, your supporting documentation should include the following: 

Type of service;



Date of service;



Service provider;



Who service is for; and



Requested reimbursement amount.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Submit your claims directly to the Claims Administrator: Aon Hewitt—Your Spending Account PO Box 785040 Orlando, FL 32878-5040 Fax: 1.888.211.9900 Note: Verbal or handwritten information for general merchandise, illegible receipts, credit card receipts, and statements with a forwarding balance will not be accepted.

Receiving Reimbursements You can request and receive reimbursements for your or your eligible Dependent’s eligible health care expenses up to your current HRA balance.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Claims and Appeals Procedures If you file a claim for reimbursement and one or more of your expenses are not reimbursed, you or a person you have designated as your authorized representative may file an appeal using the following procedures. In this SPD, a claim for reimbursement from your HRA for eligible expenses received by either you or your eligible Dependent is referred to as “your claim.” An “appeal” is a written request for benefits. A casual inquiry (even if it is in writing) regarding HRA eligibility requirements or a casual inquiry about benefits is not treated as an appeal and is not subject to these Claims and Appeals procedures. You must send your claims to the Claims Administrator and appeals to the Appeals Reviewer. If you file an appeal, you must do so in writing by U.S. mail or fax.

Responding to Your HRA Claim If the Appeals Reviewer (Claims and Appeals Management [CAM]) needs information to process your appeal, the Appeals Reviewer will notify you, in writing, within 30 days after receiving your claim of the specific information required and the date when you can expect a determination. You will have 45 days to provide the additional information. The determination period to respond to your appeal will be suspended as of the date the Appeals Reviewer sends the notice and will resume again once you have provided the additional information. This determination date will be no later than 45 days after the date you filed your initial appeal. If you do not provide the requested information within the specified time frame, the Appeals Reviewer will decide the appeal without the requested information. If the Appeals Reviewer, due to reasons beyond its control, determines that extra time is required to process your appeal, it will notify you in writing of the reasons for the extension and the new due date for its response to your appeal. The Appeals Reviewer will notify you of the extension within 30 days after its initial receipt of your appeal. The new due date will not be later than 45 days after the date you filed your initial appeal. Once you have filed an appeal, the Appeals Reviewer will notify you of its decision as soon as practicable, but no later than 30 days after receipt of your appeal. If you do not follow the required procedures for filing an appeal, the Appeals Reviewer will notify you and explain the proper procedures to follow in filing your appeal.

If Your Appeal Is Denied If your appeal is denied, in whole or in part, the Appeals Reviewer will send you a written notice of its decision including: 

The specific reason(s) for the denial of the appeal;



Reference to the specific HRA provision(s) on which the denial is based;

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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

A description of the HRA’s Level II appeal procedures and the time limits under those procedures, including your right to bring a civil action under Section 502(a) of ERISA if your appeal is denied;



If applicable, a copy of the internal rule, guideline, or protocol that was relied upon to make the determination for your appeal.

Appealing Your Adverse Determination If your appeal is denied, you will have 180 days following the receipt of the denial notice to file a written Level II appeal with the Appeals Reviewer. The following procedures will apply in considering your Level II appeal. You may submit your Level II appeal in writing or by fax to the Claims and Appeals Management (CAM). CAM will send your appeal information to Argonne. Argonne will review the facts, the reasons for the claim decision, and the information you have provided. Argonne will respond in writing within 60 days following the receipt of your Level II appeal. 

You may submit written comments, documents, records, and other information relevant to your appeal.



Upon request, you will be provided (free of charge) copies of all Appeals Reviewer’s documents, records, and other information relevant to your appeal.



The review of your Level II appeal will consider all comments, documents, records, and other information you submit on the Level II appeal and will not afford deference to the initial denial of your appeal.

Argonne will notify you, in writing, of its decision of your Level II appeal as soon as possible, but no later than 60 days after its receipt of your Level II appeal request. If Argonne determines that an extension of time for processing the Level II appeal is needed, it will notify you of the reasons for the extension and the extended due date before the end of the 60-day period.

If Your Level II Appeal Is Denied If your Level II appeal is denied, you will receive written notice of the decision, including the following information: 

The specific reason(s) for the denial of the Level II appeal;



Reference to the specific HRA provision on which the denial is based; and



If applicable, a copy of the internal rule, guideline, or protocol that was relied upon to make the Level II appeal determination.

Upon request to Argonne, you will also be provided (free of charge) copies of all of the documents, records, and other information relevant to your claim. You will have the right to bring a civil action under ERISA Section 502(a). You must appeal your claim, and that appeal must be denied by Argonne, before you may bring a civil action under ERISA. You and your Plan may also have other voluntary alternative dispute resolution options, such as mediation. One way to find out what may be available is to contact your local U.S. Department of Labor Office and your state insurance regulatory agency.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Deadline for Taking Legal Action If your Level II appeal is denied and you want to bring legal action under Section 502(a) of ERISA, you must do so by no later than the earlier of: 

One year after the date the denial of your Level II appeal is issued; or



The last day on which legal action could begin under the applicable statute of limitations under ERISA, including any state statute of limitations.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Administrative Information Discretionary Authority of the Plan Administrator The Plan Administrator has responsibility for the interpretation and construction of the HRA and final authority for the operation and administration of the HRA, including its day-to-day operation and administration. The Plan Administrator has the power and the duty to take all actions and to make all decisions necessary or proper to carry out its responsibilities, powers, and duties under the HRA. All determinations of the Plan Administrator as to any question involving its responsibilities, powers, and duties under the HRA, including interpretation of the HRA, or as to any discretionary actions to be taken under the HRA are solely at the discretion of the Plan Administrator and are final, conclusive, and binding on all persons claiming to have any right or interest in or under the HRA. In addition to any implied powers and duties, the specific powers and duties of the Plan Administrator include the power and duty to: 

Determine the eligibility of any individual to participate in the HRA and the amount of Contributions, if any, an individual is eligible for under the HRA;



Determine when, to whom, in what amount, and in what form reimbursements are to be made under the HRA;



Construe and interpret the terms and provisions of the HRA and all documents which relate to the HRA and to decide any and all matters arising thereunder, including the right to remedy possible ambiguities, inconsistencies, or omissions;



Investigate and make such factual or other determinations as will be necessary or advisable for the administration of the HRA or for the determination of benefits under the HRA;



Make and enforce such rules and regulations as it deems necessary or proper for the efficient administration of the HRA;



Review benefit claims and approve or deny any such benefit claims;



Appoint such agents, counsel, accountants, Consultants, and other persons as may be required to assist in administering the HRA; and



Allocate and delegate its responsibilities under the HRA and to designate other persons to carry out any of its responsibilities under the Plan. Wherever the Plan Administrator has delegated claims administration responsibilities to a contract administrator, that carrier or provider likewise has complete discretionary authority to interpret Plan terms and determine eligibility for benefits.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Discretionary Authority of the Benefit Plans Committee The Argonne National Laboratory Benefit Plans Committee (“Benefit Plans Committee”) has responsibility for reviewing, and the powers and duty to review, appeals of adverse benefit determinations by the Plan Administrator. The Benefit Plans Committee will have the power and the duty to take all actions and to make decisions necessary or proper to carry out its responsibility, powers, and duty under the HRA. All of the Benefit Plans Committee’s determinations as to any question involving its responsibility, powers, and duties under the HRA, including, without limitation, interpretation of the HRA or as to any discretionary items to be taken under the HRA, will be solely at the Benefit Plans Committee’s discretion and will be final, conclusive, and binding on all persons claiming to have any right or interest in or under the HRA. Note: Benefits under the HRA will be paid only if the Benefit Plans Committee decides, in their discretion, that you are entitled to them. In addition to any implied powers and duties the Benefit Plans Committee has to carry out their responsibilities under the HRA, the Benefit Plans Committee also has, in connection with such responsibilities, the power and duty to: 

Construe and interpret the terms and provisions of the HRA and all documents related to the HRA and to decide any and all matters arising under the HRA consistent with such responsibility; and



Investigate and make factual or make other determinations necessary or advisable for the resolution of appeals of adverse determinations.

Clerical Error A clerical error or other administrative error does not create benefits under the HRA. You are responsible for the accuracy of information pertaining to your participation in the HRA, including, but not limited to, your birthday, address, and Social Security Number. It is your responsibility to confirm the accuracy of statements made by Argonne or its designees that are based on such information and to promptly report errors to the Plan Administrator.

Plan Funding and Administration No funding medium of any kind is used for the accumulation of HRA assets, and no insurance company, trust fund, or any other institution maintains a fund through which the HRA is funded or Account reimbursements are provided. Aon Hewitt (through its Your Spending Account program) acts as a thirdparty Claims Administrator (the “TPA”) that Argonne has hired to process claims. The activities of the TPA may include receiving, processing, and evaluating your claim, billing Argonne for the amount due under your claim, and paying your claim. The TPA does not guarantee the payment of any claims under the HRA in any contract or insurance policy. Argonne is ultimately responsible for the payment of your claims.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Electronic Media The Plan Administrator may use electronic media in accordance with ERISA to satisfy all disclosure and recordkeeping obligations imposed on the HRAs under Title I of ERISA.

Future of the HRA Argonne reserves the right to amend or terminate the HRA at any time and for any reason. None of the plans and policies described in this Summary Plan Description represent a vested benefit. If the HRA is terminated, you will not be reimbursed for any expenses incurred on or after the HRA termination date, and you will need to file requests for reimbursement for expenses incurred before the termination date by the filing deadline established by the Plan Administrator. The Claim Administrator will not accept reimbursement requests filed after the deadline. Contributions, if any, that remain credited to any HRA after timely filed requests for reimbursement have been processed will be the sole property of Argonne.

Nonassignment of Benefits Assignment or alienation of any reimbursements provided by the Plan will not be permitted or recognized except as otherwise required by applicable law. This means that, except as required by applicable law, reimbursements provided under the HRA are not subject to sale, assignment, anticipation, alienation, attachment, garnishment, levy, execution, or any other form of transfer. Generally, state and local laws will not be recognized unless permitted by or under an applicable federal law, such as ERISA.

Additional Administrative Details Name of the Plan Argonne Retiree Health Reimbursement Account

Plan Sponsor UChicago Argonne, LLC c/o Human Resources Director Argonne National Laboratory 9700 S. Cass Avenue Lemont, IL 60439-4871 1.630.252.2989

Plan Administrator UChicago Argonne, LLC c/o Human Resources Director Argonne National Laboratory 9700 S. Cass Avenue Lemont, IL 60439-4871 1.630.252.2989

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Appeals Reviewer Claims and Appeals Management (CAM) P.O. Box 1407 Lincolnshire, IL 60069-1407

Claims Administrator Aon Hewitt Your Spending Account P.O. Box 785040 Orlando, FL 32878-5040 1.877.458.9656

Plan Year The Plan Year is the calendar year (January 1 through December 31).

Employer Identification Number 68-0628477

Plan Type The HRA is an employee welfare benefit plan under ERISA.

Plan Number 533

Agent for Service of Legal Process UChicago Argonne, LLC c/o Human Resource Director Argonne National Laboratory 9700 S. Cass Avenue Lemont, IL 60439-4871 You also may serve legal process to the Plan Administrator.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Glossary Active Service Employment with Argonne for 20 or more hours per week.

Appeals Reviewer Claims and Appeals Management (CAM).

Argonne Group Retiree Medical Plan Effective January 1, 2017, the medical plan sponsored by Argonne, which is available to eligible retired employees and their eligible Dependents who are not Medicare-Eligible.

Child(ren) A biological child, stepchild, legally adopted child, child placed for adoption, foster child, child for which the individual is the legal guardian, as long as the Child is claimed as a federal tax exemption by the individual, or the Child is covered under a qualified medical child support order (QMCSO). For purposes of this definition, “individual” refers to the Participant eligible for the HRA (or if not covered under the HRA, the eligible Spouse, eligible Surviving Spouse, or Civil Union Partner). Your Dependent Child is eligible for the HRA if he or she: 

Is at least age 65 and, as a result, is eligible for Medicare due to age;



Is incapable of self-sustaining employment, and who:



–

Is dependent upon you or other care providers for lifetime care and supervision, as long as he or she was covered prior to reaching th e e l i g ib i l it y ag e lim it un d er t he P l an (proof of the 2 Child's condition and dependence may be required), and

–

Has the same principal place of residence as you or your Spouse (or, in the case of divorce, as your divorced spouse), or who lives in a facility that provides care and supervision; and

Is enrolled in Medicare Part A and Part B.

Note: Participation is not available to a Dependent Child’s spouse or children. For more information about reporting your Child as a dependent on your federal tax return, refer to the section in this SPD titled “Tax Information.”

2

“Dependency on other care providers” is defined as requiring a Community Integrated Living Arrangement (“CILA”), group home, supervised apartment, or other residential services licensed or certified by the Department of Human Services, the Department of Health, or the Department of Public Aid.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Civil Union Partner The retiree’s legal Civil Union Partner of the same or opposite sex as defined by Illinois law, or a partner of a substantially similar legal relationship other than common law marriage legally entered into in another jurisdiction. Your Civil Union Partner must be an active participant in an Argonne group health plan immediately preceding your retirement in order to be eligible during your retirement.

Claims Administrator Aon Hewitt, the company that administers the HRA for Argonne through Your Spending Account (YSA).

COBRA The Consolidated Omnibus Reconciliation Act of 1985, as amended.

Company UChicago Argonne LLC and any entity affiliated with UChicago Argonne LLC, pursuant to Section 414(b), (c), or (m) of the Internal Revenue Code (IRC).

Consultants Aon Hewitt or such other vendor as may be designated by the Plan Administrator from time to time.

Contribution The amount, in U.S. dollars, determined annually in the sole discretion of the Plan Administrator and credited to a Participant’s HRA.

Dependent(s) Dependents are the retiree’s: 

Legal Spouse; or



Legal Civil Union Partner as defined by Illinois law, or a partner of a substantially similar legal relationship other than common law marriage, legally entered into in another jurisdiction.



Your Child, including a child who is legally adopted (with coverage from the time you are granted full care, control, and custody for the child); a stepchild; or a child for whom you are required by court order to provide coverage,

Eligible Former Employee A former employee who is eligible to participate in the HRA.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Highly Compensated Individual An individual defined under Section 105(h) of the Internal Revenue Code (IRC), as amended, as a “Highly Compensated Individual.”

HRA The Argonne-funded, non-interest-bearing, record-keeping account under the HRA established for a Participant and his or her eligible Dependents.

Medicare The program administered by the United States government, providing health insurance coverage to people who are age 65 and over, to those who are under age 65 and are permanently physically disabled or who have a congenital physical disability, and to those who meet other special criteria.

Medicare-Eligible An individual who is eligible for Medicare.

Participant(s) An Eligible Former Employee or, if the former employee is not covered under the HRA, the eligible Dependent of the former employee, who is eligible for the HRA and for whom an HRA has been established.

Plan Year The Argonne Retiree Health Reimbursement Account (“HRA”) is January 1 through December 31. The Catastrophic HRA Plan Year is the calendar year (January 1 through December 31) with a claims submission deadline of March 31 of the following year.

Pre-Medicare Participant A retired participant in the Argonne Group Retiree Medical Plan.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Spouse An individual who is legally married, as determined under applicable state law, to a Participant or a PreMedicare Participant.

Surviving Spouse An individual who was the Spouse or Civil Union Partner of an employee or retiree who met the age and service requirements to receive retiree medical coverage from Argonne as of the date of the employee’s or retiree’s death.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Your ERISA Rights Your Rights Under ERISA Note: The following applies only to individuals participating in the HRA. As an individual participating in the HRA, you are entitled to certain rights and protections under the Employee Retirement Income Security Act of 1974 (“ERISA”). ERISA provides that all those participating in the HRA are entitled to:

Receive Information About the HRA 

Examine, without charge, at the Plan Administrator’s office and at other specified locations, all documents governing the HRA, including insurance contracts, and a copy of the latest annual report (Form 5500 Series) filed by the HRA with the U.S. Department of Labor and available at the Public Disclosure Room of the Employee Benefits Security Administration.



Obtain, upon written request to the Plan Administrator, copies of documents governing the operation of the HRA, including insurance contracts, and copies of the latest annual report (Form 5500 Series) and updated Summary Plan Description (SPD). The Plan Administrator may make a reasonable charge for the copies.



Receive a summary of the HRA’s annual financial report. The Plan Administrator is required by law to furnish each Participant with a copy of this summary annual report.

Continue HRA Participation 

Continue HRA participation for yourself or your Dependents if there is a loss of coverage under the HRA that is eligible for continuation coverage under COBRA. You or your Dependents may have to pay for such coverage.



Review this SPD and the documents governing the HRA rules governing your COBRA continuation coverage rights.

Enforce Your Rights If your claim under the HRA is denied or ignored in whole or in part, you have a right to know why this was done, to obtain copies of documents relating to the decision without charge, and to appeal any denial, all within certain time schedules.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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Under ERISA, there are steps you can take to enforce the above rights. For instance, if you request a copy of HRA documents or the latest annual report from the HRA and do not receive them within 30 days, you may file suit in a federal court. In such a case, the court may require the Plan Administrator to provide the materials and pay you up to $110 a day until you receive the materials, unless the materials were not sent because of reasons beyond the control of the Plan Administrator. If you have a claim under the HRA which is denied or ignored in whole or in part, you may file suit in a state or federal court as long as you have first appealed your claim twice (and those appeals were denied) as set forth in this SPD. If it should happen that HRA fiduciaries misuse the HRA’s money or if you are discriminated against for asserting your rights, you may seek assistance from the U.S. Department of Labor, or you may file suit in a federal court. The court will decide who should pay court costs and legal fees. If you are successful, the court may order the person you have sued to pay these costs and fees. If you lose, the court may order you to pay these costs and fees, for example, if it finds your claim is frivolous.

Assistance with Your Questions If you have any questions about the HRA, you should contact the Plan Administrator. If you have any questions about this statement or about your rights under ERISA, or if you need assistance in obtaining documents from the Plan Administrator, you should contact the nearest office of the Employee Benefits Security Administration (EBSA), U.S. Department of Labor, listed in your telephone directory. You may also contact the: Division of Technical Assistance and Inquiries Employee Benefits Security Administration U.S. Department of Labor 200 Constitution Avenue N.W., Washington, D.C. 20210 or by telephone at 1.866.444.3272. You may also obtain certain publications about your rights and responsibilities under ERISA by calling the publications hotline of the Employee Benefits Security Administration. Additional information may be obtained from the Department of Labor’s website at www.dol.gov/ebsa.

© January 2017: UChicago Argonne LLC. All rights reserved.

Aon Retiree Health Exchange service center: 1.844.689.7831 (toll free) (TTY use 711 Relay) Aon Retiree Health Exchange website: retiree.aon.com/argonne Argonne, January 1, 2017

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