October 2014

Your 2015 Benefits Enrollment Summary

HealthSpan

Open Enrollment is Almost Here! At Cummins, we are committed to offering benefit choices and options to meet the specific needs of you and your family. This year is no different. We are very pleased to be in a position to continue to offer you affordable and comprehensive benefits. In order to make the most of these benefits, it’s important to re-evaluate your situation each year in order to choose the best options for you and your family. Know that there are no cost changes to your benefits this year. You will continue to pay the same amount for medical and dental coverage in 2015 as you did in 2014. There are, however, some benefit enhancements being made for 2015, which are highlighted on page 2 of this enrollment summary.

Know Your Options Soon you’ll have the opportunity to review your current benefits and decide if you want to make changes for 2015. This year’s Open Enrollment runs from October 31 through November 14. If you want to keep your current benefit elections, then you don’t need to take any action. Your 2014 benefits will carry over into 2015. However, if you want to change your benefits in any way, be sure to enroll during the Open Enrollment period. Note: If you wish to start a Flexible Spending Account for 2015, you will have to enroll during Open Enrollment. Here’s an overview of your benefit choices in 2015:

Benefit

Plan Choices

Medical (including Health Savings Account)

You can choose from two medical plans (HSA 3000 and HSA 1500). Both plans provide 100% coverage for preventive care and include a unique Health Savings Account feature that receives contributions from Cummins.

Prescription drugs

Both medical plans include prescription drug coverage. With the exception of preventive prescription drugs, you pay 100% of the cost until you meet the medical plan’s deductible. Once met, your cost is based on the type of drug you use (generic, formulary and non-formulary), and whether you go to a participating pharmacy or use the mail-order feature.

Dental

The dental plan covers diagnostic and preventive care at 100%. Once you meet the annual deductible, the plan pays a percentage of the cost for basic, major and orthodontia services.

Health Care and Dependent Care FSAs

You can save on a pre-tax basis and reimburse yourself for eligible health care and dependent care child day care expenses. If you make or receive contributions to an HSA, you are not eligible to participate in the Health Care FSA.

Life and accident insurance

You receive company-paid basic life and AD&D coverage. You can also purchase optional coverage for yourself and your eligible dependents.

Remember: You are automatically enrolled in company-paid disability and EAP.

Open Enrollment is October 31 through November 14 B

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2015 Benefit Enhancements At-A-Glance This enrollment summary, together with the resources available on the HealthSpan website, will give you all the information you need to make informed benefit choices. To start, here’s an overview of the enhancements to the Cummins benefits program for 2015:

Benefit

Enhancement for 2015

Medical and Dental plan contributions

Your contributions for medical and dental coverage will NOT change in 2015. You will continue to pay the same amount in 2015 that you do today.

Health Savings Account (HSA)

You can now contribute up to $3,350 (a $50 increase from 2014) for employee only and $6,650 (a $100 increase from 2014) for all other coverage levels.

Castlight

The Castlight tool will soon provide prescription drug and dental cost and quality information, not just medical.

Virtual physician visits

Beginning January 1, 2015, you can schedule virtual physician visits by phone or online any time through Teladoc.

An Overview of the HSA 3000 and HSA 1500 You continue to have two medical plan options for 2015: the HSA 3000 and the HSA 1500. Take a minute and review how the key features of the two options compare: Healthspan Medical Plan Options Plan Feature

HSA 3000 In-Network

HSA 1500

Out-of-Network

In-Network

Out-of-Network

Preventive Care

100%

Not applicable

100%

Not applicable

Annual Deductible

Individual: $3,000 Family: $6,000

Individual: $6,000 Family: $12,000

Employee only: $1,500 All other coverage: $3,000

Employee only: $3,000 All other coverage: $6,000

Cummins HSA Contribution

Base salary $35,000 or less: $800 employee only/$1,600 all other coverage Base salary more than $35,000: $500 employee only/$1,000 all other coverage

Employee HSA Contribution

Maximum allowable contribution per IRS guidelines Single coverage: $3,350 (including the Cummins contribution) Family coverage: $6,650 (including the Cummins contribution) Persons 55 years of age or older may contribute an additional $1,000 per year

Plan’s Coinsurance

80% after annual deductible

50% of R&C after annual deductible

80% after annual deductible

50% of R&C after annual deductible

Annual Out-of-Pocket Maximum

Individual: $5,500 Family: $11,000

Individual: $11,000 Family: $22,000

Employee only: $4,500 All other coverage: $9,000

Employee only: $9,000 All other coverage: $18,000

Open Enrollment is October 31 through November 14 2

Benefits of Your Health Savings Account (HSA) Throughout the year, you may spend a good portion of your income on health care-related expenses – from doctor’s office visits to prescription drugs to contact solution. That’s why your HSA is so valuable. As you think about your HSA contributions for 2015, remember these benefits: n You receive contributions from Cummins based on your salary and coverage level n You can fund your account through before-tax payroll deductions, which reduces the amount you pay in state and

federal taxes n Withdrawals from your HSA are tax-free when used for eligible health care expenses n You own the funds in your HSA – both your contributions and contributions from Cummins. They roll over from year to

year or you can take them with you when you leave Cummins

Eligibility to Contribute Both HSA Plans are considered “high deductible health plans,” which means – by law – you can’t contribute to an HSA if you have any medical coverage other than under a high deductible health plan. This means you cannot contribute to an HSA if: n You enroll in a medical plan sponsored by your spouse’s/domestic partner’s employer that is not a high deductible health

plan, even if you also enroll in the Cummins sponsored HSA medical plan n You or your spouse contributes to a Health Care FSA, which provides tax-free reimbursement of eligible health care

expenses n You are enrolled in Medicare or TRICARE n You have received VA health benefits in the last three months

IF YOU ARE NOT ELIGIBLE! If you enroll in the HSA 3000 or HSA 1500 medical plans but are NOT eligible to contribute to the Health Savings Account for one of the reasons outlined above, you will be automatically enrolled in a Health Reimbursement Account, or HRA. This account is funded by Cummins at the same level as the HSA, but is owned by Cummins – not you – and you cannot contribute to the account. For more information about this HRA option, contact the CBS Benefits Contact Center. For detailed information about how the plans work, go to healthspan.cummins.com.

Get Your Seasonal Flu Shot and Stay Healthy This Winter Every year, tens of millions of Americans fall victim to the flu. Even healthy people can get sick from the flu, so it is recommended that everyone over the age of six get vaccinated. Not only does getting your annual vaccination protect you, but it also protects those around you since you will not be spreading the virus to others. Cummins is once again providing flu shots to employees AND spouses/domestic partners at no cost. Take advantage of this convenient way to stay healthy this flu season. Visit the Notifications section of healthspan.cummins.com to see if a clinic is being offered at your location. If you can’t make it to the onsite flu shot clinic or one is not being offered at your location, you can still get a flu shot at no cost. Just visit the Guides/Forms/FAQS section of healthspan.cummins.com (then click on Health Tracks) to print a voucher redeemable at your local Walgreens pharmacy (Cummins ID required for employees. Photo ID required for spouses/domestic partners).

Open Enrollment is October 31 through November 14 3

What You Need to Do to Enroll Now that you’ve reviewed your enrollment materials, it’s time to begin thinking about your 2015 benefit choices. If you need more details, check out the HealthSpan website. There you can access detailed information about how each of your plan options work and find additional resources. Once your decisions are made, it’s time to enroll. It’s important that you enroll in your 2015 benefits by the enrollment deadline of November 14, 2014, so you receive the coverage you want and need.

If You Choose Not To Enroll... ...you will maintain the same medical (including prescription drugs), dental and life insurance coverage level in 2015 that you do today. In addition, your current HSA pre-tax contribution election will carry forward to 2015. If you want to participate in a Flexible Spending Account (FSA) for 2015, you must make a new election during Open Enrollment. 1. From the HealthSpan Home page, click on Enroll In/Change Benefits to access OneSource. You can enroll either at work or from home with your username (WWID) and password. 2. Click on PERC US Employee Self-Service, US Business Group. 3. Next, click Benefits Review & Enrollment to begin. 4. View a list of your dependents and then click Next to choose your 2015 benefits by clicking Update Benefits. 5. Make your 2014 benefit elections and click Next. 6. Select the dependent(s) you want to cover under your medical plan, and then do the same for the dental plan. Click Next. 7. Review your final elections, costs and covered dependents on the confirmation page. 8. Click Finish at the bottom of the confirmation page to complete the enrollment process and print that page for future reference. Your elections are not final unless you see the following message:

Your changes have been saved. To make additional changes, return to the Overview page and repeat the process. Please print this page for your records. If you log out without saving your elections, your choices will not be recorded on the system.

You will receive a final Confirmation of Benefits Statement in the mail in early December that outlines your elections for 2015.

Your OneSource Password Will Be Reset If you haven’t accessed OneSource since August 1, 2014, or reset your password via WWIMS, your OneSource password will automatically reset on October 24. When you enroll for HealthSpan benefits, use the reset (temporary) password, which is the month and day of your birth, plus the last four digits of your Social Security number (MMDD####). For example, if your birthday is September 12, and your Social Security number is 111-22-8787, your reset (temporary) password would be 09128787. Immediately after logging on to OneSource with this reset (temporary) password, you will be asked to change it to a password only you know.

If you have any questions, call the CBS Benefits Contact Center from Monday through Friday at 1-877-377-4357 from 7 a.m. to 6 p.m. Central Time.

Open Enrollment is October 31 through November 14 4

How to Earn HealthMiles Points in 2015 In 2015, you can again earn the $600 health plan incentive (a discount on your payroll contributions in 2016) if you earn 12,000 HealthMiles Points and your covered spouse/domestic partner (if applicable) earns 6,000 HealthMiles Points. Here’s how:

Wellness

Physical Activity

Online Health Assessment

BMI

Blood Glucose

Go to healthspan.cummins.com and select Online Health Assessment in the Quick Links section. 1,000 HealthMiles Points

At or below 30 1,000 HealthMiles Points

At or below 139 mg/dL 1,000 HealthMiles Points

Blood Pressure

Certify Tobacco-free

At or below 140/90 1,000 HealthMiles Points

(for the past 3 months) 1,000 HealthMiles Points

Vital Numbers

Total Cholesterol

Watch for events at Cummins sites. 2,000 HealthMiles Points

These measures recorded during your Vital Numbers screening.

At or below 220 mg/dL 1,000 HealthMiles Points

Steps

Health Station Biometrics

Challenges

Wear your GoZone® and upload your steps regularly. 20 - 100 HealthMiles Points per day

Take biometrics through a Health Station. 250 HealthMiles Points (once per month)

Complete Know and Go Challenges. 250 HealthMiles Points (once per month)

Self-Enter Activity

Ideal/Improved Numbers

Self-enter activity in your Activity Journal. 10 - 100 HealthMiles Points per entry

Achieve ideal/improved blood pressure or BMI. 200 HealthMiles Points for each (once per month)

Visit the LifeZone website. 10 HealthMiles Points (max twice per week)

LifeZone Visits

Remember: You and your covered spouse/domestic partner must create a Virgin Pulse account to get credit for completing these activities. If you already have an account, you can continue to use it in 2015. MyFitnessPal Connecting to MyFitnessPal for first time. 50 HealthMiles Points

Spread the Word

NUTRITION

Coaching*

Tell a friend about nutrition. 50 HealthMiles Points (three times per year)

Calorie Tracking • Calorie tracking entry. 20 HealthMiles Points per day • Tracking calories 5 out of 7 days. 80 HealthMiles Points per week

Challenges Nutrition Challenge competition. 150 HealthMiles Points per year

Coaching

Maternity Management

• Actively participate with coach toward individual goals. 1,000 HealthMiles Points per month

• Enroll in maternity program in first trimester. 500 HealthMiles Points

• Reach predefined program milestone. 500 HealthMiles Points

• Complete post-partum survey. 500 HealthMiles Points

*Health coaching is available to enrollees in the Cummins health plan.

Support the Cummins Every Employee, Every Community (EEEC) effort and earn 1,000 HealthMiles Points when you or your spouse/domestic partner complete four hours of community service. Employees can record their hours on the EEEC website (My Cummins > My Community > Log your hours). Spouses/domestic partners can record their hours on the Life Zone page of the Virgin Pulse website.

wellbeing

If it is unreasonably difficult due to a medical condition for you to participate in an activity or coaching program for the reward under this program, ask your physician to complete and return the Reasonable Alternative Physician Form as directed on the form. The form is available on HealthSpan (healthspan.cummins.com) under Guides/Forms/FAQs and Forms/Health Tracks. Virgin Pulse reserves the right to investigate conspicuous performance. If you falsify information or inappropriately use the GoZone, you are in violation of the Cummins Code of Business Conduct.

Open Enrollment is October 31 through November 14 5

Required Notices Women’s Health and Cancer Rights Act of 1998 Under federal law, medical plan options, such as those in HealthSpan, must provide certain benefits related to breast reconstruction. If you are receiving mastectomy benefits from a HealthSpan plan and elect breast reconstruction in connection with that mastectomy, HealthSpan will cover: n Reconstruction of the breast on which the mastectomy

has been performed. n Surgery and reconstruction of the other breast to

produce a symmetrical appearance. n Prostheses and treatment of physical complications at

all stages of the mastectomy, including lymphedemas.

Notice of HIPAA Special Enrollment Rights If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents’ other coverage). However, you must request enrollment within 31 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage). In addition, if you have a new dependent as a result of marriage, birth, adoption, or placement for adoption you may be able to enroll yourself and your dependents. However, you must request enrollment within 31 days after the marriage, birth, adoption or placement for adoption. To request special enrollment or obtain more information, contact the CBS Benefits Contact Center at 1-877-377-4357.

Summary of Benefits and Coverage and Glossary of Terms Health insurers (like Anthem) are required by Health Care Reform to provide you with a summary describing, in plain language, simple and consistent information about your health plan coverage. This summary of benefits and coverage is designed to help you better understand the benefits you have (such as covered services, your cost share and any limitations and exceptions) and allow you to easily compare the HSA 3000 and HSA 1500. You can also receive – upon request – a glossary of terms to help you understand some of the most common, but confusing, jargon used in health plans. Copies of these summaries will be available through OneSource during Open Enrollment, and on the HealthSpan website (go to the Summary Plan Description section of Guides/Forms).

Other Required Notices Other required notices, including rights under the Uniform Services Employment and Reemployment Rights Act (USERRA), the Consolidated Omnibus Budget Reconciliation Act (COBRA), Newborns’ and Mother’s Health Protection Act, and the Employee Retirement Income Security Act (ERISA), can be found in the Summary Plan Descriptions (SPDs) located on healthspan.cummins.com or by calling 1-877-377-4357.

About This Enrollment Summary This enrollment summary contains only highlights of programs and campaigns offered to HealthSpan participants. Every effort has been made to report information accurately, but the possibility of error exists. In addition, not every plan detail of every benefit that may matter to you could be included in this summary. Cummins benefit programs are governed by an official plan document. In case of any conflict between this summary and an official plan document, the plan document will be the final authority. For more detailed information about the program or any of the topics discussed in this summary, call CBS Benefits Contact Center toll-free at 1-877-377-4357 Monday through Friday, 7 a.m. to 6 p.m. Central Time, or review your Summary Plan Descriptions (SPDs). SPDs are available through the HealthSpan website.

10/14 – B

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