4 PLAN INFORMATION The name of the Medical Carrier that insures benefits under the Plan is: Meritain Health Benefit Program Plan Name: Meritain - Aetna $4000 100% HDHP POS Plan Year January 01 through December 31 Benefit Funding Type: Self Insured Policy Number: 16316 Insurance Carrier Address: 1044 Eastbury Drive Lansing , MI 48917 Insurance Carrier Phone: 888 - 324 - 5789 Insurance Carrier URL: www.meritain.com Dental is Included in this Plan Yes Vision is included in this Plan Yes Pharmaceutical is included in this Plan Yes Eligible Employee: Employees working at least 30 hours per week Excluded Classes: Part Time;Seasonal Workers;Seasonal Employees;Interns Benefit Waiting Period: 1st of Month following 30 Days Benefit Termination Date: End of Month Eligible Dependents: Spouse and Dependents up to the age of 26 Employee Coverage Only Contributions: Yes - Employee and Employer contribute Employee and Spouse ( o r Domestic Partner ) Coverage Contributions: Yes - Employee and Employer contribute Employee and Dependents Contributions: Yes - Employee and Employer contribute Employee and Family Contributions: Yes - Employee and Employer contribute If Employee contributes to premium, is that contribution collected Pre - Tax Yes Grandfathered: No