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Decisi n Time Elect your 2020 benefits October 14 – 25, 2019 ybr.com/lsc 1-844-LSC-BENS

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Page 1: Decisi n Time - Website Namespdxpresslsc.com/Docs/LSC_2020_Enrollment_Guide_FINAL_Sep10_r… · NOTE: You could pay much more than the out-of-pocket maximum if you go out-of-network

Decisi nTime

Elect your 2020 benefits October 14 – 25, 2019

ybr.com/lsc 1-844-LSC-BENS

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ii

IT'S YOUR MOVE Time to decide your benefits for 2020. This Benefits Decision Guide describes the health and welfare benefit programs available. Please review the information carefully so you can take full advantage of your benefit options.

ENROLL:+ Online at ybr.com/lsc

+ By phone at 1-844-LSC-BENS (1-844-572-2367), Monday – Friday, 8:00 a.m. – 5:00 p.m. Central Time

What’s Inside Page

Eligibility Requirements . . . . . . . . . . . . . . 1

Enrolling in Benefits . . . . . . . . . . . . . . . . 2

Your 2020 Benefit Choices Medical . . . . . . . . . . . . . . . . . . . . . . . 3

Supplemental Health Care Benefits. . . . . . . 7

Dental . . . . . . . . . . . . . . . . . . . . . . . . 8

Vision . . . . . . . . . . . . . . . . . . . . . . . . 9

Flexible Spending Accounts (FSAs) . . . . . 10

Life and Accident Insurance . . . . . . . . . . .1 1

Disability . . . . . . . . . . . . . . . . . . . . . 12

Your 2020 Benefit Premiums . . . . . . . . . 13

Useful Contacts . . . . . . . . . . . . . . . . . . 16

NEW FOR 2020! Avoid a $1,000 Surgery PenaltyTo help you better understand your treatment options, you MUST enroll in ConsumerMedical's Surgery Decision Support® program at least 30 days before you or a covered dependent undergo any of the following surgeries; otherwise, your medical plan will charge you an additional $1,000 precertification penalty for not complying:

+ Hip or knee replacement

+ Lower back surgery

+ Non-emergency hysterectomy

+ Weight loss (obesity/bariatric) surgery

Contact ConsumerMedical at 1-888-361-3944, M – F, 7:30 a.m. – 10:00 p.m. CT.

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ELIGIBILITY REQUIREMENTS In general, you’re eligible for coverage under the LSC Group Benefits Plan (the “Plan”) if you’re classified as a regular full-time or benefits-eligible part-time employee of LSC Communications or any of its participating subsidiaries. (Certain employees may also be eligible under the Affordable Care Act requirements if they worked a minimum number of hours in the prior year.)

Who Is an Eligible Dependent?In general, you may cover a spouse/domestic partner and/or child(ren) who qualify as dependents as defined in the applicable Summary Plan Description (SPD) and any related Summary of Material Modifications (SMMs). In some cases, eligibility requirements are further described in insurance certificates.

Who Isn’t an Eligible Dependent?Your parents, grandparents, brothers and sisters are not eligible for coverage. Your grandchildren are not eligible for coverage except if you are the sole legal guardian. A spouse/domestic partner or child(ren) covered as an employee or as a dependent of another employee under the Plan is not eligible to be covered by you.

Please refer to SPDxpressLSC.com for additional information on who may or may not be covered.

IMPORTANT NOTE ABOUT DEPENDENT COVERAGEWe may conduct an audit to confirm that dependents enrolled under the Plan are eligible for coverage. If you elect to cover any dependents when you enroll in coverage, you may be asked to demonstrate their eligibility.

When it is time for the audit, you will receive a letter in the mail outlining what to do. This process ensures only eligible dependents are covered, which helps us manage health care costs for both you and the company. It is your responsibility to ensure all covered dependents meet the dependent eligibility requirements. The Plan does not pay benefits for ineligible dependents, even if they are enrolled. Please refer to the applicable SPDs and related SMMs and insurance certificates for complete dependent eligibility requirement details.

IMPORTANT: If your dependent(s) were dropped from coverage during a prior audit, you will need to provide documentation to certify their eligibility before you can enroll them in coverage for 2020.

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ENROLLING in BENEFITSYour benefit elections — including any default coverage assigned to you if you don’t enroll — will be in effect through December 31, 2020. You cannot change your elections during the year unless you experience a qualified status change (e.g., marriage, divorce, birth of a child, loss of other coverage). If you experience a qualified status change during the year, you can make a new election, consistent with the status change, generally within 30 calendar days through the LSC Benefits Center (although a few events permit up to 60 days to make changes). Refer to the Qualified Status Changes SPD and any related SMMs for more information about qualified status changes.

Make the Tobacco-free PledgeLSC Communications offers a medical premium credit when you and your covered dependents make the Tobacco-free Pledge — i.e., pledge that you are either tobacco-free or that you will participate in the Tobacco: Kick It! program between January 1, 2020 and November 30, 2020. This credit is reflected in the annual medical premiums listed on page 13 of this guide. If you elect “Cessation” and pledge to participate in the Tobacco: Kick It! Program by the program deadline, but fail to do so, a retroactive surcharge will be applied in 2021, in the amounts listed below.

If you and/or any covered dependents do not make the Tobacco-free Pledge, an annual surcharge is added to your medical premium, up to the following maximums:

+ Employee Only or Spouse Only: $500

+ Employee + Spouse: $1,000

+ Dependent Child(ren) Only: $250

+ Employee + Child(ren) or Spouse + Child(ren): $750

+ Family [Employee + Spouse + Child(ren)]: $1,250

If you elected “No Tobacco” for 2019, it will carry over to 2020, and the tobacco-free credit will automatically be reflected in your 2020 medical premiums. If you or any dependent has begun using tobacco, you need to elect “Cessation” or “Yes Tobacco” for that individual.

If you elected “Cessation” for 2019 and quit tobacco, you will need to elect “No Tobacco” for 2020. If you do not change your election, you will need to participate in the Tobacco: Kick It! program again between January 1, 2020 and November 30, 2020 to avoid a retroactive surcharge for 2020.

If you elected “Yes Tobacco” for 2019, a surcharge will again apply in 2020 unless you change your status to “No Tobacco” or “Cessation” (and participate in the Tobacco: Kick It! program by the deadline).

IMPORTANT: You must make separate tobacco declarations for you and your dependents.

Tobacco: Kick It! You can enroll in the Tobacco: Kick It! program by calling 1-877-409-1488. (Note: Alternate cessation recommendations by your physician will be accommodated.) If any of you declare you use tobacco but agree to participate in the Tobacco: Kick It! program, we receive confirmation when you participate in the program. If you do not participate in the program between January 1, 2020 and November 30, 2020, you will be charged the surcharge retroactively, and these deductions will be taken from your pay in 2021.

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YOUR 2020 BENEFIT CHOICES

MEDICALYou have Medical Program options that offer different levels of coverage to help meet your needs.

Coverage OptionsYour medical coverage options for 2020 are:

PremiumsRefer to page 13 of this guide for the premiums associated with each option.

How Your 2020 Medical Program Options DifferCopays

for Certain Services

Eligible for a Full-Use Flexible Spending

Account (FSA)

Eligible for a Health Savings Account (HSA)

Prescription Drugs Apply to

Deductible Premiums

Deductible and Out-of-Pocket

Maximum

Copay Advantage X X 1 $$$$ $$

HSA Advantage X X2 $$$ $$

HSA Value X X2 $$ $$$

HSA Core X X2 $ $$$$1. Under Copay Advantage, the Plan applies copays/coinsurance immediately for prescription drugs without any deductible.2. HSA Advantage, HSA Value and HSA Core are eligible for a limited-use FSA, as explained on page 10.

Your Medical Program Vendors: Blue Cross and Blue Shield of Illinois (BCBSIL) or UnitedHealthcare (UHC)Each geographic region has a “best-in-market” medical vendor (BCBSIL or UHC), which is the vendor that generally offers the best discounts/rates with providers in the area (although individual experiences with providers and services may differ). There are no changes to the best-in-market vendor for each region for 2020.

If you make no changes during Annual Enrollment, your current medical vendor election will carry over to 2020. It is important that you verify which vendor you have elected and whether your health care providers are part of the vendor's network. If your providers are not in the network, you will pay much more for Medical Program services.

You may make changes during Annual Enrollment to elect either vendor, but if you enroll with the vendor that is not the best-in-market, the following surcharge will be added to your medical premium:

+ $12.50 per month/$5.77 per pay period for Employee Only coverage

+ $25 per month/$11.54 per pay period for all other coverage categories

Learn the specifics of your vendor by looking at their website or calling the vendor directly:

Program Vendor Website & Telephone Network Name

BCBSIL bcbsil.com/lsc + 1-888-895-6985 PPO

UHC welcometouhc.com/lsccom + 1-844-263-1622 UHC Choice Plus Network

+ Copay Advantage + HSA Advantage + HSA Value NEW! + HSA Core

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Exploring Your Medical Options With all four medical options (Copay Advantage, HSA Advantage, HSA Value and HSA Core):

+ You can use in-network or out-of-network providers. NOTE: If you see an out-of-network provider, you will typically pay more for services. In addition, because out-of-network

providers can charge you the difference between their billed charges and the Medicare reimbursement level that the Plan pays, the amount could be even higher.

+ Eligible preventive care is covered at 100% in-network with no deductible, coinsurance or copays.+ Prescription drug coverage is provided through CVS Caremark. (You do not have to fill your prescription at CVS. To find

local pharmacies in your network, register at caremark.com or download the CVS Caremark app for iPhone or Android to access the pharmacy search tool.)

+ Eligible generic cholesterol and blood pressure medications are free.+ Your out-of-pocket maximum protects you in case of unexpected or catastrophic expenses. The out-of-pocket

maximum is the most you will have to pay in a year for covered and allowed health care expenses and includes the deductible and copays/coinsurance. Premiums and any surcharges you pay, and any non-covered expenses such as precertification penalties, are NOT included in the out-of-pocket maximum.

NOTE: You could pay much more than the out-of-pocket maximum if you go out-of-network because out-of-network service has an “allowed amount,” which is generally the Medicare reimbursement level. Once you reach your out-of-pocket maximum, the Plan pays 100% of the allowed amount. You are responsible for paying any charges over the allowed amount — which could be significant — directly to your provider. Your expenses in excess of the allowed amount do not count toward the deductible or out-of-pocket maximum.

Use a Health Savings Account (HSA) to Save and Pay Tax-freeYou can contribute to a Health Savings Account (HSA) if you enroll in the HSA Core, HSA Value or HSA Advantage medical option. An HSA is a smart way to save and pay for your health care. Your unused account balance rolls over from year to year. Money in your HSA is always yours, even if you change medical options, leave the company or retire.

2020 HSA CONTRIBUTION LIMITS SET BY THE IRS

Employee Only Coverage $3,550 ($50 more than 2019)

Family Coverage (i.e., all other coverage levels) $7,100 ($100 more than 2019)

Catch-up Contribution (if you are age 55 or older by 12/31/2020 and not enrolled in Medicare) $1,000

If you participated in an HSA during 2019, your same HSA contribution amount will automatically continue in 2020 unless you make a change. If you want to contribute the new IRS maximum, you will need to increase your 2020 contribution. HSA contributions may be changed mid-year even without a qualified status change. IMPORTANT: You are responsible to make sure you don’t exceed the annual IRS limit, so track your contributions regularly.

MEDICARE AND YOUR HSAOnce you enroll in Medicare (generally at age 65), you can no longer contribute to your HSA. (This occurs even if just the automatic Medicare Part A coverage goes into effect when you start collecting Social Security retirement benefits. So unless you defer receipt of Social Security and decline Part A, you need to stop any HSA contributions you may be making to avoid any tax consequences.) However, you can continue to use the existing balance in your HSA to pay for eligible out-of-pocket health care expenses tax-free. This includes premiums, deductibles, copays and coinsurance under Medicare. This does not include MediGap premiums.

HSA CONTRIBUTION RULES FOR MARRIED PEOPLEIf both you and your spouse are eligible for an HSA, you may each set up individual accounts. The total contribution between those two accounts can’t exceed $7,100 (unless one or both of you qualify to make age-based catch-up contributions). This is true even if both of you work for LSC and have separate coverage. For example, if you have Employee Only coverage and your spouse has Family coverage, your two accounts combined cannot exceed the $7,100 maximum. Any catch-up contributions for your spouse age 55 or older must be made to his or her own HSA. Please see IRS Publication 969 for more information about contribution limits.

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Summary of Benefits for COPAY ADVANTAGE and HSA ADVANTAGEWith the Copay Advantage medical option, you pay a flat-dollar amount (i.e., a copay) for certain covered services, such as doctor’s office visits. This may help you predict your costs. (Note, however, the deductible and coinsurance still apply for certain diagnostic and treatment services performed in a doctor’s office or hospital/outpatient setting.)

The HSA Advantage medical option is eligible for a Health Savings Account (HSA), which can help you save and pay for health care tax-free. While this medical option has lower premiums than Copay Advantage, you might pay more out-of-pocket when you seek care.

COPAY ADVANTAGE HSA ADVANTAGE

COVERAGE CATEGORY

EMPLOYEE ONLY

+ EMPLOYEE +SPOUSE OR CHILD(REN)

+ FAMILYEMPLOYEE

ONLY

+ EMPLOYEE +SPOUSE OR CHILD(REN)

+ FAMILY

Annual Deductible (Medical only) $3,200 $6,4001 $3,200 $6,4001

Coinsurance

+ In-Network You pay 20% after deductible

+ Out-of-Network You pay 40% after deductible

Annual Out-of-Pocket Maximum (Medical and Prescription Drug combined) $6,200 $12,4001

(individual cap of $6,200)$6,200 $12,4001

(individual cap of $6,200)

Office Visit

+ In-Network You pay $25 PCP / $40 Specialist You pay 20% after deductible

+ Out-of-Network You pay 40% after deductible You pay 40% after deductible

Preventive Care

+ In-Network You pay 0%

+ Out-of-Network You pay 40% after deductible

Emergency Room

+ In-Network $500 copay + 20% of the remaining balance You pay 20% after deductible

+ Out-of-Network

$500 copay + 20% of the remaining balance if true emergency, otherwise 50% of the

remaining balance after deductibleNote: If admitted, inpatient stays apply to deductible and out-of-pocket maximum

You pay 20% after deductible if true emergency, otherwise 40% after deductible

Prescription Drugs Through CVS Caremark

You pay (does NOT apply to your deductible): 2

You pay (after deductible): 2

Retail Mail-Order Retail and Mail-Order

+ Generic 20% ($10 min / $40 max) 20% ($25 min / $100 max) 20%

+ Brand Formulary 30% ($40 min / $75 max) 30% ($100 min / $185 max) 30% ($1 min)

+ Brand Non-Formulary 40% ($55 min / $125 max) 40% ($140 min / $315 max) 40% ($16 min)

+ Specialty $150 More than 30-day supply not allowed 40%

1. The Plan starts paying benefits for an individual’s claims only after the total deductible for the coverage category (e.g., Family) has been met — even if those expenses are incurred by only one individual. The out-of-pocket maximum, however, works differently. No one in your family pays more than the individual out-of-pocket maximum before the Plan starts paying 100% of his/her covered expenses. Note: Any non-covered out-of-pocket expenses — such as out-of-network expenses in excess of the allowed amount or the precertification penalty related to not enrolling in ConsumerMedical Surgery Decision Support® — will not count toward your deductible and out-of-pocket maximum.

2. Any penalties related to the Prescription Drug Program — such as penalties for failure to obtain prior authorization, failure to use step therapy, or for prescriptions that specify they should be dispensed as written — will not count toward your deductible or out-of-pocket maximum.

For an interactive side-by-side comparison of your medical options, use the Health Plan Comparison Chart at ybr.com/lsc. You can compare medical options by key features such as cost, ease of use, coverage and access.

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Summary of Benefits for HSA VALUE and HSA CORE

As with HSA Advantage, the HSA Value and HSA Core medical options are eligible for a Health Savings Account (HSA). While these medical options have lower premiums than Copay Advantage and HSA Advantage, your deductibles and out-of-pocket maximums are higher. TIP: To help pay your deductible, consider contributing your premium savings to an HSA. Also take a look at the MetLife Supplemental Health Care Benefits on page 7.

HSA VALUE HSA CORE COVERAGE CATEGORY EMPLOYEE ONLY

+ EMPLOYEE +SPOUSE OR CHILD(REN)

+ FAMILY EMPLOYEE ONLY

+ EMPLOYEE +SPOUSE OR CHILD(REN)

+ FAMILY

Annual Deductible $4,600 $9,2001 $6,900 $13,800 2

(individual cap of $6,900)

Coinsurance

+ In-Network You pay 30% after deductibleYou pay 0% after deductible3

+ Out-of-Network You pay 50% after deductible

Annual Out-of-Pocket Maximum (Medical and Prescription Drug combined)

$6,550 $13,1001 (individual cap of $6,550)

$6,900 $13,8002

(individual cap of $6,900)

Office Visit

+ In-Network You pay 30% after deductibleYou pay 0% after deductible3

+ Out-of-Network You pay 50% after deductible

Preventive Care

+ In-Network You pay 0%You pay 0% 3

+ Out-of-Network You pay 50% after deductible

Emergency Room+ In-Network You pay 30% after deductible

You pay 0% after deductible3

+ Out-of-Network You pay 30% after deductible if true emergency, otherwise 50% after deductible

Prescription Drugs Through CVS Caremark — You pay (after deductible) 4:

Retail and Mail-Order Retail and Mail-Order+ Generic 30%

You pay 0% after deductible3+ Brand Formulary 40% ($1 minimum)

+ Brand Non-Formulary 50% ($16 minimum)+ Specialty 50%1. For HSA Value, there is no individual cap on the deductible; the Plan starts paying benefits for an individual’s claims only after the total deductible for the coverage category

(e.g., Family) has been met — even if those expenses are incurred by only one individual. The out-of-pocket maximum, however, works differently. No one in your family pays more than the individual out-of-pocket maximum before the Plan starts paying 100% of his/her covered expenses. So it is possible that even if the full family deductible of $9,200 has not been reached, the Plan may begin paying covered expenses for an individual family member if that family member’s own out-of-pocket expenses have reached $6,550. After total expenses for all enrolled family members reach the family deductible, the Plan starts paying a portion of covered expenses for everyone. Note: Any non-covered out-of-pocket expenses — such as out-of-network expenses in excess of the allowed amount or the precertification penalty related to not enrolling in ConsumerMedical Surgery Decision Support® — will not count toward your deductible and out-of-pocket maximum.

2. For HSA Core, no one in your family pays more than the individual deductible, which is the same as the individual out-of-pocket maximum, before the Plan starts paying 100% of his/her covered expenses. For example, if your covered spouse has a hospital stay and incurs $11,000 in covered expenses, he/she would pay $6,900 to meet the individual deductible and out-of-pocket maximum; the Plan would pay $4,100. The Plan would also begin paying 100% of your spouse’s covered expenses for the rest of the year. After total expenses for all enrolled family members reach the family deductible, the Plan starts paying 100% of covered expenses for everyone. Note: Any non-covered out-of-pocket expenses — such as out-of-network expenses in excess of the allowed amount or the precertification penalty related to not enrolling in ConsumerMedical Surgery Decision Support® — will not count toward your deductible and out-of-pocket maximum. See the HSA Core employee briefing at spdxpresslsc.com/pages/enrollment for more examples.

3. While HSA Core pays the same level of benefits in- and out-of-network, you could pay much more than the out-of-pocket maximum if you go out-of-network because out-of-network service has an “allowed amount,” which is generally the Medicare reimbursement level. The Plan pays 100% of the allowed amount, but you are responsible for paying anything over that allowed amount — which could be significant — directly to your provider. Your expenses in excess of the allowed amount do not count toward the deductible or the out-of-pocket maximum.

4. Any penalties related to the Prescription Drug Program — such as penalties for failure to obtain prior authorization, failure to use step therapy, or for prescriptions that specify they should be dispensed as written — will not count toward your deductible or out-of-pocket maximum.

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SUPPLEMENTAL HEALTH CARE BENEFITSMetLife Supplemental Health Care Benefits provide a cash payment directly to you that you may use toward your medical deductible, copays/coinsurance and other out-of-pocket costs. Policies include:

+ Hospital Indemnity

+ Critical Illness and Accident Insurance

You must be actively at work on the date the policy takes effect; otherwise, your coverage will not take effect until you return. See page 14 of this guide for premiums. Note: You pay the full cost of these benefits, available at group rates, through after-tax payroll deductions.

Hospital IndemnityHospital Indemnity provides payment when an eligible accident or sickness puts you or a covered family member in the hospital, on or after your coverage effective date.

METLIFE HOSPITAL INDEMNITY INSURANCE

Hospital Coverage — Accident

Hospital Admission Benefit1,2 $350 per accident

Hospital Confinement Benefit2 $200 per day, up to 31 days per covered person per accident

Hospital Coverage — Sickness

Hospital Admission Benefit1 $350 per calendar year

Hospital Confinement Benefit $200 per day, up to 31 days per covered person per sickness1. Paid directly to employee on flat schedule per claim (does not vary by length or service received). 2. Must occur within 180 days after the accident.

Critical Illness and Accident InsuranceCritical Illness Insurance provides a lump sum payment of $10,000 or $20,000 if you or a covered family member are diagnosed and treated on or after your coverage effective date for certain health conditions, such as cancer, heart attack, stroke and kidney failure. Accident Insurance provides payment for certain injuries resulting from accidents such as a car crash, sports injury or common child mishaps, such as a broken bone or concussion.

IMPORTANT: If you have a current condition and you enroll in Critical Illness and Accident Insurance, be sure to review the full details regarding pre-existing conditions. See the policy documents for more information regarding eligible family members. Policy documents can be found at ybr.com/lsc.

METLIFE CRITICAL ILLNESS AND ACCIDENT INSURANCE

Critical Illness Benefit Coverage OPTION 1 OPTION 2

Employee $10,000 $20,000

Spouse/Domestic Partner 100% of the employee’s initial benefit amount*

Dependent Child(ren) 100% of the employee’s initial benefit amount*

Accident Insurance for Injuries

Fractures $200 – $2,000

Concussions $200

Cuts/Lacerations $25 – $400

Accident Insurance for Medical Services & Treatment

Ambulance $150

Therapy (including physical therapy) $25

Inpatient Surgery $1,000

Review policy documents at ybr.com/lsc.

NOTE: In the event you and/or a covered family member experience more than one covered condition, the total maximum benefit amount available is 5 times that of your initial benefit amount — in other words, $50,000 or $100,000. * Benefit amount is based on option chosen.

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DENTALYour dental options include MetLife PPO and MetLife PPO Plus. Both options allow you to choose any dentist, but you receive a higher level of coverage with lower out-of-pocket costs if you use participating network dentists.

To find an in-network dentist, go to metlife.com/mybenefits, select Employee Benefits and then Dental. Look for the PDP Plus Network under Find a Dentist.

If you use an out-of-network provider, the Program pays benefits in accordance with the two options’ usual and customary (U&C) limits. This means you may be responsible to pay your provider directly for any difference between the billed charges and what the Plan pays.

Benefit Description

METLIFE PPO METLIFE PPO PLUS

IN-NETWORK & OUT-OF-NETWORK IN-NETWORK & OUT-OF-NETWORK

Deductible (no deductible applies for Type A services)

$50 individual / $150 family $50 individual / $150 family

Annual Benefit Maximum — Non Orthodontia

$1,500 per individual $2,000 per individual

Lifetime Orthodontia Maximum Benefit NA$2,000 per individual receiving

treatment per lifetime

Preventive — Type A (routine exams, cleanings, bitewing x-rays, fluoride application, sealants, etc.)

100% 100%

Basic — Type B (fillings, full mouth x-rays, routine extractions, root canals, periodontics, oral surgery, etc.)

50% 80%

Major — Type C (crowns, dentures, bridges, surgical extractions, implants, etc.)

50% 50%

Orthodontia — Type D NA 50%

See page 14 of this guide for the premiums associated with each option and coverage category.

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VISIONYour Vision Care Program options include EyeMed and EyeMed Enhanced. Both options provide:

+ Comprehensive coverage for exams, lenses, frames and contact lenses through a network of providers

+ Discounts on laser vision correction

+ Hearing care discounts through Amplifon

To find an EyeMed vision provider, visit eyemed.com and look for the Vision Care Program network. Prospective members can also call 1-866-299-1358 for assistance. To find hearing providers, visit amplifonusa.com or call 1-877-203-0675.

Benefit Description

EYEMED EYEMED ENHANCED

IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK

Frequency of Vision Service (months) + 12-month exam + 12-month frame + 12-month lens

Routine Vision Exam $10 copay Up to $35 allowance $0 copay Up to $35 allowance

Retinal Imaging $39 NA $39 NA

Frames$0 copay — $130

allowance; 20% off balance over $130

Up to $60 allowance$0 copay — $160

allowance; 20% off balance over $160

Up to $80 allowance

Lens (single vision)* $20 copay Up to $25 allowance $10 copay Up to $25 allowance

Contacts*$0 copay — $150 allowance; 15% off balance over $150

Up to $150 allowance$0 copay — $170

allowance; 15% off balance over $170

Up to $150 allowance

Laser Surgery

15% off retail price or

5% off promotional price

NA

15% off retail price or

5% off promotional price

NA

Hearing Benefits40% off hearing exams

and a discount on hearing aids

NA40% off hearing exams

and a discount on hearing aids

NA

* IMPORTANT: Benefit coverage is for either contact lenses OR frame lenses but not both.

See page 14 of this guide for the premiums associated with each option and coverage category.

Extra Savings on LensesBoth EyeMed and EyeMed Enhanced offer the Freedom Pass: Any frame, any price for $0 out-of-pocket at Sears Optical or Target Optical, or $20 off contact lenses through contactsdirect.com. Register as a member at eyemed.com to receive these special offers.

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FLEXIBLE SPENDING ACCOUNTS (FSAs)FSAs allow you to reimburse yourself for eligible out-of-pocket health and dependent care expenses with pre-tax contributions you make to your FSAs during the Plan year. You could save up to 40% or more on eligible expenses, depending on your tax bracket.

Here’s how they work:

+ Contribute from $200 to $2,700 to the Health Care FSA. You can use the Health Care FSA to reimburse eligible health care-related expenses such as coinsurance, the cost of contact lenses, prescription drug copayments, over-the-counter drugs prescribed by a doctor and more. If you are enrolled in an HSA medical option, your FSA will be limited-use (see below).

+ Contribute from $200 to $5,000 to the Dependent Care FSA. You can use the Dependent Care FSA to reimburse eligible dependent day care-related expenses such as day care for your child, elderly parent or disabled spouse. NOTE: You can contribute up to $5,000 a year if your tax filing status is single, head-of-household, or married and filing jointly for taxes. If married and filing separately, you can contribute up to $2,500 a year. If you are married, your spouse must work (or be a full-time student, active duty military or disabled), and your contributions are capped at the amount of your spouse’s earned income if that’s less than $5,000. Also, you’ll be notified if the amount you elect to contribute is reduced to comply with government requirements for high-income employees. You cannot participate if you are divorced or a single parent and the child’s other parent is the primary custodian.

+ Make a new election each year. Your prior year's election will not carry over.

+ Plan carefully. Per IRS rules, you forfeit any money remaining in your FSAs at the end of the 2020 Plan year. However, you have until March 31, 2021, to submit claims for services incurred during the 2020 Plan year.

The Flexible Spending Account Estimator at ybr.com/lsc can help you calculate eligible health care expenses and may help you determine the amount you should contribute to an FSA.

IMPORTANT + If you leave the company during the Plan year, you can only submit Health Care FSA claims for services incurred up to your

termination date. The exception is if you elect to continue your Health Care FSA coverage during your COBRA eligibility period and you pay your COBRA premiums. For the Dependent Care FSA, you may submit claims for services incurred following termination through December 31, 2020, up to the amount you contributed through your termination date.

+ You cannot change your FSA election during the year unless you experience a qualified status change (e.g., marriage, divorce, birth of a child). If you experience a qualified status change during the year, you can make a new election, consistent with the status change, within 30 calendar days through the LSC Benefits Center. Not all qualified status changes apply to FSAs. See the Qualified Status Changes SPD for more information.

+ Over-the-counter medicines (except insulin) require a doctor’s prescription to be reimbursed through an FSA or HSA.

Know How Your Medical Option Affects Your Health Care FSAThe IRS has rules that apply to how you can use your Health Care FSA based on the type of Medical Program option you have. Here are some key things to know as you make your decision:

If Your Medical Program Option Is …

Your Health Care FSA Option Will Be …

Out-of-pocket Expenses You Can Pay Through Your FSA*

Eligible For an FSA Debit Card?

Before You Meet Your Medical/Rx Deductible

After You Meet Your Medical/Rx Deductible

HSA Core, HSA Value orHSA Advantage

Limited-use FSA Eligible dental and vision expenses

+ Eligible dental and vision expenses

+ Eligible medical and prescription drug expenses**

Yes

Copay Advantage Regular, full-use FSA

+ Eligible dental and vision expenses+ Eligible medical and prescription drug expenses

Yes

* These rules also apply for expenses for eligible dependents even if they do not have coverage under your Medical Program option.** Even if the expense is not a covered expense under the Medical and Prescription Drug Programs, you still cannot pay it through your FSA until you have met your deductible.

For more information about FSA rules, eligible expenses and claims, go to Your Spending Account™ at ybr.com/lsc. You can also refer to IRS publication 969 at irs.gov.

Your Spending Account is a trademark of Alight Solutions.

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LIFE and ACCIDENT INSURANCEThe Life and Accident Insurance Program provides important financial protection in the event something happens to you, your spouse or child(ren).

IMPORTANT: You cannot cover another employee as a spouse or child under the Life and Accident Insurance Program. Also, if you increase your life insurance coverage and you are on leave of absence, the increase will not take effect until you are actively back at work.

Basic Employee Life Insurance*The Life Insurance Program pays a basic employee life insurance benefit to your beneficiary if you die. The benefit equals one times your annual base pay, up to a maximum benefit of $125,000 in accordance with Plan provisions. You don’t have to elect this coverage — it is provided to you automatically.

Optional Employee Life Insurance*You can purchase optional employee life insurance from one to seven times your annual base pay, up to a combined benefit (basic and optional) of $2 million. If you die, the Program pays a benefit to your designated beneficiary in accordance with Plan provisions.

Your premium for this coverage is based on your age, tobacco user status and coverage amount, as shown on page 15. Note that as your coverage amount or age increases, so do your premiums.

IMPORTANT: Your tobacco declarations for medical and optional life insurance must match. For example, you can’t declare yourself tobacco-free for the Medical Program but declare yourself a tobacco user for optional life insurance. You must make separate tobacco declarations for yourself and your covered dependent(s). You can contact the LSC Benefits Center if you need assistance.

Optional Spouse and Child Life InsuranceYou can purchase spouse and child life insurance coverage. Please see page 1 for more information on who is considered an eligible spouse or child(ren). If your covered eligible spouse or child(ren) dies, the Program will pay the life insurance benefit in accordance with Plan provisions. Please see page 15 for rates and refer to the SPD (and any related SMM) for details.

Optional AD&D Insurance*You can purchase optional accidental death & dismemberment (AD&D) insurance for yourself and your family. With this coverage, the Program pays a benefit of one to seven times your annual base pay (up to $2 million for yourself) in accordance with Plan provisions for accidental death and certain other losses.

IMPORTANT: If you elect optional AD&D for your family, you will need to indicate which dependents you want enrolled in that coverage.

The optional AD&D amount a beneficiary would receive on claim approval differs for an employee and covered eligible dependents:

+ The amount for an eligible spouse is 60% of the employee’s amount if there are no children (up to a maximum of $750,000).

+ The amount for an eligible dependent child is 25% of the employee’s amount, if there is no spouse (up to a maximum of $150,000).

+ If there is a spouse AND child(ren), the amount for an eligible spouse is 50% of the employee’s amount (up to a maximum of $750,000), and the amount for an eligible child(ren) is 20% of the employee’s amount (up to a maximum of $150,000).

Please see page 15 for rates, and refer to SPDxpressLSC.com for more information.

OPTIONAL LIFE INSURANCE — EVIDENCE OF INSURABILITY (EOI) If you are newly electing or increasing coverage, you will be required to provide evidence of insurability (EOI). Likewise, if you are electing or increasing spouse life insurance coverage, your spouse will need to provide EOI. EOI is not required for optional AD&D insurance or optional child life insurance.

BENEFICIARY DESIGNATIONS FOR LIFE INSURANCEYou can change your beneficiary or make a new designation at any time by using one of the methods described below:

+ Go to prudential.com/lscc. Click the “Select/Update Beneficiary” button and then the “Register Now” button and follow the prompts to register if you haven’t already done so. NOTE: Be sure to click “Submit” when you are finished changing your beneficiary designations online.

+ Contact Prudential at 1-800-778-3827 to receive a beneficiary election form via US mail.

* The amount of coverage for active employees age 65 and older is subject to annual age reductions in accordance with the Plan. Please see the Life Insurance Certificate of Coverage & Schedule of Benefits at SPDxpressLSC.com for more information.

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DISABILITYThe Disability Benefit Program provides protection against the loss of your regular pay if you’re unable to work because of a covered illness or injury, subject to the claims administrator’s approval. The Hartford Life Insurance Company is the claims administrator for the program.

For more information about how the Disability Benefit Program works, review the SPD (and any related SMM) through the website at SPDxpressLSC.com.

STD CoverageYour short-term disability (STD) coverage provides a monthly benefit of 60% of your pre-disability earnings for up to 26 weeks. You don’t have to elect STD coverage — it is provided to you automatically and is company-paid.

Basic LTD CoverageBasic long-term disability (LTD) coverage provides a monthly benefit of 50% of your earnings, up to $10,000 a month. You don’t have to elect Basic LTD coverage — it is provided to you automatically and is company-paid.

Monthly LTD benefits continue until the earlier of age 65 or the date you are no longer disabled according to the Program. If you become disabled after age 60, your benefits duration schedule may vary. Benefits are stopped after 24 months for mental health and substance use disabilities.

LTD Buy-up CoverageYou may purchase an additional 10% of LTD coverage, which would provide a total LTD benefit of 60% of your pre-disability earnings, up to $10,000 a month. This additional LTD coverage can help protect your income and pay your bills while you’re on the road to recovery. Note: Evidence of insurability (EOI) is required for LTD Buy-up if you are electing it for the first time but not if you are newly eligible for the coverage.

IMPORTANT: See the Long-term Disability SPD for pre-existing condition limitations if you elect LTD Buy-up for the first time, including as a new hire. See page 15 for rates.

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YOUR 2020 BENEFIT PREMIUMSAs you review the 2020 medical premiums below, note:

+ The tobacco-free credit is already included and applies only if you and your covered dependents will be tobacco-free in 2020 or participate in the Tobacco: Kick It! program between January 1, 2020 and November 30, 2020. See page 2 of this guide for information about the surcharge that will be applied otherwise.

+ Premiums are based on your pay band (see the chart below for details on the pay bands).

+ Premiums for medical, dental and vision are generally deducted pre-tax*; all other premiums are deducted after-tax.

Biweekly Medical Premiums for 2020

PAY BAND COVERAGE

MEDICAL PROGRAM OPTION

HSA CORE

HSA VALUE

HSA ADVANTAGE

COPAY ADVANTAGE

1 UNDER $50,000

Employee Only $4.62 $10.96 $67.96 $149.88

Employee + Spouse $108.23 $126.69 $242.42 $398.19

Employee + Child(ren) $33.81 $52.27 $202.15 $359.77

Family $115.73 $134.19 $360.69 $589.50

2

$50,000 - $79,999

Employee Only $10.15 $16.96 $100.04 $188.19

Employee + Spouse $136.62 $155.08 $316.96 $513.12

Employee + Child(ren) $48.00 $66.46 $258.46 $429.92

Family $148.96 $167.42 $447.69 $733.85

3

$80,000 - $99,999

Employee Only $28.50 $33.81 $144.69 $252.58

Employee + Spouse $177.81 $187.27 $394.27 $638.77

Employee + Child(ren) $75.69 $94.15 $327.92 $561.58

Family $186.58 $205.04 $538.85 $899.31

4

$100,000 - $149,999

Employee Only $45.69 $96.12 $227.54 $362.88

Employee + Spouse $199.50 $217.96 $487.62 $743.65

Employee + Child(ren) $100.15 $118.62 $402.00 $661.15

Family $236.54 $255.00 $645.35 $1,030.27

5

$150,000 & OVER

Employee Only $45.69 $96.12 $270.23 $386.08

Employee + Spouse $220.73 $239.19 $541.50 $773.65

Employee + Child(ren) $118.04 $136.50 $514.04 $757.15

Family $270.35 $288.81 $782.77 $1,144.16

* Employee contributions for the coverage of non-tax-dependents, such as domestic partners and their children, are deducted on a pre-tax basis based on the premium amounts noted above. However, you will also pay taxes on the value of the coverage as imputed income. Imputed income is calculated by subtracting the COBRA premium for Employee Only coverage from the COBRA premium for the coverage you have in effect such as Employee + Spouse in the case of just covering a domestic partner. The difference is your imputed income. COBRA coverage for this purpose is 100% of the unsubsidized cost of coverage and not 102%. The imputed income amount is added to your paycheck as taxable income and results in income tax withholdings.

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Biweekly Critical Illness and Accident Insurance Premiums for 2020

EMPLOYEE’S AGE

EMPLOYEE ONLY EMPLOYEE + SPOUSE EMPLOYEE + CHILD(REN) FAMILY

$10,000 $20,000 $10,000 $20,000 $10,000 $20,000 $10,000 $20,000

< 25 $2.27 $3.02 $4.30 $5.82 $4.73 $6.24 $6.30 $8.56

25 - 29 $2.32 $3.13 $4.41 $6.04 $4.78 $6.34 $6.41 $8.78

30 - 34 $2.69 $3.86 $5.08 $7.38 $5.14 $7.07 $7.08 $10.12

35 - 39 $3.33 $5.15 $6.27 $9.76 $5.79 $8.36 $8.27 $12.51

40 - 44 $4.56 $7.62 $8.58 $14.36 $7.02 $10.83 $10.57 $17.10

45 - 49 $6.55 $11.59 $12.24 $21.68 $9.00 $14.79 $14.23 $24.43

50 - 54 $9.45 $17.39 $17.45 $32.11 $11.90 $20.59 $19.44 $34.86

55 - 59 $13.35 $25.20 $24.41 $46.03 $15.81 $28.40 $26.41 $48.78

60 - 64 $19.20 $36.90 $34.91 $67.02 $21.66 $40.11 $36.90 $69.77

65 - 69 $28.92 $56.33 $52.16 $101.53 $31.38 $59.54 $54.15 $104.27

70+ $42.45 $83.39 $77.55 $152.31 $44.91 $86.60 $79.55 $155.06

Biweekly Dental and Vision Premiums for 2020

COVERAGE

DENTAL PROGRAM OPTION VISION PROGRAM OPTION

METLIFE PPO METLIFE PPO PLUS EYEMED EYEMED ENHANCED

Employee Only $11.56 $19.13 $2.73 $8.16

Employee + Spouse $23.11 $38.26 $4.98 $14.91

Employee + Child(ren) $22.53 $37.30 $4.85 $14.52

Family $34.09 $56.42 $6.71 $20.08

Employee Only $5.34

Employee + Spouse $12.05

Employee + Child(ren) $9.42

Employee + Spouse + Child(ren) $16.95

Biweekly Hospital Indemnity Premiums for 2020

NOCHANGES FROM 2019

NOCHANGES FROM 2019

NOCHANGES FROM 2019

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Monthly Rates for Optional Life Insurance for 2020 (Per $1,000 of Coverage)

AGE

EMPLOYEE OR SPOUSE

NON-TOBACCO USER TOBACCO USER

<25 $0.038 $0.076

25-29 $0.038 $0.095

30-34 $0.038 $0.124

35-39 $0.047 $0.142

40-44 $0.066 $0.152

45-49 $0.124 $0.227

50-54 $0.180 $0.350

55-59 $0.322 $0.662

60-64 $0.483 $1.022

65-69 $0.814 $1.976

70+ $1.684 $3.177

DEPENDENT CHILD OPTIONAL LIFE INSURANCE

Dependent Child $0.105

Monthly Rates for Optional Accidental Death & Dismemberment (AD&D) Insurance for 2020 (Per $1,000 of Coverage)

EMPLOYEE AD&D

EMPLOYEE + DEPENDENT AD&D

$0.015 $0.024

Monthly Rates for Long-term Disability (LTD) Buy-up for 2020 (Per $100 of Covered Monthly Payroll)

LTD BUY-UP PREMIUM CALCULATION

PREMIUM WORKSHEETSAMPLE CALCULATION: ASSUMES $45,000

ANNUAL SALARY AND 35-39 AGE BAND

STEP 1 Annual Salary / 12 = Covered Monthly Payroll $45,000 / 12 = $3,750

STEP 2 Covered Monthly Payroll / 100 = # Units $3,750 / 100 = 37.5

STEP 3 # Units x Rate = Premium Per Month 37.5 x 0.101 = $3.79

STEP 4 Bi-weekly Premium $3.79 x 12 = $45.48, $45.48 / 26 = $1.75

NOTE: To calculate your biweekly premium, multiply your monthly calculated premium amount by 12 and divide by 26.

NOCHANGES FROM 2019

LTD BUY-UP RATES

AGE BANDS <25 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70+

0.039 0.047 0.069 0.101 0.163 0.231 0.323 0.379 0.398 0.400 0.450

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2020 USEFUL CONTACTS

Benefit/Vendor Telephone/Hours of Operation Website

General Benefits Information

LSC Benefits Center 1-844-LSC-BENS (1-844-572-2367),Monday – Friday, 8:00 a.m. – 5:00 p.m. Central Time ybr.com/lsc

Summary Plan Descriptions (SPDs) & Summaries of Material Modifications (SMMs)

— SPDxpressLSC.com

Medical Benefits (Including Condition Management) and Prescription Drug Benefits

Blue Cross and Blue Shield of Illinois (BCBSIL)

1-888-895-6985, Monday – Friday,7:00 a.m. – 7:00 p.m. Central Time bcbsil.com/lsc

UnitedHealthcare (UHC) 1-844-263-1622, Monday – Friday,8:00 a.m. – 8:00 p.m. Central Time welcometouhc.com/lsccom

CVS Caremark(Prescription Drug Benefits) 1-888-528-7457, 24 hours a day, 7 days a week caremark.com

Surgery Decision Support® Program

ConsumerMedical 1-888-361-3944, Monday – Friday, 7:30 a.m. – 10:00 p.m. Central Time

myconsumermedical.com (company code LSC)

Supplemental Health Care Benefits (Hospital Indemnity and Critical Illness/Accident)

MetLife 1-855-JOINMET (1-855-564-6638), Monday – Friday, 7:00 a.m. – 10:00 p.m. Central Time metlife.com/mybenefits

Dental Benefits

MetLife Dental 1-800-942-0854, Monday – Friday,7:00 a.m. – 10:00 p.m. Central Time metlife.com/mybenefits

Vision Benefits

EyeMed Vision

1-866-723-0514, Monday – Saturday, 6:30 a.m. – 10:00 p.m. Central Time; Sunday, 10:00 a.m. – 7:00 p.m. Central Time

1-866-299-1358 (for prospective members)

eyemed.com

Disability Benefits

The Hartford 1-888-437-8671, Monday – Friday, 7:00 a.m. – 7:00 p.m. Central Time abilityadvantage.thehartford.com

Life Insurance Benefits

Prudential 1-800-778-3827, Monday – Friday,7:00 a.m. – 7:00 p.m. Central Time

prudential.com/lscc (company code: 52177)

Health Savings Account

HealthEquity 1-844-281-0928, 24 hours a day, 7 days a week healthequity.com

Flexible Spending Account

Your Spending Account™ 1-844-LSC-BENS (1-844-572-2367),Monday – Friday, 8:00 a.m. – 5:00 p.m. Central Time ybr.com/lsc

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ALERT: SUMMARIES OF BENEFITS AND COVERAGE (SBCs) AVAILABLEFor summaries of your options, including examples to illustrate common medical events, go to SPDxpressLSC.com/pages/enrollment/SBC.aspx. There you will find Summaries of Benefits and Coverage (SBCs) highlighting the key provisions, limitations and exceptions for your Medical Program options.

The SBCs are designed to help you compare options and better understand the coverage and out-of-pocket costs for each. Please review the SBCs before enrolling in benefits. You may also call the LSC Benefits Center at 1-844-LSC-BENS (1-844-572-2367) to request paper copies at no charge.

ABOUT THIS GUIDE: This guide describes the coverage offered to the majority of benefits-eligible employees under the LSC Group Benefits Plan (the “Plan”). Your benefits eligibility will determine the coverage that is offered to you, your spouse/domestic partner and any dependent child(ren). More details on benefits eligibility are available in the Summary Plan Descriptions (SPDs) and Summaries of Material Modifications (SMMs) online at SPDxpressLSC.com.

NOTE: References to spouse throughout this guide include covered domestic partners. References to dependents include spouse and/or child(ren).

IMPORTANT: The descriptions in this guide are based on official Plan documents. Every effort has been made to ensure the accuracy of this material. In the unlikely event there is a discrepancy between this document, the SPDs, SMMs, SBCs or any other materials summarizing the Plan and the official Plan documents, the official Plan documents will control. LSC Communications US, LLC reserves the right to amend, change or terminate any or all of the benefit Plans it sponsors, including without limitation, the LSC Group Benefits Plan, the LSC Flexible Benefits Plan and the LSC Separation Pay Plan in whole or in part, at any time.

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TIME TO ENROLL FOR YOUR 2020 BENEFITS October 14 - 25, 2019 + Online at ybr.com/lsc+ By phone at 1-844-LSC-BENS (1-844-572-2367) M – F, 8:00 a.m. – 5:00 p.m. CT

Copyright © 2019 LSC Communications US, LLC + All Rights Reserved + H000221707