Y O U R B E N EFIT Discover C H O I C E Sht.edwards.com/scin/edwards/sitecollectionimages/edwards/... · 2012-07-31 · See page 9 for more information on qualified changes in family

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DiscoverDiscoverY O U R B E N E F I T

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Supplemental

B e n e f i t s

Health and Welfare

B e n e f i t s

Health and Welfare Benefits

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2

Discover Your Health and Welfare Options. . . . . . 3

Eligibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Cost Sharing . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Enrollment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3

Benefits Administrator . . . . . . . . . . . . . . . . . . . 4

Your Medical Options . . . . . . . . . . . . . . . . . . . . 4

Medical Plan Comparison Chart . . . . . . . . . . . . 6

Aetna POS/HealthFund HRAAexcel Program . . . . . . . . . . . . . . . . . . . . . . . . . 8

Aetna POS/HealthFund HRA Moms-to-Babies . . . . . . . . . . . . . . . . . . . . . . . . . 8

Aetna Health Connections . . . . . . . . . . . . . . . . 9

Aetna Enhanced Medical Outreach . . . . . . . . . 9

Qualified Changes in Family Status . . . . . . . . . 9

Your Dental Options . . . . . . . . . . . . . . . . . . . . 10

Your Vision Care. . . . . . . . . . . . . . . . . . . . . . . . 11

Your Employee Life Insurance. . . . . . . . . . . . . 11

Supplemental Employee Life Insurance . . . . . 11

Business Travel Accident Insurance . . . . . . . . 11

Paid Time Off . . . . . . . . . . . . . . . . . . . . . . . . . . 11

Flexible Spending Accounts (FSA) . . . . . . . . . 12

Glossary of Terms. . . . . . . . . . . . . . . . . . . . . . . 13

Supplemental Benefits

Highlights . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Who’s Eligible . . . . . . . . . . . . . . . . . . . . . . . . . . 14

How to Enroll . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Supplemental Benefits Offered . . . . . . . . . . . . . . 14

Insurance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Legal Services . . . . . . . . . . . . . . . . . . . . . . . . . . 14

Pet Insurance . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Term Life Insurance . . . . . . . . . . . . . . . . . . . . . 15

How do youdecide.com SupplementalBenefits Work? . . . . . . . . . . . . . . . . . . . . . . . . . 15

Other Supplemental Benefits Offered . . . . . . . . . 15

Long-Term Care Insurance . . . . . . . . . . . . . . . . 15

Take it to Heart Program . . . . . . . . . . . . . . . . . 15

Adoption Reimbursement . . . . . . . . . . . . . . . . 16

Back-up Child Care . . . . . . . . . . . . . . . . . . . . . . 16

Educational Assistance Program. . . . . . . . . . . 16

Employee Assistance Program . . . . . . . . . . . . 16

MovePerks . . . . . . . . . . . . . . . . . . . . . . . . . . . . 16

How do the Edwards SupplementalBenefits Work? . . . . . . . . . . . . . . . . . . . . . . . . . 16

Table of

C o n t e n t s

1

When it comes to benefits, the needs of families

are far more unique than in the past. At Edwards

Lifesciences, we realize the importance of you

getting the most out of your Edwards benefits, and

it’s our goal to provide you with the necessary

resources to do just that. This brochure is aimed at

helping you determine which plans will best meet

your individual and family needs. At Edwards, the

opportunities are endless — and we invite you to

discover your benefit choices!

2

Health and Welfare

B e n e f i t s

Enrollment

For most health and welfare benefits, you have 31 days

from the date printed on your personalized enrollment

worksheet to enroll. If you do not enroll by the deadline

printed on your worksheet, you will not be able to enroll

until the next Open Enrollment period unless you have a

qualified change in family status. The plan year runs from

July 1 to June 30.

If you decide to waive coverage by the deadline

printed on your enrollment worksheet and later have a

qualified change in family status, you may be able to

enroll yourself and your dependents in some of the

insurance plans available in your location. See page 9 for

more information on qualified changes in family status.

There is no need to enroll in your company-paid

benefits. They will be automatically provided at no cost to

you and are effective as of your date of hire.

Here’s how you enroll for your optional benefits:

1. Using the personalized enrollment worksheet included

in your new hire benefits packet, select the types and

levels of coverage that interest you and your family.

2. Web enrollment is available 24 hours a day, 7 days a

week. You can enroll via the Web or through MyEW/My

Benefits on the Edwards intranet. Enter your user ID

and password and simply follow the online prompts to

make your benefit choices. For complete details on

how to enroll, refer to the instructions included in this

enrollment packet.

The cost for most of these benefits will be deducted

from your paycheck on a pre-tax basis. However, the

cost for some benefits, like supplemental life insurance,

will be deducted on an after-tax basis.

Discover Your Health and Welfare

O p t i o n s

3

Eligibility

All regular employees scheduled to work at least 20

hours per week are eligible for most health and welfare

benefits on the first day of the month following one

month of employment. As long as you enroll within the

specified time frame, coverage is effective on the date you

are eligible, except for Employee Life Insurance, Business

Travel Accident Insurance and Long-Term Disability.* You

are eligible for these company-paid benefits beginning on

your date of hire. You are also eligible for employee-only

vision benefits beginning on your date of hire.

Cost Sharing

The following table shows how you and Edwards share

the cost of your health and welfare benefits. Edwards

provides you with many company-paid benefits and gives

you the choice to pay for optional benefits through pre-

and after-tax payroll deductions.

* Subject to an elimination period.

Company-Paid OptionalBenefits Benefits

Employee Vision Medical

Employee Life Insurance Dental

Paid Time Off Family Vision

Business Travel Flexible Spending

Accident Insurance

Short- and Long-Term Supplemental Employee

Disability Life Insurance

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The following table shows when each type of coverage

will go into effect after you enroll:

* If you enroll within 31 days of receiving your personalized enrollment form.** You may not enroll in your Health Care Spending Account until the start

of the plan year.

W H AT I F I D O N ’ T E N R O L L ?

If you don’t enroll, you will default to no medical and

dental coverage and be enrolled in the company paid

benefits listed on page 3. If you have default coverage

and have a qualified change in family status during the

plan year, you may be able to make a change depending

on the type of qualified event you experience.

Benefits Administrator

TRI-AD, a human resources administration firm, is the

benefits administrator for Edwards’ benefit programs.

TRI-AD will handle a variety of tasks related to your Edwards

benefits, including:

•• Your enrollment in Edwards’ benefit plans, as well as any

qualified changes in status you may have throughout

the plan year

•• Beneficiary designations for benefits such as life

insurance and the Stock Option Plan

Your Medical Options

You are eligible for medical benefits on the first of the

month following one month of employment. You may

choose from any of the medical plans offered in your

area. When deciding which plan is best for you, take into

consideration all of your needs, as well as the needs of

your family.

Edwards pays approximately 85% of the premium cost

for your health care coverage. This means your contribution

amount listed on your personalized enrollment worksheet

for each of your medical choices is approximately 15% of

the total cost.

Your personalized enrollment worksheet lists the

medical plans available to you in your area. You may

choose from the Aetna HealthFund HRA, a Health

Maintenance Organization plan (HMO) and a Point-of-

Service (POS) plan. In addition, there is a “passive Preferred

Provider Organization (PPO)” option for the Catastrophic

Plan. See the table on pages 6 and 7 for specific plan

features to help you make your decision.

4

Coverage Effective Date

Medical The first of the month following

one month of employment*

Dental The first of the month following

one month of employment*

Vision (Employee and Employee: Date of hire

Dependent(s)) Dependent(s): The first of the

month following one month of

employment*

Employee Life Insurance First day of work

Supplemental Employee The first of the month following

Life Insurance one month of employment*

Business Travel Accident Insurance First day of work

Short-Term Disability After completion of six months

of employment and 1,000 hours

worked

Long-Term Disability First day of work

Health Care Spending Account Beginning of next plan year**

Dependent Care Spending The first of the month following

Account one month of employment*

healthhealth

The Health Maintenance Organization (HMO)

The HMO offers members a range of health benefits,

including preventive care, for a monthly fee and set

copayments or coinsurance for the care that you receive.

When using an HMO, you will need to select a Primary

Care Physician (PCP). Your PCP will coordinate all of your

care, including referrals to specialists. If you see a provider

outside the network without a referral from your PCP, you

will be responsible for the total cost of the service, except

for emergency or urgent care services.

The Point-of-Service (POS) Plan

The POS offers two main options for health care: an

in-network plan that limits your access to a list of

providers and an out-of-network plan that gives you the

freedom to see any doctor you choose. With the POS plan

you do not have to choose a PCP, but it is recommended

you do choose one to coordinate your care. When you

choose in-network providers you pay a fixed, low copay

and/or low coinsurance. In contrast, the out-of-network

plan provides similar benefits, but you pay higher coinsurance

because you may go to any doctor you wish. In addition,

there are annual deductibles when you decide to go out-

of-network. Refer to pages 6, 7 and 8 for coverage amounts.

Contact the carrier for a list of network providers

near you.

The Aetna HealthFund HRA

This “consumer-driven health care plan” empowers you

to be an active, informed consumer of health care. It gives

you the freedom to choose the providers who deliver your

care and offers you more control over the cost of that care.

The Aetna HealthFund HRA blends the features of a

traditional health insurance plan with a fund benefit to help

you pay for covered medical expenses. In addition, it delivers

useful tools to help you make informed medical decisions.

Here’s how the plan works:

•• At the beginning of the year, Edwards provides you

with a certain amount of money to pay for eligible

medical expenses. This money is deposited into your

Health Reimbursement Account (HRA) and depends on

your coverage election — employee only, employee plus

spouse/child(ren) or employee plus family. In addition,

you also will have a plan deductible that corresponds to

your coverage election. New hires will receive a pro-

rated HRA based on their date of hire.

•• Once you deplete your HRA, you will be responsible for

your expenses until you meet your deductible. The

amount in your HRA is applied to your deductible.

•• Once you meet your deductible (and your HRA is de-

pleted), additional expenses are covered by traditional

health insurance. Refer to pages 6, 7 and 8 for coverage

amounts.

There are many advantages to the Aetna HealthFund

HRA. Under the plan preventive care is covered at 100%

(up to $500 per member per plan year) which is not

deducted from your HRA. Also, preventive and chronic

medications are not subject to your deductible.

If you don’t use your entire HRA in any plan year, the

remaining amount is added to the following plan year’s

HRA balance — allowing you to increase your fund and

use it toward future expenses as long as you remain

enrolled in the Aetna HealthFund HRA.

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Plan Feature Aetna Choice POS II Aetna Choice POS II Aetna HealthFund HRA Aetna HealthFund HRAIn-Network Out-of-Network In-Network Out-of-Network

None

$3,000,000; Pharmacy benefits are not included

$2,000 per individual,$4,000 per family

$20 copay✝✝

100% after $20 copayat initial visit

$20 copay

100% after $100 copay;copay waived if admitted

90% after $150 copay per day, $750 max. per plan year,

limit 30 days per plan yearcombined with substance abuse

$20 copay, limit 60 visits per plan year combined with

substance abuse

90% after $150 copay perday, $750 max. per plan year,

limit 30 days per plan yearcombined with mental health

$20 copay, limit 60 visits per plan year combined with

mental health

$20 per visit

Not covered

Not covered

$500 per individual,$1,000 per family



60% after deductible✝✝

60% after deductible


100% after $100 copay;copay waived if admitted

60% after $150 copay per day, $750 max. per plan year,

limit 30 days per plan yearcombined with substance abuse

60% after deductible, limit 60visits per plan year combined

with substance abuse

60% after $150 copay perday, $750 max. per plan year,

limit 30 days per plan yearcombined with mental health


with mental health


Not covered

Not covered

$3,000,000

$3,500 per individual,$4,500 EE + spouse or child(ren),

$5,500 per family





90% after deductible, limit 30days per plan year combined





with mental health


with mental health


Not covered

Not covered

$3,000,000

$7,500 per individual,$10,500 EE + spouse or child(ren),

$13,500 per family





60% after deductible,limit 30 days per plan year

combined with substance abuse




with mental health


with mental health


Not covered

Not covered

Medical Plan Comparison Chart

✝ Your deductible includes HRA amounts✝✝ See separate Aexcel chart for information about specialty copays and coinsurance

Annual Deductible

Lifetime Maximum Benefit

Out-of-Pocket Maximum

Office Visits

Prenatal Care

Chiropractic Care

Emergency Room

Prescription Drugs (Rx)

Generic

Brand Name

Mail Order(90-day supply)

Mental Health CoverageInpatient

Outpatient

Substance Abuse CoverageInpatient

Outpatient

Infertility CoverageTesting

In Vitro

Artificial Insemination

Generic Mandatory 30-day supply except Mail Order;Generic and brand name drugs: mandatory mail order for

maintenance medication after two fills at retail;pharmacy maximum $1,500 per member/year; specialty injectable

drugs must be filled through Aetna Specialty Pharmacy

$10 copay, 30-day supply

20% with $25 minimum and $75 maximum if generic notavailable for preferred; 30-day supply; 40% with $45 minimum

and $100 maximum for non-preferred

$20 generic: 20% with $50 minimum and $150 maximumfor Brand Preferred; 40% with $100 minimum and

$200 maximum for Brand non-preferred

Generic Mandatory 30-day supply except Mail Order;Generic and brand name drugs: mandatory mail order for

maintenance medication after two fills at retail; chronic andpreventive drugs are not subject to the deductible; specialty

injectable drugs must be filled through Aetna Specialty Pharmacy


20% with $25 minimum and $75 maximum if generic notavailable for preferred; 30-day supply; 40% with $45 minimum

and $100 maximum for non-preferred

$20 generic: 20% with $50 minimum and $150 maximumfor Brand Preferred; 40% with $100 minimum and

$200 maximum for Brand non-preferred

HRA Deductible✝

Employee $500 $1,500Employee + Spouse $750 $2,000Employee + Child(ren) $750 $2,000Employee + Family $1,000 $2,500

Coverage after you meet deductible is below. Preventive care covered100% ($500 max. per member/year). HRA is prorated for new hires.

Up to $600 max.per plan year Up to $600 max.per plan year

If you would like more information about a specific plan, see your Vendor Contact card or theintranet for the appropriate phone number. If there is a conflict between this chart and theofficial Plan Documents that govern these plans, the official Plan Documents will prevail.

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Kaiser HMO Aetna HMO SelectHealth HMO Aetna HMO Catastrophic California only California only Utah only Select areas in Pennsylvania Option Plan

None

Unlimited

$1,500 per individual,$3,000 per familyper calendar year

$15 copay

$5 copay

$10 copay,30 visits per calendar year

$100 per visit;copay waived if admitted

Up to 100-day supply,closed formulary

$10 copay

$20 copay

$10 generic/$20 brand

100%, limit 30 days per calendar year

$15 individual or $7 groupper visit, limit 20 visits

per calendar year

$100 copay, residentialtreatment deductible,100%for detox, limit 60 residential

days per calendar year

$15 per individual or $5 per group visit,

unlimited

$15 per visit

Not covered

$15 per visit, limits apply

$100 per individual,$200 per family

per calendar year

$2,500,000

$1,000 per individual,$2,000 per family**

$15 PCP/$20 for specialist

$15 copay/first visit, deliverycovered 90% after deductible

Not covered

$75 after deductible forparticipating facilities;

$125 after deductible fornon-participating facilities

Generic Mandatory30-day supply except

Mail Order


$25 copay for preferred, 30-day supply;

$45 non-preferred

$10 copay for generic;$50 copay for preferred;

$135 copay for non-preferred

$100/$200 mental healthdeductible; 90% after mental

health deductible

$15 copay per visit after mentalhealth deductible; all other

services 90% after deductible

90% after mental healthdeductible

$15 copay per visit after mentalhealth deductible; all other

services 90% after deductible

50% cover after deductible,limit $1,500 per calendar year,

$5,000 lifetime max.(select services)

Not covered

Not covered

None

Unlimited, see plandocument for details


$15 per visit

Outpatient:$15 copay/first visitonly; Inpatient: $100 copay

Not covered


30-day supplyexcept Mail Order

$15 copay for formulary, up to30-day supply; $35 non-formulary

$20 copay for formulary,up to 30-day supply;$35 non-formulary

2x 30-day copayfor 31- to 90-day supply

$100 copay, limit 35 daysper plan year for inpatient

services other thanSMI and SED*

$25 per visit fornon-SMI/SED, limit 20 visits

per plan year

$100 copay; 100% forrehab., limit 30 days per plan

year, 90-day lifetime max.

$15 per visit, limit 60 visits for rehab. per

calendar year

$15 per visit

Not covered

Not covered

None

Unlimited, see plandocument for details


$15 per visit

Outpatient:$15 copay/first visitonly; Inpatient: $100 copay

Not covered


30-day supplyexcept Mail Order

$15 copay for formulary, up to30-day supply; $35 non-formulary

$20 copay for formulary,up to 30-day supply;$35 non-formulary

2x 30-day copayfor 31- to 90-day supply

$100 copay, limit 30days per calendar year for

inpatient services otherthan SMI and SED*

$25 per visit fornon-SMI/SED, limit 20 visits

per calendar year

$100 copay; 100% forrehab, limit 30 days per

calendar year

$15 per visit, limit 20 visits for rehab. per

calendar year

$15 per visit

Not covered

Not covered

*SMI is Serious Mental Illness; SED is Serious Emotional Disturbances of a child. Inpatient/Outpatient benefits for SMI and SED are paid the same as medical inpatient/outpatient services.**Separate $1,000 individual/$2,000 family out-of-pocket maximum for mental health and substance abuse coverage.






$600 plan year benefit max.after deductible


Generic Mandatory100% after deductible



Not available

100% after deductible,30 days per plan year;

combined with substanceabuse

100% after deductible,60 visits per plan year;

combined with substance abuse

100% after deductible,30 days per plan year;

combined with mental health

100% after deductible,60 visits per plan year;

combined with mental health


Not covered

Not covered

Aetna POS/HealthFund HRA Aexcel Program

If you are a member of the Aetna Choice POS II or the

HealthFund HRA, and live in Orange or Los Angeles County,

it’s easier than ever to find the most effective specialists for

your care. The Aetna Aexcel program identified specialists in

12 areas, focusing on a number of performance criteria and

their level of cost effectiveness. Top performing specialists in

these areas were designated by Aetna as Aexcel physicians

for providing superior care to members.

Aetna Aexcel Specialty Areas

Aexcel Specialists — the Best of the Best

For each specialty, Aetna evaluated the performance of

each physician using standards consistent with leading

associations like the American Heart Association, Agency

for Health Research and Quality, American College of

Obstetricians and Gynecologists, and the Society of

Thoracic Surgeons. Physicians were rated on standards

such as 30-day hospital readmission rates, rates of health

complications during hospital stay and other specialty-

specific performance measures.

When you use Aexcel-designated specialists, not only are

you getting top care, but you’re also getting it at the most

efficient price. Now that’s being a wise health care consumer.

Aetna Aexcel Coverage Levels

Regular copay and coinsurance amounts apply to

regular doctor’s office visits and specialty areas not identified

by the Aexcel program. In addition, if you live outside of the

Orange or Los Angeles County area and utilize in-network

providers, your office visit copay will remain at $20 and your

coinsurance will be 10%. See the Medical Plan Comparison

Chart on pages 6 and 7 for more details.

Finding an Aexcel Provider

For now, the Aexcel program is available only to

employees located in Orange and Los Angeles Counties. If

this applies to you, find Aexcel-designated specialists by

using the DocFind directory at www.aetna.com. Aexcel-

designated physicians are uniquely identified for your

convenience. Just look for the blue stars! If you live in

Orange or Los Angeles County and do not utilize an Aexcel

designated provider in the 12 specialty areas, your office visit

copay will increase from $20 to $40 and your coinsurance

will increase from 10% to 30%.

Aetna POS/HealthFund HRA Moms-to-Babies

If you are a member of the Aetna Choice POS II plan

or the HealthFund HRA, you are eligible to participate in

the Moms-to-Babies program. The program offers a

wealth of information for expectant mothers, and includes

a $500 gift card for members who enroll and complete a

health assessment during the first trimester.

8

optionsoptionsIn-Network In-Network Non- Out-of-Network

Plan Aexcel Provider Aexcel Provider Provider

Choice POS II Plan Pays 90% Plan Pays 70% Plan Pays 60% $20 specialist copay $40 specialist copay

HealthFund* Plan Pays 90% Plan Pays 70% Plan Pays 60%

* After you have depleted your HRA and met your deductible.

• Cardiology

• Cardiothoracic Surgery

• Gastroenterology

• General Surgery

• Neurology

• Neurosurgery

• Obstetrics and Gynecology

• Orthopedics

• Otolaryngology

• Plastic Surgery

• Urology

• Vascular Surgery

choicechoice

Aetna Health Connections

Aetna Health Connections is a confidential disease

management program designed to help Choice POS II and

HealthFund HRA members get the right treatment and

learn more about preventive care. Through this program,

members can get support for 30 common medical

conditions, such as diabetes, hypertension, asthma,

rheumatoid arthritis, various forms of cancer, chronic

hepatitis, migraines and low back pain.

This program includes a wealth of on-line educational

materials and tools, nurse case managers and a 24-hour,

toll-free phone number that you can call whenever you

have a question. Also included is ActiveHealth Management

CareEngine, a tool that can identify potentially dangerous

drug interactions, drug-disease interactions and more. If you

are enrolled in the Choice POS II or HealthFund and need

assistance in managing a chronic condition or if you think

you are at risk for one, contact Aetna at (866) 269-4500

to enroll.

Aetna Enhanced Medical Outreach

The Enhanced Medical Outreach program is designed

to provide Choice POS II and HealthFund HRA members

involved in a significant health care episode with education,

guidance and tools necessary for them to better handle

their condition and improve their overall quality of care.

Because this program is designed to strengthen Aetna’s

standard patient management program and expand on

their commitment to members, an Aetna nurse will contact

covered members before and after a scheduled overnight

hospital stay and provide information on what to anticipate

before and after the procedure, counseling to help the

member and their dependents through the procedure and

educate on how to avoid post surgery complications

through medication and treatment plan compliance.

Q U A L I F I E D C H A N G E S I N FA M I LY S TAT U S

In addition to the annual Open Enrollment period, you

may also enroll and/or make changes to your elections if you

have a qualified change in family status. A qualified change in

family status is an event that would impact certain benefits,

such as marriage, divorce, the birth or adoption of a child and

losing or gaining coverage provided by a spouse’s employer.

The change you make to your coverage must be consistent

with your qualified change in family status. For example:

• If you get married, you can add your spouse and your

spouse’s children to your health coverage and you can enroll

in the dependent care reimbursement account or make

changes to the dependent care reimbursement account.

• If your spouse loses medical coverage and you were

enrolled in your spouse’s plan, you can choose any

Edwards medical option that is available in your area.

• If your dependent becomes ineligible for coverage, you

can stop coverage for that dependent.

• If your dependent goes through Open Enrollment at their

company at a different time than Edwards’Open Enrollment,

you can make changes within 31 days from the time your

new benefits go into effect.

• If you move to a location where your medical plan is no

longer available, you can change medical options for you

and your dependents.

If you have a qualified change in family status, you may

make changes to certain benefit elections within 31 days of

the event. If you do not make changes within 31 days, you

will have to wait until the next Open Enrollment period.

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Your Dental Options

Edwards offers three different dental plans — Basic,

Basic Plus and the Dental Maintenance Organization (DMO).

You are eligible for dental benefits on the first day of the

month following one month of employment.

The Basic and Basic Plus plans allow you to see the dentist

of your choice and provide coverage for most dental services,

but Dental Basic Plus covers some services at a higher level of

benefit. Therefore, your contribution costs may be higher,

but your copays will be lower overall. In addition, there is a

“passive Preferred Provider Organization (PPO)” for these

two options as well. This means that if you choose a provider

in the Aetna PPO network, you will receive the benefits of

provider discounts that Aetna has negotiated with members

of the network.

The DMO is a prepaid managed care plan — the

dental equivalent of an HMO. You must see a dentist in

the DMO network. However, there is no annual benefit

maximum, no deductible and the copayments range

depending on the type of service.

Your dental costs are outlined on your personalized

enrollment worksheet. Edwards pays approximately 70%

of the premium costs of dental coverage for the plans.

This means the amount you will have to pay (listed on your

enrollment worksheet) for each of your medical choices is

approximately 30% of the total cost.

The dental plans are administered by Aetna Dental.

However, you are free to use non-network providers for

the Basic and Basic Plus plans and still receive the same

level of reimbursement based on contracted fees. You are

required to select a Primary Dentist for the DMO. Contact

Aetna to obtain a list of network providers near you.

The following chart lists the coverage available to you

under each plan.

* Refer to the cost chart available on the Edwards intranet.** Available in most states.

*** Lifetime maximum.

If you would like more information about a specific

plan, see your Vendor Contact card or the intranet for the

appropriate phone number.

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flexibleflexible

Plan Dental Dental Feature Basic Basic Plus DMO**

Annual Deductible

Individual $150 $125 $0

Family $300 $250 $0

Annual Maximum

Individual $2,000 per $2,000 per $0

Family person/year person/year $0

Exam and 100% 100% 100%

Cleaning covered

X-rays (two bitewings per plan year, full mouth every three years)

100% 100% 100%

Restoration (including fillings and stainless steel crowns)

and Repairs 65% 80% *

Root Canal 65% 80% *

Simple Extraction 65% 80% *

Porcelain Crowns,

Dentures 50% 50% *

Oral Surgery 65% 80% *

Orthodontia Not covered 50% up to You pay

$1,500*** $2,000

If you have… You will receive…

1-4 years of service 2 weeks per year



20 or more years of service 5 weeks per year

Business Travel Accident Insurance

Business Travel Accident Insurance provides a benefit

to you or your beneficiaries if you are injured or die during

work-related travel. The benefit is equal to four times your

eligible compensation (up to a $250,000 maximum). This is

an automatic benefit provided by Edwards at no cost to you.

Paid Time Off

Edwards provides a valuable Paid Time Off program to

help you achieve that important balance in your work and

personal life. You receive time off for vacation, holidays and

illness as part of your health and welfare benefits.

Vacation Time

The following chart shows how you begin to accrue

vacation time on your first day of hire.

It’s important that you work with your supervisor to

make sure your job duties are covered while you are away.

You will need to be flexible and schedule vacations well in

advance to coordinate with co-workers in your department.

Sick Days

You are eligible to receive up to 10 paid sick days each

calendar year.

Family Medical Leave

When you have been employed with Edwards for 12

months and worked 1,250 hours during the 12 months

prior to the request for leave, you are eligible for Family

Medical Leave. You may take up to 12 weeks unpaid time

off during a rolling 12-month period for your own serious

medical condition, the birth or adoption of a child or to care

for a family member who has a serious medical condition.

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Plan Feature Annual Cost

Eye Exams $15 copay*, covered every 12 months

Contact Lenses $25 copay*, contact lenses or regularor Eyeglasses lenses covered every 12 months;

frames covered every 24 months

* When services are obtained through a VSP provider.

Your Vision Care

All employees are eligible for vision coverage free of

charge. Because this is an automatic benefit, you will be

covered on your date of hire. If you choose to purchase

additional coverage for your dependents, their coverage

will begin on the first of the month following one month

of employment.

The vision benefit includes coverage for eye exams

and contact lenses or eyeglasses. The following chart

provides some details of the plan.

Coverage is provided by Vision Service Plan (VSP). Access

www.vsp.com for the providers available in your area, or

call (800) 877-7195.

Your Employee Life Insurance

Employee Life Insurance is provided by Edwards at

no cost to you at a benefit equal to one times your

eligible compensation. This benefit is provided to your

beneficiaries in the event of your death.

This is an automatic benefit, so there is no need to

enroll. However, you will need to designate a Beneficiary

in MyEW. The Beneficiary Designation feature provides

the option to list different beneficiaries for basic life,

supplemental life and business travel accident insurance.

Supplemental Employee Life Insurance

You may purchase supplemental life insurance for

yourself for up to five times your eligible compensation to

a maximum of $1,000,000. This benefit, like Employee

Life Insurance, provides a benefit to your beneficiaries in

the event of your death. Refer to your personalized

enrollment worksheet for pricing. Payroll deductions for

supplemental life insurance will be after-tax.

Short-Term Disability

Edwards provides short-term disability insurance at no

cost to you. If you need more than 7 calendar days to

recover from an illness or injury, you may be eligible for

short-term disability as long as you have been employed by

Edwards for at least six months and have worked more

than 1,000 hours. Exempt employees will receive 100%*

of eligible compensation for up to 28 weeks for qualified

disabilities. Hourly and salaried non-exempt employees are

eligible to receive 662/3%* of annual base pay for up to 28

weeks for qualified disabilities.

Long-Term Disability

Edwards provides long-term disability insurance at

no cost to you. If you are unable to work for more than 28

weeks, you may qualify for long-term disability. This

benefit will pay 60% of your eligible compensation, up to

a maximum of $12,000 a month until you are no longer

disabled, return to work or reach the maximum age.

Flexible Spending Accounts (FSA)

Edwards offers two reimbursement accounts — the

Health Care Spending Account and the Dependent Care

Spending Account. These accounts allow you to set aside

pre-tax dollars for eligible expenses. By paying for eligible

expenses with pre-tax dollars, you save money because

you avoid paying most federal, state and Social Security

taxes on that money.

These accounts work on a plan-year basis. Before you

decide how much money you would like to set aside for

each account, estimate how much you will need for the

remainder of the plan year. Only allocate to your accounts

as much money as you plan to spend. Any funds not used

during the plan year will be forfeited.

Health Care Spending Account

The Health Care Spending Account is an account

established in your name to pay for you and your

dependents’ eligible medical, dental and vision expenses,

such as deductibles, copays, coinsurance and other

expenses not covered by your health plans. You may

allocate up to $5,000 into the Health Care Spending

Account each plan year. You may enroll in the Health Care

Spending Account at the start of the plan year.

Aetna is our administrator for the Health Care

Spending Account. Aetna offers streamlined submission

of expenses payable under their medical or dental plans.

Expenses such as coinsurance and deductibles will be

automatically applied to the spending account. No

separate claims submission is needed. FSA reimbursements

for all non-pharmacy related expenses will be made directly

to you. You will be responsible for directly reimbursing the

provider. If you are enrolled in one of the HMO Plans, you will

need to complete a claim form to receive reimbursement

for your copays. Any out-of-pocket prescription drug

payments will automatically be deducted from your FSA at

the time of purchase and paid directly to the pharmacy if

you are enrolled in one of the Aetna medical plans.

Dependent Care Spending Account

The Dependent Care Spending Account is an account

established in your name to pay for eligible dependent

care expenses, such as care provided for a dependent

while you (and your spouse, if married) work. You may

allocate up to $5,000 to your account each plan year. If

you are married and you and your spouse file separate

income tax returns, the most each of you can contribute

to the account is $2,500. In addition, your contributions to

the Dependent Care Spending Account (if you are married)

cannot exceed the income of the lower-paid spouse.

U S E I T O R L O S E I T !

Any money left over in either of your Reimbursement

Accounts at the end of the plan year is forfeited, so be

sure to estimate as accurately as possible the amount

you will need for the remainder of the plan year.

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* Coordinated with state disability insurance, if applicable for your location.

Aetna HealthFund HRA A medical plan option that

blends the features of a traditional health insurance plan

with a fund benefit to help you pay for covered medical

expenses.

Aexcel An Aetna program that identifies top doctors in

12 specialty areas.

Annual Deductible The amount you need to pay each

year for applicable expenses before you will receive benefits

from your plan.

Coinsurance This is your share of the cost of coverage

under any given plan.

Copay Some services require you to pay a minimal set

amount before receiving care or prescription drugs. This is

a copay.

DMO Dental Maintenance Organization. A DMO is a type

of prepaid managed care plan — the dental equivalent of a

medical HMO. You must see a dentist in the DMO network.

There is no annual benefit maximum, no claim forms to fill

out, and the copayments range, depending on the type of

service. There are no benefits payable if you are enrolled in

the DMO and use out-of-network dental providers.

Eligible Compensation Generally includes your base

salary plus overtime and commissions. Definition varies for

the 401(k) Savings & Investment Plan.

HMO Health Maintenance Organization. An HMO provides

a high level of coverage when you use an in-network

provider, and no coverage if you use an out-of-network

provider, except if you require emergency or urgent care

services. HMOs are usually less expensive than other types

of plans, but are limited to only those providers in their

network. You will also need to use a Primary Care Physician

(PCP) to receive the highest level of coverage with an

HMO. This physician will give referrals if you need care from

a specialist.

In-network Some plans provide higher levels of coverage

if you use a provider from a specified group. When you

use a provider from this group, you are using an in-

network provider. Usually in-network providers have an

agreed upon schedule of benefits that states how much

they will charge for specific services. These providers have

agreed not to charge more than the agreed upon amount

for each service they provide.

Lifetime Maximum Benefit This is the total amount of

money you can receive from an insurer for all eligible

expenses during your lifetime. This includes breaks in

coverage, which means that if you exit a plan and then re-

enroll at a later date, your past benefits paid will still be

counted toward your maximum. However, pharmacy

benefits are not included.

Out-of-network Some plans provide lower levels of

coverage if you use a provider outside of a specified

group. When you use a provider from outside of this group,

you are using an out-of-network provider. When you go

out of network, you have more flexibility in the providers

you may choose, but you will usually receive a lower level

of coverage than if you used an in-network provider.

POS Point-of-Service plan. A POS is similar to an HMO in

that you receive a higher level of coverage if you use an

in-network provider. The main difference with a POS is that

you may see out-of-network providers. You will receive a

higher level of coverage when you see in-network provider

than when you see an out-of-network provider.

PPO Preferred Provider Organization (Catastrophic Plan). A

PPO allows you to use any licensed doctor or health care

facility. If you choose a physician within the network, you

receive a higher level of benefits. You also have the freedom

to choose a physician outside the network and receive

coverage at a lower reimbursement percentage than if you

have received care within the network. You pay a large

deductible when you receive coverage outside the network.

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Glossary of

Te r m s


H i g h l i g h t s

Who’s Eligible

All Edwards employees who work more than 20 hours

per week are eligible for supplemental benefits. Many

of the supplemental benefits are offered through

youdecide.com, our Supplemental Benefits provider, and

you can enroll at any time.

How to Enroll

Here’s what you need to do to enroll in the

youdecide.com supplemental benefits:

1. Read through the following Supplemental Benefits

information to decide which of these benefits

interest you.

2. Call the youdecide.com hotline (specifically for Edwards

employees) anytime at (877)326-5231. Edwards’ Unique

Client ID is ELS362. This hotline is a toll-free, auto-

mated system that is open 24 hours a day, 7 days a

week. Simply follow the prompts to navigate through

the system. Or, register to enroll online through the

Edwards intranet.

3. Your new benefits will go into effect on the date you

agree to start with the carrier of each benefit once

your enrollment is processed.

Working together to strengthen our organization means

supporting each other in our work and personal lives.

The additional after-tax benefits described here are

designed to help you balance these important aspects of

your life and enrich your overall benefits package.

The following are supplemental benefits you can

purchase after-tax, offered to you at a group rate and

provided directly through youdecide.com. If you have any

questions regarding these benefits or for complete pricing

information, contact youdecide.com’s advisors by phone

at (877) 326-5231 or online. Edwards employees’ Unique

Client ID is ELS362.

Insurance

This is a multi-provider platform for insurance. You will

enjoy competitive rates regardless of risk tier, driving record,

geographic location or personal needs. For maximum savings,

youdecide.com offers numerous insurance products to meet

any individual’s needs.

Current insurance products include:

Legal Services

Legal services include legal advice, tax advice and

financial counseling. With this program, you pay a monthly

fee for access to legal help as needs arise. You can choose

the level of service that you need — from basic to full-

service to specialty plans.


O f f e r e dThrough youdecide.com

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• Auto Insurance

• Home Insurance

• Renters Insurance

• Motorcycle Insurance

• Recreational Vehicle Insurance

• Watercraft Insurance

• Roadside Assistance Plan

• Travel to Mexico Insurance

Pet Insurance

Insurance for your best friend! You choose the plan that

best fits your needs. All plans include the following:

•• Covers thousands of medical problems and conditions

for dogs, cats, birds, ferrets, rabbits, reptiles and other

exotic pets

•• Vaccination and routine care coverage is available

•• Multiple pet discounts available, in addition to the

premium discount offered through youdecide.com

•• Fast and efficient claims processing

•• Easy enrollment and payment options!

Term Life Insurance

Term Life Insurance offers many packages of additional

life. You choose the plan, price, payment options and

portability that best suits your needs.

How do youdecide.com Supplemental

Benefits Work?

When you would like to take advantage of any

youdecide.com benefit in which you have already enrolled,

contact youdecide.com at (877) 326-5231.

Long-Term Care Insurance

Long-Term Care (LTC) insurance, offered separately

from your medical plan, protects you if you have an illness

or injury and need help with day-to-day living, including

bathing, eating and dressing. LTC insurance helps pay for

care at home, in an adult day care center, assisted living

facility, nursing home or hospice. The most common

conditions requiring LTC include Alzheimer’s disease, cancer,

stroke, Parkinson’s disease and arthritis. You can enroll in

LTC at any time during the plan year.

Take it to Heart Program

Edwards is committed to helping employees make

wellness a part of their everyday lives and providing them

with the tools and resources to become healthy, smart

consumers of health care. That is why we created the Take

it to Heart program, which is dedicated to doing just that.

The Take it to Heart program consists of various wellness/

health improvement programs such as monthly wellness

seminars and periodic screenings that focus on prevention,

and the Discover workshops series which educates

employees on the tools and resources available to help

them make the most of their medical and dental benefits.

Employees can visit the Take it to Heart website located

on the Edwards Intranet under the EW Gallery. Here you

can find information about upcoming wellness events, get

useful tips on how to live healthy and learn more about

the features of our benefits plans that help you achieve

your wellness goals.

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Other Supplemental

B e n e f i t sOffered Through Edwards Lifesciences

securitysecurity

Adoption Reimbursement

This benefit will provide coverage when you adopt

a child, reimbursing up to $2,500 for adoption-related

expenses for each adopted child. If you use this program,

your reimbursement will be treated as taxable income and

is included in your paycheck.

Back-up Child Care*

We offer back-up child care through Bright Horizons, a

comprehensive back-up child care center located approx-

imately two miles from our Corporate Office. When your

primary child care arrangements fall through, Bright

Horizons offers specialized care for children ages three

months to 13 years. The benefit covers up to 20 visits per

child per year. You are charged a minimal copay, paid

through payroll deduction, per child per visit. For more

information, you can contact Bright Horizons at

www.brighthorizons.com /backup, user name: Edwards,

Password: backup care or via telephone at (866) 273-2773.

Educational Assistance Program

If you take courses in pursuit of a bachelor’s or master’s

degree, that are work related, the company may reimburse

you up to $5,250 per year. If you are considering education,

you should contact the Edwards Benefit Service Center

(EBSC) to determine if you will be eligible for educational

reimbursement.

Employee Assistance Program

We offer an Employee Assistance Program (EAP)

through Aetna Behavioral Health. It’s designed for anyone

who can use a little help in managing demanding

everyday situations. The program gives you access to a

wide range of supportive services for issues involving elder

care, child care, legal and financial matters and more.

Whether you need counseling support for stress or family

issues, or help in locating child or adult care providers, or

legal or financial consultants, your EAP is available to you

24 hours a day, 7 days a week. Trained professionals can

assist you in identifying appropriate resources to meet

your needs. You can contact the EAP at (888) 238-6232.

MovePerks

MovePerks offers free assistance to you if you are

buying or selling a home. The service will help you manage

the entire real estate process and offer you the opportunity

to receive a cash back dividend* — MovePerks will pay

$5 per $1000 based upon the contracted sale and /or

purchase price of your home, within 30 days of closing. To

participate in either the buying or selling process through

MovePerks, you must not have listed your house with

or engaged the services of a broker. You can contact

MovePerks at (866) MOV-PERK or www.moveperks.com.

How do the Edwards Supplemental Benefits Work?

When you would like to take advantage of any Edwards

supplemental benefit, call the appropriate contact. See your

Vendor Contact card or visit the Edwards Intranet under

Inside EW/HR for the appropriate phone numbers.

* Available in most locations.

16

planningplanning

* Available at Corporate location only.

Edwards Lifesciences LLC • One Edwards Way • Irvine, CA 92614 • 800.424.3278 • www.edwards.com

Note: This brochure only summarizes the key provisions ofyour Health and Welfare Plans and your SupplementalBenefits. More details are in the summary Plan Description(SPDs). If there is a conflict between this brochure andofficial Plan Documents that govern these Plans, theofficial Plan Documents will prevail.

© Rev. 7/2007 Edwards Lifesciences LLC. All rights reserved.