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2013 2014 Medical Care Plans

Eligibility Associates who are scheduled to work at least 30 hours per week and have also attained 60 days of continuous service are eligible to participate in the programs described below. The effective date of participation will be the 1st of the month following attainment of 60 days of continuous service. Associates scheduled to work less than 30 hours per week and Temporary Associates are ineligible to participate in Mattress Firm benefit plans. Dependents Eligible dependents can enroll in Mattress Firms benefits plans; however, supporting documentation will be required to validate eligibility. Please contact the Benefits Department to determine the required supporting documentation. An eligible dependent includes: 1. 2. 3. 4. Spouse (not fianc, but your legal spouse as determined by applicable law) Common Law Spouse Legal Dependent An Associates child up to age 26 (birth, adoption, or stepchild) Qualified Medical Child Support Order

In addition to the Medical Choice Plus Plan, we are also offering a Medical High Deductible Plan. The High Deductible Health Plan provides low cost premiums for coverage involving health care visits to a Primary Care Physician / Specialist and Emergency Room visits. This plan can be used in conjunction with an optional Health Savings Account. Additional information may be found at United Healthcare Medical Coverage Plan Provisions Physician Office Visit ER/Urgent Care Deductible Co-Insurance Preventive Care Out of Pocket Pharmacy Deductible Pharmacy Co-Pays Generic / Preferred / Non-Preferred Pharmacy Mail Order Generic / Preferred / Non-Preferred Deductible Co-Insurance Out of Pocket Medical Choice Plus Plan In Network $30 PCP / $60 Specialist $250 ER / $60 Urgent Care $1,200 Associate / $2,400 Family 80% 100% $4,900 Associate / $9,800 Family None $10 / $30 / $50 $25 / $75 / $125 Out of Network $2,400 Associate / $7,200 Family 50% None Medical High Deductible Plan In Network N/A N/A $2,000 Associate / $4,000 Family 80% 100% $5,000 Associate / $10,000 Family None $10 / $35 / $60 (after medical deductible) $25 / $87.50 / $150 Out of Network $4,000 Associate / $8,000 Family 60% $10,000 Associate / $20,000 Family

Level of Coverage Associate Only Associate and Spouse Associate and Child(ren) Associate and Family

Monthly Cost to Associates Medical Choice Plus Plan Medical High Deductible Plan $126 $75 $335 $232 $283 $189 $463 $309

Information contained in this document are summarizations and not intended to replace the full details regarding eligibility, covered expenses, exclusions, limitations, definitions and other provisions of each plan contained in legal documents, handbooks and group contracts. Legal documents shall govern any differences.