INTRODUCTION

HEALTH PLAN DESCRIPTION SUMMARY

This summary has been prepared to furnish you with information regarding the benefits to which you and your eligible Dependents are entitled under the Employee Health Benefit Plan in which you are enrolled. The Employee Retirement Income Security Act of 1974" (ERISA) requires that all members be furnished a summary description of their Health Plan. Below is a general outline of the Plan which gives you this information and complete details of your benefits are covered in the provisions which follow in this summary. It has been our objective to describe the Plan clearly and directly; however, if you have any questions concerning the Plan or the information and provisions of this coverage summary, please inquire.

(1) NAME OF PLAN:

Employee Health Benefit Plan

(2) THIRD PARTY ADMINISTRATOR/AGENT FOR LEGAL PROCESS:

Phillips Administrative Service, Inc.
P.O. Box 218
Albany, OR 97321
(541) 928-1717: Federal Identification Number: 93-0907916

Toll Free: 1-800-356-9822

Your employer has delegated to Phillips Administrative Service, Inc., ministerial functions and non-discriminatory claims functions. The address of Phillips Administrative Service, Inc., is:

P.O. Box 218
Albany, OR 97321
(541) 928-1717: Federal Identification Number: 93-0907916

Toll Free: 1-800-356-9822

(3) TYPE OF PLAN:

Employee Health Benefit Plan

(4) ELIGIBILITY REQUIREMENTS:

Eligibility requirements for Employee and Dependent status are as defined in this summary and on your Schedule of Benefits.

(5) DESCRIPTION OF PLAN:

The Plan is self-funded. Plan benefit provisions are described in this summary.

Benefits for a Covered Person are determined by the Covered Person's classification and by the terms of this Plan. Any change in benefits as a result of a change in class will be effective on the date the change in class occurs. A Covered Person will not be eligible to receive payment:

(1) for which such person is not eligible;
(2) in excess of the maximum amount provided under any benefit for which such person is covered; or
(3) in excess of the Reasonable and Customary allowance for the same service performed in the same zip code area, and it will not apply to the Out-of-Pocket Maximum or the Deductible.

If any provision in the plan is in conflict with a pertinent state mandate governing self-insured plans, the Third Party Administrator will comply with the respective state regulations.

(In the case of conflicting information, your Schedule of Benefits takes precedence.)

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