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WThe National Congress of Employers (the “Association,” “NCE” or “we”) is an organization that represents America’s small and medium sized businesses via networking, advocacy and information sharing. We strive to be a strong and reliable voice for our members as we inform policymakers and the public about the needs of the business community. We are leading an exhaustive campaign for tax reform, deregulation, and expanding access to health coverage and a secure retirement for hard-working business people.

We also believe that America needs to reduce its health care costs, and reducing those costs requires individuals to take greater control over their health care spending. We help our members understand, access and use healthcare cost reduction tools and techniques. The Association provides you with programs, services and valuable benefits along with the knowledge and guidance you’ll need to take an active role in reducing your healthcare costs. By empowering our members to reduce their personal and family healthcare expenses, we can make a difference. You don’t have to hope for a government solution to the healthcare crisis; if you’re willing to do your part, we’re here to help right now!

When it comes to taking care of your health and other important areas of life, the Association provides many wonderful tools, including money saving health and lifestyle benefits, such as prescription expense assistance (Rx advocacy) and telehealth, which gives you access to licensed physicians by secure video, phone or email. We show you ways to maintain and protect your health, and reduce your need for healthcare. Our knowledgeable representatives are trained to help you select services wisely and manage the costs when you do need health services. NCE membership programs include benefits to help you cut general expenses too, like legal or travel expenses that can add up quickly, because every additionally available dollar will enable you to pay for the healthcare you do need.

NCE constantly strives to provide the best possible resources and services to educate, serve and protect you. Even reasonably priced healthcare can be extremely expensive, particularly if you are one of the millions who cannot get or afford traditional coverage. For this reason NCE offers certain membership options that include affordable types of health insurance benefits provided by major insurance carriers on a group basis. If you are not taking advantage of these great programs, call Member Services today and they will explain your options.

We are proud to present you with the benefits described in this Member Handbook. If you have any questions, comments or suggestions we would love to hear from you. Our highly trained Member Service Representatives are standing by to help you maximize the value of your membership. We can be reached toll-free at 866 258-0731 Monday through Friday between 9am and 5:30pm EST or email us at [email protected].

Welcome Aboard!National Congress of Employers

elcome to theThe National Congress of Employers

866-258-0731MEMBER SER VICESwww.TheNCE.org

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TABLE OF CONTENTS

BASIC MEMBERSHIP BENEFITS

Tech Support Page 5

ID Theft Resolution Page 6

ID Theft Monitoring Page 6

ID Theft Insurance2 Page 7

Data Backup & Storage Page 8

Small Business Legal Plan Page 9

Roadside Assistance Page 11

Pet Care Savings Page 17

Tax Preparation, Advice & Audit Assistance Page 18

Financial Education & Credit Counseling Page 21

PREMIUM MEMBERSHIP BENEFITS

Prescription Expense Assistance (Rx Advocacy) Page 22

Health Advocacy Services Page 25

Hospital Bill Audit (Limit to 1 hospitalization per year per family member, 6 month waiting period) Page 27

Telehealth Services (Telephone Consultation Access Only) Page 29

Comprehensive Wellness Testing & Profile1 2

Comprehensive Wellness Testing Terms & Conditions Page 35

DEFINED GROUP INSURANCE BENEFITS (Available to all Premium Members)

Group Accident and Sickness Fixed Indemnity Health Insurance Page 36

NCE Terms & Conditions Page 39

1 - Not available to Members in NY, NJ, RI2 - Not available to Members in NY

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GENERAL INFORMATIONG

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nYOUR NCE MEMBERSHIP CARDYour membership card contains a few pieces of important information that you’ll need to use your benefits. Some membership programs include multiple cards so review your entire Membership Kit carefully. Keep your ID cards in your wallet so you’ll have access to them when you are ready to start using your valuable benefits.

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www.TheNCE.org

866 258-0731M E M B E R S E R V I C E S

Member NameJohn Doe

Member Number301xxxxxx

Admission Date01/01/2011

Member ClassNCE Basic

Please have this number available when you call Member Services.

You may begin using your benefits as of this date.

Your NCE Membership type.

NCE contact info.

100% RISK-FREE REVIEW

& MONEY-BACK PLEDGE If you decide that you are not satisfied for any reason

you can cancel and receive a FULL refund provided you have not used your benefits and return your

fulfillment materials postage paid.* You must request cancellation within the first 10 days of the effective

date shown on your NCE membership card.

*If your fulfillment materials are not mailed back postage paid, we will deduct 25% or $10, whichever is greater, from your enrollment fee. In order to not affect your refund, the complete fulfillment materials must be returned by a trackable means (ie. Fedex, UPS, USPS) to NCE within 30 days of the effective date.

(See Terms and Conditions for complete details)


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Changing technology is significantly impacting all of our lives in very positive ways, such as making telehealth services and electronic health records possible, or completing a hospital bill audit. However, recognizing that sometimes new technologies can be difficult to figure out, NCE provides a technical support service to its members to assist in these areas. We can also help with basic computer needs such as software issues, computer maintenance, viruses, spyware, printers, scanners, internet connections and more.

When you think about it, an average cost for someone to help with technical advice could cost between $50 and $150 per hour. At no charge to you for the first hour per month, this support is just a toll-free phone call away!

Certified, licensed technicians can solve challenges large or small including software installation, operating system issues, PC maintenance, virus and spyware issues, smart phone applications, drivers, printers, scanners, Internet, e-mail, and much, much more.

• Telephone support will be available between the hours of 8am-8pm CST Monday thru Friday, and 8am-2pm CST on Saturdays.

• Secure Remote Environment: Online, Chat , Phone

• 1 Hour of Free Service Each Month

• Members can purchase additional service at the cost of $0.99 per minute

HINT: use your technical support benefit to help connect to the internet or for assistance in accessing your telehealth benefit (see pg. 29). When preparing for a video, phone, or secure email consultation, if you run into any challenges with your computer or mobile phone, don’t hesitate to use your technical support benefit for assistance.

You may also take advantage of technical support when downloading hospital bill auditing forms or submitting them to Association representatives for processing (see pg. 27).

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HOW TO ACCESS Just call 1-888-657-2568, a technical support agent will assist you over the phone and will establish a remote connection to your computer if needed. Please have your Member Number available (see pg. 4). 8am - 8pm CST Monday thru Friday 8am - 2pm CST on Saturdays

TECHNICAL SUPPORT

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IDENTITY THEFT PROTECTIONId

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Our combination of three powerful identity theft services gives you and any

covered dependents protection to help detect identity fraud before it actually

occurs, services to help you restore your identity if it is stolen and insurance

coverage to help you with any costs associated with restoring your identity as a

result of identity fraud.

HOW TO ACCESS Identity Theft Services: 1-888-657-2568

For Identity Monitoring, once you receive an alert, call the above number immediately. For Identity Theft Insurance reference Policy Number: 916304

Please have your Member Number available.

IDENTITY THEFT MONITORINGIdentity Monitoring searches and monitors for past history as well as real time identity frauds or threats. This service includes:

• Secure, hassle-free identity monitoring• Actionable identity alerts

Our Identity Monitoring does much more than monitor credit and offers a solution as robust as the ones used by the nation’s leading financial institutions to prevent theft. Identity Monitoring uses innovative technology to detect misuse or even an elevated likelihood for misuse of an individual’s Social Security number, name, address, phone, and date of birth. By creating a SNAPD identity blueprint, this program monitors billions of data on a daily basis from sources such as:

• New Credit Cards • Wireless Carrier Applications• Retail Credit Card Accounts • Automobile Loans• Mortgage Loans • Payday Loans• Utility Accounts • DMV Records• Government Data Bases • Real Estate Records• Court Records • Criminal Records• Social Security Records • Checking Accounts and Check Reorders

As identity fraud usually precedes identity theft, this type of proactive system is critical to mitigating the extensive and expensive damage perpetrated after an identity is stolen and manipulated.

IDENTITY THEFT RESOLUTION PROGRAMUpon notification of an identity theft incident, Privacy Advocates will act on behalf of our members as a dedicated case manager to:

• Investigate and confirm the fraudulent activity, including known, unknown and potentially complicated additional sources of identity theft.

• Complete and mail customized, pre-populated, state specific “Fraud Packet” via certified mail with pre-paid return instructions.

• Place phone calls, send electronic notifications, and prepare appropriate documentation on the member’s behalf, including dispute letters for defensible complaints to any and all appropriate state agencies and financial institutions.


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IDENTITY THEFT PROTECTION

• Issue fraud alerts and victim statements when necessary, with the three consumer credit reporting agencies, the FTC, SSA, and U.S. Postal Service.

• Submit Special Limited Power of Attorney and ID Theft Affidavit to involved creditors for card cancellation and new card issuance.

• Contact, follow up and escalate issues with affected agencies, creditors, financial institutions, to reinforce member’s rights.

• Assist the member in notifying local law enforcement authorities to file the appropriate official reports.

• Utilize real time access to public records reports including DMV, criminal, address changes, liens, and judgments for further investigation where applicable.

• Provide peace of mind and resolution of key issues from start to finish as swiftly as possible.

• Provide members with a “Case Completion Kit” including copies of documentation, correspondence, forms and letters for their personal records.

IDENTITY THEFT INSURANCEEach member will also receive up to $25,000 worth of insurance coverage* underwritten by a nationally recognized Insurance Carrier with an “A” or better AM Best Rating. This coverage will help members offset some of the costs of restoring their identity to its original status, including:

• Lost wages: $500.00 per week, for 4 weeks maximum • Re-filing of loans • Defense cost for certain civil lawsuits: Reasonable and necessary fees and expenses incurred in the United States by the insured with insurer’s consent for an attorney appointed by them for: (a) Defending any civil suit brought against the insured by a creditor, collection agency or other entity acting on behalf of a creditor for nonpayment of goods or services or default on a loan solely as a result of a stolen identity event. (b) Removing any civil judgment wrongfully entered against the insured solely as a result of a stolen identity event. • Reimbursement of fees: Reasonable and necessary costs incurred in the United States by the insured for: (a) Re-filing applications for loans, grants or other credit instruments that are rejected solely as a result of a stolen identity event. (b) Notarizing affidavits or other similar documents, long distance telephone calls and postage solely as a result of the insured’s efforts to report a stolen identity event and/or amend or rectify records as to the insured’s true name or identity as a result of a stolen identity event. (c) Up to six credit reports from established credit bureaus (with no more than two reports from anyone credit bureau) dated within 12 months after the insured’s discovery of a stolen identity event.

*Identity Theft Insurance not Available in the state of New York. Identity Theft Restoration and Lost Credit Card Services are available to members and their eligible dependents. Identity Theft Insurance coverage is limited to the primary member only.

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DATA BACKUP & STORAGED

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Whether its word documents, mp3, photos, contact files, business inventory, or taxes, most people manage their personal and professional lives electronically. Backing up with our remote, offsite, backup service, you ensure your electronic life will be intact when disaster strikes.

Whether it’s a malicious act, natural disaster, or human error, your computer and valued personal data are at risk. With our Data Backup and Storage solution, you can enjoy peace of mind knowing that your valuable documents and images are safe:

• 5 GB of data backup.

• 256 Bit AES Encryption

• Maximum compression conserves storage & bandwidth

• Redundant storage

ADDITIONAL DISCOUNTSAdditional storage is available at member-only discounted rates at up to 25% off. Your data will be routinely backed up over the Internet and electronically transferred to two remote storage facilities hundreds of miles apart.

Once you configure your FREE software to your specifications, back-up and file compression are automatic. And you can recover your data 24 hours a day, seven days a week, 365 days a year.

When it comes to security, every effort is made to keep your back-ups safe. Files go over the internet using 128-bit SSL Encryption. You can also control your files with 256-bit AES Encryption Key, the same type used by the U.S. military to protect top-secret information.

HOW TO ACCESS Go to https://my.intronis.com/tech-solutions/ Should you require technical assistance with the upload process, please call 1-888-657-2568. Please have your Member Number available.


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SMALL BUSINESS LEGAL PLAN

The rising costs of health insurance and the overall running a business has made itvery difficult for business owners to makes ends meet.

The NCE helps alleviate some of that financial pressure by providing businessowners with access to a nationwide network of pre‐qualified attorneys that willprovide them with free and discounted legal care.

FREE ATTORNEY PROVIDED SERVICES1

• Unlimited initial phone consultations during business hours for new legal matters.

• Attorney will review as many as 5 independent documents each quarter. These include business documents, contracts, signed or unsigned, up to 10 pages each.

• Initial telephone calls made on behalf of your business if deemed appropriate by your plan attorney (two per month). Follow up calls are made at the guaranteed low hourly rate.

• Initial letters written on behalf of your business if deemed appropriate by your plan attorney. Three per month for new subjects; follow up letters are written at the guaranteed low hourly rate.

• Initial collection letters are limited to 10 per quarter. More than 10, and any follow up letters are written at the guaranteed low hourly rate or at the contingency fee percentage, depending upon what you and your plan attorney decide.

• One on one consultations for each new legal matter. Thirty minute time limit per subject matter. Time over the 30 minutes per subject will be at the guaranteed low hourly rate.

• Registered Agent for your business in the state in which you are incorporated as well as other states where you do business.

GUARANTEED LOW HOURLY RATES2

Plan attorneys have contracted to charge no more than $125.00 per hour, or 40%off their usual and customary hourly rate, whichever is greater, for legal care thatgoes beyond the free services described above. In most cases, the attorneys willbe able to estimate the amount of hours any given case may consume prior tobeginning work on the case.

RETAINERS2

In the case of extended legal care, plan attorneys may ask you for a retainer. Anyretainer sought will be computed by multiplying the number of hours a planattorney believes a case will take, by the appropriate discounted hourly plan rate.For instance: 10 hours x $125.00 = a retainer of $1,250.00. Any unused portion ofthe retainer will be returned to the member.

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nCONTINGENCY FEE DISCOUNTS2

Attorneys often work on a contingency fee basis on such cases as personal injuryand collections. This fee is usually expressed as a percentage of the amountcollected or awarded. In collection matters, your attorney will accept 18% if thecase is settled before formal court proceedings begin. After proceedings begin,the fee is 27%.

On all other contingency matters there is a 10% discount on the lower of eitherthe state maximum or the attorney’s standard rate.

WHEN TO USE A PLAN ATTORNEY

• Business Contracts • Document Review

• Copyright • Title Searches

• Landlord/Tenant • Tax Law

• Patents • Accident/Liability Claims

• UCC Filings • Employment Matters

• Worker’s Compensation • And much more!

The hiring of a lawyer is an important decision. Before hiring the lawyer towhom you may be referred, ask the attorney for written information aboutthe lawyer’s qualifications and experience.

1 In many states, attorney liability may require plan attorneys to obtain a retainer from the member prior to providing some of the free member benefits.

2 Court costs, filing fees and time charged for travel to and from any courts are additional.

This document is an outline of coverage. A more complete explanation of privileges is defined in the Plan Guidebook. Court costs and filing fees additional.

HOW TO ACCESS Call 1-866-258-0731. Please have your Member Number available.


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LEGAL CARE SOLUTIONS

A full-time, nationwide roadside assistance plan to give you peace of mind that is always just a toll-free phone call away, with coverage that includes:

PROVIDED BY:

ROADSIDE ASSISTANCE

HOW TO ACCESS Call 1-888-825-0619. Please have your Member Number available.

NCE ROADSIDE ASSISTANCE PLAN MEMBERSHIP GUIDEPLEASE NOTE: THIS MEMBERSHIP GUIDE IS NOT AN AUTOMOBILE LIABILITY OR PHYSICAL DAMAGE INSURANCE CONTRACT, NOR IS IT INTENDED TO COMPLY WITH ANY FINANCIAL RESPONSIBILITY LAW(S).

(See footnotes on page 16)

Coverage Includes Premium

Trip planning �Jump starts / flat tire changes �Lost key/lockout assistance �Fuel delivery �Minor on-site repairs �Legal defense reimbursement Up to $1,000

Emergency trip interruption Up to $1,500

Theft reward Up to $10,000

Hit and run reward Up to $10,000

Towing Up to $150

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ROADSIDE ASSISTANCE

24-HOUR TOLL-FREE DISPATCH SERVICEPremium Membership Emergency Road Service and Towing Benefit – up to $150

If the eligible vehicle you are driving becomes disabled CALL 1-888-825-0619 for service. Dispatch service for:

• On-site emergency road service such as jump starts, gas delivery and flat tire changes up to your benefit limit. • Towing at no cost back to the service provider we send or to any destination you choose up to your benefit limit.

If for any reason you no longer need emergency road service, please call us back immediately at 1-888-825-0619. Service will be provided only if you are with your vehicle, unless other arrangements were made in advance with the dispatch operator. You are responsible for staying in a safe place until the service provider arrives. When the service provider arrives, show your membership card and sign the receipt for covered expenses up to your benefit limit. You are responsible for payment of any additional expenses not covered and expenses that exceed your benefit limit.1

You must call our dispatch service first to receive emergency road service or towing benefits. If you call us and we cannot dispatch service, the telephone representative will authorize you to call your own service provider and will give you an authorization number.

You may then call any service provider of your choice and pay them directly for services rendered. You’ll be reimbursed up to your benefit limit when you submit your written reimbursement request within 30 days of service and include your original, dated receipt with your authorization number. For procedures on how to obtain payment, see “Reimbursement Requests.” If an eligible vehicle requires two tows to reach its final place of repair, the second tow will be considered a continuation of the original tow. The maximum amount payable by us for the combined cost will be the amount of your benefit limit.

LOCK-OUT BENEFIT2 Premium Lock-Out Benefit2 – up to $150

If you are locked out of your eligible vehicle, CALL 1-888-825-0619 for service. We will send a service provider to assist you. If you call us and we cannot dispatch service, the telephone representative will authorize you to call a local service provider and will give you an authorization number.

You may then call any service provider of your choice and pay them directly for services rendered. You’ll be reimbursed up to your benefit limit when you submit your written reimbursement request within 30 days of service and include your original, dated receipt with your authorization number. See “How to Submit a Reimbursement Request” to obtain payment. VEHICLE THEFT REWARD4 Premium Membership Vehicle Theft Reward4 Benefit – up to $10,000

An amount up to your benefit limit will be paid as a reward to the witness(es) who provides information leading to the arrest and conviction for larceny or theft of anyone stealing your vehicle.



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ROADSIDE ASSISTANCE

TRIP INTERRUPTION3 Premium Membership Trip Interruption3 – up to $1,500

Due to Collision:If your vacation or personal trip is interrupted as a result of a collision involving your eligible vehicle, you may qualify for reimbursement of certain expenses incurred within 72 hours of the collision. To qualify: You must be a member at the time of the collision and the driver of an eligible vehicle; the collision must occur more than 100 miles from home; the collision between your eligible vehicle and either an object and/or another vehicle must render it inoperable and unsafe to drive; the eligible vehicle must be towed from the scene of the accident; and the repairs must be done in the vicinity of the collision. Covered expenses include: Commercial transportation (such as airline, bus, train, etc.) to your home or original travel destination; a rented vehicle from a commercial car rental agency; and meals and overnight lodging purchased in the vicinity of where your vehicle was being repaired. Only one reimbursement request may be submitted for payment per accident and only the member who was operating the vehicle at the time of the collision may submit a reimbursement request.

HIT-AND-RUN REWARD4 Premium Membership Hit-And-Run Reward4 Benefit – up to $10,000

An amount up to your benefit limit will be paid as a reward to the witness(es) who provides information leading to the arrest and conviction (for a felony - not for any lesser or different offense) of anyone responsible for bodily injury to you, your spouse or other designated driver because of a hit-and-run accident. You must be a member at the time of the incident, and the vehicle in question must be owned by the member, your spouse or other designated driver.

REIMBURSEMENT LEGAL DEFENSE5

Premium Membership Reimbursement Legal Defense5 Benefit – up to $1,000

The Legal Defense benefit provides payment for attorney fees – up to the benefit limit – to defend you in court if you are charged with certain moving violations of motor vehicle laws while driving an eligible vehicle. You may choose any attorney (other than yourself or a family member) to represent you. We cannot provide an attorney for you. For states other than New York, we will reimburse you up to the following benefit limits. For New York state residents, we must by law make the reimbursement payment directly to your attorney.

Offense or Action Premium Benefit Limit

A moving motor vehicle law violation* $75Appeal of that offense $75Reckless driving $200Appeal of that offense $200Manslaughter $550Appeal of that offense $450*Other than reckless driving and/or manslaughter.


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PERSONALIZED TRIP-PLAN SERVICEWe’ll send you a personalized TRIP-PLAN package for any driving trip you may take in the U.S. and Canada. We’ll include route maps and information on points of interest, hotels/motels or even campground information (if you request it).

How to submit a personalized trip-plan request:There are three ways to order your personalized TRIP-PLAN: write, e-mail, or call 1-888-825-0619 (See Contacts). When you place your order, be sure to include the following information: 1) Your name and membership number; 2) Your current street and e-mail address; 3) Your daytime and home telephone numbers; 4) Your departure date; 5) Your final destination; 6) The major cities you intend to visit in the order you plan to visit them; 7) Whether you prefer hotel/motel or campground information; and 8) Whether to mail or e-mail your TRIP-PLAN to you.

ELIGIBILITY INFORMATIONEligible Individuals - All the benefits described in this guide are available to you as the Member and all other driving age dependents listed as covered under your NCE plan.

Other non-covered family members, residents of your household, friends, or others riding with you are not entitled to any of the benefits or services of the membership plan you purchased. The benefits described herein are provided anywhere in the continental U.S., Alaska, and Hawaii.

Eligible Vehicles6

Because membership benefits apply to you, not to a single vehicle, your Motor Club benefits can be used to provide service for any of the following private passenger vehicles which you, or any other driving age dependents listed as covered under your NCE plan may be driving regardless of whether that vehicle is owned, leased, rented, or borrowed:

• Automobiles, including company cars assigned • Pick-up trucks, vans, and sport utility vehicles operated to the member for full-time personal use; primarily for personal use (if used commercially, said • Motorcycles (Only for Premium Membership); vehicles are only included while traveling to and from the driver’s place of work and residence).

GENERAL PROVISIONSService Providers: Emergency road and towing service is rendered by service providers who are independent contractors and who are neither agents nor employees of the Motor Club. Because these independent contractors have exclusive control over their own equipment and personnel, the Motor Club is not responsible for their acts or omissions or for the quality of any service they provide. For those same reasons, the Motor Club assumes no liability for property damage or bodily injury, if any, caused by a service provider. Any claim involving such damage or injury should be filed directly with the responsible service provider.

Vehicle Maintenance: Emergency road service is not intended as an alternative to proper vehicle maintenance. Please maintain your vehicle in good mechanical condition.

Dispatch: In certain areas and at certain times we may not be able to dispatch help to you. In those cases, we will give you an authorization number and direct to you to call a local service provider for the assistance you need. You then pay the service provider directly for services rendered, and submit to us a reimbursement request. Extreme weather conditions, acts of God or nature, heavy call volume, or lack of equipment availability may affect our ability to provide service.

Benefits: Benefits are subject to change without notice. From time to time, additional benefits and services may be offered.


ROADSIDE ASSISTANCE


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Telephone monitoring: Members who telephone Allstate Motor Club, Inc. are deemed to consent to the monitoring and recording of incoming and follow-up calls.

Inconsistency: In the event there is any inconsistency between the language of this Membership Guide and information provided by an agent or representative of NCE or an independent contractor providing service to a member, the language, terms, limits and conditions of this Guide shall control.

HOW TO SUBMIT A REIMBURSEMENT REQUESTFor All Reimbursement Requests: • Send us your written request within 30 days.7

• Always include your name, current street and e-mail addresses, your daytime and home telephone numbers, and your membership number on your submissions. • Send us only original, dated documents. Except as specified below, photocopies of relevant documents are not acceptable. • Be sure to include any additional documents relevant to your request as indicated on the following pages. • Be sure to retain copies of all such documents for your own records. • Mail your reimbursement request to the address indicated on the following pages.

We reserve the right to deny any request submitted more than 30 days after the date of service (subject to certain state restrictions), containing receipts and/or supporting documents which cannot be verified, and/or containing photocopies of receipts or supporting documents.

For Emergency Road Service, Towing & Lock-Out Service: Send us your reimbursement request within 30 days of service. You must include: your authorization number; the original, dated itemized receipt on the commercial letterhead of the service provider; and your name, address, and membership number.

For Trip Interruption: Send us your reimbursement request within 30 days of the incident. For collision: You must include a copy of the police report, the original repair bill, and an itemized, detailed list of expenses. If it is not possible to obtain these documents, you must be able to prove the following points: 1) That there was an accident; 2) That the driver of your eligible vehicle at the time of the collision was a member of this Motor Club; 3) That the collision took place more than 100 miles from the member’s home; and 4) That the eligible vehicle was not operable, or was unsafe to drive and was in fact towed from the scene.

For Vehicle Theft and Hit-And-Run Reward: Send us your reimbursement request within 30 days of the conviction. You must include the following: 1) A copy of all documents pertaining to the incident (e.g., transcripts of witness’ statements, investigation reports, etc.) including reference to the arresting officer’s name, badge number and address, as well as the current address of the witness and their relationship, if any, to you or your spouse or other designated driver; 2) A copy of the police report which includes the name of the person who provided the information which led to the arrest and conviction and which also describes the nature of the incident; and 3) A copy of the final court transcript or conviction report showing the exact offense(s) of which the thief or hit-and-run driver was finally convicted, and containing a reference to the fact that the person claiming the reward provided information leading to that conviction.


ROADSIDE ASSISTANCE

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Footnotes: 1Expenses which are not covered include, but are not limited to: Parts, products, storage, or gasoline; service(s) performed in a dealership, garage, or service station; service(s) performed in areas not regularly traveled (such as sand beaches, open fields, forests and areas not passable due to construction); service(s) needed due to an act of nature, etc.; charging a battery or delivery and repair of tires; tow bar rentals; towing due to a parking violation or towing out of a place of repair or impound areas (except for accident or theft recovery); service(s) other than that provided by a commercial garage or service station (payment will not be made to private parties or unlicensed facilities); service(s) to a disabled vehicle driven by anyone (such as a friend or distant relative) who is not a plan member, a member’s spouse or other designated driver or an associate member; removing/installing snow tires, repairs to studs, mounting and dismounting snow chains; clearing or entering snowbound driveways; shoveling vehicles out of snow banks or shoveling snow from around a vehicle; local tolls or parkway charges; service to a vehicle with an expired or missing safety inspection sticker, license plate sticker, and/or emission sticker(s) where required by law; and any other expenses not specifically mentioned as covered.

2Expenses which are not covered include, but are not limited to: Labor to produce keys, replacement keys, and mechanical failure of locks or ignition system.

3Expenses which are not covered include, but are not limited to: theft; expenses incurred beyond 72 hours; meals or lodging purchased outside the vicinity of where your vehicle was repaired or provided by anyone other than a commercial business; expenses incurred by anyone other than you, your spouse or other designated driver or associate member; telephone calls, photocopies, personal items, sundries, any type of miscellaneous items, etc.; medical expenses; and expenses paid by your insurance company.4Persons NOT entitled to receive such rewards include: You, your spouse or other designated driver, an associate member or any other person related to you, your spouse, or other designated driver by blood or marriage; law enforcement officials and/or a member of their families; and anyone with you or your spouse or other designated driver or associate member at the time of the theft or accident.

5Expenses which are not covered include, but are not limited to, the following: 1) Any offense prior to becoming a member (you must be a member at the time of the violation); 2) Any trial defense or appeal expenses for more than one traffic violation arising out of the same incident (if you are charged with multiple violations, reimbursement will be made for the violation which allows for the single highest benefit limit); 3) Any trial defense or appeal expenses for charges involving felony violations or driving under the influence of intoxicating liquor or drugs, whether or not you are convicted of the charge or convicted of a lesser offense; 4) If you are charged with other than a moving violation; and 5) Traffic fines, court costs or the costs of bail bondsmen.

6The following vehicles are NOT ELIGIBLE: Commercial and/or business-use vehicles including but not limited to taxis, limousines, automobiles, vans, trucks, and trailers.

7Wisconsin state law requires residents to provide notice of loss as soon as possible and within one (1) year from the end of the 30-day notice period. In the event it was reasonably possible to provide proof of loss within this period, and you fail to do so, we may deny your claim.

For Legal Defense: Send us your reimbursement request within 30 days of the trial. You must follow the procedures below:

For Residents of all states (except New York): 1) Pay your attorney directly and obtain a copy of the arrest citation along with an itemized bill – the latter on that attorney’s stationery – which indicates the offense for which you were charged and the fee(s) paid; 2) Be sure your attorney includes on the bill your name, current address, and membership number; and 3) Mail your request for reimbursement, including the original of that attorney’s bill and copy of the arrest citation, to the address listed below.

For Residents of New York State (New York State law requires we pay your attorney directly, up to your benefit limits): 1) Present this Membership Guide to your attorney, along with your current Motor Club membership identification card; 2) Within (30) days of your trial, have your attorney mail (to the address listed below) an itemized bill on that attorney’s stationery which indicates the offense for which you were charged and the fee(s) due him or her, along with a copy of your arrest citation; and 3) Be sure your attorney includes on the bill your name, current address, and membership number.

CONTACTS: • For 24-hour Toll-Free Emergency Road Service Call 1-888-825-0619 • For Customer Service Call 1-888-825-0619 7 a.m. to 7 p.m. CST Monday – Friday (8 a.m. to 4 p.m. Sat.) • For Reimbursement Requests, General Information, or TRIP-PLAN Requests: Allstate Motor Club, Inc., P.O. Box 3094, Arlington Heights, IL 60006-3094 • E-mail address: [email protected]

Remember to include your name, membership number, current street and e-mail addresses, plus your daytime and home telephone numbers any time you write to us.

ROADSIDE ASSISTANCE


17

PET CARE SAVINGS

Pet

Care

Sav

ings

Your pet

thinks you’re

the very

best person

in the world.

NCE has partnered with Pet Assure® so you can start saving on your pet care needs immediately! Remember, this benefit covers all of the pets in your household.

• 10%-30% off on pet supplies and specialty items from thousands of participating merchants and service providers!

• 25% off all medical services each and every time you visit a participating veterinarian from our network!* Our Pet Club has participating practices in all 50 states, Washington DC, and Puerto Rico so you are protected right at home or while you are away. With Pet Club, you receive your discount right in the vet’s office. There are no hassles like claim forms or deductibles—and remember, no pet will ever be excluded! You can enroll any pet, any age, and in any health condition…even those with pre-existing conditions.

• Free enrollment in 24/7 Pet Assistance Locator Service (PALS Tag) This recovery service has reunited thousands of lost pets with their families. Anyone who finds your lost pet simply calls the 24/7 Pet Assistance Locator Service. We go right to work calling you at home, office, cell phone and every other emergency contact you have provided until your pet is safely back home.

Pet Assure® is not insurance. Savings on food and flea products, routine boarding and grooming, outside services, low-margin pharmaceuticals, and items already discounted are at the veterinarians’ discretion, but may be available at a savings through another participating merchant.

PROVIDED BY:

HOW TO ACCESS Show your NCE Membership card with Pet Assure® logo at participating merchants.

To obtain information on receiving your PALS tags or for a complete listing of participating practices, call 1-888-825-0619.

18

TAX PREPARATION, ADVICE & AUDIT ASSISTANCE

A comprehensive tax program providing free tax return preparation, deeply discounted tax schedule preparation and unlimited, toll-free, tax related advice during normal business hours.

• Unlimited personal and sole-proprietor small business federal taxation advice by toll-free phone/fax/e-mail

• Free tax return preparation (1040EZ, 1040A, and 1040) and discounted preparation of form schedules*

• Review of prior year’s tax return• Member portal with information on tax tips, tax law changes, tax

organization, IRS audits, IRS notifications and on-line member advice • IRS audit assistance• IRS notification assistance• Tax planning• $20 discount on tax services at H & R Block for new customers

All tax and financial assistance is provided by tax attorneys, financial analysts, CPA’s, former auditors and/or Enrolled Agents certified by the IRS. All tax and financial advice is backed by a $1 million liability policy!

DETAILS AND PROVIDER TERMS AND CONDITIONS FROM LEGAL CLUB

OF AMERICA®

We provide the voice behind the software. With today’s tax software programs, users need more than help screens. Our experts step in with tax advice tailored specifically to an individual’s unique situation. Live, one-on-one, direct answers to members’ tax questions over the phone. When pop-up screens just aren’t popping up with the right answer, our experts are a phone call away with reliable advice.

We interpret “IRSspeak”. Our experts will review any notice or letter issued by the IRS and provide professional advice on how to understand and solve the matter. They assist and advise members who get audited. They review the IRS audit notification and help sort out the facts. Members also have access to a web-based IRS audit tutorial, as well as an IRS notification tutorial that helps take the terror out of those ominous-looking IRS letters.

PROVIDED BY:

HOW TO ACCESS Call Member Services at 1-888-825-0619. Please have your Member Number available.

Tax

Prep

arat

ion,

Adv

ice

& A

udit

Ass

ista

nce No more

wasted time.


19


A tax advisor for people in all income brackets. According to Thomas J. Stanley in his book The Millionaire Mind, “The number one activity for millionaires is consulting with a tax expert.” For most of us, tax consultation isn’t that high on our list of things to do, but it’s still vitally important for nearly everyone at one time or another. NCE members seek and receive advice on the tax implications of all these everyday financial matters: • Individual Retirement Accounts, Roth IRAs, 401k plans, SEPs • Real estate timing and strategies • Retirement planning • Capital gains • The tax advantages of home ownership • Investment timing and strategies • Divorce • Healthcare spending accounts • Inheritance

Our experts will also review a member’s prior year’s tax return. This review can reveal costly errors and generate a source of extra tax savings. Some of the typical questions our experts hear are: • Should I open a Roth IRA? • Is the money I inherited taxable? • Is my Social Security or retirement taxable? • Which deductions can I take if I have a home-based business? • How does the capital gains tax work? • Should I itemize deductions? • Do I get a tax break for child care expenses? • Which tax form do I file?

NCE is pleased to have your tax questions answered and your tax forms completed based upon the information you provide. Inadequate or incorrect information provided by the member to the tax professionals may lead to an incorrect answer for which the plan administrator and NCE cannot be held responsible. The plan administrator makes every effort to keep its tax profession-als abreast of changes in tax law but is not responsible for inconsistent interpretations of the tax code by the IRS and/or tax courts regarding specific matters. All benefits are available to the individual enrolled and his/her dependents as defined by the most current IRS code. The plan administrator, not NCE, assumes all liability and responsibility for the provision of, or failure to provide the stated products, services and benefits. NCE’s liability is limited to the amount of actual membership fees paid by a member for access to the tax program.

[*SEE FOLLOWING PAGE FOR DISCOUNTED PRICING FOR PREPARATION OF FORM SCHEDULES AND ADDITIONAL TAX DOCUMENTS]

20

Forms/Schedules Description Fee

1040, 1040A or

1040/EZ (1 only) Individual Income Tax Return FREE

1040 In Addition to First Return 35.00/each

1040A In Addition to First Return 29.00/each

1040EZ In Addition to First Return 24.00/each

1040ES Estimated Tax for Individuals 16.00/each

1040X Amended Return for Individuals 49.00/each

1041 Fiduciary Income Tax Return 299.00/each

1045 Tentative Refund Application 49.00/each

1065 Partnership Return 299.00/each

1116 Foreign Tax Credit 49.00/each

1120 or 1120S Corporate Return 299.00/each

2106 Employee Business Expenses 24.00/each

2210 Underpayment of Estimated Taxes 24.00/each

2441 Child/Dependent Care Expenses 24.00/each

2688** Additional 2-Month Extension to File 16.00/each

3903 Moving Expenses 24.00/each

4562 Depreciation and Amortization 15.00/entry

4797 Sale of Business Property 15.00/entry

4835 Farm Rental Income and Expenses 99.00/each

4868** Automatic 4-Month Extension to File 16.00/each

4952 Investment Interest 24.00/each

5329 Early Withdrawal Penalty 24.00/each

6251 Alternative Minimum Tax 35.00/each

6252 Installment Sales - 1st year 49.00/each

Installment Sales - Additional years 24.00/each

8275 Disclosure Statement 16.00/each

8283 Non-Cash Charitable Contributions 10.00/entry

8453* Electronic Filing Declaration 35.00/each

8582 Passive Activity Loss Limitation 24.00/each

Forms/Schedules Description Fee

8606 Non-Deductible IRA Contributions 16.00/each

8812 Additional Child Tax Credit 16.00/each

8825 Rental Property Income/Loss (Front) 35.00/prop.

8829 Home Office Expenses 35.00/each

8863 Education Credits 35.00/each

9465 Installment Request 16.00/each

940 Annual Federal Unemployment Insurance Form 24.00/each

941 Quarterly Payroll Deposits 24.00/each

Schedules:

A Itemized Deductions FREE

B Interest and Dividend Income 5.00/entry

C Sole-Proprietor Business 99.00/each

C-EZ Business (Short Form) 34.00/each

D Capital Gains and Losses 10.00/entry

E Rental Property Income/Loss (Front) 35.00/prop.

E Supplemental Income/Loss (Back) 10.00/K-1

EIC Earned Income Credit 24.00/each

F Farm Income and Expenses 99.00/each

K-1 Partner/Shareholder Income Statement 24.00/each

NOL Net Operating Loss Calc. and Carryover 149.00/each

R Credit for Elderly or Disabled 24.00/each

SE Soc. Sec. Self-Employment Tax 24.00/each

W-2 & W-3 Employee Withholding Statement 5.00/each

1099 & 1096 Miscellaneous Income Statement 5.00/each

Additional Services Available

Form 1023/1024 Exempt Organization Consulting 80.00/hour

Review of a Prior Year Tax Return FREE

Accounting and Payroll Services - Call for quote

Audit Preparation (if we prepared the return) FREE

Audit Representation 80.00/hour

Collection Representation 125.00/hour

Tax Court Representation 250.00/hour

Offer-In-Compromise/Installment Agreement Negotiations 995.00/each

Tentative Refund Application 49.00/each

Partnership Return 299.00/each

Foreign Tax Credit 49.00/each

Additional Services Available

State Income Tax Returns 49.00/each

Any form/schedule not listed above 49.00/each

Depreciation Schedule – Complete List 49.00/each

Bookkeeping time required for tax preparation 39.00/hour

Postage and handling fee to return original documents 29.00/each

*Electronic Filing not available for first year as a taxpayer or without tax preparation.

**Not applicable where client submits extensions.

Note: Client is solely responsible for State and Local Extensions.



21

This benefit provides you and your family with personalized financial and credit counseling services 24/7, 365 days per year! We provide access to counseling and financial education through a variety of delivery methods including telephone, online tools and live chat sessions.

Whether you are renting or buying a home, having problems with debt, or setting up a trust, this financial education program is designed to provide you and your family with the tools necessary to make better financial decisions. Personal financial guidance and education is provided by over 1,000 experienced financial counselors.

Benefit highlights include:

• Free Consultations - A complete financial assessment will include a review and analysis of your household income, expenses, assets and liabilities.

• Credit & Debt Counseling by Certified Credit Counselors - Assist in creating a livable budget to balance income and expenses - Provide specific advice on how to deal with creditors - Offer money management and budgeting techniques to help gain control of finances - Develop a comprehensive spending plan - Create an action plan to become debt free

• Online Counseling Sessions - Receive answers to questions on loans, budgeting, dealing with debt, etc...

• Housing Advisory Services - Advice on home ownership, mortgages, refinancing, and more...

• Online Tools, Articles & Courses - To inform, assist & educate you in areas of credit & money management.

FINANCIAL EDUCATION & CREDIT COUNSELING

PROVIDED BY:

HOW TO ACCESS Call Member Services at 1-888-825-0619. Please have your Member Number available.

Fina

ncia

l Edu

cati

on &

Cre

dit

Coun

selin

g

Credit help

available

at your

fingertips.

22

With the ever increasing cost of prescription medications, the NCE wants you to know that there are many ways to reduce or even eliminate many of your medication expenses. This is why we have set up a Prescription Expense Assistance Department that works with you to identify prescription savings and fee waiver opportunities and navigate the system, freeing up extra money to spend on meaningful healthcare. You are probably asking yourself, “How does this work?”

Most Americans are not aware of the help that is available to reduce, or in some cases eliminate their costs for brand name and generic medications. Our staff at NCE is well equipped and educated in researching and identifying programs to assist in these types of situations. We will not only help you find the appropriate options, but will assist with the application process and paperwork. Best of all, this comes at no additional charge to you!

HOW DOES IT WORK?

If you currently need prescription assistance, please complete the following documents and return them in the enclosed prepaid envelope:

• Prescription Assistance Form • Authorization for Use and Disclosure of Protected Health Information • Membership Billing Confirmation Letter

Make sure to return the completed Membership Billing Confirmation Letter in the prepaid return envelope as soon as possible, whether you need prescription assistance or not.

If you need prescription assistance at a later time, you can always complete the prescription forms and mail them to:

NCE Member Services c/o ICan Benefit Group LLC5300 Broken Sound Blvd. NW, Ste 200Boca Raton, FL 33487

Once you send back the completed form please contact Member Services to set up an initial appointment to speak with one our Prescription Specialists. The specialist will then verify all your information, explain how the process works, and answer various questions you might have. Then all you have to do is sit back and let us go to work for you. It is that easy!

WHAT IF I HAVE ADDITIONAL QUESTIONS IN THE FUTURE?

Our outstanding member services team is always here to assist in any question you have regarding utilizing your coverage to best work for you. We can be reached at 866-258-0731. Once again, we at the NCE like to welcome you to our family and anything you need we are just a phone call away.

PRESCRIPTION EXPENSE ASSISTANCE(RX ADVOCACY)

Pres

crip

tion

Exp

ense

Ass

ista

nce


23


>> continued

Pres

crip

tion

Exp

ense

Ass

ista

nce

COMMON CONDITIONS FOR RX ASSISTANCE

Conditions Names of Medications (Not Limited To)

ADD/ADHD Vynanse Concerta

Antibiotics Flagl Vibramycin

Antidepressants

Abilify Lexapro

Celexa Zoloft

Prozac Lithium

Arthritis/FibromyalgiaMeloxicam Cymbalta

Naproxen Ibuprofen

Asthma/COPD

Advair Albuterol

Proventil Pro Air

Spirivia Ventolin

Metoprolol Combivent

Atarax Singulair

Bi- PolarLamictal Lithobid

Depakote

Blood Pressure

Lisinopril Toprol

Accupril Tenormin

Attace Bumex

Cozaar Diovan

Benicar

Breast Cancer

Tykerb Femara

Arimidex Herceptin

Neupogen Ixempra

Taxotere Evista

Zoladex Zometa

Tamoxifen

Cervical Cancer Gardasil

Chemo Drugs

Sancuso Bexxar

Zofran Aloxi

Emend

Cholesterol

Crestor Zocor

Tricor Lipitor

Pravastatin Lovastitan

Welchol Zetia

Vytorin

Colon Cancer

Avastin Xeloda

Betaseron Erbitux

Vectibix

Diabetes See diabetes medications chart

HIV/AIDS

Epivir Rerovir

Fuzeon T-20 Epzicom

Combivir Emtriva

Trizivir Truvada

Atripla

Kidney Disease

Afinitor Sutent

Votrient Nexavar

Sensipar Torisel

Leukemia

Arzerra Sprycel

Treanda Arranon

Tasigna Clolar (Pediatric)

Lung Cancer Tarceva Hycamtin

Lupus/ChrohnsPlaquenil Cytoxan

Depo-Medrol

DON’T SEE YOUR

MEDICATIONS?

No problem, call Member Services and speak with a representative who will go through a full list of medications and supplies that we can help you with.

24

Medication/Supplies Names of Medications/Supplies

Insulin

Lantus Novalog

Byatta Onglyza

Humalog Levemier

Humulin Novolin R&N

Symlin*Flex Pens Also Available*

MetersPlease call and ask our

representatives about available

programs

Test Strips

Needles

Lancets

Simple Lancet

Automatic Lancet Device

Laser Lancet

Medication (Oral)

Metformin Janumet

Glyberide Avandia

Actos

Glucatrol (Glipizide)

COMMON DIABETES MEDICATIONS CHART

HOW CAN WE HELP?

Our staff will work with you to identify which medications you are currently taking and programs that are available to help you reduce your costs. Here are some of the ways that we can typically help (where and when available):

• Free Medications • Discounted Medications• Small Co-Pays• Mail Order Options

Conditions Names of Medications (Not Limited To)

LymphomaRituxan Folotyn

Treanda Arranon

MelinomaIntron A Temodar

Emeno DTIC

Mesothelioma Alimta Cytoxan

Multiple SclerosisCopaxone Betaseron

Rebif Avonex

Ovarion CancerDoxil Gemzar

Carboplatin Cisplatin

Pain Management

Oxycontin Naproxen

Celebrex Ultram

Fentanyl

Prostate Cancer

Lupron Zoladex

Privigen Cipro

Jevtana Eligard

Gardasil Uroxatral

ThyroidSynthroid Levothroid

Levoxyl


Pres

crip

tion

Exp

ense

Ass

ista

nce


25

HEALTH ADVOCACY SERVICES

You get access to your own healthcare advocate (an “Advocate”) who can help you and your covered dependents navigate the healthcare system and deal with the clinical and administrative issues you have to face to meet your medical, hospital, pharmacy and other healthcare needs.

HOW TO ACCESS Call Member Services at 1-866 258-0731. Please have your Member Number available. 9am - 5:30pm EST Monday thru Friday

ADMINISTRATIVE SERVICES • Dealing with insurance companies • Resolving insurance claim problems and disputes • Helping you manage your healthcare costs • Negotiating medical bill reductions • Getting billing mistakes corrected • Locating financial assistance programs

HEALTH COACHING • Answering questions and providing information • Enabling you to become more active in your own healthcare • Assisting with making arrangements for special needs

INFORMATION & SERVICE SUPPORT • Providing information needed for making informed healthcare decisions • Helping you complete qualification applications • Identifying, arranging and coordinating health and wellness services • Locating support groups and educational services

HEALTHCARE COORDINATION, CLAIMS & BILLING ASSISTANCEIf you have chosen to take advantage of the insured medical benefits available to members of The National Congress of Employers, your Advocate can help you get the most out of your coverage. It’s simple. If you have a healthcare or insurance issue you need help with , just call our special toll-free Health Advocacy telephone number (1-866 258-0731). When you call an Advocate will be assigned to personally help you with your questions or problem. After obtaining the necessary background information, your Advocate will begin working on your question or problem.

Hea

lth

Adv

ocac

y Se

rvic

es

You now

have

your own

advocate

to help you

and your

whole family

navigate the

healthcare

system.

26

HEALTH ADVOCACY SERVICES

Your Advocate is a trained professional who understands the complexities of obtaining healthcare and how to navigate the healthcare system. You can establish a real relationship with your Advocate, who will stay with you through to the resolution of any situation. Your Advocate and the team of administrative experts who work with your Advocate are all committed to giving you top-quality service and support.

Advocates are specially trained to handle every matter in a thoroughly confidential manner and to follow strict protocols that comply with all governmental privacy standards to ensure that your medical and personal information is properly protected.

Advocates can help you identify primary and specialist physicians, hospitals, and related healthcare providers. While they will first focus on taking advantage of network relationships to help you get the most from your benefits, they can also work to use out-of-network providers and suppliers for any necessary healthcare, supplies and equipment not available for in-network sources.

Your Advocate can explain the coding and payment rules that apply to your circumstances and help sort out and solve claims and related paperwork problems and assist with resolving coverage issues and disputes. They will research your out-of-pocket payment responsibilities, resolve any errors related to balance-billing, eligibility, benefit and claim denials with providers and/or the insurance company. When necessary, they can negotiate for fee reductions from healthcare providers to lower your erroneous charges and help resolve questions regarding denials of benefits deemed to be non-covered, not medically necessary or ineligible. If there are questions of coverage for a particular, or if coverage for clinical care has been denied, your Advocate can assist you throughout the review and appeals process. They can also assist in searching out alternative coverage options when needed.

If you are faced with a rare, serious or complex medical condition, your Advocate can identify leading critical illness providers, medical institutions, and specialized medical programs nationwide.

Your Advocate can assist you with prescription drug issues including formulary and benefit questions, provide information on generic drugs, locating lower cost sources for prescription medications not covered by your health plan and help you obtain mail order prescriptions. They can also help you answer questions about pharmaceutical supplies, DME supplies, diabetic testing supplies, and even sleep apnea machines.

If you have special services or needs, your Advocate can help locate and make arrangements for those services. You are responsible for payment of any specific services arranged on a fee-for-service basis that are not covered by an insurance plan. Your Advocate can help with locating services not covered by your health plan, (including adult day care and rehabilitation, inpatient private nursing, group homes for individuals with special needs, and home health aides), and can assist you with completing qualification applications for individual coverage options, including Medicaid and Medicare.

INDEPENDENT. CONFIDENTIAL. CONVENIENT.Advocates are not affiliated with any insurance or third party provider. Healthcare Advocacy services does not replace health insurance coverage, and Advocates do not provide medical care, render medical advice or recommend medical treatment.


27

Over 35 million people in the U.S. are admitted to a hospital each year, and their bills average close to $20,000 each (with many much higher than that!). Why so expensive? Partly because almost all of those hospital bills contain significant errors! What can be done about it? Most people can’t do anything about it, because they can’t even recognize the errors, let alone explain them or get the hospital to make corrections to them. But, as an NCE member, if you are hospitalized, we help protect you against overbilling!

NCE has contracted for the services of a highly-skilled team of physicians, compliance analysts and medical billing specialists (“Analysts”) who, will audit your eligible hospital stay bill* with the help of a unique and powerful software platform.

• Review or “Audit” of your itemized hospital stay bill and certain related records.

• Identify excessive, unwarranted, non-compliant and otherwise invalid charges.

• Create a detailed medical bill review report or “MBR” that identifies billing errors, challenges invalid charges, recommends appropriate adjustments, and explains the reasons for each challenge and adjustment.

Once your Audit is completed, the Analysts will send you an MBR along with a sample letter to a hospital billing department explaining the MBR findings and challenged charges. It is suggested that you then immediately send your own letter to the hospital, along with a copy of the MBR and payment for the undisputed portion of your bill.

IMPORTANT NOTE - You should get your hospital bill Audited prior to payment! Armed with an MBR, it is actually easier than you might imagine to get a hospital to agree to accept reduced payment on an unpaid bill. It is much more difficult to get a hospital to adjust a bill and refund monies already paid, even when an Audit shows clear cut errors.

HOSPITAL BILL AUDIT

How To Get An Audit: As soon as possible after you receive a bill for a hospital stay, please call member services at 866-258-0731 so that an NCE Member Advocate can forward to you or explain how to download the following documents:

• Customer Agreement • HIPAA Privacy Agreement • Customer Information Form • Itemized Medical Bill & Information Release Form • Medical Records Release Authorization Form • Sample Audit Advisory Letter to Hospital (with UB-04 Request)

Hos

pita

l Bill

Aud

it

28

As soon as all of the necessary agreements and forms have been completed and delivered, and the Analysts receive the itemized bill and the UB-04 (or an alternate source of coding information) for your hospital stay, the Audit will begin. Unless there is a need for additional records, the Audit should be completed and an MBR sent out within approximately 10 business days.

It is critical that you request Audit support and complete all of the steps in the process quickly, because each State requires that any challenge to a hospital bill must take place within a stipulated time period to be classified as a “disputed bill” in order for that bill to be held in abeyance until the audit is completed.

*Detailed terms and conditions for the Hospital Bill Audit service, which will be included in the Customer Agreement, may be viewed on the NCE web site and are available upon request from Member Services. You must be an NCE Member in good standing for a continuous period of 180 days (the “Waiting Period”) before you or your eligible spouse or dependent may use the Hospital Bill Audit service. Each eligible person (either you or, if any, your spouse or eligible dependent) may use the Hospital Bill Audit service one time only once during each year that you remain an NCE Member in good standing. The Hospital Bill Audit service may only be used for hospital bills incurred by one eligible person during and directly related to their stay as an admitted patient in a hospital for more than 24 continuous hours.

HOSPITAL BILL AUDITH

ospi

tal B

ill A

udit


29

InteractiveMD provides the newest and most advanced round the clock healthcare delivery system, allowing you to consult with a doctor live from the comfort of your own home or office by secure video, phone or email. To schedule an appointment with a physician all you have to do is call 1-888-866-7909 or go online and login into your account.

MEDICAL CONSULTATIONS can provide you with a more thorough assessment and possible diagnosis and treatment of a wide range of common medical conditions from a licensed physician by video conference or phone. This type of consultation requires the physician to perform a full review of your electronic health record, including your current condition and the reason for the consultation prior to any diagnostic assessment.

TELEHEALTH SERVICES

NCE Membership Programs Included

Diagnostic Consultations

Additional

Diagnostic Consultations

Basic Membership None $40 per consult

Premium Membership 2 per year $40 per consult

HOW TO ACCESS

To have a virtual consultation with the next available doctor:

Just call 1-888-866-7909 and have your Member ID available. (see pg. 4) OR

Go to www.interactiveMD.com/NCE and Login on the right of the page using your username and password. If you have not yet set-up your InteractiveMD account call Member Services and they will help you. If you do not remember your password just click “Forgot Password” and we will e-mail you a new one.

Step 1 - Complete your electronic health record. Step 2 - Select the type of consultation: advice or full diagnostic visit. Step 3 - Choose how you would like to connect: video, phone or email.

When you are ready to start, just click on “Schedule a Consult”. Our system will locate the next available professional. Just sit back and wait, one of our providers will be connecting with you shortly.

Tele

Hea

lth

Serv

ices

>> continued

30

TELEHEALTH SERVICES

COMMON CONDITIONS HANDLED THROUGH INTERACTIVEMD

Acid reflux Acne Allergies Asthma Birth control Family planning Bladder infection Bronchitis Cellulites Cold & Flu Constipation Diarrhea Diabetes Gout Hair Loss HeadacheHeartburnHemorrhoidsHigh blood pressureInfectionsJoint ache & painsNauseaPneumonia (mild)RashesShinglesSinus conditionsSore throatStable herpesThyroid conditionsUrinary tract infectionYeast infection

PEDIATRIC CARE(Ages 6yrs and up)

Cold & Flu Constipation Hemorrhoids Fever Nausea Pink eye Stomach viruses Vomiting

WHY USE InteractiveMD?On-demand healthcare - Wherever and whenever you need, as often as you need, round the clock access.Save Money - Save hundreds or thousands of dollars by avoiding unnecessary doctor’s office or medical center visits.Save time - Avoid waiting for an appointment or sitting in the doctor’s office.Our network of physicians - U.S. based, licensed and experienced.

WHEN TO USE InteractiveMD?• Your Primary Care physician is not available• Requesting basic prescriptions/refills1

• After normal business hours, nights, weekends• Traveling and need medical advice• For non-emergency medical issues & questions, and for obvious

conditions that do not require “in person visit”

You must complete a Medical Assessment and History Questionnaire prior to your scheduled medical consultation.

1 Prescriptions will only be issued when indicated and approved by a physician, and as permitted by law in your state.

Phone CallTalk to a doctor over the phone.

Video ConferenceSee a provider using your computer and a webcam over the internet.

Secure E-mail AdviceAsk questions and get advice privately using secure e-mail

VIDEO AND PHONE CONSULTATIONSFor a better quality of care, we strongly recommend that all virtual consultations are done with video conferencing. However, if a webcam is not available, we offer secure phone consultations as an alternative.

InteractiveMD is not intended to replace your primary care physician and is not health insurance. InteractiveMD physicians do not prescribe controlled medications. If you have an emergency, please dial 911. All our services are HIPAA-Compliant.

PROVIDED BY:


31

VIDEO CONSULTATIONWhen the consultation starts, you will see the doctor or healthcare professional in the consultation window. You should see your own video feed on the smaller window on your top right. Please introduce yourself, make sure both you and the provider are seeing each other and follow the professional’s instructions to start the consultation.

After the consultation ends, a recording of the complete video session is stored on our secure electronic medical record system. If applicable, the doctor may recommend a course of treatment, prescribe medication or request medical tests.

To engage in live video consultations, you need to be equipped with the right hardware and connection. If you experience any technical difficulties during the set up of a video conference or in accessing the internet, remember that you have access to the NCE Technical Support line (see pg. 14). Minimum requirements include: (1) High-speed Internet connection (2) 1GHz processor(3) Flash-enabled Web browser (4) 1GB RAM (5) Webcam (6) Windows or Mac operating system.

PRESCRIPTIONSOur TeleHealth program allows for the submission of prescriptions to a pharmacy of your choice. With thousands of pharmacies to choose from, your prescriptions can typically be sent immediately following your medical consultation.

PRESCRIPTION POLICYPhysicians providing medical consultations for TeleHealth members may write prescriptions for a wide range of medications, which can include, but are not limited to, drug classes such as antibiotics and antihistamines. Convenience prescriptions for maintenance medicines may also be obtained in cases where a member is in transition to a new insurance plan or doctor.

This program is not a drug fulfillment warehouse. Prescriptions will only be issued where indicated and approved by a physician. In the event a physician does prescribe medication, he/she will usually limit the supply based on their medical judgement. Patients with chronic illnesses should visit their primary care physicians or other specialists for extended care. It is against InteractiveMD’s policy for physicians to issue prescriptions for substances controlled by the DEA, non-therapeutic use, and/or medications which may present material risk for potential for abuse or addiction. For a current list of DEA controlled substances, visit: http://www.deadiversion.usdoj.gov/schedules

LAB TESTSYour physician might request tests to assist with your healthcare. Diagnostic tests help physicians detect diseases earlier, prescribe therapies, and monitor results. Our program has a strategic alliance with labs around the country to provide this service. Choose from over 2,000 locations nationwide at your convenience. These labs provide leading-edge medical laboratory tests and services through a national network of primary clinical laboratories including specialized Centers of Excellence.

*InteractiveMD, a Florida limited liability company, provides access to and support for online and telephonic consultations with physicians (“Participating Physicians”) and electronic medical record storage, maintenance and transmission services (collectively the “iMD Services”). Participating Physicians are not employed by InteractiveMD and the iMD Services do not include the provision of medical care, medical advice or the practice of medicine by InteractiveMD. Detailed terms and conditions for the iMD Services (the “iMD Terms of Use”) may be viewed on www.interactivemd.com or throughwww.TheNCE.org, and are also available upon request from NCE Member Services. By using any iMD Services you, your eligible spouse or dependent(s), if any (collectively, “you”), are representing and acknowledging that you have read and agree to comply with all of the iMD Terms of Use. THE IMD SERVICES ARE NOT FOR USE FOR MEDICAL EMERGENCIES OR URGENT SITUATIONS. IF YOU THINK YOU HAVE AN EMERGENCY, CALL/DIAL 911!

TELEHEALTH SERVICES

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We provide a comprehensive wellness profile at no additional cost to you!You get numerous individual blood tests and a CWP lab report that provides a thorough bio-chemical assessment of most major organ systems of your body. The tests performed as part of the Comprehensive Wellness Profile include (NOT available to Members in NY, NJ, RI):

• Complete Blood Count (CBC) • Liver Panel• Kidney Panel • Fluids and Electrolytes• Thyroid Profile w/TSH • Minerals and Bone• Lipid Profile • Glucose (Diabetes)

(Cholesterol: HDL, LDL, the risk ratio, triglycerides)

COMPREHENSIVE WELLNESS TESTING & PROFILE

HOW TO SCHEDULE YOUR DIAGNOSTIC SCREENING Call Member Services at 1-866 258-0731 to arrange for the test. PLEASE DO NOT SCHEDULE A LAB VISIT WITHOUT

CONTACTING MEMBER SERVICES.

We recommend you fast (no food) 8 hours before you have your blood drawn.

COMPREHENSIVE ADULT WELLNESS TESTING & PROFILEYou must have a continuous active membership in good standing for at least 180 days in order to use this benefit. The CWP consists of over 50 individual blood tests to provide a thorough bio-chemical assessment. The results are an indication of the proper functioning of most major organ systems of your body.

Blood tests, as part of your annual wellness routine, can help spot a wide variety of health problems, and early detection and treatment can save money, prevent further health problems and even save lives. So, every year, the Member and spouse (if applicable) can get a Comprehensive Wellness Profile (“CWP”) directly from a major clinical lab with no charge or co-payment.

The Comprehensive Wellness Profile blood test consists of the following panels with details below:

BLOOD & FLUIDSCOMPLETE BLOOD COUNTWBC - White blood cells are the body’s primary defense against disease. White blood cells help fight infection.RBC - Red blood cells are responsible for carrying oxygen and carbon dioxide to all cells. Iron deficiency will lower RBC.

NCE Membership Programs Single or Parent / Child Couple or Family

Premium Membership 1 Test per year 2 Tests per year

Basic Membership $120 $200


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Hemoglobin - A chemical compound inside red cells that transports oxygen through the blood stream to all cells of the body. Oxygen is needed for healthy organs. Hemoglobin gives the red color to blood.Hematocrit - Hematocrit measures the amount of space red blood cells take up in the blood. It is reported as a percentage.Lymphocytes - The results of this and basophils, eosinophils, monocytes and neutrophils deal with white blood cell function. Important to the body’s defense against infection. Also important in the assessment of nutritional status.Monocytes - The results of this and basophils, eosinophils, lymphocytes, and neutrophils deal with white blood cell function. lmportant to the body’s defense against infection. Also important in the assessment of nutritional status.MCH - Mean-Corpuscular Hemoglobin is one way to measure the average hemoglobin concentration within red blood cells, which varies from normal with different diseases.MCHC - Mean-corpuscular hemoglobin concentration.MCV - Mean-corpuscular volume measures red blood cell volume.Neutrophils - The results of this and basophils, eosinophils, lymphocytes, and monocytes deal with white blood cell function. lmportant to the body’s defense against infection and also important in the assessment of nutritional statusPlatelets - Blood cell particles involved with the forming of blood clots.

LIPID PROFILECholesterol, Total – knowing your cholesterol may be as important as knowing your blood pressure. Elevated cholesterol is associated with an increasing risk of coronary heart disease.HDL - Cholesterol High-density lipoproteins are believed to take cholesterol away from cells and transport it back to the liver for processing or removal. They have become known as the “good” cholesterol as persons with high levels of HDL may have less heart disease. Low HDL could be the result of smoking and lack of exercise.LDL - Cholesterol Low-density lipoproteins contain the greatest percentage of cholesterol and may be responsible for depositing cholesterol on the artery walls. For that reason, they could be known as the “bad” cholesterol.Cholesterol/HDLRatio - Calculated by dividing the total cholesterol by the HDL cholesterol. Ratio used by physicians in determining your relative risk for developing cardiovascular heart disease.Triglycerides - Triglycerides is a fat in the blood responsible for providing energy to the cells of the body. Triglycerides should be less than 400 mgldl even in a non-fasting state.

FLUIDS & ELECTROLYTESChloride, Serum - Similar to sodium, it helps to maintain the body’s electrolyte balance.Potassium - Helps to control the nerves and muscles.Sodium, Serum - One of the major salts in the body fluid; sodium is important in the body’s water balance and the electrical activity of nerves and muscles.Carbon Dioxide - ordered as part of an electrolyte panel. The electrolyte panel is used to detect, evaluate, and monitor electrolyte imbalances.

DIABETESGlucose - Blood sugar level, the most direct single test to uncover diabetes, may be used not only to identify diabetes, but also to evaluate how one controls the disease.

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LIVER PROFILEAlanine aminotransferase (ALT or SGPT) - an enzyme found primarily in the liver. Abnormalities may represent liver disease.Albumin - One of the major proteins in the blood and a reflection of the general state of nutrition.Albumin/Globulin ratio - Calculated by dividing the albumin by the globulin.Alkaline phosphatase - A body protein important in diagnosing proper bone and liver functions.Aspartate aminotransferase (AST or SGOT) - an enzyme found in skeletal and heart muscle, liver and other organs. Abnormalities may represent liver disease.Bilirubin, Total - A chemical involved with liver functions. High concentrations may result in jaundice.Globulin,Total - A major group of proteins in the blood comprising the infection fighting antibodies.Lactate Dehydrogenase (LDH) - An enzyme found mostly in the heart, muscles, liver, kidney, brain, and red blood cells. When an organ of the body is damaged, LDH is released in greater quantity into the blood stream.Protein, Total -Together with albumin, it is a measure of the state of nutrition in the body.GGT - GGT Also known as: Gamma-glutamyl transpeptidase, GGTP Formal name: Gamma-glutamyl transferase helps to detect liver and bile duct injury. Some doctors use it in all people they suspect of having liver disease, others use it only to help explain the cause of other changes or if they suspect alcohol abuse.

KIDNEY PANELUrea Nitrosen (BUN) - A by-product of protein metabolism eliminated through the kidneys. BUN is an indicator of kidney function.Creatinine, Serum - An indicator of kidney function.Uric acid - Another by-product of protein metabolism eliminated through the kidneys. Uric acid is an indicator of kidney function.Bun/Creatinine - Ratio Calculated by dividing the BUN by the Creatinine.

THYROID PANELThe thyroid gland synthesizes, stores, and releases hormones. The hormones secreted are iodine containing amino acids, thyroxine (T4) and triiodo-thyronine (T3). The thyroid hormones influence a diversity of metabolic processes. These tests help to evaluate thyroid hormones that control the body’s metabolic rate. Total T-4 (Thyroxine), T-3 uptake, Free-Thyroxine Index (FTI) T-7, TSH

BONE AND MINERALSIron, Total - An abnormally low test result may indicate iron deficiency anemia.Calcium - A mineral essential for development and maintenance of healthy bones and teeth. It is important also for the normal function of muscles, nerves and blood clotting.Phosphorus - Together with calcium, it is essential for healthy development of bones and teeth. Associated with hormone imbalance, bone disease and kidney disease. It is found mainly in bones and teeth. NOTE: a temporary drop in phosphorus level can be seen after a meal.

INTERNAL ORGANS & MINERALS



35


TERMS & CONDITIONS

Before calling Member Services to schedule your Comprehensive Wellness

Profile, you must read and agree to the following Privacy Notice and Direct

Laboratory Services disclaimer:

Privacy Policy & Disclaimer Direct Laboratory Services, Inc. (DLS) is located at: 300 Mariners Plaza Suite 321, Mandeville, LA 70448 The Privacy Policy adopted in order to maintain clear standards of privacy and security with the informa-tion we are provided by customers for confidentiality states:(1.) We will not sell or provide secure proprietary information input by custom-ers to any outside parties.(2.) No customer information is kept on the publicly available server.By accessing this web site, users agree to be bound by all of the terms and conditions of the guidelines set out in this Disclaimer. Do not consult this web site unless you agree not to hold DLS liable for any errors or omissions. We offer laboratory services for wellness monitoring. The tests, services or prod-ucts found listed in our web site are not intended to diagnose, treat, or cure disease. We give no warranty that any of our services will prevent disease. All material is provided for educational purposes only and is not intended to be a substitute for a physician’s consultation. Although DLS encourages increased self-awareness and self-care, all readers are strongly encouraged to consult and work with an experienced health-care practitioner. DLS does not engage in rendering medical advice or services. Individuals with health disorders, medical conditions, or any condition needing medical supervision assume full responsibility for obtaining such professional medical assistance. Consult your physician regarding any symptoms or medical condition. We specifically dis-claim any expressed or implied warranties or merchantability of fitness for any particular usage, application or purpose. DLS does not recommend self-diag-nosis or self-medication, and no information within this web site or presented by DLS or its associates may be construed or interpreted as recommending self-diagnosis or self medication. If a laboratory test result is outside normal range, you may be encouraged to see a physician. Many tests, to be validated, will need to be repeated at the discretion of a physician. Laboratory test results may vary depending upon age, sex, time of day blood sample is taken, diet, medications, and the limits of modern technology. A single laboratory test or group of tests cannot guarantee good health. False positive and false negative test results are possible. There are various medical diseases that cannot be uncovered by these tests alone. Testing by our medical staff only constitutes a partial evaluation of your state of health and does not represent a diagnosis or treatment of disease. DLS shall not be liable to you or anyone else for any loss or injury caused in whole or in part by procuring, compiling, interpreting, delivering or reporting information through this web site. In no event shall DLS be liable to you or anyone else for any decisions made or action taken or not taken by you in reliance on such information. Material placed online by us-ers does not represent medical advice of DLS and we make no representations with respect to the accuracy, reliability, completeness, timeliness or usefulness of the contents.Notice of HIPAA Privacy Practices: THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY AND REPORT ANY GRIEVANCE TO THE DLS PRIVACY OFFICIAL.

The Health Insurance Portability & Accountability Act of 1996 (HIPAA) is a federal program that requires that all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, are kept properly confidential. This Act gives you, the Patient, significant new rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information. We have prepared this “Summary Notice of HIPAA Privacy Practices” to explain how we are required to maintain the pri-vacy of your health information and how we may use and disclose your health information. A Notice of HIPAA Privacy Practices containing a more complete description of the uses and disclosures of your health information is available to you upon request. We may use and disclose your medical records for each of the following purposes: treatment, payment, and health care operations: TREATMENT means providing, coordinating, or managing health care and related services by one or more health care providers PAYMENT means such activities as obtaining reimbursement for services, billing or collection activi-ties and utilization review. HEALTH CARE OPERATIONS include the business aspects of running our laboratory service practice, such as conducting quality

assessment and improvement activities, auditing functions, cost-management analysis and customer service. We may also create and distribute de-identified health information by removing all references to individually identifiable information. We may contact you to provide laboratory draw site information or other health-related services that may be of interest to you.Any other uses and disclosures will be made only with your written authori-zation. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization.

You have the following rights with respect to your protected health informa-tion, which you can exercise by presenting a written request to the DLS Privacy Officer:1. You have the right to ask for restrictions on the ways we use and disclose your health information for treatment, payment and health care operations. You may also request that we limit our disclosures to persons assisting your care. We will consider your request, but are not required to accept it.2. You have the right to request that you receive communications containing your protected health information from us by alternative means or at alterna-tive locations. For example, you may ask that we only contact you at home or by mail.3. Except under certain circumstances, you have the right to inspect and copy medical, billing and other records used to make decisions about you. If you ask for copies of this information, we may charge you a nominal fee for copying and mailing.4. If you believe that information in your records is incorrect or incomplete, you have the right to ask us to correct the existing information or add missing information. Under certain circumstances, we may deny your request, such as when the information is accurate and complete.5. You have a right to receive a list of certain instances when we have used or disclosed your medical information. We are not required to include in the list uses and disclosures for your treatment before April 14, 2003 among others. If you ask for this information from us more than once every twelve months, we may charge you a fee.

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INSURANCE BENEFITS OVERVIEWIn

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wPLEASE NOTE: THE FOLLOWING IS AN OVERVIEW OF INSURANCE BENEFITS PROVIDED ONLY TO NCE CHOICE CLASS MEMBERS. IF YOU ARE A NCECHOICE CLASS MEMBER, YOU WILL RECEIVE CERTIFICATES OF COVERAGE WITH THIS HANDBOOK. TO THE EXTENT THAT ANY OF THE NCE CHOICE CLASS BENEFITS IN THE OVERVIEW DIFFER FROM THE BENEFITS AS DESCRIBED IN THE CERTIFICATES OF COVERAGE, THE CERTIFICATE OF COVERAGE SHALL CONTROL.

10 DAY RIGHT TO RETURN THE CERTIFICATEIF FOR ANY REASON YOU ARE NOT SATISFIED WITH THE CERTIFICATE, YOU MAY

RETURN IT TO US WITHIN 10 DAYS AFTER YOU RECEIVE IT AND WE WILL REFUND ANY PREMIUM PAID PROVIDED YOU HAVE NOT USED YOUR BENEFITS.

LIMITED BENEFIT HEALTH INSURANCE PLANThis limited benefit health insurance plan is underwritten by Unified Life Insurance Company.

The following information is a brief description of important features of this insurance coverage. It is not a contract of insurance. The benefits, terms, conditions, limitations, and exclusions of coverage are as set forth in the insurance policies and shown in the certificate of coverage and schedule of benefits delivered to you with this Member Handbook.

This plan provides important coverage for the treatment of illness and non-occupational injuries as well as lab tests and preventive care. Benefits under the plan are limited to specified maximum amounts shown in your summary of benefits and policy certificate for your plan.

PREFERRED PROVIDER NETWORK ACCESS PROVIDED BY:

ELIGIBLE PROVIDERS • Doctors and Physicians • Hospitals and Outpatient Surgical Centers • Clinics and Specialty Centers • Laboratories and Imaging Centers

SEE ANY DOCTORYou are free to see any doctor you choose but your coverage goes further if you select a participating Preferred Network Provider and take full advantage of the pre-negotiated network rates to reduce your medical bills before the insurance benefit is applied. Even if you elect to see a Non-Network Provider, the full insured benefit amount will still be applied to the bill for covered charges, but without the network rate reduction.

ASSIGNMENT OF BENEFITSWhen you need to visit a doctor or go to the hospital, there is no need for you to file a claim for in-network providers because your benefits are fully assignable and can be paid directly to your provider. Any daily hospital benefits will be paid directly to your Provider and all other benefits are assignable at your discretion. In order to assign benefits you sign a document allowing your doctor or your hospital to collect your health insurance benefits directly from the carrier. By assigning benefits you will not have to file a claim with the Insurance carrier to be reimbursed. If you choose, you may pay your provider at the time of service and submit the claim yourself for reimbursement. You may obtain a claim form at www.TheNCE.org.

PROVIDED BY:

Limited Benefit Plan


37

INSURANCE BENEFITS OVERVIEW

Benefit 2000 4000 6000

Doctor’s Office Visit Benefits

$50 per visit2 visits per Policy Year

per Covered Person


per Covered Person


per Covered Person

Preventive Care Test Benefit

$50 per Test1 Test per Policy Year per Covered Person



Diagnostic Tests, X-ray and Laboratory Benefit:

Lab Work/Blood Tests

$50 per Day4 Tests per Policy Year per Covered Person



X-Rays

Advanced Studies:

Angiogram/Arteriogram

EEG

Myelogram

CT Scans

MRI Scans

PET Scans

Hospital Confinement Benefits

$200 per day10 days per Policy Year

per Covered Person


per Covered Person

$1,000 per day10 days per Policy Year

per Covered Person

Mental Health Benefit

* Inpatient Benefit is per day. Outpatient Benefit is per treatment. N/A

$50 per day/treatment*10 days per Policy Year

per Covered Person

$300 per day/treatment*10 days per Policy Year

per Covered Person

Skilled Nursing Facility Benefit$50 per day

10 days per Policy Year per Covered Person


per Covered Person

Surgery Benefit

50% of 2010 RBRVS 3 Surgeries per

Policy Year per Covered Person





Anesthesia Benefit 25% of Surgical Benefit 25% of Surgical Benefit 25% of Surgical Benefit

Diabetes Outpatient Management Training

& EquipmentN/A $50 per Policy Year

per Covered Person$100 per Policy Yearper Covered Person

Accidental Death Benefit $10,000 $10,000 $10,000

Urgent Care/Emergency Room Benefit N/A$ 75 Per Visit

4 Visits per Policy Year per Covered Person

$ 75 Per Visit 4 Visits per Policy Year

per Covered Person

LIMITED BENEFIT HEALTH INSURANCE PLAN OVERVIEW

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INSURANCE BENEFITS OVERVIEWIn

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wMULTIPLAN NETWORK ACCESSYou now have access to medical providers in the MultiPlan Network. Currently, MultiPlan contracts with over 4,500 hospitals, 83,000 ancillary facilities and nearly 587,000 healthcare professionals. MultiPlan has been one of the national leaders in health care cost containment for more than 20 years, and continually strives to recruit the most respected hospitals, physicians and other healthcare professionals so you will receive the quality of care you expect and deserve. The providers in the MultiPlan Network encompass virtually every specialty and you do not need a referral from your primary care physician to get an appointment with the specialist you may need. The MultiPlan Network consistently achieves one of the best savings in the industry, giving you a great opportunity to lower claim costs, on average by 40% for practitioner claims.

If your Physician is not a MultiPlan Network participant, you can easily nominate him or her buy going to www.multiplan.com - select Providers then Nominate a Provider. You can nominate your provider through the Online Provider Referral System or download a Provider Referral Letter to present to your provider. Your provider can then contact the network to obtain an application packet.

ACCESSING THE NETWORKThe process differs slightly for Network and Non-Network visits, so please read the following carefully: 1. You may locate a Network Provider in two ways: Call Member Services at 1-866-258-0731, or Go to www.Multiplan.com. If it is

your first visit to that Provider as a member, please call the Provider to verify that the Provider is still participating in the Network at least 24 hours prior to scheduling an appointment. If the Provider is not part of the Network, you may access the Provider of your choice but will not receive the Network rate reduction.

2. Schedule an appointment with the Provider of your choice. 3. Present your NCE Choice Membership Card upon arrival. If your doctor’s

office has any questions about your coverage they can call Member Services for assistance.

4. After your visit, your Network Provider, not you will submit a claim to the insurance company for re-pricing and payment. NOTE: If Provider is not part of the Network, no re-pricing applies and you, as the member, must submit the claim to the insurance company for payment.

5. In about 45 days, you should receive an EOB (Explanation of Benefits). It will show you the amount of the Provider bill, the Network reduction, the amount paid by the insurance company, and, if there is a balance, the amount for which you, the patient, will be responsible.

6. If you have chosen not to assign your benefits, you need to call Member Services to obtain a claim form.

PRE-EXISTING CONDITION AND PREGNANCY EXCLUSIONS There is a twelve (12) month pre-existing condition exclusion from coverage for any condition for which medical care, treatment, diagnosis or advice was received or recommended during the twelve (12) months prior to your effective date of coverage.


39

TERMS & CONDITIONS

DEFINED TERMS. ANY CAPITALIZED TERM USED BUT NOT DEFINED IN THIS MEMBERSHIP HANDBOOK SHALL HAVE THE MEANING ASSIGNED TO SUCH TERM IN THE BY-LAWS OF NATIONAL CONGRESS OF EMPLOYERS.PURPOSE OF ASSOCIATION. The purpose of the National Congress of Employers (NCE) is to establish facilities and provide a forum for the exchange of ideas, opinions, technical know how and experiences among NCE’s members as well as other national and international organizations and to engage in any other lawful purpose. ADMISSION AND EFFECTIVENESS OF MEMBERSHIP. Applications for membership shall be processed by the membership committee. The applicant will be advised of action taken on their application. Effectiveness of membership shall start from the payment of entrance fees and membership dues of the applicant and after submission of other requirements that may be imposed by the membership committee and/or Board of Directors. In order to be a member in good standing, a member shall have paid all dues and assessments within thirty (30) days after the same shall have become due and payable. Members who have not fully paid their annual dues and other obligations to the Association shall be liable for any indebtedness of the Association to the extent of their unpaid account. MEMBERSHIP CLASSES: The Association has different classes of Membership (collectively “Classes” and each a “Class”), each having different privileges, benefits and rights as established by resolution of the Board from time to time. Members of all Classes have such rights as are set forth in the By-Laws of the Association, as the same may be amended from time to time (the “By-Laws”). Some but not all classes enjoy voting rights.Membership into this organization shall be classified as follows: (1) Charter Members: includes the founding members of NCE; (2) Active Members: includes individuals operating sole proprietorships and other like situated individuals duly enrolled and in good standing, having been approved for full membership by the Board of Directors or their duly authorized delegated Membership Committee; (3) Associate Members: individuals who are members of the Association, but do not enjoy voting rights, cannot hold the position of committee chairman, nor have access to the other emollients of Full Membership; (4) Supporting Members: individuals who are conferred membership as such by the Board of Directors with rights as specified thereon. Active members shall be entitled to all the privileges and services offered by the Association. Each member may vote and be voted upon for office in the Association. Reference should be made to the NCE By-Laws for a more thorough explanation of the rights of membership classes.MEMBERSHIP HANDBOOK: The membership handbook describing the General Benefits and any supplemental handbooks describing Premium Benefits are sometimes referred to collectively as “Membership Handbooks” and each individually as a “Membership Handbook.” Membership Handbooks do not contain all applicable terms and conditions for every Benefit, and additional Benefit terms and conditions not included in a Membership Handbook are available from NCE and/or the third party provider(s) of certain Benefits. By using any Benefit, you represent, acknowledge and agree that you have reviewed and accepted all of the terms and conditions of all of your Benefits, on behalf of yourself and your eligible spouse and/or dependent(s), if any, including any such terms and conditions posted on the NCE Website or the Benefit providers website. You will be deemed to have received notice of and reviewed and accepted each and every change to Benefits terms and conditions 24 hours after such change has been posted on the NCE Website or the Benefit providers website, or at such earlier time the change has been sent to you by mail or electronically, or has been explained to you by a representative or agent of NCE or the Benefit provider.ANCILLARY BENEFITS. NCE offers certain benefits that are ancillary to its Purpose and primary reason for existing. Such ancillary benefits may include insurance coverage(s) (“Insured Benefits”) under master group policies issued to the Association (collectively “Policies” and each a “Policy”) provided by licensed insurance carrier(s) (each an “Insurance Carrier”). However, NCE IS NOT AN INSURANCE COMPANY AND IS NOT RESPONSIBLE OR LIABLE FOR ANY INSURED BENEFITS OR CLAIMS UNDER ANY INSURANCE POLICY. THE INSURANCE CARRIER THAT ISSUES/UNDERWRITES A POLICY IS SOLELY RESPONSIBLE AND LIABLE FOR INSURED BENEFITS AND CLAIMS UNDER SUCH POLICY. The benefits, terms, conditions, limitations and exclusions of each Insured Benefit are set forth in the relevant Policy, a copy of which is maintained at all times in the records of the Association and available for

review at the offices of the Association upon request. Coverage under each Policy, and the essential features of such coverage, is evidenced by and described in a certificate of coverage for such Policy (the “Certificate”) which will be delivered to each Member covered under the Policy. An Insured Benefit may be offered as Premium Benefit or an Elective Benefit or both, at the discretion of the Board and in accordance with Applicable Law. If you have joined or join a Class with Premium Benefits that include any Insured Benefit(s), or you have chosen any Insured Benefit(s) available to you as an Elective Benefit, you should have or receive a Certificate issued under the terms of the Policy or Policies relating to such Insured Benefit(s). IF YOU BELIEVE THAT YOUR BENEFITS INCLUDE ANY INSURED BENEFIT FOR WHICH YOU DO NOT RECEIVE A CERTIFICATE, IT IS CRITICAL THAT YOU CONTACT MEMBER SERVICES IMMEDIATELY.PERMITTED USE / DEPENDENTS. You must be actively enrolled and be current on all payment of Charges in order to use or receive any Benefits. You agree that you will use your Membership and Benefits only for yourself and, if you have either a couple, parent-child or family Membership, any “Dependent Family Members” who are included under your chosen category of Membership. “Dependent Family Members” can include your spouse and immediate family members under the age of 25 who are living with and are financially dependent upon you. However, if your Benefits include any Insured Benefit(s), then, as to any such Insured Benefit: (i) whether any dependent(s) can be covered and who qualifies as a dependent under such Insured Benefit shall be determined, defined and governed strictly by the Policy relevant to that Benefit; and (ii) to the extent that any person qualifies as and is actually covered under such Insured Benefit beyond their 21st birthday, then such person shall be deemed to be a “Dependant Family Member” under your NCE Membership until such time as that person no longer qualifies as and is covered under such Insured Benefit. In some cases, persons who qualify as and are covered under a particular Insured Benefit may include handicapped family members who are incapable of self-support and are dependent on you for support and maintenance, regardless of their age, depending upon the Policy in question and/or the laws of your state of residence. Please refer to the Certificates applicable to your Insured Benefits, if any, to determine if coverage is or may be included or available for Dependent Family Members.ADDITIONS & MODIFICATIONS. No Member will be entitled to any Benefit that is added after such Member’s enrollment date, except as may be specifically determined by resolution of the Board in its sole and unfettered discretion. Notwithstanding anything herein to the contrary, any of the General Benefits, Premium Benefits or Elective Benefits (collectively, “Benefits” and each a “Benefit”), and the terms and conditions applicable to the same (“Benefit Terms”) may be modified, changed, replaced, substituted, discontinued or eliminated from time-to-time at the discretion of the Board, as required by the provider of the Benefit, or as may be deemed necessary or appropriate to comply with any applicable law, regulation, rule, policy or standard of any governmental or regulatory entity or agency (collectively, “Applicable Law”). Should any Benefits materially change, notice will be provided as soon as reasonably possible. The most current Benefits information can be found on the Association’s Website and/or the third party provider(s) of benefits, and your Eligible Covered Dependants shall each be deemed to have received notice of any such information once it is posted. If you do not have access to a computer, you may request current Benefits information from NCE Member Services and Benefit providers.RISK-FREE REVIEW PERIOD. Upon enrollment, you have a risk-free review period in which to evaluate your Membership (the “Review Period”). Before you use any Benefit(s), please thoroughly and carefully review the Membership Handbook(s) and all other materials relevant to the General Benefits, any Premium Benefits of your Membership Class, and each Elective Benefit you have chosen, if any. If you decide that you are not satisfied for

any reason you can cancel and receive a FULL refund provided you have not

used your benefits and return your fulfillment materials postage paid.* You must request cancellation (a “Cancellation Request”) within the first 10 days of the “Effective Date” shown on your NCE membership card. Your Cancellation Request must include your name, address and member number and should be sent to the Association by fax to 1-561-989-1489, by e-mail to [email protected], or by mail to:NCE Member Services c/o ICan Benefit Group LLC, 5300 Broken Sound Blvd.

NW, Ste 200, Boca Raton, FL 33487

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or you may speak directly with an Association member services representative and request cancellation by phone by calling 1-866-258-0731. If your qualified Cancellation Request is received by the Association before the deadline and you have not used any Benefits and return your fulfillment materials postage paid*, a full refund of all Charges paid will be made to your bank or credit card account within thirty (30) days.*If your fulfillment materials are not mailed back postage paid, we will deduct 25% or $10, whichever is greater, from your enrollment fee. In order to not affect your refund, the complete fulfillment materials must be returned by a trackable means (ie. Fedex, UPS, USPS) to NCE within 30 days of the effective date.DUES & FEES. All new Members must pay an initial application processing and enrollment fee of $20 or such other amount as may be established by the Association. Members enrolling in any Class with Premium Benefits must pay an initial application processing and enrollment fee of $100 or such other amount as may be established by the Association for such Class. Application processing and enrollment fees may be charged in connection with any Elective Benefit, as may be established by the Association from time to time. Members who cancel their Membership or are terminated by the Association and re-enroll after such cancellation or termination becomes effective, may be deemed to be new Members and may be required to pay any then-current processing and enrollment fees. Any Member who is permitted to and does change their Class of Membership or Benefits may be deemed to be a new Member and may be required to pay additional processing and enrollment fees, as determined by the Association. In order to maintain Membership in the Association, each Member must pay the monthly Association dues then in effect for General Benefits (“Dues”), plus any and all additional fees for the Premium Benefits provided to their Class (“Program Fees”) and for any Elective Benefits they have chosen (“Additional Fees”). Application processing and enrollment fees, Program Fees and Additional Fees are hereinafter collectively referred to as “Fees,” and Dues and Fees are hereinafter collectively referred to as “Charges.” Payment of all monthly Charges is due one month in advance and will be automatically drafted from or charged to the account or credit card that you have authorized NCE or its agent to draft or charge at the time of your enrollment or thereafter (your “Billing Account”). The Association reserves the right to terminate any Membership and deny any and all privileges and benefits for lack of timely payment of any Charges, or failure to satisfy any other Membership requirement. Dues and Fees may be changed for all Members of any Class (but not individually), as the Association’s Board of Directors determines is necessary, appropriate or desirable in its discretion, with notification to be provided as soon as reasonably practical. Dues and Fees collected from the Members are held and disbursed on behalf of the Association by a licensed third-party administrator as may be required by applicable laws, regulations or rules of any government authority or agency, and in order to ensure consistent and timely payment is made to third party Benefit providers.AUTHORIZATION, PROCESSING & CONFIRMATION OF CHARGES AND

PAYMENTS. By becoming a Member, you agree to and authorize all Charges for or incurred in connection with your Membership and Benefits to be made against your Billing Account. Monthly Charge’s may be handled as a single withdrawal from or charge to your Billing Account, or Dues and certain Program Fees and/or Additional Fees may be processed separately. If you do not effectively cancel during the Review Period, you will be deemed to have confirmed your continuing authorization for all Charges that accrue while you are a Member to be withdrawn from or charged to your Billing Account, including withdrawals and Charges that may be processed after you cease to be a Member for Charges that accrued while you were a Member. Depending on the monthly billing date you selected when you enrolled, Charges will be submitted on or about either the 1st, 5th, 10th, 15th, 20th, or 25th of each month for the next month (your “Billing Date”). If you did not select a Billing Date which was confirmed in your enrollment verification, your Billing Date will be on or about the 15th of each month. Payment of any Charges will not be deemed confirmed until five business days after the date of the receipt of such payment from your Billing Account by automatic bank draft or credit card.ACTIVATION & TERM. Your Membership in the Association is on a month to month basis, with the monthly periods running from 12:00 am Eastern Time on your Effective Date through 11:59 pm Eastern Time the day before your

Effective Date of the following month (a “Monthly Period”). Benefits, including Insured Benefits will be activated on your Effective Date, provided your initial payment of Charges has been confirmed. Insured Benefits are activated in accordance with the applicable Policy and Certificate, and may also be summarized in a Membership Handbook. In the event of any conflict between any such Membership Handbook and the Certificate, the Certificate governs. The term of your Membership may continue so long as you continue to meet the qualifications of Membership established by the Association and pay all required Charges in full and in a timely manner.GOVERNING DOCUMENTS. The By-Laws and/or any Member Terms and Conditions (collectively, “Membership Terms”) may be modified or amended from time to time as permitted by the NCE Articles of Incorporation and By-Laws, and as may be deemed necessary or appropriate to comply with any applicable law, regulation, rule, policy or standard of any governmental or regulatory entity or agency (collectively, “Applicable Law”). At any given time, the current Membership Terms, as the same may have been amended (collectively, the “Governing Documents”) can be provided to you by contacting NCE Member Services and such documents may be made available on NCE’s website. By becoming a Member and either using any Benefit or continuing your Membership after the Review Period, you represent, acknowledge and agree that you have reviewed and accepted all of the terms and conditions of the Governing Documents on behalf of yourself and your eligible spouse and/or dependent(s), if any. In addition, for as long as you are a Member, you will be deemed to have received notice of and reviewed and accepted each and every amendment to the Governing Documents 24 hours after such amendment has been posted on the NCE Website, or at such earlier time the amendment has been sent to you by mail or electronically, or has been explained to you by a representative or agent of NCE.CANCELLATION & TERMINATION. After the Risk-Free Trial Period, you can cancel your Membership at any time by submitting a Cancellation Request to the Association. To effect a cancellation as of the last day of a given Monthly Period, your verified Cancellation Request must be received by Member Services prior to the 25th day of that Monthly Period (the “Cancellation Deadline”). Once received, your cancellation will be processed and will become effective as of midnight on the last day of the Monthly Period for the month you submitted a timely Cancellation Request. If your Cancellation Request is NOT received prior to the Cancellation Deadline of the Monthly Period in which it is delivered, then your Membership will continue through the end of the next Monthly Period and you will be responsible for the full payment of all Charges owed for that next Monthly Period. Please note: Because of the automated nature of NCE’s billing system, if your Cancellation Request is received prior to the 20th day of the Monthly Period, but not at least five days prior to your Billing Date, Charges may unavoidably be processed against your Billing Account on or about your Billing Date, in which event such charges will be refunded to your Billing Account no later than thirty (30) days after the date of your Cancellation Request. Non-payment of any Charges will result in automatic termination of your Membership, and Benefits as of the end of the last Monthly Period for which you paid all Charges in full. If you are terminated for nonpayment, you have a grace period in which you may reactivate your Membership by paying all applicable Charges in full prior to the end of the last day of the Monthly Period to which the missed payment would apply. Notwithstanding anything herein to the contrary, the Board of Directors of the Association or its authorized Delegate (the “Board”) may terminate your Membership at any time, in its sole discretion, in accordance with the Bylaws. In the event of such termination, your Membership and Benefits will be retroactively terminated effective as of the end of the prior Monthly Period and any Dues you have paid applicable to any later point in time will be refunded to you.NOTICE OF MEETINGS & ACTIONS. All notices required under the Governing Documents or Applicable Law to be given by the Association to you of any meeting or action of the Association will be posted on the Website and/or as may otherwise be required under Applicable Law. If you or any Dependent Family Member accept or use of any Benefit, or if you remain a Member beyond the Risk-Free Review Period, you shall be deemed to have waived any right to delivery of individual notice of any such meeting or action of the Association unless you inform the Association to the contrary in writing.LIMITATION OF LIABILITY & DISCLAIMER OF WARRANTIES. You understand and agree that: (i) any claim with regard to any Benefit provided to you in

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connection with your Membership, but by any party other than NCE itself, including any Insured Benefits discount program and wellness testing, shall be made only against the provider(s) of such Benefit and not against the Association, its affiliates or contractors (collectively, the “Supporting Parties”); (ii) the sole obligation of the Supporting Parties shall be to provide and facilitate your access to and receipt of such Benefit from the third party provider(s) of that Benefit. The Supporting Parties assume no liability with regard to any Benefit provided, or to be provided, by any third party. The Supporting Parties are not merchants, manufacturers or direct providers of the Benefits and do not give any warranties, expressed or implied, as to description, quality, merchantability, fitness for any particular purpose, productiveness or any other matter, as to the Benefits, the third-party providers of Benefits, or any other services or merchandise purchased or received by you through, or in connection with, your Membership in the Association. You acknowledge that you are not relying on the Supporting Parties’ skills or judgments in selecting any third-party provider or Benefits or services available to you. In the event that any product or service purchased or received by you is cancelled, modified, defective or otherwise unsatisfactory to you, you will look solely to the provider, seller, merchant, or manufacturer of the product or service for any repair, exchange, refund, or satisfaction of the claim. It is further understood that all Benefits are subject to the availability of such Benefits, which may change without notice for reasons beyond the reasonable control of the Supporting Parties.PAYMENT TO PROVIDERS FOR PRODUCTS & SERVICES. You agree that you and your covered Dependent Family Members are solely responsible for payment of any amounts due for products or services obtained by you or your covered Dependent Family Members in connection with your Membership. Failure to make prompt payment of the amounts due may result in the termination of your Membership. None of the Supporting Parties shall be considered either a guarantor or payor for any products or services provided to any Member by any third party.GENERAL RELEASE. You on behalf of yourself and all of your covered Dependent Family Members hereby forever release, acquit and discharge each of the Supporting Parties and their respective officers, directors, employees and agents from any and all liabilities, claims, demands, actions and causes or action that you, or your covered Dependent Family Members may have by reason of any monetary damage or personal injury sustained as a result of or in connection with the provision or lack thereof of any and all Benefits or other benefits, services, or merchandise made available through or as a result of your Membership in the Association. The sole recourse available to you and your covered Dependent Family Members shall be cancellation of your Membership and any refund available as provided in the Risk-Free Review Period section of these Terms and Conditions.USE OF MEMBER INFORMATION. Keeping your financial and personal information secure is one of our most important responsibilities. Our employees are trained in the importance of maintaining confidentiality and privacy. We maintain physical, electronic and procedural safeguards to protect non-public information such as Member credit card and/or bank account information, Social Security numbers and other such sensitive information, including personal health information. Unless otherwise directed by you, we may share some of your non-public, personal information, as necessary, to maintain and service your Membership with us and as otherwise permitted or required by law. For example, we may share some of your non-public, personal information with the insurance companies who provide some of your Benefits. We may also share some other information about you (such as your name, address, age and gender) with organizations with whom NCE has joint marketing agreements who wish to extend offers that we believe may interest you. However, we endeavor to only share information with organizations that offer goods and services we believe will be of benefit to our Members. If you terminate your relationship with NCE, we will not share information we have collected about you, except as permitted or required by law. You may direct us not to share any of your information other than as required or permitted by law by e-mail notice delivered to [email protected] or by written notice mailed to: NCE Member Services c/o ICan Benefit Group LLC, 5300 Broken Sound Blvd. NW, Ste 200, Boca Raton, FL 33487, Attention to the President, stating you want to opt out of sharing your personal information. Any such opt-out notice should include your name and member number. You may make your privacy choice at any time. Your choice will remain unless

you state otherwise; however, if we do not hear from you within 30 days from the date this notice was made available to you, we may share some of your information with affiliated companies and other third parties. This notice updates and replaces any previous notices you may have received from us about the collection, use and protection of your information. We may change this privacy notice at any time and if we do, we will notify you either by e-mail or by U.S. mail, depending on your relationship with us.

TERMS & CONDITIONS

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NOTES


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NOTES

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