Common use of Option 2 Clause in Contracts

Option 2. Employees may choose to enroll in the Cigna Open Access Plus In Network (OAPIN) plan that allows for in network coverage only. The employee price tag will be 14% of the annual premium through December 31, 2016 according to the schedule in Appendix B-1, (15% for those hired on or after January 1, 2013); 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 2021. Beginning January 1, 2013 through December 31, 2021, the prescription co-pay structure shall be as follows: Cigna OAPIN: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non- formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non- formulary. Also, the hospital emergency room co-pay will be $50 per visit and is waived if admitted.

Option 2. Employees may choose to enroll in the Cigna Open Access Plus In Network (OAPIN) plan that allows for in network coverage only. The employee price tag will be 14% of the annual premium through December 31, 2016 according to the schedule in Appendix B-1, (15% for those hired on or after January 1, 2013); 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 2021. Beginning January 1, 2013 through December 31, 2021, the prescription co-pay structure shall be as follows: Cigna OAPIN: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non- formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non- non-formulary. Also, the hospital emergency room co-pay will be $50 per visit and is waived if admitted.

Option 2. Employees may choose to enroll in the Cigna Open Access Plus In Network (OAPIN) plan that allows for in network coverage only. The employee price tag will be 14% of the annual premium through December 31, 2016 2016, according to the schedule in Appendix B-1, (15% for those hired on or after January 1, 2013); 15% as of January 1, 2017; and 15% as of January 1, 2018 2018, through December 31, 2021. Beginning January 1, 2013 2013, through December 31, 2021, the prescription co-co- pay structure shall be as follows: Cigna OAPIN: Retail – up to a 30 30-day supply - $10 for generic; $20 for formulary; $35 for non- non-formulary; Mail Order: - 90 90-day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non- formulary. Also, the hospital emergency room co-pay will be $50 per visit and is waived if admitted.

Option 2. Employees may choose to enroll in the Cigna Open Access Plus In Network (OAPIN) plan that allows for in network coverage only. The employee price tag will be 14% of the annual premium through December 31, 2016 according to the schedule in Appendix B-1, (15% for those hired on or after January 1, 2013); 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 2021. Beginning January 1, 2013 through December 31, 2021, the prescription co-pay structure shall be as follows: Cigna OAPIN: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non- non-formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non- non-formulary. Also, the hospital emergency room co-pay will be $50 per visit and is waived if admitted.

Option 2. Employees may choose to enroll in the Cigna Open Access Plus In Network (OAPIN) plan that allows for in network coverage only. The employee price tag will be 14% of the annual premium through December 31, 2016 according to the schedule in Appendix B-1B, (15% for those hired on or after January 1, 2013); 15% as of January 1, 2017; and 15% as of January 1, 2018 through December 31, 2021. Beginning January 1, 2013 through December 31, 2021, the prescription co-pay structure shall be as follows: Cigna OAPIN: Retail – up to a 30 day supply - $10 for generic; $20 for formulary; $35 for non- non-formulary; Mail Order: - 90 day supply of maintenance prescriptions - $20 for generic; $40 for formulary; $70 for non- non-formulary. Also, the hospital emergency room co-pay will be $50 per visit and is waived if admitted.