As used in this Guide, "base pay" generally means your annualized base pay as of September 1, 2017, or your hire date, if later, based on a normal work week not exceeding 40 hours. It generally excludes commissions, overtime pay, bonuses, payments in lieu of vacation, all non-regular payments and any other special purpose payments. For commissioned employees, base pay is determined by using the Annual Benefits Base Rate (ABBR),which is determined annually. In addition, the IRS limits the amount of base pay that can be considered in determining plan benefits each year. Salary reduction contributions, Code Section 132(f) transportation plan and similar salary reductions, as well as any deferred compensation contributions, are included in the calculation of your base pay.

The Consolidated Omnibus Budget Reconciliation Act of 1985, as amended. This federal law requires most employers providing group health insurance to give employees and their covered dependents the opportunity to continue their employer-sponsored coverage at the employee's or dependent's sole expense (including an administrative expense) after it would otherwise end.

The portion of the cost covered services not paid for by your medical, dental and vision options, and for which you are responsible.

A fixed dollar amount you must pay out of your own pocket at the time you receive certain medical, dental and/or vision services. Copayments do not apply toward deductibles, coinsurance or out-of-pocket maximums.

Some plans require you to pay a certain amount for necessary health care expenses each year before the plan begins to pay all or part of your remaining expenses. To help limit the number of individual deductibles a family must pay each year, some plans have a "family" deductible, which is the total amount you and your covered family members have to pay in deductibles each year, regardless of the size of your family. See "True Family Deductible" of this section.

This means that your prescription must be filled with the brand-name version of the medication. (Substitution of a generic equivalent is not allowed.) Under the BNY Mellon Health Plan, if you use a DAW prescription to get a drug's brand-name version, you will be required to pay the brand copayment plus the cost difference between the brand and generic drug. If you are unable to take a generic equivalent drug for clinical reasons (e.g., you are allergic to the generic filler), your physician can appeal. If your appeal is approved, you can take the brand-name drug without paying a penalty.

A statement, usually from a claims administrator, to a plan member who files a claim. The statement details how and why benefit payments were made or not made and summarizes the charges submitted and processed, the amount allowed, the amount the plan paid and what the plan member owes, if applicable.

A list of preferred, commonly prescribed prescription drugs. These drugs are chosen by a team of doctors and pharmacists because of their clinical superiority, safety, ease of use and cost. The formulary list may differ from plan to plan.

An account paid for solely by BNY Mellon and designated for qualified health care expenses. The level of contribution is based on your annual base pay. At the end of the year, any unused contributions roll over for you to use in the future, so long as you stay employed by BNY Mellon. If you leave BNY Mellon for any reason before reaching age 55, your HRA balance is forfeited unless you continue medical coverage under COBRA. If you elect COBRA coverage, your medical coverage continues as long as you pay the required COBRA premiums by the due date. To participate in a Health Reimbursement Account, you must enroll in Plan HRA (Health Reimbursement Account) under Aetna or UnitedHealthcare.

A special tax-sheltered savings account that is similar to a traditional individual retirement account (IRA), but designated for qualified health care expenses. In addition to BNY Mellon contributions based on your annual salary, you can also contribute to this account. Your contributions and BNY Mellon contributions cannot exceed the annual IRS maximum contribution. You can use an HSA to pay for future qualified health care expenses on a tax-free basis. Contributions, earnings and distributions are exempt from federal income and Social Security (FICA) taxes when used to pay for qualified health care expenses. To participate in a Health Savings Account, you must enroll in Plan HSA under Aetna or UnitedHealthcare.

A plan in which you pay more out of your own pocket before insurance coverage begins to pay all or a portion of expenses. However, you have the opportunity to contribute tax-free dollars to a Health Savings Account if you enroll in Plan HSA to help meet your deductible.

The Health Insurance Portability and Accountability Act of 1996, as amended (HIPAA). HIPAA protects health coverage for workers and their families when they change or lose jobs. HIPAA safeguards against losing existing health care coverage, eases your ability to switch health plans and/or helps you buy coverage on your own if you lose health coverage and have no other coverage available, as well as providing certain privacy protections.

Imputed income constitutes additional taxable income reportable on each pay statement throughout the year. Any imputed income will be included on your IRS Form W-2 at the end of the year. Under the BNY Mellon Flexible Benefits Program, you will have imputed income if you receive:

Care received from physicians, dentists, eye care doctors, hospitals and health care facilities that have agreed to charge participants a pre-negotiated—and often discounted—rate for services and treatment. When you go to a network provider, you receive a higher, "in-network" level of benefits, which means your out-of-pocket costs are lower and there are no claim forms for you to complete.

Your care is considered out-of- network if you visit a provider who is not in the plan's network. You pay more for out-of-network care, and you may be responsible for submitting your own claims. Call the provider for additional information.

This is the total amount you spend on medical bills in a calendar year. Once your share of the cost of covered services* reaches the out-of-pocket maximum, the plan will cover most eligible expenses at 100 percent.

Depending on where you live, one medical carrier may offer greater provider discounts on average—making it more cost-effective for you and BNY Mellon—than the other. In these states, the carrier with the greater discounts on average is referred to as the preferred carrier. The carrier with fewer negotiated discounts is referred to as the non-preferred carrier.

Your cost for prescription drugs depends partly on how that medication is classified by your prescription drug provider. Your cost is lowest when you have your prescription filled with a generic drug. If you purchase the plan's preferred brand-name drug, you pay a higher copayment. Your cost is highest if you purchase a non-preferred brand-name drug.

Contributions to pay for your health care coverage that are generally exempt from federal income and Social Security taxes, as well as many state income taxes.

Health care benefits that are generally intended to help you avoid illness and improve your health and, depending on your age, sex and health condition, such care can include such items as screenings, shots, preventive medication or counseling services. Preventive care is not generally subject to copay, coinsurance or deductibles if it meets specific criteria, as determined by the Department of Health and Human Services and provided at http://www.hhs.gov/healthcare/facts-and-features/fact-sheets/preventive-services-covered-under-aca. Health plans are required to provide these preventive care services only through an in-network provider. The BNY Mellon health plans may allow you to receive these services from an out-of-network provider, but may charge you a fee. In addition, your doctor may provide a preventive care service, such as a cholesterol-screening test, as part of an office visit. Accordingly, if the preventive care service is not the primary purpose of the visit or if your doctor bills you for the preventive care services separately from the office visit, then your health plan could require you to pay some costs of the office visit.

A licensed doctor who has a contract to provide services in a health plan. PCPs provide basic health care services and referrals to specialists. They maintain continuity of care during periods of illness or injury.

A licensed dentist who has a contract to provide services as part of the Aetna DMO. Your primary dentist is responsible for providing most of your dental care and referring you to specialists when necessary.

Qualified health care expenses are "qualified medical expenses" as defined in Internal Revenue Code Section 213(d)." These include health care expenses not covered by your plan, such as dental and vision care expenses, as well as coinsurance for medical and prescription drug expenses.

In certain situations, courts may issue orders directing that health benefits under an employer-sponsored plan be provided to certain individuals, usually a family member of an employee or retiree.

For the purposes of BNY Mellon's Health and Welfare plans, a "spouse," is a person to whom you are legally-married and who is treated as your spouse or surviving spouse pursuant to the Internal Revenue Code and ERISA.

Under a true family deductible, if only one family member becomes ill or injured, that person must meet the family deductible (rather than the individual deductible) before the plan reimburses for benefits.

Under the BNY Mellon medical and dental plans, the usual fee a provider charges the majority of patients for similar services; the customary fee that falls within the range of charges in the area for similar services; and the reasonable fees charged because unusual circumstances or complications require additional time, skill and experience.