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www.elitebenefitsgroup.comELITEBENEFITSGROUPENHANCE - EDUCATE - ENGAGE - ENROLL - EMPOWER

Pirtek Northwest Crossing is committed toacomprehensiveemployeebenefitprogram that helps our employees stay healthy, feel secure andmaintain a work/life balance.The benefits program was designed to provide you with a competitive level of standard coveragewhile allowing you the flexibility to choosebenefits that reflect  your  needs  and personal circumstances. In addition to receiving coverage for health insurance, you have the opportunity to choose other coverage that best meets your needs.www.elitebenefitsgroup.com

1. DEDUCTIBLEThe amount you must pay before your insurance company starts to pay for covered services each year.3. COPAYMENTSA fixed amount you pay for coveredservices such as doctor visit or diagnostic test.5. COVEREDSERVICESMedical services included in your insurance plan, such as doctor visits, hospital stays and diagnostic tests.7. OUT-OF-NETWORK A doctor or medical facility that is not contracted with your insurance company. Using out-of-network providers can result in you paying a higher portion of the medical bills or possibly the entire bill.2. COINSURANCEThe percentage of a medical expense you are responsible for paying. This usually kicks in after you have met your deductible.4. OUT-OF-POCKETMAXIMUMThe most you have to pay for covered services in a plan year.6. IN-NETWORKThe doctors, hospitals and other medical facilities and suppliers that contract with your insurance company to provide medical services.8. PROVIDERThe person or facility providing services to you, including doctors, hospitals and pharmacies.www.elitebenefitsgroup.comYOU SHOULD KNOW8TERMS

United Healthcare is our medical carrier. Below is a brief summary of the medical plan. Using In- Network facilities and physicians will result in significant cost savings to the member. Network facilities and physicians can be found at myuhc.com or call 877-797-8812.www.elitebenefitsgroup.comPlan 1 (Base Plan)NavE3000i60LX21BIN NETWORKOUT OF NETWORKParticipant60% 40%N/AN/ACaCaalelelndnddararYYeaear DeeDeductible (CYD)IndividualFamily$3,000$6,000N/AN/AMaximum mOuOt of PocoockeketIndividualFamily$8,150$16,300N/AN/AOffice VisisititPrimary Care Visits (non-surgical)Specialist Visit (non-surgical)Urgent Care VisitPreventive CareRetailPPrerescscription*Preferred Generic(PSOR\HH&RQWULEXWLRQ (Bi-WeeklyEmployee onlyEmployee and SpouseEmployee and Child (ren)Employee and Family$10 / $35 / $75 / $250$0.00$136.14$325.63PlanHospitalIn-Patient ServicesOut-Patient ServicesEmergency Room$188.09MEDICAL INSURANCE$25 Copay/visit. Deductible does not apply. $75 Copay/visit. Deductible does not apply.$50 Copay/visit. Deductible does not apply. No Charge. Deductible does not apply.40% Coinsurance40% Coinsurance40% Coinsurance

United Healthcare is our medical carrier. Below is a brief summary of the medical plan. Using In- Network facilities and physicians will result in significant cost savings to the member. Network facilities and physicians can be found at myuhc.com or call 877-797-8812.www.elitebenefitsgroup.comPlan 2 (Buy- Up Plan)E1000i80LX22BIN NETWORKOUT OF NETWORKParticipant80% 20%N/AN/ACaCaalelelndnddararYYeaear DeeDeductible (CYD)IndividualFamily$1,000$2,000N/AN/AMaximum mOuOt of PocoockeketIndividualFamily$3,000$6,000N/AN/AOffice VisisititPrimary Care Visits (non-surgical)Specialist Visit (non-surgical)Urgent Care VisitPreventive CareRetailPPrerescscription*Preferred Generic(PSOR\HH&RQWULEXWLRQ (Bi-WeeklyEmployee onlyEmployee and SpouseEmployee and Child (ren)Employee and Family$10 / $35 / $75 / $250$55.72$245.92$510.62PlanHospitalIn-Patient ServicesOut-Patient ServicesEmergency Room$318.47MEDICAL INSURANCE$25 Copay/visit. Deductible does not apply. $75 Copay/visit. Deductible does not apply.$50 Copay/visit. Deductible does not apply. No Charge. Deductible does not apply.20% Coinsurance 20% Coinsurance 20% Coinsurance

DENTALwww.elitebenefitsgroup.comCLASSTYPE OF SERVICEINSURANCE PAYSNetworkOur national dental network offers more than 323,000 access points. Members may choose any dentist but may receive additional savings by choosing an in-network dentist. Plus, services not covered by this plan may also still be eligible for in-network savings. Out-of-network benefits are paid at the network negotiated rate.Dental insurance can help preserve your smile with easy-to-use coverage that promotes overall wellness.Benefits can help with a variety of dental costs, from routine cleanings to more advanced procedures. Coverage is available for you, your spouse and dependent children.Plan detailsThe benefit year maximum for this plan is $2,000 per person.Class A, B and C services apply toward the benefit year maximum.This plan has a deductible of $50 per person.Families only pay the deductible for a maximum of three people. Applies only to class B and C services.The co-insurance for this plan is:INSURANCE(Network: UNUM) $2,000, 100%80% 50%Class AClass BClass CPreventive ServiceBasic ServiceMajor Service100%80%50%

Covered Procedures & Waiting PeriodsRoutine exams and cleanings (twice every 12 months)-One additional cleaning per 12 months if memberis in second or third trimester of pregnancy.X-rays-Bitewing X-rays (up to four films; once every 12 months)-Full mouth/panoramic x-rays (once every five years)Children’s services (up to age 14)-Fluoride treatment (once every 12 months)-Sealants (once every 36 months)-Space maintainers (up to age 14; once every 24 months)Adjunctive pre-diagnostic oral cancer screening (for age 40 orolder; once every 12 months).Simple restorative services (fillings) Simple extractionsEmergency treatmentRepair of crown, denture or bridgeOral surgery (extractions and impacted teeth)Anesthesia (subject to review; covered with complex oral surgery)Periodontics (gum treatments)Endodontics (root canals)Inlays and onlaysCrownsBridgesDenturesEndosteal implants (in lieu of an approved three-unit bridge)Preventive services (Class A): No waiting periodBasic services (Class B): No waiting periodMajor services (Class C): 12 - month waiting periodEmployee Contributions (Bi-Weekly)EmployeeEmployee and SpouseEmployee and Child (ren)Employee and Family$15.52$29.32$36.77$54.44www.elitebenefitsgroup.com

Dental insurance offers an optional vision rider to help pay for eye exams and materials, such as glasses and contact lenses. This coverage can help you maintain healthy vision and overall wellness, as well as provide valuable financial protection for you, your spouse and dependent children.www.elitebenefitsgroup.comVISION BENEFITSIN-NETWORKOUT OF NETWORK ALLOWANCECO-PAYSSTANDARD PLASTIC LENSES (once per 12 months)FRAMES (once per 12 months)CONTACT LENSES (once per 12 months) (Includes fit, follow-up and materials) in lieu of eyeglass lenses and frames.Exam (once per 12 months)Materials$10$25Up to $35See belowSingle visionBifocalTrifocalLenticularProgressivePolycarbonate lenses (for children to age 19)Covered by co-payCovered by co-payCovered by co-payCovered by co-pay$80 allowance$70 allowanceUp to $25Up to $40Up to $50Up to $50Up to $40N/Achoose any frame available at provider locations$120 allowanceUp to $50ElectiveMedically NecessaryUp to $120 allowanceUp to $210 allowanceUp to $100 allowanceUp to $210 allowanceVISIONEmployee Contributions (Bi-Weekly)EmployeeEmployee and SpouseEmployee and Child (ren)Employee and Family$2.88$5.70$6.00$9.39

Voluntary Benefits 101What are voluntary benefits?Sometimes called “supplemental insurance,” voluntary benefits are policies you buy to add to the health and life insurance your employer may already provide. These benefits can help you pay for things your other insurance won’t, such as lost wages, out-of-pocket expenses and household bills.Advantages*Flexibility Use claim payments however you like – pay deductibles, co-payments and other expenses not covered by your health or life insurancePortability Take coverage with you if you leave your job or retireStability Maintain coverage whether or not you’re employedConvenience Pay premiums using your choice of payroll deduction, bank dra or direct billingTo learn more about voluntary benefits, contact us at 713-575-3722Underwritten by Colonial Life & Accident Insurance Company, Columbia, SC ©2017 Colonial Life & Accident Insurance Company. All rights reserved. Colonial Life is a registered trademark and marketing brand of Colonial Life & Accident Insurance Company.Policies Accident insurance Helps cover out-of-pocket expenses in the event of a covered accidentCancer and critical illness insurance Helps with the high cost of cancer or critical illness diagnosis and treatmentDental insurance Helps pay for dental procedures, like routine cleanings, crowns and root canalsDisability insurance Helps replace part of your regular income if you are unable to work because of a covered injury or illnessHospital confinement indemnity insurance Helps pay for covered hospital-related expenses, such as outpatient surgery and diagnostic proceduresLife insurance Protects the people who depend on you by helping cover final expenses and loss of income*Advantages may not apply to all products. See your Colonial Life benefits counselor forcomplete details.

%(1(),76(/,*,%,/,7< $VDQHPSOR\HHRIPirtek Northwest Crossing\RXKDYHDFFHVVWRWKHIROORZLQJ EHQHILWVIRUWKH3ODQ<HDUApril 24±March15.Core Plan Benefits offered:࠮࠮࠮United Healthcare =PZPVU+LU[HS7SHU :\WWSLTLU[HS)LULMP[Z[OYV\NO*VSVUPHS3PML:+2,6(/,*,%/($1':+(1 $OODFWLYHIXOOWLPH(PSOR\HHVZKRZRUNDWOHDVW30KRXUVSHUZHHN(PSOR\HH EHQHILWVDUHHIIHFWLYHWKHILUVWRIWKHPRQWKIROORZLQJ30GD\VRIDFWLYHHPSOR\PHQW(/,*,%/('(3(1'(176 <RXPD\HQUROO\RXUHOLJLEOHGHSHQGHQWVLQFRYHUDJH7KH\LQFOXGH-/HJDO6SRXVH-&KLOGUHQXSWRDJHUHJDUGOHVVRIVWXGHQWVWDWXVRUPDULWDOVWDWXVLQFOXGLQJQDWXUDOFKLOGUHQVWHSFKLOGUHQDQGOHJDOO\DGRSWHGFKLOGUHQLQFOXGLQJFKLOGUHQOLYLQJZLWK\RXEHIRUHWKHDGRSWLRQLVILQDOZKRDUH\RXUGHSHQGHQWVRUIRUZKRP\RXDUHUHTXLUHGWRSURYLGHKHDOWKFDUHFRYHUDJHXQGHUD4XDOLILHG0HGLFDO&KLOG6XSSRUW2UGHU&+$1*,1*<285&29(5$*('85,1*7+(<($5 ,I\RXQHHGWRFKDQJH\RXUFRYHUDJHWKURXJKRXWWKH\HDU\RXPD\RQO\GRVRLI\RX H[SHULHQFHDQHOLJLEOHFKDQJHLQVWDWXVOLIHHYHQWVXFKDV࠮ )PY[O(KVW[PVU࠮ *OHUNLPU0UZ\YHUJL*V]LYHNL(KKYLZZ,TWSV`TLU[:[H[\Z࠮ +LH[OPU[OL-HTPS`࠮ +LWLUKLU[*OPSK9LHJOLZ3PTP[PUN(NL࠮ +P]VYJL(UU\STLU[࠮ -43(9LSH[LK3LH]L࠮ 3LNHS:LWHYH[PVU4HYYPHNL࠮ :WV\ZL3VZZVM6[OLY*V]LYHNL࠮ ,UYVSSTLU[PU4HYRL[WSHJL*V]LYHNL<RXPXVWPDNHFKDQJHVWR\RXUEHQHILWFRYHUDJHZLWKLQGD\VRIDQHOLJLEOH FKDQJHLQVWDWXVOLIHHYHQW:+$7+$33(16,),'21¶7(152//" ,I\RXGRQRWHQUROOLQWKHEHQHILWVSURJUDP\RXZLOODXWRPDWLFDOO\UHFHLYH³GHIDXOW´ FRYHUDJHZKLFKLV1R&RYHUDJH,IODWHURQ\RXGHFLGHWRHQUROOLQEHQHILWV\RXPD\EHVXEMHFWWREHQHILWZDLWLQJ SHULRGVUHTXLUHHYLGHQFHRILQVXUDELOLW\DQGRUEHUHTXLUHGWRZDLWXQWLOWKHQH[W $QQXDO(QUROOPHQWwww.elitebenefitsgroup.com

The information in this Enrollment Guide is intended for illustrative purposes and informational purposes only. The information contained herein was taken from various summary plan descriptions, certificates of coverage and benefit information. Every effort was taken to accurately report your benefits however discrepancies and errors are always possible. It is not intended to alter or expand rights or liabilities set forth in the official plan documents or contracts. It is not an offer to contract nor are there any express or implied guarantees. In case of a discrepancy between this information and the actual plan documents, the actual plan documents will prevail. If you have any questions about this summary, please contact Human Resources or Elite Benefits GroupELITE BENEFITS GROUPMEDICALUnited HealthcareDENTAL / VISION713-575-3722CONTACT INFORMATIONwww.elitebenefitsgroup.comwww.colonialLifedental.com COLONIAL LIFEColonial Life Policies800-325-4368www.coloniallife.commyuhc.com877-797-8812888-400-9304