De ar Fo r me r M AT R IX Te a mm at e,
I h op e y ou r e xp e ri e nce w it h M A TR IX wa s p r o d ucti ve an d e n joy a bl e. Bec a use y o u a re no
l on ge r o n o u r p a yr ol l , we ha ve a ss e m ble d t hi s p ac ket f o r yo u t o b et ter u n de rst a n d h o w yo ur
MA T RI X b en ef it co ve r ag e w il l b e a ffe cte d by y ou r p e r ma n en t o r t e mp or a ry sep a r ati o n fr om
ou r Co mp a ny. I f yo u we re e n rol l e d as a n ac tive e mp l oye e i n a ny o f t h e b en ef it p la n s o n the
d ate of y ou r te r mi n ati on , yo u ma y b e a ble t o co nt i nu e th e co ve ra ge . Pl ea se re a d th e
encl os e d in f or m ati o n, a n d feel fr ee to c o nt ac t us i f yo u h a ve a ny q u esti o ns.
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ME DI CAL /D ENT AL I N S URA NC E: If y o u we re e n rolle d i n t he Me di c al/ Vis io n o r
De nt al Pl an s, c ove r ag e w il l re m ai n i n e ff ect u ntil t he l ast d ay o f t he mo nt h i n w hi ch
yo ur acti ve, ful l -ti me e mp l oy me nt e n ds. If y o u a re re hi re d a t M AT R I X w ith in n in et y
(9 0) d ay s o f yo u r te rm in ati o n da te, y ou m ay re - en te r th ese p l a ns w ith t he sa me
cove r ag e yo u ha d p rev io usl y o n t h e d at e of y o u r r e hi re, an d t he n or m al w ait i ng
p eri o d w il l b e w ai ve d.
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COB RA : Y ou wil l r ece ive C OBR A i n fo r m ati o n f ro m Disc ov er y Be ne fit s wi th i n 3 0
d ays of y o ur te r mi n at i on d ate. I f yo u el ect t o c o nti n ue y o ur Me di c al/ Vis io n o r
De nt al co ve ra ge u n de r C OBR A, y o u m u st n o t ify Disc ov er y Be ne fit s with in si xt y (6 0)
da y s fr o m t he da te o f yo ur q u alif yi n g C O BR A eve nt , o r th e d at e of y ou r not if ica ti on
lette r, w h ic hev er i s l at er. T he co st o f t he C OB R A p re mi u m i s 1 02 % o f t he to tal
gr o up p ol i cy p r em i um.
If y o u d o n ot r ece ive y ou r C OB RA e n roll m en t i nf o r mat io n f r o m Di sc ove ry Be n efi ts
wit h in 30 d ays of y o ur te r mi n ati o n d at e, p le a se co nt act t he m at 8 6 6 - 4 5 1- 33 9 9. Y o u
m ay al so e n rol l fo r C O BR A o nl i ne, t h ro u g h th eir we b site .
O nce y o ur acc ou nt h as bee n s et up , yo u m a y p ay y ou r C OB RA p re mi u ms o nl in e,
rev ie w yo u r p a ym e nt a n d ac co u nt h ist o ry.
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BAS IC LI FE I NS U R AN CE : If y o u e nr olle d i n t he Li fe In s ur a nce Pl a n, co ve ra ge will
re m ai n i n ef fect t h ro u g h y o u r l as t d ay wit h MA T RI X. Th e L if e I ns ur a nc e Pla n do es
h ave a c o nv er si on op ti on i f y ou we re acti vely a t w or k o n t he d ate y ou r e mp l oy me nt
en d e d. Y o u m us t c o m p l ete a n ap p lic ati o n a n d ap p ly f or t he se op ti o ns w ith in 3 1 d ay s
of y ou r c ove r ag e te rm i n ati o n. T o o bt a in a n a p p lica tio n , p l ea se co n t a ct P r u de nti al a t
80 0- 7 78 -3 8 27. Pl e a se not e: C o nv er si on p oli cies do n ot co nt ai n t h e s a me fe at ur es
no r t he s a me rat es.
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O PTI ONA L LI FE I NS U RA NCE : If y ou e n r olle d i n t he Op ti o nal L ife Pla n, c ove r ag e w ill
re m ai n i n ef fect u ntil t he l ast d ay o f yo u r f ull -ti me e mp l oy me nt. T h is Pl an i s
p or ta bl e a n d m ay be t ak e n wi th y o u o nce y o ur e mp l oy me n t en d s. I f yo u a re
MA T RI X Re so u rce s
int er est e d i n p or ti n g y ou r co ve r ag e, yo u mu s t c om p lete a n ap p l ica ti on a n d ap p ly fo r
the se op ti on s w i thi n 3 1 d ay s o f yo u r c ov er a g e t er mi n at io n. To o bt ai n a n a p p lic ati o n,
p lea se co nt act P r u de n tial at 8 0 0 - 77 8- 3 82 7.
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40 1( k) : I f yo u w er e e n rol l e d in t he M AT RI X Res o urc es, I nc. 4 01 ( k) Pla n a n d wo ul d
like t o ta ke a dist r i bu ti on of y o ur f u n ds , p l e a se co nt act T. Ro we P ri ce at 8 8 8 - 44 542 2 6 to i ni ti ate a p ap e rl es s dist r i b ut io n. Y ou ma y r ollov er y o ur acc ou nt t o a n I R A o r
int o y ou r f ut u re e mp l o yer 's p l an (if y o ur f ut u re p la n allo w s). Ple as e clic k h er e to
vie w yo u r op t io n s. Pl ea s e no t e, a $ 20 p e r q uar t er t erm e d p art ic i p ant f e e will b e
ap pl ie d to yo ur a cco u nt o n th e fi r st of th e q uar t er follow in g two - f ull qu art e r s aft e r
te rm i na tio n f rom MAT RI X. Te r mi n ate d p a rti cip a nt s w it h a bal a nce less t h an $1 ,0 0 0
will be au to m atic al l y d ist ri b ute d wit hi n 60 (si xty ) da ys.
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HS A : If y o u p a rt icip at ed i n t he Aet n a H S A, y ou m ay co nt i nu e to ho ld y ou r f u n ds i n
the H SA as l o n g a s yo u w is h ( fee s ap p l y fo r m ai nt ai ni n g yo u r b al a n ce o nce y ou r
emp l oy me nt e n d s). I f yo u w o ul d l ik e t o clo s e y o ur Aet n a HS A o r m ove y o ur f u n d s t o
a n ew H SA , p l ea s e c al l A et n a at 80 0 - 36 4- 2 3 86.
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FS A s : T h ese p l a ns wil l te r mi n ate o n t he d ay i n w hi ch y o ur full -ti m e emp l oy me nt
en d s. Y o u m ay s u b mi t cl ai ms f o r eli gi ble e xp en ses i nc u rr e d th r o ug h yo u r la st da y of
emp l oy me nt onl y. Y o u ha ve 9 0 da ys f ollo w in g yo u r te rm i na ti on fr o m M A TR IX t o
su b mi t cl a im s i nc ur re d w h il e y ou we re p art ici p ati n g. Fo r qu est io n s a bo ut y o ur
acc ou nt , p l ea se c al l C BIZ at 8 0 0 - 81 5- 3 02 3.
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VO LUN TA RY S H O RT - TE R M DI S ABI LIT Y P O LICIES : I f yo u we re e n rolle d i n t he
C olo ni al Pl a n, y ou r co ver a ge will t erm in at e t hi r ty - on e ( 3 1) d ay s f ol low i ng y o ur f ull tim e e mp l o ym e nt te r m in ati o n da te. T he P ru d ent ial Di sa b ilit y Pla n e n ds at m i d ni gh t
on y o ur l ast d ay o f e m p l oy me nt an d i s n ot p o rt a ble.
Th e C ol on ial Pl a n i s p o rt a bl e. I f y o u w o ul d l i ke to e x erc is e y o u r p o rt a bili ty op t i o n,
p lea se co nt act C ol o ni a l Li fe I n su r a nce at 7 70 -6 49 -1 4 07 w ith in th ir t y ( 30 ) da y s o f
yo ur ful l -ti me e mp l oy me nt te r mi n ati o n da te.
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O PTI ONA L L ON G -TE R M DI S ABI LITY : I f yo u we re e n roll e d in t he U N UM or Ma ss
M ut ual L on g - Te r m D is a bil i ty Pl a ns, y o u m ay p or t t h is co ve ra ge by calli n g U N UM or
Ma ss Mu tu al wit hi n 30 da ys o f yo u r sep a r ati on d ate. Y ou m ay co n tin u e t h e sa m e
p re mi u m co st, b ut w il l h ave t he op ti o n t o be bill e d m o nt hly o r h a ve y ou r ba n k
acc ou nt a uto m at ic al l y ch ar ge d. Y ou r c ove r a ge w ill re m ai n i n f o rce u n ti l yo u r
p ay me nt s ce ase. I f y o u w er e en r olle d i n t he Pr u de nt ial Dis a b ility P la n, t his c ove r ag e
will e n d a t mi d n ig ht o n yo u r l a st da y of e mp loy me nt an d i s n ot p o r ta ble. I f
int er est e d, p l e ase c al l U NU M a t 7 70 -3 9 2- 32 17 , o r M ass M ut ual at 80 0 - 7 67 -1 0 00
(p r ess 3 , a n d t he n 3 a g ai n ).
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O PTI ONA L L ON G -TE R M CA R E: I f yo u el ecte d Lo n g - Te r m C a re co v er ag e a n d w o ul d
like t o co nt in u e t h e p o l icy a fte r yo u le av e M AT R IX, y o u sh o ul d co n tact Jo h n H a nc oc k
MA T RI X Re so u rce s
at 8 0 0- 48 2- 0 02 2 w it hi n t hi rty ( 3 0) d ays of y ou r M A TR IX t er mi n at i on d ate a n d
re q ue st th at y o u b e d i rect bil l e d fo r y o ur p ol icy g oi n g fo r w ar d.
If y o u d o n ot co n tac t J oh n H an coc k a n d y o u stop s u b mi tti n g yo u r i ns u ra nc e
p re mi u ms , yo u r c ov er a ge w il l e n d at t he e n d of t he mo nt h i n wh ic h yo u te rm i na te
emp l oy me nt.
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O PTI ONA L PR E - PAI D LE GA L A N D/O R I DE N TITY T HEF T P R OTE CT ION : I f yo u
electe d t he P re -P ai d L eg al a n d/ or I de nti ty T he ft p r ote cti o n c ov er a ge a n d wo ul d li ke
to co nt in u e t h e p ol ic y af te r y o u le ave MA T RI X, yo u s h oul d c o nt act De a n Yo u n g at
40 4- 8 05 -5 5 58 w ith in thi rty ( 30 ) da y s of y o u r M AT R IX te r mi n ati o n d ate.
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UNE M P LO Y ME NT BE NEFI TS : W h en y o u r a ssi g n me nt is ove r w it h M A TR IX , a n d yo u
ar e n ot i m me di at el y p l ace d o n a not h er ass ig n me nt , y o u a re el ig i ble to fil e fo r
u ne mp lo y me nt be ne fit s. T hi s s ho ul d be do n e t h ro u g h yo u r re sp ect ive st at e
u ne mp lo y me nt o ff ice. I n ma n y st ate s, yo u w ill be a ble t o file o nli n e; i n ot he r st ate s,
yo u wil l ne e d to f il e i n p e rs o n at t he lo cal of f ice i n yo u r a re a. Yo u will be as ke d to
p ro vi de y o ur d ate s o f emp l oy me nt , n a me o f emp l oye r ( M AT R IX R es ou rc es, Inc. ) a n d
the re as o n yo u r e mp l o ym en t en d e d. O nce y ou r cl ai m is f ile d, M AT RI X will be
no ti fie d t o re sp o n d t o yo ur cl ai m an d v er if y t he i n fo r ma ti on y o u h a ve p r ovi d e d.
N O TE : Whe n f il in g a cl ai m, yo u wi ll n ot be re q ui red t o p ro vi de d ocu m en t at io n f ro m M A T R IX
ind ic a ti n g t h a t yo u r a s s ig n men t h a s e nde d .
Un d er n o c irc u m st an ce s d oes t he de cis io n t o p ay o r de ny be ne fit s f all to MA TR I X. E ac h
sta te w ill m a ke it s o w n dete r mi n ati o n, b ase d o n sp eci fic st at e g ui d eli nes a n d t h e f acts as
p res e nte d by bo th t h e cl ai m a nt (y o u) a n d th e fo r me r e mp loy er (M A T RI X).
Sh o ul d yo u ha ve a n y q ue sti o ns o n t he a b ov e in fo r m ati o n, p le ase fe el fr ee to c o nt act t he
MA T RI X Be ne fit s Dep a rt me nt at 8 00 -3 8 2- 55 33. W e wi s h yo u mu c h luc k i n yo u r ca r ee r
en d ea vo rs.
Si nce rely ,
S us an ne B a s ki n
Ben ef its Ma n a ge r
MA T RI X Re so u rce s, I n c.
MA T RI X Re so u rce s