Benefits
Summary
Learn about your 2016 Benefit Programs, part of your Sprint Total Rewards.
1
Total Rewards
Well-being and happiness…
Sprint Total Rewards include everything you get back
for the time, talent and effort you give the company
every day. Visit the Sprint Total Rewards site to find a
personalized view of your benefits “big picture” and
to better understand the full offerings that come with
your Sprint employment. You’ll also find details that
help explain the value of your pay, health care coverage,
wireless discounts, 401(k) plan and much more. Data is
updated about every 30 days.
Go to: sprint.com/mytotalrewards
Note to new hires: It may take as long as 60 days from
your benefit effective date to populate your personal
online Total Rewards statement.
Note: This guide is designed to provide highlights of your
2016 benefits package; not every provision of each program is
included. If there are any conflicts between this guide and the
official plan documents, the plan documents will govern.
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What’s Inside
Your Enrollment Window Discounts for Living a Healthier Life Castlight Health to Better Enable Health Consumers Employee and Dependent Eligibility Medical/prescription Drug Costs Medical and Prescription Drug Coverage Health Savings Accounts - The Rules Dental Vision Flexible Spending Accounts (FSA) Life Insurance Accidental Death & Dismemberment Insurance Disability Group Legal Plan Retirement and Wealth Educational Assistance Discount and Other Programs Time Away from Sprint Helpful Contact Information 3
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Important Legal Information Women’s Health and Cancer Rights Act of 1998
Newborns’ and Mothers’ Health Protection Act COBRA HIPAA Privacy Notice > Your Rights > Additional Information About This Notice Other Legal Information 35
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Your Enrollment Window
Existing Employees Annual Enrollment
If you do not actively enroll in or waive certain
coverage during your annual enrollment window,
you will automatically receive the coverage you
have today, if available, for as long as your current
benefits remain in effect for the next year. Please
refer to your online annual enrollment materials
for changes and actions needed. This means that
the applicable benefit deductions will be taken
from your paycheck and you will not be able to
enroll in any other coverage unless you have a
qualifying life event.
NOTE: You must re-enroll in flexible spending
accounts (FSA) each calendar year as the FSA do
not carry forward.
You must also designate your medical surcharge if
you are covering a spouse or domestic partner on
a Sprint Medical plan each year.
New Hire Enrollment
If you are newly hired (or rehired more than
30 days after your prior Sprint employment
ended), you must actively enroll in or waive
coverage. Most benefits are effective on the 30th
consecutive calendar day after your date of hire.
If you do NOT enroll in or waive certain coverage
during the 30-day waiting period, you will receive
the following coverage effective on the 30th
calendar day after your hire/rehire date:
Medical/Prescription Drug:
• Plan: Health Account Plan at new hire premiums
• Coverage level: Employee only
(no dependents)
Life and AD&D Insurance:
• Coverage amount: $10,000
• Coverage level: Employee only
Changing your elections during the year
Your benefits elections are binding through Dec. 31, 2016, except for changes allowable
or required in connection with a qualifying life or employment event. These are changes in your family
such as birth, adoption, marriage, divorce, death of a dependent or change in employment status of you
or your spouse/domestic partner. As a general rule, if you have a qualifying life or employment event that
impacts your benefit needs, you must make a request for changes no later than the thirtieth calendar day
after the event. All life event requests are made through the Sprint Employee Help Line.
For complete details regarding qualifying life and employment events, how to make changes to your
benefits and your beneficiary designations outside of your normal enrollment period, and the dates
when benefits changed during the year will become effective, go to i-Connect > Life & Career > Life and
Employee Events.
3
What makes me
benefit eligible?
Am I regularly scheduled to work
20+ hours per week for Sprint?
Yes? Congrats! You have 30 calendar days
from your hire date/re-hire date or date you
become benefit eligible to make elections.
Note: Some of the plans and per-paycheck premium
costs provided in this guide are for employees who
are scheduled to work 30 or more hours per week.
Where different, those per-paycheck premium costs
for employees working 20 to 29 hours per week are
published in the online enrollment system.
Discounts for a Healthier Life
Healthy Living Discount (HLD) for Medical/Prescription Drug premiums
During the year an employee must complete/affirm Sprint’s Healthy Actions under the Healthy Living Discount
by a specified deadline. Type HLD in your i-Connect browser for more details.
Extra Healthy Rewards!
Tobacco-free discount for Life Insurance
Sprint also offers a tobacco-free discount on Employee and Spouse/Domestic Partner Life Insurance. For Sprint Life
Insurance plans, a “tobacco user” is anyone who at any point during the coverage period uses a tobacco product such
as cigars, cigarettes or chewing tobacco.
For Sprint Life Insurance plans, tobacco status is based upon the covered individual (employee, spouse or domestic
partner), not the household. When enrolling in Employee and/or Spouse/Domestic Partner Life Insurance coverage, you
must select the appropriate option based on the covered individual’s tobacco status.
Castlight Health
The health care system can be complex and confusing, but Castlight makes it easier to use.
These three simple facts will help you get more out of your health care benefits:
1. It pays to shop around — a procedure, like an MRI, can have a huge price difference just in your town!
2.Better care doesn’t have to be expensive — prices for health care are not based on your doctor’s education or ability, but
sometimes based on the size of the practice they are in.
3.YOU are in charge ­— get all of your options and then make an informed decision.
Castlight Health provides the tool you need to make smart health care decisions for you and your family. Take charge today!
https://mycastlight.com/sprint/
Castlight Health is available to members of all the Sprint health plans except Kaiser and TRICARE.
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Employee and Dependent Eligibility
When enrolling in Sprint benefits, you can cover yourself and eligible members of your family (as described below).
Who qualifies as my dependent(s)?
• Your spouse – the person to whom you are legally married.
• Domestic partner (same or opposite sex)*
• Your child from until age 26 including:
- your spouse’s or your domestic partner’s* biological, legally adopted or
step child; or
- placed for adoption or otherwise placed by court order or placement
agency (e.g., foster children, under legal guardianship) with you, your
spouse or your domestic partner; or
- an “alternate recipient” pursuant to a Qualified Medical Child Support
Order (QMCSO), as determined by the Plan Administrator.
• Disabled children – your, your spouse’s or your domestic partner’s
biological or legally adopted child who was covered under a Sprint benefit
plan immediately prior to age 26 and who is permanently and totally
disabled.
• Your domestic partner’s children may be enrolled only if the domestic
partner is also enrolled.
Get the details at: i-Connect > Life & Career to review Summary Plan
Descriptions and Dependent Eligibility Verification Processes.
* Domestic partner – your same- or opposite-sex partner for so long as
you both: are at least 18 years old and legally competent to consent to the
domestic partner relationship; are not related to each other by blood; are
in an exclusive committed relationship similar to marriage and intend to
remain so indefinitely; are not married to each other or any other person;
have not ended a marriage or domestic partnership with each other or any
other person for at least 12 months; have resided together continuously
for at least 12 months and intend to reside together indefinitely; share joint
responsibility for each other’s common welfare and/or financial obligations;
and are not domestic partners for the sole purpose of obtaining Sprint
benefits. (Note: Employees in a California HMO may also enroll an individual
meeting California requirements for a Domestic Partner.) Costs for Medical/
Prescription Drug, Dental and Vision coverage for domestic partners and
domestic partners’ child(ren) may differ from those listed in the summary.
These costs are after-tax. Also, the employer-provided cost of your
domestic partner’s coverage is considered taxable income. You will be
subject to the federal, state, local and FICA tax withholdings.
5
Eligibility for families with more than one
Sprint employee
• You cannot be covered as both a Sprint employee and the dependent of
a Sprint employee under the Medical/Prescription Drug, Dental or Vision
plans.
• None of your dependents can be covered by both you and another Sprint
employee under the Medical/Prescription Drug, Dental or Vision plans.
• You may be insured as both an employee and the spouse/domestic
partner of an employee under the Employee and Spouse/Domestic Partner
Life Insurance plans.
• If both you and your spouse/domestic partner are Sprint employees, you
both may elect Dependent Life Insurance for the same eligible dependent
children.
NOTICE:
Enrolling, attempting to enroll or
maintaining enrollment for ineligible
persons is considered misrepresentation
or fraud, which is prohibited by the
Sprint benefit plans and will result in
consequences including, but not limited
to, repayment of plan benefits paid and
discipline up to and including termination.
Medical Surcharge
Medical/Prescription Drug Premiums
Individual per-paycheck deductions for Medical/Prescription Drug plans are based on your Benefits Eligible Earnings. Your
“Benefits Eligible Earnings” is defined as your annual base pay plus any targeted incentives or commissions for which you
are eligible. Benefits are taken out of 24 paychecks during the calendar year although Sprint will have 26 pay periods.
These deductions are withheld before taxes except for domestic partner dependent coverage. If you are scheduled to
work part time 20-29 hours per week, costs are available online when you make elections or i-Connect >Life & Career. To
use this chart, find your Benefits Eligible Earnings column and look at the appropriate cost for the plan of your choice.
A medical surcharge of $75 semi-monthy will be
charged when your spouse (SP) or domestic partner
(DP) has access to medical/prescription drug
benefits at their work place and you have enrolled
them in Sprint medical. For more details, go to
i-Connect > Life & Career or sprint.com/benefits to
review FAQs. Sprint may audit at any time.
Living Well Plus: 2016 Medical/Prescription Drug Premiums
< $40,000
$40,000 - $69,999
$70,000 - $99,999
$100,000 $149,999
> =$150,000
Employee Only
$22.00
$33.00
$44.00
$55.00
$71.00
Employee + Spouse/Domestic Partner
$51.00
$77.00
$102.00
$128.00
$165.00
Employee + Child(ren)
$47.60
$71.40
$95.20
$119.00
$153.80
Employee + Family
$79.60
$119.40
$159.20
$199.00
$257.80
Employee Only
$36.00
$49.00
$62.00
$77.00
$94.00
Employee + Spouse/Domestic Partner
$84.00
$115.00
$145.00
$180.00
$219.00
Employee + Child(ren)
$78.60
$107.40
$135.20
$168.00
$204.80
Employee + Family
$131.60
$179.40
$226.20
$281.00
$342.80
Employee Only
$12.00
$17.00
$23.00
$31.00
$42.00
Employee + Spouse/Domestic Partner
$28.00
$39.00
$53.00
$72.00
$97.00
Employee + Child(ren)
$25.60
$35.40
$47.20
$64.00
$86.80
Employee + Family
$42.60
$57.40
$77.20
$104.00
$141.80
Employee Only
$25.20
$34.30
$43.40
$53.90
$65.80
Employee + Spouse/Domestic Partner
$58.80
$80.50
$101.50
$126.00
$153.30
Employee + Child(ren)
$55.02
$75.18
$94.64
$117.60
$143.36
Employee + Family
$92.12
$125.58
$158.34
$196.70
$239.96
Employee Only
$35.00
$49.00
$60.00
$74.00
$92.00
Employee + Spouse/Domestic Partner
$82.00
$114.00
$139.00
$172.00
$213.00
Employee + Child(ren)
$76.60
$106.40
$130.20
$161.00
$198.80
Employee + Family
$128.60
$178.40
$217.20
$269.00
$332.80
Benefits Eligible Earnings
H E ALT H AC C O U N T P L AN
C O N SU M E R AC C ESS P L AN
BAS I C PL AN
A E T N A W H O L E H E A LT H
K AI S E R PE R M AN E NTE (GEORGI A)
6
Living Well Plus: 2016 Medical/Prescription Drug Premiums cont.
< $40,000
$40,000 - $69,999
$70,000 - $99,999
$100,000 $149,999
> =$150,000
Employee Only
$38.00
$52.00
$64.00
$79.00
$97.00
Employee + Spouse/Domestic Partner
$87.00
$121.00
$148.00
$183.00
$226.00
Employee + Child(ren)
$81.60
$113.40
$138.20
$171.00
$211.80
Employee + Family
$136.60
$189.40
$231.20
$286.00
$353.80
Benefits Eligible Earnings
K AI S E R PE R M AN E NTE (COLOR AD O)
K AI S E R PE R M AN E NTE (NORTHE R N CALI FOR NI A)
Employee Only
$42.00
$58.00
$70.00
$87.00
$108.00
Employee + Spouse/Domestic Partner
$96.00
$134.00
$163.00
$202.00
$250.00
Employee + Child(ren)
$90.60
$125.40
$152.20
$189.00
$233.80
Employee + Family
$150.60
$209.40
$255.20
$316.00
$390.80
K AI S E R PE R M AN E NTE (SOU THE R N CALI FOR NI A)
Employee Only
$21.00
$29.25
$36.00
$45.00
$51.00
Employee + Spouse/Domestic Partner
$49.50
$68.25
$83.25
$103.50
$118.50
Employee + Child(ren)
$46.20
$64.05
$78.15
$96.75
$110.85
Employee + Family
$76.95
$106.80
$129.90
$161.25
$185.10
Employee Only
$25.00
$25.00
$25.00
$25.00
$25.00
Employee + Spouse/Domestic Partner
$57.00
$57.00
$57.00
$57.00
$57.00
Employee + Child(ren)
$52.60
$52.60
$52.60
$52.60
$52.60
Employee + Family
$87.60
$87.60
$87.60
$87.60
$87.60
Employee Only
$37.00
$51.00
$62.00
$77.00
$95.00
Employee + Spouse/Domestic Partner
$85.00
$118.00
$144.00
$187.00
$220.00
Employee + Child(ren)
$79.60
$110.40
$134.20
$166.00
$205.80
Employee + Family
$132.60
$184.40
$224.20
$278.00
$343.80
Employee Only
$33.50
$33.50
$33.50
$33.50
$33.50
Employee + Spouse/Domestic Partner
$66.00
$66.00
$66.00
$66.00
$66.00
Employee + Child(ren)
$66.00
$66.00
$66.00
$66.00
$66.00
Employee + Family
$89.00
$89.00
$89.00
$89.00
$89.00
K AI S E R PE R M AN E NTE (HAWAI I )
K AI S E R PE R M AN E NTE (MI D -AT L ANTI C)
T R I CAR E
7
Living Well: 2016 Medical/Prescription Drug Premiums
Special Note: For new hires/rehires and newly benefit eligible (ex. life event), Living Well Premiums apply to your medical/prescription drug premiums.
< $40,000
$40,000 - $69,999
$70,000 - $99,999
$100,000 $149,999
> =$150,000
Employee Only
$33.00
$44.00
$55.00
$66.00
$82.00
Employee + Spouse/Domestic Partner
$71.00
$97.00
$122.00
$148.00
$185.00
Employee + Child(ren)
$65.60
$89.40
$113.20
$137.00
$171.80
Employee + Family
$106.60
$146.40
$186.20
$226.00
$284.40
Employee Only
$47.00
$60.00
$73.00
$88.00
$105.00
Employee + Spouse/Domestic Partner
$104.00
$135.00
$165.00
$200.00
$239.00
Employee + Child(ren)
$96.60
$125.40
$153.20
$186.00
$222.80
Employee + Family
$158.60
$206.40
$253.20
$308.00
$369.80
Employee Only
$23.00
$28.00
$34.00
$42.00
$53.00
Employee + Spouse/Domestic Partner
$48.00
$59.00
$73.00
$92.00
$117.00
Employee + Child(ren)
$43.60
$53.40
$65.20
$82.00
$104.80
Employee + Family
$69.60
$84.40
$104.20
$131.00
$168.80
Employee Only
$36.20
$45.30
$54.40
$64.90
$76.80
Employee + Spouse/Domestic Partner
$78.80
$100.50
$121.50
$146.00
$173.30
Employee + Child(ren)
$73.02
$93.18
$112.64
$135.60
$161.36
Employee + Family
$119.12
$152.58
$185.34
$223.70
$266.96
Employee Only
$46.00
$60.00
$71.00
$85.00
$103.00
Employee + Spouse/Domestic Partner
$102.00
$134.00
$159.00
$192.00
$233.00
Employee + Child(ren)
$94.60
$124.40
$148.20
$179.00
$216.80
Employee + Family
$155.60
$205.40
$244.20
$296.00
$359.80
Benefits Eligible Earnings
H E ALT H AC C O U N T P L AN
S PR I N T C O N SU M ER ACCESS P L AN
BAS I C PL AN
A E T N A W H O L E H E A LT H
K AI S E R PE R M AN E NTE (GEORGI A)
8
Living Well: 2016 Medical/Prescription Drug Premiums cont.
Special Note: For new hires/rehires and newly benefit eligible (ex. life event), Living Well Premiums apply to your medical/prescription drug premiums.
< $40,000
$40,000 - $69,999
$70,000 - $99,999
$100,000 $149,999
> =$150,000
Employee Only
$49.00
$63.00
$75.00
$90.00
$108.00
Employee + Spouse/Domestic Partner
$107.00
$141.00
$168.00
$203.00
$246.00
Employee + Child(ren)
$99.60
$131.40
$156.20
$189.00
$229.80
Employee + Family
$163.60
$216.40
$258.20
$313.00
$380.80
Benefits Eligible Earnings
K AI S E R PE R M AN E NTE (COLOR AD O)
K AI S E R PE R M AN E NTE (NORTHE R N CALI FOR NI A)
Employee Only
$53.00
$69.00
$81.00
$98.00
$119.00
Employee + Spouse/Domestic Partner
$116.00
$154.00
$183.00
$222.00
$270.00
Employee + Child(ren)
$108.60
$143.40
$170.20
$207.00
$251.80
Employee + Family
$177.60
$236.40
$282.20
$343.00
$417.80
K AI S E R PE R M AN E NTE (SOU THE R N CALI FOR NI A)
Employee Only
$29.25
$37.50
$44.25
$53.25
$59.25
Employee + Spouse/Domestic Partner
$64.50
$83.25
$98.25
$118.50
$133.50
Employee + Child(ren)
$59.70
$77.55
$91.65
$110.25
$124.35
Employee + Family
$97.20
$127.05
$150.15
$181.50
$205.35
Employee Only
$25.00
$25.00
$25.00
$25.00
$25.00
Employee + Spouse/Domestic Partner
$57.00
$57.00
$57.00
$57.00
$57.00
Employee + Child(ren)
$52.60
$52.60
$52.60
$52.60
$52.60
Employee + Family
$87.60
$87.60
$87.60
$87.60
$87.60
Employee Only
$48.00
$62.00
$73.00
$88.00
$106.00
Employee + Spouse/Domestic Partner
$105.00
$138.00
$164.00
$198.00
$240.00
Employee + Child(ren)
$97.60
$128.40
$152.20
$184.00
$223.80
Employee + Family
$159.60
$211.40
$251.20
$305.00
$370.80
Employee Only
$33.50
$33.50
$33.50
$33.50
$33.50
Employee + Spouse/Domestic Partner
$66.00
$66.00
$66.00
$66.00
$66.00
Employee + Child(ren)
$66.00
$66.00
$66.00
$66.00
$66.00
Employee + Family
$89.00
$89.00
$89.00
$89.00
$89.00
K AI S E R PE R M AN E NTE (HAWAI I )
K AI S E R PE R M AN E NTE (MI D -AT L ANTI C)
T R I CAR E
9
No Discount: 2016 Medical/Prescription Drug Premiums
< $40,000
$40,000 - $69,999
$70,000 - $99,999
$100,000 $149,999
> =$150,000
Employee Only
$44.00
$55.00
$66.00
$77.00
$93.00
Employee + Spouse/Domestic Partner
$91.00
$117.00
$142.00
$168.00
$205.00
Employee + Child(ren)
$83.60
$107.40
$131.20
$155.00
$189.80
Employee + Family
$133.60
$173.40
$213.20
$253.00
$311.80
Employee Only
$58.00
$71.00
$84.00
$99.00
$116.00
Employee + Spouse/Domestic Partner
$124.00
$155.00
$185.00
$220.00
$259.00
Employee + Child(ren)
$114.60
$143.40
$171.20
$204.00
$240.80
Employee + Family
$185.60
$233.40
$280.20
$335.00
$396.80
Employee Only
$34.00
$39.00
$45.00
$53.00
$64.00
Employee + Spouse/Domestic Partner
$68.00
$79.00
$93.00
$112.00
$137.00
Employee + Child(ren)
$61.60
$71.40
$83.20
$100.00
$122.80
Employee + Family
$96.60
$111.40
$131.20
$158.00
$195.80
Employee Only
$47.20
$56.30
$65.40
$75.90
$87.80
Employee + Spouse/Domestic Partner
$98.80
$120.50
$141.50
$166.00
$193.30
Employee + Child(ren)
$91.02
$111.18
$130.64
$153.60
$179.36
Employee + Family
$146.12
$179.58
$212.34
$250.70
$293.96
Employee Only
$57.00
$71.00
$82.00
$96.00
$114.00
Employee + Spouse/Domestic Partner
$122.00
$154.00
$179.00
$212.00
$253.00
Employee + Child(ren)
$112.60
$142.40
$166.20
$197.00
$234.80
Employee + Family
$182.60
$232.40
$271.20
$323.00
$386.80
Benefits Eligible Earnings
H E ALT H AC C O U N T P L AN
C O N SU M E R AC C ESS P L AN
BAS I C PL AN
A E T N A W H O L E H E A LT H
K AI S E R PE R M AN E NTE (GEORGI A)
Medical Surcharge
A medical surcharge of $75 semi-monthy will be charged when
your spouse (SP) or domestic partner (DP) has access to medical/
prescription drug benefits at their work place and you have enrolled
them in Sprint medical. For more details, go to i-Connect > Life & Career
or sprint.com/benefits to review FAQs. Sprint may audit at any time.
10
No Discount: 2016 Medical/Prescription Drug Premiums cont.
< $40,000
$40,000 - $69,999
$70,000 - $99,999
$100,000 $149,999
> =$150,000
Employee Only
$60.00
$74.00
$86.00
$101.00
$119.00
Employee + Spouse/Domestic Partner
$127.00
$161.00
$188.00
$223.00
$266.00
Employee + Child(ren)
$117.60
$149.40
$174.20
$207.00
$247.80
Employee + Family
$190.60
$243.40
$285.20
$340.00
$407.80
Benefits Eligible Earnings
K AI S E R PE R M AN E NTE (COLOR AD O)
K AI S E R PE R M AN E NTE (NORTHE R N CALI FOR NI A)
Employee Only
$64.00
$80.00
$92.00
$109.00
$130.00
Employee + Spouse/Domestic Partner
$136.00
$174.00
$203.00
$242.00
$290.00
Employee + Child(ren)
$126.60
$161.40
$188.20
$225.00
$269.80
Employee + Family
$204.60
$263.40
$309.20
$370.00
$444.80
K AI S E R PE R M AN E NTE (SOU THE R N CALI FOR NI A)
Employee Only
$37.50
$45.75
$52.50
$61.50
$67.50
Employee + Spouse/Domestic Partner
$79.50
$98.25
$113.25
$133.50
$148.50
Employee + Child(ren)
$73.20
$91.05
$105.15
$123.75
$137.85
Employee + Family
$117.45
$147.30
$170.40
$201.75
$225.60
Employee Only
$25.00
$25.00
$25.00
$25.00
$25.00
Employee + Spouse/Domestic Partner
$57.00
$57.00
$57.00
$57.00
$57.00
Employee + Child(ren)
$52.60
$52.60
$52.60
$52.60
$52.60
Employee + Family
$87.60
$87.60
$87.60
$87.60
$87.60
Employee Only
$59.00
$73.00
$84.00
$99.00
$117.00
Employee + Spouse/Domestic Partner
$125.00
$158.00
$184.00
$218.00
$260.00
Employee + Child(ren)
$115.60
$146.40
$170.20
$202.00
$241.80
Employee + Family
$186.60
$238.40
$278.20
$332.00
$397.80
Employee Only
$33.50
$33.50
$33.50
$33.50
$33.50
Employee + Spouse/Domestic Partner
$66.00
$66.00
$66.00
$66.00
$66.00
Employee + Child(ren)
$66.00
$66.00
$66.00
$66.00
$66.00
Employee + Family
$89.00
$89.00
$89.00
$89.00
$89.00
K AI S E R PE R M AN E NTE (HAWAI I )
K AI S E R PE R M AN E NTE (MI D -AT L ANTI C)
T R I CAR E
11
Medical/Prescription Information
Medical Surcharge
A medical surcharge of $75 semi-monthly will be charged when your spouse (SP) or domestic partner (DP) has access to
medical/prescription drug benefits at their work place and you have enrolled them in Sprint medical.
For more details, go to i-Connect > Life & Career or sprint.com/benefits to review FAQs. Sprint may audit at any time.
Waive Sprint Medical/Prescription Drug Coverage:
You receive an annual credit of $600 (prorated for newly hired/re-hired employees based on when benefit eligibility starts).
Medical Plans
(includes prescription drug coverage)
For a detailed view, please read the Summary Plan Descriptions (SPDs)
and Summaries of Benefit Coverage (SBC) at i-Connect > Life & Career and
sprint.com/benefits. The plans are designed to fit a variety of needs,
meaning that there’s a plan out there that’s best for you!
• Sprint’s Self-insured Plans –administered by Aetna, BlueCross and
BlueShield of Illinois (BCBSIL) or United HealthCare (UHC) based on your
home state. See chart for the administrator available in your area. See
Medical/Prescription Drug Plan Comparison Chart for more details.
• Health Maintenance Organizations (HMOs) – available in some regions
and administered by Kaiser Permanente. More details on Kaiser medical
options, please refer to the plan documents.
• TRICARE Supplement Plan TRICARE is the Department of Defense health
benefit program for the military community. It consists of TRICARE Prime,
TRICARE Extra, TRICARE Standard, and TRICARE Reserve Select (TRS).
12
Washington DC
Aetna
BCBSIL
UHC
Aetna WholeHealth℠: California locations: Sacramento, Riverside,
Santa Clara. Also: Cincinnati, Ohio; Denver, Colo.
Kaiser: Available in: Hawaii; Also, Northern California; Southern
California; Colorado; Virginia (Mid-Atlantic); Georgia
Military: TRICARE
Medical Administrator — All States
States
Aetna
Arizona, California, Connecticut, New Jersey, New York, Ohio, Oklahoma,
Pennsylvania, Washington
Aetna WholeHealth Plans℠
California: Riverside, Sacramento, Santa Clara
Colorado: Denver
Ohio: Cincinnati
Blue Cross Blue Shield of Illinois (BCBSIL)
Alabama, Delaware, Idaho, Kansas, Louisiana, Michigan, Minnesota, Missouri, New
Mexico, North Carolina, Tennessee, Virginia, Washington, DC, West Virginia
Basic, Health Account and Consumer Access Plans
Basic, Health Account and Consumer Access Plans
United HealthCare (UHC)
Basic, Health Account and Consumer Access Plans
Kaiser
in select regions
13
Alaska, Arkansas, Colorado, Florida, Georgia, Illinois, Indiana, Iowa, Kentucky, Maine,
Massachusetts, Maryland, Mississippi, Montana, Nebraska, New Hampshire, Nevada,
North Dakota, Oregon, Rhode Island, South Carolina, South Dakota, Texas, Utah,
Vermont, Wisconsin, Wyoming
Northern California, Southern California, Colorado, Georgia, Hawaii and Mid-AtlanticVirginia
Summary • Medical/Prescription Drug Coverage
Features
Basic Plan
N E T WO R K /
N O N -N E T WO R K
NET WOR K
Choice of doctor/facility
May use any doctor/facility; however, plan pays higher
benefits with network providers
For preventive medical
services, plan generally
pays…
100% even if deductible
not met (examples: wellchild visits up to age 6
and adult screenings as
defined in the Summary
Plan Description)
N ON -N ET WORK
Routine physical exams,
well-child visits through
age 5 and preventive
screenings for adults
covered at 60% coinsurance of allowable
charges (after
deductible met); other
services not covered
Health Account Plan
Consumer Access Plan
N ET WORK
NE T WO RK
N ON -N ET WOR K
May use any doctor/facility; however, plan pays higher
benefits with network providers
100% even if deductible
not met (examples: wellchild visits up to age 6
and adult screenings as
defined in the Summary
Plan Description)
Routine physical exams,
well-child visits through
age 5 and preventive
screenings for adults
covered at 60%
co-insurance of
allowable charges (after
deductible met); other
services not covered
NO N- NE T WO RK
May use any doctor/facility; however, plan pays higher
benefits with network providers
100% even if deductible
not met (examples: wellchild visits up to age 6
and adult screenings as
defined in the Summary
Plan Description)
Routine physical exams,
well-child visits through
age 5 and preventive
screenings for adults
covered at 60%
co-insurance of
allowable charges (after
deductible met); other
services not covered
Funded 100% by Sprint, your HRA pays for eligible
medical and prescription drug expenses before you
pay anything out of pocket.
HRA amount (pro-rated for partial-year enrollment):
Health Reimbursement
Account (HRA)
Not Available
See Health Savings Account information below.
• $800/employee-only coverage (plus any carryover
HRA funds from prior year)
• $1,600/family coverage tiers (plus any carryover HRA
funds from prior year)
Not Availalbe
For members enrolled in the Health Account Plan
administered by BCBSIL, a debit card will be issued
by ConnectYourCare to apply available HRA funds
towards prescription drug expenses. Available HRA
will be automatically applied to medical claims at the
time they are processed by BCBSIL.
14
The maximum amount you can carry over from year
to year in the Sprint Health Account Plan’s Health
Reimbursement Account is:
$3,000/Individual
$6,000/Family
Not Applicable
$1,900/Individual
$3,800/Family
$1,000/Individual
$2,000/Family
Annual carryover
maximum for plan’s
health-funding account
(HRA)
Not Applicable
Annual deductible
$1,850/Individual
$3,700/Family
Individual or Family deductible
Individual deductible applies only for employee-only coverage.
If enrolled in any coverage level covering dependents, the Family deductible must be met before co-insurance benefits apply.
HRA funds are automatically used to help satisfy the deductible. HSA funds are optional.
$3,700/Individual
$7,400/Family
$3,800/Individual
$7,600/Family
$2,000/Individual
$4,000/Family
Features
Basic Plan
N E T WO R K /
N O N -N E T WO R K
NET WOR K
N ON -N ET WORK
Health Account Plan
Consumer Access Plan
N ET WORK
NE T WO RK
N ON -N ET WOR K
NO N- NE T WO RK
Tax-exempt savings account, which may be opened
by employees enrolled in a designated High
Deductible Health Plan, such as the Basic Plan.
Employees who open a HSA and contribute at least
$24 (spread out equally over their 2016 paychecks)
will receive additional funding from Sprint (provided
in equal increments across 2016 paychecks and prorated for partial-year enrollment):
$500/employee-only coverage
$1,000/family coverage tiers
Health Savings Account (HSA)
Not Available
Not Available
Eligible medical and prescription drug expenses
Eligible medical and prescription drug expenses
Eligible medical and prescription drug expenses
$4,000/Individual
$8,000/Family*
$3,750/Individual
$7,500/Family*
*The Plan contains an
embedded individual
out of pocket limit
within the network
family out of pocket
limit, meaning that if
one family member
incurs network OOP
costs that exceed
$6,850, the Plan will
pay 100% of that family
member’s remaining
network expenses for
the calendar year, even
if the aggregate network
out-of-pocket expenses
of all family members
have not reached the
cost-sharing limit for
family coverage.
*The Plan contains an
embedded individual
out of pocket limit
within the network
family out of pocket
limit, meaning that if
one family member
incurs network OOP
costs that exceed
$6,850, the Plan will
pay 100% of that family
member’s remaining
network expenses for
the calendar year, even
if the aggregate network
out-of-pocket expenses
of all family members
have not reached the
cost-sharing limit for
family coverage.
Members’ 2016 maximum contributions from all
sources (Sprint’s contributions plus member’s
contributions) is:
$3,350/employee-only coverage
$6,750/family coverage tiers
(Employee age 55 or older in 2016, may make an
additional “catch up” contribution of up to $1,000.)
Remaining HSA funds may be used even if you are no
longer in the Sprint Basic Plan or a Sprint employee.
HSAs are subject to federal regulations.
Deductible applies to...
Annual Out-of-Pocket (OOP)
Limit
For non-preventive
medical services, plan
generally pays…
15
80% co-insurance,
after deductible
(you pay 20%)
$8,000/Individual
$16,000/Family
60% co-insurance of
allowable charges, after
deductible (you pay
40%, plus any amounts
over charges)
80% co-insurance,
after deductible
(you pay 20%)
$7,500/Individual
$15,000/Family
$3,400/Individual
$6,800/Family
$6,800/Individual
$13,600/Family
60% co-insurance of
allowable charges, after
deductible (you pay
40%, plus any amounts
over charges)
80% co-insurance,
after deductible
(you pay 20%)
60% co-insurance of
allowable charges, after
deductible (you pay
40%, plus any amounts
over charges)
Features
Basic Plan
N E T WO R K /
N O N -N E T WO R K
NET WOR K
Urgent care, retail
clinics and virtual health visits
where applicable
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Overland Park, Kan., and
Reston, Va., On-Site Campus
Health Centers
Consumer Access Plan
N ON -N ET WORK
N ET WORK
N ON -N ET WOR K
NE T WO RK
NO N- NE T WO RK
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Eligible preventive
services covered at 100%
Other services charged
similar to off-site
doctor’s office visit
N/A
Eligible preventive
services covered at 100%
$10 co-pay for other
services
N/A
Eligible preventive
services covered at 100%
$10 co-pay for other
services
N/A
Specialist care
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Inpatient and outpatient
facilities
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Plan pays 80%
coinsurance, after
deductible
(you pay 20%)
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Emergency-room services
(true emergencies)
Plan pays 80% co-insurance after your co-pay (once
deductible met); you pay 20% co-insurance
Emergency-room services
(non-emergencies – as
determined by plan
administrator)
Plan pays 60% coinsurance after your
co-pay (once deductible
met); you pay 40% coinsurance
Bariatric services
(treatment for obesity)
Member must use a
bariatric Center of
Excellence (if available
within 150 miles)
Plan pays 50%
co-insurance, after
deductible. Your outof-pocket expenses
towards bariatric
services counts toward
your Out-of-Pocket Limit
Note: Specific criteria must
be met to receive coverage;
see Basic Plan Summary
Plan Description for more
information.
16
Health Account Plan
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay 40%
co-insurance, plus any
amounts over allowable
charges)
Not covered
Plan pays 80% co-insurance after your co-pay (once
deductible met); you pay $125 co-pay and 20% coinsurance
Plan pays 60% coinsurance after your
co-pay (once deductible
met); you pay $125
co-pay and 40%
coinsurance
Member must use a
bariatric Center of
Excellence (if available
within 150 miles)
Plan pays 50%
co-insurance, after
deductible. Your outof-pocket expenses
towards bariatric
services counts toward
your Out-of-Pocket Limit
Note: Specific criteria must
be met to receive coverage;
see Health Account Plan
Summary Plan Description
for more information.
Plan pays 80% co-insurance after your co-pay (once
deductible met); you pay $125 co-pay and 20% coinsurance
Plan pays 60% coinsurance of allowable
charges, after
deductible and co-pay
(you pay $125 co-pay
and 40% co-insurance,
plus any amounts over
allowable charges)
Plan pays 60% coinsurance after your
co-pay (once deductible
met); you pay $125
co-pay and 40%
coinsurance
Plan pays 60% coinsurance of allowable
charges, after
deductible and co-pay
(you pay $125 co-pay
and 40% co-insurance,
plus any amounts over
allowable charges)
Not covered
Not covered
Not covered
Features
Basic Plan
N E T WO R K /
N O N -N E T WO R K
NET WOR K
Infertility medical treatment
Plan pays 80%
co-insurance, after
deductible, up to
lifetime maximum of
$7,500 for medical
expenses
N ON -N ET WORK
For diagnosis office
visits ONLY:
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
No other non-network
infertility services
covered
Claims procedure
No claims to file
Prescription Drug
coverage claims
administrator
CVS Caremark
855-848-9165 and www.caremark.com
Specialty pharmacy for
specialty medications
Required
Plan pays 80%
coinsurance,
after deductible
(you pay 20%)
You must file claims
Required Plan pays
60% co-insurance of
allowable charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
Health Account Plan
Consumer Access Plan
N ET WORK
NE T WO RK
Plan pays 80%
co-insurance, after
deductible, up to
lifetime maximum of
$7,500 for medical
expenses
No claims to file
For diagnosis office
visits ONLY:
Plan pays 60% coinsurance of allowable
charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
No other non-network
infertility services
covered
You must file claims
CVS Caremark
855-848-9165 and www.caremark.com
Required
Plan pays 80%
coinsurance,
after deductible
(you pay 20%)
Required Plan pays
60% co-insurance of
allowable charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
For diagnosis office
visits ONLY:
Plan pays 80%, you pay
20% (once deductible
met)
No other infertility
services covered
No claims to file
NO N- NE T WO RK
For diagnosis office
visits ONLY:
Plan pays 60%, you pay
40% (once deductible
met)
No other infertility
services covered
You must file claims
CVS Caremark
855-848-9165 and www.caremark.com
Required
Plan pays 80%
coinsurance,
after deductible
(you pay 20%)
NOTE: Specialty Drugs
have a separate $200
co-pay (not applied to
deductible)
Required Plan pays
60% co-insurance of
allowable charges, after
deductible (you pay
40%, plus any amounts
over allowable charges)
NOTE: Specialty Drugs
have a separate $200
co-pay (not applied to
deductible)
Supply limits, Step
Therapy and 90-day fill
requirements for certain
medications
Yes
See SPD or CVS Caremark for specific
requirements, limits or drug lists
Additional Voluntary Services
Offer additional no cost services including support to manage health conditions, case management and 24/7 nurseline. Refer to the Summary Plan Descriptions on
i-Connect >Life & Career, www.sprint.com/benefits or contact for more information regarding these services.
For additional details,
see…
Sprint Basic Plan Summary Plan Description on
i-Connect >Life & Career, www.sprint.com/benefits
or contact medical and/or prescription drug
administrator
Yes
See SPD or CVS Caremark for specific
requirements, limits or drug lists
Sprint Health Account Plan Summary Plan Description
on i-Connect >Life & Career, www.sprint.com/
benefits, or contact medical and/or prescription
drug administrator
Note: Kaiser HMO availability and Aetna WholeHealth℠ (ACO) coverage varies by region. For information more
information on Kaiser HMOs or Aetna WholeHealth℠, please visit i-Connect > Life & Career or sprint.com/benefits.
17
N ON -N ET WOR K
Yes
See SPD or CVS Caremark for specific
requirements, limits or drug lists
Sprint Consumer Access Plan Summary Plan
Description on i-Connect >Life & Career, www.sprint.
com/benefits or contact medical and/or prescription
drug administrator
Aetna WholeHealth℠ Aetna
Select Plan
TRICARE
Supplement Plan
The Aetna WholeHealth℠ Aetna Select plan is administered by Aetna and
provides preferred benefit coverage and access to certain covered services
and supplies through a designated network of health care providers
and facilities that are unique to the Plan. This plan is designed to lower a
member’s out-of-pocket costs when the member uses designated network
providers for covered expenses. There is no out of network coverage. This
Plan is only offered to Sprint participants in the following locations:
The TRICARE Supplement Plan is secondary coverage to TRICARE. It
pays the subscriber’s share of covered medical expenses under the
TRICARE Prime (in-network), Extra and Standard and TRS options. Eligible
participants have almost 100 percent coverage.
• California
Sacramento
Riverside
Santa Clara
• Cincinnati
Ohio
• Denver
Colorado
PCP designation required--To access network benefits, you must select a
Primary Care Physician (PCP) from Aetna’s network of providers. Each covered
family member may select his or her own PCP. If your covered dependent is a
minor, or otherwise incapable of selecting a PCP, you should select a PCP on
their behalf. You may search online for the most current list of participating
providers in your area by using DocFind, Aetna’s online provider directory at
www.aetna.com.
Prescriptions are administered by CVS Caremark.
Below is high level information regarding this plan. For specific details, please
refer to the plan documents. The medical/prescription drug deductible is
$1,000 (individual only coverage) or $2,000 (family coverage tiers). For family
coverage, the entire family deductible must be met (by one person or a
combination of 2 or more) before coinsurance applies.
The medical/prescription drug in-network out-of-pocket limit is $3,000
(individual only coverage) or $6,000 (family coverage tiers).
Coinsurance — Plans pays 85% after deductible, member pays 15% after
deductible.
Outpatient Specialty drugs have a $200 co-payment. This co-payment does
not apply to the deductible, but does apply to the out of pocket limit.
18
The TRICARE Supplement Plan is designed for TRICARE-eligible active
employees until they turn age 65 and become eligible for TRICARE for Life.
Eligible individuals must be registered with the Defense Enrollment
Eligibility Reporting System (DEERS) and must not be eligible for Medicare.
An individual who is unsure if he/she is eligible for TRICARE may confirm
eligibility with DEERS at 800-538-9552 before enrolling in the TRICARE
Supplement.
The TRICARE Supplement Plan is available to:
Eligible employees, retirees and survivor subscribers and spouses who are
under age 65 and not eligible for Medicare:
• Military retirees receiving retired, retainer or equivalent pay
• Spouse/surviving spouse of a military retiree
• Retired reservists between the ages of 60 and 65 and spouses/surviving
spouses of retired reservists
• Retired reservists younger than 60 and enrolled in TRICARE Retired
Reserve (TRR) (“Gray Area” retirees) and spouses/surviving spouses of
retired reservists enrolled in TRR.
• Qualified National Guard and Reserve Members (TRS).
Health Savings Accounts – The Rules
A Health Savings Account (HSA) is a tax-exempt savings account established exclusively for paying qualified health care expenses. You may open an HSA if you are
enrolled in a specifically designated High Deductible Health Plan (HDHP). The Basic Plan is considered a HDHP. Sprint’s other Medical/Prescription Drug plans are not
considered HDHPs, so employees enrolled in these other plans are not eligible to open an HSA.
Using BenefitWallet™
Deadline
Requirements
If you select the Basic Plan, you may work with our
HSA administrator, BenefitWallet™, to set up your
HSA. When you do so and elect to make a payroll
contribution of $24 or more per plan year (divided
across 24 paychecks among your remaining 2016
paychecks), Sprint will make contributions to your
HSA up to the amount of $500 (for employee-only
coverage) or $1,000 (for family coverage tiers)
over the course of the year for each pay period
that you have a payroll- deduction contribution;
if you join the plan anytime during the year these
amounts will be pro-rated accordingly. You can
contribute additional pre-tax funds up to an
annual total of $3,350 (employee only coverage)
or $6,750 (family coverage tiers); these totals
include Sprint’s contribution.
If you are age 55 or older in 2016, you are eligible
to make an additional catch-up contribution of
$1,000.
If you don’t set up your HSA with BenefitWallet™
by the 31st day after your Basic Plan coverage
begins, any potential Sprint funding for that
period will be forfeited and your HSA payroll
deduction contributions withheld during that
time will be paid out to you. If you miss the
initial deadline, you can re-elect a contribution
at anytime throughout the year going forward
and still receive funding by contacting the Sprint
Employee Help Line.
Must be enrolled in an HSA-compatible medical
plan; the Basic Plan will qualify.
You can use your HSA as you choose to offset
your deductible of $1,850 (employee-only
coverage) or $3,700 (family coverage levels) or
to pay for other eligible out-of-pocket medical,
prescription drug, dental and vision expenses.
Basic Plan users, set up your HSA through
BenefitWallet™:
https://mybenefitwallet.com/HSA/sprinthsa.adv
19
Once set up, you can use your HSA to pay or
be reimbursed for eligible medical, prescription
drug, dental and vision expenses as outlined
in IRS Publication 502 http://www. irs.gov/
pub/irs-pdf/p502.pdf for you and any of your
qualified tax dependents (Domestic partners and
Domestic Partner children are not recognized tax
dependents). You will receive a debit card for use
with your HSA and may also request a checkbook.
You may also choose to have funds automatically
withdrawn from your HSA when you use a
BlueCross BlueShield network provider.
Fees: HSAs have a monthly account-maintenance
fee; you may be charged additional fees for
optional services, like extra checks or extra debit
cards or setting up an investment account.
Note: If you choose to contribute to a Health
Savings Account while enrolled in a Health Care
Flexible Spending Account (FSA), there will be tax
implications. At Sprint, we will not allow you to
make contributions to an HSA and a health care
FSA.
• May not have any other medical coverage
that is not HDHP and Sprint will not monitor. If
your spouse has a Health Care FSA (other than
a “limited purpose” FSA) or other non-HDHP
through his or her employer that also covers
you, you will be ineligible for a HSA. Other
types of insurance coverage, such as accident,
disability, dental care, vision care, critical-illness
or long-term care, are permitted.
• Employee may not be enrolled in Medicare.
Once enrolled in Medicare, you are no longer
eligible to contribute to a HSA and can keep
any funds in the account prior to enrolling
in Medicare and use those funds to pay for
qualified medical expenses tax-free. Sprint will
not monitor employees’ Medicare status in
relation to HSA eligibility; it is your responsibility
to comply accordingly. If the employee has
a spouse that is enrolled in Medicare, but the
employee is not enrolled in Medicare, the
employee may contribute to HSA and use those
expenses for the Medicare eligible spouse.
• Additional HSA rules can be found at
www.mybenefitwallet.com.
Questions?
Call BenefitWallet™
877-635-5472
Basic and Premium Dental Plans
Sprint offers two Dental plan options that pay benefits for exams,
cleanings and fillings; as well as comprehensive dental work.
For more details, contact 866-913-3375 or www.deltadentalks.com.
Dental Plans
Family
Coverage Level
Basic
Dental Plan
Premium
Dental Plan
D ELTA D ENTAL
P P O NE T WOR K
D ENTI STS ONLY
D ELTA
D EN TAL PP O
NE T WORK
DELTA DENTAL
PREMIER*/
OUT-OFNETWORK
Employee-only
$2.30
$5.61
Employee + Spouse/
Domestic Partner
$5.39
$14.74
Employee + Child(ren)
$5.61
$14.91
Employee + Family
$8.91
$24.75
Note: Pricing for employees scheduled to work 30 hours or more per week.
Benefits are taken out of 24 paychecks during the calendar year although
Sprint will have 26 pay periods.
Dental Plans Coverage Summary
Service Type
Basic Dental
Premium Dental Plan
D E LTA D E NTA L
PP O NE T WO RK
D E NT ISTS O NLY
D E LTA D E NTA L
PP O NE T WO RK
D E LTA D E NTA L
PRE M IE R*/O U T- O FNE T WO RK
Diagnostic and Preventive Care
(Routine exams, cleanings,
X-rays, sealants and fluoride
treatments, etc.)
Plan pays 100% of
maximum plan
allowance, two
visits per year (no
deductible)
Plan pays 100%
of maximum plan
allowance, two visits
per year
(no deductible)
Plan pays 80%
of maximum plan
allowance, two visits
per year
(no deductible)
General Dental Care
(Fillings,extractions,
non-surgical periodontal
services and other basic
dental procedures)
Plan pays 50% of
maximum plan
allowance covered
after $25 annual
deductible
Plan pays 80%
of maximum
plan allowance
covered after $50
annual deductible
Plan pays 60%
of maximum
plan allowance
covered after
$50 annual
deductible
If a member enrolled in the Premium Plan for more than 12 months
has not had a routine cleaning or exam in the preceding 12 months,
all listed General Dental Care services are reduced to fifty (50%)
percent coverage. Once the qualifying cleaning or exam has been
received, benefits will return to the original coinsurance the first day
of the following month.
Important
Newly enrolled members will have 12 months to satisfy this
requirement.
Major and Restorative Care
(Crowns, root canals, surgical
periodontal services, bridges,
dentures, etc.)
Plan pays 50% of
max. plan allowance
covered after $25
annual deductible
Newly enrolled
participants may only
be covered for certain
Major and Restorative
services after a waiting
period
Plan pays 50% of maximum plan allowance
covered after $50 annual deductible; dental
implants at 50% of maximum plan allowance,
subject to a separate $50 annual deductible
Newly enrolled participants may only be covered
for certain Major and Restorative services after a
waiting period.
If a member enrolled in the Premium Plan for more than 12 months
has not had a routine cleaning or exam in the preceding 12 months,
all listed General Dental Care services are reduced to fifty (50%)
percent coverage. Once the qualifying cleaning or exam has been
received, benefits will return to the original coinsurance the first day
of the following month.
Important
Newly enrolled members will have 12 months to satisfy this
requirement.
20
Annual Individual
Benefit Maximum
$750
Diagnostic and
preventive care
charges do NOT get
counted toward this
maximum
Orthodontia
(Child/Adult Braces/limited
TMJ coverage)
Not covered
Plan pays 50% of maximum plan
allowance covered after $50 lifetime
orthodontia deductible
(separate from annual deductible)
Orthodontia Lifetime
Benefit Maximum
N/A
$1,500
(separate from non-orthodontia maximum)
*Delta Dental Premier Network is out-of-network
$1,500 (does not include orthodontia)
Diagnostic and preventive care
charges do NOT get counted toward
this maximum
Vision
Vision benefit that helps pays for eye exams, glasses and
contacts and even provides discounts on laser eye surgery,
all through the Surency Vision network of eye-care providers
featuring EyeMed’s independent private practitioners and
retail chains.
You get the most out of the plan when you use professionals
within the Surency Vision network, which includes a wide
network of covered vision providers, including many national
retail chains such as JCPenney Optical, LensCrafters, Pearle
Vision, Sears Optical and Target Optical.
For more details, contact Surency at
866-818-8805 or www.surency.com.
Vision Plan: Benefits with a Surency Vision Doctor
Per-paycheck premiums*
Eye Exams (one per calendar year)
Lenses (once per calendar year) - includes
lenticular lenses, scratch-resistant coating,
ultraviolet coating, tints and dyes, and (for
children under the age of 19) polycarbonate
lenses
Single vision
Employee-only
$2.15
Employee +
One
$4.50
Employee +
Family
$8.00
Plan pays 100% after $15 co-pay
Plan pays 100% after $25 co-pay
Plan pays 100% after $50 co-pay
Lined bifocals, lined trifocals, and standard
progressive covered
Frames (one pair per calendar year)
Plan pays 100% of allowable amount of $140; discounts are provided
at the point of sale for additional pairs of glasses (frame and lenses)
or charges over the allowable amount
Contacts (once per calendar year)
Plan pays for 100% up to $140 allowance
Lens fit and follow-up
The maximum you will pay is $55 for standard contact lenses; a 10%
discount is provided at the point of sale if fit and follow-up is for
premium contact lenses
In-Network Laser Eye Surgery**
LasikPlus Center
Provides greater discounts; the maximum you pay is:
U.S. Laser Network
Discounted rates available;
the maximum you pay is:
Traditional LASIK with Bladefree
(enhancements up to one year)
$695 per eye
PRK
$1,500 per eye
Traditional LASIK with Bladefree
(enhancements for life)
$1,395 per eye
LASIK
$1,800 per eye
Custom LASIK with Bladefree
(enhancements for life)
$1,895 per eye
Custom LASIK
$2,300 per eye
Benefits when using non-Surency Vision provider
Surency reimburses you up to $45
Surency reimburses you:
Single Vision
up to $45
Lined Bifocal and Standard Progressive
up to $65
* Pricing for employees scheduled to work 30 or more hours per week.
Lined Trifocal
up to $85
Benefits are taken out of 24 paychecks during the calendar year although
Sprint will have 26 pay periods.
Tints and dyes
up to $5
Frame
up to $47
Contacts
up to $105
** Call (877) 637-9090 to determine the Surency Vision discount in your area.
21
Eye exam
Lenses
Flexible Spending Accounts (FSA)
With FSAs, you set aside money – before taxes are deducted –
to pay certain health care or dependent day care expenses that
you will likely incur. This means lower withholding taxes on your
paycheck – and more take-home pay for you!
Flexible Spending Accounts
Health Care Flexible
Spending Account
To learn more, go to www.spendingaccounts.info.
Eligible out-of-pocket health care expenses that
are not covered by a medical, prescription drug,
dental or vision plan, including deductibles,
co-pays and co-insurance. Expenses may be for
yourself or any eligible dependent.
Important: If you choose to contribute to a Health Savings
Account, you are not eligible to enroll in a Health Care Flexible
Spending Account (FSA).
No-carryover rule. Unused money in your account as of the
end of the calendar year is lost; you cannot carry that balance
forward year to year, and you cannot withdraw the money as
cash – so it’s important to plan for your 2016 expenses and
contributions carefully!
Claim filing deadline. Generally, claims for eligible expenses for
you and your dependents must be filed by the deadline of March
31, 2017 (or three months after the end of the month of your
termination of employment or coverage end date, if earlier).
Special rule for highly compensated employees. Federal
regulations require both plans to be tested on an annual basis to
make sure that highly compensated employees (as defined by
regulation) do not contribute more than a permissible amount
relative to non-highly compensated employees. If either plan
fails this test, the company may need to reduce the contribution
elections of highly compensated employees to that plan.
What can be
reimbursed?
Reminder: You must first exhaust your Health
Reimbursement Account (HRA) funds if enrolled
in the Health Account medical plan before
you can submit claims for covered medical or
prescription drug services to your Health Care
FSA for reimbursement.
Dependent Care
Flexible Spending
Account
Eligible out-of-pocket day
care expenses for the care of
children under age 13 or for
an incapacitated spouse or
dependent parent incurred so
that you (and your spouse, if you
are married) can work or
attend school full time.
Note: Certain over-the-counter drugs and
medicines must be prescribed by a doctor.
How much
can I
contribute?
$100 to $2,550 per year
Can I make
changes
mid-year?
Changes may be allowed if you have a qualified life event.
Otherwise, you may not make changes during the plan year
Direct
payment
of services
You will receive a Health Care FSA debit card
from ADP. This card has your account elections
“stored” and can be used to pay qualified
expenses, eliminating the need for filing
a claim for reimbursement in some cases.
Substantiation of your expense(s) may be
required at any time, so keep all receipts and/or
Explanation of Benefit forms.
$100 to $5,000 per year
Not available for
Dependent Care.
Fax or mail your paper claim form (available
through https://myspendingaccount.adp.com)
and supporting documentation to ADP 866-6432219 or ADP Benefits Services, P. O. Box 34700,
Louisville, KY 40232.
How do I
reimburse
myself using
an FSA?
-- OR -Complete and submit an online claim
form and supporting documentation at
https://myspendingaccount.adp.com
Same as Health Care FSA
Claims must be submitted by the end of the
3rd month after the month coverage ends. If
coverage ends on Dec. 31, the deadline is March
31 of the year after the expense is incurred.
22
Claims
Administrator
ADP (https://myspendingaccount.adp.com)
Be sure to set up a website account so that you can manage
your accounts anywhere, anytime.
Life Insurance
Employee Life Insurance: Coverage for you
Sprint provides you the opportunity to purchase the level of protection
you want for you and your family:
About Life Insurance premium costs
Your per-pay-period premiums for Employee Life Insurance are based
on your Benefits Eligible Earnings, your age, your tobacco status and
the amount of coverage you elect. Dependent Life Insurance costs for
your spouse/domestic partner are based on age, tobacco/non-tobacco
status and the amount of coverage elected. Due to these variables,
employee’s premium costs will vary for each employee. Please see the
online enrollment system for your specific cost(s). Benefits are taken out
of 24 paychecks during the calendar year although Sprint will have 26 pay
periods.
Sprint provides employees the following life insurance benefits at no cost:
Basic Employee Life Insurance (paid for by Sprint)
Waive coverage
(receive taxable earnings
credit)
$10,000
(receive taxable earnings
credit)
$50,000 or
1x Benefits Eligible Earnings
(whichever is lower)
Supplemental Employee Life Insurance (premiums paid for by you)
Waive coverage
1x Benefits Eligible Earnings
2x Benefits Eligible Earnings
3x Benefits Eligible Earnings
4x Benefits Eligible Earnings
5x Benefits Eligible Earnings
6x Benefits Eligible Earnings
7x Benefits Eligible Earnings
8x Benefits Eligible Earnings
Note: Your “Benefits Eligible Earnings” is defined as your annual base pay plus any targeted
incentives or commissions for which you are eligible.
23
Rules for Supplemental
Employee Life Insurance
• If enrolled in Basic Employee Life Insurance options ($10,000 or 1x your
Benefit Eligible Earnings up to $50,000), you may purchase additional
Supplemental Employee Life Insurance coverage.
• If you are an existing employee who has previously waived Life Insurance,
you are limited to $10,000 only at enrollment. Once you have enrolled,
you may increase this amount during subsequent annual enrollments,
including your supplemental life.
Dependent Life Insurance:
Coverage for your family
Dependent Life Insurance cover level options
for your spouse/domestic partner
$5,000
$10,000
$25,000
$50,000
$75,000
$100,000
$200,000
and/or for your child(ren)
$5,000 each child
$10,000 each child
$20,000 each child
• Evidence of insurability is required if you choose a level of Supplemental
coverage in excess of $300,000 or coverage that is greater than three
times your benefits eligible earnings.
Rules for Dependent Life Insurance
• Maximum Supplemental coverage amount is $2 million.
• To enroll in dependent life, you must be enrolled in Employee Basic Life.
• If you are an existing employee who has previously waived Life Insurance
coverage, you are limited to $10,000 only at enrollment. Once you have
enrolled, you may increase this amount during subsequent enrollments.
• Coverage for your spouse/domestic partner is limited to no more than 100%
of your Employee Life Insurance amount.
• If you are an existing employee, you must be currently enrolled for
$10,000 or 1x your Benefit Eligible earnings up to $50,000 to enroll for
supplemental employee life at this enrollment.
• Employee Life Insurance from Sprint is portable; using the Portability or
Life Conversion option, your coverage can be retained.
• Coverage for your child(ren) cannot be more than your Employee Life
Insurance amount.
• Evidence of insurability is required for spouse/ domestic partner coverage
over $25,000.
• If Child Life Insurance is selected, it covers all eligible child(ren) to include any
additional children born during the year.
• If you are an existing employee who has previously waived Dependent Life
Insurance for your spouse/domestic partner, you are limited to only $5,000
coverage at this enrollment.
Sprint’s Life Insurance Plan
Services offered at no cost when enrolled in Sprint Employee Life Insurance Plan
Beneficiary Assist
Funeral Planning/Concierge Services
Will Services
Identity Theft Assistance
For more details, go to i-Connect
24
Evidence of Insurability (EOI)
and personal health applications
Sprint provides you the opportunity to purchase the level of protection you
want for you and your family.
Depending on the Supplemental Employee Life and/or Spouse/Domestic
Partner Life Insurance coverage level you select, you may be required
to show Evidence of Insurability (EOI) by completing a personal health
application.
• If you are signing up for new Supplemental Employee Life Insurance or
are increasing your current level of Employee Life Insurance and your new
coverage level will (a) exceed $300,000 and/ or (b) be more than three
times your Benefits-Eligible Earnings, you will be required to provide EOI.
If you elect a Supplemental Employee Life Insurance coverage level that
requires EOI, your Employee Life Insurance coverage will remain at the
highest multiple-of-pay level not requiring evidence of insurability until the
personal health application has been submitted to and approved by the
Life Insurance carrier.
• Any new or increased Dependent Life Insurance for your spouse/
domestic partner that exceeds $25,000 requires EOI. If you elect a
Dependent Life Insurance coverage level for your spouse/domestic
partner that requires EOI, your Dependent Life Insurance coverage will
remain at a maximum of $25,000 until the personal health application has
been submitted to and approved by the Life Insurance carrier.
• Employees and dependents will receive information on how to complete
this questionnaire within a few weeks after their coverage Life Insurance
benefit effective date.
• EOI is not required for Child Life insurance.
Accidental Death &
Dismemberment Insurance
Accidental Death & Dismemberment (AD&D) Insurance gives you added
financial protection. It pays full benefits for death and partial benefits for
paralysis or loss of limb(s), eyesight, speech or hearing within 365 days of a
covered accident. Sprint pays for your Basic AD&D.
Basic AD&D (paid for by Sprint)
25
Waive coverage
(receive taxable
earnings credit)
$10,000
(receive taxable
earnings credit)
$50,000 or
1x Benefits Eligible Earnings
(whichever is lower)
Supplemental AD&D (premiums paid for by you)
Waive coverage
1x Benefits Eligible Earnings
2x Benefits Eligible Earnings
3x Benefits Eligible Earnings
4x Benefits Eligible Earnings
5x Benefits Eligible Earnings
6x Benefits Eligible Earnings
7x Benefits Eligible Earnings
8x Benefits Eligible Earnings
About Accidental Death & Dismemberment
Insurance premium costs
Your per-paycheck deductions for Employee AD&D are based on your benefitseligible earnings and the amount of coverage you elect. Due to all of these
variables, employee’s premium costs will vary for each employee. Please see the
online enrollment system for your specific cost(s). Benefits are taken out of 24
paychecks during the calendar year although Sprint will have 26 pay periods.
Rules for AD&D
• Maximum AD&D benefit is $2 million per employee.
• Coverage for your spouse or domestic partner is equal to 50% of your coverage
amount, up a maximum of $750,000.
• Each child is covered to 25% of your coverage amount, up to a maximum of
$100,000.
• Additional benefits are payable in the event of your or your spouse’s death (in
the event you elect coverage for your Dependents) that may assist with your
child’s education, spouse education or daycare benefits. For example, if you have
a child enrolled in an accredited institution of learning, benefits may be payable
for up to four years and will pay 10% of the principal sum up to $25,000 a year.
• If there are no covered children at the time of your spouse or domestic partner’s
death, the benefit will be 60% of your coverage amount up to a maximum of
$900,000. Accidental Death & Dismemberment Insurance is portable.
Life Insurance and AD&D Beneficiaries
When you enroll in Employee Life Insurance and/or Accidental Death &
Dismemberment Insurance (AD&D), you must designate your beneficiaries.
You may make changes to these designations at any time during the
plan year. Beneficiary designations you make on Basic Employee Life
and AD&D will also be applied to your Supplemental Employee Life
Plan election.
Disability
Disability benefits pay you money for an approved disability when you are
unable to work for a period of time because of an illness or injury. Sprint
provides company-paid disability coverage for employees who have worked for
the company a year or more.
Short-Term Disability Benefit per Year Served
Completed Years of Service
Maximum Benefit Period
(in work weeks)
1
6
Sprint offers two Disability programs:
• Short-Term Disability (STD) – 75% coverage provided by the company
• Long-Term Disability (LTD) – 50% coverage provided by the company;
additional coverage can be purchased by employee
If you are eligible, STD and LTD benefits are provided so that you receive some
replacement income during times you are unable to work due to a disabling
medical condition. If you continue to be unable to work due to a documented
medical condition, you may then be eligible for LTD benefits (if approved by
Sprint’s LTD administrator). Both STD and LTD pay benefits based on your
benefit-eligible earnings.
2
8
3
10
4
12
5
14
6
16
7
18
8
20
9
22
10
24
11+
26
Go to i-Connect, Life & Career or sprint.com/benefits for more details
Disability coverage options
Short-Term Disability
Long-Term Disability
Coverage level
Replaces 75% of base pay plus annualized sales
commission (when applicable)
Replaces 50%, 55%, 60% or 65%
of Benefits Eligible Earnings
Amount
provided by
Sprint
75% (maximum level)
50% up to $12,000 monthly maximum; employees may
purchase additional coverage levels up to a monthly
maximum of $25,000 (including company paid coverage)
Benefits start
date
Benefits begin on the eighth day of Disability
Benefits are payable after 180day disability waiting period
Maximum
Benefit Period
Benefits payable up to 26 weeks based on
completed years of service (see chart to the right)
Based on age (see chart on the right)
Costs
Company Paid
Company paid for 50% of earnings. Buy up coverage option
costs at 55%, 60% and 65%, are reflected in the online
system in Employee Self Service.
Important: If you work in California, Hawaii, New Jersey, New York or Rhode Island, statemandated
disability benefits may apply and could vary from those described here.
26
Individual Short Term
Disability insurance is
also available through
our Voluntary Benefits,
see page 29
LTD Maximum Benefit Period
Sprint 401(k) Plan
Your maximum LTD benefit duration is based on your age
(as of the date your disability leave begins) as shown on this chart:
Long-Term Disability Maximum Benefit Period
Your age on date
disability leave begins
Maximum benefit duration
61 and under
Later of: Age 65
-- or —
calendar month in which you reach
Social Security normal retirement age
62
42 months
63
36 months
64
30 months
65
24 months
• You can make pre-tax, Roth or aftertax contributions to the 401(k) Plan up
to 80% of your eligible pay (subject to
certain regulatory limits).
• Sprint matches your pretax and Roth
contributions at 50% up to 4% of your
eligible pay.
Learn more: i-Connect > Life & Career >
Benefits > Retirement and Wealth
To Enroll: netbenefits.com/sprint
or call (800) 877-4015
* Vesting Schedule
(Applies to Employees Hired on or after January 1, 2016)
66
21 months
67
18 months
Less than 1 yaer
0%
68
15 months
1 year, but less than 2 years
33%
69 and over
12 months
2 years, but less than 3 years
66%
3 years of more
100%
Group Legal Plan
Whether you’re buying a new home, drawing up a will, identity theft
management or are just in need of legal advice, the Group Legal Plan from
Hyatt Legal can give you easy access to more than 14,000 experienced
attorneys. Plus, you’ll receive a wide range of covered legal services at an
affordable price and an attorney is just a phone call away.
The after-tax cost of the Group Legal Plan is $8.45 per pay period. Benefits
are taken out of 24 paychecks during the calendar year although Sprint will
have 26 pay periods.
Learn more at: http://www.legalplans.com/Legal-Plans-TV/Data-InsightsChannel/Legal-Services-Plan-Helps-with-Lifes-Legal-Needs.aspx
Retirement and Wealth
27
Build your financial security for the future
while reducing your current taxable
income through the Sprint 401(k) Plan.
• You choose 401(k) plan investment
options for your contributions
Company-matching contributions
are invested in the same investment
options you have chosen for your own
contributions. You can easily monitor
the growth toward your financial goals.
• Your contributions and your Sprint
contributions are 100% vested.*
Your physical health is important, but so is your financial health. That’s
why Sprint offers a selection of benefits designed to help you invest for
the future.
Years of Service at Separation
Employees Stock
Purchase Plan (ESPP)
The ESPP provides the opportunity
for you to purchase Sprint common
stock at a 5% discount. Contribute from
1%–20% of your annual compensation
(base pay plus any commissions) to your
ESPP account.
• Your ESPP account increases each
pay period through convenient payroll
deductions.
• Stock is purchased at the end of each
quarter at a 5% discount.
• You can purchase up to a value of
$25,000 worth of Sprint stock each
calendar year.
Learn more: i-Connect > Life & Career >
Benefits > Retirement and Wealth
To enroll: netbenefits.com/sprint
or call (800) 877-4015
Vested Percentage
Financial planning and
workplace education
Sprint provides several options to
access information, resources and tools
to provide you the tools and resources.
Ameriprise Financial serves Sprint’s
workplace as a financial education
vendor with a unique, collaborative
and comprehensive approach to
financial planning that can help you
make informed decisions about your
employee benefits and personal
finances. Their services include a
complementary initial one-on-one
consultation with a financial advisor,
workplace seminars, online financialplanning tools, and discounts on
financial-advisory services.
Learn more: ameriprise.com/sprint or
call (913) 451-2811
Fidelity
The Sprint 401(k) Plan record-keeper
provides a variety of complimentary
financial resources available to you
via the Web, the phone and in person.
Learn more:
www.netbenefits.com/sprint
or call (800) 603-4015.
MetLife Premier
Client Group
This team specializes in investments
and insurance who bring different
points of view to your financial plan.
Learn more: Call (913) 234-4825
Learn more: i-Connect > Life & Career
> Benefits > Retirement & Wealth
Live and Work
Your Best
Sprint offers many other programs
that you and your family can take
advantage year round.
Note: For most Sprint programs,
you must work at least 20 hours a
week. Some programs, such as Paid
Time Off, adjust accruals based on
other factors, such as employee
classification, full/part-time status
and years of service.
Educational
Assistance
28
Beginning on your first day of
hire, this program provides to you
free access to an EdAssist team
of Academic and College Finance
Advisors. Whether just comparing
options for schools/programs
or already on the path for your
degree, EdAssist can help meet your
educational goals. Additional services
include discounted rates to many
popular colleges and universities
across the country.
Upon six months of service with
Sprint, employees are eligible to start
coursework and receive up to $3,500
annually in the form of Sprint tuition
reimbursement.
College Coach provides free
access to a world-class team of
insiders; former college admissions
and financial aid offers for family
education needs from the nation’s
top institutions, personalized one-onone assistance, and comprehensive
information available through an ondemand resource library.
Learn more: i-Connect > Life and
Career > Discounts and Other
Benefits.
Guidance Resources −
Employee Assistance
Counseling and
Concierge services
Managing daily life (whether big
or small) can affect your work,
health and family. That’s why 24
hours a day, seven days a week
GuidanceResources is there to help
you gain control over your busy life
and move forward with the things
you want to do.
GuidanceResources offers a host of
free services and support for you
and your family such as confidential
counseling; personal convenience
for work/life needs; financial, identity
protection and legal services, and
online information and identity
protection.
Learn more: guidanceresources.com
(company ID: SPRINT)
or call (888) 303- 3957
Discount
Programs
Learn more about the discount
programs: i-Connect > Life & Career
Sprint Marketplace
Sprint employee discount site, Sprint
Marketplace, is a fast, convenient
website that provides access to
exclusive discounts on merchandise
and services from top brand-name
retailers, online stores and local
merchants. Products range from
clothing to computers, gifts to golf and
tickets to toys. This is a benefit that
employees can use every day of the
year.
Employee Phone
Programs
We are proud of our products and
services, and one way we show it is
through our employee phone discount
program. For you and your immediate
family: Employee Wireless Discount
(EWD) offers for Sprint employees
includes one free unlimited phone line,
one $20/month 20GB tablet line and
one $20/month mobile broadband
line. In addition employees will also be
allowed to have their immediate family
(defined as a household member) on
their EWD account. The total number
of lines on the EWD account cannot
exceed 10 lines. All family lines on the
EWD account must be on either one of
the Advantage Unlimited rate plans or
on a consumer rate plan. These family
lines on EWD can be any mix of phones,
tablets, mobile broadband or Sprint
Phone Connect.
For detailed information including on
network data limits, visit the Employee
Wireless Discounts page found on
i-Connect: Life & Career > Employee
Discounts > Employee Phone Programs
> Employee Wireless Discounts (EWD).
For your friends
and family:
Sprint Wireless
Advantage Club
The Sprint Wireless Advantage Club
offers wireless discounts for family
members and close friends. Get
unlimited talk, text and data for
smartphones, starting as low as $25/
month under Easy Pay and leasing
options. Advantage Club customers
are also eligible for a $40/monthly
unlimited plan with a subsidized phone
purchase. Early upgrade options are
available under some plans. You may
sponsor up to 20 accounts under
Advantage Club.
Advantage Unlimited rate plans or on
a consumer rate plan. These family
lines on EWD can be any mix of
phones, tablets, mobile broadband or
Sprint Phone Connect. For detailed
information on SWAC plans visit
i-Connect: Life & Career > Employee
Discounts > Employee Phone Programs
> Sprint Wireless Advantage Club
(SWAC).
Note: Migrations of consumer Sprint
accounts to Advantage Club are
permitted in certain circumstances.
Your customer referrals are valuable
to Sprint.
For referrals: Employees
Referring Customers (ERC)
Employees Referring Customers provides an
exciting way for Sprint employees to refer new
customers to Sprint at a discount.
For detailed information visit i-Connect: Life &
Career > Employee Discounts > Employee Phone
Programs > Employees Referring Customers
(ERC).
Voluntary Benefits
Sprint offers voluntary benefits for individual
short-term disability insurance, critical illness,
auto/home, pet insurance, Group Accident, long
term care and life insurance. New hires may
apply for coverage in all of the Voluntary Benefits
programs by the 30th consecutive calendar day.
Guaranteed coverage is available for some plans,
but others may require employees to complete a
medical questionnaire. All benefits are
portable and can be taken with you if you should
leave Sprint.
Learn more:
https://sprint.benefithub.com/?refer=JZSGVF
Sprint Commuter
Spending Account (CSA)
Save money on your commute to work by
participating in Sprint’s Commuter Spending
Account program. Use pre-tax dollars to pay for
eligible commuting expenses for bus, parking,
subway, train or vanpooling. Employees can
pay for expenses by using a Commuter Check
(debit) Card or by using the Direct Pay feature
where your transit pass is purchased for you in
advance and/or your parking facility is paid in
advance. Green up your ride to work by using
Sprint iCommute site. It is your one-stop shop for
finding “greener” alternatives to driving alone to
work.
Learn more: i-Connect > Life & Career
29
Sprint Fitness Centers
and On-site Clinics
To help employees to lead a healthy lifestyle,
Sprint offers on-site health clinics and staffed
fitness centers at campus locations in Overland
Park, Kan., and Reston, Va. Sprint also provides
unstaffed fitness centers in some call centers
nationally.
Adoption
Assistance Program
Sprint provides financial assistance to employees
who have chosen to adopt. Eligible employees
can receive up to $5,000 per child to assist with
expenses with a maximum of two children per year.
Learn More: i-Connect > Life & Career
Rewards and
Recognition programs
Recognition is a powerful way to motivate
our employees, build our culture and drive
success. At Sprint, we take the opportunity to let
employees know we appreciate them and have
robust programs to support our passion for and
commitment to recognition. So, no matter where
you work in Sprint, there are managers and coworkers who are just waiting to recognize you.
Learn more: sprint.com/irecognize
The Sprint
Volunteer Program
The Sprint Volunteer Program opens doors for
our employees to actively volunteer in their
local communities through company-sponsored
projects, group-volunteer opportunities
organized by employee community volunteer
committees and a dedicated volunteer website,
which provides information and resources for
volunteering. Through the Dollars for Doers
program, employees who volunteer at least 40
hours during a calendar year to a qualified nonprofit organization can receive a $250 Sprint
Foundation grant for that organization.
Learn more: sprint.com/volunteer
Time Away from Sprint
Sprint provides a variety of ways to give you the time you need away from work.
These include the following:
• Paid Time Off (PTO)
• Holidays
• Military Duty
• Bereavement
• Disaster Leave
• Other Types of Leave
• Unpaid Personal Leave of Absence
• Family/Medical Leave
• Domestic Partner Leave
Workers’ Compensation
To protect your rights under Workers’ Compensation laws following any accident
or injury suffered on the job you need to report the incident to your manager or
supervisor within 24 hours. Workers’ Compensation laws vary from state to state.
For more information, contact Risk Management at (800) 777-6892.
Additional information about each of these leave programs can be found at
i-Connect > Life & Career.
30
Helpful Contact Information
31
Benefit Plan
Contact Details
Visit the Sprint Total Rewards
site to find a personalized
view of your full offering of
Sprint benefits.*
www.sprint.com/mytotalrewards
Health Account, Basic and
Consumer Account Plans
(medical coverage, nurseline
and programs to manage
health conditions)
Administered in select states by UnitedHealthcare
(800) 228-0194
www.myuhc.com
i-Connect > Life & Career
Health Account, Basic and
Consumer Access Plans
(medical coverage, nurseline
and programs to manage
health conditions)
Administered in select states by BlueCross
BlueShield of Illinois
(877) 284-1571
www.bcbsil.com/sprint
i-Connect > Life & Career
Health Account,
Basic, Consumer Account Plans
and Aetna WholeHealth℠ (ACO)
(medical coverage, nurseline
and programs to manage
health conditions)
Administered in select states by Aetna
(800)798-0083
www.aetna.com
i-Connect > Life & Career
Health Savings Account
(option available exclusively
with the Basic Plan)
BenefitWalletTM
(877) 635-5472
i-Connect > Life & Career
ConnectYourCare
(Health Reimbursement
Account Debit card option
available exclusively with
the Health Account Plan
administered by BlueCross
BlueShield of Illinois)
ConnectYourCare
(866)808-1444
www.connectyourcare.com
i-Connect > Life & Career
Prescription drug coverage
for Basic, Consumer Access,
Health Account and Aetna
WholeHealth℠ Plans
CVS Caremark
(855) 848-9165.
www.caremark.com
i-Connect > Life & Career
Minimum
Scheduled Hours
to be Eligible
When to Enroll and When Effective
Existing employees
Newly hired and
re-hired employees
20 hours
No enrollment necessary. Personalized
information updated every 30-60
days.
No enrollment necessary.
Personalized information updated 3060 days after benefit effective date.
20 hours
Enroll during the Annual
Enrollment window
Effective Jan. 1, 2016
20 hours
Enroll during the Annual
Enrollment window
Effective Jan. 1, 2016
20 hours
For full Sprint contribution, elect
to contribute funds during Annual
Enrollment window and set up
account by Jan. 31, 2016, using
contact information to the left
Payroll deductions effective Jan. 1,
2016; Sprint funds deposited in equal
allocations in 24 paychecks
20 hours
Will be used to pay the HRA’s first
dollar coverage for prescriptions only
(medical claims applied to the HRA
will be done automatically through
the claims processing system)
20 hours
Automatically enrolled when you
enroll in a national Medical/
Prescription Drug plan during Annual
Enrollment window
Effective Jan. 1, 2065
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
For full Sprint contribution, elect
to contribute funds during Annual
Enrollment window and set up
account by Jan. 31, 2016, using
contact information to the left
Payroll deductions effective Jan.
1, 2016; Sprint funds deposited in
equal allocations in 24 paychecks
Automatically enrolled when
you enroll in a national Medical/
Prescription Drug plan during your
enrollment window
Effective on the 30th consecutive
calendar day after your date of hire
Benefit Plan
Contact Details
Minimum
Scheduled Hours
to be Eligible
When to Enroll and When Effective
Existing employees
HMOs
TRICARE Supplement Plan (and
TRICARE Select Reserve)
Selman and Company
Phone: (800) 638-2610, ext. 255
Website: www.asicorporation.com
Dental Plan
Delta Dental of Kansas, Inc.
Phone: (866) 913-3375
www.deltadentalks.com
i-Connect > Life & Career
Vision Plan
32
Kaiser Permanente
i-Connect > Life & Career
http://my.kp.org/sprint
(personalized website for Sprint members)
Surency Vision
(866) 818-8805 Group #: 9729229
www.surency.com/Members/VisionMembers
i-Connect > Life & Career
Flexible Spending Accounts
(FSAs) – Health Care and
Dependent Care
ADP
(866) 907-0235
https://myspendingaccount.adp.com
i-Connect > Life & Career
Life Insurance and AD&D
Employee Help Line
(800) 697-6000
i-Connect > Life & Career
or https://thehartford.com/benefits/sprint
Disability Coverage –
Short-Term Disability (STD)
and Long-Term Disability (LTD)
Employee Help Line
(800) 697-6000
i-Connect > Life & Career
Group Legal Plan
Hyatt Legal
(888) 693-1388 (option 5)
https://info.legalplans.com
(login or enter access code: 5130010)
20 hours
20 hours
20 hours
20 hours
20 hours
20 hours
20 hours
20 hours
Enroll during the Annual
Enrollment window
Effective Jan. 1, 2016
Enroll during the Annual
Enrollment window
Effective Jan. 1, 2016
Enroll during the Annual
Enrollment window
Effective Jan. 1, 2016
Enroll during the Annual
Enrollment window
Effective Jan. 1, 2016
Enroll during the Annual
Enrollment window
Effective Jan. 1, 2016
Enroll during the Annual
Enrollment window
Effective Jan. 1, 2016
Company-funded STD and LTD (50%
level) automatically provided after one
year of employment
Enroll in additional LTD coverage after
one year of employment during the
Annual Enrollment window
Effective Jan. 1, 2016, or after one year
of employment (whichever is later)
Enroll during Annual
Enrollment window
Effective Jan. 1, 2016
Newly hired and
re-hired employees
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
Company-funded STD and LTD (50%
level) automatically provided after
one year of employment
Enroll for additional LTD coverage
within 30 calendar days after your
date of hire; effective after one year
of employment.
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Effective on the 30th consecutive
calendar day after your date of hire
Benefit Plan
Contact Details
Minimum
Scheduled Hours
to be Eligible
When to Enroll and When Effective
Existing employees
Employee
Assistance Program
(GuidanceResources)
ComPsych/GuidanceResources
(888) 303-3957
www.guidanceresources.com Company ID: SPRINT
i-Connect > Life & Career
20 hours
No enrollment necessary
Can use anytime
Sprint 401(k) Plan
Fidelity
(800) 877-4015
www.netbenefits.com/sprint
i-Connect > Life & Career > Retirement and Wealth
No minimum
Enroll at any time
Participation begins after enrollment complete
Employees Stock
Purchase Plan
Fidelity
(800) 877-4015
www.netbenefits.com/sprint
i-Connect > Life & Career > Retirement and Wealth
20 hours
Financial Planning
• Ameriprise Financial Services
(913) 451-2811
www.ameriprise.com/sprint
• Fidelity Netbenefits.com/sprint
(800) 603-4015
• MetLife Premier Client Group
(913) 234-4825
i-Connect > Life & Career > Retirement and Wealth
No minimum
Individual Short-Term
Disability coverage
33
Newly hired and
re-hired employees
UNUM
(888) 693-1388 (option 7)
https://sprint.benefithub.com/?refer=JZSGVF
Enrollment is at any time up to the middle of the last month of calendar quarter.
20 hours
New enrollment or changes are effective beginning the first pay period in the
next quarter.
No enrollment necessary
Can use anytime
Available for enrollment
during select periods
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Coverage effective on the first of the
month of the first payroll deduction
following application approval.
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Critical Illness Insurance
MetLife
(888) 693-1388 (option 6)
https://sprint.benefithub.com/?refer=JZSGVF
20 hours
Available for enrollment
during select periods
Group Accident Insurance
Aflac
(888) 693-1388 (option 8)
https://sprint.benefithub.com/?refer=JZSGVF
20 hours
Enroll year-round
Coverage effective on the first of the month following receipt of application
Universal Life Insurance
Allstate Benefits
(888) 693-1388 (option 4)
https://sprint.benefithub.com/?refer=JZSGVF
20 hours
Enroll at any time with completion of medical questionnaire
Coverage effective upon approval date
Coverage effective on the first of
the month following 60 days of
employment
Benefit Plan
Contact Details
Minimum
Scheduled Hours
to be Eligible
When to Enroll and When Effective
Existing employees
34
Newly hired and
re-hired employees
Long-Term Care Insurance
Unum
(888) 693-1388 (option 2)
https://sprint.benefithub.com/?refer=JZSGVF
20 hours
Enroll at any time with completion of
medical questionnaire
If application is approved between:
1st - 15th of month - effective 1st of
the following month
16th - 30/31st - effective
1st of the next following month.
Enrollment deadline is 30th
consecutive calendar day after your
date of hire
Auto and Home Insurance
Liberty Mutual, MetLife Auto & Home and Travelers
(888) 693-1388 (option 1)
https://sprint.benefithub.com/?refer=JZSGVF
20 hours
Enroll year-round
Coverage effective upon approval date
Pet Insurance
VPI Pet Insurance
(888) 693-1388 (option 3)
https://sprint.benefithub.com/?refer=JZSGVF
20 hours
Enroll year-round
Coverage effective upon approval date
Rewards and Recognition
www.sprint.com/irecognize
No minimum
Available year-round
Employee Phone Programs
i-Connect > Life & Career
20 hours
Available year-round
Sprint Employee
Discount Site
Sprint MarketPlace
https://sprint.benefithub.com/?refer=JZSGVF
No minimum
Available year-round
Paid Time Off /Holidays
i-Connect > Life & Career
20 hours
PTO available year-round (check PTO policy on i-Connect)
Leaves of Absence
i-Connect > Life & Career
20 hours
Refer to Employee Guide
Business Travel
Accident Insurance
The Hartford
(888) 563-1124 (toll-free from the U.S. or Canada)
i-Connect > Life & Career
20 hours
No enrollment necessary (automatically covered if eligible)
Travel Assistance Program
The Hartford
(888) 563-1124 (toll-free from the U.S. or Canada)
i-Connect > Life & Career
20 hours
No enrollment necessary (automatically covered if eligible)
Medical Benefits Abroad
Cigna International
(800) 243-1348 (inside U.S. and Canada)
i-Connect > Life & Career
40 hours
No enrollment necessary (automatically covered if eligible)
Adoption Assistance Program
i-Connect > Life & Career
30 hours
Available year-round
Sprint Volunteers Program
sprint.com/volunteers
No minimum
Available year-round
Employee Help Line
(800) 697-6000
Intranet: type “ehlticket” into Web browser
No minimum
Available for employee questions
Coverage effective the first of the
monthafter the enrollment signature
date
Important Legal Information
Women’s Health and Cancer
Rights Act of 1998
As required by the Department of Labor and the
Department of Health and Human Services, Sprint
is providing this notice about the Women’s Health
and Cancer Rights Act of 1998. This notice serves
as the annual notice required by the Department
of Labor. The Women’s Health and Cancer
Rights Act of 1998 provides certain benefits for
mastectomy-related services. These benefits
include coverage for:
• Reconstruction of the breast on which the
mastectomy has been performed;
• Surgery and reconstruction of the other breast
to produce a symmetrical appearance; and
• Prosthesis and treatment of physical
complications for all stages of the mastectomy,
including lymphedema
Children’s Health
Insurance Program (CHIP)
If you are eligible for health coverage from Sprint,
but are unable to afford the premiums, some
states have premium-assistance programs that
can help pay for coverage.
These states use funds from their Medicaid or
CHIP programs to help people who are eligible
for employer sponsored health coverage, but
need assistance in paying their health premiums.
Additional details can be found on i-Connect.
Newborns’ and Mothers’
Health Protection Act
As required by the Department of Labor, Sprint is
providing this notice about the Newborns’ and
Mothers’ Health Protection Act. Group health
35
plans and health insurance issuers generally
may not, under federal law, restrict benefits for
any hospital length of stay in connection with
childbirth for the mother or newborn child to
less than 48 hours following a vaginal delivery or
less than 96 hours following a Cesarean section.
However, federal law generally does not prohibit
the mother’s or newborn’s attending.
• Your spouse’s hours of employment are
reduced;
What is COBRA
continuation coverage?
Your dependent children will become qualified
beneficiaries if they lose coverage under the Plan
because any of the following qualifying events
happens:
COBRA continuation coverage is a continuation
of Plan coverage when coverage would otherwise
end because of an event known as a “qualifying
event.” Specific qualifying events are listed below.
After a qualifying event, COBRA continuation
coverage must be offered to each person who
is a “qualified beneficiary.” You, your spouse
and your dependent children could become
qualified beneficiaries if coverage under the Plan
is lost because of the qualifying event. Under the
Plan, qualified beneficiaries who elect COBRA
continuation coverage must pay for the coverage.
If you are an employee, you will become a
qualified beneficiary if you lose your coverage
under the Plan because any one of the following
qualifying events happens:
• Your hours of employment are reduced; or
• You are absent from work by reason of
approved military service leave under
the Uniformed Services Employment and
Reemployment Rights Act (USERRA); or
• Your employment ends for any reason, other
than your gross misconduct. If you are the
spouse of an employee, you will become a
qualified beneficiary if you lose your coverage
under the Plan because any of the following
qualifying events happens:
• Your spouse dies;
• Your spouse’s employment ends for any reason,
other than his or her gross misconduct;
> Your spouse becomes entitled to Medicare
benefits (under Part A, Part B or both); or
• You become divorced from your spouse.
• The parent-employee dies;
• The parent-employee’s hours of employment
are reduced;
• The parent-employee’s employment ends
for any reason, other than his or her gross
misconduct;
• The parent-employee becomes entitled to
Medicare benefits (Part A, Part B or both);
• The parents become divorced; or
• The child stops being eligible for coverage
under the plan as a “dependent child.”
A child born to, adopted by or placed for adoption
with a covered employee during a period of
COBRA continuation coverage is considered
to be a qualified beneficiary provided that the
covered employee is a qualified beneficiary and
the covered employee has elected continuation
coverage for himself or herself.
When is COBRA
coverage available?
The Plan will offer COBRA continuation coverage
to qualified beneficiaries only after the Plan
Administrator has been notified that a qualifying
event has occurred. When the qualifying event
is the end of employment or reduction of hours
of employment, death of the employee or the
employee becoming entitled to Medicare benefits
(under Part A, Part B or both), the employer must
notify the Plan Administra- tor of the qualifying
event.
You must give notice
of some qualifying events
For the other qualifying events (divorce of the
employee and spouse or a dependent child’s
losing eligibility for coverage as a dependent
child), you must notify the Plan Administrator in
writing within 31 calendar days after the qualifying
event or the loss of coverage, whichever is later.
You must notify the Plan Administrator using
the notice procedures specified below. If these
notice procedures are not followed, any spouse or
dependent child who loses coverage will not be
offered the option to elect COBRA continuation
coverage. In addition, as described below, if you
or anyone in your family is determined to be
disabled by the Social Security Administration
(“SSA”), you must inform the Plan Administrator in
a timely fashion.
Notice procedures
If you are a current Sprint employee at the time
of the qualifying event, you must either provide
notice of the qualifying event by contacting the
Employee Help Line (EHL) through submitting an
online EHL ticket in the i-Connect Web browser
within 31 calendar days of the qualifying event or
the loss of coverage, whichever is later.
If you are not a Sprint employee but are a
qualified beneficiary, you must provide notice
of the qualifying event by contacting the Plan
36
Administrator through the Taben Group within 31
calendar days of the qualifying event or the loss
of coverage, whichever is later. Your notice must
be in writing and be sent to Sprint at the following
address:
The Taben Group
PO BOX 7330
Shawnee Mission, KS 66207
Your written notice must state the name of the
Plan, the name and address of the employee
covered under the Plan and the name(s) and
address(es) of the qualified beneficiary(ies). Your
notice must also name the qualifying event and
the date it happened. See below for additional
information about notice procedures relating to
disability extensions and second qualifying event
extensions. Please direct all questions to the
COBRA Plan Administrator.
How is COBRA
coverage provided?
Once the Plan Administrator receives timely
notice that a qualifying event has occurred,
COBRA continuation coverage will be offered
to each of the qualified beneficiaries pursuant
to an election notice. Each qualified beneficiary
will have an independent right to elect COBRA
continuation coverage. Covered employees
may elect COBRA continuation coverage on
behalf of their spouses, and parents may elect
COBRA continuation coverage on behalf of their
children. If you or your spouse or dependent
children do not elect COBRA continuation
coverage within the 60-day election period, as
described in the election notice, you will lose
your right to elect COBRA continuation coverage.
COBRA continuation coverage is a temporary
continuation of coverage. When the qualifying
event is the death of the employee, the employee
becoming entitled to Medicare benefits (under
Part A, Part B or both), divorce, or a dependent
child losing eligibility as a dependent child,
COBRA continuation coverage lasts for up to a
total of 36 months. When the qualifying event is
the end of employment or reduction of the
employee’s hours of employment and the
employee became entitled to Medicare benefits
less than 18 months before the qualifying event,
COBRA continuation coverage for qualified
beneficiaries other than the employee lasts until
36 months after the date of Medicare entitlement.
For example, if a covered employee becomes
entitled to Medicare 8 months before the date
on which his employment terminates, COBRA
continuation coverage for his spouse and eligible
children can last up to 36 months after the date of
Medicare entitlement, which is equal to 28 months
after the date of the qualifying event (36 months
minus 8 months). Otherwise, when the qualifying
event is the end of employment or reduction of
the employee’s hours of employment, COBRA
continuation coverage generally lasts for up to a
total of 18 months. There are two ways in which
this 18-month period of COBRA continuation
coverage can be extended.
Disability extension of
month period of COBRA
continuation coverage
Second qualifying event
extension of 18-month period of
COBRA continuation coverage
If you or anyone in your family covered under
the Plan is determined by the SSA to be disabled
and you notify the Plan Administrator in a timely
fashion, you and your entire family may be
entitled to receive up to an additional 11 months
of COBRA continuation coverage, for a total
maximum of 29 months. The disability would
have to have started at some time before the
60th day of COBRA continuation coverage and
must last at least until the end of the 18-month
period of continuation coverage. You must notify
Sprint of the disability before the date that is 60
days after the latest of: (1) the date of the SSA’s
disability determination; (2) the date on which the
qualifying event occurs; or the date on which you
would lose coverage under the Plan as a result of
the qualifying event. In all cases, the notice must
be provided before the end of the first 18 months
of COBRA continuation coverage. Your notice
must be in writing and be sent to Sprint at the
following address:
If your family experiences another qualifying
event while receiving 18 months of COBRA
continuation coverage (or the 11-month disability
extension), the spouse and dependent children
in your family can get up to 18 additional months
of COBRA continuation coverage, for a maximum
of 36 months from the initial qualifying event, if
notice of the second qualifying event is properly
given to the Plan Administrator.
The Taben Group
PO BOX 7330
Shawnee Mission, KS 66207
Your written notice must include the name of
the disabled qualified beneficiary, the date the
qualified beneficiary became disabled and the
date that the SSA made its determination. Your
written notice must also include a copy of the
SSA’s determination. If these notice procedures
are not followed, the notice does not contain the
required information or the notice is not provided
to the Plan Administrator within the required
period, there will be no disability extension of
COBRA continuation coverage.
37
The notice procedures for second qualifying
events are described in the election notice, and
if they are not followed, then there will be no
extension of COBRA continuation coverage due
to a second qualifying event. This extension may
be available to the spouse and any dependent
children receiving continuation coverage if the
employee or former employee dies, becomes
entitled to Medicare benefits (under Part A, Part
B or both) or gets divorced or legally separated
or if the dependent child stops being eligible
under the Plan as a dependent child, but only
if the event would have caused the spouse or
dependent child to lose coverage under the
Plan had the first qualifying event not occurred.
Shorter maximum coverage for Health Flexible
Spending Account. The maximum COBRA
continuation coverage for a health flexible
spending account maintained by Sprint ends
on the last day of the plan year in which the
qualifying event occurs.
Early termination of
COBRA coverage
However, the law also provides that continuation
coverage will be terminated before the end of
the maximum period for any of the following five
reasons:
• Sprint and all participating companies no
longer provide group health coverage to any of
its employees;
• The required premium for continuation
coverage is not paid on time;
• After the date of your COBRA election, the
qualified beneficiary becomes covered under
another group health plan that does not contain
any exclusion or limitation with respect to any
pre-existing condition he or she may have (in
the case of a Sprint Medical Plan, the Sprint
Dental Plan and the Sprint Vision Care Plan);
• After the date of your COBRA election, the
qualified beneficiary becomes entitled to
Medicare (in the case of a Sprint Medical Plan,
the Sprint Dental Plan and the Sprint Vision Care
Plan);
• The qualified beneficiary extends coverage for
up to 29 months due to disability and there has
been a final determination that the individual is
no longer disabled; or
• In the case of a qualifying event involving an
absence from employment by reason of military
service under USERRA, the date which is the
earlier of: (1) the date which is 18 months after
the date on which the person is required to
apply for or the return to covered employment,
as determined under 38 United States Code
Section 4312(e); or (2) the date which is 36
months after the date on which the absence
began.
If the Plan Administrator determines that
continuation coverage of a qualified beneficiary
must terminate earlier than the end of the
maximum period of continuation coverage
applicable to such qualifying event, the Plan
Administrator shall provide notice to such
qualifying beneficiary as soon as practicable
following the Plan Administrator’s decision.
The notice shall provide: (i) the reason that
continuation coverage has terminated earlier than
the end of the maximum period of continuation
coverage applicable to such qualifying event; (ii)
the date of termination of continuation coverage;
and (iii) any rights the qualified beneficiary
may have under the Plan or under applicable
law to elect an alternative group or individual
coverage. The Health Insurance Portability and
Accountability Act of 1996 (HIPAA) restricts the
extent to which group health plans may impose
pre-existing condition limitations. These rules are
generally effective for plan years beginning after
June 30, 1997.
HIPAA coordinates COBRA’s other coverage cutoff rule with these new limits as follows. If you
become covered by another group health plan
and that plan contains a pre- existing condition
limitation that affects you, your COBRA coverage
cannot be terminated. However, if the other plan’s
pre-existing condition rule does not apply to you
by reason of HIPAA’s restrictions on pre-existing
condition clauses, the Sprint Medical Plan may
terminate your COBRA coverage. If you have any
questions about COBRA, please contact the EHL.
Also, if you have changed marital status, or you
or your spouse have changed addresses, please
notify the EHL in the manner discussed above.
HIPAA Privacy Notice
General Information About This
Notice Purpose:
This Notice describes what Sprint Corporation,
under existing federal regulations, can and
cannot disclose regarding your Personal Health
Information (“PHI”), and to whom.
Plans Covered:
This Notice relates to the use and disclosure of
your PHI by the following group health plans
(“Plans”) maintained by Sprint Corporation, or
any of its related subsidiaries or other affiliates
(“Sprint”):
• Consumer Access Medical/Prescription Plan
• Health Account Medical/Prescription Plan
• Basic Medical/Prescription Plan
• WholeHealth Medical (ACO)/Prescription Plan
• TriCare Medical Plan
• HMO Medical/Prescription Plan
• Dental Plan
If you have questions
Questions concerning the Plan or your COBRA continuation coverage rights
should be addressed to the Plan Administrator at the following address:
Sprint Health Care Plan
Attention:
Sprint Benefits Administrator
6500 Sprint Parkway
Mail Stop: KSOPHL0312-3A
Overland Park, KS 66251-1202
38
• Vision Plan
• Health Care Flexible Spending Account
• Employee Assistance Plan
• Health Clinic
• Health Reimbursement Arrangement
Please note that, depending on the
circumstances, the term “Plans” as used in this
Notice may mean multiple Plans or a single Plan.
Likewise, the level of PHI that is used or disclosed
may be different
depending on whether the plan is fully-insured
through a separate health insurance provider.
Your health insurance provider will notify you
separately of any specific policies or procedures
regarding the disclosure of PHI if your plan is fullyinsured.
The Plans are committed to maintaining the
confidentiality of your PHI regarding coverage
under the plans. This Notice describes the Plans’
legal duties and privacy practices with respect to
your PHI. This Notice also describes your rights,
and the Plans’ obligations, regarding the use and
disclosure of your PHI.
In an effort to generally describe your rights
under HIPAA (Health Insurance Portability and
Accountability Act of 1996), you are being
provided with a copy of this Notice as a person
eligible to receive coverage under one of the
Sprint-sponsored Plans. However, to the extent
you are covered under one of the fully-insured
plans identified on the attached schedule, you
may have further rights and obligations specific to
that plan’s form of coverage. To the extent there
is a conflict between this general Notice and the
Notice pro- vided separately by a health insurer
providing fully-insured benefits, the terms of the
more specific Notice from the health insurer is
controlling with respect to that coverage.
Who Must Comply:
This Notice applies to:
• The Sprint Plans listed in this Notice;
• Employees or other individuals acting on behalf
of the Plans; and
• Third parties performing services for the Plans.
Privacy Requirements:
The Plans are required by law to:
• Keep private any PHI that identifies you;
• Provide you with this Notice of the Plans’ legal
duties and privacy
• practices with respect to your PHI;
• Follow the terms of the Notice that is currently
in effect; and
39
• Notify affected individuals follow- ing a breach
of unsecured PHI.
General Requirements:
Under HIPAA, the Plans are required to maintain
the privacy of your PHI. PHI is the information that
is created, or received by, or on behalf of, the
Plans and includes:
• Information that relates to your past, present,
or future physical or mental health or condition,
including genetic information;
• The provision of health care services to you;
• The past, present, or future payment for the
provision of health care services to you; and
• Information that either identifies you or with
respect to which there is a reasonable basis to
believe the information can be used to identify
you.
PHI may be maintained or transmitted
electronically or in any other form or medium. If
the Plans amend this Notice for any reason, an
updated privacy Notice will be provided to you.
Plans’ Use and Disclosure of
Your Medical Information
General Uses And Disclosures:
Although general use and disclosure
of PHI is strictly limited, the Plans are allowed to
use your PHI as follows:
Use or disclosure for payment: The Plans may
use and disclose your PHI so the Plans can make
proper payment for the services provided to
you. For example, the Plans may use your PHI to
determine your benefit eligibility or coverage
level, to pay a health care provider for your
medical treatment, or to reimburse you for your
direct payment to a health care provider.
Use or disclosure for treatment: The Plans may
use and disclose your PHI to the extent necessary
to facilitate your treatment. For example, the Plans
may use or disclose PHI to provide, manage and
coordinate health care and related services.
Use or disclosure for health care operations:
The Plans may use and disclose your PHI to the
extent necessary to administer and maintain the
Plans. For example, the Plans may use your PHI in
the process of negotiating contracts with third
party administrators, such as HMOs and provider
networks, or for internal audits.
Disclosure to Sprint: With respect to your Plan
coverage, the Plans may use and disclose your
PHI to Sprint as permitted or required by the Plan
documents, or as required by law.
Certain Sprint employees who perform
administrative functions for the Plans may use
or disclose your PHI for Plan administration
purposes. A written authorization is required for
the Plans to disclose any PHI to Sprint for reasons
other than payment or Plan administra- tion.
At no time will PHI be disclosed to Sprint for
employment-related actions or decisions.
Disclosures to Family or Close Friends: Under
certain circumstances, as determined by the
Company in its sole discretion, the Plan may
release your PHI to either a family member or
someone who is involved in your health care or
payment for your care.
Your Written Authorization
The Plans will not make any use or disclosure of
your PHI for marketing purposes, or any disclosure
that constitutes a sale of PHI, without your prior
written authorization. Furthermore, the Plans will
not use or disclose your PHI for any purposes
not described in this Notice without your prior
written authorization. If you provide the Plans with
authorization to use or disclose your PHI, you may
revoke that permission, in writing to the Privacy
Officer’s attention, at any time. If you revoke your
authorization, the Plans will no longer use or
disclose your PHI for the reasons covered by your
written authorization.
However, if you revoke your authorization,
the Plans will be unable to reverse any
disclosures already made based upon your
prior authorization.
Other Special
Disclosure Situations
The following are further examples
of when the Plans may disclose your PHI without
your authorization:
Required by Law: The Plans may use or disclose
your PHI to the extent such disclosure is required
by law and the use or disclosure complies with,
and is limited to, the relevant requirements of
such law.
Required for Public Health:
The Plans may use or disclose your PHI for public
health reasons, such as the following:
Prevention or control of disease, injury or
disability;
• To report child abuse or neglect;
• To report reactions to medications or problems
with products;
• To notify individuals of recalls of medications
or products they may be using and track FDA
regulated products as directed by the FDA; and
• To notify a person who may have been exposed
to a disease, or may be at risk for contracting or
spreading a disease or condition.
Victims of Abuse, Neglect or Domestic
Violence: As permitted or required by law, the
Plans may disclose your PHI to an appropriate
government authority if the Plans reasonably
believe you are the victim of abuse, neglect or
domestic violence.
40
Health Oversight Activities: As required by
law, the Plans may disclose your PHI to health
oversight agencies. Such disclosure will
occur during audits, investigations, inspections,
licensure, and other government monitoring and
activities related to health care provision or public
benefits or services.
Judicial Proceedings, Lawsuits and Disputes:
The Plans may disclose your PHI in response to
an order of a court or administrative tribunal,
provided the Plans disclose only the PHI expressly
authorized by such order.
If you are involved in a lawsuit or a dispute, the
Plans may disclose your PHI when responding
to a subpoena, discovery request, or other
lawful process where there is no court order
or administrative tribunal. Under these
circumstances, the Plans will require satisfactory
assurance from the party seeking your PHI that
such party has made reasonable effort either to
ensure you have been given notice of the request
or opportunity to secure a qualified protective
order.
Law Enforcement: In response to a court order,
subpoena, warrant, summons or other legal
request, or upon a law enforcement official’s
request, the Plans may release your PHI to a law
enforcement official. The Plans may also release
medical information about you to authorized
government officials for purposes of public and
national security.
Coroners, Medical Examiners and Funeral
Directors: Upon your death, the Plans may
release your PHI to a coroner or medical examiner
for purposes of identifying you or to determine
a cause of death, and to funeral directors as
necessary to carry out their duties.
National Security and Intelligence Activities:
The Plans may release medical information about
you to authorized federal officials for intelligence,
counterintelligence, and any other national
security activities authorized by law.
Military and Veterans: If you are, or were, a
member of the armed forc- es, the Plans may
release your PHI as required by military command
au- thorities. The Plans may also release PHI about
foreign military personnel to the appropriate
authorities.
Workers’ Compensation: The Plans may release
your PHI to comply with workers’ compensation or
similar programs.
PLEASE NOTE: ALTHOUGH HIPAA GENERALLY
ALLOWS USE AND DISCLOSURE OF PHI UNDER
THE CONDITIONS AND CIRCUMSTANCES
DESCRIBED ABOVE, TO THE EXTENT THE LAWS
OF ANY STATE IN WHICH THE PLANS PROVIDE
COVERAGE ARE MORE STRINGENT THAN WHAT
HIPAA GENERALLY REQUIRES, THE PLANS SHALL
COMPLY WITH THE APPLICABLE LAWS OF SUCH
STATE.
Your Rights
You have the following rights
regarding your PHI maintained by the Plans:
Right to request restriction:
You have the right to request a restriction or
limitation on the Plans’ use or disclosure of
your PHI for treatment, payment or health care
operations purposes as set forth above. You
also have the right to request a limit on the PHI
the Plans disclose about you to someone who
is involved in your care or the payment of your
care. The Plans are not required to agree to your
request. The Plans will generally comply with
your request unless the information is needed to
provide you with emergency treatment.
To request restrictions on the use and disclosure
of your PHI, you must complete and submit a
written request on a “Request for Restrictions
or Limitations Form” found on i-Connect to the
Privacy Official. Your written request must specify:
(1) the information you want to limit; (2) whether
you want the Plans to limit the use, disclosure, or
both; and (3) to whom you want the restrictions to
apply.
Right to receive confidential communications:
You have the right to ask the Plans to
communicate with you about your
PHI in a certain manner or at a certain location.
For example, you may ask that the Plans contact
you only at home and not at work.
To receive confidential communications in a
certain manner, you must complete and submit a
written request on the “Request for Confidential
Communications Form” found on i-Connect.
The Plans will accommodate all reasonable
requests if you clearly state you are requesting
the confidential communication because you feel
disclosure could endanger your life. You must
make sure your request specifies how or where
you wish to be contacted.
41
Right to inspect and copy your PHI: You have
the right to inspect and copy your PHI in records
maintained, used, collected or disseminated by
the Plans. This PHI usually includes the medical
and billing records maintained by the Plans but
does not include psychotherapy notes, if any, to
which the Plans have access.
To inspect and copy your PHI maintained by the
Plans, you must submit a written request to the
Privacy Official. The Plans may charge you fees
for the costs of copying, mailing or other supplies
directly associated with your request.
If the Plans deny your request, you will have
an opportunity to have the denial reviewed if
the denial was based on a licensed health care
professional’s opinion that:
• The access is reasonably likely to endanger
the life or physical safety of you or another
individual; or
• Your PHI makes references to another person,
and the Plans believe that the requested access
would likely cause substantial harm to the other
person.
If this occurs, a licensed health care professional
chosen by the Plans will review the request and
denial. The person conducting the review will not
be the person who denied your request. The Plans
will comply with the outcome of the review.
Right to amend your PHI: You have the right to
request an amendment to your PHI maintained by
the Plans if you believe the PHI is incorrect
or incomplete. To request an amendment, you
must submit a written request to the Privacy
Official. You must provide the Plans with a reason
that supports your request.
The Plans may deny your request for
an amendment in any of the following
circumstances:
• Your request is not in writing, or it does not
include a reason to support the request;
• The PHI to which your request refers was not
created by the Plans, unless the person or entity
that created the PHI is no longer available to
make the amendment;
• The PHI to which your request refers is not
part of the medical information, enrollment,
payment, claims adjudication or management
records kept by the Plans;
• The PHI to which your request refers is not part
of the information you would be permitted to
inspect or copy; or
• The PHI to which your request refers is accurate
and complete.
Right to receive an accounting of disclosures
of PHI: Subject to certain exceptions, you have
the right to request a list of the disclosures
regarding your PHI made by the Plans.
In order to receive such an accounting of
disclosures, you must submit a written request to
the Privacy Off Your request must include (1) the
time period for the accounting, which may not
be longer than six (6) years and may not include
dates prior to April 14, 2003; and (2) the form (e.g.,
electron- ic, paper) in which you would like the
accounting.
Your first request within a 12-month period will
be free. The Plans may charge you for costs
associated with providing you additional lists. The
Plans will notify you of the costs involved, and you
may choose to withdraw or modify your request
before you incur any costs.
Note: Sprint may not have some of the above
information and may only be available from the
health care vendor. In that case, you would need
to contact the vendor directly.
Right to receive a paper copy of this Notice:
Additional Information
About This Notice
In order to receive a paper copy, you must submit
a written request to the Privacy Official. You
may receive a paper copy of this Notice, even
if you previously agreed to receive this Notice
electronically.
Changes to this Notice
You have the right to receive a paper copy of this
Notice.
Filing A Complaint Against The Plans
If you believe your rights have been violated, you
may file a complaint with the Plans. The complaint
should contain a brief description of how you
believe your rights have been violated. You should
attach any doc- uments or evidence that supports
your belief, along with the Plans’ Privacy Notice
provided to you, or the date of such Notice. The
Plans take complaints seriously. You will not be
retaliated against for filing such a complaint.
Please contact the Privacy Official, in care of
the follow- ing contact name and address, for
additional information and/or to file a complaint:
Ms. Maureen Cooney
Head of Privacy
Sprint Corporation
PO Box 4600
Reston, VA 20195
You may also file complaints with the United
States Department of Health and Human Services
at:
The U.S. Department of Health
and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
Alternatively, you may visit the HHS website,
at http://www. hhs.gov/ocr/privacy/hipaa/
complaints/index.html, for more information
about filing a complaint or to file a complaint
electronically.
42
The Plans reserve the right to change their privacy
practices as described in this Notice. These
changes may affect the use and disclosure of
your PHI already maintained by the Plans, as well
as any of your PHI that the Plans may receive or
create in the future. The Plans will provide a copy
of the current Notice to individuals currently
eligible for coverage under the Plans and to new
Plan enrollees at the time of enrollment. A copy
of the current Notice is also available during
normal business hours upon request to the
Privacy Official, and online internally at i-Connect.
Additionally, the Plans will provide you with any
revised Notices within sixty (60) days of material
revisions to this Notice.
No Guarantee of Employment
Nothing in this Notice shall be construed as a
contract of employment between Sprint and
any employee, nor as a right of any employee
to continued employment at Sprint.
No Change to Plans
Except for the privacy rights described in this
Notice, nothing contained in this Notice shall be
construed to change any rights or obligations
you may have under the Plans. You should refer
to the Plan documents for complete information
regarding any rights or obligations you may have
under the Plans.
What you need to know about
HIPAA and its impact on the availability
and portability of health coverage.
The Health Insurance Portability &
Accountability Act of 1996 (“HIPAA”) is
a federal law that affects group health
plans and health insurance issuers.
The HIPAA provisions are designed to improve the
availability and portability of health coverage by
limiting exclusions for pre-existing conditions and
providing individuals with special rights to enroll
in health coverage when they lose their existing
coverage. To help you better understand how
HIPAA affects your access to health coverage, we
are providing the following brief description of
some of HIPAA’s most significant provisions. We
hope you find this information helpful.
Special enrollment periods
If you waive coverage for yourself
and your eligible dependents (including your
spouse) in the Sprint Medical Plan because of
other health insurance coverage or group health
plan coverage, you may in the future be able
to enroll yourself or your eligible dependents
(including your spouse) in medical coverage,
provided that you request enrollment within
31 days after you or your eligible dependents’
(including your spouse’s) other coverage ends
(or after the employer providing other coverage
stops contributing toward the other coverage).
For certain dependents, if you have a new
dependent, you may be able to enroll yourself
and your dependents, provided that you request
enrollment. Coverage is effective on the date you
gain the new dependent if you request enrollment
by the 30th day after the birth or adoption.
Coverage is effective prospectively if you request
enrollment by the 30th day after the date of a
marriage or attaining domestic partner status. See
applicable summary plan descriptions (SPDs) for
details. All questions about the special enrollment
rights should be directed to your health care Plan
Administrator.
Other important ERISA Information
For more information about your rights under
Employee Retirement Income Security Act
(ERISA), COBRA, the Health Insurance Portability
and Accountability Act (HIPAA) and other laws
affecting group health plans, you may also
contact the nearest Regional or District Office of
the U.S. Department of Labor’s Employee Benefits
Security Administration (EBSA) in your area or visit
the EBSA Web site at dol.gov/ ebsa.
(Addresses and phone numbers of Regional and
District EBSA Offices are available through
EBSA’s website.)
Keep your Plan informed of address changes
In order to protect your family’s rights, you should
keep the Plan Administrator informed of any
changes in the addresses of family members. You
should also keep a copy, for your records, of any
notices you send to the Plan Administrator.
43
Important Notice from Sprint about Your
Prescription Drug coverage and Medicare
When Can You Join a Medicare Prescription
Drug Plan?
Please read this Notice carefully and keep it where
you can find it. This Notice has information about
your current prescription drug coverage with
Sprint and about your options under Medicare’s
prescription drug coverage. This information
can help you decide whether or not you want to
obtain Medicare prescription drug plan. If you are
considering obtaining Medicare’s prescription
drug coverage, you should compare your current
coverage**, including which drugs are covered
at what cost, with the coverage and costs of
the plans offering Medicare prescription drug
coverage in your area. Information about where
you can get help to make decisions about your
prescription drug coverage is at the end of this
Notice. There are two important things you
need to know about your current coverage and
Medicare’s prescription drug coverage:
You can join a Medicare prescription drug plan
when you first become eligible for Medicare and
each year from Nov. 15 through Dec. 31. However,
if you lose your current creditable prescription
drug coverage**, through no fault of your own,
you will also be eligible for a two (2) month
Special Enrollment Period (SEP) to join a Medicare
prescription drug plan.
1. Medicare prescription drug coverage
became available in 2006 to everyone with
Medicare. You can get this coverage if you
join a Medicare Prescription Drug Plan or join
a Medicare Advantage Plan (like an HMO or
PPO) that offers prescription drug coverage.
All Medicare prescription drug plans provide
at least a standard level of coverage set by
Medicare. Some plans may also offer more
coverage for a higher monthly premium.
2. Sprint has determined that the prescription
drug coverage offered by each Sprint Medical/
Prescription Drug Plan is, on average for all
applicable plan participants, expected to pay
out as much as standard Medicare prescription
drug coverage pays and is therefore
considered Creditable Coverage. Because your
existing coverage is Creditable Coverage, you
can keep this coverage and not pay a higher
premium** (a penalty) if you later decide to join
another Medicare prescription drug plan.
What Happens to Your Current Prescription
Drug Coverage If You Decide to Join a
Medicare Prescription Drug Plan?
Joining a Medicare prescription drug plan in
and of itself does not affect your current Sprint
coverage**.
When Will You Pay a Higher Premium (Penalty)
to Join a Medicare Prescription Drug Plan?
You should also know that if you don’t join a
Medicare prescription drug plan within 63
continuous days after your Sprint coverage
ends**, you may pay a higher premium (a penalty)
to join a Medicare prescription drug plan later.
If you go 63 continuous days or longer without
creditable prescription drug coverage, your
monthly premium may go up by at least 1% of the
Medicare base beneficiary premium per month for
every month that you did not have that creditable
coverage.
For example, if you go nineteen months without
creditable coverage, your premium may
consistently be at least 19% higher than the
Medicare base beneficiary premium. You may
have to pay this higher premium (a penalty) as
long as you have Medicare prescription drug
coverage. In addition, you may have to wait until
the following November to join.
**Note: Sprint coverage of prescription drug expenses will end
for any covered person as of the later of
— the end of the month in which such covered person becomes
eligible for Medicare prescription drug coverage, and
— the end of the month in which employee (not retiree, LTD or
COBRA-continued) coverage ends, whether or not such person
is enrolled in a Medicare drug plan and whether such a person
becomes eligible for Medicare prescription drug coverage by
turning age
65, receipt of Social Security or Railroad Retirement Board
disability or otherwise.
For More Information About Your Options
Under Medicare Prescription Drug Coverage…
More detailed information about Medicare plans
that offer prescription drug coverage is in the
“Medicare & You” handbook. You’ll get a copy
of the handbook in the mail every year from
Medicare. You may also be contacted directly by
Medicare drug plans.
For more information about Medicare prescription
drug coverage: Visit medicare.gov
• Call your State Health Insurance Assistance
Program (see the inside back cover of your
copy of the “Medicare & You” handbook for their
telephone number) for personalized help
• Call 1-800-MEDICARE (1-800-633-4227).
TTY users should call 1-877-486-2048.
If you have limited income and resources, extra
help paying for Medicare prescription
drug coverage is available. For information about
this extra help, visit Social Security on the Web at
socialsecurity.gov, or call them at
1-800-772-1213 (TTY 1-800-325-0778).
Remember: Keep this Creditable Coverage Notice.
If you decide to join one of the Medicare drug
plans, you may be required to provide a copy of
this Notice when you join to show whether or not
you have maintained creditable coverage and,
therefore, whether or not you are required to pay
a higher premium (a penalty).
44
New Health Insurance Marketplace
coverage options and your health coverage
PART A: General Information
When key parts of the health care law took
effect in 2014, there was a new way to buy health
insurance: the Health Insurance Marketplace.
To assist you as you evaluate options for you
and your family, this notice provides some basic
information about the new Marketplace and
employment based health coverage offered by
Sprint.
What is the Health Insurance Marketplace?
The Marketplace is designed to help you find
health insurance that meets your needs and fits
your budget. The Marketplace offers “one-stop
shopping” to find and compare private health
insurance options. You may also be eligible for a
new kind of tax credit that lowers your monthly
premium right away.
Can I Save Money on my Health Insurance
Premiums in the Marketplace?
You may qualify to save money and lower your
monthly premium, but only if Sprint does not offer
coverage, or offers coverage that doesn’t meet
certain standards. The savings on your premium
that you’re eligible for depends on your household
income.
Does Sprint Health Coverage Affect
Eligibility for Premium Savings through the
Marketplace?
Yes. If you have an offer of health coverage
from Sprint that meets certain standards, you
will not be eligible for a tax credit through the
Marketplace and may wish to enroll in Sprint’s
health plan. However, you may be eligible for a tax
credit that lowers your monthly premium, or
a reduction in certain cost-sharing if Sprint does
not offer coverage to you at all or does not offer
coverage that meets certain standards. If
the cost of a plan from Sprint that would cover
you (and not any other members of your family)
is more than 9.5% of your household income for
the year, or if the coverage Sprint provides does
not meet the “minimum value” standard set by the
Affordable Care Act, you may be eligible for a tax
credit.
Note: If you purchase a health plan through
the Marketplace instead of accepting health
coverage offered by Sprint, then you may lose
Sprint’s contribution (if any) to the Sprint-offered
coverage. Also, this Sprint contribution as well
as your employee contribution to Sprint-offered
coverage is often excluded from income for
Federal and State income tax purposes. Your
payments for coverage through the Marketplace
are made on an after- tax basis.
How Can I Get
More Information?
For more information about your coverage offered
by Sprint, please check your summary plan
descrip- tion or the Marketplace can help you
evaluate your coverage options, including your
eligibility for coverage through the Marketplace
and its cost. Please visit HealthCare.gov for more
information, including an on- line application
for health insurance coverage and contact
information for a Health Insurance Marketplace in
your area.
PART B: Information About Health
Coverage Offered by Sprint
This section contains information about health
coverage offered by Sprint. If you decide to
complete an application for coverage in the
Marketplace, you will be asked to provide this
information. This information is numbered to
correspond to the Marketplace application.
Employer Name: Sprint
Here is some basic information about health
coverage offered by Sprint:
As your employer, we offer a health plan to some
employees.
• Eligible employees are classified on Sprint’s
payroll records as:
−− our regular, common law employee;
and regularly scheduled to work 20
or more hours per week; and not on a
personal leave of absence exceeding 30
consecutive calendar days (and for initial
coverage not on any leave of absence).
−− A regular, common-law employee does
not include an individual classified
in our payroll records as an intern,
temporary employee or temporary
worker or contractor, even if a court,
administrative agency or other person or
entity determines such an individual is a
common law employee.
• With respect to dependents, we offer coverage.
Eligible dependents are:
Employer Identification Number (EIN):
48-1077227
−− Spouse: a Spouse is person to whom you
are legally married.
Employer Address: 6500 Sprint Parkway
−− Domestic Partner: a Domestic Partner (DP)
is your same- or opposite-sex partner for
so long as you both:
Employer Phone Number: 800-697-6000
City: Overland Park
State: Kansas
ZIP Code: 66251
Who can we contact about employee health
coverage at this job? Sprint Employee Help
Line: 800-697-6000
Phone Number (if different from above) Email
address: [email protected]
++ are at least 18 years old and legally
competent to consent to the DP
relationship;
++ are not related to each other by blood;
++ are in an exclusive committed
relationship similar to marriage and
intend to remain so indefinitely but are
not married under federal law to each
other or any other person;
++ have not ended any federally recognized
marriage or any domestic partnership
with each other or any other person for
at least 12 months;
++ have resided together continuously for
at least 12 months and intend to reside
together indefinitely;
45
++ share joint responsibility for each
other’s common welfare or financial
obligations; and
++ are not domestic partners for the sole
purpose of obtaining Sprint benefits.
• Child: a Child is a person from birth up to age
26 who is:
−− your, your Spouse’s or DP’s biological,
legally adopted or step child;
−− placed for adoption or otherwise placed
by court order or placement agency (e.g.,
foster children, under legal guardianship)
with you, your Spouse or your DP; or
−− a child who is an “alternate recipient”
pursuant to a Qualified Medical Child
Support Order (QMCSO) per the
QMCSO Procedures in the Sprint’s Legal
Information Section of the Summary Plan
Description.
This coverage meets the minimum value standard,
and the cost of this coverage to you is intended to
be affordable, based on your wages.
Even if Sprint intends your coverage to be
affordable, you may still be eligible for a
premium discount through the Marketplace. The
Marketplace will use your household income,
along with other factors, to determine whether
you may be eligible for a premium discount.
If, for example, your wages vary from week to
week (perhaps you are an hourly employee or
you work on a commission basis), if you are
newly employed mid-year, or if you have other
income losses, you may still qualify for a premium
discount.
46