Subject: Review your benefit elections today! ADP TotalSource Benefits Enrollment (12434-182)
From: <[email-masked]>
To: <[email-masked]>
Date: Fri, 22 May 2015 05:36:27 -0400

It's time to review your ADP TotalSource Benefits Elections!

Your benefits election window has closed. Please review the details of the plan elections we have recorded to ensure they are
accurate along with important disclosure information about you and your family members' COBRA, HIPAA and Medicare
rights. Note that as the plan participant, you are responsible for providing these disclosures to your enrolled
dependents.

Here's how to review your benefits elections:

Log in to My TotalSource (www.MyTotalSource.com) and click on the Myself tab, then My Benefits and select
Full Statement.
.

View your benefits elections on the ADP Mobile Solutions app. Learn more.

Act now! Once your benefits start you cannot make changes to your coverage unless you experience an IRS-qualified family status change or HIPAA special
enrollment event. Examples of qualifying events include changes in marital status, including marriage, death of spouse, divorce or legal separation; number of
dependents, including birth, adoption or death; and employment status, including beginning or termination of employment. You must notify ADP TotalSource of any change in status
for you or your dependents, submit your completed enrollment change form, and submit documented proof of the status change within sixty (60) days of the
qualifying event date or your request for benefit election changes will be denied.

If the plan or dependent information shown doesn't match the benefits elections you made, please contact the Employee Service Center at (800) 554-1802.
To access your insurance certificate of coverage visit My TotalSource or contact the Employee Service Center. Please note that during the start of a new Plan Year,
some certificates of coverage may not yet be available.

Regards,
ADP TotalSource

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