2020B E N E F I T S

G U I D E

2020 - 2021B E N E F I T S

G U I D E

Dutch Missions in the United States

Here’s where to find ...

A Message from HR at the Embassy of the Netherlands 2

Eligibility 3

Medical Insurance 4

Telehealth 6

Cigna Resources 7

Dental Insurance 8

Vision Insurance 9

401(k) 10

401(k) Plan Features 11

Short- and Long-Term Disability 12

Paid Time Off 13

Glossary 14

Contacts 15

A MESSAGE FROM HR: At the Embassy of the Netherlands, we recognize our ultimate success depends on our talented and dedicated workforce. We understand the contribution of each employee makes our accomplishments. Our goal is to provide a comprehensive program of exceptional benefits to attract and retain the best employees available. Through our benefits programs we strive to support the needs of our employees and their dependents by providing a benefit package that is easy to understand, easy to access and affordable for all our employees. This brochure is designed to help you understand the benefits available to you, and to utilize them to the fullest. Please contact me or another member of the Human Resources/supervisory team if you have questions or we can support you in any way.

Sincerely, JJ van Herksen

WELCOME TO YOUR BENEFITS

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Eligibility Eligible EmployeesYou may enroll in the Embassy of the Netherlands Employee Benefits Program if you are a Full-Time employee who is actively working 17.5+ hours/week.

Eligible DependentsIf you are eligible for our medical benefits, then your dependents are too. In general, eligible dependents include your spouse, domestic partner and children up to age 26. Spouses are eligible for health coverage under the Embassy’s plans if the spouse’ employment income is less than the employee’s. If your child is mentally or physically disabled, coverage may continue beyond age 26 once proof of the ongoing disability is provided. Children may include natural, adopted, step-children and children obtained through court-appointed legal guardianship, as well as dependents of a domestic partner.

Eligible dependent children under the age of 24, as long as they are full time students, can receive dental insurance coverage via the employee.

Enrolling in CoverageYour benefits are effective on your date of hire. Please note you must elect benefits within your first 30 days of employment. The benefits you elect will remain in place for the full plan year, which renews annually on July 1, unless you have a qualifying family status change.

Family Status ChangeA change in family status is a change in your personal life that may impact your eligibility or dependent’s eligibility for benefits.

Examples of family status changes include:

� Change of legal marital status (i.e., marriage, divorce, death of spouse)

� Change in number of dependents (i.e., birth, adoption, death of dependent, ineligibility due to age)

� Change in employment or job status (e.g., spouse gains or loses access to benefits through his/her employer)

If such a change occurs, you must make the changes to your benefits within 30 days of the event date. Documentation may be required to verify your change of status. Failure to request a change of status within 30 days of the event may result in your having to wait until the next open enrollment period to make your change. Please contact HR to make these changes.

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2020-2021 Benefits Guide

MedicalThe Embassy of the Netherlands offers the choice between three medical plans administered by CIGNA. Please note that although only the High Plan offers out-of-network coverage, all three plans utilize the same national Cigna Open Access Plus network. To find a participating provider, go to cigna.com and search under the “Open Access Plus” network.

Medical and prescription drug plan summary

High Plan Choice Plan Base PlanBenefit InformationPCP selection required? no no noReferrals required? no no no

In-Network

Deductible None None$1,000 per person $3,000 per family

Coinsurance (amount plan pays after deductible)

100% 100% 100%

Out-of-Pocket Maximum (maximum amount you'll pay)

$3,000 per person $6,000 per family

$3,000 per person $6,000 per family

$3,000 per person $6,000 per family

Preventive Care No charge No charge No chargeOffice Visit - PCP $10 $15 $25 Office Visit - Specialist $15 $30 $50 Telehealth $10 $15 $25 Urgent Care $35 $75 $75 ER $75 $150 $150 Diagnostic labs/xrays No charge No charge No chargeMajor diagnostics/imaging No charge $150 Deductible, then no chargeOutpatient services No charge $100 Deductible, then no chargeInpatient services No charge $250 Deductible, then no charge

Out-Of-Network

Deductible$500 per person $1000 per family

n/a n/a

Coinsurance (amount plan pays) 80% n/a n/aOut-of-Pocket Maximum (maximum amount you'll pay)

$3,000 per person $6,000 per family

n/a n/a

Rx BenefitRetailGeneric $10 $10 $20 Preferred Brand $20 $20 $30 Non-Preferred Brand $40 $40 $50

Mail Order2.5x retail 2.5x retail 2.5x retail

This is a summary of your coverage only. Please refer to your summary plan description for the full scope of coverage

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Employee Medical Payroll Contributions (monthly)

Active Employee Contribution (28%)

PPO Plan Choice Plan Base PlanEmployee Only $292.51 $273.13 $248.67

Employee + 1 $614.27 $573.59 $522.21

Employee + Family $827.80 $772.98 $703.74

Retired Employee Contribution (30%)

PPO Plan Choice Plan Base PlanEmployee Only $313.40 $292.64 $266.43

Employee + 1 $658.14 $614.56 $559.51

Employee + Family $886.93 $828.19 $754.00

Disabled Retiree Employee Contribution (35%)

PPO Plan Choice Plan Base PlanEmployee Only $365.63 $341.42 $310.84

Employee + 1 $767.83 $716.99 $652.76

Employee + Family $1,034.75 $966.22 $879.67

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2020-2021 Benefits Guide

TelehealthCigna’s medical plans all include the Cigna Telehealth Connection program. This lets you connect with a board-certified physician via phone or secure video chat, at your convenience and without leaving your home. Providers can treat a wide range of conditions and even provide most prescriptions.

� CHOOSE WHEN: Day or night, weekdays, weekends and holidays.

� CHOOSE WHERE: Home, work or on the go.

� CHOOSE HOW: Phone or video chat.

� CHOOSE WHO: Amwell or MDLIVE doctors.

Say it’s the middle of the night and your child is sick. Or you’re at work and not feeling well. Or you’re following social distancing rules. Once you’re registered under the Telehealth Connection, you can speak with a doctor for help with:

� Sore throat

� Allergies

� Headache

� Rash

� Stomachache

� Acne

� Fever

� Cold and Flu

� UTIs and more

THE COST AND CONVENIENCE SAVINGS ARE CLEAR. Televisits with Amwell and MDLIVE are the same as your PCP copayment, much less than a convenience care clinic, urgent care center, or emergency room.

Remember, your telehealth services are only available for minor, non-life threatening conditions. In an emergency, dial 911 or go to the nearest hospital.

Cigna partners with two telehealth providers: Amwell and MDLive. Register for one or both today so you’ll be set up in the system and ready to go when you need them.

� AmwellforCigna.com MDLIVEforCigna.com

� 855-667-9722 888-726-3171

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Register for your Cigna AccountVisit mycigna.com or download to the myCigna mobile app to register for your Cigna account. Once you register, you will be able to find providers, view claims, manage your account, and more all from the myCigna website or app. Dial 1-800-Cigna24 to speak to your Cigna One Guide.

Mail-Order MedicationsGetting your maintenance medications by mail is a great way to save time and money; limit unnecessary trips to the pharmacy; and reduce the likelihood of running out of medication. To access a list of drugs that qualify for mail-order delivery, or to enroll in mail order, visit mycigna.com or call 800-835-3784

Cigna ResourcesNavigating your health care isn’t always easy. Cigna One Guide provides a highly personalized support system, available by phone or app, designed to make it easy to get the most out of your health care benefits.

� Start your plan year off on the right foot with clear information about how your coverage works, right at your fingertips.

� Make decisions about your care with confidence, using simple search tools and easy-to-understand educational materials that are fully tailored based on your plan.

� Stay motivated to stay on top of your health with friendly, proactive reminders sent to you through the mobile app.

� Maximize savings opportunities. Your personal guide will connect you to the right resources based on your plan, and explain any wellness or incentive programs available to you.

� Find discounts on products and programs for weight management, nutrition, fitness, vision and hearing care, alternative medicine, and more.

� Easily keep track of the doctors, and facilities you prefer to visit, simply by adding them to your My Health Team list in the myCigna mobile app. Important information like phone numbers and addresses are right at your fingertips, all in one place.

Worry Less, Enjoy Life More!

Cigna has two science-based apps designed to help boost your emotional health and resiliency.

Happify (happify.com/Cigna) is a fun, free app that can help you defeat negative thoughts, reduce stress and anxiety, and boost health and performance. Happify has more than 60 interactive programs available, including self-reflection activities, articles, podcasts, and more. Earn points for each activity you complete and win prizes!

iPrevail is a digital therapeutics platform to help you take control of the stresses of everyday life and challenges. Programs are customized to you and include interactive video lessons, 1:1 coaching, support communities and online wellness activities. And while you’re getting healthier, earn points toward Amazon.com gift cards for participating!

For peak results, iPrevail recommends you complete one level per week (about 15 minutes). To get started, go to myCigna.com, Stress and Emotional Wellness page, and click on the iPrevail link.

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2020-2021 Benefits Guide

BONUS VISION DOLLARS!

The Ameritas dental plan also provides you with a $100 allowance to use toward vision expenses, such as an exam, glasses, or contacts. This is in addition to the $2,500 annual dental benefit. It is also in addition to any benefits you may receive under the Cigna vision plan.

DentalThe Embassy of the Netherlands offers Dental coverage through Ameritas. Under this plan, you may visit any dentist you choose. However, your benefits will go farther if you visit an in-network provider. Not only will the provider charge a discounted fee, but the plan will pay a higher percentage of that fee.

To find a participating provider, visit Ameritas.com and search for the Classic PPO network.

Preventive care is 100% covered by the plan – no cost to you for your twice-yearly dental checkups and cleanings! We encourage you to get regular dental care to help detect and deter dental issues.

Ameritas In- Network Out-Of-NetworkMaximum Benefit, per person $2,500 per calendar year

Calendar-Year Deductible$25 per person$75 per family

Diagnostic and Preventive Care Exams, X-Rays, Cleanings

100% deductible waived

Basic Care Fillings, periodontics, endodontics, extractions

90% 80%

Major CareCrowns, dentures, bridges, implants

60% 50%

Orthodontia Children Only

50%, deductible waived$2,000 lifetime maximum benefit

This is a summary of your coverage only. Please refer to your summary plan description for the full scope of coverage.

Employee Dental Payroll Contributions (monthly)

Active Retired Disabled RetireeEmployee Only $12.11 $12.97 $15.13

Employee + 1 $23.89 $25.60 $29.86

Employee + Family $42.24 $45.25 $52.79

Register for your secure member account at ameritas.com

ONE-TIME SET UP IS QUICK AND EASY

1.Go to ameritas.com

2.Click Account Access in the upper right corner or Account Access on a mobile device

3.Select the Dental/Vision/Hearing drop-down

4.Choose “Secure Member Account”

5.On the Login page select Register Now

6.Complete the New User Registration form

Using online services helps to minimize your risk of identity theft, protect your privacy and get your benefit information faster than through the mail.

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VisionThe Embassy of the Netherlands offers a vision plan through CIGNA. The Vision plan provides coverage for routine eye exams and also provides benefits for the cost of glasses or contact lenses if you need them. You can see in- or out-of-network providers, however, your benefits will go farther if you visit an in-network provider.

In-Network Out-Of-NetworkEye exam with dilation as necessary - Every 12 months

$10 Up to $45 allowance

Frames - Every 12 months

$130 allowance after $10 copay Up to $71 allowance

Standard lenses - Every 12 MonthsSingle visionBifocalTrifocalLenticular

Covered in full after $10 copay

Up to $32 allowanceUp to $55 allowanceUp to $65 allowanceUp to $80 allowance

Contact lenses - lieu of eyeglasses - Every 12 MonthsMedically necessary Covered at 100% Up to $210 allowanceElective $130 allowance after $10 copay Up to $105 allowance

This is a summary of your coverage only. Please refer to your summary plan description for the full scope of coverage.

Employee Vision Payroll Contributions (monthly)

Active Retired Disabled RetireeEmployee Only $2.00 $2.15 $2.50

Employee + 1 $3.83 $4.10 $4.78

Employee + Family $6.22 $6.67 $7.78

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2020-2021 Benefits Guide

401(k) Plan � An employee may elect to become a

Participant in the Plan the first day of the month after completion of three months of service

� Maximum contribution: 15% of salary

� The Embassy will contribute 5% of pensionable pay. Employer contributions are immediately vested and are not contingent on any employee contribution.

� The Embassy will also match up to a maximum of 4-4.8% of pensionable after-tax pay (depending on nationality)

� Once you are eligible to participate, you will automatically be enrolled into the 401(k) with a 2% after-tax employee contribution, unless and until you select an alternate contribution percentage

Getting Started with NetBenefits

SETUP IS EASY AND SECURE. No matter where you are in planning for your financial future, Fidelity NetBenefits® is a great place to start. It’s your one-stop online resource, designed so you can quickly and easily set up, monitor, and manage your retirement account.

� Go to NETBENEFITS.COM

� Click the Register Now link.

� Follow the instructions to set up your username and password.

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401(k) Plan FeaturesEligibility Requirements All Contributions Complete 3 months of service

Enrollment All ContributionsFirst day of each monthYour plan offers an Automatic Enrollment feature.

Contributions

Employee ContributionsIRS Limit Pre-Tax2020 $19,500Catch-up Limit2020 $6,500

1% to 15% of eligible pretax pay1% to 15% of eligible after tax payEGTRRA Catch Up Provision

Company ContributionsCompany Match:US citizen - 100% up to 4%Non-US citizen - 120% up to 4%

Safe Harbor

The Employer will make a Safe Harbor contributionon your behalf in an amount equal to 6% (5% permanent + 1% during DB freeze, ending on 12/31/2020) of your eligible compensation. Starting 1/1/2021 the Safe Harbor contribution will default back to 5%.

Vesting

Employee Contributionsand Safe Harbor

100% immediate

Company MatchYears of Service

less than 11

Vesting Percentage100%100%

Loans Although your plan account is intended for the future, you may take a loan from your account.

Withdrawals Withdrawals from the Plan are generally permitted in the event of termination of employment,retirement disability, or death.

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2020-2021 Benefits Guide

Life and Disability ProtectionThe Embassy of the Netherlands provides the following protections to you should you become unable to work. The costs of these programs are fully borne by the Embassy.

Life Benefits

The Embassy provides a surviving dependents’ pension. In addition, an additional payment may be made if you suffer disability or death during the course of your official duties.

Short-Term Disability (STD)

If you are unable to work due to illness, injury, or maternity, the Embassy provides the following benefits, beginning on the date you are unable to work.

� First six months: 100% of earnings

� Next six months: 70% of earnings

� Job security will be maintained for 52 weeks

Long-Term Disability (LTD)

� After 52 weeks, disability benefits will be 60% of earnings

Specific details of the life and long-term disability benefits are based upon your service history. Please contact HR for details.

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Paid Time OffVacation Days

Each year, you will be eligible for 150 hours, or 18.75 days, of vacation (prorated based on hire date). As your years of service increase, you will be eligible for additional vacation time as follows:

Years of Service Vacation Time≥ 3 years and < 10 years 174 hours

≥ 10 years and < 15 years 186 hours

≥ 15 years and < 20 years 196 hours

≥ 20 years and over 212 hours

Holidays and Leaves

In addition to vacation time, you will also receive paid time off for the following events as applicable:

� 13 paid holidays per year (days will be set every year upon advice upon the Mission Council)

� 16 weeks paid maternity leave

� Special leave

z Marriage of employee – 3 days

z Marriage of parent or child – 1 day

z When your partner gives birth – 5 days

z Death of partner, child, parent, or family member in the 2nd degree – 7 days

z Death of family member in the 3rd degree – 2 days

� Jury duty

Employees may also be eligible for additional time off under the Family and Medical Leave Act to care for a newborn, adopted, or foster child; or to care for a family member with a serious health condition.

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2020-2021 Benefits Guide

GlossaryBRAND NAME DRUGS: Drugs that have trade names and are protected by patents. Brand name drugs are generally the most costly choice.

COINSURANCE: The percentage of a covered charge paid by the plan.

COPAYMENT (COPAY): A flat dollar amount you pay for medical or prescription drug services regardless of the actual amount charged by your doctor or health care provider.

DEDUCTIBLE: The annual amount you must pay each year before the plan pays benefits. In general, the deductible does not apply to services with copays, such as office visits and prescription drugs.

GENERIC DRUGS: Generic drugs are less expensive versions of brand name drugs that have the same intended use, dosage, effects, risks, safety and strength. The strength and purity of generic medications are strictly regulated by the Federal Food and Drug Administration.

IN-NETWORK: Use of a health care provider that participates in the plan’s network. When you use providers in the network, you lower your out-of-pocket expenses because the plan pays a higher percentage of covered expenses.

OUT-OF-NETWORK: Use of a health care provider that does not participate in a plan’s network.

MAIL ORDER PHARMACY: Mail order pharmacies generally provide a 90-day supply of a prescription medication for the same cost as a 60-day supply at a retail pharmacy. Plus, mail order pharmacies offer the convenience of shipping directly to your door.

INPATIENT: Services provided to an individual during an overnight hospital stay.

OUTPATIENT: Services provided to an individual at a hospital facility without an overnight hospital stay.

OUT-OF-POCKET MAXIMUM: The maximum amount you and your family must pay for eligible expenses each plan year. Once your expenses reach the out-of-pocket maximum, the plan pays benefits at 100% of eligible expenses for the remainder of the year.

PRIMARY CARE PHYSICIAN (PCP): physician (generally a family practitioner, internist or pediatrician) who provides ongoing medical care. A primary care physician treats a wide variety of health-related conditions and refers patients to specialists as necessary.

SPECIALIST: A physician who has specialized training in a particular branch of medicine (e.g.,, a surgeon, gastroenterologist or neurologist).

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STAY ON THE LOOKOUT FOR OUR NEW BENEFITS WEBSITE THAT WE’LL BE LAUNCHING IN THE NEXT

FEW WEEKS.

It’s your one-stop-shop for everything benefits where you can:

� Enroll in benefits

� Access 24/7 at home or on-the-go

� View the benefits guide and rates

� View carrier contact information

� Important links to carrier tools

Contacts

CIGNA MEDICAL

#613852 1-866-494-2111 mycigna.com

CIGNA VISION

#613852 1-866-494-2111 mycigna.com

AMERITAS DENTAL

#51093 1-800-487-5553 ameritas.com

FIDELITY

#32257 1-800-835-5095 netbenefits.com

EMBASSY HR / BENEFITS TEAM WAS-HR@minbuza.nl

The descriptions of the benefits are not guarantees of current or future employment or benefits. If there is any conflict between this guide and the official plan documents, the official documents will govern.

Important Notice:

The material in this benefits brochure is for informational purposes only and is neither an offer of coverage or medical or legal advice. It contains only a partial description of plan or program benefits and does not constitute a contract. Consult the Summary Plan Descriptions to determine governing contractual provisions, including procedures, exclusions and limitations relating to your plans. In case of a conflict between your plan documents and this information, the plan documents will govern. The availability of a plan or program may vary by geographic service area.

Participating physicians, hospitals and other health care providers are independent contractors and are neither agents nor employees of our respective insurance companies or our broker. The availability of any particular provider cannot be guaranteed, and provider network composition is subject to change. While this material is believed to be accurate as of the print date, it is subject to change. Notice of change shall be provided in accordance with applicable state and federal law. All trademarks, trade names or company names referenced herein are used for informational and identification purposes only and are the exclusive property of their respective owners.