2013 BENEFITS SUMMARY for Guam Salaried and Full-time Hourly Associates What’s Inside IMPORTANT NOTICE 1 Life Events This 2013 Benefits Summary contains an important notice about your prescription drug coverage and Medicare. 13 Eligibility and Enrollment 26 Benefits for Domestic Partners You will find this notice in the Medicare Part D chapter in the back of this book. 32 Medical/Vision 43 The Critical Illness Protection Plan 52 Dental 57 Spending Accounts ¿No habla o lee inglés? 70 Life Insurance Por favor llame al Benefits Choice Center (Centro de 79 Disability—Full-Time Hourly Opción de Beneficios) al 1-800-555-4954 y diga “Estados 87 Disability—Salaried Unidos” para hablar con un representante en español. 96 Accidental Death & Dismemberment 104 FutureBuilder 138 Employee Stock Purchase Plan 149 Work/Life Benefits 154 Time-Off Benefits 155 Leaves of Absence 156 COBRA Coverage 164 Claims and Appeals 172 Plan Administration The Company benefit plans also provide benefits to the following groups of associates of Home Depot U.S.A., Inc. and its affiliates in the U.S., who receive different versions 178 Medicare Part D of the Benefits Summary: part-time hourly associates and certain associates of THD 181 HIPAA Notice At-Home Services who are paid 100% by commission. The Company benefit plans also provide benefits to full-time hourly, part-time hourly and salaried associates in the 185 Benefits Contact List Company’s affiliates in Guam, Puerto Rico and St. Thomas, who receive different 186 Payroll Deductions for 2013 versions of the 2013 Benefits Summary. FfOoM SrRA UB IBMNEE MNMNEAEFRNFIYTIUTS S MTHAISN CMHEANPUT EfoRr CONTACT LIST SEARCH ElLigibfielity E &v Eneronlltmse nt Guam Salaried & Full-Time Hourly Associates Chapter Contents 2 Life Events 5 Adoption, Placement or Termination of Adoption 2 Domestic Partner Life Events 5 Death of… 3 Marriage 6 Loss of Coverage Due to Moving 3 Divorce/Annulment 6 Gain or Loss of Other Coverage 4 Judgement, Order or Decree, including a 10 Change of Employment Status Qualified Medical Child Support Order (QMCSO) 11 Military Leave 4 Birth 12 Leaves of Absence Guam Salaried & Full-Time Hourly Associates 1 To enroll, go to www.livetheorangelife.com; for help, call 1-800-555-4954 MAIN MENU MAIN MENU for Life Events FOR BENEFITS THIS CHAPTER CONTACT LIST SEARCH SUMMARY Get the Most Value from Your Plan What do you need? Find it here... Notify the Benefits Choice Center within 30 days of your Call the Benefits Choice Center at 1-800-555-4954 and speak with a representative qualified status change Make allowed changes in your benefits after qualified status change Go to Your Benefits Resources at http://resources.hewitt.com/homedepot; or call the Benefits Choice Center at 1-800-555-4954 Remember that all election changes made as a whether they are considered your dependents under Life Events result of a life event must be made within 30 days other chapters in this summary. When your life changes, chances are your benefits after the date of the event unless noted otherwise. will need to change too. As you learn more about Note: The Plan Administrator may also permit any when you are able to change your benefit elections If you experience a qualified status change, your other changes provided for under the Plan document during the year, you’ll find out that marriage, divorce, requested change in benefits must be consistent or IRS regulations in addition to those listed in these birth or adoption, or your spouse’s employment with, and correspond to, the qualified status change. charts. change are events that may allow you to make cer- For example, if you are divorced and had been cov- tain changes in your benefits. You’ll also find out that ered under your spouse’s medical plan, it would be Domestic Partner Life Events you have 30 days from the date of the event to con- consistent to elect coverage under the Company’s For information on making coverage changes for tact the Benefits Choice Center or to visit Your Medical Plan. However, if you did not lose coverage your domestic partner or children of your partner, Benefits ResourcesTM and make your changes. as a result of the divorce, it would not be consistent see the Benefits for Domestic Partners chapter. for you to elect medical coverage. Although, due to tax regulations, you are generally not permitted to make election changes during the year If you experience a qualified status change during for benefits paid through a cafeteria plan on a pre-tax the grace period under the healthcare spending basis, election changes are allowed during the year account, changes are only allowed for your election on account of and consistent with certain life events in the current year and not in the year to which the (also referred to in this book as qualified status grace period applies. changes). This section outlines the life events which For purposes of this Life Events chapter, your spouse may permit you to make election changes to the ben- means your spouse as defined in the Eligibility and efits provided to you by the Company. Use the charts Enrollment chapter, and references to your child or to help guide you through the benefit coverages you children only include your own children, and do not may need to change following a particular life event. include the child(ren) of your domestic partner. In addi- Absent a qualified status change or rolling 12-month tion, references to your dependents do not include your election for life and disability, no mid-year election domestic partner or his or her child(ren) regardless of changes can be made. Guam Salaried & Full-Time Hourly Associates 2 To enroll, go to www.livetheorangelife.com; for help, call 1-800-555-4954 MAIN MENU MAIN MENU for Life Events FOR BENEFITS THIS CHAPTER CONTACT LIST SEARCH SUMMARY You can change your benefits as follows: You will be You must notify Voluntary Term asked to provide the Benefits Life, Dependent the Benefits Choice Center Medical/Vision, Health Care Dependent Day Term Life, AD&D If you have the Choice Center within 30 days Dental and Critical Spending Care Spending Insurance, Legal following change with… after… Illness Protection3 Account Account Services Plan1,2,4 Disability2 Marriage You wish to add Documentation veri- Date of marriage Can add coverage for Can start or Can start or increase Can add or increase Not applicable spouse and/or fying the dependency spouse and/or chil- increase contribu- contributions to (within limits) cover- children or status change. dren and change tions to accommo- accommodate newly age for self, spouse medical option date newly eligible eligible dependent(s) and/or children dependents You wish to drop Documentation veri- Date of marriage or Can drop coverage Can stop or Can stop or Can drop or coverage fying the dependency date new for self and/or chil- decrease contribu- decrease contribu- decrease coverage or status change. coverage gained, dren, if covered under tions, if covered tions if new spouse is for self, spouse whichever is later spouse’s employer’s under new spouse’s not employed or and/or children plan health plan makes a dependent care election under his or her plan Divorce/Annulment You wish to drop Documentation veri- Date of decree Can drop coverage Can start, stop, Can start, stop, Can add, increase, Not applicable your dependents’ fying the dependency for children with proof increase or increase or decrease drop or decrease coverage under or status change. of coverage under decrease contributions coverage for self the plan other parent’s plan contributions and/or children You must drop cov- Documentation veri- erage for spouse fying the dependency and any stepchil- or status change. dren who cease to be your dependents You wish to add Documentation veri- Can add or change Can start or Can add or increase self and/or your fying the dependency coverage option for increase contribu- coverage for self eligible children or status change. self and/or children if tions where and/or children under the plan you or at least one coverage is lost child has lost coverage under spouse’s under spouse’s plan health plan 1 An Evidence of Insurability form may be required for adding or increasing voluntary term life and voluntary dependent term life coverage for you or your spouse. See the Life Insurance chapter for more information. 2 Must be actively at work for coverage to take effect. 3 Coverage in the Critical Illness Protection Plan can be dropped at any time for self and/or dependents. 4 Changes to the Legal Services Plan can only be made during Annual Enrollment. Guam Salaried & Full-Time Hourly Associates 3 To enroll, go to www.livetheorangelife.com; for help, call 1-800-555-4954 MAIN MENU MAIN MENU for Life Events FOR BENEFITS THIS CHAPTER CONTACT LIST SEARCH SUMMARY You can change your benefits as follows: You will be You must notify Voluntary Term asked to provide the Benefits Dependent Life, Dependent If you have the the Benefits Choice Center Medical/Vision, Dental Health Care Day Care Term Life, AD&D following change Choice Center within 30 days and Critical Illness Spending Spending Insurance, Legal in status… with… after… Protection4 Account Account Services Plan1,2,5 Disability2 Judgement, Order or Decree, including a Qualified Medical Child Support Order (QMCSO)3 Requires coverage Approved court Issuance of a court Coverage is automatically Can increase No change No change permitted Not applicable for your child under order, judgement or order added for child(ren) and or start contributions permitted this plan decree requiring self, if not enrolled, coverage Coverage will start as as specified by the judge- soon as order ment order or decree is approved Medical Plan option may change to provide required coverage Requires coverage Approved order Date other employer Drop coverage for child(ren) Can decrease or of your child under requiring coverage plan accepts the order covered by the order stop contribution spouse’s plan Birth You wish to add Documentation Date of birth Can add coverage for new Can start or Can start Can add or increase Not applicable self, spouse and/ verifying the child, self, other children increase or increase (within limits) cover- or new child3 dependency or and spouse and/or change contributions contributions age for self, spouse status change. coverage option and/or children You wish to drop Documentation Can drop coverage for self, Can stop or No change No change permitted coverage for self, verifying the spouse and/or other decrease contribu- permitted spouse, or other dependency or dependents if you gain tions children and status change. coverage under spouse’s cover under plan following birth spouse’s plan 1 An Evidence of Insurability form may be required for adding or increasing voluntary term life and voluntary dependent term life coverage for you or your spouse. See the Life Insurance chapter for more information. 2 Must be actively at work for coverage to take effect. 3 A QMCSO may require coverage for your child, but not your spouse or former spouse. 4 Coverage in the Critical Illness Protection Plan can be dropped at any time for self and/or dependents. 5 Changes to the Legal Services Plan can only be made during Annual Enrollment. Guam Salaried & Full-Time Hourly Associates 4 To enroll, go to www.livetheorangelife.com; for help, call 1-800-555-4954 MAIN MENU MAIN MENU for Life Events FOR BENEFITS THIS CHAPTER CONTACT LIST SEARCH SUMMARY You can change your benefits as follows: You will be You must notify Voluntary Term asked to provide the Benefits Dependent Life, Dependent the Benefits Choice Center Medical/Vision, Health Care Day Care Term Life, AD&D If you have the Choice Center within 30 days Dental and Critical Spending Spending Insurance, Legal following change with… after… Illness Protection3 Account Account Services Plan1,2,4 Disability2 Adoption, Placement or Termination of Adoption You wish to add Documentation veri- Date of adoption Can add self, spouse Can start or increase Can start or Can add or increase Not applicable self, spouse and/or fying the dependency or placement and child(ren) and contributions increase (within limits) new child3 or status change. change coverage option contributions coverage for self, (e.g., HMO to PPO) spouse and/or child You wish to drop Can drop coverage for Can stop or Can stop or No change coverage and self, spouse and/or decrease contribu- decrease contri- permitted cover child under dependents if become tions if adoption pro- butions if termi- spouse’s plan covered under spouse’s ceedings terminate nation decreases plan the number of dependents You wish to drop Must drop coverage for Drop affected coverage due to child who ceases to be child only termination of adop- an eligible dependent tion proceedings Death of… Your dependent Documentation veri- Date of death Must drop coverage for Can decrease or Can decrease or Drop coverage for Not applicable covered under fying the dependency dependent who died stop contributions stop contribu- deceased dependent; Home Depot plan or status change. tions can drop or decrease your coverage Your spouse, and Date coverage Can add coverage for Can start or increase Can start or Can add or increase you and/or your ends with other self and/or children or contributions increase (within limits) cover- child(ren) lose cov- employer change coverage option if contributions age for self and erage under your you or any child lost cov- children spouse’s plan erage under spouse’s plan 1 Evidence of Insurability form may be required for adding or increasing voluntary term life and voluntary dependent term life coverage for you or your spouse. See the Life Insurance chapter for more information. 2 Must be actively at work for coverage to take effect. 3 Coverage in the Critical Illness Protection Plan can be dropped at any time for self and/or dependents. 4 Changes to the Legal Services Plan can only be made during Annual Enrollment. Guam Salaried & Full-Time Hourly Associates 5 To enroll, go to www.livetheorangelife.com; for help, call 1-800-555-4954 MAIN MENU MAIN MENU for Life Events FOR BENEFITS THIS CHAPTER CONTACT LIST SEARCH SUMMARY You can change your benefits as follows: You will be You must Voluntary Term asked to notify the Dependent Life, Dependent If you have the provide the Benefits Choice Medical/Vision, Health Care Day Care Term Life, AD&D following change Benefits Choice Center within Dental and Critical Spending Spending Insurance, Legal in status… Center with… 30 days after…3 Illness Protection4 Account Account Services Plan1,2,5 Disability2 Loss of Coverage Due to Moving You have a work site Address must be Your move to a new Can change plan option No change permitted No change No change permitted You are automatically transfer or ZIP Code updated in payroll ZIP code permitted enrolled in coverage change resulting in a system when first eligible. See change to your plan the Disability chapter eligibility for more information on coverage once enrolled You have a work site Address must be Your move to a new No change permitted No change permitted No change No change permitted No change permitted transfer or ZIP Code updated in payroll ZIP code permitted change resulting in no system change to your plan eligibility Gain or Loss of Other Coverage3 Gain of coverage due Documentation Effective date of Can drop or decrease No change permitted Can stop or Can drop or Not applicable to spouse’s employer’s verifying the coverage gained coverage for self, spouse decrease decrease coverage period of coverage dependency or and/or children if become contributions for self, spouse differing from Home status change. covered under spouse’s and/or children Depot’s period of plan coverage6 Loss of coverage due Documentation Effective date of Can add or increase Can start or Can add or increase to spouse’s employer’s verifying the coverage lost coverage for self, spouse increase (within limits) cover- period of coverage differ- dependency or and/or children if covered contributions age for self, spouse ing from Home Depot’s status change. under the spouse’s plan and/or children period of coverage Gain coverage due to Documentation Date coverage Can drop or decrease No change Can drop or change in spouse’s or verifying the begins with other coverage for self, spouse permitted decrease coverage dependent’s employ- dependency or employer and/or children if covered for self, spouse ment6 status change. under newly available and/or children plan 1 An Evidence of Insurability form may be required for adding or increasing voluntary term life and voluntary dependent term life coverage for you or your spouse. See the Life Insurance chapter for more information. 2 Must be actively at work for coverage to take effect. 3 You must notify the Benefits Choice Center after the loss of coverage has occurred but before the 30 days have passed since that loss of coverage. 4 Coverage in the Critical Illness Protection Plan can be dropped at any time for self and/or dependents. 5 Changes to the Legal Services Plan can only be made during Annual Enrollment. 6 Once the spouse gains coverage and is therefore no longer eligible, he/she must be removed from coverage under the Home Depot plan. Guam Salaried & Full-Time Hourly Associates 6 To enroll, go to www.livetheorangelife.com; for help, call 1-800-555-4954 MAIN MENU MAIN MENU for Life Events FOR BENEFITS THIS CHAPTER CONTACT LIST SEARCH SUMMARY You can change your benefits as follows: You will be You must Voluntary Term asked to provide notify the Life, Dependent If you have the the Benefits Benefits Choice Medical/Vision, Health Care Dependent Day Term Life, AD&D following change Choice Center Center within 30 Dental and Critical Spending Care Spending Insurance, Legal in status… with… days after… Illness Protection6 Account Account Services Plan1,2,6 Disability2 Gain or Loss of Other Coverage3 (continued) Loss of coverage Documentation veri- Effective date of You must drop cover- No change permitted Can stop or decrease Can drop or Not applicable due to child’s loss fying the dependency coverage lost age for dependent child contributions for decrease coverage of eligibility under or status change. dependent who loses for self, spouse the Home Depot eligibility and/or children plans You, your child or Can add coverage Not applicable dependent lose cov- and/or change erage under another coverage for you, health plan because your spouse or your it no longer offers children benefits to similarly situated individuals Loss of coverage Date coverage ends Can add or increase Can increase or start No change permitted Not applicable Not applicable due to you, your coverage for self, contributions spouse’s or your spouse and/or children dependent’s loss or change coverage of eligibility under option if you add affect- another health plan4 ed dependent Loss of coverage Date other coverage Can add or increase No change permitted Can increase Not applicable due to action of involuntarily ends coverage for self, or start contributions other employer by spouse and/or children termination of all or change coverage plans of the same option if covered under type or by ceasing spouse's plan all employer contri- butions to coverage that is not COBRA coverage 1 An Evidence of Insurability form may be required for adding or increasing voluntary term life and voluntary dependent term life coverage for you or your spouse. See the Life Insurance chapter for more information. 2 Must be actively at work for coverage to take effect. 3 You must notify the Benefits Choice Center after the loss of coverage has occurred but before the 30 days have passed since that loss of coverage. 4 Loss of eligibility does not include loss of coverage due to failure to pay premiums on a timely basis or termination for cause (such as making fraudulent claims). 5 Coverage in the Critical Illness Protection Plan can be dropped at any time for self and/or dependents. 6 Changes to the Legal Services Plan can only be made during Annual Enrollment. Guam Salaried & Full-Time Hourly Associates 7 To enroll, go to www.livetheorangelife.com; for help, call 1-800-555-4954 MAIN MENU MAIN MENU for Life Events FOR BENEFITS THIS CHAPTER CONTACT LIST SEARCH SUMMARY You can change your benefits as follows: You will be You must Voluntary Term asked to provide notify the Life, Dependent If you have the the Benefits Benefits Choice Medical/Vision, Health Care Dependent Day Term Life, AD&D following change Choice Center Center within 30 Dental and Critical Spending Care Spending Insurance, Legal in status… with… days after… Illness Protection6 Account Account Services Plan1,2,4 Disability2 Gain or Loss of Other Coverage3 (continued) Loss of coverage Documentation veri- Date COBRA cover- Can add or increase Can increase No change permitted No change permitted Not applicable due to the exhaus- fying the dependency age ends with other coverage for self, spouse or start contribu- tion of COBRA or status change. employer and/or children or change tions coverage5 coverage option if cov- ered under spouse’s plan Spouse’s employer Documentation veri- Effective date If option is eliminated, No change eliminates or adds a fying the dependency of change can add coverage for permitted benefit option (e.g., or status change. self, spouse, and/or HMO, PPO, POS or children Indemnity) If option is added, can drop coverage for self, spouse and/or children if covered under new option You, your spouse Documentation veri- Date when coverage Can add or increase cov- Can increase Not applicable or your dependent fying the dependency ends erage for self, spouse or start contribu- lose coverage under or status change. and/or children who lost tions Medicare and you coverage under wish to add cover- Medicare or Medicaid age (medical only) You or your spouse Documentation veri- Date when Medicare Can drop or decrease Can decrease gain coverage by fying the dependency or Medicaid coverage for self, spouse or stop contribu- Medicare and or status change. coverage begins and/or children covered tions you wish to drop by Medicare or Medicaid coverage (medical only) 1 An Evidence of Insurability form may be required for adding or increasing voluntary term life and voluntary dependent term life coverage for you or your spouse. See the Life Insurance chapter for more information. 2 Must be actively at work for coverage to take effect. 3 You must notify the Benefits Choice Center after the loss of coverage has occurred but before the 30 days have passed since that loss of coverage. 4 Changes to the Legal Services Plan can only be made during Annual Enrollment. 5 Exhaustion of COBRA means that an individual's COBRA continuation coverage ceases for any reason other than either failure of the individual to pay premiums on a timely basis, or for cause (such as making a fraudulent claim or an intentional misrepresentation of a material fact in connection with the plan) 6 Coverage in the Critical Illness Protection Plan can be dropped at any time for self and/or dependents. Guam Salaried & Full-Time Hourly Associates 8 To enroll, go to www.livetheorangelife.com; for help, call 1-800-555-4954