Contributions that are taken from your pay before federal (and, in most cases, state and local) taxes are withheld. Before-tax dollars are also generally taken from your pay before Social Security taxes are withheld. This lowers your taxable income and your income tax liability. This reduction to taxable income will not affect any other pay-related benefits, such as basic life insurance, long-term disability insurance, and your Retirement Plan benefits. So, your other benefits will continue to be based on your full, unreduced benefits pay.

Keep in mind that before-tax contributions do not count as earnings for Social Security purposes. Therefore, your future Social Security benefit could be slightly reduced if your total earnings for the year are less than the Social Security wage base ($102,000 in 2008). However, this reduction is nominal and may be outweighed by the immediate tax savings resulting from using before-tax dollars to pay for your benefits.

The company that provides certain claims administration services for the Medical Plan.

The way you share costs for certain Medical Plan coverage options — and Prescription Drug Plan preferred and non-preferred brand drugs — after you pay any applicable deductible. Certain Medical Plan options pay a percentage of reasonable and customary (R&C) charges for medically necessary services, and you pay the remainder. Other Medical Plan options with in-network providers pay a percentage of the claims administrator's negotiated fee with the provider. The actual percentage depends on the option you've chosen and the type of covered service.

A federal law that allows you and/or your covered dependents to continue Medical Plan coverage on an after-tax basis (under certain circumstances) when coverage would otherwise have ended. The "Plan Administration" section of this Guide provides details on COBRA coverage.

The rules that determine how benefits are paid when a patient is covered by more than one group plan. Rules include:

In general, the following coordination of benefits rules apply:

Specific rules may vary, depending on whether the patient is an employee in active status (or the dependent of an employee) or covered by Medicare. These rules do not apply to any private insurance you may have. In addition, these rules do not apply to HMOs, which have their own coordination of benefits provisions. If you are covered by an HMO, please check with that HMO to learn how it handles coordination of benefits.

The amount you pay toward certain health care services under the Point-of-Service (POS) High and Low Options* (for in-network care), the Health Maintenance Organization (HMO) Option, and the Exclusive Provider Organization (EPO) Option. For example, the POS Low Option might require a $40 copayment for an office visit. The POS High Option, HMO Option, and EPO Option may require a $20 copayment for an office visit. Copayments may also apply to certain drugs under the Prescription Drug Plan.

*In some areas, your Medical Plan option administrator may refer to these plans as a Preferred Provider Organization (PPO).

The reasonable and customary (R&C) charges for medically necessary covered services or supplies that qualify for full or partial reimbursement under the Medical Plan's POS High and Low Options, the HMO Option, the EPO Option, the Consumer Driven Health Option (CDHO).

Medical procedures that are generally reimbursable by the JPMorgan Chase Medical Plan when they are "Medically Necessary." (See the definition of "Medically Necessary" in this section.) While the plan provides coverage for numerous services and supplies, there are limitations on what's covered. For example, experimental treatments, most cosmetic surgery expenses, and inpatient and outpatient private duty nursing are not covered under the Medical Plan. So, while a service or supply may be medically necessary, it may not be covered under the Medical Plan.

Medical or non-medical services that do not seek to cure, are provided during periods when the medical condition of the patient is not changing, or do not require continued administration by medical personnel. An example of custodial care is assistance in the activities of daily living.

The amount you pay in a calendar year for covered expenses before the POS High and Low Options (for out-of-network care), the CDHO, or the Traditional Indemnity Option, begins to pay benefits. Amounts in excess of reasonable and customary (R&C) charges or ineligible charges do not count toward the deductible. A deductible may also apply to the Prescription Drug Plan.

You may cover a "domestic partner" as an eligible dependent under the Medical Plan if you're not currently covering a spouse.

OR

You must certify that your domestic partner meets the eligibility rules as defined under the plan before coverage can begin. You may also be asked to certify that your domestic partner and/or your domestic partner's children qualify as tax dependent(s) as determined by the IRC to avoid any applicable imputed income.

Please Note: Some HMOs may not cover domestic partners. Please check with your carrier for details, or refer to the Domestic Partner Coverage Guide available on Company Home > HR & Personal > Pay & Benefits > Library, or contact the Benefits Call Center for more information on qualified adult coverage.

Under the Medical Plan, your eligible dependents can include your spouse or domestic partner (please see the definition of "Domestic Partner" in this section for more information), and your dependent children. Please see "Your Eligible Dependents" for more information.

Medical, surgical, diagnostic, psychiatric, substance abuse, or other health care services, technologies, supplies, treatments, procedures, drug therapies, or devices that, at the time the claims administrator makes a determination regarding coverage in a particular case, are determined to be:

The claims administrator, in its judgment, may determine an experimental, investigational, or unproven service to be covered under the Medical Plan for treating a "life-threatening" sickness or condition if the claims administrator determines that a service:

Please Note: For the purpose of this definition, the term "life-threatening" is used to describe sicknesses or conditions which are more likely than not to cause death within one year of the date of the request for treatment.

If services are denied because they are deemed to be experimental, investigational, or unproven, and the service is approved by the claims administrator within six months of the date of service, you may resubmit your claim for payment.

A statement that the claims administrator prepares, which documents your claim and provides a description of benefits paid and not paid under the Medical Plan.

Generally, a full-time student is defined as a dependent enrolled in an educational institution on a full-time basis at the time services are received. An educational institution is defined as a school maintaining a regular faculty, an established curriculum, and having an organized student body in attendance. It includes high schools, colleges, technical schools, and similar institutions but not on-the-job training. JPMorgan Chase will use the educational institution's definition of a full-time student. During the summer term, when few students are enrolled, coverage will be based on enrollment during the previous term, unless the student has completed his or her full course of studies.

Medical Plan options for which the benefits payments are the responsibility of the insurance carrier or HMO. (HMOs offered under the Medical Plan are fully insured.)

An alternative to inpatient hospitalization during a patient's recovery period. If the attending physician believes that part-time care will suffice in treating the sickness or injury, the physician can prescribe a schedule of services to be provided by a state-licensed home health care agency. This schedule may include administration of medication, a regimen of physical therapy, suctioning or cleansing of a surgical incision, or the supervision of intravenous therapy.

A program that tends to the needs of a terminally ill patient as an alternative to traditional health care, while meeting medically necessary and acceptable standards of quality and sound principles of health care administration. The program must be a written plan of hospice care for a covered person, and it must be approved by the appropriate claims administrator.

An institution legally licensed as a hospital — other than a facility owned or operated by the United States Government — that's engaged primarily in providing bed patients with diagnosis and treatment under the supervision of licensed physicians. The hospital must have 24-hour-a-day registered graduate nursing services and facilities for major surgery. Institutions that don't meet this definition don't qualify as hospitals.

A requirement under certain Medical Plan options that you notify the claims administrator of a non-emergency hospital admission before the admission takes place or if a maternity stay exceeds the guidelines. If you're a participant in the Traditional Indemnity Option or if you are admitted to a hospital under the POS High or Low Options, the EPO Option, or the CDHO, you need to provide notification to the claims administrator.

Terms referring to whether a covered service is performed by a physician who is part of the network associated with the Medical Plan POS High or Low Options or CDHO ("in-network") or by a physician who is not part of the network ("out-of-network"). When a service is performed in-network, benefits are generally paid at a higher level than they are when a service is performed out-of-network.

The most a Medical Plan option will pay for covered services in each participant's lifetime.

Health care services and supplies that are determined by the claims administrator to be medically appropriate and:

Please Note: For the purpose of this definition, the term "life-threatening" is used to describe sicknesses or conditions that are more likely than not to cause death within one year of the date of the request for treatment.

The fact that a physician has performed or prescribed a procedure or treatment or the fact that it may be the only treatment for a particular injury, sickness, or condition does not mean that it is a medically necessary service or supply as defined above. The definition of "medically necessary" used here relates only to coverage and may differ from the way in which a physician engaged in the practice of medicine may define "medically necessary."

Medicare is the Health Insurance for the Aged and Disabled provisions of Title XVIII of the Social Security Act of the United States, as enacted or later amended. Coverage is available to most U.S. residents age 65 and older, those with a disability for at least 29 months, and those with end-stage renal disease (ESRD). Generally, Medicare is the primary coverage for those individuals who are age 65 and older, unless these individuals are actively working.

Under the POS High and Low Options (both in-network and out-of-network), the EPO Option, the CDHO, and the Traditional Indemnity Option, surgical procedures that are performed on the same date of service are subject to the multiple surgical procedure reduction policy. Of the reasonable and customary (R&C) charges, 100% are reimbursable for the primary/major procedure, 50% of R&C charges are reimbursable for the secondary procedure, and 50% of R&C charges are reimbursable for all subsequent procedures. Participants undergoing surgery are urged to discuss this policy with their health care provider.

The Medical Plan does not allow for duplication of benefits. If you and your eligible dependents are covered under more than one group plan, the primary plan (the one responsible for paying benefits first) needs to be determined. You are entitled to receive benefits up to what you would have received under the Medical Plan if it were your only source of coverage, but not in excess of that amount. If you have other coverage that is primary to the Medical Plan, the claims administrator will reduce the amount of coverage that you would otherwise receive under this plan by any amount you receive from your primary coverage. Please see the definition of "Coordination of Benefits" in this section.

The most you would need to pay in a calendar year for medically necessary covered services under the POS High and Low Options, the CDHO, or the Traditional Indemnity Option. Once the out-of-pocket maximum is reached, the Medical Plan option will pay 100% of reasonable and customary (R&C) charges for medically necessary covered services for the rest of the year. Under the POS High and Low Options, and the Traditional Indemnity Option, amounts that you pay toward your deductible, copay, and amounts above R&C charges, do not count toward your out-of-pocket maximum. Under the CDHO, the annual out-of-pocket maximum does include the annual deductible. An out-of-pocket maximum also applies to the Prescription Drug Plan.

Under many HMO Options and EPO Options, the network physician who provides or coordinates all the care you receive. Services not authorized by your PCP (or network obstetrician/gynecologist, where applicable) may not be covered unless it qualifies as emergency care.

The plan that provides initial coverage to the participant. If the participant is covered under both a JPMorgan Chase Medical Plan option and another plan, the rules of the primary plan govern when determining the coordination of benefits between the two plans.

Specific rules may vary, depending on whether the patient is an employee in active status (or the dependent of an employee) or covered by Medicare. These rules do not apply to any private insurance you may have.

The JPMorgan Chase benefits you elect during each annual benefits enrollment period will generally stay in effect throughout the plan year, unless you elect otherwise due to a qualified change in status (such as marriage, divorce, the birth or adoption of a child, etc.) within 31 days of the event for benefits to be effective the date of the event. If you miss the 31-day deadline, coverage for certain benefits will be effective as of the date you contact the Benefits Call Center.

Please Note: Any changes you make during the year must be consistent with your qualified change in status. Please see "Qualified Change in Status" for more information.

The actual charges that are considered for payment when you receive medically necessary care for covered services from an out-of-network provider under the POS High and Low Options, the CDHO, and the Traditional Indemnity Option. R&C means the prevailing charge for most providers in the same or a similar geographic area for the same or similar service or supply. These charges are subject to change at any time without notice. Reimbursement is based on the lower of this amount and the provider's actual charge.

If your provider charges more than the R&C charges considered under the plans, you'll have to pay the difference. Amounts that you pay in excess of the R&C charge are not considered eligible expenses. Therefore, they don't count toward your deductible, benefit limits, or maximums.

The category that is assigned to a state or region based on the cost of health care for that region in relation to the national average. The Regional Cost Category is a factor used to determine your Medical Plan contributions and is based on your home address.

How JPMorgan Chase pays for medical claims under the POS High and Low Options, the EPO Option, the CDHO, the Traditional Indemnity Option, and the Prescription Drug Plan.

An institution that primarily provides skilled nursing care and related services for people who require medical or nursing care and that rehabilitates injured, disabled, or sick people.

Total annual cash compensation is your base salary plus applicable job differential pay (e.g., shift pay) as of each August 1, plus any cash earnings from any incentive plans (e.g., annual bonus, commissions, draws, overrides, and special recognition payments or incentives) that are paid to or deferred by you for the previous 12-month period ending each July 31. Overtime is not included. For purposes of determining the Medical Plan contribution pay tier that applies to you, your total annual cash compensation is recalculated as of each August 1 to take effect the following January 1 and will remain unchanged throughout the year. For most employees hired on or after August 1, total annual cash compensation will be equal to base salary plus job differentials.

Separate definitions may apply to employees in certain sales positions who are paid on a draw-and-commission basis. If this situation applies to you, you will be notified.

A visit is an encounter with a provider which involves direct patient contact. Some benefit provisions limit the number of covered visits. Unless a visit is defined for a particular benefit provision (such as home health care), each procedure code billed counts as a visit toward the limit. The length of a visit may vary by procedure code.