Benefits at a Glance

This page summarizes the current terms of certain employee benefit plans and programs available to Honeywell employees. Honeywell’s formal employee plan documents govern the terms and conditions of the plans. The information provided in this presentation and oral and written statements made by a supervisor or human resources representative cannot change the terms and condition of the written plans. Honeywell has reserved the right to modify, change, and revise the terms and conditions of the Company’s employee benefits plans, as well as the right to terminate the plans (subject to applicable collective bargaining agreements). Honeywell has also reserved the right to change the premiums charged to employees and other cost sharing features of the Company’s employee benefit plans (subject to applicable collective bargaining agreements). The information provided in this presentation is not a guarantee of the future availability or design of the Company’s employee benefits.

Annual Deductibles and Out-of-Pocket Maximums

Service	In Network	Out of Network
Deductible – Individual	An upfront $1,500 deductible per covered member will apply.	An upfront $3,000 deductible per covered member will apply.
Deductible – Family	An upfront $3,000 deductible per family will apply.	An upfront $6,000 deductible per family will apply.
Individual Out-of- Pocket Maximum	$2,500 per year for Employees with annualized base pay of $50,000 or less; $4,000 per year for Employees with annualized base pay of more than $50,000.	$8,000
Family Out-of-Pocket Maximum	$5,000 per year for Employees with annualized base pay of $50,000 or less; $8,000 per family with a per individual max of $7,900 for Employees with annualized base pay of more than $50,000.	$16,000
Lifetime Maximum	None	None

Preventive Care

Service	In Network	Out of Network
Periodic physicals for adults	Covered at 100% for annual well visit and preventive services.	Not covered
Well-child care (including routine exams, injections and immunizations)	Covered at 100% for annual well visit and preventive services.	Not covered
Annual Preventive Mammograms, Prostate Screenings and Pap Smears	Covered at 100% for annual well visit and preventive services.	Not covered
Annual Preventive Colonoscopies, Endoscopies and Sigmoidoscopies	Covered at 100% for annual well visit and preventive services.	Not covered
Preventive Lab & X-ray	Covered at 100% for annual well visit and preventive services.	Not covered

Physician Office and Physician’s Staff Services

Service	In Network	Out of Network
Primary Care Office Visit	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. Waived if preventive. For Cigna Staff participants: In-network office visits out of the Cigna Staff model are covered at 70% after deductible	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Specialist Office Visit	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. Waived if preventive. For Cigna Staff participants: In-network office visits out of the Cigna Staff model are covered at 70% after deductible	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached
Office or home visits (including allergy injections)	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. For Cigna Staff participants: In-network visits out of the Cigna Staff model are covered at 70% after deductible	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.

X-ray and Laboratory Services

Service	In Network	Out of Network
Diagnostic X-ray and laboratory, including CAT Scan, MRI	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Preventive X-ray and laboratory	Covered at 100% for annual well visit and preventive services.	Not covered

Inpatient Hospital Services

Service	In Network	Out of Network
Anesthesiologist	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Inpatient physical, occupational and speech therapy	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Other Necessary Services and Supplies	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Physician/Surgeon Services	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Semi-private Room and Board	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.

Outpatient Hospital Services

Service	In Network	Out of Network
Chemotherapy	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Colonoscopy, Endoscopy and Sigmoidoscopy	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. Waived if preventive.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Dialysis	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Infusion Therapy	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Other Medically Necessary Services and Supplies	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Physicians’ and Surgeons’ Charges	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Pre-Admission Testing	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Surgery (including services and supplies)	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.

Emergency Care

Service	In Network	Out of Network
Emergency Care for a life-threatening condition (See Covered Services & Supplies section for an explanation of what constitutes Emergency Care.)	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	All out-of-network Emergency claims will be paid at the in-network benefit level.
Non-Emergency Care	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Ambulance for emergencies (to the nearest facility providing adequate care)	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	All out-of-network Emergency claims will be paid at the in-network benefit level.
Ambulance transportation from one facility to another if medically necessary	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached. If precertification is approved by both facilities, then benefit is paid at the in-network level.
Air Ambulance if medically necessary	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. Not covered if not medically necessary.	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Not covered if not medically necessary.

Maternity Care

Service	In Network	Out of Network
Office visits for Prenatal & Postnatal care	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. Waived if preventive.	For Cigna Staff participants: In-network visits out of the Cigna Staff model are covered at 70% after deductible	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Birth Center (including certified Nurse-Midwife), where available	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Delivery	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.

Other Services

Service	In Network	Out of Network
Blood and blood transfusions (including administrative fees for collection)	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Durable Medical Equipment	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Injury to sound, natural teeth by an external force	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Organ Transplants	If the health plans network transplant program is utilized the deductible applies; then the plan pays 100%. If the health plans network transplant program is not utilized, the deductible applies; then the plan pays 80%. After deductible; plan pays 100% after out-of-pocket is reached. Plan pays up to a maximum of $100 per night for food and lodging and coach airfare for two people to a center of excellence.	The deductible applies; then the plan pays 50%. After deductible; plan pays 100% after out-of-pocket is reached.
Orthogenetic Surgery	Upfront deductible applies; then plan pays 80% after deductible to repair or correct a severe facial deformity or disfigurement that orthodontics alone cannot correct. Plan pays 100% after out-of- pocket maximum is reached. See Section 5.B. for details.	Upfront deductible applies; then plan pays 50% after deductible to repair or correct a severe facial deformity or disfigurement that orthodontics alone cannot correct. Plan pays 100% after out-of-pocket maximum is reached. See Section 5.B. for details.
Overseas Coverage	Emergency, Urgent Care and other conditions which require immediate treatment are covered at the In-network benefit level. Other covered services paid at Out-of- Network benefit level; preventive care is excluded.	Emergency, Urgent Care and other conditions which require immediate treatment are covered at the In- network benefit level. Other covered services paid at Out-of-Network benefit level; preventive care is excluded.
Prosthetics	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Urgent Care	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	All out-of-network Emergency facility claims will be paid at the in-network benefit level.

Other Services - Limits combined for In-network and Out- of network

Service	In Network	Out of Network
Chiropractic Care	Deductible applies; then plan pays 80% after deductible; plan pays 100% after out- of-pocket maximum is reached to a maximum of 30 visits per calendar year (on a combined in-network and out-of- network basis).	Upfront deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached to a maximum of 30 visits per calendar year (on a combined in-network and out-of-network basis).
Home Health Care	BCBS - Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. To a maximum of 120 visits per calendar year.	BCBS - Upfront deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached. To a maximum of 40 visits per calendar year.
Home Health Care	Cigna – Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. To a maximum of 120 days per calendar year	Cigna – Upfront deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached. To a maximum of 40 days per calendar year.
Hospice	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached up to 180 days.	Upfront deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached up to 180 days.
Orthotics	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached to a maximum of one per calendar year (except for individuals with diabetes, in which case this limit will not be imposed). The following items are excluded: arch supports, lifts, inserts, wedges, soles, and those available over the counter.	Upfront deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached to a maximum of one per calendar year (except for individuals with diabetes, in which case this limit will not be imposed). The following items are excluded: arch supports, lifts, inserts, wedges, soles, and those available over the counter.
Outpatient Physical Therapy	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. To a maximum of 30 visits per calendar year.	Upfront deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached. To a maximum of 30 visits per calendar year.
Outpatient speech and/or occupational therapy	Deductible applies; then plan pays 80% after deductible; plan pays 100% after out- of-pocket maximum is reached to a maximum of 30 visits per calendar year.	Deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached to a maximum of 30 visits per calendar year.
Private Duty Nursing	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached limited to outpatient care given by a licensed nurse (RN, LPN or LVN) for professional nursing services at the direction of a doctor.	Not Covered
Skilled Nursing/Extended Care Facility	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached to a maximum of 120 days per calendar year.	Upfront deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached to a maximum of 120 days per calendar year.
Temporomandibular Joint (TMJ) Dysfunction	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached for services received in an Inpatient or Outpatient facility. All treatment must be pre-approved.	Upfront deductible applies; then plan pays 50% after deductible; plan pays 100% after out-of-pocket maximum is reached for services received in an Inpatient or Outpatient facility. All treatment must be pre-approved.

Mental Health/Substance Abuse

Service	In Network	Out of Network
Inpatient	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.
Outpatient	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached.

Prescription Drugs

Service	In Network	Out of Network
Prescription Drugs dispensed at network pharmacies	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. Generic Preventive medications at mail order are provided at no cost.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached. No mail order available.
Mail-Order Maintenance Prescription Drugs	Upfront deductible applies; then plan pays 80% after deductible; plan pays 100% after out-of-pocket maximum is reached. Generic Preventive medications at mail order are provided at no cost.	Upfront deductible applies; then plan pays 50% of Maximum Reimbursable Charge after deductible; plan pays 100% after out-of-pocket maximum is reached. No mail order available.

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