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Retiree Medical, Prescription Drug and Mental Health and Substance Abuse Programs - RR Donnelley   
Program Premium Cost
Determining an Annual Premium for You and Your Spouse
Annual Subsidy Cap Amount
On January 1, 1997, RR Donnelley implemented a cap (the “annual subsidy cap amount”) on how much a Participating Employer will pay, on and after January 1, 1997, to the Plan for coverage of a retiree and his or her spouse in the Program, based on the Medical Program in which the retiree and his or her spouse are enrolled, if the retiree satisfies an age and continuous service requirement. When the total cost of coverage (e.g., without a subsidy) exceeds the annual subsidy cap amount, the retiree and his or her spouse, if eligible for the annual subsidy cap amount, are responsible for the total cost of coverage in excess of their annual subsidy cap amount. As a result, if you and your spouse are eligible for an annual subsidy cap amount, the premiums you and your spouse are charged for participating in the Program will be equal to the total cost of coverage you and your spouse would otherwise have to pay, based on the Medical Program in which you and your spouse are enrolled (without the subsidy), minus the annual subsidy cap amount for you and your spouse for that Medical Program.
You and your spouse are eligible, on and after January 1, 1997, for an annual subsidy cap amount only if you have 10 years of “continuous service,” you are at least age 55 at the time of termination of employment with RR Donnelley or any of its subsidiaries, and your 10 years of continuous service must end on or after you attain age 55 while you are employed in a benefits-eligible position.
On and after January 1, 2002, RR Donnelley eliminated the annual subsidy cap amount for you and your spouse if you are an employee of RR Donnelley or any of its subsidiaries who was hired on or after January 1, 2002, or who was hired prior to January 1, 2002 but never worked prior to January 1, 2002 in a benefits-eligible position.
On and after January 1, 2005, RR Donnelley froze the group of retirees and their spouses who were, or could have become, eligible for the annual subsidy cap amount. To be eligible, or to become eligible, for the annual subsidy cap amount, you must satisfy the eligibility criteria created effective on and after January 1, 1997 and January 1, 2002, plus you either (1) must have terminated employment with RR Donnelley or any of its subsidiaries, or died while employed by RR Donnelley or any of its subsidiaries, prior to January 1, 2005, or (2) must have a combination of your age and continuous service as of December 31, 2004 equal to at least 65. If you could have become eligible for the annual subsidy cap amount but your combined age and continuous service, on December 31, 2004, was less than 65, you and your spouse will become eligible for a reduced annual subsidy cap amount when you satisfy the eligibility criteria created effective January 1, 1997 and January 1, 2002.
If you and your spouse are eligible for an annual subsidy cap amount, the following charts outline the current amount of an annual subsidy cap amount based on the Medical Program in which you and your spouse are enrolled.
You satisfy the eligibility criteria created effective on and after January 1, 1997 and January 1, 2002, and you:
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Annual subsidy cap amount per individual if you or your spouse is under age 65 and you or your spouse is enrolled in the CIGNA Open Access Plus or CIGNA Indemnity Option
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- Terminate employment or die before January 1, 2005.
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$5,180
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- Terminate employment or die on or after January 1, 2005 and your age and continuous service, when combined, equal at least 65 as of December 31, 2004.
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$5,180
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- Terminate employment or die on or after January 1, 2005 and your age and continuous service, when combined, is less than 65 as of December 31, 2004.
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$2,590
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You satisfy the eligibility criteria created effective on and after January 1, 1997 and January 1, 2002, and you:
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Annual subsidy cap amount per individual if you or your spouse is age 65 or older and is enrolled in the CIGNA Post-65 Medical Option
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- Terminate employment or die before January 1, 2005.
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$1,458
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- Terminate employment or die on or after January 1, 2005 and your age and continuous service, when combined, equal at least 65 as of December 31, 2004.
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$1,458
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- Terminate employment or die on or after January 1, 2005 and your age and continuous service, when combined, is less than 65 as of December 31, 2004.
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$500
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The annual subsidy cap does not affect the $2 million lifetime maximum benefit and is not associated with health care claims of individual retirees or their spouses.
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