November 2013
2013 Summary of Material Modifications (SMM) to August 2011 Costco Employee Benefits Program SPD
The August 2011 Summary Plan Description (SPD) is the official plan document of the
Costco Employee Benefits Program. The SPD has been supplemented with information in your 2011 Summary of Materials Modifications, 2012 Annual Open Enrollment Guide,
2013 Benefit Plan Changes Booklet and 2013 Summary of Material Modifications. This
2014 Benefit Plan Changes Booklet further supplements the information in the SPD.
2014 Benefit Plan Changes

Dear Costco Employee,
Over the past year, we have all seen many media reports about the new federal health care legislation and about some companies making significant cut backs in the health care benefits provided to their employees. Not Costco. We remain committed to providing our full-time and part-time employees and their families with quality, affordable care.
Of course, it is important for all of us to understand that providing healthcare benefits to our employees and their families is among Costco’s highest expenses. Costco is “selfinsured” for the majority of employees’ health care expenses – this means that the costs of healthcare are paid by Costco (and you, with deductibles, co-pays and co-insurance), not an insurance company. And, because these are our costs, we are always looking for ways to provide these benefits in an efficient, affordable way.
We also believe that all employees can play a role by being smart consumers of healthcare services. By all of us working together on this, we can contribute greatly toward the continuation of our generous benefit plan.
We ask you to read the changes in this booklet; if you have questions, please feel free to contact your manager or the benefits department.
Thank you.
Craig Jelinek
CEO and President
2014 Benefit Plan Changes

Currently, approximately 96% of services for Costco employees are received from innetwork providers. The use of out-of-network providers can be more expensive for both
Costco and for employees. Beginning on September 1, 2014 the Costco medical plans will no longer cover any out-of-network services or providers. Of course if you have an emergency, your treatment will be covered by the plan even if the facility or provider is out-of-network.
This change doesn’t apply to Freedom of Choice or to anyone in an Out-of-Area location. If you are enrolled in one of these plans see below for more information.
For the vast majority of you who always use in-network providers, this will have no impact. And for those that currently use out-of-network providers, you have plenty of time to find an in-network provider that meets your needs. Our Live Healthy Coaches stand ready to help you find the right provider and coach you through that transition.
You can call a Live Healthy Coach at 1-800-814-3543 (press 2).
You also have the opportunity to nominate your provider for consideration as an innetwork provider. You can do that by completing the Physician Nomination Form located on www.costcobenefits.com
or by calling Aetna Concierge Service at 1-800-
814-3543 (press 1).
You can expect to see more information about this change as we get closer to
. September 1 st
How do I Find Out if my Provider is In-Network?
This is easier than you think. You can check your provider by going to www.costcobenefits.com
and clicking on Find a Provider in the top menu bar. You can search by name.
You can also call Aetna at 1-800-814-3543 (press 1) and a Concierge Representative will be able to assist you.
How does this affect Employees in Freedom of Choice?
The Freedom of Choice Plan will continue to have out-of-network benefits. But remember that Freedom of Choice will be discontinued on December 31, 2014.
Open Enrollment is a great time to review your claims during the past year. Especially if you’ve been seeing in-network providers you might consider moving to Choice Plus during this Open Enrollment. You could save money on your healthcare expenses – that’s because Choice Plus has lower payroll contributions, lower deductibles and lower co-insurance maximums.
2014 Benefit Plan Changes Page 2

Here’s another way you’ll save money. The Freedom of Choice Plan requires you to meet your deductible before Costco covers any of your medical expenses. If you just have an office visit once or twice a year you could be paying 100% of the cost of those visits instead of just a co-pay that employees in Choice Plus pay. That’s because the deductible in the Choice Plus Plan doesn’t apply to office visits.
How does this affect Employees in an Out-of-Area Plan?
This won’t change how the Out-of-Area benefits work. Some Costco locations are designated as Out-of-Area for the Healthplan. This designation means that there aren’t enough in-network providers in that area to support the healthcare needs of our employees and their families. Because there isn’t enough access to in-network providers employees in an Out-of-Area Healthplan are allowed to see out-of-network providers. You’ll still be able to see out-of-network providers.
Employee contributions for Employees and Children are not changing for 2014. For employees who were hired before January 1, 2013, Costco is increasing the employee contribution for covering a S pouse or Domestic Partner and for Spouses and
Domestic Partners who are also benefit eligible Costco Employees.
Plan
AETNA PARTICIPANTS
Current Payroll
Deduction
$25
New deduction effective 1/1/2014
$30 Choice Plus (Full-time and Parttime) for Spouse or Domestic
Partner
Choice Plus (Full-time and Parttime) for Costco Spouse or
Domestic Partner
$10 $12.50
Plan
HAWAII PARTICIPANTS
Current Payroll
Deduction
$25 HMSA HMO and PPO for Spouse or Domestic Partner
HMSA HMO and PPO (Full time only) for Costco Spouse or
Domestic Partner
$2.50
Plan
ALL PARTICIPANTS
Current Payroll
Deduction
$4 Core Dental (Full-time and Parttime) for Spouse or Domestic
Partner
Premium Dental (Full-time only) for Spouse or Domestic Partner
$6
New deduction effective 1/1/2014
$30
$3.50
New deduction effective 1/1/2014
$6
$8
2014 Benefit Plan Changes Page 3

The 2014 Rate Booklet lists all employee contributions for all Costco benefit programs.
A copy is available from your payroll clerk or benefits representative. You can also request a copy from the Benefits Department by sending an email to benefits@costco.com or calling 1-800-284-4882.
Costco is adding three new tools to the resources available to you through your Aetna coverage – iTriage, Teladoc and WellMatch. Each of these tools provides a unique, new way of looking at how we access healthcare. Whether you’re on vacation or in your own backyard you can find an in-network provider, know how much a procedure will cost – even have a telephone appointment with a Doctor. These mobile apps (also available on your computer) are designed to help you find the best care and save money no matter where you are.
Teladoc – Starting on December 1, 2013 you can talk to a doctor anytime, anywhere by telephone or online video consultations. From work, from home, on vacation you can consult with a doctor 24 hours a day, 7 days a week, 365 days a year.
Teladoc doctors are U.S. board-certified and licensed in their respective state and average 15 years of practice experience. They can provide treatment and prescribe medication for these conditions:
Cold and Flu Symptoms Allergies
Urinary tract infection
Pediatric care
Bronchitis
Respiratory Infection Sinus problems
Pink Eye
Ear Infection
Your co-pay is less too - only $10 for full-time employees and $15 for part-time employees per visit. Teladoc will bill Aetna for the visit but they don’t bill you for your co-pay. You’ll pay your co-pay at the time of service. Your co-pay can be made with a
American Express, Mastercard, Visa or Discover Card branded credit or debit card.
Watch for the Welcome Letter coming to your home address very soon. It will provide all of the information you need to set up a Teladoc account for you and your family members. iTriage is a free mobile app from Aetna that gives you quick, convenient access to medical information and lets you instantly access local doctors in Aetna’s network. We introduced it last year but beginning November 1, 2013 it will be customized to your
Costco coverage.
What can you do with iTriage? How about:
 Find in-network providers - doctors, labs, radiology center, hospitals
 Find alternative treatment options instead of the Emergency Room
 Check symptoms and find possible causes and treatments
2014 Benefit Plan Changes Page 4

 Find the right level of care for your situation
 Research tests, procedures, diseases and medications
 Manager your health by storing and saving medical information in MyiTriage
 Set medication dosage and refill reminders
 Find the Emergency Room closest to you
Get started today! If you haven’t done it already - download the free iTriage app from the App Store or Google Play Store. You can also text the word iTriage to 31996 for access to the app stores. Follow these easy steps:
 Create a “MyiTriage” account.
 Choose “My Insurance” and select “Aetna”
 Identify your employer – just begin typing Costco until it’s displayed and then select.
 Select your insurance plan from the list provided
 Enter your Aetna Member ID and Group Number – this is on your Aetna ID card
 Select “Link Insurance Account” and add your Aetna Navigator login and password. Don’t have one? You can create one on this page.
As soon as the setup is done you’ll get custom information just for you.
WellMatch (coming in February 2014) – Ever wish you knew how much you and
Costco will be paying for a medical procedure before you got it done? Did you know that providers and hospitals can charge different amounts for the same service even if they are in-network? Ever wonder if another qualified provider would do the same thing for less money?
WellMatch is a new on-line tool from Aetna that lets you search for providers close to where you live and work and view side-by-side each provider’s price for a specific procedure. Here’s where the choices you make can have a positive impact on the amounts both you and Costco pay for healthcare expenses. For example, the cost for a simple MRI can range from $400 to $1500 - your out-of-pocket could range from $40 to
$150, if you’ve met your annual deductible and Costco pays the rest. By choosing a less expensive provider you are saving money for yourself and helping Costco control the cost of providing healthcare.
You can read reviews to help with your selection of a provider. Did you like the provider? Let everyone know by writing a review of your own.
Since it’s an Aetna tool it already knows which medical plan you’re enrolled in, the amounts you’ll see take into consideration the amounts you have already paid for things like your annual deductible and co-insurance.
Visit www.wellmatchhealth.com
to register and be ready to check pricing on your next procedure.
2014 Benefit Plan Changes Page 5

Beginning on January 1, 2014 two things will change with regard to vision benefits.
 The benefit will increase from $150 to $175 once per calendar year.
 Vision hardware (eye glasses and cont a ct lenses) benefits will be provided by
MES Vision instead of Aetna.
REMEMBER: You still have to go to Costco to get your vision hardware.
MES will not be issuing Vision Cards so it is important to remember when filling a prescription at Costco Optical you will need your Costco Employee number and your date of birth. Dependents filling prescriptions at Costco will need to have your Costco
Employee number and your Date of Birth.
For 2014, the Health Care Reimbursement Account limit won’t be changing. Each benefit eligible employee may contribute between $120 and $2,500.
The Health Care Reimbursement Account allows you to set aside money on a pre-tax basis to reimburse eligible healthcare expenses incurred by you, your Spouse (including same sex spouses), and your Dependents. In general a dependent includes any biological or adopted child, step-child, or eligible foster child of yours who is under age
26.
The payroll contribution for Voluntary Short Term Disability will increase on January 1,
2014 from 1.48% to 1.79% of eligible earnings.
The payroll contributions for Supplemental Life Insurance and Spouse Supplemental
Life Insurance are decreasing on January 1, 2014. Here are the new rates:
Employee
Age
Under Age 30
30 to 34
35 to 39
40 to 44
45 to 49
Rate per $10,000 of Coverage
$0.16
$0.18
$0.23
$0.36
$0.67
Employee
Age
50 to 54
55 to 59
60 to 64
65 to 69
70 and over
Rate per $10,000 of Coverage
$1.05
$1.63
$2.55
$4.21
$7.52
Please Note: Your actual payroll deductions reflected on your paycheck may be different than these printed rates due to rounding.
2014 Benefit Plan Changes Page 6

The payroll contributions for Supplemental AD&D Insurance will be decreasing on
January 1, 2014. Here are the new rates:
Full
Benefit
Amount
$50,000
$100,000
$150,000
$200,000
$250,000
$300,000
$350,000
$400,000
$450,000
$500,000
$550,000
$600,000
$650,000
$700,000
$750,000
Employee
Only
$0.35
$0.70
$1.04
$1.39
$1.74
$2.08
$2.43
$2.77
$3.12
$3.47
$3.81
$4.16
$4.50
$4.85
$5.20
Employee
& Children
$0.42
$0.84
$1.25
$1.67
$2.08
$2.50
$2.91
$3.33
$3.74
$4.16
$4.57
$4.99
$5.40
$5.82
$6.24
Employee
&
Family
$0.60
$1.20
$1.80
$2.40
$3.00
$3.60
$4.20
$4.80
$5.40
$6.00
$6.60
$7.20
$7.80
$8.40
$9.00
Full Benefit
Amount
$800,000
$850,000
$900,000
$950,000
$1,000,000
$1,050,000
$1,100,000
$1,150,000
$1,200,000
$1,250,000
$1,300,000
$1,350,000
$1,400,000
Employee
Only
$5.54
$5.89
$6.24
$6.58
$6.93
$7.27
$7.62
$7.97
$8.31
$8.66
$9.00
$9.35
$9.70
$1,450,000 $10.04
$1,500,000 $10.39
Employee
& Children
$6.65
$7.07
$7.48
$7.90
$8.31
$8.73
$9.14
$9.56
$9.97
$10.39
$10.80
$11.22
$11.64
$12.05 $17.40
$12.47 $18.00
Employee
&
Family
$9.60
$10.20
$10.80
$11.40
$12.00
$12.60
$13.20
$13.80
$14.40
$15.00
$15.60
$16.20
$16.80
2014 Benefit Plan Changes Page 7