Annual Notices Plan Year 2015-2016

Annual notices – plan year 2015-2016

Information only – no action is required

FAMILY AND MEDICAL LEAVE ACT OF 1993

You are eligible for leave under the Family and Medical Leave Act (FMLA) if you have been employed for a total of 12 months and worked at least 1,250 hours during the 12 months preceding the leave.

Eligible employees will receive up to 12 weeks of leave within any rolling 12-month period for the birth or adoption of a child, for the employee’s own serious health condition, or to care for a child, spouse, or parent with a serious health condition.

Eligible employees may also be eligible for FMLA leave to care for a family member who is a member of the Armed Forces under certain circumstances.

GENETIC INFORMATION NONDISCRIMINATION ACT 2008

Title II of the Genetic Information Nondiscrimination Act of 2008 protects applicants and employees from discrimination based on genetic information in hiring, promotion, discharge, pay, fringe benefits, job training, classification, referral, and other aspects of employment. GINA also restricts employers’ acquisition of genetic information and strictly limits disclosure of genetic information. Genetic information includes information about genetic tests of applicants, employees, or their family members; the manifestation of diseases or disorders in family members (family medical history); and requests for or receipt of genetic services by applicants, employees, or their family members. Our Plan complies with these requirements.

HIPAA special Enrollment Notice

If you are declining enrollment for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself or your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).

In addition, if you have a new dependent as result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, adoption, or placement for adoption.

Special enrollment rights also may exist in the following circumstances:

If you or your dependents experience a loss of eligibility for Medicaid or a state Children’s Health Insurance Program (CHIP) coverage and you request enrollment within 60 days after that coverage ends; or

If you or your dependents become eligible for a state premium assistance subsidy through Medicaid or a state CHIP with respect to coverage under this plan and you request enrollment within 60 days after the determination of eligibility for such assistance.

Note: The 60-day] period for requesting enrollment applies only in these last two listed circumstances relating to Medicaid and state CHIP. As described above, a 30-day] period applies to most special enrollments.

To request special enrollment or obtain more information, contact your HR Department.

COBRA CONTINUATION OF COVERAGE

Under the federal law, known as COBRA, you and your dependents generally may continue medical, dental, and vision if coverage ends due to either:

A reduction in the number of hours you work or
Termination of your employment for any reason other than gross misconduct.

Your dependents may continue their medical, dental and vision coverage under this plan if their coverage ends for any of the following reasons:

Your death
you become entitled to Medicare
your divorce, annulment, or legal separation, provided the company is notified within 60 days
your dependent loses dependent status, provided the company is notified within 60 days.

This is not a complete description of all COBRA-related provisions. You should consult your SPD for more details.

The following chart shows how long you can continue your COBRA coverage:

If you lose coverage
because . . . / Then you can continue coverage for . . . / If your dependent loses coverage
because . . . / Then your dependent can continue coverage for . . .
You are no longer eligible / 18 months / Of your death / 36 months
You are no longer eligible and either you or your dependent is disabled (according to the Social Security Administration) within 60 days of your loss of eligibility / 29 months / You become eligible for Medicare after your COBRA election begins / 36 months
You and your spouse divorce / 36 months
He or she is no longer a dependent (because of age or divorce) / 36 months

Premium AssistanceUnderMedicaid & the Children’s Health Insurance Program (CHIP)

If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit

If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, contact your State Medicaid or CHIP office to find out if premium assistance is available.

If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan.

Ifyouoryour dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at orcall1-866-444-EBSA(3272).

Ifyoulive in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of July 31, 2015. Contact your State for more information on eligibility –

ALABAMA – Medicaid / GEORGIA – Medicaid
Website:
Phone: 1-855-692-5447 / Website:
- Click on Programs, then Medicaid, then Health Insurance Premium Payment (HIPP)
Phone: 404-656-4507
ALASKA – Medicaid / INDIANA – Medicaid
Website:
Phone (Outside of Anchorage): 1-888-318-8890
Phone (Anchorage): 907-269-6529 / Website:
Phone: 1-800-889-9949
COLORADO – Medicaid / IOWA – Medicaid
Medicaid Website:
Medicaid Customer Contact Center: 1-800-221-3943 / Website:
Phone: 1-888-346-9562
FLORIDA – Medicaid / KANSAS – Medicaid
Website:
Phone: 1-877-357-3268 / Website:
Phone: 1-800-792-4884
KENTUCKY – Medicaid / NEW HAMPSHIRE – Medicaid
Website:
Phone: 1-800-635-2570 / Website:
Phone: 603-271-5218
LOUISIANA – Medicaid / NEW JERSEY – Medicaid and CHIP
Website:
Phone: 1-888-695-2447 / Medicaid Website:
dmahs/clients/medicaid/
Medicaid Phone: 609-631-2392
CHIP Website:
CHIP Phone: 1-800-701-0710
MAINE – Medicaid / NEW YORK – Medicaid
Website:
Phone: 1-800-977-6740TTY 1-800-977-6741 / Website:
Phone: 1-800-541-2831
MASSACHUSETTS – Medicaid and CHIP / NORTH CAROLINA – Medicaid
Website:
Phone: 1-800-462-1120 / Website:
Phone: 919-855-4100
MINNESOTA – Medicaid / NORTH DAKOTA – Medicaid
Website:
Click on Health Care, then Medical Assistance
Phone: 1-800-657-3739 / Website:
Phone: 1-800-755-2604
MISSOURI – Medicaid / OKLAHOMA – Medicaid and CHIP
Website:
Phone: 573-751-2005 / Website:
Phone: 1-888-365-3742
MONTANA – Medicaid / OREGON – Medicaid
Website:
Phone: 1-800-694-3084 / Website:

Phone: 1-800-699-9075
NEBRASKA – Medicaid / PENNSYLVANIA – Medicaid
Website:
Phone: 1-855-632-7633 / Website:
Phone: 1-800-692-7462
NEVADA – Medicaid / RHODE ISLAND – Medicaid
Medicaid Website:
Medicaid Phone: 1-800-992-0900 / Website:
Phone: 401-462-5300
SOUTH CAROLINA – Medicaid / VIRGINIA – Medicaid and CHIP
Website:
Phone: 1-888-549-0820 / Medicaid Website:
Medicaid Phone: 1-800-432-5924
CHIP Website:
CHIP Phone: 1-855-242-8282
SOUTH DAKOTA - Medicaid / WASHINGTON – Medicaid
Website:
Phone: 1-888-828-0059 / Website: index.aspx
Phone: 1-800-562-3022 ext. 15473
TEXAS – Medicaid / WEST VIRGINIA – Medicaid
Website:
Phone: 1-800-440-0493 / Website:
Phone: 1-877-598-5820, HMS Third Party Liability
UTAH – Medicaid and CHIP / WISCONSIN – Medicaid and CHIP
Website: Medicaid:
CHIP:
Phone: 1-866-435-7414 / Website:

Phone: 1-800-362-3002
VERMONT– Medicaid / WYOMING – Medicaid
Website:
Phone: 1-800-250-8427 / Website:
Phone: 307-777-7531

To seeifanyother states have added a premium assistance program since July 31, 2015, or for more information on special enrollment rights, contact either:

U.S. Department of Labor U.S. Department of Health and Human Services

EmployeeBenefits Security AdministrationCenters for Medicare & Medicaid Services

1-866-444-EBSA (3272)1-877-267-2323, MenuOption 4, Ext. 61565

OMB Control Number 1210-0137 (expires 10/31/2016)

SUMMARY ANNUAL REPORT

For Stein Mart, Inc. & Subsidiaries Group Disability and Vision Plan

This is a summary of the annual report of the Stein Mart, Inc. & Subsidiaries Group Disability and Vision Plan, EIN 64-0466198, Plan No. 501, for period January 01, 2014 through December 31, 2014. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).

Insurance Information

The plan has contracts with Liberty Life Assurance Company of Boston and Humana Insurance Company of NE to pay vision, temporary disability and long-term disability claims incurred under the terms of the plan. The total premiums paid for the plan year ending December 31, 2014 were $685,053.

Your Rights To Additional Information. You have the right to receive a copy of the full annual report, or any part thereof, on request. The items listed below are included in that report:

• insurance information, including sales commissions paid by insurance carriers;

To obtain a copy of the full annual report, or any part thereof, write or call the office of Stein Mart, Inc. at 1200 Riverplace Blvd., Jacksonville, FL 32207, or by telephone at (904) 346-1500. The charge to cover copying costs will be $0.25 per page for any part thereof.

You also have the right to receive from the plan administrator, on request and at no charge, a statement of the assets and liabilities of the plan and accompanying notes, or a statement of income and expenses of the plan and accompanying notes, or both. If you request a copy of the full annual report from the plan administrator, these two statements and accompanying notes will be included as part of that report. The charge to cover copying costs given above does not include a charge for the copying of these portions of the report because these portions are furnished without charge.

You also have the legally protected right to examine the annual report at the main office of the plan ( Stein Mart, Inc., 1200 Riverplace Blvd., Jacksonville, FL 32207) and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Depart should be addressed to: Public Disclosure Room, Room N1513, Employee Benefits Security Administration, U.S. Depart of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

SUMMARY ANNUAL REPORT

For Stein Mart, Inc. & Subsidiaries Life Insurance Plan

This is a summary of the annual report of the Stein Mart, Inc. & Subsidiaries Life Insurance Plan, EIN 64-0466198, Plan No. 502, for period January 01, 2014 through December 31, 2014. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).

Insurance Information

The plan has a contract with Liberty Life Assurance Company of Boston to pay life insurance and accidental death & dismemberment claims incurred under the terms of the plan. The total premiums paid for the plan year ending December 31, 2014 were $229,880.

Your Rights To Additional Information. You have the right to receive a copy of the full annual report, or any part thereof, on request. The items listed below are included in that report:

• insurance information, including sales commissions paid by insurance carriers;

You also have the legally protected right to examine the annual report at the main office of the plan ( Stein Mart, Inc., 1200 Riverplace Blvd., Jacksonville, FL 32207) and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N1513, Employee Benefits Security Administration, U.S. Depart of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

SUMMARY ANNUAL REPORT

For Stein Mart, Inc. & Subsidiaries Flexible Benefit Plan

This is a summary of the annual report of the Stein Mart, Inc. & Subsidiaries Flexible Benefit Plan, EIN 64-0466198, Plan No. 509, for period January 01, 2014 through December 31, 2014. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).

Stein Mart, Inc. has committed itself to pay certain FSA claims incurred under the terms of the plan.

Your Rights To Additional Information You have the right to receive a copy of the full annual report.

You also have the legally protected right to examine the annual report at the main office of the plan ( Stein Mart, Inc., 1200 Riverplace Blvd., Jacksonville, FL 32207) and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N1513, Employee Benefits Security Administration, U.S. Depart of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

SUMMARY ANNUAL REPORT

For Stein Mart, Inc. & Subsidiaries Health Benefit Plan

This is a summary of the annual report of the Stein Mart, Inc. & Subsidiaries Health Benefit Plan, EIN 64-0466198, Plan No. 507, for period January 01, 2014 through December 31, 2014. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).

Stein Mart, Inc. has committed itself to pay certain Medical and Dental claims incurred under the terms of the plan.

Your Rights To Additional Information You have the right to receive a copy of the full annual report.

You also have the legally protected right to examine the annual report at the main office of the plan ( Stein Mart, Inc., 1200 Riverplace Blvd., Jacksonville, FL 32207) and at the U.S. Department of Labor in Washington, D.C., or to obtain a copy from the U.S. Department of Labor upon payment of copying costs. Requests to the Department should be addressed to: Public Disclosure Room, Room N1513, Employee Benefits Security Administration, U.S. Department of Labor, 200 Constitution Avenue, N.W., Washington, D.C. 20210.

SUMMARY ANNUAL REPORT

For Stein Mart, Inc. & Subsidiaries Part-Time Employees Benefit Plan

This is a summary of the annual report of the Stein Mart, Inc. & Subsidiaries Part-Time Employees Benefit Plan, EIN 64-0466198, Plan No. 510, for period January 01, 2014 through December 31, 2014. The annual report has been filed with the Employee Benefits Security Administration, U.S. Department of Labor, as required under the Employee Retirement Income Security Act of 1974 (ERISA).

Insurance Information

The plan has a contract with Standard Security Life Insurance Company to pay health, dental, vision, life insurance and AD&D, anesthesia, doctors office visit, surgical, emergency room, hospital inpatient, preventative care claims incurred under the terms of the plan. The total premiums paid for the plan year ending December 31, 2014 were $238,810.