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The 2014 Employee Benefits Guide has been designed to help you select the benefit plans that are right for you and your family. Please review all the benefits information that you have been given. These materials are designed to help you weigh the costs and benefits of each plan and to help you choose the coverage that best meets your needs.

What’s New for 2014

3

On-Line Enrollment / Kaiser Arbitration

4

Eligibility & Contributions

5

Medical Plan Options

6

HMO Options

7

HSA

8, 9

Dental

10

Vision

11

Flexible Spending Accounts (Health / Dependent Care/ Non Employer Sponsored Premiums)

12

Employee Assistance Program

13

Short and Long Term Disability

14

Basic Life & AD&D

15

Voluntary Life & AD&D

15

Carrier Contacts

16

Gallagher Service Support Center

17

Benefit Contribution Cost Summary

18

2


You may have heard about the Affordable Care Act. What does this mean for you? All Americans will be required to have medical coverage in 2014. The good news is that the plans offered by Otis College of Art and Design meet the federal guidelines and satisfies your individual coverage mandate. For anyone in your family not eligible for the Otis College plan (dependents over the age of 26, parents, cousins, etc) direct them to Covered California, our state marketplace. It is the only place to get the federal tax subsidy for eligible individuals. (Otis employees and dependents are not eligible for tax subsidies through Covered California.)

• Kaiser HMO • Anthem Traditional HMO – large provider choice To contact Covered California:

• Anthem Select HMO - narrower provider options but most affordable

https://www.coveredca.com/

premiums

or call (800) 300-1506

• Anthem Lumenos HSA – PPO type benefit plan but with a large deductible. Includes savings account for pre-tax dollars to save for future health expenses. For 2014, there will also be an employer contribution to your HSA bank account. • Standard PPO is no longer available

All plans now have a contribution to enroll in a medical plan option. Otis College has increased its contribution for dependents to help make family coverage more affordable.

Beginning in 2014, UNUM will be our life and disability carrier. Otis will receive the same benefits but with an improved level of service.

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Annual Open Enrollment elections will again be submitted through the online enrollment system. If you are making changes to your benefit plans (i.e. changing medical, dental, or vision plans, adding or deleting a dependent, electing life insurance or increasing/decreasing life insurance amounts, or enrolling in a Flexible Spending Account for 2014), instruction on how to make changes are available on-line. If you are not making changes to your benefits, and you do not wish to have a FSA for 2014, please make sure to still review and update your personal information, review the Medical plan designs and rates for 2014. For medical coverage, don’t forget to remove any dependents that are no longer eligible Kaiser enrollees must sign the Kaiser Arbitration Agreement.

(i.e. children who are over age 26) or if they are going to be covered under another plan (i.e. spouses plan or Covered California).

Please see link for arbitration document and return to HR.

As our lives and situations change, those who we intend to provide our life

[ embedded pdf of arbitration]

insurance benefits often change. Please go on-line and check your Life and/or Accidental Death and Dismemberment (AD&D) insurance beneficiaries and update them to reflect current beneficiary preferences. You will receive an email on Monday, November 4, 2013 from Melinda Herbert (Human Resource Generalist) that will provide you with your login information.

Enrolling in Kaiser requires that each participant complete the Kaiser Arbitration agreement. If you are electing Kaiser for the first time, you will need to sign the required Kaiser Arbitration agreement. Please see link on the sidebar, read and sign it and return the form to HR.

4


Full-time faculty and staff are able to enroll in benefits. You become eligible for coverage on the first day of the month following your hire date. You may also enroll your eligible dependents in the Medical, Dental, Vision, and Voluntary Life and AD&D insurance plans. Your eligible dependents include: • Spouse – any gender • Domestic Partner* (an opposite sex partner when you or your partner is at least age 62; a same-sex domestic partner) • Unmarried dependent children up to age 26 (including stepchildren, adopted children, and your domestic partner’s children) • Disabled children who have reached the maximum age and who are (or become) physically or mentally incapable of self-support (medical certification required); • Any child for whom you are required to provide coverage under a Qualified Medical Child Support Order

Medical Plans

You pay $75 of the employee only premium for the Kaiser or Anthem Traditional HMO, and $50 for the employee only premium for the Anthem Select HMO or Lumenos Plan.

Dental Plan

Otis College will pay 100% of the employee only premium for the Aetna Dental Plan

Vision Plan

Otis College will pay 100% of the employee only premium for the VSP Plan

Basic Life & AD&D, LTD, STD

Otis College pays 100%

Voluntary Plans (Dep. Life and AD&D)

You pay 100% through payroll deductions

Employee Assistance Program

Otis College pays 100%

*You may enroll your domestic partner in the following programs: medical, dental, vision, and supplemental insurance. You may also enroll your domestic partner’s child(ren) who meet the IRS definition of dependent child(ren) and are eligible to participate in the benefits programs. The Internal Revenue Code requires that any portion of domestic partner dependent premium cost funded by Otis College of Art and Design be included in the employee’s gross income for Federal income taxes and FICA employment taxes. In addition, any portion of domestic partner premium cost funded by the employee must be paid for with post-tax dollars (not pre-tax through the Section 125 plan). Please speak with your tax and legal advisors to insure that you understand all the tax implications.

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As a benefits eligible employee, you may choose between four medical plan options: Kaiser HMO Plan, Anthem Traditional and Select HMO Plans, and Anthem Lumenos Plan.

A Health Maintenance Organization (HMO) is a network of doctors and health care facilities that closely manage your medical care to control your out-of-pocket costs. There are no deductibles to pay or claim forms to fill out on an HMO plan. If you enroll in one of the HMO plans, you (and each of your enrolled dependents) must choose a Primary Care Physician (PCP). Whenever you have a medical need, your PCP should be contacted, including emergencies, as quickly as possible. Specialist care is also available when authorized in advance through your PCP or physician group. You do not have to choose the same physician group or PCP for all members of your family. If you are hospitalized, your PCP will assist you in the entire process. In the event of an emergency, you must contact your PCP for the proper procedure for treatment. With Kaiser, all of your care must be accessed through Kaiser providers at Kaiser facilities. There is an added convenience in having all health related services located at a single location. Anthem provide greater flexibility in choosing providers. The Traditional HMO provides a broad HMO network of doctors to chose from while the Select HMO has fewer doctors but offers more affordable premiums for you and your family. Pick the option that best suits your needs.

The Anthem Lumenos HSA plan is similar to a traditional PPO plan with the largest provider choice but with a large deductible that must be met before plan benefits are paid. The exception to this rule is for preventive benefits such as well women exams, well child care, and annual physicals. To help save up for the deductible, the plan includes a Health Savings Account (HSA). The account allows you to contribute pre-tax dollars for you and your family each year. Similar to a regular savings account, your money grows with interest and investment opportunities year over year until you need it for health care expenses, now or when you retire.

You can save time and money when you order your prescription drugs by mail. Ordering prescription refills is a safe, convenient way to obtain medications you take on a daily basis for a long period of time because you get a 90-day supply of medication for less money. This feature is already covered under the health plans offered by Otis and is available at no additional cost to you, including standard shipping. For Anthem members, you may order refills by mail, phone, or at www.anthem.com/ca. For Kaiser members, you can call the phone number on your prescription label or visit www.kp.org/myhealthmanager and click on “Pharmacy Center�. 6


This chart shows how the plans work and how each type of service is covered. This year, Anthem is providing two HMO options that provide the same benefit coverage but with two networks. The Traditional HMO plan provides access to the broadest number of providers while the Select HMO plan has fewer providers but offers more affordable premiums. To determine provider status in your choice of plan, please see the Anthem Provider website at www.anthem.com/ca. If you enroll in the Kaiser HMO Plan, you must visit Kaiser facilities for medical care and see only Kaiser doctors. www.kaiserpermanente.org MEDICAL HMO PLAN HIGHLIGHTS | This chart compares the main feature of your HMO health plan options. EMPLOYEE Monthly Cost Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

ANTHEM TRADITIONAL HMO

ANTHEM SELECT HMO

KAISER PERMANENTE

$75.00 $643.92 $454.30 $850.18

$50.00 $514.00 $359.34 $682.22

$75.00 $534.34 $381.24 $706.60

Annual out-of-pocket maximum

$2,000 ind. / $4,000 family

$1,500 ind. / $3,000 family

Office visit

$15 copay

$15 copay

Preventive services

No copay

No copay

Emergency services

$100 copay (waived if admitted)

$100 copay (waived if admitted)

$30 copay

$15 copay

Hospitalization

$250 per admission

$250 per admission

Outpatient services

$125 per procedure

$15 copay

$15 copay

Not covered

$15 copay (ltd to 60-day period)

Not covered

$100 for advanced imaging / No copay for all others

No copay

$250 per admission $15 copay

$250 per admission $15 copay

30-day supply

30-day supply

Urgent Care

Acupuncture Chiropractic care (when ordered by a PCP) X-Ray and laboratory services Mental health & substance abuse -inpatient visit -outpatient visit Prescription drugs Tier 1 Tier 2 Tier 3 Tier 4

$10 $30 $50 30% of maximum allowed amount (max $150 copay)

Generic Brand-name

$15 copay $30 copay

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This chart shows how the LUMENOS HSA PPO plan works. Essentially, it is a PPO plan with a high deductible. You must satisfy the deductible prior to any plan benefits except for preventive care. In addition to the PPO benefits, the plan includes a Health Savings Account. The HSA bank account allows you to put pre-tax dollars to save for a rainy day when you may need to pay your deductible for you and/or your family. All pre-tax dollars saved in your HSA bank account are vested and are yours to use for life for qualified health expenses. Otis College will contribute $500 for each employee and $1,000 for each family to your HSA plan in 2014. For 2014, an individual’s maximum pre-tax contributions to an HSA is $3,300 and $6,550 for family. HSA participants over the age of 54 can put in an additional “catch up” contribution of $1000.

MEDICAL ANTHEM LUMENOS HSA PLAN HIGHLIGHTS EMPLOYEE Monthly Cost Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

$50 $562.26 $391.50 $946.44 In-Network

Annual Deductible Individual Family Annual out-of-pocket maximum Individual Family

Out-of-Network $1,250 $2,500

$2,500 $5,000

$5,000 $10,000

10%

30%

Preventive services

No copay

30%

Emergency services

10%

10%

Hospitalization

10%

30%

Outpatient services

10%

30% ($350 / day max benefit)

Acupuncture

10% ($30 / 12 visit max benefit)

30% ($30 / 12 visit max benefit)

Chiropractic

10%

30% ($25 / visit max benefit)

X-Ray and laboratory services

10%

30% ($800 max benefit for imaging)

Mental health & substance abuse -inpatient visit -outpatient visit

10% 10%

30% 30%

30-day supply No copay $10 copay $30 copay $50 copay 30% of max allowed amount

All Tiers: 30% of the prescription drug maximum allowed amount & costs in excess of the prescription drug maximum allowed amount

Office visit

Prescription drugs Female oral contraceptives generic Tier 1 (includes diabetic supplies) Tier 2 Tier 3 (includes compound drugs) Tier 4

(compound drugs & specialty pharmacy drugs not covered)

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Justin is a healthy 28-year old single man who is active in sports and goes to the gym three times a week. He contributes $1,000 each year to his Health Savings Account (HSA). His plan’s annual deductible is $1,250 for individual coverage. If Justin uses his HSA to pay for covered services, this will reduce his out-of-pocket amount needed to meet his deductible before traditional health coverage begins. Here is a look at the first two years of Justin’s HSA plan, assuming the use of in-network providers.

YEAR 1 USING YOUR HSA DOLLARS

HSA - $1,000 contribution

$1,000

Total Expenses: Prescription drugs - $150 Routine Physical / Lab tests - $350

$500

Amount paid by preventive care benefit – not deducted from HSA

$350

• Coinsurance

Amount paid from HSA

$150

• Copays

HSA Rollover to Year 2

$850

• Dental Costs

Since Justin did not spend all of his HSA dollars, he did not need to pay any additional amounts out-of-pocket this year.

HSA dollars can be used for any qualified health expense. Some examples of allowable expenses are as follows: • Deductibles

• Vision Costs • Other eligible expenses similar to FSA rules • Cosmetic surgery is not an allowable expense Note that HSA participants cannot participate in the FSA Health

YEAR 2 HSA Balance: $850 from Year 1, plus $1,000 contribution for Year 2

$1,850

Total Expenses: Office visits - $100 Blood work - $150 Prescription drugs - $200

$450

Paid by preventive care benefit – not deducted from HSA

$150

Amount paid from HSA

$300

HSA Rollover to Year 3

$1,550

Reimbursement plan.

Once again, since Justin did not spend all of his HSA dollars, he did not need to pay any additional amounts out-of-pocket this year.

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This chart shows how the dental plan works and how each type of service is covered. With the Aetna Freedom of Choice dental plan, you get two plans in one. You must elect either the DMO or PPO plan, but you can switch during the year if you call Aetna by the 15 th of the month to be effective the 1st of the following month. The DMO has fewer providers but no annual benefit limits. The PPO provides a larger panel of dentists but puts limits on annual benefits and a lifetime limit on orthodontia.

USING YOUR BENEFITS WISELY

For more detailed information, please refer to the official benefit summary.

• To pay the least amount out-ofpocket, always use in-network

DENTAL PLAN HIGHLIGHTS

dentists.

EMPLOYEE Monthly Cost

DMO

PPO NETWORK & NON-NETWORK

Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

$0 $48.56 $50.78 $99.04

$0.00 $48.56 $50.78 $99.04

Deductible – applies to basic and major services only

None

$50 Individual $150 Family

Preventive services Exams, cleanings, x-rays

100%

100%

Basic services – Fillings, simple extractions

100%

80%

Major services – Oral surgery, root canal, crowns

60%

50%

Annual benefit maximum

None

$2,000

Office visit copay

None

N/A

Orthodontic Deductible Lifetime maximum

50% None None

50% $50 $1,500

• Use your preventive benefits and get cleanings for you and your family twice a year. • If your services are estimated to be $350 or more by your dentist, be sure to have your dentist get pre-determination of benefits through Aetna to ensure services are covered and to get an estimate of what the plan will pay.

The coverage reflected online at Otis is what you initially elected. Please call Aetna if you are uncertain about which plan you are currently enrolled in. If you do switch plans, please request a new ID card from Aetna at (877) 238-6200 or check the Aetna website: www.aetna.com.

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Vision Service Plan (VSP) provides coverage for annual eye examinations and provides an allowance for contacts or frames each year. The plan features network (VSP Signature) and non-network option allowing you to see any vision provider you wish. A new feature of the VSP network is the inclusion of COSTCO vision centers. Using COSTCO retail locations can add additional convenience for you and your family.

ADDITIONAL BENEFIT: If you are enrolled in Aetna’s Dental Plan, you can receive Aetna Vision Discounts for a savings of 5% to 40% off the retail price of eye exams at participating providers. Please visit www.aetna.com

If you utilize the services of a network provider listed in VSP’s Signature Network, your benefits include routine vision exams for a $25 copay, and preferred pricing on a large selection of brand-name, designer frames, lenses, and lens options. If you see a non-VSP provider, you will receive an allocated reimbursement as listed in the summary below. For more detailed information, please refer to the official benefit summary. To find a network contracted provider, please visit www.vsp.com/eyedoctor.html. The chart below shows how the vision plan works and how each type of service is covered. For more detailed information, please refer to the official benefit summary.

or call (800) 793-8616 for a list of

VISION PLAN HIGHLIGHTS

participating providers.

EMPLOYEE MONTHLY COST

VSP

Employee only

No cost

Employee + one

$5.12

Family

$13.52

VSP Choice – Plan B

Network

Frequency of benefits Exam Lenses (contacts included) Frames

Non-Network Once every 12 months Once every 12 months Once every 24 months

Deductible Exam Lenses Single Bifocal Trifocal Frame Additional pairs Contacts

None $25 copay

Up to $50 reimbursement

Covered in full “ “

Up to $50 reimbursement Up to $75 reimbursement Up to $100 reimbursement

$130 frame allowance

Up to $70 reimbursement

30% discount

Not covered

Up to $130 allowances (can be used for Contacts or frames)

Up to $105 retail

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The Health FSA offered through Otis College is administered by TASC FlexSystem. When you enroll in a Health, Dependent Care, or Non Employer Sponsored Premium FSA, you elect the dollar amount you wish to contribute based on your estimated expenses for the upcoming year. The funds will be deducted pre-tax in equal amounts from each paycheck throughout the plan year. You must re-enroll every year. For your convenience, Otis has provided you with a TASC Card to purchase eligible medical expenses with your FSA funds at the point of purchase. Use it just like a debit card, but make sure to keep a copy of all receipts for your records. In the event you lose or misplace your card, simply submit a request for reimbursement to TASC. For the Dependent Care FSA or if you do not have your TASC card, simply submit a request for reimbursement to TASC. FlexSystem offers multiple methods for requesting a reimbursement: Online, Text Message, Mobile App, Fax, or mail. You may use any of the following self-service options to access your FlexSystem accounts and TASC card transactions: • MyTASC online: www.tasconline.com/mytasc • MyTASC mobile app: free download at www.tasconline.com/mobile • MyTASC text messaging: elect through your MyTASC account online

EXAMPLE HEALTHCARE FSA ESTIMATE WORKSHEET ANTICIPATED ANNUAL EXPENSES FOR YOU AND YOUR DEPENDENTS ESTIMATED AMOUNT Coinsurance, co-payments and deductibles

$

Dental expenses (crowns, root canals, routine examinations, etc.)

$

Monthly orthodontia expense (see restrictions in the above section)

$

Prescription drug expenses

$

Eyeglasses, contact lenses, solution, etc.

$

Chiropractic and massage therapy expenses

$

Over-the-counter meds (must be prescription)

$

Annual Total (cannot exceed $2,500)

$

Divide by 12 (except for new hires) for monthly amount

$

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As a benefits eligible employee, you are provided with the Employee Assistance Program (EAP) at no cost to you. The EAP is a confidential counseling and referral service that can help you and your dependents deal with life’s challenges.

• 3 face-to-face sessions per issue at an office convenient to your home or work; there is no limit to the number of issues. All calls and counseling FOR 24-HOUR EAP HELP, CALL AETNA RESOURCES FOR LIVING EAP TOLL-FREE: (888) 238-6232 or visit: www.aetnaeap.com and enter company ID: EAP4OTIS

sessions are confidential, except as specified by law (such as when a person’s emotional condition is a threat to him or herself or others, or if there is child or elder abuse). • Easy access to services and crisis counseling 24 hours a day, 7 days a week, via a toll-free telephone number and website (please see sidebar for login information). • Accessibility to employees and anyone in the household. Employee assistance professionals will listen to your concerns with an open mind and help you identify the cause of your problem. They will work with you and the EAP’s network of specialized providers to develop a practical solution as quickly as possible.

• Work-related issues • Family problems • Marital and relationship issues • Alcohol and drug abuse, and co-dependency issues • Emotional problems • Physical concerns • Financial and legal issues

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Otis provides full-time employees with Short-Term and Long-Term Disability income benefits, and pays the full cost of this coverage. Short-Term Disability is intended to protect your income for a short duration of time in case you become ill or injured. You are not eligible to receive Short-Term Disability benefits if you are receiving Worker’s Compensation benefits. In the event you continue to be disabled after six (6) months, Long-Term Disability income benefits are provided as a source of income.

SHORT-TERM DISABILITY Benefits begin

8th day for an accident or illness

Maximum weekly benefit

60% of weekly salary up to $1,000 per week

Maximum benefit duration

25 weeks

Benefit reductions may occur

If you are receiving benefits from any compulsory benefit, act, or law such as a state disability plan or if you are receiving sick leave pay from your employer

LONG-TERM DISABILITY Benefits begin

After180 days of being disabled

Maximum monthly benefit

60% of salary up to $6,000 per week

Minimum monthly benefit

$100

Maximum benefit duration

Later of age 65 or Social Security Normal Retirement Age

Benefit limitations

Mental illness: 24 months Substance abuse: 24 months

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Otis College of Art and Design provides full-time employees with group Life and Accidental Death and Dismemberment (AD&D) insurance in the amount of 1 times your basic annual earnings at a maximum of $50,000, and pays the full cost of this benefit. Please contact Human Resources to update your beneficiary information.

• Benefit Amount: One times your annual salary rounded to the next higher $1,000 • Maximum Amount: $50,000 • Guarantee Issue: $50,000 • Benefit Reduction: 35% at age 70; an additional 20% of the original amount at age 75 and will terminate upon retirement

Employees who want to enhance the group life insurance benefits provided by Otis may purchase additional coverage. When you enroll yourself and/or your dependents in this benefit, you pay the full cost through payroll deductions. The minimum amount of coverage you can purchase for yourself is $10,000 and the maximum is $500,000 with Guarantee Issue of $200,000 if you purchase this when first eligible (under age 70). The minimum you can purchase for your spouse is $5,000 and the maximum is $500,000, with Guarantee Issue of $30,000. Your spouse may not elect more than 100% of the employee elected amount. Please be aware that if you do not apply for this option when you are first eligible, you will need to wait until Open Enrollment to apply and will be considered a Late Entrant. You will need to complete an EOI Form and the total amount of insurance you apply for will be subject to medical underwriting. You will be notified of either approval or disapproval of the coverage amount for which you applied. Until you have been notified, you do not have the additional coverage. Please see the benefit summaries for the premium amounts.

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QUESTIONS?

BENEFIT

GROUP ID

PHONE / WEBSITE

Kaiser Permanente

111784

(800) 464-4000 www.kaiserpermanente.org

Anthem

275328

(877) 811-3107 www.anthem.com

Aetna Dental

879962

(877) 238-6200 www.aetna.com

VSP

00114144

(800) 877-7195 www.vsp.com

TASC

FSA 4601-6467-9863 HSA 4203-1919-9184

(800) 422-4661 www.tasconline.com

UNUM | Customer Contact Center: (800) 421-0344; 8am8pm EST (M-F)

Life AD&D, Voluntary Life Policy: 601663 LTD & STD: 601662

Disability: (877)851-7637 Life: (800) 445-0402 Portability / Conversion: (800) 343-5406

Aetna Resources for Living EAP

EAP4OTIS

(888) 238-6232 www.aetnaeap.com

Gallagher Support Center

Otis

(855) 670-2222

This guide summarizes the benefits that are available to you as an employee of Otis College of Art and Design. This is a brief summary and is not intended to cover all the details. For specific questions, please contact the Gallagher Support Center or the benefits providers at the phone numbers listed on this page.

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MEDICAL

MEDICAL

ANTHEM TRADITIONAL HMO

EMPLOYEE MONTHLY COST

Employee Employee + Spouse Employee + Child(ren) Employee + Family

$75.00 $643.92 $454.30 $850.18

ANTHEM SELECT HMO Employee Employee + Spouse Employee + Child(ren) Employee + Family

MEDICAL

are made before taxes except for domestic partners.

ANTHEM LUMENOS Employee Employee + Spouse Employee + Child(ren) Employee + Family

All health insurance deductions

MEDICAL

$75.00 $534.34 $381.24 $706.60

AETNA DENTAL Employee Employee + Spouse Employee + Child(ren) Employee + Family

VISION

$50.00 $562.26 $391.50 $946.44

KAISER Employee Employee + Spouse Employee + Child(ren) Employee + Family

DENTAL

$50.00 $514.00 $359.34 $682.22

$0.00 $48.56 $50.78 $99.04

VSP VISION Employee only Employee + 1 Dependent Employee + Family

$0.00 $5.12 $13.52

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2014 oe emag final ss 11413