PLAN DESIGN

Customer Name: The Romine Group

Proposed Effective Date: 01-01-2015

Policy Period: 12

Data Source ID: Q3188722 - 1 - All Employees/NC/250/4629MIPP#2139

Option: $250 PPO Plan Option

Plan: PPO Plan

Location(s): Michigan

Specialty Networks Included: None Quoted

Organization Name: Aetna




The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:21 PM Page 1
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $250 Individual $10,000 Individual $500 Family $20,000 Family All covered expenses accumulate separately toward the preferred or non-preferred Deductible. Unless otherwise indicated, the deductible must be met prior to benefits being payable. Member cost sharing for certain services, as indicated in the plan, are excluded from charges to meet the Deductible. Pharmacy expenses do not apply towards the Deductible. The family Deductible is a cumulative Deductible for all family members. The family Deductible can be met by a combination of family members; however no single individual within the family will be subject to more than the individual Deductible amount. Member Coinsurance 10% 50% Applies to all expenses unless otherwise stated. Payment Limit (per calendar year) $750 Individual $12,000 Individual $1,500 Family $24,000 Family All covered expenses accumulate separately toward the preferred or non-preferred Payment Limit. Certain member cost sharing elements may not apply toward the Payment Limit. Pharmacy expenses apply towards the Payment Limit. Only those out-of-pocket expenses resulting from the application of coinsurance percentage, copays, and deductibles (except any penalty amounts) may be used to satisfy the Payment Limit. The family Payment Limit is a cumulative Payment Limit for all family members. The family Payment Limit can be met by a combination of family members; however no single individual within the family will be subject to more than the individual Payment Limit amount. Lifetime Maximum Unlimited except where otherwise indicated. Payment for Non-Preferred Care** Not Applicable Professional: 105% of Medicare Facility: 140% of Medicare Primary Care Physician Selection Not Applicable Not Applicable Certification Requirements - Certification for certain types of Non-Preferred care must be obtained to avoid a reduction in benefits paid for that care. Certification for Hospital Admissions, Treatment Facility Admissions, Convalescent Facility Admissions, Home Health Care, Hospice Care and Private Duty Nursing is required - excluded amount applied separately to each type of expense is $400 per occurrence. Referral Requirement None None PREVENTIVE CARE IN-NETWORK OUT-OF-NETWORK Routine Adult Physical Exams/ Immunizations Covered 100%; deductible waived 50%; after deductible 1 exam every 12 months for members age 22 to age 65; 1 exam every 12 months for adults age 65 and older. Routine Well Child Exams/Immunizations Covered 100%; deductible waived 50%; after deductible 7 exams in the first 12 months of life, 3 exams in the second 12 months of life, 3 exams in the third 12 months of life, 1 exam per year thereafter to age 22. Routine Gynecological Care Exams Covered 100%; deductible waived 50%; after deductible Recommended: One exam per calendar year. Includes routine tests and related lab fees. Routine Mammograms Covered 100%; deductible waived 50%; after deductible Recommended: One baseline mammogram for covered females age 35-39, one mammogram per calendar year for covered females age 40 and over. Women's Health Covered 100%; deductible waived 50%; after deductible Includes: Screening for gestational diabetes, HPV (Human- Papillomavirus) DNA testing, counseling for sexually transmitted infections, counseling and screening for human immunodeficiency virus, screening and counseling for interpersonal and domestic violence, breastfeeding support, supplies and counseling.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:21 PM Page 2
Contraceptive methods, sterilization procedures, patient education and counseling. Limitations may apply. Routine Digital Rectal Exam Covered 100%; deductible waived 50%; after deductible Prostate-specific Antigen Test Covered 100%; deductible waived 50%; after deductible Colorectal Cancer Screening Covered under Routine Adult Exams Covered under Routine Adult Exams Recommended: For all members age 50 and over. Routine Eye Exams Covered 100%; deductible waived Not Covered 1 routine exam per 24 months. Routine Hearing Exams Not Covered Not Covered Routine Hearing Screening Covered 100%; deductible waived 50%; after deductible PHYSICIAN SERVICES IN-NETWORK OUT-OF-NETWORK Office Visits to non-Specialist $30 office visit copay; deductible waived 50%; after deductible Includes services of an internist, general physician, family practitioner or pediatrician. Specialist Office Visits $30 office visit copay; deductible waived 50%; after deductible Pre-Natal Maternity Covered 100%; deductible waived Covered according to standard claim practice. E-visit to Non-Specialist $30 copay; deductible waived 50%; after deductible An E-visit is an online internet consultation between a physician and an established patient about a non-emergency healthcare matter. This visit must be conducted through our authorized internet E-visit service vendor. E-visit to Specialist $30 copay; deductible waived 50%; after deductible An E-visit is an online internet consultation between a physician and an established patient about a non-emergency healthcare matter. This visit must be conducted through our authorized internet E-visit service vendor. Walk-in Clinics $30 office visit copay; deductible waived 50%; after deductible Walk-in Clinics are network, free-standing health care facilities. They are an alternative to a physician's office visit for treatment of unscheduled, non-emergency illnesses and injuries and the administration of certain immunizations. It is not an alternative for emergency room services or the ongoing care provided by a physician. Neither an emergency room, nor the outpatient department of a hospital, shall be considered a Walk-in Clinic. Allergy Testing Member cost sharing is based on the type of service performed and the place of service where it is rendered; deductible waived Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible Allergy Injections Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible DIAGNOSTIC PROCEDURES IN-NETWORK OUT-OF-NETWORK Diagnostic X-ray 10%; after deductible 50%; after deductible If performed as a part of a physician office visit and billed by the physician, expenses are covered subject to the applicable physician's office visit member cost sharing. Diagnostic Laboratory 10%; after deductible 50%; after deductible If performed as a part of a physician office visit and billed by the physician, expenses are covered subject to the applicable physician's office visit member cost sharing. Diagnostic Outpatient Complex Imaging 10%; after deductible 50%; after deductible EMERGENCY MEDICAL CARE IN-NETWORK OUT-OF-NETWORK Urgent Care Provider $50 copay; deductible waived 50%; after deductible Non-Urgent Use of Urgent Care Provider Not Covered Not Covered


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:21 PM Page 3
Emergency Room $150 copay; deductible waived Same as preferred care Non-Emergency Care in an Emergency Room Not Covered Not Covered Emergency Use of Ambulance $100 copay; after deductible $100 copay; after deductible Non-Emergency Use of Ambulance Not Covered Not Covered HOSPITAL CARE IN-NETWORK OUT-OF-NETWORK Inpatient Coverage 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Inpatient Maternity Coverage (includes delivery and postpartum care) 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Outpatient Hospital Expenses 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. Outpatient Surgery 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. Outpatient Surgery - Freestanding Facility 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. MENTAL HEALTH SERVICES IN-NETWORK OUT-OF-NETWORK Inpatient 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Outpatient $30 copay; deductible waived 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. ALCOHOL/DRUG ABUSE SERVICES IN-NETWORK OUT-OF-NETWORK Inpatient 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Residential Treatment Facility 10%; after deductible 50%; after deductible Treatment Facility 10%; after deductible 50%; after deductible Outpatient $30 copay; deductible waived 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. OTHER SERVICES IN-NETWORK OUT-OF-NETWORK Convalescent Facility 10%; after deductible 50%; after deductible Limited to 60 days per calendar year. The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Home Health Care 10%; after deductible 50%; after deductible Limited to 60 visits per calendar year. Each visit by a nurse or therapist is one visit. Each visit up to 4 hours by a home health care aide is one visit. Hospice Care - Inpatient 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Hospice Care - Outpatient 10%; after deductible 50%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. Private Duty Nursing - Outpatient Not Covered Not Covered Outpatient Short-Term Rehabilitation $30 copay; deductible waived 50%; after deductible Includes Speech, Physical, and Occupational Therapy, limited to 60 visits per calendar year. Spinal Manipulation Therapy $30 copay; deductible waived 50%; after deductible Limited to 20 visits per calendar year.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:21 PM Page 4
Autism Behavioral Therapy $30 copay; deductible waived 50%; after deductible Covered same as any other Outpatient Mental Health benefit Autism Applied Behavior Analysis $30 copay; deductible waived 50%; after deductible Covered same as any other Outpatient Mental Health benefit with no age or visit limitations. Autism Physical Therapy $30 copay; deductible waived 50%; after deductible Visits combined with Short Term Rehabilitation. Autism Occupational Therapy $30 copay; deductible waived 50%; after deductible Visits combined with Short Term Rehabilitation. Autism Speech Therapy $30 copay; deductible waived 50%; after deductible Visits combined with Short Term Rehabilitation. Durable Medical Equipment 10%; after deductible 50%; after deductible Diabetic Supplies -- (if not covered under Pharmacy benefit) Covered same as any other medical expense. Covered same as any other medical expense. Generic FDA-approved Women's Contraceptives Covered 100%; deductible waived Not Covered Contraceptive drugs and devices not obtainable at a pharmacy Covered 100%; deductible waived Covered same as any other medical expense. Transplants 10%; after deductible 50%; after deductible Preferred coverage is provided at an IOE contracted facility only. Non-Preferred coverage is provided at a Non-IOE facility. Bariatric Surgery Not Covered Not Covered The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. "Other" Health Care -- 20% member coinsurance after the preferred (per calendar year) deductible for services that are neither "preferred" nor "non-preferred". FAMILY PLANNING IN-NETWORK OUT-OF-NETWORK Infertility Treatment Member cost sharing is based on the type of service performed and the place of service where it is rendered Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible Diagnosis and treatment of the underlying medical condition. Comprehensive Infertility Services Not Covered Not Covered Advanced Reproductive Technology (ART) Not Covered Not Covered Vasectomy Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible. Tubal Ligation Covered 100%; deductible waived Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible. Voluntary Abortion Not Covered Not Covered PHARMACY IN-NETWORK OUT-OF-NETWORK Pharmacy Plan Type Open Formulary; with mid year changes Retail $10 copay for generic drugs, $40 copay for formulary brand-name drugs, and $60 copay for non-formulary brand-name drugs up to a 30 day supply at participating pharmacies. 50% of submitted cost after the applicable preferred copay


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:21 PM Page 5
Mail Order $20 copay for generic drugs, $80 copay for formulary brand-name drugs, and $120 copay for non-formulary brand-name drugs up to a 31-90 day supply from Aetna Rx Home Delivery®.
Not Applicable
Aetna Specialty CareRx First prescription fill at any retail drug facility. Subsequent fills must be through Aetna Specialty Pharmacy®. Choose Generics - If the member or the physician requests brand when generic is available, the member pays the applicable copay plus the difference between the generic price and the brand price. Plan Includes: Diabetic supplies and Contraceptive drugs and devices obtainable from a pharmacy. Oral and injectable fertility drugs included (physician charges for injections are not covered under RX, medical coverage is limited). Precert for growth hormones included. Expanded Precert included with 90 day Transition of Care. Formulary Generic FDA-approved Women's Contraceptives and certain over-the-counter preventive medications covered 100% in network. GENERAL PROVISIONS Dependents Eligibility Spouse, children from birth to age 26 regardless of student status. Pre-existing Conditions Exclusion On effective date: Waived After effective date: Waived

**We cover the cost of services based on whether doctors are "in network" or "out of network." We want to help you understand how much we pay for your out-of-network care. At the same time, we want to make it clear how much more you will need to pay for this "out-of-network" care.

You may choose a provider (doctor or hospital) in our network. You may choose to visit an out-of-network provider. If you choose a doctor who is out of network, your health plan may pay some of that doctor's bill. Most of the time, you will pay a lot more money out of your own pocket if you choose to use an out-of-network doctor or hospital.

When you choose out-of-network care, we limit the amount it will pay. This limit is called the "recognized" or "allowed" amount.

• For doctors and other professionals the amount is based on what Medicare pays for these services. The government sets the Medicare rate. Exactly how much we "recognize" depends on the plan you or your employer picks.

• For hospitals and other facilities, the amount is based on what Medicare pays for these services. The government sets the Medicare rate. Exactly how much we "recognize" depends on the plan you or your employer picks.

Your doctor sets his or her own rate to charge you. It may be higher -- sometimes much higher -- than what your plan "recognizes." Your doctor may bill you for the dollar amount that we don't "recognize." You must also pay any copayments, coinsurance and deductibles under your plan. No dollar amount above the "recognized charge" counts toward your deductible or out-of-pocket maximums. To learn more about how we pay out-of-network benefits visit our website.

You can avoid these extra costs by getting your care from Aetna's broad network of health care providers. Go to www.aetna.com and click on "Find a Doctor" on the left side of the page. If you are already a member, sign on to your Navigator member site.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:21 PM Page 6

This applies when you choose to get care out of network. When you have no choice (for example: emergency room visit after a car accident, or for other emergency services), we will pay the bill as if you got care in network. You pay cost sharing and deductibles for your in-network level of benefits. Contact us if your provider asks you to pay more. You are not responsible for any outstanding balance billed by your providers for emergency services beyond your cost sharing and deductibles.

This way of paying out-of-network doctors and hospitals applies when you choose to get care out of network. When you have no choice (for example: emergency room visit after a car accident), we will pay the bill as if you got care in network. You pay your plan's copayments, coinsurance and deductibles for your in-network level of benefits. Contact us if your provider asks you to pay more. You are not responsible for any outstanding balance billed by your providers for emergency services beyond your copayments, coinsurance and deductibles.

Plans are provided by: Aetna Life Insurance Company. While this material is believed to be accurate as of the production date, it is subject to change.

Health benefits and health insurance plans contain exclusions and limitations. Not all health services are covered.

See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change. You may be responsible for the health care provider's full charges for any non-covered services, including circumstances where you have exceeded a benefit limit contained in the plan. Providers are independent contractors and are not our agents. Provider participation may change without notice. We do not provide care or guarantee access to health services.

The following is a list of services and supplies that are generally not covered. However, your plan documents may contain exceptions to this list based on state mandates or the plan design or rider(s) purchased by your employer.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:21 PM Page 7

• All medical and hospital services not specifically covered in, or which are limited or excluded by your plan documents. • Cosmetic surgery, including breast reduction. • Custodial care. • Dental care and dental X-rays. • Donor egg retrieval. • Durable medical Equipment • Experimental and investigational procedures, except for coverage for medically necessary routine patient care costs for members participating in a cancer clinical trial. • Hearing aids • Home births • Immunizations for travel or work, except where medically necessary or indicated. • Implantable drugs and certain injectable drugs including injectable infertility drugs. • Infertility services, including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI and other related services, unless specifically listed as covered in your plan documents. • Long-term rehabilitation therapy. • Non-medically necessary services or supplies. • Orthotics except diabetic orthotics. • Outpatient prescription drugs (except for treatment of diabetes), unless covered by a prescription plan rider and over-the-counter medications (except as provided in a hospital) and supplies. • Radial keratotomy or related procedures. • Reversal of sterilization. • Services for the treatment of sexual dysfunction or inadequacies, including therapy, supplies or counseling or prescription drugs. • Special duty nursing. • Therapy or rehabilitation other than those listed as covered. • Treatment of behavioral disorders. • Weight control services including surgical procedures, medical treatments, weight control/loss programs, dietary regimens and supplements, appetite suppressants and other medications; food or food supplements, exercise programs, exercise or other equipment; and other services and supplies that are primarily intended to control weight or treat obesity, including Morbid Obesity, or for the purpose of weight reduction, regardless of the existence of comorbid conditions.

Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna's Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. Aetna Rx Home Delivery refers to Aetna Rx Home Delivery, LLC, a licensed pharmacy subsidiary of Aetna Inc., that operates through mail order. The charges that Aetna negotiates with Aetna Rx Home Delivery may be higher than the cost they pay for the drugs and the cost of the mail order pharmacy services they provide. For these purposes, the pharmacy's cost of purchasing drugs takes into account discounts, credits and other amounts that they may receive from wholesalers, manufacturers, suppliers and distributors.

In case of emergency, call 911 or your local emergency hotline, or go directly to an emergency care facility.

Translation of the material into another language may be available. Please call Member Services at 1-888-982-3862.

Puede estar disponible la traduccion de este material en otro idioma. Por favor llame a Servicios al Miembro al 1-888-982-3862.

Plan features and availability may vary by location and group size.

For more information about Aetna plans, refer to www.aetna.com.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:21 PM Page 8

© 2014 Aetna Inc.






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PLAN DESIGN

Customer Name: The Romine Group

Proposed Effective Date: 01-01-2015

Policy Period: 12

Data Source ID: Q3188722 - 2 - All Employees/NC/250/4629MIPP#2148

Option: $3000 PPO Plan

Plan: PPO Plan

Location(s): Michigan

Specialty Networks Included: None Quoted

Organization Name: Aetna




The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:23 PM Page 1
PLAN FEATURES IN-NETWORK OUT-OF-NETWORK Deductible (per calendar year) $3,000 Individual $6,000 Individual $6,000 Family $12,000 Family All covered expenses accumulate separately toward the preferred or non-preferred Deductible. Unless otherwise indicated, the deductible must be met prior to benefits being payable. Member cost sharing for certain services, as indicated in the plan, are excluded from charges to meet the Deductible. Pharmacy expenses do not apply towards the Deductible. The family Deductible is a cumulative Deductible for all family members. The family Deductible can be met by a combination of family members; however no single individual within the family will be subject to more than the individual Deductible amount. Member Coinsurance Covered 100% 20% Applies to all expenses unless otherwise stated. Payment Limit (per calendar year) $3,000 Individual $11,000 Individual $6,000 Family $22,000 Family All covered expenses accumulate separately toward the preferred or non-preferred Payment Limit. Certain member cost sharing elements may not apply toward the Payment Limit. Pharmacy expenses apply towards the Payment Limit. Only those out-of-pocket expenses resulting from the application of coinsurance percentage, copays, and deductibles (except any penalty amounts) may be used to satisfy the Payment Limit. The family Payment Limit is a cumulative Payment Limit for all family members. The family Payment Limit can be met by a combination of family members; however no single individual within the family will be subject to more than the individual Payment Limit amount. Lifetime Maximum Unlimited except where otherwise indicated. Payment for Non-Preferred Care** Not Applicable Professional: 105% of Medicare Facility: 140% of Medicare Primary Care Physician Selection Not Applicable Not Applicable Certification Requirements - Certification for certain types of Non-Preferred care must be obtained to avoid a reduction in benefits paid for that care. Certification for Hospital Admissions, Treatment Facility Admissions, Convalescent Facility Admissions, Home Health Care, Hospice Care and Private Duty Nursing is required - excluded amount applied separately to each type of expense is $400 per occurrence. Referral Requirement None None PREVENTIVE CARE IN-NETWORK OUT-OF-NETWORK Routine Adult Physical Exams/ Immunizations Covered 100%; deductible waived 20%; after deductible 1 exam every 12 months for members age 22 to age 65; 1 exam every 12 months for adults age 65 and older. Routine Well Child Exams/Immunizations Covered 100%; deductible waived 20%; after deductible 7 exams in the first 12 months of life, 3 exams in the second 12 months of life, 3 exams in the third 12 months of life, 1 exam per year thereafter to age 22. Routine Gynecological Care Exams Covered 100%; deductible waived 20%; after deductible Recommended: One exam per calendar year. Includes routine tests and related lab fees. Routine Mammograms Covered 100%; deductible waived 20%; after deductible Recommended: One baseline mammogram for covered females age 35-39, one mammogram per calendar year for covered females age 40 and over. Women's Health Covered 100%; deductible waived 20%; after deductible Includes: Screening for gestational diabetes, HPV (Human- Papillomavirus) DNA testing, counseling for sexually transmitted infections, counseling and screening for human immunodeficiency virus, screening and counseling for interpersonal and domestic violence, breastfeeding support, supplies and counseling.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

Prepared: 09/25/2014 03:23 PM Page 2
Contraceptive methods, sterilization procedures, patient education and counseling. Limitations may apply. Routine Digital Rectal Exam Covered 100%; deductible waived 20%; after deductible Prostate-specific Antigen Test Covered 100%; deductible waived 20%; after deductible Colorectal Cancer Screening Covered under Routine Adult Exams Covered under Routine Adult Exams Recommended: For all members age 50 and over. Routine Eye Exams Covered 100%; deductible waived Not Covered 1 routine exam per 24 months. Routine Hearing Exams Not Covered Not Covered Routine Hearing Screening Covered 100%; deductible waived 20%; after deductible PHYSICIAN SERVICES IN-NETWORK OUT-OF-NETWORK Office Visits to non-Specialist $40 office visit copay; deductible waived 20%; after deductible Includes services of an internist, general physician, family practitioner or pediatrician. Specialist Office Visits $40 office visit copay; deductible waived 20%; after deductible Pre-Natal Maternity Covered 100%; deductible waived Covered according to standard claim practice. E-visit to Non-Specialist Not Covered Not Covered An E-visit is an online internet consultation between a physician and an established patient about a non-emergency healthcare matter. This visit must be conducted through our authorized internet E-visit service vendor. E-visit to Specialist Not Covered Not Covered An E-visit is an online internet consultation between a physician and an established patient about a non-emergency healthcare matter. This visit must be conducted through our authorized internet E-visit service vendor. Walk-in Clinics $40 office visit copay; deductible waived 20%; after deductible Walk-in Clinics are network, free-standing health care facilities. They are an alternative to a physician's office visit for treatment of unscheduled, non-emergency illnesses and injuries and the administration of certain immunizations. It is not an alternative for emergency room services or the ongoing care provided by a physician. Neither an emergency room, nor the outpatient department of a hospital, shall be considered a Walk-in Clinic. Allergy Testing Member cost sharing is based on the type of service performed and the place of service where it is rendered; deductible waived Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible Allergy Injections Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible DIAGNOSTIC PROCEDURES IN-NETWORK OUT-OF-NETWORK Diagnostic X-ray Covered 100%; after deductible 20%; after deductible If performed as a part of a physician office visit and billed by the physician, expenses are covered subject to the applicable physician's office visit member cost sharing. Diagnostic Laboratory Covered 100%; after deductible 20%; after deductible If performed as a part of a physician office visit and billed by the physician, expenses are covered subject to the applicable physician's office visit member cost sharing. Diagnostic Outpatient Complex Imaging Covered 100%; after deductible 20%; after deductible EMERGENCY MEDICAL CARE IN-NETWORK OUT-OF-NETWORK Urgent Care Provider $50 copay; deductible waived 20%; after deductible Non-Urgent Use of Urgent Care Provider Not Covered Not Covered


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

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Emergency Room $150 copay; deductible waived Same as preferred care Non-Emergency Care in an Emergency Room Not Covered Not Covered Emergency Use of Ambulance $100 copay; after deductible $100 copay; after deductible Non-Emergency Use of Ambulance Not Covered Not Covered HOSPITAL CARE IN-NETWORK OUT-OF-NETWORK Inpatient Coverage Covered 100%; after deductible 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Inpatient Maternity Coverage (includes delivery and postpartum care) Covered 100%; after deductible 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Outpatient Hospital Expenses Covered 100%; after deductible 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. Outpatient Surgery Covered 100% 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. Outpatient Surgery - Freestanding Facility Covered 100%; after deductible 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. MENTAL HEALTH SERVICES IN-NETWORK OUT-OF-NETWORK Inpatient Covered 100%; after deductible 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Outpatient $40 copay; deductible waived 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. ALCOHOL/DRUG ABUSE SERVICES IN-NETWORK OUT-OF-NETWORK Inpatient Covered 100%; after deductible 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Residential Treatment Facility Covered 100%; after deductible 20%; after deductible Treatment Facility Covered 100%; after deductible 20%; after deductible Outpatient $40 copay; deductible waived 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. OTHER SERVICES IN-NETWORK OUT-OF-NETWORK Convalescent Facility Covered 100%; after deductible 20%; after deductible Limited to 60 days per calendar year. The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Home Health Care Covered 100%; after deductible 20%; after deductible Limited to 60 visits per calendar year. Each visit by a nurse or therapist is one visit. Each visit up to 4 hours by a home health care aide is one visit. Hospice Care - Inpatient Covered 100%; after deductible 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. Hospice Care - Outpatient Covered 100%; after deductible 20%; after deductible The member cost sharing applies to all covered benefits incurred during a member's outpatient visit. Private Duty Nursing - Outpatient Not Covered Not Covered Outpatient Short-Term Rehabilitation $40 copay; deductible waived 20%; after deductible Includes Speech, Physical, and Occupational Therapy, limited to 60 visits per calendar year. Spinal Manipulation Therapy $40 copay; deductible waived 20%; after deductible Limited to 20 visits per calendar year.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

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Autism Behavioral Therapy $40 copay; deductible waived 20%; after deductible Covered same as any other Outpatient Mental Health benefit Autism Applied Behavior Analysis $40 copay; deductible waived 20%; after deductible Covered same as any other Outpatient Mental Health benefit with no age or visit limitations. Autism Physical Therapy $40 copay; deductible waived 20%; after deductible Visits combined with Short Term Rehabilitation. Autism Occupational Therapy $40 copay; deductible waived 20%; after deductible Visits combined with Short Term Rehabilitation. Autism Speech Therapy $40 copay; deductible waived 20%; after deductible Visits combined with Short Term Rehabilitation. Durable Medical Equipment Covered 100%; after deductible 20%; after deductible Diabetic Supplies -- (if not covered under Pharmacy benefit) Covered same as any other medical expense. Covered same as any other medical expense. Generic FDA-approved Women's Contraceptives Covered 100%; deductible waived Not Covered Contraceptive drugs and devices not obtainable at a pharmacy Covered 100%; deductible waived Covered same as any other medical expense. Transplants Covered 100%; after deductible 20%; after deductible Preferred coverage is provided at an IOE contracted facility only. Non-Preferred coverage is provided at a Non-IOE facility. Bariatric Surgery Not Covered Not Covered The member cost sharing applies to all covered benefits incurred during a member's inpatient stay. "Other" Health Care -- 20% member coinsurance after the preferred (per calendar year) deductible for services that are neither "preferred" nor "non-preferred". FAMILY PLANNING IN-NETWORK OUT-OF-NETWORK Infertility Treatment Member cost sharing is based on the type of service performed and the place of service where it is rendered Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible Diagnosis and treatment of the underlying medical condition. Comprehensive Infertility Services Not Covered Not Covered Advanced Reproductive Technology (ART) Not Covered Not Covered Vasectomy Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible. Tubal Ligation Covered 100%; deductible waived Member cost sharing is based on the type of service performed and the place of service where it is rendered; after deductible. Voluntary Abortion Not Covered Not Covered PHARMACY IN-NETWORK OUT-OF-NETWORK Pharmacy Plan Type Open Formulary; with mid year changes Retail $15 copay for generic drugs, $35 copay for formulary brand-name drugs, and $60 copay for non-formulary brand-name drugs up to a 30 day supply at participating pharmacies. 20% of submitted cost after the applicable preferred copay


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

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Mail Order $30 copay for generic drugs, $70 copay for formulary brand-name drugs, and $120 copay for non-formulary brand-name drugs up to a 31-90 day supply from Aetna Rx Home Delivery®.
Not Applicable
Aetna Specialty CareRx First prescription fill at any retail drug facility. Subsequent fills must be through Aetna Specialty Pharmacy®. Choose Generics - If the member or the physician requests brand when generic is available, the member pays the applicable copay plus the difference between the generic price and the brand price. Plan Includes: Diabetic supplies and Contraceptive drugs and devices obtainable from a pharmacy. Oral and injectable fertility drugs included (physician charges for injections are not covered under RX, medical coverage is limited). Precert for growth hormones included. Expanded Precert included with 90 day Transition of Care. Formulary Generic FDA-approved Women's Contraceptives and certain over-the-counter preventive medications covered 100% in network. GENERAL PROVISIONS Dependents Eligibility Spouse, children from birth to age 26 regardless of student status. Pre-existing Conditions Exclusion On effective date: Waived After effective date: Waived

**We cover the cost of services based on whether doctors are "in network" or "out of network." We want to help you understand how much we pay for your out-of-network care. At the same time, we want to make it clear how much more you will need to pay for this "out-of-network" care.

You may choose a provider (doctor or hospital) in our network. You may choose to visit an out-of-network provider. If you choose a doctor who is out of network, your health plan may pay some of that doctor's bill. Most of the time, you will pay a lot more money out of your own pocket if you choose to use an out-of-network doctor or hospital.

When you choose out-of-network care, we limit the amount it will pay. This limit is called the "recognized" or "allowed" amount.

• For doctors and other professionals the amount is based on what Medicare pays for these services. The government sets the Medicare rate. Exactly how much we "recognize" depends on the plan you or your employer picks.

• For hospitals and other facilities, the amount is based on what Medicare pays for these services. The government sets the Medicare rate. Exactly how much we "recognize" depends on the plan you or your employer picks.

Your doctor sets his or her own rate to charge you. It may be higher -- sometimes much higher -- than what your plan "recognizes." Your doctor may bill you for the dollar amount that we don't "recognize." You must also pay any copayments, coinsurance and deductibles under your plan. No dollar amount above the "recognized charge" counts toward your deductible or out-of-pocket maximums. To learn more about how we pay out-of-network benefits visit our website.

You can avoid these extra costs by getting your care from Aetna's broad network of health care providers. Go to www.aetna.com and click on "Find a Doctor" on the left side of the page. If you are already a member, sign on to your Navigator member site.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

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This applies when you choose to get care out of network. When you have no choice (for example: emergency room visit after a car accident, or for other emergency services), we will pay the bill as if you got care in network. You pay cost sharing and deductibles for your in-network level of benefits. Contact us if your provider asks you to pay more. You are not responsible for any outstanding balance billed by your providers for emergency services beyond your cost sharing and deductibles.

This way of paying out-of-network doctors and hospitals applies when you choose to get care out of network. When you have no choice (for example: emergency room visit after a car accident), we will pay the bill as if you got care in network. You pay your plan's copayments, coinsurance and deductibles for your in-network level of benefits. Contact us if your provider asks you to pay more. You are not responsible for any outstanding balance billed by your providers for emergency services beyond your copayments, coinsurance and deductibles.

Plans are provided by: Aetna Life Insurance Company. While this material is believed to be accurate as of the production date, it is subject to change.

Health benefits and health insurance plans contain exclusions and limitations. Not all health services are covered.

See plan documents for a complete description of benefits, exclusions, limitations and conditions of coverage. Plan features and availability may vary by location and are subject to change. You may be responsible for the health care provider's full charges for any non-covered services, including circumstances where you have exceeded a benefit limit contained in the plan. Providers are independent contractors and are not our agents. Provider participation may change without notice. We do not provide care or guarantee access to health services.

The following is a list of services and supplies that are generally not covered. However, your plan documents may contain exceptions to this list based on state mandates or the plan design or rider(s) purchased by your employer.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

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• All medical and hospital services not specifically covered in, or which are limited or excluded by your plan documents. • Cosmetic surgery, including breast reduction. • Custodial care. • Dental care and dental X-rays. • Donor egg retrieval. • Durable medical Equipment • Experimental and investigational procedures, except for coverage for medically necessary routine patient care costs for members participating in a cancer clinical trial. • Hearing aids • Home births • Immunizations for travel or work, except where medically necessary or indicated. • Implantable drugs and certain injectable drugs including injectable infertility drugs. • Infertility services, including artificial insemination and advanced reproductive technologies such as IVF, ZIFT, GIFT, ICSI and other related services, unless specifically listed as covered in your plan documents. • Long-term rehabilitation therapy. • Non-medically necessary services or supplies. • Orthotics except diabetic orthotics. • Outpatient prescription drugs (except for treatment of diabetes), unless covered by a prescription plan rider and over-the-counter medications (except as provided in a hospital) and supplies. • Radial keratotomy or related procedures. • Reversal of sterilization. • Services for the treatment of sexual dysfunction or inadequacies, including therapy, supplies or counseling or prescription drugs. • Special duty nursing. • Therapy or rehabilitation other than those listed as covered. • Treatment of behavioral disorders. • Weight control services including surgical procedures, medical treatments, weight control/loss programs, dietary regimens and supplements, appetite suppressants and other medications; food or food supplements, exercise programs, exercise or other equipment; and other services and supplies that are primarily intended to control weight or treat obesity, including Morbid Obesity, or for the purpose of weight reduction, regardless of the existence of comorbid conditions.

Aetna receives rebates from drug manufacturers that may be taken into account in determining Aetna's Preferred Drug List. Rebates do not reduce the amount a member pays the pharmacy for covered prescriptions. Aetna Rx Home Delivery refers to Aetna Rx Home Delivery, LLC, a licensed pharmacy subsidiary of Aetna Inc., that operates through mail order. The charges that Aetna negotiates with Aetna Rx Home Delivery may be higher than the cost they pay for the drugs and the cost of the mail order pharmacy services they provide. For these purposes, the pharmacy's cost of purchasing drugs takes into account discounts, credits and other amounts that they may receive from wholesalers, manufacturers, suppliers and distributors.

In case of emergency, call 911 or your local emergency hotline, or go directly to an emergency care facility.

Translation of the material into another language may be available. Please call Member Services at 1-888-982-3862.

Puede estar disponible la traduccion de este material en otro idioma. Por favor llame a Servicios al Miembro al 1-888-982-3862.

Plan features and availability may vary by location and group size.

For more information about Aetna plans, refer to www.aetna.com.


The Romine Group Proposed Effective Date: 01-01-2015 Open Choice® (PPO) - Michigan
PLAN DESIGN & BENEFITS PROVIDED BY AETNA LIFE INSURANCE COMPANY

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© 2014 Aetna Inc.

version 2-14 Date Printed: 10-14-2014
Effective Date: 01-01-2015 Plan 19a External Plan ID 9849662419 Line Value 366 12 12 12 Exam Aetna Vision Network
Routine/Comprehensive Eye Exam $10 Copay $25 Reimbursement Standard Contact Lens Fit/Follow-up Member pays discounted fee of $40 Not Covered Premium Contact Lens Fit/Follow-up Member pays 90% of retail Not Covered
Single vision lenses $10 Copay $20 Reimbursement Bifocal vision lenses $10 Copay $40 Reimbursement Trifocal vision lenses $10 Copay $65 Reimbursement Lenticular vision lenses $10 Copay $65 Reimbursement Standard Progressive vision lenses $75 Copay $40 Reimbursement
Premium Progressive vision lenses1
20% Discount off retail minus $120 plan allowance plus $75 Copay = member out-of-pocket
$40 Reimbursement
UV treatment Member pays discounted fee of $15 Not Covered Tint (Solid and Gradient) Member pays discounted fee of $15 Not Covered Standard plastic scratch coating $0 Copay $15 Reimbursement Standard polycarbonate lenses - Adult Member pays discounted fee of $40 Not Covered Standard polycarbonate lenses - Children to age 19 $0 Copay $35 Reimbursement Standard anti-reflective coating Member pays discounted fee of $45 Not Covered Polarized Member pays 80% of retail Not Covered
Conventional contact lenses $130 Allowance** Additional 15% off balance over allowance
$90 Reimbursement Disposable contact lenses $130 Allowance $90 Reimbursement Medically necessary contact lenses $0 Copay $200 Reimbursement
Any Frame available, including frames for prescription sunglasses
$130 allowance Additional 20% off balance over allowance
$65 Reimbursement
Additional pairs of eyeglasses or prescription sunglasses. Discount applies to purchases made after the plan allowances have been exhausted.
Up to a 40% Discount No Discount
Non-covered items such as cleaning cloths and contact lens solution2 20% Discount No Discount Lasik Laser vision correction or PRK from U.S. Laser Network3 only. Call 1-800-422-6600 15% discount off retail or 5% discount off the promotional price No Discount Retinal Imaging4 Member pays a discounted fee up to $39 No Discount
Replacement contact lenses
Receive significant savings after your lens benefit has been exhausted on replacement contacts by ordering online. Visit www.aetnavision.com for details
No Discount
Quality health plans & benefits Healthier living Financial well-being Intelligent solutions Aetna VisionSM Preferred visit www.aetnavision.com
In Network Out of Network* Summary of Benefits for The Romine Group
Use your Lens coverage once every rolling 12 months to purchase either 1 pair of eyeglass lenses OR 1 order of contact lenses
Use your Exam coverage once every rolling 12 months
Discounts
Eyeglass Lenses /Lens options
Contact Lenses
Use your Frame coverage once every rolling 12 months
Use your Lens coverage once every rolling 12 months to purchase either 1 pair of eyeglass lenses OR 1 order of contact lenses
Frames
Discounts cannot be combined with any other discounts or promotional offers and may not be available on all brands.
version 2-14 Date Printed: 10-14-2014
This material is for information only, and is not an offer or invitation to contract. Extraterritorial state requirements may apply to members residing in specific States. If your plan covers members in other states, impacts to your plan of benefits and rates adjustments (if any) will be evaluated and communicated to you at the point of sale.
**Allowances are one-time use benefits. No remaining balances may be used. The plan does not provide a declining balance benefit. 1Premium progressives and premium anti-reflective Brand designations are subject to annual review and change based on market conditions. Ask your eye care provider for more information. 2Non covered discounts may not be available in all states. 3Lasik or PRK from the US Laser Network, owned and operated by LCA Vision. 4Retinal Imaging available at participating locations. Contact your eyecare provider to verify if available. Vision insurance plans are underwritten by Aetna Life Insurance Company (Aetna). Certain claims administration services are provided by First American Administrators, Inc. and certain network administration services are provided through EyeMed Vision Care (“EyeMed”), LLC. Providers participating in the Aetna Vision network are contracted through EyeMed Vision Care, LLC. EyeMed and Aetna are independent contractors and not employees or agents of each other. Participating vision providers are credentialed by and subject to the credentialing requirements of EyeMed. Aetna does not provide medical/vision care or treatment and is not responsible for outcomes. Aetna does not guarantee access to vision care services or access to specific vision care providers and provider network composition is subject to change without notice.
*You can choose to receive care outside the network. Simply pay for the services up front and then submit a claim form to receive an amount up to the out of network reimbursement amounts listed above. Reimbursement will not exceed the providers actual charge. Claim forms can be found at www.aetnavision.com or by calling customer service Mon-Sun @ 877-9-SEE-AETNA. Submit completed claim form with receipts to Aetna, PO Box 8504 Mason, OH 45040-7111. Vision insurance plans contain exclusions and limitations. Not all vision services are covered. See your plan booklet for details. Partial list of Exclusions and Limitations
For Employees of The Romine Group ELIGIBILITY - ALL ELIGIBLE EMPLOYEES Eligibility Requirement You must be actively at work (able to perform all normal duties of your job) to be eligible for coverage. Dependent Eligibility Requirement To be eligible for coverage, your dependents must be able to perform normal activities and not be confined (at home, in a hospital, or in any other care facility). Minimum Work Hours You must be working a minimum of30hours perweek to be eligible for coverage. Coverage Payment Your employer pays 100% of the premium for this coverage. LATE ENTRANTS WAITING PERIODS Type A Waived Type B 12 Months Type C 12 Months Orthodontia 12 Months CALENDAR YEAR DEDUCTIBLES AND MAXIMUMS PARTICIPATING PROVIDERS2 NON-PARTICIPATING PROVIDERS2* Type A Deductible Waived Waived Type B & C Deductible §Each Insured Person $0 $0 §Family 3 times Individual 3 times Individual Maximum(s) (For Each Insured Person) §Type A, B & C Combined $1,000 $1,000 §Orthodontia $1,000 (Lifetime1) $1,000 (Lifetime1) 1Reference to "Lifetime" indicates an amount that applies or is available only once while insured under this policy. 2The same expense(s) may be used to satisfy the deductibles for participating and non-participating providers. COVERED SERVICES PARTICIPATING NON-PARTICIPATING* Type A Services 100% 50% §Examination(s)/Evaluation(s) §Bitewing X-ray(s) §Other X-ray(s) §Fluoride Treatment(s) §Cleaning(s) (Prophylaxis) §Sealant(s) §Space Maintainer(s) (Including Recementation) §Emergency Treatment §Brush Biopsy/Cancer Screening Type B Services 75% 50% §Periodontal Maintenance (Following Active Periodontal Treatment) §Filling(s) §Stainless Steel Crowns §Extraction(s) §Oral Surgery §General Anesthesia or Intravenous (I.V.) Sedation §Endodontics §Periodontics §Repair of Removable Dentures §Adjustments, Tissue Conditioning, Rebasing or Relining of Removable Dentures §Repair and Re-Cementation of Bridges §Crowns, Inlays, Onlays §Repair and Re-cementation of Cast Crowns/Inlays/Onlays
COVERED SERVICES (CONTINUED) PARTICIPATING NON-PARTICIPATING* Type C Services 50% 50% §Full or Partial Removable Dentures §Bridgework (Fixed Dentures) §Endosteal Implant(s) Orthodontia §Available for dependent children 50% 40% The plan pays the percentage shown after the deductible is satisfied, up to the maximum. Additional information about the benefits and covered services of this plan will be included in the certificate booklet, which you will receive after enrolling for this coverage. Please contact your employer or benefits administrator if you have questions prior to enrolling. This plan provides different coverage levels for participating and non-participating providers. By using a participating provider, plan members will save more through the predetermined fee arrangement and better benefit coverage. *The Maximum Allowance for non-participating providers is based on the 90th percentile of prevailing fee data for the geographical area. Charges that exceed the Maximum Allowance (as defined in the certificate booklet) for any covered dental service are not considered. LIMITATIONS AND EXCLUSIONS Information about the limitations and exceptions for this plan will be included in the certificate booklet, which you will receive after enrolling for this coverage. Please contact your employer or benefits administrator if you have any questions prior to enrolling. This information describes some of the features of the benefits plan. Benefits may not be available in all states. Please refer to the certificate booklet for a full explanation of the plan's benefits, exclusions and limitations. Should there be any discrepancy between the certificate booklet and this outline, the certificate booklet will prevail. Dental insurance is underwritten by Mutual of Omaha Insurance Company or United of Omaha Life Insurance Company. Mutual of Omaha Insurance Company is licensed in all 50 states. United of Omaha Life Insurance Company is licensed in all states but New York. In New York, Mutual of Omaha Insurance Company underwrites the plan. Policy Form Number 7000GM-MU-EZ 2001.

(Date - Check - Vendor - Amount)

07/07/2014 372 OFFICEMAX -139.81 07/07/2014 373 Mari Tours & Transportation -3,200.00 07/07/2014 374 H.C.M.A. -180.00 07/08/2014 375 Comcast -520.25 07/10/2014 376 Howey & Associates, Inc. -835.60 07/10/2014 377 Howey & Associates, Inc. -429.00 07/11/2014 378 The Romine Group -38,000.00 07/11/2014 379 Northville Community Foundation -160.00 07/11/2014 380 Barbara Bicknell 0.00 07/11/2014 381 Suzanne March -352.00 07/11/2014 382 Paradise Park -480.00 07/11/2014 383 C.J. Barrymores -540.00 07/17/2014 384 The Romine Group -2,354.85 07/18/2014 385 Barbara Bicknell -120.00 07/18/2014 386 Observer and Eccentric -28.96 07/18/2014 387 Quill Corporation -904.82 07/18/2014 388 Gopher -2,395.60 07/18/2014 389 Burton & Sons Inc. -222.84 07/18/2014 390 The Detroit Institute for Children -1,188.00 07/18/2014 391 DTE Energy -1,456.23 07/18/2014 392 Allied Waste Services #241 -137.51 07/18/2014 393 Moonlight Printing Inc -190.00 07/18/2014 394 Mutual Of Omaha -640.21 07/18/2014 395 Therapy Source -816.00 07/18/2014 396 CJ's Company Store -8,456.40 07/18/2014 397 King Bouncers Rental , LLC -150.00 07/18/2014 398 Division of Ethnic Artwork, Inc. -75.00 07/18/2014 399 H.C.M.A. -180.00 07/18/2014 400 Croskey Lanni, PC -2,666.00 07/18/2014 401 Comcast -529.59 07/22/2014 402 Rolling Hills County Park -225.00 07/22/2014 403 Oakland County Parks -350.00 07/25/2014 404 Blue Cross Blue Shield of Michigan -2,200.40 07/25/2014 405 Blue Cross Blue Shield of Michigan -11,032.65 07/28/2014 406 Howey & Associates, Inc. -1,144.00 07/29/2014 407 The Romine Group -38,000.00 07/31/2014 408 Great Lakes Zoological Society -246.00 07/31/2014 409 Diamond Jack's River Tours -240.00 07/30/2014 410 CJ's Company Store -4,223.00 07/30/2014 411 Applied Imaging -277.83 07/30/2014 412 Michigan Science Center -222.00 07/30/2014 413 Academic Planners Plus -675.10 07/31/2014 414 Suzanne March -125.00 07/31/2014 415 Suzanne March -90.00 07/31/2014 416 Suzanne March -59.00 07/31/2014 417 Suzanne March -144.00 07/31/2014 418 Suzanne March -186.00 07/31/2014 419 Suzanne March -364.00 08/07/2014 420 OFFICEMAX -3.61 08/13/2014 423 The Detroit Institute for Children -1,334.00 08/11/2014 421 MAPSA -680.00 08/11/2014 422 Allied Waste Services #241 -137.21 08/13/2014 424 Downriver Bus Repair Inc -3,791.87 08/13/2014 425 The Romine Group -50,781.41 08/21/2014 426 Suzanne March -166.98 08/21/2014 427 Michelle Jones -121.88 08/21/2014 428 Mike Collard -157.76 08/21/2014 429 Lyndsey Berry -62.50 Page 1 of 8 08/21/2014 430 Tiffany Barnum -62.50
Tipton Academy Bill Payment List July 2014 - June 2015
Operating Account
08/21/2014 431 Maria Malanyn -62.50 08/21/2014 432 Jorie Watts -62.50 08/21/2014 433 April Davis -62.50 08/21/2014 434 James Sayen -62.50 08/21/2014 435 Brandi Woodard -62.50 08/21/2014 436 City of Garden City -538.14 08/21/2014 437 Mutual Of Omaha -640.21 08/21/2014 438 Suzanne March -140.00 08/21/2014 439 Michelle Jones -17.65 08/21/2014 440 Suzanne March -288.00 08/21/2014 441 Michelle Jones -240.00 08/21/2014 442 Suzanne March -274.72 08/21/2014 443 Michelle Jones -100.00 08/24/2014 444 The Romine Group -40,000.00 08/24/2014 445 Blue Cross Blue Shield of Michigan -12,274.60 08/24/2014 446 Blue Cross Blue Shield of Michigan -3,755.49 08/24/2014 447 The Romine Group -15,928.52 08/24/2014 448 Charter Technologies Inc. -9,659.00 08/24/2014 449 The Romine Group -1,507.22 08/25/2014 450 Howey & Associates, Inc. -1,239.00 08/29/2014 451 Howey & Associates, Inc. -1,139.00 08/29/2014 452 Mutual Of Omaha -535.29 09/05/2014 453 Comcast -519.89 09/05/2014 454 State of Michigan -800.00 09/05/2014 455 Applied Imaging -121.06 09/08/2014 456 Wayne County Health Department -164.00 09/08/2014 457 Wayne County Health Department -356.00 09/08/2014 458 Tonya Letasz -62.50 09/08/2014 459 Ashley Collard -62.50 09/08/2014 460 Tyler Cederlind -62.50 09/08/2014 461 Rebecca Thompson 0.00 09/08/2014 462 OFFICEMAX -498.10 09/08/2014 463 Republic Services #241 -159.84 09/08/2014 464 Applied Imaging -36.25 09/08/2014 465 Rebecca Thompson -62.50 09/11/2014 466 The Romine Group -53,000.00 09/15/2014 467 Rebecca Thompson 0.00 09/15/2014 468 WOW! Business -213.44 09/15/2014 469 DTE Energy -735.53 09/15/2014 470 Citizens Insurance Company -330.00 09/15/2014 471 Eugene Conor -62.50 09/19/2014 472 Mick's Landscaping & Snow Removal, Inc. -600.00 09/23/2014 473 Tyco Integrated Security LLC -1,591.65 09/23/2014 474 Mike Collard -374.45 09/23/2014 475 Suzanne March -865.47 09/23/2014 476 Michelle Jones -368.96 09/23/2014 477 Howey & Associates, Inc. -1,139.00 09/29/2014 478 The Romine Group -68,771.44 09/29/2014 479 Blue Cross Blue Shield of Michigan -10,720.21 09/29/2014 480 Blue Cross Blue Shield of Michigan -12,914.00 10/14/2014 481 The Romine Group -53,217.91 10/14/2014 482 The Romine Group -10,000.00 10/21/2014 483 OFFICEMAX -714.19 10/21/2014 484 Burton & Sons Inc. -674.33 10/21/2014 485 Tyco Integrated Security LLC -1,873.15 10/21/2014 486 Brave Sales and Service LLC -961.00 10/21/2014 487 Croskey Lanni, PC -2,667.00 10/21/2014 488 Westland Lock & Key Inc -125.00 10/21/2014 489 Quill Corporation -1,948.42 10/21/2014 490 Jessica Randles -62.50 10/21/2014 491 AB Lock and Safe, Inc. -150.18 10/21/2014 492 Allied-Eagle Supply Co. -2,714.74 10/21/2014 493 Image Works -415.00 10/21/2014 494 Mick's Landscaping & Snow Removal, Inc. -2,400.00 10/21/2014 495 Kohls Asphalt Maintenance -1,783.00 Page 2 of 8 10/21/2014 496 Howey & Associates, Inc. -401.00
10/21/2014 497 Schultz-Mullins Psychological & Educational Services, L -515.00 10/21/2014 498 Mutual Of Omaha -1,196.28 10/21/2014 499 Comcast -532.39 10/21/2014 500 WOW! Business -64.44 10/21/2014 501 Republic Services #241 -822.24 10/21/2014 502 Charter Technologies Inc. -9,228.25 10/21/2014 503 Randa Sabbaugh -148.80 10/21/2014 504 Moonlight Printing Inc -46.80 10/21/2014 505 Lisa Mays -81.67 10/21/2014 506 The Detroit Institute for Children -4,255.20 10/21/2014 507 Charter Technologies Inc. -1,987.00 10/21/2014 508 Gregory C. Smith -125.00 10/21/2014 509 Observer and Eccentric -59.94 10/21/2014 510 Aimee Woodcock -62.50 10/21/2014 511 Real Life Farm -864.00 10/24/2014 512 DTE Energy -3,023.17 10/24/2014 513 City of Garden City -282.74 10/24/2014 514 Allied-Eagle Supply Co. -832.79 10/24/2014 515 City of Garden City -603.03 08/05/2014 DC07292014 Amazon.com -1,318.11 10/28/2014 516 Blue Cross Blue Shield of Michigan -7,237.85 10/28/2014 517 Blue Cross Blue Shield of Michigan -15,130.90 10/28/2014 518 The Romine Group -94,000.00 10/31/2014 519 FBN Flooring -313.00 10/31/2014 520 Dickinson Wright PLLC -923.00 10/31/2014 521 OFFICEMAX -461.59 10/31/2014 522 Jamie Mack -62.50 10/31/2014 523 Wayne RESA -250.00 10/31/2014 524 Discount School Supply -7,490.34 10/31/2014 525 Allied-Eagle Supply Co. -405.57 10/31/2014 526 Mutual Of Omaha -1,009.57 10/31/2014 527 Rochester 100 Inc. -230.00 10/31/2014 528 Riegle Press Inc. -38.30 10/31/2014 529 Applied Imaging -584.33 10/31/2014 530 Comcast -532.70 10/31/2014 531 Charter Technologies Inc. -4,958.00 10/31/2014 532 Houghton Mifflin Harcourt Pub. Co. -11,838.65 10/31/2014 533 Pearson Education -9,874.60 11/04/2014 534 MIEM -175.00 11/04/2014 535 MIEM -175.00 11/04/2014 536 Quill Corporation -828.46 11/13/2014 537 The Romine Group -52,000.00 11/13/2014 538 The Romine Group -1,125.45 11/13/2014 539 Super Science Investigators -1,700.00 11/13/2014 540 Family Heating, Cooling & Electric, Inc. -142.90 11/13/2014 541 Republic Services #241 -282.00 11/13/2014 542 DTE Energy -2,835.19 11/13/2014 543 WOW! Business -64.45 11/13/2014 544 Quill Corporation -426.62 11/13/2014 545 Epilepsy Foundation of Michigan -250.00 11/13/2014 546 Learning Things, LLC -65.48 11/13/2014 547 DTE Energy -29.24 11/13/2014 548 Cynthia J. Bockart -625.00 11/17/2014 549 Suzanne March -731.80 11/17/2014 550 Michelle Jones -54.88 11/17/2014 551 Market Day -7,570.00 11/21/2014 552 Howey & Associates, Inc. -2,278.00 11/26/2014 553 The Romine Group -52,000.00 11/26/2014 554 Blue Cross Blue Shield of Michigan 0.00 11/26/2014 555 Mutual Of Omaha 0.00 11/26/2014 556 Blue Cross Blue Shield of Michigan 0.00 11/26/2014 557 Blue Cross Blue Shield of Michigan -7,237.85 11/26/2014 558 Mutual Of Omaha -939.53 11/26/2014 559 Blue Cross Blue Shield of Michigan -13,862.60 11/26/2014 560 CJ's Company Store -10,250.78 Page 3 of 8 11/26/2014 561 The Detroit Institute for Children -6,841.66
12/02/2014 562 The Romine Group -11,114.73 12/02/2014 563 Academic Facilities, LLC -28,080.42 12/02/2014 564 Applied Imaging -741.05 12/02/2014 565 Quill Corporation -752.41 12/02/2014 566 Comcast -523.21 12/02/2014 567 Office Depot Business Credit -34.10 12/12/2014 568 The Romine Group -53,000.00 12/12/2014 569 Teacher's Curriculum Institute -2,700.60 12/12/2014 570 Cengage Learning -4,287.85 12/12/2014 571 Mick's Landscaping & Snow Removal, Inc. -2,400.00 12/12/2014 572 Moonlight Printing Inc -620.00 12/12/2014 573 Alexander Moyer -62.50 12/12/2014 574 Ewing and Associates LLC -1,500.00 12/12/2014 575 Handwriting Without Tears -1,611.50 12/12/2014 576 School Specialty -1,260.50 12/12/2014 577 Scholastic Book Fairs -1,474.10 12/12/2014 578 Discount School Supply -3,762.20 12/12/2014 579 WOW! Business -64.45 12/12/2014 580 Teaching Strategies, LLC -2,342.41 12/12/2014 581 Environmental Consulting Solutions, LLC -850.00 12/17/2014 582 Republic Services #241 -285.81 12/17/2014 583 DTE Energy -3,954.70 12/17/2014 584 Schultz-Mullins Psychological & Educational Services, L -1,695.00 12/17/2014 585 City of Garden City -1,246.41 12/17/2014 586 Dickinson Wright PLLC -1,360.80 12/17/2014 587 Applied Imaging -454.75 12/17/2014 588 Family Heating, Cooling & Electric, Inc. -994.95 12/17/2014 589 Allied-Eagle Supply Co. -1,943.30 12/17/2014 590 Fun Services -3,630.55 12/17/2014 591 Heather Briscoe -40.12 12/17/2014 592 Suzanne March -147.99 12/17/2014 593 Mike Collard -101.80 12/17/2014 594 AB Lock and Safe, Inc. -102.68 12/17/2014 595 Howey & Associates, Inc. -1,139.00 12/17/2014 596 The Detroit Institute for Children -6,847.34 12/26/2014 600 The Romine Group -56,998.03 12/26/2014 598 Mutual Of Omaha Dental -1,151.72 12/26/2014 597 Croskey Lanni, PC -3,859.00 12/26/2014 601 Houghton Mifflin Harcourt Pub. Co. -7,531.20 12/26/2014 602 CJ's Company Store -288.00 12/26/2014 603 Tyco Integrated Security LLC -1,642.58 12/26/2014 604 Wayne RESA -290.00 12/26/2014 605 Michigan Tree & Stump -2,400.00 12/26/2014 606 Quill Corporation -1,052.99 12/26/2014 607 Therapy Source -787.44 12/26/2014 608 School Specialty -59.99 12/29/2014 609 Comcast -532.62 12/29/2014 610 Lakeshore Learning -593.38 12/30/2014 611 School Outfitters -28,159.79 01/06/2015 ACH Debit Office Depot Business Credit -183.36 12/30/2014 612 Charter Technologies Inc. -49,862.10 12/30/2014 613 Scantron Corporation -2,960.00 12/30/2014 614 NCS Pearson Inc. -3,500.00 01/12/2015 615 The Romine Group -11,637.71 01/12/2015 616 Academic Facilities, LLC -14,040.21 01/12/2015 617 Charter Technologies Inc. -4,958.00 01/12/2015 618 IXL Learning, Inc. -1,657.00 01/12/2015 619 Suzanne March -18.00 01/12/2015 620 Christi Ruper -32.52 01/12/2015 621 Nawal Ajami -100.00 01/12/2015 622 Lindsay Grodzicki -100.00 01/12/2015 623 Discount School Supply -4,474.28 01/12/2015 624 Howey & Associates, Inc. -1,139.00 01/12/2015 625 Plank Road Publishing, Inc. -88.74 01/12/2015 626 Dickinson Wright PLLC -123.20 Page 4 of 8 01/12/2015 627 Sharon's Heating & Air Conditioning -218.31
01/14/2015 628 The Romine Group -53,000.00 01/14/2015 629 Kristina Delarossa -62.50 01/14/2015 630 Republic Services #241 -319.55 01/14/2015 631 WOW! Business -64.45 01/14/2015 632 Danielle Wensing -60.00 01/14/2015 633 Brittany Redden -60.00 01/14/2015 634 Staff Development for Educators -1,128.00 01/15/2015 635 Suzanne March -133.94 01/21/2015 636 Therapy Source -2,012.12 01/21/2015 637 DTE Energy -4,815.47 01/28/2015 638 Aetna, Inc. -1,368.37 01/28/2015 639 Aetna, Inc. -1,368.37 01/28/2015 640 Aetna, Inc. -18,570.93 01/28/2015 641 Aetna, Inc. -18,570.93 01/28/2015 642 Michigan Tree & Stump -2,000.00 01/28/2015 643 The Detroit Institute for Children -3,257.65 01/28/2015 644 Henderson Glass, Inc. 0.00 01/28/2015 645 CJ's Company Store -11,701.81 01/28/2015 646 Comcast -529.96 01/28/2015 647 Allied-Eagle Supply Co. -879.69 01/28/2015 648 The Romine Group -53,000.00 01/28/2015 649 Charter Technologies Inc. -518.00 01/28/2015 650 Quill Corporation -446.32 01/30/2015 651 The Romine Group -11,376.89 02/02/2015 652 Academic Facilities, LLC -14,040.21 02/02/2015 653 Michigan Tree & Stump -2,400.00 02/02/2015 654 Westland Lock & Key Inc -582.40 02/06/2015 655 CJ's Company Store -12,802.03 02/06/2015 656 Cynthia J. Bockart -625.00 02/06/2015 657 WOW! Business -68.32 02/06/2015 658 The Romine Group -7,688.92 02/12/2015 659 The Romine Group -57,000.00 02/13/2015 660 Ricoh USA, Inc. -569.96 02/13/2015 661 Lakeshore Learning -325.39 02/13/2015 662 Applied Imaging -345.04 02/13/2015 663 Learning A-Z -1,299.35 02/13/2015 664 Plank Road Publishing, Inc. -461.50 02/13/2015 665 Jorie Watts -100.00 02/13/2015 666 Republic Services #241 -266.46 02/13/2015 667 Sharon's Heating & Air Conditioning -121.51 02/13/2015 668 Burton & Sons Inc. -375.53 02/16/2015 669 Michigan Tree & Stump -1,400.00 02/16/2015 670 DTE Energy -29.24 02/16/2015 671 Wayne RESA -4,000.00 02/16/2015 672 DTE Energy -7,122.16 02/18/2015 673 The Detroit Institute for Children -3,490.03 02/18/2015 674 Howey & Associates, Inc. -1,139.00 02/19/2015 675 Suzanne March -1,310.24 02/19/2015 676 Rebecca Thompson -100.00 02/19/2015 677 Comcast -533.02 02/19/2015 678 Ricoh USA, Inc. -400.00 02/19/2015 679 Michelle Jones -15.79 02/19/2015 680 Quill Corporation -1,400.48 02/23/2015 681 Michigan Tree & Stump -1,400.00 02/23/2015 682 Main Office Mailers, Inc. -1,136.00 02/26/2015 683 The Romine Group -57,000.00 02/26/2015 684 The Romine Group -26,296.63 02/28/2015 685 Aetna, Inc. -19,958.35 02/28/2015 686 Mutual Of Omaha -919.35 02/28/2015 687 Mutual Of Omaha -2,260.41 02/28/2015 688 Mutual Of Omaha -2,493.59 03/02/2015 689 Academic Facilities, LLC 0.00 03/02/2015 690 Henderson Glass, Inc. 0.00 03/02/2015 693 Academic Facilities, LLC -14,040.21 03/02/2015 694 Henderson Glass, Inc. -703.25 Page 5 of 8 03/02/2015 695 Applied Imaging -371.18
03/02/2015 691 Moonlight Printing Inc -400.00 03/02/2015 692 O'Callaghan Electric -455.65 03/12/2015 701 The Romine Group -59,219.81 03/06/2015 696 CJ's Company Store -8,620.53 03/06/2015 697 City of Garden City -538.06 03/06/2015 698 City of Garden City -832.94 03/23/2015 ACH Debit DTE Energy -6,622.58 03/12/2015 699 Michigan AEYC -730.00 03/12/2015 700 Howey & Associates, Inc. -1,139.00 03/20/2015 702 Ewing and Associates LLC -1,500.00 03/20/2015 703 Wayne County Department of Public Health -114.00 03/20/2015 704 Sharon's Heating & Air Conditioning -2,497.90 03/20/2015 705 Michigan Tree & Stump -700.00 03/20/2015 706 Therapy Source -1,003.68 03/20/2015 707 Republic Services #241 -276.26 03/20/2015 708 WOW! Business -73.93 03/20/2015 709 Tyco Integrated Security LLC -1,642.58 03/20/2015 710 Comcast -533.02 03/20/2015 711 Quill Corporation -811.58 03/24/2015 712 Rsvp Embroidery Service -172.00 03/24/2015 713 Brittany Redden -60.00 03/24/2015 714 Observer and Eccentric -538.67 03/24/2015 715 Burton's Plumbing & Heating Co -501.00 03/24/2015 716 CJ's Company Store -11,580.76 03/24/2015 717 The Detroit Institute for Children -4,624.93 03/24/2015 718 Lakeshore Learning -711.69 03/24/2015 719 Oriental Trading Company, Inc. -458.46 03/24/2015 720 Office Depot Business Credit -240.97 03/24/2015 721 Allied-Eagle Supply Co. -500.82 03/27/2015 722 The Romine Group -57,000.00 03/31/2015 723 Mutual Of Omaha -2,335.29 03/31/2015 724 Aetna, Inc. -19,945.65 04/07/2015 725 Academic Facilities, LLC -21,552.47 04/07/2015 726 Lyndsey Grodzicki -17.50 04/07/2015 727 Jeremy Nowka -195.75 04/07/2015 728 Jamie Mack -195.75 04/07/2015 729 Kristi Saville -310.17 04/07/2015 730 Suzanne March -473.62 04/07/2015 731 Georgina Montoya -67.43 04/07/2015 732 Applied Imaging -365.73 04/10/2015 733 Westland Lock & Key Inc -677.60 04/10/2015 734 Therapy Source -663.00 04/14/2015 735 The Romine Group -58,106.96 03/06/2015 ACH Debit Office Depot Business Credit -43.97 04/15/2015 736 Ricoh USA, Inc. -584.21 04/15/2015 737 Tiffany Barnum -100.00 04/15/2015 738 Heritage Logo Works -60.00 04/15/2015 739 Michelle Jones -54.95 04/15/2015 740 Detroit Newspaper Partnership -972.61 04/15/2015 741 Stephanie Franzen -29.96 04/15/2015 742 Quill Corporation -579.50 04/15/2015 743 Republic Services #241 -255.98 04/15/2015 744 Oriental Trading Company, Inc. -20.00 04/15/2015 745 WOW! Business -83.93 04/15/2015 746 CJ's Company Store -8,636.33 04/15/2015 747 City of Garden City -528.59 04/15/2015 748 The Detroit Institute for Children -5,189.74 04/15/2015 749 Applied Imaging -210.00 04/15/2015 750 DTE Energy -3,992.14 04/15/2015 751 Wayne County Health Department -165.00 04/15/2015 752 Burton's Plumbing & Heating Co -199.00 04/15/2015 753 Allied-Eagle Supply Co. -1,139.20 04/17/2015 754 Anita Marcott -250.00 04/17/2015 755 Marilyn Martin -250.00 04/17/2015 756 Kristi Saville -164.45 Page 6 of 8 04/17/2015 757 Lakeshore Learning -504.64
04/17/2015 758 Suzanne March -325.71 04/17/2015 759 O'Callaghan Electric -97.65 04/17/2015 760 City of Garden City -857.75 04/20/2015 761 Midwest School Shows -600.00 04/24/2015 762 Comcast -533.39 04/29/2015 763 The Romine Group -57,000.00 04/29/2015 764 Aetna, Inc. -19,945.65 04/29/2015 765 Mutual Of Omaha -2,255.61 05/01/2015 766 Michigan Tree & Stump -700.00 05/01/2015 767 Allied-Eagle Supply Co. -1,049.49 05/04/2015 768 Quill Corporation -137.97 05/04/2015 769 Michigan Council For Exceptional Children -1,365.00 05/04/2015 770 MIEM -150.00 05/04/2015 771 Wayne RESA -292.00 05/04/2015 772 Ricoh USA, Inc. -299.23 05/04/2015 773 Applied Imaging -331.09 05/04/2015 774 Mybinding.com -84.47 05/04/2015 775 Republic Services #241 -274.89 05/04/2015 776 Therapy Source -617.44 05/04/2015 777 WOW! Business -73.93 05/04/2015 778 DTE Energy -2,654.35 05/04/2015 779 Cynthia J. Bockart -625.00 05/08/2015 780 Play Environments Inc -8,900.00 05/08/2015 781 The Romine Group 0.00 05/14/2015 785 The Romine Group -57,000.00 05/08/2015 782 The Romine Group -31,892.99 05/14/2015 783 Ewing and Associates LLC -1,500.00 05/14/2015 784 Comcast -533.39 05/22/2015 786 Science Alive -815.00 05/22/2015 787 Suzanne March -707.76 05/22/2015 788 Office Depot Business Credit -630.06 05/22/2015 789 Scholastic Book Fairs -1,618.47 05/22/2015 790 Wendy Miller -167.35 05/22/2015 791 Sharon's Heating & Air Conditioning -1,793.00 05/22/2015 792 Mybinding.com -200.65 05/22/2015 793 Stemp's Lawn Care and Landscaping -650.00 05/22/2015 794 CJ's Company Store -10,357.02 05/22/2015 795 Ricoh USA, Inc. -367.61 05/22/2015 796 The Detroit Institute for Children 0.00 05/22/2015 797 Charter Technologies Inc. -4,958.00 05/22/2015 798 Quill Corporation -709.80 05/22/2015 799 Christopher Adkins -109.39 05/22/2015 800 Lakeshore Learning -309.25 05/22/2015 801 Michigan Court Officer Services, LLC -33.00 05/22/2015 802 Therapy Source -691.56 05/22/2015 803 Allied-Eagle Supply Co. -1,137.88 05/27/2015 804 The Romine Group -40,455.71 05/27/2015 805 The Detroit Institute for Children -6,359.98 05/28/2015 806 The Romine Group -54,354.03 05/27/2015 ACH Debit 052715 DTE Energy -29.28 05/29/2015 807 Aetna, Inc. -20,402.27 05/30/2015 808 Mutual Of Omaha -2,307.86 06/12/2015 814 James Minner Construction -200.00 06/12/2015 815 Applied Imaging -340.55 06/12/2015 816 The Romine Group -56,585.48 06/12/2015 809 CJ's Company Store -12,570.59 06/12/2015 810 Ricoh USA, Inc. -284.98 06/12/2015 811 Republic Services #241 -254.66 06/12/2015 812 WOW! Business -73.93 06/12/2015 813 The Detroit Institute for Children -5,987.63 06/18/2015 ACH Debit DTE Energy -3,318.93 06/18/2015 817 Applied Imaging -303.05 06/18/2015 818 Observer and Eccentric -14.48 06/18/2015 819 Downriver Bus Repair Inc -120.00 06/18/2015 820 Westland Grand Digital Cinema -215.00 Page 7 of 8 06/18/2015 821 Cherry Hill Lanes -200.00
06/18/2015 822 City of Garden City -1,230.87 06/18/2015 823 Suzanne March -103.16 06/19/2015 824 Krystal Fauls -200.00 06/24/2015 825 Pearson Education -1,204.65 06/24/2015 826 The Romine Group -75.00 06/24/2015 827 Lane Plumbing & Heating, Inc. -275.00 06/24/2015 828 Jones School Supply Co., Inc. -118.39 06/24/2015 829 Northville Community Foundation -184.50 06/24/2015 830 Ricoh USA, Inc. -161.71 06/24/2015 831 Rose Pest Solutions -455.00 06/27/2015 832 The Detroit Institute for Children -2,523.05 06/27/2015 833 Allied-Eagle Supply Co. -1,807.25 06/27/2015 834 Therapy Source -436.56 06/27/2015 835 Comcast -533.39 06/27/2015 836 Quill Corporation -709.80 06/27/2015 837 Office Depot Business Credit -104.36 06/28/2015 838 The Romine Group -57,000.00 06/29/2015 839 The Romine Group -42,225.34 06/30/2015 840 Mutual Of Omaha -2,507.00 06/30/2015 841 Aetna, Inc. -20,402.27 06/30/2015 842 The Romine Group -31,314.94 06/30/2015 843 Charter Technologies Inc. 0.00 06/30/2015 844 General Binding Corporation -14.22 -$ 2,501,364.57

Educational Service Provider: Operating Expenditures

School District: Tipton Academy (82754)

Fiscal Year: 2014-2015

Educational Service Provider Operating Expenditures
Instructional Expenditures (1xx, 293) $1,287,998 78.74%
Pupil Support Services (21x) $5,872 0.36%
Instructional Staff Support Services (22x) $0 0.00%
General Administration (23x) $0 0.00%
School Administration (24x) $217,081 13.27%
Business Services (25x) $0 0.00%
Operations and Maintenance (26x) $69,232 4.23%
Transportation (27x) $0 0.00%
Central & Other Support Services (28x, 291, 292, 295, 299) $0 0.00% Total Operating Expenditures from ESP $1,580,183 96.60%
Total from ESP file $1,635,749 100.0%

Report based on district's 2015 Financial Information Database (FID) submission.

Caution should be used when using these financial data. Sound conclusions can only be drawn when the data elements are used in proper context. The ESP operational expenditure costs reported to the charts above are based on function codes as submitted to the Financial Information Database (FID). Districts are required by law (MCL 380.1281) to follow a common chart of accounts published as the Michigan Public School Accounting Manual when reporting financial data. Definitions for each of the function codes listed in the charts above may be found in the Manual available at: http://www.michigan.gov/documents/appendix_33974_7.pdf.

More district financial information can be found online at www.michigan.gov/cepi.

Educational Service Provider: Operating Expenditures

School District: Tipton Academy (82754)

Fiscal Year: 2013-2014

Educational Service Provider Operating Expenditures
Instructional Expenditures (1xx, 293) $849,878 80.56%
Pupil Support Services (21x) $5,889 0.56%
Instructional Staff Support Services (22x) $0 0.00%
General Administration (23x) $0 0.00%
School Administration (24x) $128,580 12.19%
Business Services (25x) $0 0.00%
Operations and Maintenance (26x) $45,796 4.34%
Transportation (27x) $0 0.00%
Central & Other Support Services (28x, 291, 292, 295, 299) $0 0.00% Total Operating Expenditures from ESP $1,030,143 97.65%
Total from ESP file $1,054,962 100.0%

Report based on district's 2014 Financial Information Database (FID) submission.

Caution should be used when using these financial data. Sound conclusions can only be drawn when the data elements are used in proper context.

The ESP operational expenditure costs reported to the charts above are based on function codes as submitted to the Financial Information Database (FID).

Districts are required by law (MCL 380.1281) to follow a common chart of accounts published as the Michigan Public School Accounting Manual when reporting financial data. Definitions for each of the function codes listed in the charts above may be found in the Manual available at: http://www.michigan.gov/documents/appendix_33974_7.pdf.

More district financial information can be found online at www.michigan.gov/cepi.

Educational Service Provider: Transparency Expenditure Report

School District: Tipton Academy (82754)

Fiscal Year: 2014-2015

Educational Service Provider Expenditures
Salaries (1xxx) $1,216,738 74.38%
Employee Benefits (2xxx) $419,011 25.62%
Rentals (42xx) $0 0.00%
Purchased Services (3xxx) $0 0.00%
Repairs & Maintenance (41xx) $0 0.00%
Supplies and Materials (5xxx) $0 0.00%
Capital Outlay (6xxx) $0 0.00%
Other Expenditures, Dues and Fees (74xx) $0 0.00%
Total from above $1,635,749 100.00%
Total expenditures reported in ESP file $1,635,749 100.0%

Report based on district's 2015 Financial Information Database (FID) submission.

Caution should be used when using these financial data. Sound conclusions can only be drawn when the data elements are used in proper context. The ESP expenditure costs reported to the charts above are based on objects codes in the ESP file as submitted to the Financial Information Database (FID). Districts are required by law (MCL 380.1281) to follow a common chart of accounts published as the

Michigan Public School Accounting Manual when reporting financial data. Definitions for each of the object codes listed in the charts above may be found in the Manual available at: http://www.michigan.gov/documents/appendix_33974_7.pdf.

More district financial information can be found online at www.michigan.gov/cepi.