RE: Plan Administrator of the Interim HealthCare Deferred Savings Plan and the Interim HealthCare
Welfare Benefits Plan (collectively, “the Plans”)
Dear Employee:
As an individual entitled to receive benefits under one or both of the Plans, you are entitled to certain
communications from the Plan Administrator or other Plan official. The Plans can deliver some or all of these
communications electronically. If you wish to receive Plan communications electronically, you must consent. Before you
consent, you should be aware of the following:
Type of documents. The Plans may deliver electronically any document required to be disclosed to you under the federal
laws governing employee benefit plans (ERISA), including:
the Summary Plan Description (SPD)
any required Summaries of Material Modification (SMMs)
any document required under ERISA to be made available to, or furnished on request by, a
participant or beneficiary.
Electronic delivery method. Documents communicated electronically will be posted on the Company’s website at
www.interimhealthcare.com/teamvirginia. You will also be notified by email when a new document is posted on the
website. To access the document, you must have (1) an electronic device with internet access and (2) a program or app
installed on the device allowing you to browse the internet and log onto www.interimhealthcare.com/teamvirginia. Copies
of documents furnished electronically will remain on our website until they become obsolete.
If any of these requirements change in a way that creates a material risk that you will no longer be able to access and retain
electronically-transmitted documents, you will be furnished with notice and required to provide another consent for
receiving documents electronically.
What you must do. To receive documents electronically, you must:
1. Complete and return the Consent to Electronic Communications on the reverse side by mail Attn: HR
to the address at the bottom of this notice, or fax to (434) 295-4938, or scan to
hasluphr@interimhealthcare.com. You may withdraw your consent at any time by sending an email
message to hasluphr@interimhealthcare.com that states in the subject line: Consent Withdrawn for
Electronic Communications and includes in the body your full name, address and phone number.
2. Provide us with an email address to which electronic documents should be sent. To update your email
address, send an email message to hasluphr@interimhealthcare.com that states in the subject line:
Change in Email Address for Electronic Communications.
Your right to a paper copy. Even if you consent to electronic communication from the Plans, you always have the right
to request and obtain at no charge a paper version of any document the Plans furnish to you electronically. Contact our
Human Resources Department, who acts on behalf the Plan Administrator, at (434) 295-5501 or
hasluphr@interimhealthcare.com to request a paper copy.
Consent for Electronic Communications
I have read and received the Statement Regarding Electronic Communications for the Interim HealthCare Deferred
Savings Plan and Interim HealthCare Welfare Benefits Plan (“Statement”).
I consent to receiving the types of documents described in the Statement by electronic means at the following
email address:
EMAIL ADDRESS
I confirm that I can access information in the electronic form described in the Statement. I understand I will
receive copies of these documents only in the electronic form described in the Statement unless I expressly
exercise my right to request a paper copy.
I understand I can withdraw this consent at any time by sending an email an email message to
hasluphr@interimhealthcare.com that states in the subject line: Consent Withdrawn for Electronic
Communication and includes in the body my full name, address and phone number.
Participant or Beneficiary
Date