July 1, 2024 June 30, 2025
YOUR 2024-25 BENEFITS
Welcome
Your benefits are an important part of your overall compensation. We are pleased to offer a comprehensive array of valuable benefits to protect your health, family and way of life. This guide answers some of the basic questions you may have about your benefits. Please read it carefully, along with any supplemental materials you receive.
Eligibility
You are eligible for benefits if you work 20 or more hours per week. You may also enroll your eligible family members under certain plans you choose for yourself. Eligible family members include:
Your legally married spouse
Your registered domestic partner (RDP)* and/or their children, where applicable by state law
Your biological children, stepchildren, adopted children or children for whom you have legal custody (age restrictions may apply). Disabled children age 26 or older who meet certain criteria may continue on your health coverage.
When Coverage Begins
New Hires: You must complete the enrollment process within 30 days of your date of hire. If you enroll on time, coverage is effective on the first of the month following your date of hire. If you fail to enroll on time, you will NOT have benefits coverage (except for company-paid benefits) until you enroll during our next annual Open Enrollment period.
Open Enrollment: Changes made during Open Enrollment are effective July 1, 2024 - June 30, 2025.
*Your contributions to cover an RDP are the same as those to cover a legal spouse. However, because of Internal Revenue Code (IRC) restrictions, in most cases, the fair market value of your RDP’s or RDP’s children’s (if they are not federal tax dependents) healthcare coverage will be taxable to you as imputed income. This value is determined by the amount that The Company pays in premium for RDP coverage. This amount raises your taxable gross income. Also, the payroll deductions to cover an RDP must be taken on an after-tax basis.
Choose Carefully
Due to IRS regulations, you cannot change your elections until the next annual Open Enrollment period, unless you have a qualifying life event during the year. Following are examples of the most common qualifying life events:
Marriage or divorce
Birth or adoption of a child
Child reaching the maximum age limit
Death of a spouse, RDP or child
You lose coverage under your spouse’s/RDP’s plan
You gain access to state coverage under Medicaid or The Children’s Health Insurance Program
Making Changes
To change your benefit elections, you must contact Human Resources within 30 days of the qualifying life event. Be prepared to show documentation of the event, such as a marriage license, birth certificate or a divorce decree. If changes are not submitted on time, you must wait until the next Open Enrollment period to change your elections.
Required Information You will be required to enter a Social Security number (SSN) for all covered dependents when you enroll. The Affordable Care Act (ACA) requires the company to report this information to the IRS each year to show that you and your dependents have coverage. This information will be securely submitted to the IRS and will remain confidential.
Health Savings Accounts (HSAs)
Flexible Spending Accounts (FSAs)
Life and AD&D
Employee Assistance Program (EAP)
Voluntary Benefits
Valuable Extras
Cost of Benefits
Inside Medical Dental Vision
Disability
Contact information Enrollment Go to Paycom. There you will find detailed information about the plans available to you and instructions for enrolling.
Medical
We are proud to offer you a choice of medical plans that provide comprehensive medical and prescription drug coverage. The plans also offer many resources and tools to help you maintain a healthy lifestyle. Following is a brief description of each plan.
Medical Mutual of Ohio (MMO) PPO Plan
This plan gives you the freedom to seek care from any provider of your choice. However, you will maximize your benefits and lower your out-of-pocket costs if you choose a provider who participates in the network.
The plan pays the full cost of qualified in-network preventive health care services.
You may also have to pay a fixed dollar amount (copay) for certain services.
Once you meet the deductible, you pay a percentage of certain health care expenses (coinsurance) and the plan pays the rest.
Once your deductible, copays and coinsurance add up to the out-of-pocket maximum, the plan pays the full cost of all qualified health care services for the rest of the year.
Medical Mutual of Ohio (MMO) HSA Plan
The High-Deductible Health Plan (HDHP) works similarly to a traditional PPO:
You may see any health care provider and still receive coverage, but will maximize your benefits and lower your out -of-pocket costs if you see an in-network provider.
The plan pays the full cost of qualified in-network preventive health care services.
You pay the full cost of non-preventive health care services until you meet the annual deductible.
Once you meet the deductible, you pay a percentage of your health care expenses (coinsurance) and the plan pays the rest.
Once your deductible and coinsurance add up to the out-ofpocket maximum, the plan pays the full cost of all qualified health care services for the rest of the year.
Health Savings Account
The HDHP comes with a type of savings account called a health savings account (HSA) through Bank of America. The HSA lets you set aside pre-tax dollars to help offset your annual deductible and pay for qualified health care expenses.
Here’s how the HSA works:
You contribute pre-tax funds to the HSA through automatic payroll deductions.
In addition, we will contribute to your HSA; company contribution amounts can be found on the medical overview grid.
Your contributions, in addition to the company’s contributions, may not exceed the annual IRS limits listed below.
You can withdraw HSA funds, tax free, to pay for qualified health care expenses now or in the future. Unused funds roll over from year to year and are yours to keep, even if you change medical plans or leave your employer.
What to do when you have a qualified expense and want to use your HSA:
Save your receipts every time you use your debit card to pay for an eligible expense or make a withdrawal to “pay yourself back” for an eligible expense that you have paid for out of your own pocket. The IRS may ask you to verify the expense if you are ever audited.
At the pharmacy you may swipe your HSA debit card and the available funds will be taken out of your account automatically. It may be beneficial for you to compare prescription drug prices at various pharmacies. The insurance carrier has different contracted amounts with each pharmacy, and you may have the opportunity to save money depending on where you buy your prescription drugs.
At the doctor’s office, tell the staff that you do not have an office copay, but have $10 or $20 on hand just in case your doctor’s office requires a small down payment. The doctor’s office will submit the claim to the insurance carrier and the insurance carrier will apply the appropriate in-network discount. When you get the bill from your doctor’s office, match it up with the explanation of benefits (EOB) from your health insurance carrier, to ensure you are being billed the discounted amount. You may pay the bill with your HSA debit card, or you may pay by cash, check or credit card and make a withdraw from your HSA account to “pay yourself back” for your out-of-pocket expenses.
Important Notes:
You must meet certain eligibility requirements to have an HSA: You must a) be at least 18 years old, b) be covered under a qualified HDHP, c) not be enrolled in Medicare and d) cannot be claimed as a dependent on another person’s tax return. For more information, visit www.irs.gov/formspubs/about-publication-969
For a complete list of qualified health care expenses, visit www.irs.gov/forms-pubs/about-publication-502
Adult children must be claimed as dependents on your tax return for their medical expenses to qualify for payment or reimbursement from your HSA.
HSA Contribution Limit 2024 Employee Only $4,150 Family (employee + 1 or more) $8,300 Catch-up (age 55+) $1,000
Medical (Cont’d)
Following is a high-level overview of the coverage available. For complete coverage details, please refer to the Summary Plan Description (SPD).
Company Contribution to Your Health Savings Account (HSA) (per plan year; prorated for new hires/newly eligible)
Drugs (Tiers)
Coinsurance percentages and copay amounts shown in the above chart represent what the member is responsible for paying. *Benefits with an asterisk ( * ) require that the deductible be met before the Plan begins to pay. To be eligible for the HSA, you cannot be covered through Medicare Part A or Part B or TRICARE programs. See the plan documents for full details.
1. If you use an out-of-network provider, you will be responsible for any charges above the maximum allowed amount.
2. If you enroll one or more family members, each family member must meet their own individual deductible until the total amount of deductible expenses paid by all family members meets the overall family deductible.
3. If you enroll one or more family members, you must meet the full individual out-of-pocket maximum until the overall family out
of-pocket limit has been met.
4. The Gorilla Glue medical plan renews on 7/1 each year, but the benefits (deductible, coinsurance, maximum out-of-pocket, and
limits) follow the calendar year. Key Medical Benefits
-
other plan
MMO PPO MMO HDHP In-Network Only Out-of-Network1 In-Network Only Out-of-Network1 Deductible (per calendar year) Individual / Family $500 / $1,000 $10,000 / $20,000 $3,200 / $6,400 $10,000 / $20,000 Out-of-Pocket Maximum (per calendar year) Individual / Family $2,000 / $4,000 $20,000 / $40,000 $3,200 / $6,400 $20,000 / $40,000
Individual / Family Not Applicable Not Applicable $750 / $1,500 $750 / $1,500 Covered Services Office Visits (physician/specialist) $30 / $30 Copay N/A 0%* 50%* Virtual Visits $30 Copay N/A 0%* 50%* Routine Preventive Care No Charge 50% No Charge 50% Outpatient Diagnostic (lab/X-ray) No Charge 50% 0%* 50%* Complex Imaging No Charge 50% 0%* 50%* Chiropractic $30 Copay N/A 0%* 50%* Ambulance 0%* 0%* 0%* 0%* Emergency Room $300 Copay $300 Copay 0%* 0%* Urgent Care Facility $75 Copay 50% 0%* 50%* Inpatient Hospital Stay 0%* 50%* 0%* 50%* Outpatient Surgery 0%* 50%* 0%* 50%*
Retail Pharmacy (30-day supply) $10 / $35 / $70 / 25% up to $200 Not Applicable 0%* Not Applicable Mail Order (90-day supply) $10 / $88 / $175 / 25% up to $200 Not Applicable 0%* Not Applicable
Prescription
Dental
We are proud to offer you a choice of dental plans.
Delta Dental PPO: This plan offers you the freedom and flexibility to use the dentist of your choice. However, you will maximize your benefits and lower your out-of-pocket costs if you choose a dentist who participates in the network. The following is a high-level overview of the coverage available.
Key Dental Benefits
Coinsurance percentages shown in the above chart represent what the member is responsible for paying.
*Benefits with an asterisk ( * ) require that the deductible be met before the Plan begins to pay.
1. If you use an out-of-network provider, you will be responsible for any charges above the maximum allowed amount.
We are proud to offer you a vision plan.
This plan gives you the freedom to seek care from the provider of your choice. However, you will maximize your benefits and lower your out-of-pocket costs if you choose a provider who participates in the network.
Vision
EyeMed
Delta Dental DPPO (Core) Delta Dental DPPO (Buy-Up) In-Network Only Out-of-Network1 In-Network Only Out-of-Network1 Deductible (per calendar year) Individual / Family $50 / $150 $50 / $150 None None Benefit Maximum
Preventive, Basic,
combined) Per Individual $1,000 $1,000 $2,000 $2,000 Covered Services Preventive Services No charge No charge No charge No charge Basic Services 20%* 20%* 10% 10% Major Services 50%* 50%* 40% 40% Orthodontia (Child & Adult) Not Applicable Not Applicable 50%; $1,500 Max. Benefit 50%; $1,500 Max. Benefit Key Vision
EyeMed In-Network Out-of-Network Reimbursement Exam (once every 12 months) $10 Up to $40 Materials Copay $25 N/A Lenses (once every 12 months) Single Vision No charge after materials copay Up to $30 Bifocal Up to $50 Trifocal Up to $70 Frames (once every 24 months) Covered up to $130, 20% off balance over $130 Up to $91 Contact Lenses (once every 12 months; in lieu of glasses) Covered up to $130, 15% off balance over $130 Up to $130
(per calendar year;
and Major Services
Benefits
Flexible Spending Accounts
We provide you with an opportunity to participate in our flexible spending accounts (FSAs) administered by Navia. FSAs allow you to set aside a portion of your income, before taxes, to pay for qualified health care and/or dependent care expenses. Because that portion of your income is not taxed, you pay less in federal income, Social Security and Medicare taxes.
Health Care FSA
FSA Rules
YOU MUST ENROLL EACH YEAR TO PARTICIPATE
Prescriptions and Overthe-Counter Drugs
Orthodontia
For 2024, you may contribute up to $3,200 to cover qualified health care expenses incurred by you, your spouse and your children up to age 26. Some qualified expenses include: Coinsurance Copayments Deductibles
Menstrual Care
Dental treatment
Eye Exams, Materials, LASIK
For a complete list of eligible expenses, visit www.irs.gov/pub/irs-pdf/p502.pdf
Limited-Purpose Health Care FSA (for HSA participants)
If you enroll in the HSA medical plan, you may only participate in a limited-purpose Health Care FSA. This type of FSA allows you to be reimbursed for eligible dental, orthodontia and vision expenses while preserving your HSA funds for eligible medical expenses. Dependent Care
FSA
For 2024, you may contribute up to $5,000 (per family) to cover eligible dependent care expenses ($2,500 if you and your spouse file separate tax returns). Some qualified expenses include:
Care of a dependent child under the age of 13 by babysitters, nursery schools, preschool or daycare centers
Care of a household member who is physically or mentally incapable of caring for him/herself and qualifies as your federal tax dependent
For a complete list of eligible expenses, visit www.irs.gov/pub/irs-pdf/p503.pdf
Life and AD&D
Life insurance provides your named beneficiary(ies) with a benefit after your death.
Accidental death and dismemberment (AD&D) insurance provides specified benefits to you in the event of a covered accidental bodily injury that directly causes dismemberment (i.e., the loss of a hand, foot or eye). In the event that your death occurs due to a covered accident, both the life and the AD&D benefit would be payable.
Basic Life/AD&D (Company-paid)
This benefit is provided at NO COST to you through VOYA.
Benefit Amount
Employee 1 Times your base salary, up to a $300,000 maximum
Because FSAs can give you a significant tax advantage, they must be administered according to specific IRS rules:
Health Care FSA: Unused funds up to $640 can carry over from the 2024-2025 plan year to the following plan year. Carryover funds will not count against or offset the amount that you can contribute annually. Unused funds over $640 will NOT be returned to you or carried over to the following year.
Dependent Care FSA: Unused funds will NOT be returned to you or carried over to the following year.
Supplemental Life/AD&D (Employee-paid)
If you determine you need more than the basic coverage, you may purchase additional coverage through VOYA for yourself and your eligible family members.
LIMITED ENROLLMENT OPPORTUNITY: During this special open enrollment, you can purchase coverage up to the Guarantee Issue amounts and you will not have to answer medical questions.
1. During your initial eligibility period only, you can receive coverage up to the Guaranteed Issue amounts without having to provide Evidence of Insurability (EOI, or information about your health). Coverage amounts that require EOI will not be effective unless approved by the insurance carrier.
Benefit Option Guaranteed Issue1 Employee $10,000 increments; minimum of $20,000 up to $500,000 $150,000 Spouse/RDP $5,000
$5,000 up to $250,000
to exceed 50% of your additional life coverage) $50,000 Child(ren) Under age 26 - $5,000 up to $10,000 $10,000
increments; minimum of
(not
Disability insurance provides benefits that replace part of your lost income when you become unable to work due to a covered injury or illness.
Short-Term Disability
Provided at NO COST to you through VOYA
Benefit Percentage 60%
Weekly Benefit Maximum $6,000
When Benefits Begin After 7th day of disability
Maximum Benefit Duration 13 weeks
Long-Term Disability
Provided at NO COST to you through VOYA
Monthly Benefit Maximum $10,000
When Benefits Begin After 90th day of disability
Maximum Benefit Duration Social Security Retirement Age
Employee Assistance Program (EAP)
Life is full of challenges, and sometimes balancing them all can be difficult. We are proud to provide a confidential program dedicated to supporting the emotional health and well-being of our employees and their families. The EAP is provided at NO COST to you through VOYA.
The EAP can help with the following issues, among others: EAP Benefits
▪ Mental health
▪ Relationships or marital conflicts
▪ Child and eldercare
▪ Substance abuse
▪ Grief and loss
▪ Legal or financial issues
▪ Assistance for you and your household members
▪ Up to three in-person sessions with a counselor per issue, per year, per individual
▪ Unlimited toll-free phone access and online resources
Call (877) 533-2363 or visit guidanceresources.com and use Web ID: My5848i
The EA
This is a comprehensive wellness program that is part of the Medical Mutual benefit plan. Through the EA Wellness, you will have access to an online portal that offers several challenges and health information to help you earn points for incentives. The best part is that the portal helps you focus on goals that are most important to you, so you can choose your way to well-being.
The first step is to register to online portal at: https:// eawellness7.mywellmetrics.com. Click on “Get Started”. You will need your MMO ID number.
Voluntary Benefits
Our benefit plans are here to help you and your family live well and stay well. But did you know that you can strengthen your coverage even further? It’s true! Our voluntary benefits through VOYA are designed to complement your health care coverage and allow you to customize our benefits to you and your family’s needs. The best part? Benefits from these plans are paid directly to you! Coverage is also available for your spouse and dependents. You can enroll in these plans during Open Enrollment they’re completely voluntary, which means you are responsible for paying for coverage at affordable group rates.
Accident Insurance
Accident insurance can soften the financial impact of an accidental injury by paying a benefit to you to help cover the unexpected out-ofpocket costs related to treating your injuries. Some accidents, like breaking your leg, may seem straightforward: You visit the doctor, take an X-ray, put on a cast and rest up until you’re healed. But in reality, treating a broken leg can cost up to $7,5001. And it’s not only broken limbs an average non-fatal injury could cost you $6,620 in medical bills2. When your medical bill arrives, you’ll be relieved you have accident insurance on your side.
Critical Illness
Most of us don’t have an extra $7,000 ready to spend and even if we do, we don’t want to spend it on medical expenses. Unfortunately, the average cost to treat a critical illness is just that: $7,0003. But with critical illness insurance, you’ll receive a lump-sum benefit if you are diagnosed with a covered condition. You can use this benefit however you like, including to help pay for: treatments, prescriptions, travel, increased living expenses and more.
Hospital Indemnity Insurance
When you or a dependent need to be hospitalized, your family deserves to focus on their well-being, not the stress of the average three-day hospital stay, which can cost you $30,0001. Hospital indemnity insurance can help reduce costs by paying you or a covered dependent a benefit to help cover your deductible, coinsurance and other out-of-pocket costs due to a covered hospitalization.
1. Why health insurance is important: Protection from high medical costs. HealthCare.gov
2. Average medical cost of fatal and non-fatal injuries by type in the USA, December 2019. National Library of Medicine.
3. MetLife Accident and Critical Illness Impact Study.
4. Cancer Facts & Figures, 2021. American Cancer Society.
Pet Insurance
Pet insurance offered by Nationwide allows for up to 90% back on eligible vet bills and has wellness plan options.
This benefit is enrolled directly with Nationwide and not in Paycom. To enroll you can call (877) 738-7874 or go https:// benefits.petinsurance.com/the-gorilla-glue-company
Disability
Benefit Percentage 60%
LegalShield
A voluntary benefit with legal assistance provided through LegalShield. Services include:
▪ Personal Legal Advice unlimited issues
▪ 24/7 Emergency Access for covered situations
▪ Contracts/Documents reviewed up to 15 pages
▪ Online Legal Forms/Videos
▪ Lawyer Prepared (Wills, Living Will, Health Care Power of Attorney)
▪ Trial Defense – Pre-Trial & Trial
▪ Traffic-Related Issues
▪ Family/Domestic Services
▪ Uncontested Divorce
▪ Uncontested Adoption
▪ Uncontested Separation/ Annulment
▪ Uncontested Name Change
▪ IRS Audit Assistance
AURA Identity Guard
Help protect your personal, credit, and financial assets from the constantly evolving threats of fraud so you can live your life with peace of mind.
Identity Guard can help with the following issues, among others:
▪ Monitoring your personal information, credit, and bank account for signs of fraud
▪ Alerting you of breaches and credit fraud in near real-time
▪ If you are a victim of fraud, agents will help you resolve the issue
▪ All plans offer $1M identity theft insurance to cover legal fees, stolen funds, and more
▪ Unlimited toll-free phone access and online resources
Monitoring over all of the following:
▪ All Financial Accounts (401k, Credit and Debit Cards, Investments, Student Loans, etc.)
▪ High-risk Transactions
▪ Address & Home Title
▪ Criminal Record
▪ Dark Web
▪ Social Media Accounts
Gorilla Gives Back
The Gorillas Give Back charity program provides an opportunity for employees to donate from a list of charities we support through payroll deduction. Our charity list represents causes from neglected and homeless children, addiction, and veterans, to serving those with disabilities, animal rescue, and sustainability in our community
How it Works:
▪ This is an OPT-IN program through Paycom
▪ For every $1 you give, Gorilla gives $1
Cincinnati Works
An on-site workforce solution that provides confidential life, employment, and financial coaching to employees. This can help employees access necessary resources to remove any life challenges they may be facing and facilitate on-going skills trainings.
Provides assistance with:
▪ Difficulty managing income and expenses
▪ Budgeting
▪ Unreliable transportation
▪ Housing challenges
▪ Lack of family support system
▪ Life Changes ▪ issues
▪ Mental/physical health challenges
Taxes
The Work Number
A fast and secure way to provide proof of your employment and income for:
▪ Obtaining Credit
▪ Financing a home or automobile
▪ Leasing an apartment
▪ Securing Government Benefits or Services (Medicaid, SSI/ SSDI, SNAP, Child Support, Public Housing, etc.)
The Work Number by Equifax is available to Verifiers 24 hours a day, 7 days a week by calling (800) 367-5690. You tell the lender (verifier) you work with The Gorilla Glue Company or give them our Code (20247) plus your Social Security Number that’s it!
EarnedIt
This is a free program that allows you to receive 80% of your pay in advance of payday, eliminating the need for high interest payday loans. You can transfer your funds daily to your account or pay card with a fee of $3.45 for same day transactions or no fee if you access the money the next day.
Download the app using the QR Code to get started
Valuable Extras
We also offer the following additional benefits:
▪ 401(k) Retirement Plan
▪ College Reimbursement Program
▪ Auto Group Insurance
▪
Cost of Benefits Contact Information
Benefit Spot
Your contributions toward the cost of benefits are automatically deducted from your pay check before taxes. The amount will depend upon the plan you select and if you choose to cover eligible family members.
Enrollment Management Services (EMS)
Dental (10510)
Flexible Spending Accounts (GGB)
(866) 939-3633
(800) 669-3539
DISCLAIMER: The material in this benefits brochure is for informational purposes only and is neither an offer of coverage or medical or legal advice. It contains only a partial description of plan or program benefits and does not constitute a contract. Please refer to the Summary Plan Description (SPD) for complete plan details. In case of a conflict between your plan documents and this information, the plan documents will always govern. Annual Notices: ERISA and various other state and federal laws require that employers provide disclosure and annual notices to their plan participants. The company will distribute all required notices annually.
Coverage
Number) Carrier Phone # Website/Email
MMO
www.medmutual.com
(Group
Medical (356578)
(888) 636-3622
Tracy Barnes (513) 978-5951 tracy@enrollmentmanagementservices.com
Delta
EyeMed
www.naviabenefits.com Health Savings Account Bank of America (800) 718-6710 www.SaveItUseIt.com Life/AD&D VOYA (800) 955-7736 www.voya.com Disability VOYA (800) 955-7736 www.voya.com/claims Employee Assistance Program (EAP) VOYA/ComPsych (877) 533-2363 www.guidanceresources.com Voluntary Benefits (Accident, Critical Illness, Hospital Indemnity) VOYA (800) 955-7736 www.voya.com Legal Coverage LegalShield (800) 654-7757 www.legalshield.com Identity Protection AURA Identity Guard (855) 443-7748 customercare@identityguard.com
Dental of Ohio (800) 524-0149 www.deltadentaloh.com Vision (1011738)
www.eyemed.com
Navia
We
need
get started,
Apple
company code: Gorilla
sensitive) Benefits Website Paycom can be accessed anytime you want additional information on our benefit programs. Questions? If you have additional questions, you may also contact: HUB’s Advocacy Team (844) 694-6726 engagement@horanassoc.com Gorilla’s HR Benefit Team benefits@gorillaglue.com
’ve gone mobile! To help you access your benefits information even when you’re away from work and
it most we’ve launched a mobile benefits app. To
Download “Benefit Spot” on the
App Store or Google Play and enter
(case
MEDICAL HDHP with HSA
PART
MEDICAL PPO
PART TIME MEDICAL HDHP with HSA
2024-2025 RATE SHEET
Bi-Weekly Rates Low Risk Moderate Risk High Risk Non-Participant Employee $32.57 $39.76 $46.14 $112.37 Employee + Spouse/RDP $65.00 $79.35 $92.07 $144.79 Employee + Child(ren) $61.75 $75.39 $87.48 $141.55 Family $103.90 $126.84 $147.19 $183.70 (26 Pay Periods) Bi-Weekly Rates Low Risk Moderate Risk High Risk Non-Participant Employee $29.75 $35.97 $41.74 $99.88 Employee + Spouse/RDP $59.37 $71.78 $83.30 $129.21 Employee + Child(ren) $56.41 $68.20 $79.14 $126.28 Family $94.91 $114.76 $133.16 $164.40 Your contributions toward the cost of medical, dental, and vision coverage are automatically deducted from yourpaycheck before taxes.
MEDICAL PPO
TIME
Bi-Weekly Rates Low Risk Moderate Risk High Risk Non-Participant Employee $66.50 $73.68 $82.45 $108.99 Employee + Spouse/RDP $132.70 $147.03 $164.54 $209.40 Employee + Child(ren) $126.08 $139.69 $156.34 $202.73 Family $212.13 $235.04 $263.04 $288.84 Bi-Weekly Rates Low Risk Moderate Risk High Risk Non-Participant Employee $60.16 $66.66 $74.60 $120.31 Employee + Spouse/RDP $120.05 $132.73 $148.86 $190.46 Employee + Child(ren) $114.06 $126.38 $141.44 $184.47 Family $191.91 $212.64 $237.97 $262.32
LIFE AND AD&D
2024-2025 EE’S RATE SHEET
HOSPITAL INDEMNITY
Registered Domestic Partner (RDP) Contributions:Your contributions to cover an RDP are the same as those to cover a legal spouse. However, because of Internal Revenue Code (IRC) restrictions, in most cases, the fair market value of your RDP’s or RDP’s children’s (if they are not federal tax dependents) healthcare coverage will be taxable to you as imputed income. This value is determined by the amount that Gorilla pays in premium for RDP coverage. This amount raises your taxable gross income. Also, the payroll deductions to cover an RDP must be taken on an after-tax basis.
Weekly Rates Low Buy-Up Employee $6.25 $10.80 Employee + One $12.56 $21.43 Family $19.98 $37.61 DENTAL Bi Weekly Rates Deduction Employee $2.83 Employee + Spouse $5.38 Employee + Child(ren) $5.66 Family $8.33 VISION (26 Pay Periods) FLEXIBLE SPENDING
Healthcare and Limited-Purpose FSA contributions permitted up to $3,200. Dependent Care FSA contributions up to $5,000 annually. Bi Weekly Rates Deduction Per $1,000 0-29 $0.051 30-34 $0.060 35-39 $0.065 40-44 $0.092 45-49 $0.129 50-54 $0.235 55-59 $0.360 60-64 $0.406 65-69 $0.692 70+ $1.680 VOLUNTARY
Bi Weekly Rates Deduction Per $1,000 <30 $0.16 30-39 $0.24 40-49 $0.52 50-59 $1.00 60-69 $1.56 70+ $2.11 CRITICAL ILLNESS Bi Weekly Rates Deduction Employee $4.61 Employee + Spouse $14.46 Employee + Child(ren) $10.38 Family $20.24
ACCOUNTS (FSA)
Bi Weekly Rates Deduction Employee $5.51 Employee + Spouse $9.30 Employee + Child(ren) $9.58 Family $13.37 ACCIDENT Bi Weekly Rates Deduction Individual $3.61 Family $4.04 LEGALSHIELD