Technifab Benefit Guide | 2023

BENEFITS

GUIDE OCTOBER 1, 2022 - SEPTEMBER 31, 2023

WELCOME TO YOUR BENEFITS At Technifab we understand the important role that our benefit programs play in the lives of our employees and their families.

Technifab would not be the successful company it is today without the dedication of our hard-working employees. We are proud to offer a comprehensive benefits package that is designed to insure and protect you and your family against financial hardship and loss.

WE OFFER THE FOLLOWING BENEFITS: Medical, Dental, Vision, Wellness Program, Health Savings Account (HSA), Basic Life and AD&D, Voluntary Life and AD&D, Short-Term Disability (STD), Long-Term Disability (LTD), Employee Assistance Program (EAP), Travel Assistance, ID Theft, and a 401(k) Retirement Plan to all full-time employees.

NEW CARRIER CHANGES THIS YEAR: •

Dental | Your dental benefits have enhanced, and will now be provided by Delta Dental AZ.

•

Vision | Your vision benefits will now be provided by Delta Dental AZ.

DISCOVERING

YOUR BENEFITS CARRIER/VENDOR

FIND IT ON PAGE

UnitedHealthcare

9

Proactive MD

11

Fidelity

12

UnitedHealthcare

15

Dental

Guardian

16

Vision

Guardian + VSP

18

Life and AD&D Insurance

Guardian

20

Disability

Guardian

22

HEALTH BENEFITS Medical Employee Wellness Clinic HSA Virtual Visits

FINANCIAL BENEFITS

3

DIGITAL GUIDE

NAVIGATION

WHAT ONLINE FUNCTIONS ARE AVAILABLE? Your Home Screen.

Use the side arrows to help you jump to the next page or the previous page.

A SIMPLE WAY TO HELP YOU NAVIGATE THROUGH YOUR BENEFITS. Your Benefit Guide is accessible online through your computer, tablet, or smartphone. It is designed to help you navigate through your benefits with a few simple clicks!

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If you are using a tablet or smartphone, look for the cursor icon and be sure to tap it on certain pages.

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Download a PDF to save the guide to your device and print it. Please note that some digital functions may get lost.

WHAT DOES

THAT WORD MEAN?

ANNUAL DEDUCTIBLE

ANNUAL OUT-OF-POCKET MAXIMUM

BALANCE BILLING

COINSURANCE

COPAYMENTS OR COPAYS

HEALTH SAVINGS ACCOUNT (HSA)

EXPLANATION OF BENEFITS (EOB)

IN-NETWORK

MEDICARE

USUAL, CUSTOMARY, AND REASONABLE (UCR) CHARGES

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Medicare Annual Out-of-Pocket Maximum Usual, Customary, Reasonable (UCR) A federal (Jan program 1 through ofand medical Dec care 31) benefits Deductible disabled or designed forAnnual those permanently Charges Balance Billing Flexible Spending Account (FSA) (Jan 1 through Dec 31) over age Health Explanation 65.

Created Savings under Benefits Account the year Social (EOB) (HSA) Security Preferred Provider Organization The most you pay In-Network in aof calendar for(PPO) covered Medicare law, A. Hospital Insurance Benefits for Healthcare charges that are determined by your services that are subject to coinsurance/copays.

Similar to the HSA, an FSA is also a savings Copayments or difference Copays between When youinformation are billed for the Provides the A special, Aged and tax-advantaged, Disabled, Coinsurance about a basic how interest plan your bearing covering claim was AThe healthcare arrangement designed tothe provide health plan vendor and are based on range deductible is save included inand this amount.

If The amount you arecharge required to pay per account used to and pay for qualified the Aprovider’s group ofhelp doctors, actual hospitals and the other amount processed account hospital by to and the related insurance plan and care. pay company.

Persons for qualified age The 65 EOB healthcare services at a discounted cost for of fees charged by doctors with comparable you reach the annual out-of-pocket maximum, calendar year before certain benefits area paid medical Except while this account The flat expenses. dollar amount you pay fororwith certain in-is healthcare reimbursed providers under that the medical contract dental plan The details are percentage health automatically what care portion you expenses eligible pay of the for (including for covered claim this was plan, expenses. plan paid but by members to use designated providers (the training and experience for the same or similar the plan pays 100% of covered in-network for by the plan.

Once you meet the deductible tax-advantaged, it doesn’t gain interest and isat network services. vendor plan.

This to provide occurs quality when you healthcare go outside services ofishigh the the they deductible) insurance must enroll while company before covered and they what by become a qualified portion covered your network), but which also provides coverage (at a service in your area.

When you receive ineligible expenses for the remainder of the plan amount, expenses are covered by the plan only goodprovider for one year. There are medical FSAs preferred favorable network. rates.

Balance billing does (entitled).

B. deductible Supplementary responsibility. health Medical plan.

Insurance lower level) for services received from providers network care, UCR charges do not apply.

You are year.

Office visits and prescription copays are based onand the coinsurance percentage.

This Dependent Care FSAs. not apply towards out-of-pocket maximum.

Benefits for the Aged and Disabled, afor voluntary that are not part ofevery the network. responsible for amounts over UCR out-ofincluded in the annual out-of-pocket maximum deductible starts over January 1st. supplementary plan covering the doctor’s network for our medical plans.

Thiscare. maximum startsbills over and other costsevery of medical and health services.

January 1st.

5

More terms are on the next page!

COVERING

YOU AND YOUR FAMILY

EMPLOYEES

DEPENDENTS

Regular full time employees working at least 30 hours per week are eligible for coverage on the 31st day of employment.

Eligible dependents for benefits plans include: •

Legal spouse

•

Children* • • • •

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Biological Adopted Any child you support who lives with you in a parent-child relationship and for whom you are the legal guardian** Disabled children of any age who are (or become) physically or mentally incapable of self-support while covered by our employee benefits program

ENROLLING

QUALIFIED LIFE EVENTS

IN YOUR BENEFITS

NEW HIRE

OPEN ENROLLMENT

Benefits go into effect on the 31st day of employment.

During the annual benefits open enrollment period.

Enroll at www.employeenavigator.com

What should you know?

•

Elections made now will remain until the next open enrollment

•

You may elect to participate or waive benefits that are offered to you

•

You must complete enrollment even if waiving coverage

•

Open Enrollment period is Sept. 9-16, 2022

•

New enrollees: use company identifier Tfab when setting up your account. Everyone else can use current username and password.

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Enroll at www.employeenavigator.com

S E PT E M

BER

After Open Enrollment, benefits begin on October 1st.

The only time you can make changes outside of open enrollment is when you have a change in status, called a qualified life event (QLE), as defined by the Internal Revenue Service (IRS).

EXAMPLES OF QLE •

Change in Marital Status

•

Birth or Adoption of child

•

You and/or your dependents become eligible or lose coverage with another group health plan

•

Spouse’s Open Enrollment

•

Change in work status (part-time to full-time)

REMEMBER! You must provide proper documentation within 30 days of the QLE in order to obtain coverage.

HEALTH

BENEFITS

YOUR MEDICAL

INSURANCE OPTIONS

Administered through UnitedHealthcare

HSA PLAN IN-NETWORK

OUT-OF-NETWORK

Annual Deductible Individual | Family

$3,000 | $6,000

$9,000 | $18,000

Out-of-Pocket Maximum Individual | Family

$6,250 | $12,500

$18,750 | $37,500

Plan Pays 100% Co-pays apply for Rx, ER, UC, OV

Plan Pays 60%

Subject to deductible and coinsurance

Subject to deductible and coinsurance

$300 After Deductible

$300 After Deductible

WHAT IS THE MOST I WILL PAY?

Coinsurance After Deductible

HOW WILL IT WORK AT THE HOSPITAL? Inpatient Surgery Outpatient Surgery Emergency Room

HOW DOES IT WORK AT THE DOCTOR’S OFFICE? Preventive Care

Covered 100%

Not Covered

Office Visit

$30 co-pay After Deductible

Specialist

$60 co-pay After Deductible

Urgent Care

$100 After Deductible

Virtual Visits

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Subject to deductible and coinsurance

$25 co-pay After Deductible

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View more plan details on the next page!

HSA PLAN IN-NETWORK

OUT-OF-NETWORK

HOW MUCH DOES IT COST FOR PRESCRIPTIONS? Prescription Drugs Retail

After Deductible then, $10 copay $35 copay $60 copay $100 copay $300 copay

Prescription Drugs Mail Order

After Deductible then, $25 copay $87.50 copay $150 copay not covered

• • • • • • • • •

Tier 1 Tier 2 Tier 3 Specialty Tier 2 Specialty Tier 3 Tier 1 Tier 2 Tier 3 Specialty Tiers

Technifab will contribute $700 to your HSA annually! This will be paid out weekly in $13.46 increments.

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HEALTH AND

WELLNESS CENTER

REAL LIFE. EVERY DAY LIFE. YOUR LIFE. With the Proactive MD Health and Wellness Center, employees of Technifab can access affordable healthcare at a convenient location with above average care. As part of our mission to maintain a great employee experience for you, we know that health and wellness are key to a successful work life.

If you’re enrolled in our medical plan, you and any dependents who are also on the plan will automatically have clinic access at no additional cost. You can also purchase access to the clinic for dependents who aren’t on our medical plan.

YOU NOW HAVE ACCESS TO FREE MEDICATIONS THROUGH THE CLINIC. VISIT THE SITE TO SEE IF YOURS ARE ON THE LIST: www.dpcindiana.com Return to my benefit options.

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HEALTH SAVINGS ACCOUNT (HSA) By enrolling in the HDHP medical plan, you get access to a Health Savings Account (HSA), which can be used to pay for qualified health care expenses.

WHO IS ELIGIBLE?

HSA FACTS YOU HAVE CONTROL •

You can use the funds on medical, dental and vision expenses for you and your family.

•

There is no “use it or lose it” rule.

YOU SAVE ON TAXES

Anyone who fits all of the following conditions is eligible for our HSA:

•

All money deposited is tax free.

✓

IS enrolled in our HDHP medical plan.

•

x

IS NOT enrolled (and not planning to enroll) in: any other medical plan that has copays, Medicare, Tri-Care, or Medicaid.

Withdrawals for eligible expenses are exempt from federal income tax.

•

You can earn interest tax free.

x

IS NOT eligible to be claimed as a dependent on someone else’s tax return.

ANNUAL CONTRIBUTIONS ANNUAL CONTRIBUTION LIMITS 2022 (Individual | Family)

$3,650 | $7,300

2023 (Individual | Family)

$3,850 | $7,750

HSA ADVANTAGES

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QUICK FACTS

Individuals age 55 and older are eligible to make catch-up contributions of an additional $1,000 annually.

ELIGIBLE EXPENSES

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EXAMPLES OF ELIGIBLE EXPENSES •

Costs incurred at, Hospitals, Dr’s offices, the Pharmacy and expenses for Acupuncture, Hearing Aids including batteries, Infertility Treatment, and Medical Supplies.

THE IMPORTANCE of PREVENTIVE CARE WHAT IS PREVENTIVE CARE?

WHY PREVENTIVE CARE?

Services are considered preventive when you don’t have any symptoms or diagnosed health issues connected with the preventive service. These services are often provided as part of your wellness exam.

Even when you’re feeling fine, a serious condition could later put your health at risk. Your health coverage offers specific preventive care services at no out-of-pocket cost when completed by an in-network provider. If you’re enrolled in our medical plan, you can also visit the Health and Wellness Clinic to receive preventive care.

You and your doctor will determine what services are right for you based on your: Age | Gender | Personal health history | Current health

Taking advantage of available services at the right time can help you stay healthier by:

WHAT IS NOT PREVENTIVE CARE?

✓

Identifying minor issues now before they develop into a major issue later

✓

Preventing certain illnesses and conditions

If you have been diagnosed by a doctor with a health issue, the additional screenings and tests following this diagnosis are no longer considered preventive.

✓

Proactively detecting health problems at early stages, when treatments may be more successful

Your health plan may still provide coverage, but it will not fall under the preventive category of care.

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HOW TO save more

MONEY

✓

UTILIZE IN-NETWORK PROVIDERS.

✓

LIMIT YOUR VISITS TO THE EMERGENCY ROOM.

✓ ✓ ✓

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Your medical costs increase when you visit a provider that is not in your network. Make sure to check and confirm your provider is in the correct Cigna network based on your plan selection (Open Access Plus or Local Plus), especially when being referred to another facility for services.

Visit the emergency room only in the case of a true emergency. Check your area for an Urgent Care location or Convenience Care Clinic.

SAVE TIME AND MONEY. Take advantage of the mail order prescription drug program. Check out cigna.com for more details.

USE GENERIC PRESCRIPTIONS IF AVAILABLE. Ask your doctor for a Generic or request the Generic equivalent when having your prescription filled. Check with your local retail pharmacy (Fry’s, Walmart, Sam’s Club, Target, Costco, etc.) to see if your generic medication is on their $4 or $10 Generic Prescription List. If your generic medication is on their list, you can save money and also reduce plan costs.

SAVE MONEY ON PRESCRIPTIONS WITH GOODRX. GoodRx is 100% free - no obligations, no sign-ups. All you do is download the app, search for your medication, and save money. Even when a prescription drug is covered by insurance, GoodRx is frequently able to find cheaper prices (you will not automatically receive credit toward your plan deductible or out-of-pocket maximum, but you may be able to receive credit by submitting a manual claim yourself).

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VIRTUAL VISIT

RESOURCES

THEY ARE GREAT FOR...

• Abdominal pain

VIRTUAL VISITS A telehealth option to talk to a doctor by phone or video, 24/7 When you need care — anytime, day or night — Virtual Visits can be a convenient option. From treating flu and fevers to caring for migraines and allergies, you can chat with a doctor 24/7.

• Allergies • Bladder / urinary tract infection • Bronchitis • Coughing • Diarrhea

• Use your mobile device, tablet or computer

• Fever

• Connect with a doctor by phone or video

• Migraine / headache

• Get prescriptions, if needed

SIGN IN TO START YOUR VIRTUAL VISIT Set up a myuhc.com account if you don’t already have one or sign in to get started.

OR CLICK HERE! Return to my benefit options.

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• Pinkeye • Rash • Seasonal flu • Sinus problem • Sore throat • Stomachache • Yeast infection • And much more

YOUR DENTAL

INSURANCE OPTION

Provided through Guardian

Technifab Products is offering you two options through Guardian. This benefits you because you can choose the network that suits your family.

VALUE PLAN:

NAP PLAN:

Choose this plan if your dentist is included in the guardianpreferred network. If you use a dentist that isn’t in the network, the insurance will only pay what a network dentist receives, leaving you with a greater out-of-pocket and having to pay more.

Choose this plan if you want to be able to use any dentist and still receive the highest amount of benefits.

NAP PLAN

VALUE PLAN

IN AND OUT-OF-NETWORK

IN AND OUT-OF-NETWORK

In-Network Calendar Year Deductible Individual

$50

$50 Network Deductible $50 Non-Network Deductible

Maximum Benefit Per Person per Calendar Year

$1,000

$1,000 Network Plan Max $1,000 Non-Network Plan Max

HOW DOES THE PLAN WORK? Preventive Services Cleanings (every 6 months) and X-rays

Covered 100%

Basic Services Fillings and Extractions

Covered 80%

Covered 100%

Major Services Crowns and Bridgework

Covered 50%

Covered 60%

Orthodontics Child Only (up to age 19)

$1,000 maximum per person 50% coverage

$1,000 maximum per person 50% coverage (network only)

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GUARDIAN DENTAL

MEMBER BENEFITS

GUARDIAN MAX ROLLOVER PROGRAM To qualify, you must submit a claim for covered services for which a benefit is paid, in excess of deductible or co- pay, and you must not exceed the paid claims threshold during the benefit year. Covered members maintain separate rollover amounts based on your own claim activity. You can view your rollover statement at www.guardiananytime.com.

Threshold

Maximum Rollover Amount

In-Network Only Maximum Rollover Amount

Maximum Rollover Account Limit

$500

$250

$350

$1,000

POLICY YEAR

SUBSCRIBER REWARD

SUBSCRIBER’S REWARD BALANCE

Initial Registration

500

2,500

2

2,000

4,500

3

2,000

6,500

4

4,500 (bonus year)

11,000

5

2,000

13,000

6

2,000

15,000

7

2,000

17,000

TO REGISTER Tuition Rewards can only be earned if you are registered for benefit. www.guardian.collegetuitionbenefit.com User ID: 486780 | Password: Guardian

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YOUR VISION

INSURANCE OPTION

Provided by Guardian + VSP

VISION PLAN IN-NETWORK VSP

OUT-OF-NETWORK

$10 copay

$39 maximum benefits

$25 co-pay, with additional discounts available with lens enhancements

maximum benefits of $27 | $37 | $49 | NA

A frame allowance up to $130 is included in the $30 co-pay.

Additional 20% discount is provided for any balance

$46 maximum

Allowance of $130 for contact lenses

$100 maximum

BENEFITS Eye Exam (once every 12 months) Eyeglass Lenses (once every 12 months) Single | Bifocal | Trifocal | Progressive

Frames (once every 24 months) Contacts Lenses (instead of glasses)

MATERIALS ONLY

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FINANCIAL

BENEFITS

LIFE AND

AD&D INSURANCE

Administered through Guardian

BASIC LIFE AND AD&D COVERAGE AMOUNT

$20,000.

AGE REDUCTION

Coverage reduces by age.

You must designate a beneficiary for Basic Life and AD&D. You have the right to change the beneficiary at any time by written or electronic notice. You can change your beneficiary through Employee Navigator.

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CONTINUED VOLUNTARY LIFE AND AD&D This is a voluntary plan though Guardian that provides you the option to purchase coverage beyond the Basic Term Life Insurance provided by Technifab.

THINGS TO KNOW 1.

$10,000 increments up to EMPLOYEE $400,000 BENEFIT Guarantee Issue: $100,000

A “guarantee issue” amount is the dollar amount of coverage you can be approved for without completing a health questionnaire.

Guarantee issue amounts only apply during the 31 days following your initial eligibility period when hired.

HOW MUCH

LIFE INSURANCE DO I NEED?

When it comes to protecting the financial security of you and your family, nothing is more important than planning ahead.

Even if you already have a life insurance policy in addition to the company-provided policy, it’s important to ask yourself:

“Do I have the protection I need to cover all of my financial responsibilities?”

A few categories to consider include: Daily Living Expenses

SPOUSE BENEFIT

CHILD BENEFIT

50% of employee benefit up

2.

to $200,000 Guarantee Issue: $10,000 10% of employee benefit up to $10,000 Guarantee Issue: N/A 3.

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If you wish to enroll in the Voluntary Life and AD&D plan or increase your coverage after your initial eligibility period, you will be required to complete the Evidence of Insurability form which contains questions about your health.

Mortgages and Other Loans Children’s or Grandchildrens’ College Tuition If you have expected expenses like these, you may want to consider purchasing additional coverage. For help deciding how much coverage you need, go online and search for “life insurance calculator.”

Rates are based on your age and the amount of coverage you elect. Spouse rates are also based off of the employee age.

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DISABILITY

INSURANCE

Administered through Guardian

VOLUNTARY SHORT TERM DISABILITY

VOLUNTARY LONG TERM DISABILITY

If you purchase STD coverage, you will receive disability income during the duration of disability or until such time that you are able to return to work per a doctor’s release. If elected, you pay the full cost of these voluntary coverages through payroll deductions.

The plan offers a monthly benefit to help replace lost income if you experience a disability lasting longer than 180 days.

Benefit Amount

60% of weekly salary

Benefit Amount

60% monthly salary

When are Benefits Payable?

1st consecutive day of accident or the 8th day of illness

When are Benefits Payable?

After 180 days of disability

Maximum Benefit

$500/week

Maximum Benefit

$5,000/month

Maximum Benefit Duration

26 weeks

Maximum Benefit Duration

Until you are no longer disabled or reach age 65

DID YOU KNOW?

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1 IN EVERY 8

30%

people will become disabled for five years or more in their lifetime.

of people use disability.

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46% of all foreclosures are caused by financial hardship due to a disability.

IMPORTANT

BENEFIT CONTACTS

BENEFIT

PROVIDER

PHONE

WEBSITE/EMAIL

Medical

UnitedHealthcare

Refer to the number on your ID card

www.uhc.com

Vision

Guardian + VSP

800-877-7195

www.vsp.com

Health Savings Account

Fidelity

800-343-3548

www.fidelity.com/go/hsa/hsa-provider

Guardian

888-428-7342

www.guardiananytime.com

Employee Wellness Clinic

Proactive MD

888-862-9525

www.dpcindiana.com

Human Resources

Laura Drake

812-442-0520

HumanResources@technifab.com

Dental Life and AD&D Voluntary Life and AD&D Disability WillPrep

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The information in this Enrollment Guide is presented for illustrative purposes and is based on information provided by the employer. The text contained in this Guide was taken from various summary plan descriptions and benefit information. While every effort was taken to accurately report your benefits, discrepancies or errors are always possible. In case of discrepancy between the Guide and the actual plan documents, the actual plan documents will prevail. All information is confidential pursuant to the Health Insurance Portability and Accountability Act of 1996.