Spectra A&D Benefit Guide 2024

2024

BENEFITS GUIDE January 1, 2024 – December 31, 2024

TABLE OF CONTENTS 03

A SMARTER WAY TO BETTER HEALTH

04

ELIGIBILITY & ENROLLMENT

05

MEDICAL PLANS

08

HEALTH SAVINGS ACCOUNT

09

HEALTH REIMBURSMENT ACCOUNT

10

FLEXIBLE SPENDING ACCOUNT

11

GOOD RX

12

DENTAL

13

VISION

15

LIFE/AD&D

16

DISABILITY

17

ACCIDENT & CRITICAL ILLNESS

18

CONTRIBUTIONS

19

KEY CONTACTS & IMPORTANT INFORMATION Spectra A&D Benefits Guide | 02

A SMARTER WAY TO BETTER HEALTH

It’s Your Health.

Get Involved

Your health is a work in progress that needs your consistent attention and support. Each choice you make for yourself and your family is part of an ever-changing picture. Taking steps to improve your health such as going for annual physicals and living a healthy lifestyle can make a positive impact on your well-being.

It’s up to you to take responsibility and get involved, and we are pleased to offer programs that will support your efforts and help you reach goals.

Preventative Health Care Services

Preventive care includes services like checkups, screenings and immunizations that can help you stay healthy and may help you avoid or delay health problems. Many serious conditions such as heart disease, cancer, and diabetes are preventable and treatable if caught early. It’s important for everyone to get the preventive care they need. Some examples of preventive care services are: o o o o

Immunizations

Understanding What’s Covered

Blood pressure, diabetes, and cholesterol tests Certain cancer screenings, such as mammograms, colonoscopies Counseling, screenings and vaccines to help ensure healthy pregnancies Regular well-baby and well-child visits

Some immunizations and vaccinations are also considered preventive care services.

Standard immunizations recommended by the Centers for Disease Control (CDC) Include: hepatitis A and B, diphtheria, polio, pneumonia, measles, mumps, rubella, tetanus and influenza although these may be subject to age and/or frequency restrictions.

Generally speaking, if a service is considered preventive care, it will be covered at 100%. If it’s not, it may still be covered subject to a copay, deductible or coinsurance. The Affordable Care Act (ACA) requires that services considered preventive care be covered by your health plan at 100% in-network, without a copay, deductible or coinsurance. To get specifics about your plan’s preventive care coverage, call the customer service number on your member ID card. You may want to ask your doctor if the services you’re receiving at a preventive care visit (such as an annual checkup) are all considered standard preventive care.

If any service performed at an annual checkup is as a result of a prior diagnosed condition, the office visit may not be processed as preventive and you may be responsible for a copay, coinsurance or deductible. To learn more about the ACA or preventive care and coverage, visit www.healthcare.gov.

Spectra A&D Benefits Guide | 03

ELIGIBILITY & ENROLLING Who is Eligible to Join the Benefit Plan?

Qualifying Event Changes

You and your dependents are eligible to join the health and our company welfare benefit plans if you are a fulltime employee regularly scheduled to work 30 hours per week. You must be enrolled in the plan to add dependent coverage.

You are allowed to make changes to your current benefit elections during the plan year if you experience an IRS-approved qualifying change in life status. The change to your benefit elections must be consistent with and on account of the change in life status.

IRS-approved qualifying life status changes include:

Who is an Eligible Dependent?

• Marriage, divorce or legal separation

• Your spouse to whom you are legally married

• Birth or adoption of a child or placement of a child for adoption

• Your dependent child under the maximum age specified in the Carriers’ plan documents including:    

Natural child Adopted child Stepchild Child for whom you have been appointed as the legal guardian

*Your child’s spouse and a child for whom you are not the legal guardian are not eligible.

The Dependent Maximum Age Limits is up to age 26.

The dependent does not need to be a full-time student; does not need to be an eligible dependent on parent’s tax return; is not required to live with you; and may be unmarried or married.

Once the dependent reaches age 26, coverage will terminate on the last day of the birth month.

A totally disabled child who is physically or mentally disabled prior to age 26 may remain on the if the child is primarily dependent on the enrolled member for support and maintenance.

When Do Benefits Become Effective?

Your benefits become effective on the first day of the month following your date of hire as a full-time employee with Spectra A&D. Annual Open Enrollment?

Each year during the annual Open Enrollment Period, you are given the opportunity to make changes to your current benefit elections. To find out when the annual Open Enrollment Period occurs, contact Human Resources.

• Death of a dependent • Change in employment status, including loss or gain of employment, for your spouse or a dependent • Change in work schedule, including switching between full-time and part-time status, by you, your spouse or a dependent • Change in residence or work site for you, your spouse, or a dependent that results in a change of eligibility • If you or your dependents lose eligibility for Medicaid or the Children’s Health Insurance Program (CHIP) coverage • If you or your dependents become eligible for a state’s premium assistance subsidy under Medicaid or CHIP If you have a life status change, you must notify the company within 60 days for changes in life status due to a Medicare or CHIP event and within 31 days of the other events.

If you do not notify the company during that time, you and/or your dependents must wait until the next annual open enrollment period to make a change in your benefit elections.

!

Please note, loss of coverage due to non-payment or voluntary termination of other coverage outside a spouse’s or parent’s open enrollment is not an IRSapproved qualifying life event and you do not qualify for a special enrollment period.

Spectra A&D Benefits Guide | 04

BASE TRADITIONAL PLAN – $4000 DEDUCTIBLE POINT OF SERVICE Cigna - $4000 80% POS Plan Plan Highlights

In Network – You Pay

Out-of-Network – You Pay

Deductible

$4,000 Individual | $8,000 Family

$8,000 Individual | $16,000 Family

Coinsurance

20% after deductible

40% after deductible

Annual Out-of-Pocket Maximum

$7,900 Individual | $15,800 Family

$15,800 Individual | $31,600 Family

Primary Care Physician Office Visit

$25 copay

Deductible, then 40%

Specialist Office Visit

$75 copay

Deductible, then 40%

Plan pays 100%

Deductible, then 40%

Laboratory Diagnostics & X-Ray

Deductible, then 20%

Deductible, then 40%

Complex Imaging Services (CT Scans, PET Scans & MRI’s)

Deductible, then 20%

Deductible, then 40%

Hospital Inpatient Care

Deductible, then 20%

Deductible, then 40%

Outpatient Surgery

Deductible, then 20%

Deductible, then 40%

Emergency Room

Facility: $300 copay ER Physician: Deductible, then 0%

Paid as In-network

$50 copay

Deductible, then 40%

Preventive Care Services

Urgent Care

Prescription Drugs

Quantity Limits: Retail = 30-day supply Mail-Order = 90-day supply 2.5x retail copay

Tier 1 — Generic Drugs

Retail: $15 copay

Tier 2 — Preferred Brand-Name

Retail: $50 copay

Tier 3 — Non-Preferred Brand-Name

Retail: $150 copay

Tier 4 - Specialty Drugs

Retail: $300 copay

!

*You could be balanced billed by providers and/or facilities when using an out-of-network facility.”

Spectra A&D Benefits Guide | 05

BUY-UP TRADITIONAL PLAN – $2500 DEDUCTIBLE POINT OF SERVICE Cigna - $2500 100% POS Plan Plan Highlights

In Network – You Pay

Out-of-Network – You Pay

Deductible

$2,500 Individual | $5,000 Family

$5,000 Individual | $10,000 Family

Coinsurance

0% after deductible

30% after deductible

Annual Out-of-Pocket Maximum

$5,000 Individual | $10,000 Family

$10,000 Individual | $20,000 Family

Primary Care Physician Office Visit

$25 copay

Deductible, then 30%

Specialist Office Visit

$75 copay

Deductible, then 30%

Plan pays 100%

Deductible, then 30%

Laboratory Diagnostics & X-Ray

Deductible, then 0%

Deductible, then 30%

Complex Imaging Services (CT Scans, PET Scans & MRI’s)

Deductible, then 0%

Deductible, then 30%

Hospital Inpatient Care

Deductible, then 0%

Deductible, then 30%

Outpatient Surgery

Deductible, then 0%

Deductible, then 30%

Emergency Room

Facility: Deductible, then $300 copay ER Physician: Deductible, then 0%

Paid as In-network

$50 copay

Deductible, then 30%

Preventive Care Services

Urgent Care

Prescription Drugs

Quantity Limits: Retail = 30-day supply Mail-Order = 90-day supply 2.5x retail copay

Tier 1 — Generic Drugs

Retail: $15 copay

Tier 2 — Preferred Brand-Name

Retail: $50 copay

Tier 3 — Non-Preferred Brand-Name

Retail: $150 copay

Tier 4 - Specialty Drugs

Retail: $300 copay

!

*You could be balanced billed by providers and/or facilities when using an out-of-network facility.”

Spectra A&D Benefits Guide | 06

HDHP PLAN w/ HSA – $3200 DEDUCTIBLE POINT OF SERVICE Cigna - $3200 100% HDHP HSA Plan Plan Highlights

In Network – You Pay

Out-of-Network – You Pay

Deductible

$3,200 Individual | $6,400 Family

$6,400 Individual | $12,800 Family

Coinsurance

0% after deductible

30% after deductible

Annual Out-of-Pocket Maximum

$4,500 Individual | $9,000 Family

$9,000 Individual | $18,000 Family

Primary Care Physician Office Visit

Deductible, then $25 copay

Deductible, then 30%

Specialist Office Visit

Deductible, then $75 copay

Deductible, then 30%

Plan pays 100%

Deductible, then 30%

Laboratory Diagnostics & X-Ray

Deductible, then 0%

Deductible, then 30%

Complex Imaging Services (CT Scans, PET Scans & MRI’s)

Deductible, then 0%

Deductible, then 30%

Hospital Inpatient Care

Deductible, then 0%

Deductible, then 30%

Outpatient Surgery

Deductible, then 0%

Deductible, then 30%

Emergency Room

Facility: Deductible, then $300 copay ER Physician: Deductible, then 0%

Paid as In-network

Deductible, then $50 copay

Deductible, then 30%

Preventive Care Services

Urgent Care

Medical Deductible Applies Prescription Drugs

Quantity Limits: Retail = 30-day supply Mail-Order = 90-day supply 2.5x retail copay

Tier 1 — Generic Drugs

Retail: Deductible, then $10 copay

Tier 2 — Preferred Brand-Name

Retail: Deductible, then $50 copay

Tier 3 — Non-Preferred Brand-Name

Retail: Deductible, then $150 copay

Tier 4 - Specialty Drugs

Retail: Deductible, then $300 copay

!

*You could be balanced billed by providers and/or facilities when using an out-of-network facility.”

Spectra A&D Benefits Guide | 07

HEALTH SAVINGS ACCOUNT (HSA) Administered by Flores Available only if you enrolled in the $3,200 high deductible health plan What is a Health Savings Account?

How Does an HSA Work?

A Health Savings Account (HSA) is an account permitted under the federal tax law that allows you to save money for healthcare expenses on a tax-favored basis. It is an individual account that belongs to you and is not part of Spectra A&D’s medical plan. The account is portable, which means it is not tied to your employment at Spectra A&D. Your HSA stays with you if you retire or leave the company.

Because the HSA has special tax status under the law, it is governed by numerous mandatory tax rules and regulations.

You fund the HSA with your dollars up to a certain limit each year by making a deposit directly into your HSA account. The account must be funded prior to any withdrawals. Then, as you have eligible qualified expenses, you may withdraw money from your HSA to pay expenses that are not otherwise paid by the health, dental or vision plans, e.g. your deductible or coinsurance. It’s up to you whether to use your HSA funds. You are not required to use the money, you may save it for the future and let it continue to accumulate. It’s important to understand that the HSA, unlike a Healthcare Flexible Spending Account (FSA), will not pay for qualified expenses that exceed the balance in the HSA.

How Do I Enroll in an HSA? This account must be set up prior to any contributions being made. It is your responsibility to verify your account set up so Human Resources can direct deposit contributions through payroll deductions. Once you are enrolled and contributing, Spectra A&D will bolster your savings by contributing matching dollars over the next 26 pay periods into your HSA Account:

What Type of Expenses Can Be Paid From an HSA? You can receive tax-free distributions from your HSA to pay for or to be reimbursed for qualified medical expenses that are incurred after you establish your HSA. These include: Any medical expenses that apply toward your deductible, Any healthcare expenses that are qualified expenses for tax purposes under Section 213 of the Internal Revenue Code. Some of these expenses are described in IRS Publication 502, Once your reach age 65, Medicare premiums or other health insurance, other than a Medicare supplemental policy.

▪ $3,000 HDHP Plan: • • • •

Employee Only Annual Max: $500 Employee + Spouse Annual Max: $750 Employee + Child Annual Max: $750 Family Annual Max: $1,000

▪

▪

Who is Eligible for an HSA?

When can I Begin Contributions to My HSA Account?

Generally, to be eligible to set up and contribute to an HSA, you:

You may begin funding your HSA account as soon as your account is established.

▪ ▪ ▪ ▪

Loss of Other Coverage

Must be covered by a Consumer Directed Health Plan (CDHP) Cannot be claimed as a dependent on anyone else’s tax return Are not enrolled in Medicare (due to age or disability) or Tricare Cannot be enrolled in a general purpose FSA, nor can your spouse

You may find information about these rules on the IRS website (www.irs.gov), including IRS Publication 969 and 502. You may also want to consult a tax-advisor.

Can I Invest My HSA Funds?

Depending upon who you choose to be your HSA custodian – there could be different options.

Can I Use The Money in My HSA for Anything Other Than Eligible Medical Expenses?

You can withdraw your HSA at anytime and use it for any purpose; however, you will pay income taxes on the amount withdrawn, plus a 20% penalty. After age 65, the 20% penalty no longer applies.

How Much Can I Contribute to An HSA? As noted by federal law, the annual contribution limits are: ▪ ▪

The amount for 2024 is $4,150 for individual coverage and $8,300 for family coverage.

Individuals age 55 or older may be eligible to make a catch-up contribution of $1,000.

Spectra A&D Benefits Guide | 08

HEALTH REIMBURSEMENT ARRANGEMENT (HRA) Administered by Flores An HRA is an employee benefit that is provided by Spectra A&D at no cost to the employees covered under the Cigna Base Traditional plan. Spectra A&D provides the HRA to assist employees with paying for substantial medical expenses that may arise.

The HRA will reimburse participants for expenses which are covered by the Cigna medical plan. Once you incur an eligible medical expense you are eligible for reimbursement. Spectra A&D sets funds aside the following funds when enrolled in the Base Traditional Plan ($4,000):  Employee Only: $750  Employee + Spouse: $1,000  Employee + Child(ren): $1,000  Family: $1,500

Spectra A&D Benefits Guide | 09

FLEXIBLE SPENDING ACCOUNT (FSA) You may only enroll in a Limited Purpose FSA if you are contributing to an HSA. Administered by Flores Spectra A&D offers employees the opportunity to participate in the Healthcare Flexible Spending Account (FSA) and Dependent Care FSA. These programs may provide you with significant tax advantages as they allow you to pay for eligible out-of-pocket expenses with pre-tax dollars through payroll deductions.

Healthcare Flexible Spending Account You may defer up to $3,200 to your Healthcare FSA to fund eligible out-of-pocket healthcare expenses. The following list provides examples of expenses eligible for reimbursement under the IRS guidelines: • Non-covered medical expenses that quality under Section 217 of the IRS code • Deductibles • Office visit copays • Prescription medication • Over-the-counter medications (require physician prescription) • Hearing and dental expenses not covered by insurance Examples of non-eligible expenses include: cosmetic surgery, electrolysis, toiletries, vitamins, health club dues.

Limited Purpose Healthcare Flexible Spending Account You may defer up to $3,200 for eligible Dental and Vision expenses ONLY. Used for those who are also contributing to a Health Savings Account.

Dependent Care FSA You may defer up to $5,000 to your Dependent Care FSA to fund eligible out-of-pocket expenses for childcare and eldercare. To be eligible for reimbursement, expenses must meet the following criteria established by the IRS: ▪ ▪ ▪ ▪ ▪

The person cared for must be under age 13, or if older, physically or mentally incapable of self-care.

Day care must be necessary in order for you and your spouse to work.

The person cared for must be claimed as a dependent on your federal tax return and must reside in your home at least eight hours per day.

Payment for care cannot be made to anyone you claim as a dependent on your income tax return, to your spouse or to a child under age 19.

If care is provided by a center that cares for more than six individuals, it must be licensed.

For a complete list of eligible medical and dependent care expenses, you may access publications #502 (healthcare) and #503 (dependent care) on the web at www.irs.gov.

Spectra A&D Benefits Guide | 10

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Spectra A&D Benefits Guide | 11

DENTAL Spectra A&D sponsors a dental plan through Cigna. You can create your very own Cigna account online at my.cigna.com. To search for an in-network dentist, visit https://hcpdirectory.cigna.com/ and click on Find a Dentist.

This plan uses the Cigna DPPO network.

Dental Plan Highlights

In-Network

Out of Network

Your Deductible

$50 individual / $150 Family

$50 individual / $150 Family

Calendar Year Maximum Applies to preventive, basic, and major services

$1,500 combined Innetwork and Out-ofNetwork

$1,500 combined Innetwork and Out-ofNetwork

Preventive & Diagnostic Services Exams, Cleanings, Routine X-Rays, Fluoride Application, Sealants, Space Maintainers, Non-Routine X-Rays, Emergency care to relieve pain

100% (Deductible waived)

100% (Deductible waived)

Basic Services Filings, Simple Extractions, Emergency Treatment, Endodontics (root canal), Periodontics (gum surgery), Oral Surgery

80% After deductible

80% After deductible

50% Coinsurance

50% Coinsurance

Orthodontics (Adult & Children)

50% Coinsurance

50% Coinsurance

Lifetime Orthodontia Maximum

$1,500

$1,500

Major Services Crowns, Bridgework, Full & Partial Dentures, Repair of Dentures

Spectra A&D Benefits Guide | 12

VISION Spectra A&D gives employees the opportunity to elect a vision plan through Cigna serviced by EyeMed. You can create your very own Cigna account online at my.cigna.com. To search online from here go to Providers (eyemed.com).

EYEMED NETWORK In Network

Out Of Network Reimbursement

$10 Copay

Up to $45

$150 frame allowance + 20% off

Up to $83

Single

$25 Copay

Up to $32

Bifocal

$25 Copay

Up to $55

Trifocal

$25 Copay

Up to $65

$150 allowance

Up to $120

Covered in full after copay

Up to $210

Services Eye Exam: Routine Exam with Dilation

Frames: Any available frame at provider location

Standard Plastic Lenses:

Contact Lenses: (in lieu of complete set of glasses) Elective Medically Necessary

Frequency: Examination

Once every 12 months

Frames

Once every 12 months

Eyeglass Lenses

Once every 12 months

Contact Lenses

Once every 12 months

Spectra A&D Benefits Guide | 13

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LIFE AND AD&D Employer Paid Life Insurance And Accidental Death & Dismemberment (AD&D) Life Insurance is a key element of proper financial planning and helps provide financial stability and protection for families in case of an untimely death. If you are an eligible full-time employee, Spectra A&D provides 1.5 times your salary to a maximum of $150,000. Spectra A&D also provides an additional matching amount of accident death and dismemberment (AD&D) insurance through Guardian. The benefit reduces to 65% of original amount at age 65.

Supplemental Life Insurance And Accidental Death & Dismemberment (AD&D) Employees have the option of purchasing Supplemental Life Insurance through Guardian, in addition to their employer-paid life insurance. Supplemental Life Insurance and Accidental Death and Dismemberment (AD&D) are intended to provide additional protection to full-time employees. AD&D provides double the benefit in the event of accidental death. It also covers loss of limb or eye due to accident. Those interested can elect the amount that suits their needs at an affordable rate.

If you do not enroll in supplemental employee or spouse life when you are first eligible (within 30 days of your eligibility), there is no guaranteed issue amount and any amounts requested are subject to Evidence of Insurability (EOI).

Supplemental Life/AD&D Insurance This coverage is portable; you may take it with you when separating from the company by contacting Guardian within 30 days.

Employee: Increments of $10,000 up $500,000.

The guarantee issue amount for new hires is $100,000 under the age of 65. Employees wishing to apply for coverage above $100,000 will need to seek approval for this coverage by completing an Evidence of Insurability (EOI) form, where they will answer a series of simple health questions for Guardian underwriting to review. Benefits reduce to 65% of the elected benefit at age 65.

Spouse: Increments of $5,000 up to $500,000, not to exceed employee amount. The guarantee issue amount is $50,000.

Child: $10,000, not to exceed 100% of Employee’s, up to age 26 if a full-time student. All child life is guarantee issue.

Choose Your Beneficiary ⇾ Make sure your life and accident death benefits will be paid as you intend.

⇾ Be sure you name a beneficiary when you enroll in Life and AD&D benefits during open enrollment.

Spectra A&D Benefits Guide | 15

DISABILITY INSURANCE Disability coverage provides the financial security of knowing that you will continue to receive income if you are unable to work due to illness or injury.

Short-Term Disability (Company Paid) Even a few weeks away from work can make it difficult to manage household expenses. Short-Term Disability is provided to you through Guardian. This coverage will pay up to 60% of your weekly salary up to a maximum of $1,500 per week for non work-related accidents or sicknesses, so you can focus on getting better, and worry less about keeping up with your bills. Benefits begin on the 8th day of disability for accident or sickness. Benefits are payable up to a maximum of 12 weeks. This coverage is paid for 100% by Spectra A&D.

Long-Term Disability (Company Paid) Serious illnesses or accidents can come out of nowhere. They can interrupt your life and your ability to work for months ─ even years.

Long-Term Disability coverage is provided to you through Guardian.

This benefit pays 60% of your monthly earnings in the event of a disability after 90 days for accident and illness up to a maximum monthly benefit of $10,000 per month. The Long-Term Disability benefit pays up to your Social Security Normal Retirement Age (SSNRA).

The policy does not provide benefits for up to 1 year after the policy goes in-force from a disability caused by a pre-existing condition. A pre-existing condition is any condition for which you received medical treatment, consultation, care or services including diagnostic measures, or took prescribed drugs or medicines prior to your effective date of coverage. Please refer to the plan certificate for the pre-existing guidelines. This coverage is paid for 100% by Spectra A&D.

Plan Highlights

Short-Term Disability

Plan Highlights

Long-Term Disability

Waiting Period

7 days

Waiting Period

90 days

Benefit Percentage

60%

Benefit Percentage

60%

Weekly Benefit Maximum

$1,500

Monthly Benefit Maximum

$10,000

Benefit Duration

12 weeks

Benefit Duration

SSNRA

Spectra A&D Benefits Guide | 16

ACCIDENT INSURANCE You have the option to purchase Accident Insurance with Guardian. Benefits are paid directly to you based on a flat schedule when an accident occurs off the job.

Some examples of covered accidents include: fracture, dislocation, burn, concussion, coma, torn cartilage in knee, laceration, broken tooth, eye injury, ambulance, hospital admission, paralysis, dismemberment, etc.

Guardian pays a wellness reimbursement of $50 per covered member per year for providing proof of preventive screening tests rendered.

You can elect coverage for your spouse and children. The policy is portable. You can take it with you at the same rate by notifying Guardian within 30 days of termination and requesting direct bill.

CRITICAL ILLNESS INSURANCE You have the option to purchase Critical Illness Insurance with Guardian. The Critical Illness policy provides a financial cushion if you are diagnosed with a critical illness or cancer.

Employees have the option to choose a lump sum benefit in increments of $5,000 up to $20,000, and you may also elect coverage for your dependents. Spouses are eligible for up to $10,000. Coverage for children is 25% of the employee’s benefit amount and is automatically included with employee election.

This benefit has a pre-existing condition limitation of a 3-month look back and 12-month exclusion.

Guardian pays a wellness reimbursement of $50 per covered member per year for providing proof of preventive screening tests rendered.

The policy is portable. You can take it with you at the same rate by notifying Guardian within 30 days of termination and requesting direct bill.

Spectra A&D Benefits Guide | 17

CONTRIBUTIONS Spectra A&D contributes to the cost of medical, dental, life, short and long-term disability coverage for all eligible employees. For an additional premium employees can add dependent coverage. Please refer to the chart below for your bi-weekly payroll deductions.

Bi-Weekly Payroll Deductions Bi-weekly Employee Contributions

Employee Only

Employee & Spouse

Employee & Child(ren)

Family

Medical Base Traditional Plan $4,000 Deductible Point of Service

$56.36

$175.54

$159.00

$258.51

Medical Buy-Up Traditional Plan $2,500 Deductible Point of Service

$99.19

$237.91

$219.14

$345.09

Medical HDHP w/HSA $3,200 High Deductible Health Plan

$38.23

$128.09

$120.03

$207.06

Dental Plan

$4.48

$8.95

$10.69

$15.99

Vision

$3.24

$6.15

$7.24

$10.16

Accident

$6.04

$10.10

$10.62

$14.68

Critical Illness

Premiums based on benefit amounts selected and your age.

Supplementary Life / AD&D

Premiums based on benefit amounts selected and your age.

Long Term Disability

Spectra A&D pays 100%

Short Term Disability

Spectra A&D pays 100%

Basic Life / AD&D

Spectra A&D pays 100%

Spectra A&D Benefits Guide | 18

KEY CONTACTS & RESOURCES Questions on your benefits or need assistance with Claims? Contact Sterling Seacrest Pritchard:

MALCOLM BROWN

SSP CLIENT SERVICE ASSISTANT

Your Employee Support Contacts

404-845-7337 malcolmb@sspins.com

SARAH HATCHER

SSP CLIENT SERVICE EXECUTIVE 678-538-2111 shatcher@sspins.com

Benefit

Company

Phone

Website

Medical, Dental, Vision

Cigna

866-866-6622

www.cigna.com

Guardian

800-627-4200

www.guardiananytime.com

Flores

Contact HR

www.flores247.com

Life, Disability, Accident and Critical Illness

FSA & HRA

Spectra A&D Benefits Guide | 19

IMPORTANT INFORMATION This guide provides a summary of you employee benefits rights and regulations as determined by Federal and State Laws. Information included in this guide includes the following: Special Open Enrollment Rights Children’s Health Insurance Program (CHIP) Premium Assistance

General Notice of the Cobra Continuations Rights Affordable Care Act (ACA) – Insurance Mandate

Health Insurance Marketplace Coverage Options and Your Group Health Coverage Affordable Care Act (ACA) – Preventive Services for Non-grandfathered Plans Newborns’ and Mothers’ Health Protection Act of 1996 Break Time for Nursing Mothers Under the Fair Labor Standards Acts (FLSA) Women’s Health & Cancer Rights Act The Generic Information Nondiscrimination Act of 2008 (GINA) HIPAA Privacy Rules

SPECIAL OPEN ENROLLMENT RIGHTS This notice is being provided to ensure that you understand your right to apply for group health insurance coverage. A special enrollment period is a time outside of the annual open enrollment period during which you and your family have a right to sign up for health coverage. In the Marketplace, you qualify for a special enrollment period 60 days following certain life events that involve a change in family status (for example, marriage or birth of a child) or loss of other health coverage. Job-based plans must provide a special enrollment period of 30 days.

Some events will require additional documentation to be submitted with the application at the time of enrollment.

You should read this notice even if you plan to waive coverage at this time.

Marriage, Birth, or Adoption

Loss of Other Coverage

Medicaid or CHIP

If you have a new dependent as a result of a marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must request enrollment within 30 days after the marriage, birth, or placement for adoption.

If you are declining coverage for yourself or your dependents (including your spouse) because of other health insurance or group health plan coverage, you may be able to enroll yourself and your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing toward your or your dependents’ other coverage). However, you must request enrollment within 30 days after your or your dependents’ other coverage ends (or after the employer stops contributing toward the other coverage).

If you or your dependents lose eligibility for coverage under Medicaid or the Children’s Health Insurance Program (CHIP) or become eligible for a premium assistance subsidy under Medicaid or CHIP, you may be able to enroll yourself and your dependents. You must request enrollment within 60 days of the loss of Medicaid or CHIP coverage or the determination of eligibility for a premium assistance subsidy.

To request special enrollment or obtain more information, please contact HR. Spectra A&D Benefits Guide | 20

IMPORTANT INFORMATION COBRA Continuation of Coverage The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end. For more information about your rights and obligations under the Plan and under federal law, you should review the Plan’s Summary Plan Description or contact the Plan Administrator. For additional information regarding COBRA qualifying events, how coverage is provided and actions required to participate in COBRA coverage, please see your Human Resources department.

Newborns’ and Mothers’ Health Protection Act The group health coverage provided complies with the Newborns’ and Mothers’ Health Protection Act of 1996. Under this law group health plans and health insurance issuers generally may not, under federal law, restrict benefits for any hospital length of stay in connection with childbirth for the mother or newborn to less than 48 hours following a vaginal delivery, or less than 96 hours following a cesarean section. However, Federal law generally does not prohibit the mother’s or newborn’s attending provider, after consulting with the mother, from discharging the mother or her newborn earlier than 48 hours (or 96 hours as applicable.) In any case, plans and issuers may not, under federal law, require that a provider obtain authorization from the plan or the insurance issuer for prescribing a length of stay not in excess of 48 hours (or 96 hours).

Premium Assistance under Medical and CHIP If you or your children are eligible for Medicaid or CHIP (Children’s Health Insurance Program) and you are eligible for health coverage from your employer, your State may have a premium assistance program that can help you pay for coverage. These States use funds from their Medicaid or CHIP programs to help people who are eligible for employersponsored health coverage but need assistance in paying their health premiums. If you or your dependents are already enrolled in Medicaid or CHIP you can contact your State Medicaid or CHIP office to find out if premium assistance is available. If you or your dependents are NOT currently enrolled in Medicaid or CHIP, and you think you or any of your dependents might be eligible for either of these programs, you can contact your State Medicaid or CHIP office or dial 1877-KIDS NOW or www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask the State if it has a program that might help you pay the premiums for an employer-sponsored plan. Please see Human Resources for a list of state Medicaid or CHIP offices to find out more about premium assistance.

Special Enrollment Events An Eligible Person and/or Dependent may also be able to enroll during a special enrollment period. A special enrollment period is not available to an Eligible Person and his or her dependents if coverage under the prior plan was terminated for cause, or because premiums were not paid on a timely basis.

An Eligible Person and/or Dependent does not need to elect COBRA continuation coverage to preserve special enrollment rights. Special enrollment is available to an Eligible Person and/or Dependent even if COBRA is elected.

Please be aware that most special enrollment events require action within 30 days of the event. Please see Human Resources for a list of special enrollment opportunities and procedures.

Women’s Health and Cancer Rights Act If you have had or are going to have a mastectomy , you may be entitled to certain benefits under the Women’s Health and Cancer Rights Act of 1998 (WHCRA). For individuals receiving mastectomy-related benefits, coverage will be provided in a manner determined in consultation with the attending physician and the patient, for: All stages of reconstruction of the breast on which the mastectomy has been performed; Surgery and reconstruction of the other breast to produce a symmetrical appearance; and Prostheses and treatment of physical complications of the mastectomy, including lymphedemas. These benefits will be provided subject to deductibles and coinsurance applicable to other medical and surgical benefits provided under this plan. If you would like more information on WHCRA benefits, call your plan administrator.

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IMPORTANT INFORMATION GINA The Genetic Information Nondiscrimination Act (GINA) prohibits health benefit plans from discriminating on the basis of genetic information in regards to eligibility, premium and contributions. This generally also means that private employers with more than 15 employees, its health plan or “business associate” of the employer, cannot collect or use genetic information, (including family medical history information). The once exception would be that a minimum amount of genetic testing results make be used to make a determination regarding a claim.

You should know that GINA is treated as protected health information (PHI) under HIPAA. The plan must provide that an employer cannot request or require that you reveal whether or not you have had genetic testing; nor can your employer require that you participate in a genetic test. An employer cannot use any genetic information to set contribution rates or premiums.

PPACA Compliant Plan Notice Since key parts of the health care law took effect in 2014, there is a new way to buy health insurance: the Health Insurance Marketplace. To assist you as you evaluate options for you and your family, this notice provides some basic information about the new Marketplace and employment based health coverage offered by your employer.

If your employer offers health coverage that meets the “minimum value” plan standard, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan. The “minimum value” plan standard is set by the Affordable Care Act. Your health plans offered by [Company] are ACA compliant plans (surpassing the “minimum value” standard), thus you would not be eligible for the tax credit offered to those who do not have access to such a plan.

NOTE: If you purchase a health plan through the marketplace instead of accepting health coverage offered by your employer, then you will lose the employer contribution to the employer offered coverage. Also, this employer contribution, as well as your employee contribution to employer offered coverage, is excluded from income for Federal and State income tax purposed.

USERRA Notice The Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA) established requirements that employers must meet for certain employees who are involved in the uniformed services. In addition to the rights that you have under COBRA, you (the employee) are entitled under USERRA lo continue the coverage that you (and your covered dependents, if any) had under the [Company] plan.

You Have Rights Under Both COBRA and USERRA. Your rights under COBRA and USERRA are similar but not identical. Any election that you make pursuant to COBRA will also be an election under USERRA, and COBRA and USERRA will both apply with respect to the continuation coverage elected. If COBRA and USERRA give you different rights or protections, the law that provides the greater benefit will apply. The administrative policies and procedures described in the attached COBRA Election Notice also apply to USERRA coverage, unless compliance with the procedures is precluded by military necessity or is otherwise impossible or unreasonable under the circumstances.

Definitions "Uniformed services" means the Armed Forces, the Army National Guard, and the Air National Guard when an individual is engaged in active duty for training, inactive duty training, or full-time National Guard duty (i.e., pursuant to orders issued under federal law), the commissioned corps of the Public Health Service, and any other category of persons designated by the President in time of war or national emergency.

"Service in the uniformed services" or "service" means the performance of duty on a voluntary or involuntary basis in the uniformed services under competent authority, including active duty, active and inactive duty for training, National Guard duty under federal statute, a period for which a person is absent from employment for an examination to determine his or her fitness to perform any of these duties, and a period for which a person is absent from employment to perform certain funeral honors duty. It also includes certain service by intermittent disaster response appointees of the National Disaster Medical System.

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IMPORTANT INFORMATION Duration of USERRA Coverage General Rule: 24-Month Maximum. When a covered employee takes a leave for service in the uniformed services, USERRA coverage for the employee (and covered dependents for whom coverage is elected) can continue until up to 24 months from the date on which the employee's leave for uniformed service began. However, USERRA coverage will end earlier if one of the following events takes place: A premium payment is not made within the required time; You fail to return to work or to apply for reemployment within the time required under USERRA (see below) following the completion of your service in the uniformed services; You lose your rights under USERRA as a result of a dishonorable discharge or other conduct specified in USERRA. Notice of Privacy Provision This Notice of Privacy Practices (the "Notice") describes the legal obligations of [Company] (the "Plan") and your legal rights regarding your protected health information held by the Plan under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Among other things, this Notice describes how your protected health information may be used or disclosed to carry out treatment, payment, or health care operations, or for any other purposes that are permitted or required by law. We are required to provide this Notice of Privacy Practices to you pursuant to HIPAA. The HIPAA Privacy Rule protects only certain medical information known as "protected health information." Generally, protected health information is health information, including demographic information, collected from you or created or received by a health care provider, a health care clearinghouse, a health plan, or your employer on behalf of a group health plan, from which it is possible to individually identify you and that relates to: • Your past, present, or future physical or mental health or condition; • The provision of health care to you; or • The past, present, or future payment for the provision of health care to you.

If you have any questions about this Notice or about our privacy practices, please contact your Human Resources department. The full privacy notice is available with your Human Resources Department.

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IMPORTANT NOTICE ABOUT YOUR PRESCRIPTION DRUG COVERAGE & MEDICARE CREDITABLE Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with Spectra A&D and about your options under Medicare’s prescription drug coverage. This information can help you decide whether or not you want to join a Medicare drug plan. If you are considering joining, you should compare your current coverage, including which drugs are covered at what cost, with the coverage and costs of the plans offering Medicare prescription drug coverage in your area. Information about where you can get help to make decisions about your prescription drug coverage is at the end of this notice.

There are two important things you need to know about your current coverage and Medicare’s prescription drug coverage: •

Medicare prescription drug coverage became available in 2006 to everyone with Medicare. You can get this coverage if you join a Medicare Prescription Drug Plan or join a Medicare Advantage Plan (like an HMO or PPO) that offers prescription drug coverage. All Medicare drug plans provide at least a standard level of coverage set by Medicare. Some plans may also offer more coverage for a higher monthly premium.

•

Spectra A&D has determined that the prescription drug coverage offered by the Cignal plans are, on average for all plan participants, expected to pay out as much as standard Medicare prescription drug coverage pays and is therefore considered Creditable Coverage. Because your existing coverage is Creditable Coverage, you can keep this coverage and not pay a higher premium (a penalty) if you later decide to join a Medicare drug plan.

When Can You Join a Medicare Drug Plan?

You can join a Medicare drug plan when you first become eligible for Medicare and each year from October 15th to December 7th. However, if you lose your current creditable prescription drug coverage, through no fault of your own, you will also be eligible for a two (2) month Special Enrollment Period (SEP) to join a Medicare drug plan.

What Happens To Your Current Coverage If You Decide to Join A Medicare Drug Plan?

If you decide to join a Medicare drug plan, your current Spectra A&D coverage will not be affected. Please review prescription drug coverage plan provisions/options under the certificate booklet provided

by Cigna. See pages 7- 9 of the CMS Disclosure of Creditable Coverage To Medicare Part D Eligible Individuals Guidance which outlines the prescription drug plan provisions/ options that Medicare eligible individuals may have available to them when they become eligible for Medicare Part D. If you do decide to join a Medicare drug plan and drop your current Spectra A&D coverage, be aware that you and your dependents may not be able to get this coverage back.

When Will You Pay A Higher Premium (Penalty) To Join A Medicare Drug Plan?

You should also know that if you drop or lose your current coverage with Spectra A&D and don’t join a Medicare drug plan within 63 continuous days after your current coverage ends, you may pay a higher premium (a penalty) to join a Medicare drug plan later. If you go 63 continuous days or longer without creditable prescription drug coverage, your monthly premium may go up by at least 1% of the Medicare base beneficiary premium per month for every month that you did not have that coverage. For example, if you go nineteen months without creditable coverage, your premium may consistently be at least 19% higher than the Medicare base beneficiary premium. You may have to pay this higher premium (a penalty) as long as you have Medicare prescription drug coverage. In addition, you may have to wait until the following October to join.

For more information about this notice or your current prescription drug coverage, contact your carrier.

NOTE: You’ll get this notice each year. You will also get it before the next period you can join a Medicare drug plan, and if this coverage through Spectra A&D changes. You also may request a copy of this notice at any time.

More detailed information about Medicare plans that offer prescription drug coverage is in the “Medicare & You” handbook.

You’ll get a copy of the handbook in the mail every year from Medicare. You may also be contacted directly by Medicare drug plans. For more information about Medicare prescription drug coverage Visit www.medicare.gov. Call your State Health Insurance Assistance Program (see the inside back cover of your copy of the “Medicare & You” handbook for their telephone number) for personalized help Call 1-800-MEDICARE (1-800-6334227). TTY users should call 1-877-486- 2048. If you have limited income and resources, extra help paying for Medicare prescription drug coverage is available. For information about this extra help, visit Social Security on the web at www.socialsecurity.gov, or call them at 1-800-772-1213 (TTY 1-800-325-0778).

Remember: Keep this Creditable Coverage notice. If you decide to join one of the Medicare drug plans, you may be required to provide a copy of this notice when you join to show whether or not you have maintained creditable coverage and, therefore, whether or not you are required to pay a higher premium (a penalty).

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HEALTH INSURANCE MARKETPLACE PART A: GENERAL INFORMATION To assist you as you evaluate options for you and your family, this notice provides some basic information about the Marketplace and employment-based health coverage offered by your employer.

What is the Health Insurance Marketplace?

The Marketplace is designed to help you find health insurance that meets your needs and fits your budget.

The Marketplace offers “one-stop shopping” to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away. Open enrollment for health insurance coverage through the Marketplace runs from November 1, 2022 through December 15, 2022 for coverage starting as early as January 1, 2023.

Can I Save Money on my Health Insurance Premiums in the Marketplace?

You may quality to save money and lower your monthly premium, but only if our employer does not offer coverage, or offers coverage that doesn’t meet certain standards. The savings on your premium that you’re eligible for depends on your household income.

Does Employer Health Coverage Affect Eligibility for Premium Savings Through the Marketplace?

Yes. If you have an offer of health coverage from your employer that meets certain standards, you will not be eligible for a tax credit through the Marketplace and may wish to enroll in your employer’s health plan. However, you may be eligible for a tax credit that lowers your monthly premium, or a reduction in certain cost-sharing if your employer does not offer coverage to you at all or does not offer coverage that meets certain standards. If the cost of a plan from your employer that would cover you (and not any other members of your family) is more than 9.5% of your household income for the year, or if the coverage your employer provides does not meet the “minimum value” standard set by the Affordable Care Act, you may be eligible for a tax credit.

!

If you purchase a health plan through the Marketplace instead of accepting health coverage by your employer, then you may lose the employer contribution (if any) to the employer-offered coverage. Also, this employer contribution – as well as your employee contribution to employer-offered coverage – is often excluded from income for Federal and State income tax purposes. Your payments for coverage through the Marketplace are made on an alter-tax basis.

How Can I Get More Information?

For more information about your coverage offered by your employer, please check your summary plan description or contact Human Resources.

The Marketplace can help you evaluate your coverage options, including your eligibility for coverage through the Marketplace and its cost. Please visit www.healthcare.gov for more information, including an online application for health insurance coverage and contact information for a Health Insurance Marketplace in your area.

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HEALTH INSURANCE MARKETPLACE PART B: INFORMATION ABOUT HEALTH COVERAGE OFFERED BY YOUR EMPLOYER This section contains information about any health coverage offered by your employer. If you decide to complete an application for coverage in the Marketplace, you will be asked to provide this information. This information is numbered to correspond to the Marketplace application.

3. Employer Name Spectra A&D

4. Employer Identification Number (EIN) 86-1905528

5. Employer Address 6435 Shiloh Rd

6. Employer Phone Number 470-239-7400

7. City Alpharetta

8. State GA

9. Zip Code 30005

10. Who can we contact about health coverage at this job?

Erica Ware 11. Phone Number (if different from above)

12. Email Address Erica.ware@fdsavionics.com

Here is some basic information about health coverage offered by this employer: As your employer, we offer a health plan to: All employees. Eligible employees are: Active full-time employees working 30 or more hours a week.

Some employees. Eligible employees are:

With respect to dependents: We do offer coverage. Eligible dependents are: Spouses and children up to age 26.

We do not offer coverage.

If checked, this coverage meets the minimum value standard and the cost of this coverage to you is intended to be affordable, based on employee wages. ** Even if your employer intends your coverage to be affordable, you may still be eligible for a premium discount through Marketplace. The Marketplace will use your household income, along with other factors, to determine whether you may be eligible for a premium discount. If for example, your wages vary from week to week (perhaps you are an hourly employee or you work on a commission basis), if you are newly employed mid-year, or if you have other income losses, you may still qualify for a premium discount.

If you decide to shop for coverage in the Marketplace, Healthcare.gov will guide you through the process. Here’s the employer information you’ll enter when you visit to find out if you can get a tax credit to lower your monthly premiums.

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HEALTH INSURANCE TERMINOLOGY Health insurance terminology can be confusing. As a result, understanding your benefits and what you may owe out of pocket can be difficult. In order to make sure you are using your coverage effectively, it is important to understand some key insurance terms.

You can purchase either group or individual health insurance. Group health insurance is typically acquired through your employer and covers many people.

Individual insurance, on the other hand, is usually purchased by an individual or a family and is not tied to a job.

To better understand your health insurance, be aware of the following terms: Participant There are a few different participants involved in health insurance. One is the “provider”, or a clinic, hospital, doctor lab, health care practitioner or pharmacy. The ”insurer” or the “carrier” is the insurance company providing coverage. The “policyholder” is the individual or entity who purchased the coverage, and the “insured” is the person with the coverage”.

Premium The amount of money charged by an insurance company for coverage. Rates are typically paid annually or in smaller payments over the course of the year (for example monthly).

Deductible The amount you owe for health care services each year before your insurance company begins to pay. Your deductible may not apply to all services, such as preventive care.

Copayment The fixed amount that you pay for a covered health care service. That amount can vary by the type of covered health care service (for example, a doctor’s office visit or a specialist, urgent care or emergency room visit).

Coisurance

20%

80%

You Pay Health Plan Pays

The percentage of a medial bill that you pay (for example, 20 percent) and the percentage that the health plan pays (for example, 80 percent). You pay coinsurance plus any deductible you owe for a covered health service.

Out-of-pocket maximum (OOPM) The most you should have to pay for health care during a year, excluding the monthly premium. After you reach the annual OOPM, your plan begins to pay 100 percent of the allowed amount for covered health services.

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