MEDICAL PLAN BENEFITS

YOUR Rx CHOICE TIERED NETWORK

Level 1 includes nearly 20,000 pharmacies where you can get your prescriptions filled for the copay or percentage of the drug costs you normally pay as part of your prescription drug plan. Level 1 includes popular chains such as:

• CVS

• Target

• Walmart

• Kroger

• Safeway

Level 2 offers you more pharmacy choices, but you’ll also pay a little more an extra amount on top of your share of the drug cost, depending on your benefit no matter which drug you fill. Pharmacies available on Level 2 include:

• Walgreens

• Rite Aid

• Sam’s Club

• Meijer

• Costco

Dental Plan Benefits

OPTION Single – up to $20 allowance Bifocal – up to $100 allowance Trifocal – up to $160 allowance Contacts 12 months $130 retail allowance 15% off balance Up to $130 allowance Lasik & PRK N/A Provider Discount up to 20% Not available

LIFE AND AD&D INSURANCE PLAN

Life Insurance is payable to the designated beneficiary upon the death of the insured.

Accidental Death & Dismemberment (AD&D) Insurance provides specified benefits for a covered accidental bodily injury that directly causes dismemberment (i.e., the loss of a hand, foot or eye). If death occurs from an accident, both the Life and AD&D benefit would be payable.

Employer Sponsored Basic Life Insurance

Life Benefit

AD&D Benefit

Benefit Reduction Benefits are reduced by 35% at age 65, by an additional 15% at age 70

Conversion If you terminate your employment, you may convert your coverage to an individual Whole Life Policy offered by the insurance carrier

Voluntary Life Insurance Plan

This plan provides the opportunity to purchase additional coverage on yourself. If you enroll, you may also purchase coverage on your spouse and/or children. If you do not elect at initial enrollment, you will need to complete an application which includes medical questions. You may be declined or offered a lower amount than requested. If you elect less than the maximum benefit, you may be eligible at open enrollment to increase your amount.

Voluntary Life Insurance

$50,000 guarantee issue, if under age 70.

Life Benefit

$10,000 guarantee issue, if age 70 and above. $10,000 increments up to $300,000.

Benefit Reduction Benefits are reduced by 35% at age 65, by an additional 15% at age 70

Conversion If you terminate your employment, you may convert your coverage to an individual Whole Life Policy offered by the insurance carrier

Spouse Coverage

$5,000 increments up to $100,000. Cannot exceed 100% of employees benefit. $20,000 guarantee issue if under age 70. $10,000 guarantee issue if age 70 and above.

Children Coverage $5,000 or $10,000 – eligible children 14 days or older (if under 14 days of age receive $1,000)

Disability Plan Benefits

If you become disabled and cannot work, no benefit becomes more important to your financial security than disability income protection. As an eligible employee you are eligible for both Short-Term Disability (STD) and Long-Term Disability (LTD) Insurance. The premiums are post-tax; therefore, if you ever receive a disability benefit payment, it will be a tax-free benefit. STD has a pre-existing condition limitation of 3/6. LTD will require you to complete an application which includes medical questions if you do not elect the benefit when initially offered at new hire.

Benefits Begin 90 days after you have been absent from work due to a covered accident or illness

Benefit Duration Age 65