2025 E MPLOYEE BENEFITS GUIDE
WELCOME TO YOUR BENEFIT ENROLLMENT GUIDE 2025 PLAN YEAR
JohnsonCo is proud to offer you a comprehensive benefits package for the upcoming plan year. This enrollment guide will assist you in determining the coverage levels that will provide you and your family with the protection that gives you peace of mind. The health care coverage you elect begins with your initial eligibility date and continues through the end of the enrollment year. JohnsonCo’s health care benefit year begins January 1 st and ends December 31 st . You may also enroll or change your benefits during the annual Open Enrollment period. This guide explains each type of coverage, and provides examples to help you determine your benefit and payroll deduction amounts. We encourage you to take the time to review the enrollment guide prior to enrollment. You must make your elections during the specified enrollment window, or you will not have coverage. To have coverage, you must confirm your benefit choices through Arcoro by the deadline.
WHO IS AN ELIGIBLE DEPENDENT? You can enroll the following dependents in our group benefit plans: • Your legal spouse • Your natural, adopted, or stepchildren living with you, or any other children whom you have legal guardianship, up to age 26 • Unmarried children of any age if disabled and claimed as a dependent on your federal income taxes ELIGIBILITY: All regular full-time employees working at least 30 hours per week are eligible for benefits. As a new hire, you are eligible on the first day of the month following 60 days of employment. ADDITIONAL INFORMATION
WHEN YOU CAN ENROLL IN BENEFITS: • During your initial new hire eligibility period • During the annual Open Enrollment period for a January 1st effective date
If you fail to enroll within the timeframe given for the new hire eligibility or annual enrollment window, you will not be able to elect benefits again until the next Open Enrollment period, and you will not have coverage, unless you experience a qualified life event. Please make your elections on time, or you may experience a delay in using your benefits.
QUALIFYING LIFE EVENTS are events that cause an individual to lose his or her group health coverage. The type of qualifying event determines who the qualified beneficiaries are for that event and the period of time that a plan must offer continuation of coverage. Qualifying Life events include: • Marriage, divorce, or legal separation • Death of spouse or other dependent • Birth or adoption of a child • You or your spouse experience a work event that effects your benefits • A dependent’s eligibility status changes due to age, student status, marital status, or employment • Relocation into or outside of your plan’s service area You must notify Human Resources within 30 days of the qualifying life event. Depending on the type of event, you may be asked to provide proof of the event. If you do not contact Human Resources within 30 days of the qualifying event, you will have to wait until the next annual enrollment period to make changes. TERMINATION OF COVERAGE: • If you leave your job, your coverage will terminate on the last day of the month following the termination or resignation date. • When a covered dependent reaches age 26, their coverage will terminate on the last day of the month following their date of birth.
MEDICAL BENEFITS
PRESCRIPTION DRUGS When you enroll in a medical plan, you are automatically enrolled in prescription drug coverage. If you regularly take the same medications, a mail-order program may allow you to get a 90-day supply for a lower cost, saving you trips to the pharmacy and time waiting in line. Check with your pharmacy to determine if any special programs are available. Discuss lower-cost alternatives with your physician and check the insurance company’s website for a complete drug list at myCigna.com. JohnsonCo employees have the choice between three medical plans offered through Cigna: a High Deductible Health Plan (HDHP) that is compatible with a Health Savings Account (HSA), a Mid Copay plan, a Buy-Up Copay plan. These plans offer services on the Open Access Plus network. HDHP participants are eligible to open a Health Savings Account to set aside pre-tax dollars to pay for their deductible and other out-of-pocket health care costs. See page 8 for more information on the tax-advantaged savings account that can help you save on health care expenses. All plans offer preventive care visits covered at 100%, an out-of-pocket maximum to protect you should a catastrophic event occur, and out-of-network coverage if needed. Although out-of-network coverage is available, using in-network providers will save you money. You can find Cigna network providers online at myCigna.com and search the Open Access Plus network. PREVENTIVE CARE All medical plans include preventive care services 100% covered under your medical insurance, meaning no copays or deductibles will apply when an in-network provider delivers the covered services. Preventive exams can detect if you are at risk for a chronic disease that may be preventable. Talk to your health care provider to determine which screenings are recommended for you and when you need them.
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CIGNA MEDICAL INSURANCE JohnsonCo offers the following plans through Cigna. Please reference the Summary Plan Description for more details. Insurance Carrier: Cigna Medical Insurance
HDHP + HSA You pay:
Mid Plan - HMO You pay:
Buy-Up Plan You pay:
In-Network:
Deductible (first dollar cost for covered in-network services) Individual / Family $5,000 / $10,000
$6,000 / $12,000
$3,000 / $6,000
Coinsurance (after you reach your deductible) Plan Pays 80%
80%
100%
Out-of-Pocket Maximum (includes deductibles, copays, prescription costs, and coinsurance) Individual / Family $6,750 / $13,500 $8,000 / $16,000
$6,500 / $13,000
Plan Features Preventive Care Primary Care Visits
Covered in full
Covered in full
Covered in full
20% after deductible 20% after deductible
$50 copay $80 copay
$35 copay $60 copay
Specialist Visits
$50 copay - urgent & primary care $80 copay - specialty visits $50 copay + 20% coinsurance
$35 copay - urgent & primary care $60 copay - specialty visits
MDLive Virtual Care
20% after deductible
Urgent Care
20% after deductible 20% after deductible 20% after deductible 20% after deductible 20% after deductible 20% after deductible
$75 copay
Emergency Room Inpatient Hospital Outpatient Surgery Labs and X-rays Advanced Imaging Prescription Benefits Rx Deductible
$350 copay
$350 copay
20% after deductible 20% after deductible 20% after deductible 20% after deductible
0% after deductible 0% after deductible
No charge
0% after deductible
Combined with medical
N / A
$150 Individual / $300 Family
Tier 1 - $10 copay Tier 2 - $30 copay Tier 3 - $60 copay Tier 4 - 20% up to $250
Tier 1 - $10 copay Tier 2 - $40 copay Tier 3 - $70 copay Tier 4 - 25% Tier 1 - $30 copay Tier 2 - $120 copay Tier 3 - $210 copay
Retail 30-day supply
20% after deductible
Tier 1 - $30 copay Tier 2 - $90 copay Tier 3 - $180 copay
Mail Order 90-day supply
20% after deductible
Employee Contributions (per paycheck cost for coverage) Employee Only $52.70
$84.41 $284.90
$99.48 $316.55
$218.31
Employee + Spouse
Employee + Child(ren)
$188.20
$248.45
$277.08
$383.93
$458.06
$504.02
Family
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MEDICAL PLAN TOOLS & RESOURCES CIGNA WEBSITE
myCigna is the secure member website where you can check your coverages and claims, locate network providers, access health programs, manage your prescriptions, print or request an ID card, and more. To get started, log on to myCigna.com and complete the registration process.
CIGNA APP The myCigna mobile app can help you stay organized and in control of your health anytime, anywhere. Log in from your mobile device to access your account. Search your mobile device’s app store to download. VIRTUAL VISITS See and talk to a doctor from a mobile device or computer without an appointment, 24/7. Most visits take 10-15 minutes, and virtual visits are a part of your health benefits. Telemedicine doctors can diagnose and treat many non-emergency medical conditions and provide services such as writing a prescription if needed. Common conditions treated with virtual care include allergies, cough, fever, headaches, sinus problems, skin rashes, pink eye, bladder infections, and more. To get started, visit myCigna.com or download the myCigna the app to connect to MDLive.
888-726-3171
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HEALTH SAVINGS ACCOUNT (HSA)
When you enroll in a High Deductible Health Plan (HDHP), you are eligible to open a Health Savings Account (HSA) through Health Equity. This account lets you put pre-tax money aside for qualified health care expenses. Because your contributions are deducted pre-tax, you can save up to an estimated 25% on out-of-pocket costs. To participate in an HSA, you must meet the following requirements: • Be enrolled in a qualified HDHP • Not be covered by any other non-HSA qualified health plan • Not be enrolled in Medicare • Not eligible to be claimed as a dependent on someone else’s taxes • Not enrolled in a standard Health care FSA while actively contributing to your HSA
2025 IRS Calendar Year Contribution Limit
The Internal Revenue Service (IRS) sets the annual contribution levels for HSAs. It is your responsibility to monitor the amounts deposited not to exceed the maximum limit, keeping in mind that any funds contributed by JohnsonCo also count towards the maximum amount. In addition to your contributions, JohnsonCo will annually contribute the following: Individual & Family coverage - $250.00
2025 $4,300 $8,550 $1,000
If you cover just yourself on the plan:
If you cover yourself and a spouse or dependents:
Age 55+ Catch-Up:
HOW DOES IT WORK? You determine the amount you wish to be deducted from each paycheck. The funds are automatically deposited into your account. Unused funds carry over from year to year and can build over time. HSAs are portable; if you leave JohnsonCo, you can take the account and all the funds in it. WHAT CAN YOU USE YOUR HSA FUNDS ON? Use your HSA funds to pay for health care items such as copays, prescriptions, home care, medical supplies and equipment, and other out-of-pocket expenses your insurance may not cover. You may also use these funds for dental and vision expenses, counseling, chiropractic care, physical therapy, certain OTC medications, and more. Visit irs.gov/forms-pubs/about-publication-502 to see a complete list of IRS-qualified expenses.
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DENTAL BENEFITS
Regular dental exams can help you and your dentist detect problems in the early stages when treatment is simpler and costs are lower.
Keeping your teeth and gums clean and healthy will prevent most tooth decay and periodontal disease, and is an important part of maintaining your medical health.
Your dental plan is through Unum and offers “in and out-of-network” benefits. To find in-network providers, go to unumdentalcare.com and search the Unum Dental network.
Insurance Carrier:
Unum Dental Insurance PPO Plan You pay:
Calendar Year Deductible
$50 Individual / $150 Family
Annual Plan Maximum
$1,000 per member
Orthodontia Lifetime Maximum
$1,000 per member
Preventive Services
Covered in full
Basic Services
20% after deductible
Major Services
50% after deductible
Orthodontics (children up to age 19 only)
50% up to $1,000
Employee Contributions
Employee Only
$7.55
Employee + Spouse
$15.10
Employee + Child(ren)
$20.89
Family
$28.76
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VISION BENEFITS
The vision plan covers routine eye exams and also pays for all or a portion of the cost of glasses or contact lenses if you need them.
You can help protect your eyesight by visiting an eye doctor regularly. Taking care of your eyes today can lead to a better quality of life later.
Your vision plan is through Unum and offers “in and out-of-network” benefits. To find in-network providers visit EyeMedVisionCare.com/Unum and enter your search criteria.
Insurance Carrier:
Unum Vision Insurance
In-Network You pay:
Out-of-Network You are reimbursed:
Eye Exam every 12 months
$10 Copay
Up to $35
Lenses every 12 months • Single Vision
Covered by copay Covered by copay Covered by copay $80 Allowance $70 Allowance
Up to $25 Up to $40 Up to $50 Up to $50 Up to $40
• Bifocal • Trifocal • Lenticular • Progressive
Frames every 24 months
$100 Allowance + 20% off balance
Up to $50 retail
Contacts every 12 months • Elective • Medically Necessary
$100 allowance + 20% off balance Covered in full
Up to $100 Up to $210
Employee Contributions
Employee Only
$1.15 $2.30 $2.54 $3.78
Employee + Spouse Employee + Child(ren)
Family
*Contacts benefit is in lieu of eyeglass frames and lens benefit.
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LIFE AND AD&D INSURANCE
JohnsonCo employees may purchase Voluntary Basic Life and AD&D insurance through Unum. In addition, you may purchase coverage for a spouse and child(ren) after electing coverage for yourself. The Guarantee Issue (GI) amount is the highest amount of coverage that you or your dependents may elect without completing an Evidence of Insurability (EOI) form. If you elect an amount above the GI limit or wish to increase your benefit amount at a future date, the coverage amount over the GI level will not go into effect until your EOI has been reviewed and approved and payroll deductions have begun. For full details, refer to the Certificate of Coverage. You may purchase the following amounts for yourself and your dependents. Refer to Arcoro to calculate your coverage cost.
Insurance Carrier:
Unum Voluntary Life Insurance
Voluntary Life w/ AD&D Eligibility Requirement Employee Benefit Amounts Employee
All Full Time Employees
Increments of $10k up to 5x annual salary amount up to $500,000
Spouse
Increments of $5k up to $500,000 not to exceed 100% of the employee amount
Birth to 6 months of age - $1k Age 6 months and older - increments of $2k up to $10,000
Child(ren)
Guarantee Issue Employee
$130k
Spouse
$25k
Children
$10k
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DISABILITY INSURANCE
Whether you are disabled and unable to work due to an accident or illness, JohnsonCo offers voluntary Short-Term Disability benefits options through Unum. Disability is insurance for your paycheck should you become disabled due to an off-the-job injury or illness. This coverage will provide a percentage of your salary once you satisfy the waiting period. Refer to the Plan Summaries for details. Your cost for coverage can be calculated on Arcoro when you make your benefit elections.
Insurance Carrier:
Unum Short-Term Disability Insurance
Plan Type:
Voluntary
Eligibility Requirement
All Full Time Employees
Maximum Weekly Benefit
60% of your weekly pre-disability earnings to a maximum of $1,000 per week
Waiting Period
7 Days
12 weeks or until you no longer meet the definition of disability, whichever occurs first
Benefit Duration
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WORKSITE BENEFITS
JohnsonCo offers employees the option to purchase supplemental worksite benefits including Accident and Critical Illness voluntarily provided through Unum. In addition, you have the option to cover your spouse and child(ren) after electing coverage for yourself. The premiums for elected benefits are deducted from your paycheck. VOLUNTARY CRITICAL ILLNESS insurance pays a lump sum cash benefit when you or a covered family member is diagnosed with a serious illness, such as a heart attack, stroke, major organ failure, or cancer. You may use this benefit in any way you choose to pay for expenses that are not medical but have occurred due to the diagnosis, such as lost wages, family care, rehabilitation, or transportation. The plan may also offer a health screening benefit. Benefits are paid to you regardless of any additional coverage you may have. Your cost for coverage can be calculated when making your benefit elections on Arcoro. VOLUNTARY ACCIDENT Where most medical plans only pay a portion of the bills, Accident insurance can help pick up where other insurance leaves off. This policy provides a cash benefit to cover expenses if you or a covered dependent experience an eligible event. Employees can receive reimbursement for covered services, including: • Hospital/ICU admission
Employee Contributions Employee Only Employee + Spouse Employee + Child(ren)
$2.58 $4.53 $6.25 $8.19
• Emergency transportation and care • Fractures, burns, lacerations, and more • Accidental death benefit
Family
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HOW TO ENROLL Our benefits portal, Arcoro, enables you to make your benefit elections whenever and wherever it is most convenient. This site will guide you, step-by-step, through the enrollment process. For each benefit, you will be able to review your choices, if applicable, select your coverage level, and include any dependents you want to cover for that benefit. To use our online enrollment system, follow these three easy steps below to log in and make your benefit elections: Step 1: Log in Go to https://identity.arcoro.com/Account/Login Enter your user name and password, and choose Log In. Step 2: Go to the Open Enrollment Event Under Change Events you’ll see your open enrollment. Just choose Begin Event to get started. Step 3: Make your benefit choices The system will walk you through your options for each benefit so just follow the online instructions. When you’re done, make sure to save and review your choices.
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JOHNSONCO VACATION POLICY
VACATION POLICY
Vacation time is offered to full-time eligible employees based on a 'Years of Service' and ‘Position’ schedule. All salaried and non-salaried employees are given 6 paid holidays (New Years Day, Memorial Day, 4 th of July, Labor Day, Thanksgiving, and Christmas). Vacation is paid by Vertical Earth Inc. to regular full-time employees as follows:
❑ 0-120 Days
o No Holidays, No Vacation Days, and No Sick Days
❑ 120 Days-1 Year
o Salaried Employees (Holidays, 5 Vacation Days, and 2 Sick Days) o Hourly Employees (Holidays)
❑ After 1 Year
o Salaried Employees (Holidays, 8 Vacation Days, and 3 Sick Days) o Hourly Employees (Holiday, 3 Vacation Days, and 2 Sick Days)
❑ After 2 Years
o Salaried Employees (Holidays, 10 Vacation Days, and 3 Sick Days) o Hourly Employees (Holidays, 5 Vacation Days, and 3 Sick Days)
❑ 3 – 5 Years
o Salaried Employees (Holidays, 12 Vacation Days, and 3 Sick Days) o Hourly Employees (Holidays, 10 Vacation Days, and 3 Sick Days)
❑ 5 + Years
o Salaried Employees (Holidays, 15 Vacation Days, and 5 Sick Days) o Hourly Employees (Holidays, 15 Vacation Days, and 5 Sick Days)
It is the responsibility of the employee to be aware of their vacation eligibility. All employees are required to give at least 30 DAYS notice to their supervisor of their vacation plans. You are required to take your vacation within 365 DAY calendar year after you earn it. You will not be eligible to receive pay instead of vacation time except with company permission or upon termination. Any conflict in vacation requests will be decided based on employee seniority and company needs. You will not be entitled to accrued vacation during periods when you are on personal leave of absence or if you are suspended from the company.
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JOHNSONCO VACATION POLICY
You are not eligible for any paid vacation until you have completed one year of employment with the company. Vacations are earned from the anniversary date of hire. This time must be consecutively accrued. For example, if you leave the company after nine months of employment, you will not be eligible for any vacation pay benefits. Employees are encouraged to use available paid vacation time for rest, relaxation, and personal pursuits. If available vacation is not used by the end of the benefit year, employees will lose accrued vacation time for that benefit year. Vertical Earth will not carryover or pay out any unused vacation time from one year to the next unless required to do so by state law.
Vacation time must be scheduled and approved in advance by your supervisor and HR/Operations.
Employees will request vacation as follows: • Log into Arcoro Employee Portal • Select Time and Labor • Click “ View/Request Time Off ”
• Choose the tab labeled “ Time Off Request ” • Select each day that associate is requesting • Click “ Add Selected Dates ” • Select the type of time you are taking (Vacation/Sick) o Please leave comments in the comment section • Submit request • The request is then sent for approval.
Vacation is approved or denied based on a first come first served basis.
When given advance notice, Vertical Earth will consider requests for additional time without pay. If you have a special type of vacation in mind, talk to your supervisor to see if a solution can be reached.
Employees who are terminated for disciplinary reasons forfeit all vacation, sick days, bonuses, and any other benefits. Employees who resign will forfeit all unused vacation and sick days.
Management may, at its sole discretion, at any time, modify, suspend, or terminate vacation and/or holiday policies. Management may deny vacation requests.
An employee who is absent for reasons other than those permitted or excused by Vertical Earth’s holiday, vacation, or leave polices, or who repeatedly fails to provide notice as required, will be subject to appropriate disciplinary action, up to and including dismissal. Employees may be discharged after one (1) unexcused absence or tardy arrival.
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JOHNSONCO 401K PLAN
VERTICAL EARTH 401(K) PLAN PLAN HIGHLIGHTS IMPORTANT: This is a summary of the plan features. For full details, please refer to the Summary Plan Description. Eligibility Excluded Employees: You are excluded from the Plan if you are a member of any of the following classes of employees: •
Employees covered by a collective bargaining agreement, for purposes of Elective Deferral Contributions, Safe Harbor Matching Contributions and Non-Elective Contributions. Any leased employee, for purposes of Elective Deferral Contributions, Safe Harbor Matching Contributions and Non-Elective Contributions. Non-resident aliens, for purposes of Elective Deferral Contributions, Safe Harbor Matching Contributions and Non-Elective Contributions.
•
•
Elective Deferral Contributions, Safe Harbor Matching Contributions and Non-Elective Contributions: Elective Deferral Contributions, Safe Harbor Matching Contributions and Non-Elective Contributions:
You must meet the following criteria to become eligible to participate in the Plan: • Attain age 18 • Complete 90 days elapsed time. You will enter the Plan on the first day of each plan quarter coincident with or next following the time you meet the eligibility criteria specified above. Under certain circumstances, you may be automatically enrolled in the Plan. A notice will be provided with details prior to the beginning of each plan year.
Contributions Elective Deferral: You may elect to defer up to 100% of your Plan Compensation on a pre-tax basis. You may also elect to make Roth contributions to the Plan on an after-tax basis. You may elect to change your elections to contribute to the Plan on the dates established pursuant to Plan Administrator procedures. Federal law also limits the amount you may elect to defer under the Plan ($22,500 in 2023). However, if you are age 50 or over, you may defer an additional amount up to $7,500 (in 2023). These dollar limits are indexed; therefore, they may increase each year for cost-of-living adjustments.
Safe Harbor Matching Contributions:
The Employer will contribute a matching contribution to your Safe Harbor Matching Contribution Account in an amount equal to: (i) 100% of the Matched Employee Contributions that are not in excess of 1% of your Plan Compensation, plus (ii) 50% of the amount of the Matched Employee Contributions that exceed 1% of your Plan Compensation but that do not exceed 6% of your Plan Compensation. Matching contributions will be allocated to the Safe Harbor Matching Contribution Accounts of Participants as soon as administratively feasible after the end of each pay period. The Employer may, in its sole discretion, make a Non-Elective Contribution on your behalf in an amount determined by the Employer. Such contribution, if made, will be allocated in an amount designated by the Employer to be allocated to similarly situated eligible Participants. You must complete at least 1,000 hours of service during the Applicable Period and be employed by the Employer on the last day of the Applicable Period in order to receive a Non-Elective Contribution. For purposes of this section, the Applicable Period for determining satisfaction of service requirements for an allocation of Non-Elective Contributions will be each Plan Year.
Non-Elective Contributions:
16 | JohnsonCo 2025 Benefits Guide Vertical Earth 401(k) Plan
Copyright © 2002-2023 CCH Incorporated, DBA ftwilliam.com
JOHNSONCO 401K PLAN
Rollovers: The Plan may accept a Rollover Contribution made on behalf of any Employee not excluded from the Plan who has met the age and service requirements of the Plan. If you have money in a non-Roth account you may rollover/transfer the account balance to a Roth (after-tax) account under this plan. Vesting Fully Vested Accounts: You will have a fully vested and nonforfeitable interest in your Elective Deferral Account, Rollover Contribution Account and Qualified Non-Elective Contribution Account. Safe Harbor Matching Contributions: Your interest in your Safe Harbor Matching Contribution Account will vest according to a 2-year cliff vesting schedule (100% after two years of vesting service). Non-Elective Contributions: Your Non-Elective Contribution Account is subject to a 2-6 year graded vesting schedule (20% per year starting with two years of vesting service). Investing Plan Contributions Investments: You may direct the investment of all of your Accounts in one or more of the available
Investment Funds. Your elections will be subject to such rules and limitations as the Plan Administrator may prescribe. The Plan Administrator may restrict investment transfers to the extent required to comply with applicable law. The Plan is intended to constitute a plan described in section 404(c) of ERISA. This means that Plan fiduciaries may be relieved of liability for any of your losses that are the result of your investment elections. Distributions and Loans You may receive a distribution from your account under the following circumstances: • Immediately after your employment terminates • Hardship • After age 59 1/2 • From the Rollover Contribution Account at any time • Death • Disability
Distributions from the plan:
Loans: The minimum loan amount is $1,000 and the maximum number of loans outstanding is one (1). Please see your Loan Procedures for additional details on taking a loan from the Plan. Contact Information
Plan Administrator:
Vertical Earth, Inc Address: 6025 Matt Highway, Cumming, Georgia 30028 Phone number: 770-888-2224
Note: These plan highlights are intended to be a very concise overview of plan features. For a detailed description of plan features, please review the Summary Plan Description or contact the Plan Administrator for more information. The plan features described in these plan highlights are subject to change and in the event of a discrepancy between the legal plan document and these highlights (or any other summary of plan features), the plan document shall control.
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Vertical Earth 401(k) Plan
Copyright © 2002-2023 CCH Incorporated, DBA ftwilliam.com
PRINCIPAL FINANCIAL PLANNING
Personalized financial planning
More tools and resources Visit principal.com/Welcome to set up your account and enroll in the retirement plan.
Meet 1-on-1 with a Principal ® retirement education specialist Create a customized strategy for your goals and get answers to your retirement questions. Cover topics like: • If you’re saving enough for retirement • When you may be able to retire • Combining retirement accounts • Paying for education expenses • Ways to diversify your savings
Compare me On your account overview page, check out the Compare me tab to see how your savings compare to peers in your same age and salary range.
Principal ® Milestones Dive into financial topics like student loans, budgeting, healthcare and more at principal.com/Milestones .
Download the Principal ® app to manage your account whenver, wherever. Visit principal.com/OnTheGo .
Visit principal.com/Virtual1on1
Questions? Visit principal.com or call 800-547-7754 . Retirement education specialists are available Monday through Friday from 7 a.m.—9 p.m. CT.
18 | JohnsonCo 2025 Benefits Guide The subject matter in this communication is educational only and provided with the understanding that Principal ® is not rendering legal, accounting, investment advice or tax advice. You should consult with appropriate counsel, financial professionals, and other advisors on all matters pertaining to legal, tax, investment or accounting obligations and requirements. Retirement professionals provide education, which may be helpful in making personal retirement decisions. Responsibility for those decisions is assumed by the participant, not by any member of Principal ® . Participants should regularly review their savings progress and post-retirement needs. Principal, Principal and symbol design and Principal Financial Group are trademarks and service marks of Principal Financial Services, Inc., a member of the Principal Financial Group.
FREQUENTLY ASKED QUESTIONS
What is included in the Medical Out-of-Pocket maximum? What is included in the Pharmacy Out- of-Pocket maximum? The Medical Out-of-Pocket maximum is the maximum amount a member must pay during the policy year for covered essential health benefits. The OOP includes a member’s deductible and any coinsurance member responsibility. The Pharmacy OOP includes only phar - macy co-pays. The Medical OOP does NOT include monthly premiums, or billing from out-of-network providers. What is an in-network vs out-of-network provider? Cigna contracts with a wide range of doctors, as well as specialists, hospitals, labs, radiology facilities and pharmacies. These are the providers that are considered “in your network”. Specifically, each of these providers has agreed to accept Cigna’s contracted rate for your medical care and services rendered. The contracted rate includes both Cigna’s share of the cost, and the member’s. Your share may be in the form of a co-payment, deductible, or co-insurance. For example, Cigna’s contracted rate for a primary care visit might be $125. The Plan has a $25 co-payment for the visit; the member will pay $25 of the cost and your insurance plan will pay the remaining $100. An “out-of-network” provider is a medical doctor or facility that is not in contract with Cigna. This means that the provider may charge members higher rates for medical services and care, outside of the standard “in-network” rates. For example, a out-of-network provider may charge $200 for a primary care visit. Cigna may pay an adjustment of an out-of-network benefit of $80 dollars to the provider, so the member may be balance-billed for the remaining $120 cost of the visit.
When can I change my beneficiary information for my Basic Life Insurance? Any time! It is important that all beneficiary information be kept up-to-date. You may need to change it after a marriage, divorce, or birth of a child.
Term
Definition
Network Office Visit (PCP)
The “per visit” co-pay cost for a primary care or standard network doctor.
The “per visit” co-pay cost for a specialized doctor (cardiologist, OB/GYN, orthopedic, gastrointestinal, etc.) The amount of money a member owes for any In-network health care services before co- insurance coverage begins. These are generally services that are NOT covered under a standard co-pay (inpatient surgery, outpatient surgery, MRI, etc.) Deductibles run on a calendar year basis. After any applicable deductible is met, the remaining cost of any in-network health care service is divided between the insurance carrier and the member. A 70% / 30% network co-insurance would divide the cost of a service with 70% paid by the insurance carrier and 30% paid by the member. These are generally services that are NOT covered under a standard co-pay (inpatient surgery, outpatient surgery, MRI, etc.) The maximum amount a member must pay during the policy year for covered essential health benefits. The OOP includes a member’s deductible, any co-insurance member responsibility, primary care and specialist office visit co-pays, ER or Urgent Care co-pays, and prescription co-pays / costs. The OOP does NOT include monthly premiums, billing from out-of-network providers, or spending for non-essential health benefits. The cost of a one month supply of a prescription drug. All covered drugs are designated into tiered levels based on drug usage, cost, and clinical effectiveness. Tier 1 usually includes generics, while Tier 2 generally includes preferred brand name medications. Tier 3 typically includes non-preferred brand name medications, Tier 4 usually includes higher cost drugs and Specialty Drugs are covered under a separate tier.
Specialist Office Visit
Network Deductible
Co-Insurance
Network Out-of-Pocket Maximum (OOP)
Prescription Drug Tiers and Monthly Co-Pays
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LEGAL NOTICES
Medicaid and the Children’s Health Insurance Program (CHIP) Offer Free or Low-Cost Health Coverage to Children and Families If you or your children are eligible for Medicaid or CHIP and you’re eligible for health coverage from your employer, your state may have a premium assistance program that can help pay for coverage, using funds from their Medicaid or CHIP programs. If you or your children aren’t eligible for Medicaid or CHIP, you won’t be eligible for these premium assistance programs but you may be able to buy individual insurance coverage through the Health Insurance Marketplace. For more information, visit www. healthcare.gov. If you or your dependents are already enrolled in Medicaid or CHIP and you live in a State listed below, 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, contact your State Medicaid or CHIP office or dial 1-877-KIDS NOW or www. insurekidsnow.gov to find out how to apply. If you qualify, ask your state if it has a program that might help you pay the premiums for an employer-sponsored plan. If you or your dependents are eligible for premium assistance under Medicaid or CHIP, as well as eligible under your employer plan, your employer must allow you to enroll in your employer plan if you aren’t already enrolled. This is called a “special enrollment” opportunity, and you must request coverage within 60 days of being determined eligible for premium assistance. If you have questions about enrolling in your employer plan, contact the Department of Labor at www.askebsa.dol.gov or call 1-866-444-EBSA (3272). If you live in one of the following states, you may be eligible for assistance paying your employer health plan premiums. The following list of states is current as of January 31, 2022. Contact your State for more information on eligibility –
ALABAMA - Medicaid Website: http://myalhipp.com/ Phone: 1-855-692-5447 ALASKA - Medicaid The AK Health Insurance Premium Payment Program Website: http://myakhipp.com/ Phone: 1-866-251-4861 Email: Customer Service@MyAKHIPP.com Medicaid Eligibility: http://dhss.alaska.gov/dpa/Pages/medicaid/default. aspx ARKANSAS - Medicaid Website: http://myarhipp.com/ Phone: 1-855-MyARHIPP (855-692-7447) COLORADO - Medicaid Website: http://www.colorado.gov/hcpf Customer Contact Center: 1-800-221-3943 KANSAS - Medicaid Website: http://www.kdheks.gov/hcf/ Phone: 1-785-296-3512 KENTUCKY - Medicaid Website: http://chfs.ky.gov/dms/default.htm Phone: 1-800-635-2570 LOUSIANA - Medicaid Website: http://dhh.louisiana.gov/index.cfm/ subhome/l/n/331 Phone: 1-888-695-2447
FLORIDA - Medicaid Website: http://flmedicaidtplrecovery.com/hipp/ Phone: 1-877-357-3268 GEORGIA - Medicaid Website: http://dch.georgia.gov/medicaid - click on Health Insurance Premium Payment (HIPP) Phone: 404-656-4507 INDIANA - Medicaid Healthy Indiana Plan for Low-Income Adults 19-64 Website: http://www.hip.in.gov Phone: 1-877-438-4479 All other Medicaid Website: http://www.indianamedicaid.com Phone: 1-800-403-0864 IOWA - Medicaid Website: http://www.dhs.state.ia.us/hipp/ Phone: 1-888-346-9562 MAINE - Medicaid Website: http://maine.gov/dhhs/ofi/public-assistance/ index.html Phone: 1-800-442-6003 TTY: Maine relay 711
MASSACHUSETTS - Medicaid and CHIP Website: http://www.mass.gov/MassHealth
Phone: 1-800-462-1120 MINNESOTA - Medicaid Website: http://mn.gov/dhs/ma/ Phone: 1-800-657-3739
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LEGAL NOTICES
MISSOURI - Medicaid Website: http://www.dss.mo.gov/mhd/participants/pages/hipp.htm
Phone: 1-800-692-7462 RHODE ISLAND - Medicaid Website: http://www.eohhs.ri.gov/ Phone: 401-462-5300 SOUTH CAROLINA - Medicaid Website: http://www.scdhhs.gov Phone: 1-888-549-0820 SOUTH DAKOTA - Medicaid
Phone: 573-751-2005 MONTANA - Medicaid Website: http://dphhs.mt.gov/ MontanaHealthcarePrograms/HIPP
Phone: 1-800-694-3084 NEBRASKA - Medicaid
Website: http://www.dhhs.ne.gov/Children_Family_ Services/AccessNebraska/Pages/accessnebraska_ index.aspx Phone: 1-855-632-7633 NEVADA - Medicaid Website: http://dwss.nv.gov/ Phone: 1-800-992-0900 NEW HAMPSHIRE - Medicaid Website: http://www.dhhs.nh.gov/oii/documents/hippapp.pdf Phone: 603-271-5218 NEW JERSEY - Medicaid and CHIP Medicaid Website: http://www.state.nj.us/humanservices/dmahs/cli - ents/medicaid/ Medicaid Phone: 609-631-2392 CHIP Website: http://www.njfamilycare.org/index.html CHIP Phone: 1-800-701-0710 NEW YORK - Medicaid Website: http://www.nyhealth.gov/health_care/medicaid/ Phone: 1-800-541-2831 NORTH CAROLINA - Medicaid Website: http://www.ncdhhs.gov/dma Phone: 919-855-4100 NORTH DAKOTA - Medicaid Website: http://www.nd.gov/dhs/services/medicalserv/medicaid/ Phone: 1-844-854-4825 OKLAHOMA - Medicaid and CHIP Website: http://www.insureoklahoma.org Phone: 1-888-365-3742 OREGON - Medicaid Website: http://healthcare.oregon.gov/Pages/index.aspx http://oregonhealthcare.gov/index-es.html Phone: 1-800-699-9075 PENNSYLVANIA - Medicaid Website: http://www.dhs.pa.gov/hipp
Website: http://dss.sd.gov Phone: 1-888-828-0059 TEXAS - Medicaid Website: http://www.dhs.state.ia.us/hipp/ Phone: 1-888-346-9562 UTAH - Medicaid and CHIP Medicaid Website: http://health.utah.gov/medicaid CHIP Website: http://health.utah.gov/chip
Phone: 1-877-543-7669 VERMONT - Medicaid Website: http://www.greenmountaincare.org Phone: 1-800-250-8427 VIRGINIA - Medicaid and CHIP Medicaid & CHIP Website: http://www.coverva.org/programs_premi - um_assistance.cfm Medicaid Phone: 1-800-432-5924 CHIP Phone: 1-855-242-8282 WASHINGTON - Medicaid Website: http://www.hca.wa.gov/free-or-low-costhealth-care/pro - gram-administration/premiumpayment- program Phone: 1-800-562-3022 ext. 15473 WEST VIRGINIA - Medicaid Website: http://www.dhhr.wv.gov/bms/Medicaid%20Expansion/Pages/ default.aspx Phone: 1-877-598-5820, HMS Third Party Liability WISCONSIN - Medicaid and CHIP Website: http://www.dhs.wisconsin.gov/publications/p1/p10095.pdf
Phone: 1-800-362-3002 WYOMING - Medicaid Website: http://wyequalitycare.acs-inc.com/ Phone: 307-777-7531
To see if any more States have added a premium assistance program since January 31, 2022, or for more information on special enrollment rights, you can contact either:
U.S. Department of Labor Employee Benefits Security Administration www.dol.gov/ebsa 1-866-444-EBSA (3272)
U.S. Department of Health and Human Services Centers for Medicare & Medicaid Services www.cms.hhs.gov 1-877-267-2323, Menu Option 4, Ext. 61565
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LEGAL NOTICES
Important Notices about Medical Coverage
HIPPA Special Enrollment Rights If you are declining enrollment 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 or your dependents in this plan if you or your dependents lose eligibility for that other coverage (or if the employer stops contributing towards 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). In addition, if you have a new dependent as result of marriage, birth, adoption, or placement for adoption, you may be able to enroll yourself and your dependents. However, you must enroll within 30 days after the marriage, birth, adoption, or placement for adoption. Effective April 1, 2009 special enrollment rights also exist in the following circumstances: • If you or your dependents experience a loss of eligibility for Medicaid or your State Children’s Health Insurance Program (SCHIP) coverage; or • If you or your dependents become eligible for premium assistance under an optional state of Medicaid or SCHIP program that would pay the employee’s portion of the health insurance premium. NOTE: In the two above listed circumstances only, you or your dependents will have sixty (60) days to request special enrollment in the group health plan coverage. An individual must request this special enrollment within sixty (60) days of the loss of coverage described at bullet one, and within sixty (60) days of when eligibility is determined as described in bullet two. Women’s Health and Cancer Rights Act of 1998 Annual Notice 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 was performed; surgery and reconstruction of the other breast to produce a symmetrical appearance; prostheses; and treatment of
physical complications of the mastectomy, including lymphedema. These benefits will be provided subject to the same deductibles and co-insurance applicable to other medical and surgical benefits provided under this plan. Our plan complies with these requirements. Benefits for these items generally are compatible to those provided under our plan for similar types of medical services and supplies. Of course, the extent to which any of these items is appropriate following mastectomy is a matter to be determined by consultation between the attending physician and the patient. Our plan neither imposes penalties (for example, reducing or limiting reimbursements) nor provides incentives to induce attending providers to provide care inconsistent with these requirements. If you would like more information on WHCRA benefits, call Yates at (706) 323-1600. Paperwork Reduction Act Statement According to the Paperwork Reduction Act of 1995 (Pub. L. 104-13) (PRA), no persons are required to respond to a collection of information unless such collection displays a valid Office of Management and budget (OMB) control number. The Department notes that a Federal agency cannot conduct or sponsor a collection of information unless it is approved by OMB under the PRA, and displays a currently valid OMB control number, and the public is not required to respond to a collection of information unless it displays a currently valid OMB control number. See 44 U.S.C. 3507. Also, not withstanding any other provisions of law, no person shall be subject to penalty for failing to comply with a collection of information if the collection of information does not display a currently valid OMB control number. See 44 U.S.C. 3512. The public reporting burden for this collection of information is estimated to average approximately seven minutes per respondent. Interested parties are encouraged to send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to the U.S. Department of Labor, Employee Benefits Security Administration, Office of Policy and Research, Attention: PRA Clearance Officer, 200 Constitution Avenue, N.W., Room N-5718, Washington, DC 20210 or email ebsa.opr@dol.gov and reference the OMB Control Number 1210-0137.
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MEDICARE PART D
Medicare Part D Notice of Creditable Coverage
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 JohnsonCo 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 a 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 further information, call Yates at (706) 323-1600. 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 JohnsonCo changes. You may also 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: Medicare Part D Notice of Creditable Coverage, cont. 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 (1-800-633-4227). 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.
Please read this notice carefully and keep it where you can find it. This notice has information about your current prescription drug coverage with JohnsonCo 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 currant coverage and Medicare’s prescription drug coverage: 1. 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. 2. JohnsonCo has determined that the prescription drug coverage offered by Cigna 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 through 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 Join a Medicare Drug Plan? Ifyou decide to join a Medicare drug plan, your current JohnsonCo coverage may or may not be affected. See pages 7-9 of the CMS Disclosure of Creditable Coverage to Medicare Part D Eligible Individuals Guidance (available at https://www.cms. hhs.gov/Creditable Coverage/ ), 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 JohnsonCo coverage, be aware that you and your dependents may or may not be able to get this coverage back.
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