3428075_24_Sanitized Scrubbed Guide Presentation

Employee Benefits 2024-2025 Subtitle

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Here’s where to find... Welcome 2 Who is eligible? 3 Making changes 3 How to enroll 3 Enrollment deadlines 3 Payroll contributions 4 Medical 5 How to be a smart consumer 6 Commuter benefits 8 Dental 9 Vision 9 Guardian’s oral health rewards program 10 How maximum rollover works 11 Life and disability insurance 12 Additional benefits 13 Glossary of terms 14 Contacts 15

WELCOME TO ANNUAL ENROLLMENT! Company appreciates your commitment to our success. We’re equally committed to providing you with competitive, affordable health and wellness benefits to help you take care of yourself and your family. Please read this guide carefully. It has a summary of your plan options and helpful tips for getting the most value from your benefits plans. We understand that you may have questions about annual enrollment, and we’ll do our best to help you understand your options and guide you through the process. This guide is not your only resource, of course. Any time you have questions about benefits or the enrollment process, you can contact your HR team. Although this guide contains an overview of benefits, for complete information about the plans available to you, please see the Summary Plan Description (SPD).

Company Name • 2024-2025 Benefits Guide

WHO IS ELIGIBLE? Benefits are available to all full-time Employees working a minimum of 30 hours per week and eligible dependents. For those enrolling during Open Enrollment, your benefits will become effective on April 1st, 2024. For new hires, your benefits will become effective on the first of the month following 30 days from your date of hire.

MAKING CHANGES You may only make changes to your elections during open enrollment each year or during the year if you experience a qualifying event. Qualifying events include, but are not limited to: z Birth, legal adoption, or placement for adoption. z Marital status. z Dependent child reaches age 26. z Spouse gains or loses employment or eligibility with current employer. z Death of a covered dependent. z Spouse or dependent becomes eligible or ineligible for Medicare/Medicaid or SCHIP. z Change in residence that changes eligibility for coverage. z Court-ordered change. Changes to your coverage due to a qualifying life event must be made within 30 days of that life event. Proof of the qualifying life event is required (marriage certificate, divorce decree, birth certificate, or loss of coverage letter). You can submit a Qualifying Life Event directly in UKG under the Life Events tab.

Eligible dependents include:

Your legal spouse or domestic partner

Your children from birth to age 26

(Including your natural/legally adopted/stepchildren, and/ or your unmarried dependent children of any age who are mentally or physically disabled and who are dependent on you for support) HOW TO ENROLL To sign up for benefits, visit https:xyz.com before the end of your enrollment period.

Note: Any change you make to your coverage must be consistent with the change in status.

ENROLLMENT DEADLINES

Type of Employee/Dependent

Enrollment opportunity

Coverage effective date

Current Employee

Annually during the enrollment period

Start of plan year

First of the month following 30 days from your date of hire.

New hire

Must enroll within 30 days of hire

Changes must be made within 30 days of life event

Qualified life event

Date of life event

EMPLOYEE PAYROLL CONTRIBUTIONS

Cigna Medical/Rx

$5,000 HSA Plan

$2,500 HSA Plan

$1,000 PPO Plan

Employee

$6.00

$11.25

$50.50

Employee + spouse

$12.00

$22.00

$60.25

Employee + child(ren)

$15.00

$27.00

$100.00

Family

$24.50

$42.70

$110.75

Guardian Dental

Base Plan

Enhanced Plan

Employee

$6.00

$11.25

Employee + spouse

$12.00

$22.00

Employee + child(ren)

$15.00

$27.00

Family

$24.50

$42.70

Guardian Vision

Base Plan

Enhanced Plan

Employee

$3.00

$4.99

Employee + spouse

$5.80

$9.50

Employee + child(ren)

$5.00

$9.75

Family

$9.50

$15.25

Note: Rates displayed is the amount per paycheck. For months with three paychecks, deductions are only taken for the first two paychecks of that month.

Company Name • 2024-2025 Benefits Guide

MEDICAL CIGNA

www.mycigna.com 800.555.1234

Your medical benefits are provided by Cigna and provides coverage for both in-network and out-of- network providers. You will always have stronger benefits when visiting in-network providers.

Medical

$5,000 HSA Plan

$2,500 HSA Plan

$1,000 PPO Plan

In-network

Annual deductible (Individual/Family)

$5,000/$10,000

$2,500/$5,000

$1,000/$2,000

Out-of-pocket maximum (Individual/Family)*

$ 6,000/$12,000

$5,000/$6,000

$4,000/$8,000

Preventive care

100%

Primary physician office visit

30% coinsurance*

20% coinsurance*

$25 copay

Specialist office visit

30% coinsurance*

20% coinsurance*

$30 copay

Inpatient hospital services

30% coinsurance*

20% coinsurance*

10% coinsurance*

Outpatient hospital services (lab, x-ray, diagnostic)

30% coinsurance*

20% coinsurance*

10% coinsurance*

Advanced diagnostics

30% coinsurance*

20% coinsurance*

10% coinsurance*

Urgent care

30% coinsurance*

20% coinsurance*

$50 copay

$150 copay + 10% coinsurance*

Emergency room care

30% coinsurance*

20% coinsurance*

Prescription drugs Retail (30-day supply)

Generic

$15 copay*

$15 copay

Brand preferred

$35 copay*

$25 copay*

$25 copay

Brand non-preferred

$60 copay*

$40 copay*

$40 copay

Mail order (90-day supply)

Generic

$30 copay*

$30 copay

Brand preferred

$70 copay*

$50 copay*

$50 copay

Brand non-preferred

$120 copay*

$80 copay*

$80 copay

This is a summary of coverage; please refer to your summary plan description for the full scope of coverage. In-network services are based on negotiated charges; Out-of-network services are based on a percentage of Medicare charges. * After deductible is satisfied.

HOW TO BE A SMART CONSUMER

Pharmacy z Find an in-network pharmacy or use the drug cost estimator tool by visiting www.mycigna.com . z Discount sites like GoodRx and WellRx can help you instantly save ( please note: prescriptions acquired under these plans do not go through your insurance). z Ask if a generic/mail order is available. z Generic contraceptives and diaphragms are covered and available at no cost. z See if your drug has a Patient Assistance Program.

myCigna Mobile App The myCigna app lets you easily access your healthcare information and gives you tools to help estimate costs, manage claims and find providers — anytime and anywhere. It’s built to be your go-to healthcare resource when you’re on the go.

24/7 Nurse Line

Telemedicine

www.mycigna.com

Cigna provides access to telemedicine through MDLIVE.

z Choose appropriate medical care. z Find a doctor or hospital. z Understand treatment options. z Achieve a healthier lifestyle. z Answer medical questions.

The program lets you get the care you need — including most prescriptions — for a wide range of minor acute conditions. Now you have access to these board- certified doctors via secure video chat or phone, without leaving your home or office. When, where and how it works best for you.

Cost Estimator Different doctors and hospitals may charge different amounts for the same service. www.mycigna.com can help you compare costs based on your own benefits.

MDLIVE www.mycigna.com 888.726.3171

Company Name • 2024-2025 Benefits Guide

HEALTH SAVINGS ACCOUNT (HSA) INSPIRA

www.inspirafinancial.com 800.555.1234

AVAILABLE TO PARTICIPANTS IN THE PLAN. A HSA is a tax-advantaged savings account that can be used for your qualified healthcare expenses. You own your HSA and can contribute to the account with pre-tax payroll deductions based on your needs. Did you know an HSA provides triple tax benefits? The money you contribute is pre-tax, and the interest that accumulates in the account is tax- free. In addition, money withdrawn from an HSA isn’t taxed, provided you use it for qualified healthcare expenses. Like a savings account, you will only be able to withdraw funds that are in the account.

z You are enrolled in the HDHP z You are not covered by a spouse’s plan z No one else can claim you as a dependent z You are not enrolled in Medicare, TRICARE or TRICARE for Life z You have not received VA benefits in the past 3 months How Do I Access/Make Contributions to My HSA? You can manage your HSA at www.xyzfinancial.com . You’ll set up your payroll contributions during your enrollment period and can make changes at any time throughout the year (although it may take between 1–2 payroll periods for any changes to be processed).

Other HSA Advantages

z You can use the account to pay for qualified healthcare expenses. z Unspent dollars roll over each year and are yours to keep if you retire or leave the company. z You can invest your HSA funds, so your available healthcare dollars can grow over time.

How Much Can Be Deposited into an HSA in 2024?

Up to $4,150 for individual

Up to $8,300 for employee + spouse, employee + child(ren), and family

<55*

*Not enrolled in Medicare

The maximum contribution increases by $1,000 *Not enrolled in Medicare

You are eligible if you enroll in a High Deductible Health Plan.

55+*

*PayFlex is now Inspira Financial

COMMUTER BENEFITS

Eligible Commuter Expenses With commuter accounts, you can set aside pre- tax dollars to use for certain work-related commuting expenses. Parking Accounts can be used for parking on or near your company’s premises. It also includes parking on or near the location from which you commute to work using mass transit, commuter highway vehicles or carpools. It doesn’t include parking at or near your home. Transit Accounts include any passes, tokens, farecards, vouchers or similar items that allow you to ride free of charge (or at a reduced rate) on mass transit or in a vehicle that seats at least seven adults, including the driver (vanpooling).

Tax Exclusion Limits Federal tax law establishes a maximum amount of commuter assistance benefits that you can exclude from income for tax purposes. Limits are indexed annually. These are the limits for taxable years beginning in 2024:

Parking: $315 per month Transit: $315 per month

These two accounts are kept separately, and funds cannot be co-mingled. This means if you’d like to set money aside for both transit and parking you will need to set up two separate accounts. Elections and Rollover Elections may be made prospectively on a monthly basis for the following month’s use. You may change your election as needed during the year without any kind of life event, however, be sure to make a note of your company’s payroll cut-off for this benefit. There is no limit to the amount of rollover in these accounts either during the year or into the next plan year, however funds are forfeit upon termination of employment, so employees are encouraged not to stockpile funds. For this benefit only, you will enroll directly with Inspira once your eligibility has been sent to them by Company name.

Neither account can be used for any highway tolls or commuter lanes.

If you have any questions please visit www.xyz.com

Company Name • 2024-2025 Benefits Guide

DENTAL GUARDIAN Although you can choose any dental provider, when you use an

www.guardianlife.com 800.555.1234

in-network dentist, you will generally pay less. If you choose an out-of-network provider, you may be billed the difference between what Guardian pays, and what your out-of-network provider charges for the services. To locate an in-network provider, please visit www.guardianlife.com .

Dental

Base Plan

Enhanced Plan

In-network

Annual deductible (Individual/Family)

$50 / $100

Annual maximum (per person)

$1,500

$2,000

Diagnostic and preventive care - Includes cleanings, fluoride treatments, sealants and x-rays Basic services - Includes fillings, periodontics, scaling and root planning, and oral surgery Major services - Includes crowns, bridges and full and partial dentures

100%

90%

60%

Not Covered

Orthodontia

50%

Lifetime maximum

$1,000

Plan includes out-of-network benefits, see plan summary for additional details.

VISION GUARDIAN

www.guardianlife.com 800.555.1234

Our vision care benefits include coverage for eye exams, lenses and frames, contact lenses, and discounts for laser surgery. The vision plan is built around the Guardian providers, who have higher benefits at a lower cost to you. When you need services, consider using an in-network provider for the most bang for your buck! When you use an out-of-network provider, you will be reimbursed for services according to the grid below. To locate an in-network provider, visit www.guardianlife.com .

Vision

Base Plan

Enhanced Plan

In-network

Examination (every calendar year)

$10 copay

$0 copay

Material

$25 copay

$0 copay

Lenses (every calendar year) Single

$25 copay

$0 copay

Bifocal

$25 copay

$0 copay

Trifocal

$25 copay

$0 copay

Frames (every calendar year) New frames

$130 allowance

$150 allowance

Contact lenses (every calendar year) Elective

$130 allowance

$150 allowance

Medically necessary

$0 copay

Employees can elect dental and/or vision regardless of whether they are enrolled in medical.

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care (Enhanced Plan Only) The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist. The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist. The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist. The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist. The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist. GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist.

HELPING EMPLOYEES MAINTAIN GOOD HEALTH HELPING EMPLOYEES MAINTAIN GOOD HEALTH • Members simply submit a claim without exceeding the paid claims threshold during the benefit year. • Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. • The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. • Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! z Members simply submit a claim without exceeding the paid claims threshold during the benefit year. z Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. z The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. z Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! • Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. • The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. • Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! • Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. • The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. • Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! • Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. • The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. • Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! • Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. • The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. • Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! HELPING EMPLOYEES MAINTAIN GOOD HEALTH • Members simply submit a claim without exceeding the paid claims threshold during the benefit year. HELPING EMPLOYEES MAINTAIN GOOD HEALTH • Members simply submit a claim without exceeding the paid claims threshold during the benefit year. HELPING EMPLOYEES MAINTAIN GOOD HEALTH • Members simply submit a claim without exceeding the paid claims threshold during the benefit year. HELPING EMPLOYEES MAINTAIN GOOD HEALTH • Members simply submit a claim without exceeding the paid claims threshold during the benefit year.

HOW MAXIMUM ROLLOVER WORKS

HOW MAXIMUM ROLLOVER WORKS Guardian will roll over a portion of the unused annual dental maximum into a personal Maximum Rollover Account, which can be used in future years if the plan’s annual maximum is reached. As an added advantage, more money is rolled over if in- network dentists are used exclusively during the benefit year. HOW MAXIMUM ROLLOVER WORKS

Guardian will roll over a portion of the unused annual dental maximum into a personal Maximum Rollover Account, which can be used in future years if the plan’s annual maximum is reached. As an added advantage, more money is rolled over if in- network dentists are used exclusively during the benefit year. is rolled over if in-network dentists are used exclusively during the benefit year. Guardian will roll over a portion of the unused annual dental maximum into a personal Maximum Rollover Account, which can be used in future years if the plan’s annual maximum is reached. As an added advantage, more money HOW MAXIMUM ROLLOVER WORKS HOW MAXIMUM ROLLOVER WORKS

PRACTICE GOOD ORAL HEALTH

VISIT THE DENTIST

ROLLOVER DENTAL FUNDS FOR THE FUTURE

VISIT THE DENTIST

ROLLOVER DENTAL FUNDS FOR THE FUTURE

VISIT THE DENTIST

ROLLOVER DENTAL FUNDS FOR THE FUTURE

VISIT THE DENTIST

ROLLOVER DENTAL FUNDS FOR THE FUTURE

VISIT THE DENTIST

ROLLOVER DENTAL FUNDS FOR THE FUTURE

CONTACT YOUR GUARDIAN GROUP SALES REPRESENTATIVE FOR MORE INFORMATION.

CONTACT YOUR GUARDIAN GROUP SALES REPRESENTATIVE FOR MORE INFORMATION. CONTACT YOUR GUARDIAN GROUP SALES REPRESENTATIVE FOR MORE INFORMATION. CONTACT YOUR GUARDIAN GROUP SALES REPRESENTATIVE FOR MORE INFORMATION.

WWW.GUARDIANANYTIME.COM

WWW.GUARDIANANYTIME.COM WWW.GUARDIANANYTIME.COM WWW.GUARDIANANYTIME.COM

CONTACT YOUR GUARDIAN GROUP SALES REPRESENTATIVE FOR MORE INFORMATION. CONTACT YOUR GUARDIAN GROUP SALES REPRESENTATIVE FOR MORE INFORMATION.

The Guardian Life Insurance Company of America 7 Hanover Square New York, NY 10004-4025 www.guardiananytime.com

The Guardian Life Insurance Company of America ® (Guardian). May not be available in all states. Guardian's Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. Information provided in this communication is for informational purposes only. Dental Policy Form # GP-1-DEN-16. Page 1 of 2 The Guardian Life Insurance Company of America ® (Guardian). May not be available in all states. Guardian's Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. Information provided in this communication is for informational purposes only. Dental Policy Form # GP-1-DEN-16. Page 1 of 2

The Guardian Life Insurance Company of America 7 Hanover Square New York, NY 10004-4025 www.guardiananytime.com

The Guardian Life Insurance Company of America ® (Guardian). May not be available in all states. Guardian's Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. Information provided in this communication is for informational purposes only. Dental Policy Form # GP-1-DEN-16. The Guardian Life Insurance Company of America ® (Guardian). May not be available in all states. Guardian's Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. Information provided in this communication is for informational purposes only. Dental Policy Form # GP-1-DEN-16.

The Guardian Life Insurance Company of America 7 Hanover Square New York, NY 10004-4025 www.guardiananytime.com

Page 1 of 2

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

Company Name • 2024-2025 Benefits Guide

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

DENTAL INSURANCE MAXIMUM ROLLOVER

2017-42998 (07/19)

HOW MAXIMUM ROLLOVER WORKS: $2,000 ANNUAL EXAMPLE (ENHANCED PLAN ONLY) Depending on the plan’s annual maximum, if claims dollars for the year don’t exceed a certain threshold, the set Maximum Rollover Amount (pre-determined based on the annual maximum) can be rolled over. How Maximum Rollover Works: $2,000 Annual Example

Plan Annual Maximum* Depending on the plan’s annual maximum, if claims dollars for the year don’t exceed a certain threshold, the set Maximum Rollover Amount (pre-determined based on the annual maximum) can be rolled over. Threshold Maximum Rollover Amount In-Network Only Rollover Amount Maximum Claims Reimbursement PLAN ANNUAL MAXIMUM* The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist. The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist. $2,000 $800 $400 $600 GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care GUARDIAN’S ORAL HEALTH REWARDS PROGRAM Help Encourage Good Oral Care

Enhanced Plan

$1,500

Claims amount that determines rollover eligibility The connection between oral and overall wellness is clear. Visiting the dentist regularly can help prevent and detect early stages of many diseases and conditions. Help your clients promote good oral care with Guardian’s Maximum Rollover Oral Health Rewards Program – a unique tool that encourages and rewards members who visit the dentist. Additional dollars added to Plan Annual Maximum for future years $600 Additional dollars added to Plan Annual Maximum for future years if only in-network providers were used during the benefit year $1,500 THRESHOLD MAXIMUM ROLLOVER AMOUNT IN-NETWORK ONLY ROLLOVER AMOUNT MAXIMUM ROLLOVER ACCOUNT LIMIT $2,000 $800 $400

The Maximum Rollover Account cannot exceed $1,500

Additional dollars added to Plan Annual Maximum for future years if only in-network providers were used during the benefit year

Additional dollars added to Plan Annual Maximum for future years

Claims amount that determines rollover eligibility

The Maximum Rollover Account cannot exceed $1,500

Maximum Claims Reimbursement

SAMPLE PLAN: $2,000 ANNUAL MAXIMUM HELPING EMPLOYEES MAINTAIN GOOD HEALTH • Members simply submit a claim without exceeding the paid claims threshold during the benefit year. • Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. • The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. • Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! HELPING EMPLOYEES MAINTAIN GOOD HEALTH • Members simply submit a claim without exceeding the paid claims threshold during the benefit year. • Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. • The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. • Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! • Guardian will reward them by rolling over a portion of their unused annual dental maximum into their own personal Maximum Rollover Account (MRA) for future use. • The reward can be used to supplement dental care costs in the future beyond the plan’s normal annual maximum. • Plus! If they use the services of in-network dentists exclusively during the benefit year, we’ll increase the amount credited to the MRA! HELPING EMPLOYEES MAINTAIN GOOD HEALTH • Members simply submit a claim without exceeding the paid claims threshold during the benefit year.

YEAR ONE: Jane starts with a $2,000 Plan Annual Maximum. She submits $150 in dental claims. Since she did not exceed the $800 Threshold, she receives a $400 rollover that will be applied to Year Two. YEAR TWO: Jane now has an increased Plan Annual Maximum of $2,400. This year, she submits $400 in claims and receives an additional $400 rollover added to her Plan Annual Maximum. YEAR THREE: Jane now has an increased Plan Annual Maximum of $2,800. This year, she submits $2,700 in claims. All claims are paid due to the Maximum Rollover Amount accumulated YEAR FOUR: Jane’s Plan Annual Maximum is $2,100 ($2,000 Plan Annual Maximum + $100 remaining Maximum Rollover Amount accumulated) SAMPLE PLAN: $2,000 ANNUAL MAXIMUM YEAR ONE: Jane starts with a $2,000 Plan Annual Maximum. She submits $150 in dental claims. Since she did not exceed the $800 Threshold, she receives a $400 rollover that will be applied to Year Two. YEAR TWO: Jane now has an increased Plan Annual Maximum of $2,400. This year, she submits $400 in claims and receives an additional $400 rollover added to her Plan Annual Maximum. YEAR THREE: Jane now has an increased Plan Annual Maximum of $2,800. This year, she submits $2,700 in claims. All claims are paid due to the Maximum Rollover Amount accumulated. YEAR FOUR: Jane’s Plan Annual Maximum is $2,100 ($2,000 Plan Annual Maximum + $100 remaining Maximum Rollover Amount accumulated). HOW MAXIMUM ROLLOVER WORKS HOW MAXIMUM ROLLOVER WORKS HOW MAXIMUM ROLLOVER WORKS

+ $400

- $700

PRACTICE GOOD ORAL HEALTH

$800

+ $400 PRACTICE GOOD ORAL HEALTH

$400

$100

$2,000

YEAR 1 ROLLOVER DENTAL FUNDS FOR THE FUTURE

YEAR 2

YEAR 3 VISIT THE DENTIST

YEAR 4

VISIT THE DENTIST

ROLLOVER DENTAL FUNDS FOR THE FUTURE

VISIT THE DENTIST

ROLLOVER DENTAL FUNDS FOR THE FUTURE

ANNUAL MAX

ROLLOVER BALANCE

CONTACT YOUR GUARDIAN GROUP SALES REPRESENTATIVE FOR MORE INFORMATION.

WWW.GUARDIANANYTIME.COM WWW.GUARDIANANYTIME.COM

WWW.GUARDIANANYTIME.COM

* If a plan has a different annual maximum for PPO benefits vs. non-PPO benefits, ($1500 PPO/$1000 non-PPO for example) the non-PPO maximum determines the Maximum Rollover plan. May not be available in all states. Guardian's Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. Information provided in this communication is for informational purposes only. Dental Policy Form # GP-1-DEN-16. WWW.GUARDIANANYTIME.COM WWW.GUARDIANANYTIME.COM

The Guardian Life Insurance Company of America 7 Hanover Square New York, NY 10004-4025 www.guardiananytime.com

The Guardian Life Insurance Company of America ® (Guardian). May not be available in all states. Guardian's Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. Information provided in this communication is for informational purposes only. Dental Policy Form # GP-1-DEN-16. The Guardian Life Insurance Company of America ® (Guardian). May not be available in all states. Guardian's Dental Insurance is underwritten and issued by The Guardian Life Insurance Company of America, New York, NY. Products are not available in all states. Policy limitations and exclusions apply. Optional riders and/or features may incur additional costs. Plan documents are the final arbiter of coverage. Information provided in this communication is for informational purposes only. Dental Policy Form # GP-1-DEN-16.

The Guardian Life Insurance Company of America 7 Hanover Square New York, NY 10004-4025 www.guardiananytime.com

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Page 1 of 2

LIFE AND DISABILITY INSURANCE GUARDIAN

www.guardianlife.com 800.555.1234

Life Insurance We provide Basic Life and AD&D insurance at no cost to you!

Insurance coverage

Benefit

Basic Life and AD&D

$100,000

If you would like additional coverage, Voluntary Life and AD&D insurance is available to you, your spouse and your dependent children. You must enroll in coverage for yourself in order to cover your spouse or children. If you don’t enroll in Voluntary Life when it’s first available to you, or elect an amount over the Guaranteed Issue, you may be required to complete an Evidence of Insurability (EOI) form.

Insurance coverage

Benefit

$10,000 to $500,000 in $10,000 increments. The Guaranteed Issue amount is $100,000.

Voluntary Employee life

$5,000 to $250,000 in $5,000 increments, not to exceed 100% of Employee’s amount. The Guaranteed Issue amount is $30,000. $5,000 to $20,000 in $5,000 increments, not to exceed 100% of Employee’s amount. The Guaranteed Issue amount is $20,000.

Voluntary spouse life

Voluntary child life

Disability You have the opportunity to purchase Short-Term Disability and the company provides Long-Term Disability. These plans give you income protection in the event you are ill or injured in a non-work related injury, and can’t come to work. If you don’t enroll in Disability coverage when it’s first available, you may be required to complete and an Evidence of Insurability (EOI) form.

Voluntary Short-term disability benefits

Long-term disability benefits

Elimination period

7 days

Elimination period

180 days

Weekly benefit

60% of weekly earnings

Monthly benefit

60% of monthly earnings

Maximum weekly benefit

$2,000

Maximum monthly benefit

$10,000

Maximum benefit period

26 weeks

Maximum benefit period

SSNRA

Company Name • 2024-2025 Benefits Guide

ADDITIONAL BENEFITS

Benefit

Description

Contact information

Who pays?

We are pleased to offer an Employee Assistance Program to assist you and your family through difficult times. z Unlimited access to Master’s-level counselors by phone. z Up to 3 visits per employee/household member per issue, per year.

www.guidanceresources. com 800.555.1234 App: GuidanceNow Web ID: Guardian

Unlimited telephonic intake 24/7.

Employer Paid

z Bereavement - support available through telephonic or face-to-face sessions.

Employee Assistance Program

z Online modules and coaching available.

z EAP website resources - includes webinars, podcasts, articles, videos, FAQs, etc.; additionally, individuals can chat online with an EAP consultant. With a legal plan, you can rest assured that whether you’re facing a legal issue that’s big, small or somewhere in between, you’ll have access to legal advice and services when you need them.

guidanceresources.com App: GuidanceNowSM Web ID: Guardian 24/7 Live Assistance: Call: 800.555.1234

Discounted rates available

ID theft

Legal & Financial Consultation

Will preparation

Legal document preparation

Tax consultation

GLOSSARY OF TERMS COPAYMENT : A copayment (copay) is the fixed dollar amount you pay for certain in-network services on a PPO-type plan. In some cases, you may be responsible for coinsurance after a copay is made. COINSURANCE: Your share of the costs of a healthcare service, usually figured as a percentage of the amount charged for services. You start paying coinsurance after you’ve met the deductible. Your plan pays a certain percentage of the total bill, and you pay the remaining percentage. DEDUCTIBLE: A deductible is the amount of money you must meet before your plan begins paying for services covered by coinsurance. Some services, such as office visits that require copays do not apply to the deductible. For example, if your plan’s deductible is $1,000, you’ll pay 100 percent of eligible healthcare expenses until you have met the $1,000 deductible. After that, you share the cost with your plan by paying coinsurance.

FORMULARY : A list of prescription drugs covered by the plan. Also called a drug list.

HIGH DEDUCTIBLE HEALTH PLAN (HDHP): This is a type of medical plan that requires the member to reach a deductible prior to having services covered by coinsurance. All expenses paid by the member count toward the deductible and out-of-pocket maximum. IN-NETWORK: A group of doctors, clinics, hospitals and other healthcare providers that have an agreement with your medical plan provider. You pay a negotiated rate for services when you use in-network providers. OUT-OF-NETWORK: Care received from a doctor, hospital or other provider that is not part of the plan agreement. You’ll pay more when you use out-of-network providers since they don’t have a negotiated rate with your plan provider. You may also be billed the difference between what the out-of-network provider charges for services and what the plan provider pays for those services. OUT-OF-POCKET MAXIMUM: This is the most you must pay for covered services in a plan year. After you spend this amount on deductibles and coinsurance, your health plan pays 100 percent of the costs of covered benefits. However, you must pay for certain out-of-network charges above reasonable and customary amounts.

Company Name • 2024-2025 Benefits Guide

CONTACTS

Medical Plan(s) Cigna Member services: 800.555.1234 Website: www.mycigna.com

Vision Guardian

Life & Disability Guardian Member services: 800.555.1234 Website: www.guardianlife.com

Member services: 800.555.1234 Website: www.guardianlife.com

Prescription Services Cigna

Health Savings Account (HSA) Inspira Member services: 800.555.1234 Website: www.inspirafinancial.com Commuter Benefits Inspira Member services: 800.555.1234 Website: www.inspirafinancial.com

People Operations Email: pd-us@xconsulting.com

Member services: 800.555.1234 Website: www.mycigna.com

Dental Guardian

Member services: 800.555.1234 Website: www.guardianlife.com

Annual notices and the CHIP notice is available here: https://online.flippingbook.com/

The descriptions of the benefits are not guarantees of current or future employment or benefits. If there is any conflict between this guide and the official plan documents, the official documents will govern.

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