The benefits plan year runsJanuary 1st, 2024 throughDecember 31st, 2024. Unless you have a qualified change-in-status event that impacts your eligibility and thechange is allowed underthe terms of the insurancecontract or plan document, you cannot make changes to your benefits until the nextOpen Enrollment period.Benefit changes must be consistent with yourqualified change-in-statusevent.Changes must besubmitted to HumanResources within 30 daysof the event;documentationsupporting the changewill be required.Who is eligible for benefits?All full-time employees who work a minimum of 30 hours per week are eligible for benefits. For new hires, benefits are effective on the first of the month following your date of employment.In addition to enrolling yourself, you may also enroll any eligible dependents.Eligible dependents are defined below:• Spouse: a person to whom you are legally married by ceremony• Child(ren): Your biological, adopted, or legal dependents up to age 26 regardlessof student, financial, and marital status; coverage for a dependent child will terminate at the end of the month in which the child turns age 26Change-in-Status EventsUnless you have a qualified change-in-status event that impacts your eligibility andthe change is allowed under the terms of the insurance contract or plan document,you cannot make changes to the benefits you elect until the next Open Enrollmentperiod. Some examples of qualified change-in-status events are highlighted below:Marriage or divorceBirth, adoption, or deathChange in employment, or employment status for you, your spouse, or your dependent childChange in coverage under another employer plan, such as a change made during your spouse’s Open EnrollmentCFI Companies takes pride in providing acomprehensive employee benefits program, andwe recognize the important role employee benefitsplay as a critical component of your overallcompensation. We strive to maintain a benefitsprogram that is rewarding and competitive.WHAT’S INSIDEEmployee ResourcesEmployee ContributionsMedicalHealth Savings Account (HSA) Dental VisionLife/AD&DDisability InsuranceSupplemental Benefits Additional Benefits 2
EMPLOYEE RESOURCESPlanPolicy Number Phone Number and WebsiteMedicalAetna0194866(888) 802-3862www.aetna/health-loginTeleadocTeladoc/Aetna0194866(855) 835-2362www.aetna/AFA-tdocDentalPrincipal Financial1055642(800) 986-3343www.principal.com/dentistVisionEyemed9809625(866) 268-4063www.eyemedvisioncare.comLifeand Voluntary Life InsurancePrincipal Financial1152730(800) 986-3343www.principal.comDisability InsurancePrincipal Financial1152730(800) 986-3343www.principal.comLong-Term CareUNUM1152730(800) 693-4988www.unum.comSupplemental BenefitsColonial LifeE5497516(800) 325-4368www.colonialife.comEmployee Assistance ProgramMagellan Health / Principal 1152730(800) 450-1327www.magellanascend.comTravel Assistance AXA Assistance / Principal 1152730(888) 647-2611www.principal.com/travelassistanceTHERE’S AN APP FOR THAT!EMPLOYEE CONTRIBUTIONS PER PAY PERIODBased on 24 pay periods per year3Plan Features Employee Employee + Spouse Employee + Child(ren) FamilyMEDICAL—Aetna$500 PPO$37.30 $571.32 $391.67 $903.20$2,000 EPO$0.00 $465.65 $309.00 $755.05$4,500 HDHP$0.00 $384.97 $255.46 $624.22DENTAL—PrincipalDental Plan$0.77 $22.71 $24.12 $48.68VISION—PrincipalVision Plan$0.00 $2.54 $2.82 $5.50
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.4CFI Companies provides an array of benefits that can help you enjoy increased well-being, deal with an unexpected illness or accident, build and protect your financialsecurity, balance your personal and professional life and meet everyday needs.These benefits are affordable, comprehensive and competitive.The table below summarizes the benefits available to eligible staff and theirdependents. These benefits are described in greater detail in this booklet.4Benefits Eligibility Carrier MedicalEmployee + DependentsShared FundingAetna Dental PlanEmployee + DependentsShared FundingPrincipalVision PlanEmployee + DependentsShared FundingEyeMedLife / AD&DEmployee Only100% Company PaidPrincipalVoluntary Life / AD&DEmployee + Dependents100% Employee PaidPrincipalShort-Term & Long-Term DisabilityEmployee Only100% Company PaidPrincipalLong–Term Care Employee Only100% Company PaidUnumSupplemental Benefits(Cancer, Accident, Medical Bridge, Critical Illness)Employee + Dependents100% Employee PaidColonial Life Employee Assistance ProgramEmployee + Dependents100% Company PaidMagellan HealthcareTravel AssistanceEmployee + Dependents100% Company PaidAXA Travel AssistanceOVERVIEW OF BENEFIT PROGRAMS
This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.KEY TERMS TO REMEMBER & PLAN DETAILSANNUAL DEDUCTIBLEThe amount you must pay each year beforethe plan starts paying a portion of medicalexpenses. All family members’ expenses thatcount toward a health plan deductibleaccumulate together in the aggregate;however, each person also has a limit on theirown individual accumulated expenses (theamount varies by plan).OUT-OF-POCKET MAXIMUMThis is the total amount you can pay out ofpocket each calendar year before the planpays 100 percent of covered expenses forthe rest of the calendar year. Most expensesthat meet provider network requirementscount toward the annual out-of-pocketmaximum, including expenses paid to theannual deductible*, copays and coinsurance.*Except for Grandfathered medical plansCOPAYS AND COINSURANCEThese expenses are your share of cost paidfor covered health care services. Copays area fixed dollar amount and are usually due atthe time you receive care. Coinsurance isyour share of the allowed amount chargedfor a service and is generally billed to youafter the health insurance companyreconciles the bill with the provider.5PLAN TYPESPPO – A network of doctors, hospitals, andother healthcare providers. You havecoverage in and out of network.EPO – A network of doctors, hospitals, andother healthcare providers that offers onlyin-network coverage (same network asPPO). There no out-of-network coverageoutside of a true emergency.HDHP – A plan that has higher deductiblesin exchange for lower premiums. HDHPs arecompatible with Health Savings Accounts(HSA).5MEDICAL TERMS
6This chart is intended for summary purposes only. If there are any discrepancies, the official plan documents will always govern. Pre-certification may be required for certain services.MEDICAL & PRESCRIPTION PLAN HIGHLIGHTS Plan Features $500 Buy Up PPO $2,000 Base Plan EPO$4,500 HDHP w/ HSA EPOProvider Network AFA CPOSII $500 80% AFA OAAS $2,000 80% AFA OAAS $4,500 100%HSA Compatible No No YesDeductibles(Individual / Family)You Pay $500 / $1,000You Pay $2,000 / $4,000You Pay $4,500 / $9,000Coinsurance(Member Responsibility)20% after deductible 20% after deductible 0% after deductible Out-of-Pocket Max(Individual / Family)$4,500 / $9,000 $6,000 / $12,000 $7,500 / $15,000Preventive Care No Charge No Charge No ChargeTelehealth / Virtual Visit $0 copay $0 copay $0 copayPrimary Care Visit $25 copay $25 Copay0% after deductible Specialist Visit $75 copay $75 CopayDiagnostic Test (x-ray, blood work)20% after deductible No charge0% after deductibleComplex Imaging (CT/MRI, PET scan)20% after deductible 20% after deductible Outpatient Procedure 20% after deductible 20% after deductible Inpatient Visit 20% after deductible 20% after deductible Emergency Room$300 copay + 20% after ded. $300 copay + 20% after ded $500 copay Urgent Care $75 Copay $75 Copay 0% after deductible Retail Pharmacy(30-day supply)$3 / $10 / $45 / $75 / 20% / 40% copay$3 / $10 / $50 / $80 / 20% / 40%CopayAfter deductible is met:$3 / $15 / $50 / $100 / 20% / 40%CopayMail Order Pharmacy / RX(90 Day Supply)2x retail copay 2x retail copay 2x retail copayOUT-OF-NETWORK $500 Buy Up PPO $2,000 Base Plan EPO$4,500 HDHP w/ HSA EPODeductibles (Individual / Family)$2,000 / $6,000 No Coverage No CoverageCoinsurance(Member Responsibility)50% after deductible No Coverage No CoverageOut-of-Pocket Max(Individual / Family)$12,000 / $36,000 No Coverage No CoverageEmergency Room$300 copay + 20% after ded. $300 copay + 20% after ded $500 copay
7HEALTH SAVINGS ACCOUNT (HSA)How much can I contribute?IRS ANNUAL LIMITSEmployer Annual Contribution2024 Max Contribution (Employer + Employee)2024 Maximum Employee Contribution Single Only$1,200 / year $4,150 $2,950Employee + Spouse$1,200 / year $8,300 $7,100Employee + Child(ren)$1,200 / year $8,300 $7,100Employee + Family*$1,200 / year $8,300 $7,100Catch-Up Contribution Employees Age 55+ may contribute an additional $1,000Who Is Eligible?* All three criteria must be met:• Enrolled in an IRS “qualified” High Deductible Health Plan (HDHP)• Not covered by another medical plan unless the other plans is also a “qualified” HDHP• Not enrolled in Medicare coverage*It is the employee’s responsibility to notify HR if you are not eligible for HSA.How does it work?The $4,500 HDHP EPO allows employees to set aside money on a pre-tax basis into a Health SavingsAccount (HSA). The HSA is an account established exclusively for the purpose of paying for qualified medicalexpenses for you and your eligible dependents on a tax-free basis.Contributions to the HSA are funded with pre-tax deductions withheld from your paycheck. The funds aredeposited into an interest-bearing account in your name. The money in the HSA can be used to reimburseeligible expenses not covered by your insurance plan, including the deductible, coinsurance, and copays.Any money not used for medical reimbursement remains in the account. In the event you leave Stor.ai, youown the account and the money therein. For a complete list of “qualified medical expenses, please refer toPublication 502 at www.irs.gov.* Employer Contribution of $50 to the HSA are funded each pay period. Funds are available as accumulated.Funds can take 2-3 business days to appear in account.
8HEALTH SAVINGS ACCOUNT (HSA)
We are pleased to offer you comprehensive dental plans. You can visit any licensed dentist, but your costs are usually lowest withan in-network dentist. In-network dentists accept reduced fees for covered services; out-of-network dentists may balance bill youthe difference between their usual fee and what the plan pays.Need to locate a participating, in-network provider?To locate a participating provider, visit www.principal.com. Select “Find aDentist” and then “Search for a dentist.”DENTAL PLAN HIGHLIGHTS9Principal Insurance CompanyPlan Features PPO PlanProvider Network Principal Dental PPO NetworkIN-NETWORKCalendar Year Maximum $1,500Annual Deductible (Individual / Family)$50 / $150Preventive Care•Routine Exam (once every 6 months)•Routine Cleanings (once every 6 months)•Bitewing X-ray0% (deductible waived)Basic Procedures•Simple extractions•Fillings•Stainless steel crowns20% after deductible Major Procedures •Periodontics & Endodontics•Inlays & Onlays•Bridges•Dentures50% after deductible OrthodontiaNot CoveredOUT-OF-NETWORKOut-of-NetworkClaim Payment Basis90thPercentile
Need to locate a participating, in-network provider?To locate a participating provider, visit www.eyemed.com. Select “Find a Doctor”and then enter search criteria using the “Choice” network.10Your vision coverage provides a full range of vision care services. You may receive care from any provider you choose, but yourbenefits are greater when you see a participating provider in the network. If you choose to receive services from an out-of-network provider, you will be required to pay that provider at the time of service and submit a claim form for reimbursement.Plan Features In-NetworkOut-of-Network ReimbursementProvider NetworkEyemedVision ExamOnceevery 12 months$10 copay Up to $35Eyeglass FramesOnceevery 24 months$120 plan allowance + 20% discount On balance over $130 Up to $48Eyeglass LensesOnce every 12 monthsSingleBifocalTrifocalLenticular$10 copay$10 copay$10 copay$10 copayUp to $25Up to $40Up to $60Up to $40ContactLenses Onceevery 12 months in lieu of eyeglassesElective: $135 allowanceNecessary: $0 copayUp to $95Up to $200Additional Discounts•Cosmetic Extras average of 20-25% off retail price.•Laser Correction Surgery: Up to 15% off usual and customary charge, or 5% off promotional price. Limitations or waiting periods may apply for some benefits; some services may be excluded from yourplan. These charts are intended for summary purposes only. If there are any discrepancies, the plandocument will always govern.Please refer to your plan documents for additional information.VISION PLAN HIGHLIGHTS
Basic Term Life Insurance (Company Paid)All full-time employees working 30 or more hours per week are automatically enrolled in the basic life benefit. While coverage is automatic, it is critical that you complete a beneficiary form when first enrolling in benefits. You can change your beneficiary at any time and as frequently as needed. During your benefits enrollment, don’t forget to designate a beneficiary11Life insurance helps protect your family from financial risk and sudden loss of income in the event of your death. Accidental deathand dismemberment (AD&D) insurance provides an additional benefit if you lose your life, sight, hearing, speech, or limbs in anaccident.Employer Paid SummaryLife Benefit1X salary with a max of $50,000Accidental Death Benefit1X salary with a max of $50,000Reduction ScheduleBenefit Reduces by: 30% at 65, 55% at age 70+Additional BenefitsConversion, Living Care Benefit, Waiver of PremiumVoluntary Term Life Insurance (Employee Paid)All full-time employees working 30 or more hours per week are eligible to enroll in additional voluntary life insurance aboveand beyond the employer paid benefits. Voluntary term life rates are offered at heavily discounted group rates. So long asyou enroll when first eligible, guaranteed coverage is also available to you, regardless of your current health status.Voluntary Life SummaryPlan Benefits-Employee (increments of $10,000)$10,000 - $300,000-Spouse(increments of $5,000)$5,000 - $100,000-Child(ren) (to age 26)Up to $10,000Guaranteed Issue Coverage (no medical questions required)-Employee Under age 70: $100,000 / Over age 70: $10,000-Spouse Under age 70: $20,000 / Over age 70: $10,000-Child(ren) Up to $10,000 Reduction Schedule Benefit Reduces by: 35% at 65, 50% at age 70+Additional BenefitsConversion, Living Care Benefit, Waiver of Premium, Portability & Annual Increase Option** Annual Increase Option- if you are enrolled in voluntary lifeinsurance, you have the option of increasing up to $10,000 eachyear without having to submit evidence of insurability, up to theguaranteed issue amounts.LIFE INSURANCE
12Why do you need Long-Term Disability? (Company paid)A lengthy disability can be devastating and is more common than you may think. Long-term disability may lead to a loss ofincome, independence, and financial security. A disability insurance policy can help provide security when you need it most. Itpays you cash benefits when you’re sick or hurt and can’t work. As an active, full-time employee of CFI Companies, you areautomatically enrolled for Long-Term Disability at no cost to you.Why do you need Short-Term Disability? (Company paid)How will you pay your bills if you were sick or injured? Even a short illness or injury could seriously impact your paycheck. Whathappens when your sick time runs out? Disability replaces part of your income if you are unable to work due to an accident,illness, or if you are expecting a new addition to your family. Maternity Leave is one of the most common uses for disabilityinsurance. Fortunately, all active, full-time employee of CFI Companies, you are automatically enrolled for Short-Term Disabilityat no cost to you.Plan FeaturesPrincipal Employee Benefit Amount 60% of weekly benefitMaximum Benefit Amount $2,000 per weekElimination Period (Waiting Period)Accident & Sickness7 DaysBenefit Duration 12 WeeksPlan FeaturesPrincipalEmployee Benefit Amount 60% of monthly earningsMaximum Benefit Amount $10,000 per monthElimination Period 90 days Own Occupation Period SSNRABenefit Duration Social Security Normal Retirement Age (SSNRA)Pre-Existing Conditions Clause 3 / 12**A pre-existing condition is one for which you have received medical treatment, consultation, care or services including diagnostic measures, or if you wereprescribed or took prescription medications in the predetermined time frame prior to your effective date of coverage. The pre-existing condition under thisplan is 3/12 which means any condition (including pregnancy) that you receive medical attention for in the 6 months prior to your effective date of coveragethat results in a disability during the first 12 months of coverage, would not be covered.DISABILITY INSURANCE
13LONG – TERM CARE INSURANCE (COMPANY PAID)Who Controls your future?Be prepared with long term care insurance from UNUM.Your life, your choiceThere are plenty of decisions to make for retirement...• Fishing or golf?• Motor home or long-awaited cruise?• A house at the beach or close to thegrandchildren?Long term care insurance may help you avoid a farmore difficult decision: Whether to exhaust yoursavings or liquidate your assets to pay for a period oflong-term care. This policy may help you be preparedfor the financial realities and help you be prepared forthe important decisions, such as:• Who would take care of me?• Where can I choose to receive care?• Would I be a burden on my children if mysavings couldn’t cover my care?What is long term care?Whether it’s due to a motorcycle accident or a seriousillness, it is the type of care you may need if youcouldn’t independently perform the basic activities ofdaily living: bathing, dressing, using the toilet,transferring from one location to another, continenceand eating, or if you suffered severe cognitiveimpairment from a condition such as Alzheimer’sdisease.Who’s at risk?Long term care insurance is not just for the elderly.40% of people currently receiving long term care areworking-age adults 18 to 64 years old.About 70% of individuals over age 65 will require sometype of long-term care services during their lifetime.Fortunately, CFI Companies provides full time active employees whowork a minimum of 30 hours per week with Long-Term Care Insurancefrom UNUM. Your employer funded basic plan 1 includes the followingbenefits:Employer Paid Base Plan:Facility Monthly Benefit Amount: $2,000Facility Benefit Duration: 3 yearsLifetime Maximum: $72,000Long Term Care Facility: 100% of facility Monthly Benefit Amount.Professional Home and Community Care: 50% of Facility MonthlyBenefit Amount.Elimination Period: 90 accumulated days. The elimination period needonly be satisfied once during a period of 730 consecutive dates.You have the option to select alternate options available to you and yourfamily members. Please contact UNUM Customer service for availableoptions at 1-800-227-4165 or with questions regarding your Long-TermCare Insurance.Employee Buy-Up Options: Benefit Duration(3 Years)(6 Years)LifetimeFacility Benefit AmountIn Increments of $1,000$2,000 to $8,000$2,000 to $8,000$2,000 to $8,000Assisted Living Facility Percent100%100%100%Lifetime MaximumPer $1,000 Increments$36,000$72,000Lifetime DurationProfessional Home & Community Care50%50%50%Total Choice Home Care -Option50%50%50%Inflation Protection* OptionCompoundCompoundCompoundADDITIONAL BENEFITS
14Accident Insurance* - Helps offset medical expenses such as emergency room fees,deductibles and co-payment that can result from accidental injury.•Emergency Treatment•Dislocation•Fractures•Lacerations•Hospital Admission•Hospital Confinement•Intensive Care•Medical ImagingHospital Confinement Insurance* - Helps with out-of-pocket medical expenses related tocancer that most medical plans don't cover and has and annual wellness benefit toencourage regular checkups.•Hospital Confinement•Outpatient Surgery•Wellness Benefit•Rehabilitation Unit•Wellness Screening•Initial Diagnosis•Hospital Confinement•Radiation and Chemotherapy•Experiment Treatment•Stem Cell Transplant•Bone Marrow Transplant•Surgery•Heat Attack•Stroke•Major Organs Failure•End Stage Renal (Kidney) Failure•Permanent Paralysis due to Cov. Acc.•Coma•Blindness•Occ. HIV or Occ. Hepatitis B, C or D•Coronary Artery Bypass Graft Surgery•Annual Health ScreeningLearn more about these and all of the personal insurance products and services that Colonial LifeOffers at www.coloniallife.com.*This is a sample of benefits. Many other benefits are included.ACCIDENT INSURANCEHOSPITAL CONFINEMENT INSURANCECANCER INSURANCECancer Insurance* - Helps with the out-of-pocket medical expenses related to cancer that mostmedical plans don’t cover and has an annual wellness benefit to encourage regular checkups.CRITICAL ILLNESS INSURANCECritical Illness Insurance* - Provides a large, lump sum benefit for various serious illnesssuch as heart attack and stroke and has a wellness benefit similar to the cancer plan.SUPPLEMENTAL INSURANCE
15Employee Assistance Program - 100% Company PaidLifeisn’t always easy. Sometimes a personal or professional issue can affect your work, health, and general well-being. During thesetoughtimes, it’s important to have someone to talk with to let you know you’re not alone.Weare pleased to offer an employee assistance program (EAP) for you and your immediate family members. Our EAP isacomprehensiveresource providing access to professional assistance for a wide range of personal and work-related issues.Theservice is provided by Stor.ai, at no cost to you, and is available to you and your immediate family members twenty-four hoursaday,365 days a year, and provides resources to help employees find solutions to everyday issues.Servicesinclude 3 face-to-face counseling or video sessions per household, unlimited phone counseling with master’s-levelconsultantsto help with more serious issues, and online resources. Participation is voluntary and strictly confidential.Sampletopics include:✓Legal and financial matters✓Work and lifestyle✓Child / elder care resources and referrals✓Stress, anxiety, depression✓Substance abuse and addictionTravel Assistance Program - 100% Company PaidTakecomfort in knowing that travel assistance travels with you worldwide, offering access to a network of professionals who canhelpyouwith local medical referrals or provide emergency assistance services in foreign locations. Travel assistance can help youavoidunexpectedbumps in the road anywhere in the world for you, your spouse, and dependent children on any single trip, more than100milesfrom home.You have options! Don’t delay if you need help. To speak to a counselor, or to learn more about your EAP plan, simply:Pre-Trip Assistance ➢ Travel, health advisories, and inoculation requirements for foreign countries➢ Daily Foreign currency exchange rates➢ Consulate and embassy locations Emergency Travel Support➢ 24/7 access to telephonic translation services➢ Assistance with lost, stolen, or delayed baggage while traveling on a common carrier➢ Emergency payment and cashMedical Assistance ➢ Help locating medical providers➢ Transportation home for further treatment – in the event of death, assist in the return of mortal remains➢ Coordination with your health insurance carrier during a medical emergencyADDITIONAL BENEFITS
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