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The benefits plan year runsJuly 1st, 2024, through June30th, 2025. Unless you have aqualified change-in-statusevent that impacts youreligibility and the change isallowed under  the terms ofthe insurance contract or plan document, you cannotmake changes to yourbenefits until the next OpenEnrollment period.Benefit changes must beconsistent with yourqualified change-in-statusevent.Changes must be submitted to HumanResources within 30 daysof the event; documentation supporting 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 91st day 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• Domestic Partners: a significant other with whom you share a household • Child(ren): Your biological, adopted, or legal dependents up to age 26 regardless of student, financial, and marital status; coverage for a dependent child willterminate 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, oremployment status for you, yourspouse, or your dependent childChange in coverage under anotheremployer plan, such as a changemade during your spouse’s Open EnrollmentEmpire  Wireline  takes pride in providing acomprehensive employee benefits program,and we recognize the important roleemployee benefits play as a criticalcomponent of your overall compensation. Westrive to maintain a benefits program that isrewarding and competitive.WHAT’S INSIDE2Employee Resources Employee Contributions FAQ’s Medical Health Savings Account (HSA) Dental Plan Vision Life/AD&D Voluntary Life and AD&D Disability Additional Benefits

EMPLOYEE RESOURCESEMPLOYEE CONTRIBUTIONS PER PAY PERIOD Plan Features Employee Employee + Spouse Employee + Child(ren) FamilyMEDICAL— United Healthcare$4,000 HDHP PPO $0.00 $0.00 $0.00 $0.00$3,000 PPO$0.00 $0.00 $0.00 $0.00$1,500 PPO$30.17 $63.36 $55.82 $87.50DENTAL—Mutual of OmahaDental Plan $0.00 $0.00 $0.00 $0.00VISION—Mutual of Omaha Vision Plan $0.00 $0.00 $0.00 $0.003Based on 26 pay periods per yearCarrier Name Group # Website Phone NumberMedical/RXUnitedHealthcare / All Savers1439628www.myuhc.com(877) 797-88121.Visit www.myallsavers.com (best to register and log-in)2. Select "Find a Doctor"3. Select "Search for doctors and hospitals"4. Select State5. Select 'Choice Plus' network6. Enter search criteriaTelehealthUnitedHealthcare / All Savers1439628 www.myUHC.com/virtualvisits Health Savings Account (HSA)Wex49077 www.wexinc.com (866) 451-3399DentalPrincipal1160209www.principal.com(800) 247-46951.Click “Find a Dentist” under 'Insure' Tab2. Select “Search Providers”3. Click “Find a Dentist”4. Select “PPO Plan Type”5. Enter your zip code or city and stateVisionPrincipal1160209www.vsp.com(800) 877-71951.Click “Find a Vision Provider”2. Select “Search Providers”3. Click “Find a Vision Provider”4. Select “VSP Choice”Short- & Long-Term DisabilityMutual of OmahaG000CC7K www.mutualofomaha.com (800) 877-5156Life / AD&DMutual of OmahaG000CC7K www.mutualofomaha.com (800) 775-8805Employee Assistance Program (EAP)Mutual of OmahaG000CC7K www.mutualofomaha.com/eap (800) 316-2796AXA Travel Assistance ProgramMutual of OmahaG000CC7K www.mutualofomaha.com Within US: (800) 856-9947Outside US: (312) 935-3658Will Preparation ServicesMutual of OmahaG000CC7K www.willprepservices.comCode: MUTUALWILLS

Frequently Asked QuestionsBENEFIT TERMINATION DATEWhen do benefits end if I were no longer eligible forbenefits or when I leave the company?The date coverage ends will depend on the benefitplan. Some may end on your last day of employment,while others may continue through the last day of themonth in which you worked. Refer to your benefitsummary, contact your HR Department, or call theinsurance carrier directly to confirm the date benefitsend for each of your benefit plans.BENEFIT CONTINUATIONMay I continue my benefits if I lose coverage due to theabove-mentioned reasons?Yes, you may be eligible to continue your medical,dental and vision plans through COBRA if covered underthese plans. Please refer to the Cobra section of the compliance toolkit.You may be eligible for Conversion/Portability for your life, insurance if you request within 31 days from youremployment termination or change to part-time status.Please refer to the respective benefit plansummaries or Summary Plan Description for additionalinformation.ACTIVELY-AT-WORK CLAUSEDo any of the benefit plans summarized in this guideinclude what is referred to an “Actively-at-Work” clause?Yes. Some plans will require that you be actively at workon the day benefits are scheduled to take effect. If youare not actively at work on mentioned date, coveragewill be delayed, and benefits will not take effect until thedate you are actively at work; this stipulation may alsoapply to your covered dependents.BENEFIT PREMIUM PAYMENTSHow do I find out how much my share of the benefitpremium cost is for the benefits I elect to enroll in?Please refer to page 3 of this guide or carrier summaries for the cost per pay period information. How will I pay for the voluntary benefits I elect to enrollin?Once your benefits take effect, premiums associatedwith each voluntary benefit plan option you enroll in willbe deducted from your paychecks.COMPREHENSIVE PLAN DETAILSDoes this benefit guide include all plan coverage details,exclusions, restrictions, limitations, and/or otherstipulations that apply to the benefits described in thisguide?No. This guide is intended to provide benefit coverageinformation in a summarized fashion and so does notInclude all plan coverage information.For detailed coverage information, please refer to therespective benefit plan’s Summary Plan Description.NETWORKS & YOUR OUT-OF-POCKET COSTSHow do I make sure I get the best coverage?Many of your benefit plan options have provider networks. When you use doctors, other health care providers, hospitals, and facilities that are in your plan’s network you will receive the best coverage your benefit plans have to offer. Making sure that you use in-networkproviders will ensure you get the best coverage as out-of-network coverage does not provide discounts, doesnot protect you from balance billing, and may imposehigher deductibles, co-insurance, and out - of - pocketmaximums.If you receive services from out-of-network providers yourout-of-pocket costs are usually considerably higher. Thisis partly the case because you lose valuable networkdiscounts and, in addition to you not receiving adiscount, you may also be balance billed*.*Balance billing occurs when an out-of-network providerbills a patient for the difference between what theybilled for services rendered and what the insurancecompany has established as the maximum allowablecharge for the service(s) rendered by out-of-networkproviders; depending on the type of service(s) renderedyou may be balanced billed hundreds or thousands ofdollars more than what you would have been billed hadyou used an in-network provider. Why pay more? Selectfrom in-network providers and enjoy the best coverageyour plans have to offer.How do I locate in-network providers?Call the specific insurance carrier’s customer servicenumber or visit their website to locate in-networkproviders. Refer to the “Employee Resources” pagesection of this guide for instructions on how to locate In-network providers for each of the benefit plans youare enrolled in.44

Summary of CoverageMedical Coverage5IN-NETWORK$4,000 HDHP PPO (HP40002575i8021)$3,000 PPO (P3000i80LX22)$1,500 PPO(P1500i80LXES21)Provider Network Choice Plus Choice Plus Choice PlusHSA Compatible? YES NO NODeductible(Individual / Family)$4,000 / $8,000 $3,000 / $6,000 $1,500 / $3,000Coinsurance(Member Responsibility)20% after deductible 20% after deductible 20% after deductibleOut-of-Pocket Maximum(Individual / Family)$7,000 / $14,000 (Includes Deductible,Coinsurance, & Copays)$6,500 / $13,000(Includes Deductible,Coinsurance, & Copays)$5,000 / $10,000(Includes Deductible,Coinsurance, & Copays)Preventive Care No Charge No Charge No ChargePrimary Care Visit $25 copay after deductible$25 copay($0 copay for children <19)$25 copay($0 copay for children <19)Telehealth*Designated virtual network provider$0 copay* after deductible $0 copay* $0 copay*Specialist Visit $75 copay after deductible $75 copay $75 copayDiagnostic Lab & X-Ray 20% after deductible 20% after deductible 20% after deductibleComplex Imaging 20% after deductible 20% after deductible 20% after deductibleEmergency Room$300 copay + $300 copay + $300 copay +20% after deductible 20% after deductible 20% after deductibleUrgent Care $50 copay after deductible $50 copay $50 copayRetail Pharmacy (30-Day Supply)Generic/Preferred/Non-Preferred/SpecialtyMedical Deductible Applies First $10 / $35 / $70 / $150Specialty Rx: $10 / $150 / $350 / $500$10 / $35 / $75 / $250 Specialty Rx: $10 / $150 / $350 / $500$10 / $35 / $75 / $250Specialty Rx: $10 / $150 / $75 / $500Mail Order Pharmacy (90-Day Supply)Generic/Preferred/Non-Preferred/Specialty*Medical Deductible Applies First $25 / $87.50 / $175 / $375*Specialty RX excluded$25 / $87.50 / $187.50 / $625 $25 / $87.50 / $187.50 / $625OUT-OF-NETWORK $4,000 HDHP PPO $3,000 PPO $1,500 PPODeductible(Individual / Family)$8,000 / $16,000 $6,000 / $12,000 $3,000 / $6,000Coinsurance(Member Responsibility)50% after deductible 50% after deductible 50% after deductibleOut-of-Pocket Maximum(Individual / Family)$14,000 / $28,000 $12,000 / $24,000 $10,000 / $20,000Emergency Room(must be true emergency)$300 copay + 20% after deductible$300 copay + 20% after deductible$300 copay + 20% after deductible

Health Savings Account (HSA) 6Who Is Eligible?* All three criteria must be met:• Enrolled in an IRS “qualified” High Deductible Health Plan (our $4,000 HDHP plan)• Not covered by another medical plan unless the other plan 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 HDHP allows employees to set aside money on a pre-tax basis into a Health Savings Account (HSA). The HSA is an account established exclusively for the purpose of paying for qualified medical expenses 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 are deposited into an interest-bearing account in your name. The money in the HSA can be used to reimburse eligible expenses not covered by your insurance plan, including the deductible, coinsurance, and copays. Any money not used for medical reimbursement remains in your account. In the event you leave the company, you still own the account and the money therein. For a complete list of “qualified medical expenses, please refer to Publication 502 at www.irs.gov. How much can I contribute?**You are responsible for tracking your contributions to ensure you do not exceed the maximum allowable contribution. IRS Annual Limits**2024 Maximum Contribution(Employer + Employee)Annual Employer ContributionHow much YOU can contribute in 2024Single Only $4,150 $600 $3,550Employee + Spouse $8,300 $1,200 $7,100Employee + Child $8,300 $1,200 $7,100Employee + Family $8,300 $1,500 $6,500Catch-Up Contribution Employees Age 55+ may contribute an additional $1,000

Virtual Visits7

Dental Coverage(100% Company Paid) 8Plan Features Principal Financial GroupProvider Network Principal PPOIN-NETWORKCalendar Year Maximum$1,500 Annual Deductible (Individual / Family) $50 / $150Preventive CareCovered 100% (deductible waived)•Routine Exams•Routine cleanings •Bitewing X-rays •Sealants (Children under 14)Basic ProceduresCovered at 80% after deductible•Emergency Exams•Fillings•General Anesthesia•Oral SurgeryMajor ProceduresCovered at 50% after deductible•Dentures •Single Crowns•Surgical Extractions•BridgesOrthodontia (Dependent Children under the age of 19)Covered 50% (deductible waived)Orthodontia Lifetime Maximum$1,500 Rollover Benefit*•Threshold$750 •Rollover Amount$375 •Rollover Account Limit$1,500 OUT-OF-NETWORKOut-of-Network Claim Payment Basis 90th Percentile UCR

Vision Coverage(100% Company Paid) 9Plan FeaturesPrincipal Financial GroupIn-NetworkOut-of-Network ReimbursementProvider NetworkVSP Choice PPOVision Exam$10 copay Up to $45Prescription Lenses*Single$25 copay Up to $30Lined Bifocal$25 copay Up to $50Lined Trifocal$25 copay Up to $65Lenticular$25 copay Up to $100Frames$130 allowance + 20% discount on balance over allowanceUp to $70Elective Contact Lenses*$130 allowance Up to $105Medically Necessary Contact Lenses$25 copay Up to $210Laser Correction Surgery DiscountUp to 15% off the usual charge or 5% off the promotional pricingN/AAdditional pairs of frames and lenses20% off retail price** N/AFrequency (from date of last service)ExamEvery 12 MonthsLensesEvery 12 MonthsContactsEvery 12 MonthsFramesEvery 12 Months*Benefit includes coverage for contacts or glasses, not both.**For the discount to apply, your purchase must be made within 12 months of the eye exam.

Group Term-Life and AD&D(100% Company Paid) 10Who Is Eligible:All Active, full-time, regular employeesBenefits You Receive:Empire Wireline provides every eligible employee with group term life and AD&D insurance of $50,000 at no cost to you. Coverage is automatic and does not require an election, though your beneficiary designation is required.Summary of CoverageAccelerated Death Benefit – 80% of the amount of the life insurance benefit is available to you if terminally ill, not to exceed $40,000. Conversion – If your employment ends, you may apply for an individual life insurance policy from Mutual of Omaha without having to provide evidence of insurability (information about your health). You will be responsible for the premium for the coverage.Waiver of Premium– If it is determined that you are totally disabled, your life insurance benefit will continue without payment of premium, subject to certain conditions. Designating a Beneficiary:You must name a person(s) or entity to receive benefits in the event of your death. The beneficiarydesignation applies to your group term life and AD&D and voluntary life AD&D insurance. Contact Gray Richard to update your beneficiary information. You can update your life insurance beneficiary at any timethroughout the year and as many times as needed.Group Term Life and AD&D (Employer Paid)Plan Features Employer Paid Term Life and AD&DEmployee Life $50,000 Employee AD&D $50,000 Included BenefitsAccelerated Death Benefit, Conversion, and Waiver of PremiumThe following benefit reduction schedule shows how much benefits are reduced at certain ages:Age Benefit reduces by:65 35%70 Additional 15%

Voluntary Life and AD&D(100% Employee Paid) 11Benefits You Receive:Empire Wireline provides every eligible employee the opportunity to purchase term life and AD&D insurance at group discounted rates. You may also purchase coverage for your dependent spouse and child(ren). Any amounts in excess of the guaranteed issue limits will require a health questionnaire. Summary of CoverageDesignating a Beneficiary:You must name a person(s) or entity to receive benefits in the event of your death. Thebeneficiary designation applies to your group term life and AD&D and voluntary life AD&Dinsurance. Contact Gray Richard to update your beneficiary information. You can update your lifeinsurance beneficiary at any time throughout the year and as many times asneeded.Annual Benefit Amount Increase – If you enroll for even the minimum amount of coverage during your initial enrollment, you can enroll for additional coverage at your next enrollment by up to $10,000 provided the total amount of insurance does not exceed your maximum benefit amount. Amounts over the Guarantee Issue amount will require evidence of insurability. Accelerated Death Benefit – 80% of the amount of the life insurance benefit is available to you if terminally ill, not to exceed $300,000. Conversion – If your employment ends, you may apply for an individual life insurance policy from Mutual of Omaha without having to provide evidence of insurability. You will be responsible for the premiums. Portability – Allows you to continue this insurance should you leave your employer for any reason, without having to provide evidence of insurability. You will be responsible for the premiums. Waiver of Premium – If it is determined that you are totally disabled, your life insurance benefit will continue without payment of premium, subject to certain conditions. Coverage Provided ForVoluntary Term Life and AD&D (Employee Paid) Guaranteed Issue*(new hires under age 70 only)Minimum Maximum IncrementsEmployee $10,000 5x annual salary up to $500,000$10,000 5x annual salary up to $150,000Spouse (terminates at age 70)$5,000 100% of employee’s benefit up to $150,000 $5,000 100% of employee's benefit up to $50,000Child(ren) (14 days to 26 years)$10,000 100% of employee’s benefit up to $10,000$10,000 100% of employee's benefit up to $10,000Included BenefitsAnnual Benefit Increase Option, Accelerated Death Benefit, Conversion, Portability, Waiver of PremiumThe following benefit reduction schedule shows how much benefits are reduced at certain ages:Age Benefit Reduces by:65 35%75 50%Who Is Eligible:All Active, full-time, regularemployees

Disability Insurance(100% Company Paid) 12Why do you need Disability Insurance? How will you pay your bills if you were sick or injured temporarily? Even a short illness or injury could seriously impact your paycheck. What happens 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 causes of short-term claims. Fortunately, all full-time employees who work a minimum of 30 hours per week are automatically enrolled in Short-Term & Long-Term Disability benefits and Empire Wireline pays 100% of the costs.Plan Features Short-Term Disability Employee Benefit Amount 60% of before-tax weekly earnings Maximum Benefit Amount $2,300 per WeekElimination Period (Waiting Period) 7 DaysBenefit Duration 12 WeeksPre-Existing Condition Exclusion None*Your plan is subject to a pre-existing condition limitation. A pre-existing condition is one for which you have received medical treatment, consultation, care or services including diagnostic measures, or if you were prescribed or took prescription medications in the predetermined time frame prior to your effective date of coverage. The pre-existing condition under this plan is 3/12 which means any condition that you receive medical attention for in the 3 months prior to your effective date of coverage that results in a disability during the first 12 months of coverage, would not be covered.Plan Features Long-Term Disability Employee Benefit Amount 60% of before-tax monthly earnings Maximum Benefit Amount $10,000 per monthOwn Occupation Period 2 YearsElimination Period (Waiting Period) 90 DaysBenefit Duration Social Security Normal Retirement AgePre-Existing Condition Exclusion* 3 / 12Why do you need Long-Term Disability? A lengthy disability can be devastating and is more common than you may think. Long-term disability may lead to a loss of income, independence, and financial security. A disability insurance policy can help provide security when you need it most. It pays you cash benefits when you’re sick or hurt and can’t work.

Additional Benefits(100% Company Paid) 13→ Pre-trip assistance→ Emergency travel support services→ Telephonic translation / interpreter services→ Document Replacement→ Medical assistance→ Identity theft → Prescription replacement assistance→ Emergency medical evacuation✓ Counseling Options✓ National network of more than 10,000 licensed clinical providers✓ Legal and financial matters✓ Work and lifestyle✓ Employee Family Legal Services✓ Child / Elder care resources / referrals✓ Stress, anxiety, depression✓ Substance abuse and addiction✓ Online support and moreEmployee Assistance ProgramTravel Assistance ProgramLife isn't always easy. Sometimes a personal or professional issue can affect your work, health and general well-being. During these tough times, it's important to have someone to talk with to let you know you're not alone. With Mutual of Omaha's Employee Assistance Program, you can get the help you need so you spend less time worrying about the challenges in your life and can get back to being the productive worker your employer counts on to get the job done.Our EAP is a comprehensive resource providing access to professional assistance for a wide range of personal and work-related issues. The service is available to you and your immediate family members twenty-four hours a day, 365 days a year, and provides resources to help employees find solutions to everyday issues. Services include unlimited phone counseling with master’s-level consultants to help with more serious issues, online resources and up to 3 face-to-face sessions with a counselor per household per year. Participation is voluntary and strictly confidential. Sample topics include:Take comfort in knowing that Travel Assistance travels with you worldwide, offering access to a network of professionals who can help you with local medical referrals or provide other emergency assistance services in foreign locations. Travel Assistance can help you avoid unexpected bumps in the road anywhere in the world for you, your spouse, and dependent children on any single trip, up to 120 days in length, more than 100 miles from home. Sample topics include:Will PreparationCreating a will is an important investment in your future. It specifies how you want your possessions to be distributed after you pass away. Whether you’re single, married, have children, or you’re a grandparent, your will should be tailored for your life situation. That’s why it’s good that you have access to FREE online will preparation services provided by Epoq, Inc.Epoq provides the following FREE documents: ➢ Last Will and Testament➢ Power of Attorney➢ Healthcare Directive➢ Living Trust Here’s how it works: 1. Log onto www.willprepservices.com and use code MUTUALWILLS to register2. Answer simple questions and customize your document in real time3. Download, print, and share your documents instantly 4. Don’t forget to update your documents with any major life changes, including marriage, divorce, and birth of a child5. Make the document legally binding – check with your state for requirements