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Medical | UHC $3,500 80% PPO PlanEmbedded Deductible In-Network$1,500 80% PPO PlanEmbedded Deductible In-Network$1,000 100% PPO PlanEmbedded Deductible In-NetworkCoinsurance (Member pays)20% 20% 0%Calendar Year Deductible- Individual- Family$3,500$7,000$1,500$3,000$1,000$2,000Out-of-Pocket Maximum(Deductible included)- Individual- Family$7,900$15,800$4,000$8,000$3,500$7,000Office Visit- Primary- Specialist$25 Copay$75 Copay$25 Copay$75 Copay$25 Copay$75 CopayPreventive Visits 100% Covered 100% Covered 100% CoveredInpatient Services 20% after Deductible 20% after Deductible DeductibleOutpatient Services 20% after Deductible 20% after Deductible DeductibleEmergency Room Services(Waived if Admitted)$300 Copay, then 20% after Deductible$300 Copay, then 20% after Deductible$300 Copay, then DeductibleUrgent Care $50 Copay $50 Copay $50 CopayPrescription Coverage(30 Day Supply)$3,500 80% PPO Plan $1,500 80% PPO Plan $1,000 100% PPO PlanTier 1Tier 2Tier 3Tier 4$15 Copay$50 Copay$150 Copay$300 Copay$15 Copay$50 Copay$150 Copay$300 Copay$15 Copay$50 Copay$150 Copay$300 CopayMail Order(90 Day Supply)$3,500 80% PPO Plan $1,500 80% PPO Plan $1,000 100% PPO PlanTier 1Tier 2Tier 3Tier 4$37.50 Copay$125 Copay$375 Copay$750 Copay$37.50 Copay$125 Copay$375 Copay$750 Copay$37.50 Copay$125 Copay$375 Copay$750 CopayEmployee Contributions(Semi-Monthly)$3,500 80% PPO Plan $1,500 80% PPO Plan $1,000 100% PPO PlanEmployeeEmployee + SpouseEmployee + Child(ren)Family $44.34$155.64$141.45$219.48$94.94$192.05$174.39$271.50$108.91$221.39$200.94$313.42This summary reflects in-network benefits only. Refer to your plan documents for out-of-network coverage. Benefits at a Glance2024 - 2025Pen-Tech Associates Inc.Worksite Benefits* | Atlantic AmericanCritical Illness Insurance* provides a cash benefit if you are affected by a covered illness. Accident Insurance* provides members a cash benefit if they are injured by an off-the-job accident.Hospital Indemnity Insurance complements your present medical coverage by providing cash benefits to help pay out-of-pocket expenses associated with hospital confinement.

Medical | UHCMember Services: 1.866.633.2446www.myuhc.com Dental, Vision, Life, & Disability | Mutual of OmahaMember Services: 1.800.775.6000www.mutualofomaha.com Worksite Benefits | Atlantic American Member Services: 1.866.458.7502groupcustomercare@atlam.comIdentity Theft Protection | ExperianMember Services: 1.888.397.3742www.experian.comThis document is intended as a convenient summary of the major points of benefit plans. This document does not cover all provisions, limitations and exclusions. The official plan documents, policies and certificates of insurance govern in all cases and are available for your inspection at any time.Dental | Mutual of Omaha In / Out-of-NetworkAnnual Deductible- Individual- Family$50$150Preventive Services 100%Basic Services 80%Major Services 50%Orthodontic Services (to age 19) N/AOrthodontia Lifetime Maximum N/AAnnual Plan Maximum $2,000Employee Contributions(Semi-Monthly)EmployeeEmployee + SpouseEmployee + Child(ren)Family $21.11$43.57$44.84$71.69Vision | Mutual of OmahaIn-NetworkOut-of-Network ReimbursementExams $10 Copay Up to $37Frames$150 Allowance + 20% off Remaining BalanceUp to $66Lenses- Single Vision- Bifocal- Trifocal$10 Copay$10 Copay$10 CopayUp to $32Up to $48Up to $76Contact Lenses- Elective- Medically Necessary $150 Allowance 100% CoveredUp to $102Up to $210FrequencyExam/Lenses/Contacts/Frames 12/12/12/24Employee Contributions(Semi-Monthly)EmployeeEmployee + SpouseEmployee + Child(ren)Family $3.24$6.48$5.98$9.39Basic Life and AD&D | Mutual of OmahaLife and AD&D Benefit: $25,000Benefit reduces by 35% at age 65, 60% at age 70, 75% at age 75 and 85% at age 80.100% Employer PaidLong Term Disability | Mutual of OmahaMonthly Benefit Percentage 60%Maximum Monthly Benefit $7,500Elimination Period 90 Days Accident/IllnessDuration SSRNA100% Employer PaidOneDigital Client AdvocateKelly WardDirect 1.404.846.3579kelly.ward@onedigital.com Contact InformationShort Term Disability | Mutual of OmahaMonthly Benefit Percentage 60%Maximum Weekly Benefit $1,400Elimination Period 7 Days Accident/IllnessDuration 12 Weeks100% Employer PaidIdentity Theft Protection | ExperianMillions of Americans have their identity stolen each year, and the process to resolve and repair your identity can be very tedious. Protect yourself against an identity theft and access robust restorative services in the case of an attack through Experian.100% Employer Paid*If your spouse is also a benefits-eligible employee at Pen-Tech Associates, you may not be eligible to purchase spousal coverage for voluntary life, critical illness and accident benefits. If both spouses are employed at Pen-Tech Associates, only one spouse can elect voluntary life, critical illness and accident coverage for their child(ren). Please refer to the plan documents for more details.Voluntary Life and AD&D* | Mutual of OmahaEmployee BenefitGuaranteed IssueIncrements of $10,000, 5X Annual salary, Up to $100,0005x Annual salary up to $100,000Spouse BenefitGuaranteed IssueIncrements of $5,000, 100% of Employee coverage, Up to $25,000100% of Employee coverage, Up to $25,000Child(ren) BenefitGuaranteed IssueIncrements of $1,000, Up to $10,000$10,000Benefit reduces by 65% at age 65, and 50% at age 70.