2024 Employee Benefits Guide
HOW TO ENROLL You will be able to complete your enrollment by following the steps listed below ENROLLMENT OPTIONS 01 You can enroll independently through our online Enrollment Platform Login instructions are included on the next page 02 You can click the link that was emailed text to you and schedule a time to have a benefits counselor call you at your chosen time review your options and enroll you over the phone
_R__e__d_o__n__d_o___M__a__n_u__f_a_c__t_u_r_i_n_g___ EMPLOYEE BENEFITS HOW TO LOGIN TO BERNIE PORTAL ACCOUNT Below are the instructions for how to login both with and without an email address How to login with email Go to https www bernieportal com en login Employee default logins Username email address Password Select the forgot password option if you do not remember or have not set one up before OR How to login without email https www bernieportal com en emplovercode login Employee code logins 2 digit code 2 digit birth month Example March 03 4 digit code last 4 of social Employer code ____1_2_e_d3_3____
_R_e_d_o_n_d_o_M__a_n_u_fa_c_t_u_ri_n_g_______________________ __ Redondo Manufacturing thrives on balance balancing professional and personal worlds balancing work and rest while always balancing cost and value We also understand that balance must be individualized What is right for one person may not be appropriate for another It is our goal to offer choices allowing you to tailor your benefits plan specifically to what is best for you and your family members Your Choices _R_e_dondo Manufacturing Provides a complete package of benefits aimed at providing flexible insurance protection and programs to meet your ever changing needs _R_e_dondo Manufacturing shares the cost of some benefits with you while making additional benefits available that you pay for if you choose to enroll The part of the benefit costs that you are responsible for will be automatically deducted from your paycheck either before or after your taxes are calculated Benefit Health Insurance Dental Insurance Vision Insurance Pre Tax or Post Tax Pre Tax Pre Tax Pre Tax Short Term Disability Post Tax Critical Illness Post tax Accident Post Tax Voluntary Life Post Tax Who pays the cost Employer Shared Employee Paid Employee Paid Employee Paid Employee Paid Employee Paid Employee Paid Why do I pay for some benefits with before tax money While not all benefits qualify for pre tax contribution there is a definite advantage to paying for those that do Taking the money out before your taxes are calculated lowers the amount of your taxable income Therefore you pay less in taxes How Your Benefits Work Full time employees are eligible for most benefits on __th_e__fi_rs_t_d_a_y__o_f _th_e__m_o_n_t_h_f_o_ll_o_w_in_g__6_0_d_a_y_s__ of hire Making Changes Generally you can only change your benefits choices during the annual Benefits Enrollment Period However you can change your benefits choices during the year if you have a life event change Life event changes include but are not limited to Marriage Divorce Birth adoption or placement for adoption of an eligible child Death of your spouse or covered child Change in you or your spouse s work status that results in cancellation of your benefits Becoming eligible for Medicare or Medicaid during the year If you have a life event change you must notify Human Resources within 31 days of the change for example a marriage or birth certificate If you do not notify Human Resources within 31 days you will have to wait until the next annual Open Enrollment period to make benefits changes unless you have another life event change Any changes you make to your benefit choices must be directly related to the life event change
Portability If you leave the company some of your benefits end and some of your benefits are portable This means you can take them with you if you leave as long as you continue to pay the premiums yourself Once terminated you will be notified through the mail if any of your benefits are portable When Coverage Ends Benefits end on the last day of the month following termination or when you cease to meet eligibility guidelines Continuing Your Coverage Under certain circumstances you may continue your health care coverage when it would otherwise end This is called ______C_o_b_ra_______ Cobra applies to these plans Health Insurance Dental Insurance Vision Insurance When can I continue coverage under _________C_ob_ra_________ You and or your dependents are eligible to continue health care coverage under __________C_o_b_r_a__________ If coverage is lost because Your employment ends for any reason other than gross misconduct Your work hours are significantly reduced You die You become entitled to and enroll in Medicare prior to losing coverage You divorce or become legally separated from your spouse Your dependent loses dependent status NOTES _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ _____________________ Looking ahead Now let s look at each benefit that makes up the Redondo Manufacturing benefits program In the following pages you ll learn more about the valuable benefits your employer offers You ll also see how choosing the right combination of benefits can help protect you and your family s health
Carrier Plan Name Network Coverage Deductible Family Deductible Coinsurance Out Of Pocket Office Visit Specialty Doctor Office Visit Inpatient Hospital Services Diagnostic Lab X Ray Advanced Imagining Urgent Care Emergency Room RX Employee Only Employee Spouse Employee Child ren Employee Family Base Mid M MTBAB014H T B Blue Advantage HMO H S A l I In n 5 000 10 000 100 5 000 10 000 7 100 After Ded 4 100 After Ded 9 8 100 After Ded 0 8 100 After Ded 0 8 100 After Ded 0 100 After Ded 7 100 After Ded 5 00 100 After Ded 1 Weekly 37 21 80 85 64 85 108 49 M Semi Monthly o 80 63 175 18 140 51 235 06 MTBEE040 Blue Essentials HMO In 5 000 15 000 80 7 900 15 800 40 Copay 80 Copay 80 After Ded 80 After Ded 80 After Ded 75 Copay 500 Copay 80 after Ded 0 10 50 100 150 250 Weekly 57 33 124 56 99 90 167 13 Semi Monthly 124 23 269 89 216 46 362 13
Buy Up Carrier Plan Name Network Coverage Deductible Family Deductible Coinsurance Out Of Pocket Office Visit Specialty Doctor Office Visit Inpatient Hospital Services Diagnostic Lab X Ray Advanced Imagining Urgent Care Emergency Room RX MTBCB035 PPO In Out 4 000 10 000 12 000 20 000 80 50 8 150 16 300 Unlimited 35 Copay 50 After Ded 70 Copay 50 After Ded 80 After Ded 50 After Ded 80 After Ded 50 After Ded 80 After Ded 50 After Ded 75 Copay 500 Copay 80 after Ded 50 After Ded 50 After Ded 0 10 50 100 150 250 Copay 50 Monthly Rates Employee Only Employee Spouse Employee Child ren Employee Family Weekly 64 53 140 21 112 45 188 14 Semi Monthly 139 83 303 79 242 15 407 63
REDONDO MANUFACTURING D WDO UD F FD OS R SD IRU G WDO DP FO D L D G RW U UYLF How does it work RRG G WDO FDU L FULWLFDO WR R U RY UDOO OO E L LW 8 P WDO L UD F R FD W W DWW WLR R U W W G DW D FR W R FD DIIRUG 8 P WDO DOOR R WR D G WL W R F RR 7R W W PR W IURP R U E ILW D G U G F R W RI SRFN W FR W F RR D L W RUN SURYLG U E WLOL L R U ODU DWLR DO W RUN 7 SURYLG U DY D U G WR ILO R U FODLP D G S ROG W L W T DOLW WD GDUG R FD IL G L W RUN SURYLG U DW PG WDOFDU FRP Why is this coverage so valuable 5R WL G WDO FDU N S R U PR W D G RO ERG DOW R U SOD L EDFN G E 8 P FRPPLWP W WR F OO F L F WRP U UYLF 3 U R DOL G E LW D G PRELO DSS WR PD D R U E ILW L FO GL FODLP L IRUPDWLR FDUG D G PRU 7 U R DLWL S ULRG IRU SU Y WLY D G ED LF UYLF What else is included HOO HVV EH HILWV 2UDO FD F U FU L L UL N IDFWRU IRU SDWL W D G ROG U LW P H WDO DUH RP 8 PG WDOFDU FRP D G W PRELO DSS DUF IRU SURYLG U PD D R U E ILW D G O DU DER W RRG G WDO DOW DW U L FO G D DFF WR DUG FODLP L WRU D G FRY UD L IRUPDWLR DUU R HU EH HILWV 0 PE U R WDN FDU RI W LU W W E W R O SDUW RI W LU D DO PD LP P E ILW G UL D E ILW S ULRG DU U DUG G LW WUD E ILW L I W U DU DUU RY U E ILW LOO E DFFU G D G WRU G L W L U G FDUU RY U DFFR W WR E G L W W E ILW DU The limits for this policy certificate are Passive PPO Carryover benefit Threshold limit Carryover account limit 1 25 03 2 6 Unum D UD 11
Coverage details and costs HU LH Benefit Year Maximum Deductible OD RL V UD H Class A Preventive DVVL H S U E ILW DU 0D LP P S U IDPLO HW RUN R HW RUN Class B Basic Class C Major SSOLHV WR ODVV D G 6HUYLFHV LI DSSOLFDEOH DLYHG IRU ODVV DSSOLHV WR ODVV D G 6HUYLFHV H WDO R HUDJH You You and your spouse You and your children Family 5DWHV J DUD WHHG IRU PR W V IURP W H HIIHFWLYH GDWH DVVL H Monthly cost 90 Dental carryover bene t and how it works D EH HILW HDU D PHPEHU P VW D H 2 FO D L 2 U ODU DP D G 7RWDO G WDO FODLP IRU SU Y WLY ED LF D G PDMRU FRY U G SURF G U SDLG G UL W DU E OR W W U ROG OLPLW I DOO W U FULW ULD DERY DU P W D SRUWLR RI W D DO PD LP P LOO FDUU RY U WR W W DU W HU SH LIL DWLR V DF FRY U G IDPLO P PE U U F LY W LU R FDUU RY U E ILW UR S FDUU RY U E ILW ULG U P W E L II FW IRU R E ILW DU E IRU D P PE U FD WLOL FDUU RY U E ILW P PE U P W E R W SOD IRU D PL LP P RI W U PR W E IRU DFFU L FDUU RY U E ILW DUU RY U E ILW PD E G WR DUG SU Y WLY ED LF D G PDMRU FRY U G UYLF R O P PE U FDUU RY U DFFR W LOO E OLPL DW G D G W DFFU G FDUU RY U E ILW OR W LI W L U G D D EU DN L FRY UD IRU D O W RI WLP RU D U D R HSH H W LO UH S G W D LG OL YDU E WDW 3O D U I U WR R U SROLF F UWLILFDW RU FR WDFW F WRP U UYLF DW 888 400 9304 HU L HV RW OLVWH I R S FW WR U T LU D G WDO UYLF RW L FO G G R W L EURF U LW PD WLOO E FRY U G 3O D FR WDFW F WRP U UYLF DW 888 400 9304 WR FR ILUP R U DFW E ILW OWHU DWH WUHDWPH W 8 P FRY U W O D W S LY PR W FRPPR O G D G DFF SW G P ULFD WDO RFLDWLR WU DWP W 3OD P PE U PD O FW D PRU S LY WU DWP W E W LOO E U SR LEO IRU W FR W GLII U F U OWL IURP W PRU S LY SURF G U 1 25 03 2 6 Unum D UD 12
R HUH UR H UHV DLWL J HULR V DVVL H Waiting Period None 5R WL DP S U PR W 3URS OD L S U PR W LW L UD PD LP P RI ILOP S U PR W O RULG WU DWP W IRU F LOGU S WR D S U PR W 6 DOD W IRU F LOGU S WR D S UPD W PRODU S U PR W 6SDF 0DL WDL U IRU F LOGU S WR D S U PR W Waiting Period None P U F 7U DWP W S U PR W OO PR W SD RUDPLF UD S U PR W 6LPSO U WRUDWLY UYLF ILOOL ILW DOOR U WRUDWLR R SR W ULRU W W 6LPSO WUDFWLR G IRU DPDO DP Waiting Period 12 months 2UDO 6 U U WUDFWLR D G LPSDFW G W W W LD EM FW WR U YL FRY U G LW FRPSO RUDO U U 5 SDLU RI FUR G W U RU EULG OD D G R OD 1R 6 U LFDO S ULRGR WLF 6 U LFDO S ULRGR WLF P WU DWP W GRGR WLF URRW FD DO UR EULG G W U D G GR W DO LPSOD W L OL RI D RU LW EULG 5HIHU WR R U FHUWLILFDWH RI FRYHUDJH IRU W H VHUYLFHV FRYHUHG GHU R U SOD 1 25 03 2 6 Unum D UD 13
unum com L LL L 8 P PHPEHUV RVH GH WDO SOD L FO GHV FRYHUDJH RI FUR V D G EULGJHV LOO DYH W H RSWLR RI F RRVL J D H GRVWHDO LPSOD W WR UHSODFH D PLVVL J WRRW L VWHDG RI D FR YH WLR DO IL HG LW EULGJH H D LW EULGJH LV DSSURYHG IRU FRYHUDJH UR V SODFHG R LPSOD WV LOO DOVR EH FRYHUHG 2W HU LPSOD WV RU LPSOD W UHODWHG VHUYLFHV DUH RW FRYHUHG 7 H IROOR L J GH WDO VHUYLFHV DUH RW FRYHUHG OHVV VWDWHG RW HU LVH L W H HUWLILFDWH RI RYHUDJH D WUHDWPH W LF LV HOHFWLYH RU SULPDULO FRVPHWLF L DW UH D G RW JH HUDOO UHFRJ L HG DV D JH HUDOO DFFHSWHG GH WDO SUDFWLFH E W H PHULFD H WDO VVRFLDWLR DV HOO DV D UHSODFHPH W RI SULRU HOHFWLYH RU FRVPHWLF UHVWRUDWLR V W H FRUUHFWLR RI FR JH LWDO PDOIRUPDWLR V UHSODFHPH W RI D UHPRYDEOH GHYLFH RU DSSOLD FH W DW LV ORVW PLVVL J RU VWROH D G IRU W H UHSODFHPH W RI UHPRYDEOH DSSOLD FHV W DW DYH EHH GDPDJHG G H WR DE VH PLV VH RU HJOHFW 7 LV PD L FO GH E W RW EH OLPLWHG WR UHPRYDEOH SDUWLDO GH W UHV RU GH W UHV UHSODFHPH W RI D SHUPD H W RU UHPRYHDEOH GHYLFH RU DSSOLD FH OHVV W H GHYLFH RU DSSOLD FH LV R OR JHU I FWLR DO D G LV ROGHU W D W H OLPLWDWLR L W H 6F HG OH RI RYHUHG 3URFHG UHV 7 LV PD L FO GH E W RW EH OLPLWHG WR EULGJHV GH W UHV D G FUR V D DSSOLD FH VHUYLFH RU SURFHG UH SHUIRUPHG IRU W H S USRVH RI VSOL WL J WR DOWHU YHUWLFDO GLPH VLR RU WR UHVWRUH RFFO VLR D DSSOLD FH VHUYLFH RU SURFHG UH SHUIRUPHG IRU W H S USRVH RI FRUUHFWL J DWWULWLR DEUDVLR HURVLR DEIUDFWLR ELWH UHJLVWUDWLR RU ELWH D DO VLV F DUJHV IRU LPSOD WV H FHSW RWHG DERYH UHPRYDO RI LPSOD WV SUHFLVLR RU VHPL SUHFLVLR DWWDF PH WV GH W UH G SOLFDWLR RU GH W UHV D G D DVVRFLDWHG V UJHU RU RW HU F VWRPL HG VHUYLFHV RU DWWDF PH WV VHUYLFHV SURYLGHG IRU D W SH RI WHPSRURPD GLE ODU MRL W 70 G VI FWLR P VF ODU VNHOHWDO GHILFLH FLHV L YROYL J 70 RU UHODWHG VWU FW UHV P RIDVFLDO SDL LL L 0 OWLSOH UHVWRUDWLR V R R H V UIDFH DUH SD DEOH DV R H V UIDFH 0 OWLSOH V UIDFHV R D VL JOH WRRW LOO RW EH SDLG DV VHSDUDWH UHVWRUDWLR V 2 D JLYH GD PRUH W D SHULDSLFDO UD V RU D SD RUDPLF ILOP L FR M FWLR LW ELWH L JV LOO EH SDLG DV D I OO PR W UDGLRJUDS 3UH HVWLPDWHV DUH UHFRPPH GHG IRU D WUHDWPH W H SHFWHG WR H FHHG E IL 7DNHRYHU EH HILWV DSSO LI H DUH WDNL J RYHU D FRPSDUDEOH EH HILWV SOD IURP D RW HU FDUULHU D G R O LI W HUH LV R EUHDN L FRYHUDJH EHW HH W H RULJL DO SOD D G W H WDNHRYHU GDWH 7DNHRYHU LV DYDLODEOH WR W RVH L GLYLG DOV L V UHG GHU W H HPSOR HU V GH WDO SOD L HIIHFW DW W H WLPH RI W H HPSOR HU V DSSOLFDWLR I WDNHRYHU EH HILWV DUH L FO GHG L R U EH HILWV W H DLWL J SHULRGV IRU VHUYLFH LOO EH DLYHG IRU W H L GLYLG DOV F UUH WO L V UHG GHU W H HPSOR HU V SUHYLR V SOD G UL J W H PR W SULRU WR FRYHUDJH PRYL J WR V SSOLFDWLR RI WDNHRYHU EH HILWV LV V EMHFW WR 8 GHU ULWL J UHYLH D G DSSURYDO 1H LUHV LW SULRU OLNH GH WDO FRYHUDJH ODSVH L FRYHUDJH P VW EH OHVV W D GD V LOO UHFHLYH WDNHRYHU FUHGLW IRU W H OH JW RI WLPH W H DG LW W H SULRU FDUULHU D G P VW SURYLGH SURRI RI FRYHUDJH L FO GL J FRYHUDJH GDWHV WR UHFHLYH WDNHRYHU FUHGLW L H R H SDJH EH HILW V PPDU HUWLILFDWH RI UHGLWDEOH RYHUDJH HWF PSOR HHV W DW DLYH FRYHUDJH DW L LWLDO H UROOPH W LW L GD V RI HIIHFWLYH GDWH RU L W H H HPSOR HH HOLJLELOLW SHULRG D G RU WHUPL DWH FRYHUDJH LW 8 P LOO DYH D W HOYH PR W DLWL J SHULRG DSSOLHG WR EDVLF D G PDMRU VHUYLFHV D G RUW RGR WLD SR UH DSSO L J 7 H SULRU FDUULHU LV UHVSR VLEOH IRU UHLPE UVHPH W RI FRVWV IRU SURFHG UHV EHJ SULRU WR W H HIIHFWLYH GDWH 6 EMHFW WR WDNHRYHU EH HILWV 1HW RUN FFHVV SOD LV DYDLODEOH 7 6 32 352 6 0 7 1 76 7 LV EURF UH LV RW L WH GHG WR EH D FRPSOHWH GHVFULSWLR RI W H L V UD FH FRYHUDJH DYDLODEOH 7 H SROLFLHV RU W HLU SURYLVLR V PD YDU RU EH DYDLODEOH L VRPH VWDWHV 7 H SROLFLHV DYH H FO VLR V D G OLPLWDWLR V LF PD DIIHFW D EH HILWV SD DEOH RU FRPSOHWH GHWDLOV RI FRYHUDJH D G DYDLODELOLW SOHDVH UHIHU WR 3ROLF RUP 6HULHV H WDO 1 1 D G 1 RU FR WDFW R U 8 P H WDO UHSUHVH WDWLYH 8 GHU ULWH E 6WDUPR W LIH V UD FH RPSD DWR 5R JH k 8 P UR S OO ULJ WV UHVHUYHG 8 P LV D UHJLVWHUHG WUDGHPDUN D G PDUNHWL J EUD G RI 8 P UR S D G LWV L V UL J V EVLGLDULHV 1 25 03 2 6 14
DO PO DP DD V D QXP HQWDO 0HPEHU RX KDYH WKH IUHHGRP WR YLVLW DQ GHQWLVW KRRVLQ DQ LQ QHW RUN GHQWLVW LOO SURYLGH RX UHDWHU VDYLQ V DQG D VHDPOHVV H SHULHQFH QXP V ODU H DQG UR LQ GHQWDO QHW RUN extends from coast to coast o ering FRQYHQLHQW DFFHVV WR DQ GHQWLVW LQ RXU QHW RUN LVLW XQXPGHQWDOFDUH FRP to nd D GHQWLVW WKDW LV UL KW IRU RX DQG VHH RXU dental bene ts go further DYLQ V W PR I RP RX SOD VS GL O VV RL L W R N DOOR V RX WR VW WF RX ILWV IX W XDOLW RI FDUH OO G WLVWV L RX W R N PXVW P W D G DG WR VW LFW VWD GD GV W DW VX W SRVV VV W S RI VVLR DO F G WLDOV S L F D G W DL L WR S R LG W VW TXDOLW FD 1R FODLP IRUPV 0RVW L W R N S R LG V LOO ILO FODLPV R RX DOI S R LGL D V DPO VV DVVO I SL F 2 0 1 0 0 5 HQWDO FRVWV YDU IURP UH LRQ WR UH LRQ EXW QXP HQWDO PHPEHUV HYHU KHUH EHQHILW W R DV LVFRX W G I V IR L W R N V LF V VX D F FR D RI XS WR R RI VRP V LF V 1 2 1 1 1 25 1HW RUN DYHUD H QH RWLDWHG IHH 10 1 25 03 LOOHG FKDU H 52 1 FRLQVXUDQFH 3ODQ SD V RX SD FRLQVXUDQFH 3ODQ SD V RX SD 1HW RUN GH WLVWV KDYH DJUHHG WR HJRWLDWHG IHHV DV SD PH W L IXOO IRU FRYHUHG VHUYLFHV DVHG R DYHUDJH HJRWLDWHG IHH IRU LS FRGH 1HJRWLDWHG IHHV DUH VXEMHFW WR FKD JH DVHG R WK SHUFH WLOH RI XVXDO D G FXVWRPDU FKDUJHV IRU LS FRGH 8 XP L WHU DO GDWD RXU SD PH W LV EDVHG R WKH HJRWLDWHG IHH RU ELOOHG FKDUJH PXOWLSOLHG E WKH PHPEHUV FRL VXUD FH IRU WKH FRYHUHG VHUYLFH D G DVVXPHV GHGXFWLEOH KDV EHH PHW 15
XQXPGHQWDOFDUH FRP D D R U E ILW 6 D F IR L W R N G WDO S R LG V FF VV W G WDO DOW F W R L WR O D VVLVW RX FD 3 L W FD GV 9L FODLP LVWR FF VV FR D L IR PDWLR R ORDG W O D V VVLVW PR LO DSS WR L RX FD G D G ILW L IR PDWLR IL G D S R LG D RX D D G FOLFN WR FDOO WR TXLFNO VF GXO D DSSRL WP W L G D W RUN SUR LG U FK G O R U DSSRL W W VF GXOL RX DSSRL WP W LG WLI RX V OI DV D QXP HQWDO P P D G O W W G WDO RIILF N R WR F FN W W R N DP D G L IR PDWLR R RX PP FD G I RX G WLVW GR V W FR L W L SD WLFLSDWLR L W W R N FR WDFW XVWRP 6 LF DW R PDLO 3 R LG 5 ODWLR V X XP FRP 3O DV L FOXG W S R LG V DP DGG VV D G S R XP 2X W DP LOO DSS WR DF RXW WR W G WLVW U UR L R U W RUN IRU R I RX G WLVW LV RW L W R N SO DV V G W L FR WDFW L IR PDWLR WR W R N F XLWL X XP FRP D G RX W DP RI W R N F XLW V LOO DF RXW WR W P OLFN 6 D F 1R L W L G D WDO 3 R LG V FWLR ORFDW G R W O IW D G VLG 6 O FW WR V D F G WLVW DP R ORFDWLR FLW VWDW LS R IL P W G WLVW V DP D G DGG VV 1 W R N G WLVWV R S DFWLF DW PXOWLSO RIILF V PD RW FR W DFW G L W R N DW RIILF 7 W R N GL FWR LV XSGDW G PR W O WR IO FW F WO DGG G S R LG V D G PR L DFWL R V LUWXDO HQWDO LVLWV WKURX K HOH HQWLVWU FRP G WDO FD IR G WDO P FL V D L S VR LVLW LV W D RSWLR DLOD O IR DFWL G WDO P P V DV D S WL V LF 9LVLW X XPG WDOFD FRP D G FOLFN 9L WXDO WDO 9LVLWV WR W VWD W G XQXP FRP Virtual dentist visits are a preventive service and subject to the policy year maximum bene t 1 7 25 66 3 1 6 9 127 25 86 1 1 0 2 25 25 21 86 216 1 0 7 7 216 The following dental services are not covered unless stated otherwise in the Certi cate of Coverage WUHDWPH W KLFK LV HOHFWLYH RU SULPDULO FRVPHWLF L DWXUH D G RW JH HUDOO UHFRJ L HG DV D JH HUDOO DFFHSWHG GH WDO SUDFWLFH E WKH PHULFD H WDO VVRFLDWLR DV HOO DV D UHSODFHPH W RI SULRU HOHFWLYH RU FRVPHWLF UHVWRUDWLR V 5HSODFHPH W RI D UHPRYDEOH GHYLFH RU DSSOLD FH WKDW LV ORVW PLVVL J RU VWROH D G IRU WKH UHSODFHPH W RI UHPRYDEOH DSSOLD FHV WKDW KDYH EHH GDPDJHG GXH WR DEXVH PLVXVH RU HJOHFW 7KLV PD L FOXGH EXW RW EH OLPLWHG WR UHPRYDEOH SDUWLDO GH WXUHV RU GH WXUHV 5HSODFHPH W RI D SHUPD H W RU UHPRYDEOH GHYLFH RU DSSOLD FH X OHVV WKH GHYLFH RU DSSOLD FH LV R OR JHU IX FWLR DO D G LV ROGHU WKD WKH OLPLWDWLR L WKH 6FKHGXOH RI RYHUHG 3URFHGXUHV 7KLV PD L FOXGH EXW RW EH OLPLWHG WR EULGJHV GH WXUHV D G FUR V DSSOLD FH VHUYLFH RU SURFHGXUH SHUIRUPHG IRU WKH SXUSRVH RI VSOL WL J WR DOWHU YHUWLFDO GLPH VLR RU WR UHVWRUH RFFOXVLR DSSOLD FH VHUYLFH RU SURFHGXUH SHUIRUPHG IRU WKH SXUSRVH RI FRUUHFWL J DWWULWLR DEUDVLR HURVLR DEIUDFWLR ELWH UHJLVWUDWLR RU ELWH D DO VLV KDUJHV IRU LPSOD WV H FHSW RWHG DERYH UHPRYDO RI LPSOD WV SUHFLVLR RU VHPL SUHFLVLR DWWDFKPH WV GH WXUH GXSOLFDWLR RU GH WXUHV D G D DVVRFLDWHG VXUJHU RU RWKHU FXVWRPL HG VHUYLFHV RU DWWDFKPH WV 6HUYLFHV SURYLGHG IRU D W SH RI WHPSRURPD GLEXODU MRL W 70 G VIX FWLR PXVFXODU VNHOHWDO GHILFLH FLHV L YROYL J 70 RU UHODWHG VWUXFWXUHV P RIDVFLDO SDL Limitations Multiple restorations on one surface are payable as one surface Multiple surfaces on D VL JOH WRRWK LOO RW EH SDLG DV VHSDUDWH UHVWRUDWLR V 2 D JLYH GD PRUH WKD SHULDSLFDO x rays or a panoramic lm in conjunction with bitewings will be paid as a full mouth radiograph 3UH HVWLPDWHV DUH UHFRPPH GHG IRU D WUHDWPH W H SHFWHG WR H FHHG 7 6 32 3529 6 0 7 1 76 7KLV EURFKXUH LV RW L WH GHG WR EH D FRPSOHWH GHVFULSWLR RI WKH L VXUD FH FRYHUDJH DYDLODEOH 7KH SROLFLHV RU WKHLU SURYLVLR V PD YDU RU EH unavailable in some states The policies have exclusions and limitations which may a ect any bene ts payable For complete details of coverage and availability please refer to Policy Form 6HULHV H WDO 1 32 1 1 D G 1 L FOXGHV VWDWH DEEUHYLDWLR V KHUH XVHG IRU H DPSOH 1 1 RU FR WDFW RXU 8 XP H WDO UHSUHVH WDWLYH 7KH DSSURYHG VHUYLFH DUHD FR VLVWV RI DOO 0DVVDFKXVHWWV H FHSW XNHV D G 1D WXFNHW RX WLHV 8 GHU ULWWH E 6WDUPRX W LIH VXUD FH RPSD DWR 5RXJH 1H RUN SOD V X GHU ULWWH E 3URYLGH W LIH D G DVXDOW VXUD FH RPSD KDWWD RRJD 71 k 8 XP URXS OO ULJKWV UHVHUYHG 8 XP LV D UHJLVWHUHG WUDGHPDUN D G PDUNHWL J EUD G RI 8 XP URXS D G LWV L VXUL J VXEVLGLDULHV 1 25 03 2 6 16
Redondo Manufacturing RCSS Unum Vision Quality eye care meets convenience Plan features Our network offers members access to a large national network including independent optometrists and retail stores like Walmart Sam s Club Target Optical America s Best and many more Find an in network provider at unumvisioncare com Manage benefits online with AlwaysAssist com and onthe go with the AlwaysAssist mobile app Covered benefits Exam Each member is entitled to a comprehensive vision exam An exam co pay applies and is outlined in the grid at right Materials Each member has coverage for covered services and materials Purchases are subject to benefit frequencies and co pays Plan features include Frame benefit You may choose any frame within a provider s collection subject to the retail frame allowance listed at right If the cost is greater than the plan s benefits you are responsible for the difference Eyeglass lens benefit Standard plastic CR 39 Plastic Material single vision bifocal trifocal and specialty lenses are generally covered after any applicable materials copay If covered by plan allowance you are responsible for any cost greater than the plan s benefit Contact lens benefit Members electing contact lenses instead of eye glass lenses may apply the contact lens allowance to any lenses in the provider s collection If the cost is greater than the plan s benefits you are responsible for the difference Laser vision correction Discounts are available with participating surgery providers across the country not an insured benefit Unum Vision benefits Vision Care Services Exam 1 per 12 months Materials Standard Plastic Lenses 1 per 12 months Single Vision Bifocal Trifocal Lenticular Progressive Lens Options Scratch Resistant Coating Polycarbonate Lenses for children to age 19 Frames 1 per 24 months Members choose from any frame available at provider locations Contact Lenses 1 per 12 months In lieu of eyeglass lenses and frames Includes fit follow up and materials Elective Medically Necessary In network Providers 10 co pay 25 co pay Out of network Allowances Up to 35 See allowances below Covered by co pay Covered by co pay Covered by co pay 80 allowance 70 allowance Up to 25 Up to 40 Up to 50 Up to 50 Up to 40 Covered by co pay at Walmart only Covered by co pay Not covered Not Covered 130 allowance Up to 50 25 co pay 130 allowance 210 allowance See allowances below Up to 100 Up to 210 How much does it cost Monthly premium You 4 95 You and your spouse 9 89 You and your children 11 04 Family 17 25 Some providers such as Walmart may charge for a contact lens fit and evaluation separately from your contact lens allowance leaving the entire allowance for materials EN 376255 4 20 FOR EMPLOYEES 18
Vision Insurance Laser Vision Correction Network Membership provides access to preferred pricing Transactions are handled directly between members and providers Refractive surgery is an elective procedure and may involve potential risks to patients This is not an insured benefit Unum cannot and does not guarantee the outcome of any refractive surgical procedure or a total elimination of the need for glasses or contacts Providers may not be available in all metropolitan areas Login to www alwaysassist com for a list of participating laser vision correction providers Hearing Savings Plan Unum offers a Hearing Savings Plan at no additional cost to all of its Unum Dental and Unum Vision members Partnering with EPIC Hearing Healthcare the Hearing Savings Plan provides 30 60 discounts off MSRP on name brand hearing instruments 40 savings on hearing aid batteries shipped directly to members homes On call support for member questions managed by professional hearing counselors Other Unum Vision Specifications Dependent children Dependent age guidelines vary by state Please refer to your policy certificate or contact customer service at 888 400 9304 Services not listed If you expect to require a vision service not included on this brochure it may still be covered Please contact customer service at 888 400 9304 to confirm your exact benefits This is a primary vision care benefit and is intended to cover only eye examinations and corrective eyewear Medical or surgical treatment of eye disease or injury is not provided under this plan Coverage may not exceed the lesser of actual cost of covered services and materials or the limits of the policy Some providers at optical and or retail chains such as Walmart may charge for a contact lens fit and evaluation separately and apart from your contact lens allowance leaving the entire allowance for materials Covered materials that are lost or broken will be replaced only at normal service intervals indicated in the Plan Design however these materials and any items not covered below may be purchased at Preferred Pricing from a Participating Provider In addition benefits are payable only for expenses incurred while the Group and individual Member coverage is in force This plan will not cover Orthoptics or vision training and any supplemental testing Plano non prescription lenses or two pair of eyeglasses in lieu of bifocals or trifocals Medical or surgical treatment of the eyes An eye exam or corrective eye wear required by an employer as a condition of employment Any injury or illness covered under Workers Compensation or similar law or which is work related Plain or prescription sunglasses or tinted lenses and no line bifocals and blended lenses subject to allowance Sub normal vision aids Services rendered or materials purchased outside the U S or Canada unless the insured resides in the U S or Canada and the charges are incurred while on a business or pleasure trip Charges in excess of Usual and Customary for services and materials Experimental or non conventional treatments or devices Safety eyewear Spectacle lens styles materials treatments or add ons not shown in the Schedule of Benefits This brochure is not intended to be a complete description of the insurance coverage available The policies or their provisions may vary or be unavailable in some states The policies have exclusions and limitations which may affect any benefits payable For complete details of coverage and availability please refer to Policy Form Series VI 2002 VI 2007 and VI 2019 or contact your Unum Vision representative Starmount Life Insurance Company 8485 Goodwood Boulevard Baton Rouge LA 70806 PH 888 400 9304 Vision plans are marketed by Unum administered and underwritten by Starmount Life Insurance Company Baton Rouge LA 2020 Unum Group All rights reserved Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries EN 376255 4 20 FOR EMPLOYEES 19
Rates for these lines are loaded in the online enrollment platform and explained in more detail on the following pages RCSS LLC Redondo Manufacturing Voluntary Group Term Life AD D Voluntary Group Term Life Insurance is also available for you your spouse and your dependent children through ______U__N_U_M_______ As an employee you may purchase Term Life Insurance for yourself in benefit amounts between 10 000 and ___ _5_0_0_ _0_0_0___ in 10 000 increments Guaranteed Issued You can purchase up to ____ _5_0_ _0_0_0____ without having to answer a medical questionnaire If you choose not to enroll when you are first offered the opportunity and choose to enroll at a later time you will have to complete a medical questionnaire and are subject to the carrier s approval denial Critical Illness with Cancer Coverage Everyday thousands of people are diagnosed with a serious illness such as cancer or are stricken with a heart attack stroke or other unexpected medical conditions The costs associated with serious illnesses even for individuals with medical insurance can be astronomical This plan can help overcome some of the costs related to sudden illnesses that are not covered by medical insurance You may also purchase coverage on your spouse age 18 70 and your dependent children under the age of 26 who are unmarried and your dependent Diagnosis has to take place after the policy effective date Upon diagnosis of a covered Critical Illness the covered individual will receive 100 of the lump sum benefit amount elected Accident Insurance Accidents are unexpected as are the various expenditures associated with them While most health insurance covers major expenses it does not cover every related cost You could face office visit copays deductibles and transportation lodging costs all cost you weren t expecting The Accident Insurance gives you the protection for the unexpected The plan pays you a benefit that can be applied to expenditures surrounding an accident including but not limited to ambulance emergency room treatment doctor s visits and surgery related to the accident It also pays benefits for common accidental injuries such as burns concussions emergency dental work dislocations fractures and much more The amount of benefit you receive depends on the nature of the injury or the type of service you receive And these benefits are paid in addition to any medical insurance you might have Short Term Long Term Disability Insurance How do you see yourself five years from now Or ten Chances are you don t see yourself disabled But a surprising number of people do find themselves injured or sick and unable to work even if only for a short time But would a month seem like a short time if you had no income Your employer offers plans that will help you pay for your household expenses if you become disabled and cannot work These plans may be purchased without answering health questions as long as you enroll when you are first hired or the first year the plan is offered Enrollment at any other time will require medical evidence of insurability Rates for these plans are loaded in the online enrollment platform and explained in more detail on the following pages 20
Redondo Manufacturing LI D LD D L D How does it work RX RR D RX RI RY UD D U IRU RX D G RX S RY UD IRU D S U RG RI RU U I RX G GXU D U R D OS RXU ID O SD IRU ED O Y S I DO DUUD X R D G RU XUD DO R DYD ODEO SD D E I I RX XUY Y D D G EX DY U D U RX MXU SD D DGG R DO D RX I RX G IUR D RY U G D G Why is this coverage so valuable I RX EX D X RI U D RXU RY UD RXU UR G7 U R TXDO I IRU RY UD RI RY UD R RX D IX XU XS R R RXOG E R G DO X G U U What else is included LYL LW I RX DU G D R G D U DO OO O D R R O Y RX D U TX RI RXU O I XUD E I XS R O RX DU OO O Y 7 D RX OO E D RX RI G D E I D G D E D DEO E LW S P W P Y WW LSL W L LEL LW LL W Y P W E LW WLW P W P EW E 5S RXOG R XO U D D RU RU DGY RU E IRU X O O Y E I SD LY S PL P RXU R R DOO G DEO G IRU D S U RG RI D E D Y G I RX DU 3 W EL LW RX D E DEO R S RY UD I RX O DY R SD U U RU D X E U RI RXU RX RU PSOR HH RU GHSH GH W R DYH D LFN H RU L M U DYL D PDWHULDO HIIHFW R OLIH H SHFWD F DW W H WLPH W HLU UR S FRYHUD H H G DUH RW HOL LEOH IRU SRUWDELOLW Who can get Term Life coverage I RX DU D Y O D RU D O D DSSO IRU RY UD IRU RXU S U RX D RRRR IIUURR RR UU XXSS RR RXRUXUDUDU RX D XS R 7 RRI XRYDUD XRSX RD TXDO I IRU7 D RX R G DO XD GRXU U RI RY UD RX D TXDO I IRU R G DO X G U U XS R RI RY UD S U XS R 6SRX RRIY RUDY UD D R G RI RY UD D RX RX SXU D IRU S RXUU OI 6SRX RY UD D R G RXU SRRI X DRY UD XSDR RX RX SXU R D IRUG RDXOUX OGI U U I O EO G OD G II Y GD RXU SRX D XS R R GXSDORX G U U RI RYI UDO EO G OD G L IIU Y GDI O EO G OD G II Y GD 2 SRO RY U DOO RI RXU OGU X O U XESU RGD RI RY UD L 7 U D X I EO EIO IRU GOGODU GO Y IIE U Y R R GD 2 SRO RY U DOO RI RXU OGU Who can getXAccO ideUntal DEeUathGD Dismemberment AD D cove7rage D X E I IRU OGU O Y E U R R XS R RI RXU OI U RXU DU RY UD IRU R D D X RI XS R RI RY UD IRU RXU S SRX U I O EO G OD G II Y GD XS R RI RY UD IRU RXU OGU L U I O EO G OD G II Y GD 1R PHGLFDO GHU ULWL L UHT LUHG IRU FRYHUD H 1 25 0 2 6 Unum LI D 21
How much coverage can I get W W U RY UD D RX RX D YG E R D RX 0XO SO E UD 8 UD DEO DU RI G UD ED G R D RR H W H D H R LOO EH H R U FRYHUD H EHFRPH HIIHFWLYH 6HH R U SOD DGPL L WUDWRU IRU R U SOD HIIHFWLYH GDWH 7R GHWHUPL H R U SR H UDWH F RR H W H D H W H HPSOR HH LOO EH H FRYHUD H EHFRPH HIIHFWLYH 6HH R U SOD DGPL L WUDWRU IRU R U SOD HIIHFWLYH GDWH U RXU R PS S L Age 1 Employee monthly rate Per 10 000 of coverage R 2 3 4 W W Spouse monthly rate Per 5 000 of coverage R Child monthly rate 0 600 per 2 000 of coverage U RY UD D RX RX D YG E R D RX 0XO SO E 8 DEO D U UD UD UD RI G U RXU R PS S L PS S L AD D 1 2 AD D monthly rates Coverage amount SU RI RY UD SU RI RY UD SU RI RY UD 3 4 W W Rate LOOHG DPR W PD YDU OL WO I R DSSO IRU FRYHUD H DERYH W H DUD WHHG L H DPR W R PD EH EMHFW WR PHGLFDO GHU ULWL R P W E FRYHUD H IRU R U HOI RYHUD H DPR W FD RW H FHHG RI R U FRYHUD H DPR W LF PD DIIHFW R U DELOLW WR HW W H ODU HU FRYHUD H DPR W RUGHU WR S UF D H FRYHUD H IRU R U GHSH GH W 1 25 0 2 6 Unum LI D 22
RD DR DR OL LEOH HPSOR HH P W EH DFWLYHO DW RUN WR DSSO IRU FRYHUD H HL DFWLYHO DW RUN PHD R W H GD W H HPSOR HH DSSOLH IRU FRYHUD H W H L GLYLG DO P W EH RUNL DW R H RI L HU FRPSD E L H ORFDWLR RU W H L GLYLG DO P W EH RUNL DW D ORFDWLR HUH H H L UHT LUHG WR UHSUH H W W H FRPSD I DSSO L IRU FRYHUD H R D GD W DW L RW D F HG OHG RUNGD W H HPSOR HH LOO EH FR LGHUHG DFWLYHO DW RUN D RI L HU OD W F HG OHG RUNGD PSOR HH DUH RW FR LGHUHG DFWLYHO DW RUN LI W H DUH R D OHDYH RI DE H FH RU OD RII PDUULHG D GLFDSSHG GHSH GH W F LOG R EHFRPH D GLFDSSHG SULRU WR W H F LOG DWWDL PH W D H RI PD EH HOL LEOH IRU EH HILW OHD H HH R U SOD DGPL L WUDWRU IRU GHWDLO R HOL LELOLW PSOR HH P W EH 6 FLWL H RU OH DOO D W RUL HG WR RUN L W H 6 WR UHFHLYH FRYHUD H PSOR HH P W EH DFWLYHO HPSOR HG L W H LWHG 6WDWH LW W H PSOR HU WR UHFHLYH FRYHUD H PSOR HH P W EH L UHG GHU W H SOD IRU SR H D G GHSH GH W WR EH HOL LEOH IRU FRYHUD H RD DR LIH L UD FH EH HILW LOO RW EH SDLG IRU GHDW FD HG E LFLGH RFF UUL LW L HIIHFWLYH GDWH RI FRYHUD H 7 H DPH DSSOLH IRU L FUHD HG RU DGGLWLR DO EH HILW PR W DIWHU W H RD DR FFLGH WDO GHDW D G GL PHPEHUPH W EH HILW LOO RW EH SDLG IRU OR H FD HG E FR WULE WHG WR E RU UH OWL IURP L HD H RI W H ERG GLD R WLF PHGLFDO RU U LFDO WUHDWPH W RU PH WDO GL RUGHU D HW IRUW L W H ODWH W HGLWLR RI W H LD R WLF D G 6WDWL WLFDO 0D DO RI 0H WDO L RUGHU 60 6 LFLGH HOI GH WU FWLR LOH D H L WH WLR DOO HOI L IOLFWHG L M U LOH D H RU HOI L IOLFWHG L M U LOH L D H DU GHFODUHG RU GHFODUHG RU D DFW RI DU FWLYH SDUWLFLSDWLR L D ULRW RPPLWWL RU DWWHPSWL WR FRPPLW D FULPH GHU WDWH RU IHGHUDO OD 7 H YRO WDU H RI D SUH FULSWLR RU R SUH FULSWLR GU SRL R I PH RU RW HU F HPLFDO E WD FH OH HG DFFRUGL WR W H SUH FULSWLR RU GLUHFWLR RI R U RU R U GHSH GH W GRFWRU 7 L H FO LR GRH RW DSSO WR R RU R U GHSH GH W LI W H F HPLFDO E WD FH L HW D RO WR LFDWLR HL L WR LFDWHG PHD R U RU R U GHSH GH W EORRG DOFR RO OHYHO HT DO RU H FHHG W H OH DO OLPLW IRU RSHUDWL D PRWRU YH LFOH L W H WDWH RU M UL GLFWLR HUH W H DFFLGH W RFF UUHG D D RR D UD FH FRYHUD H LOO EH GHOD HG LI R DUH RW D DFWLYH HPSOR HH EHFD H RI D L M U LFN H WHPSRUDU OD RII RU OHDYH RI DE H FH R W H GDWH W DW L UD FH R OG RW HU L H EHFRPH HIIHFWLYH HOD HG IIHFWLYH DWH LI R U SR H RU F LOG D D HULR L M U LFN H RU GL RUGHU RU L FR IL HG W HLU FRYHUD H PD RW WDNH HIIHFW D PH W RI SUHPL P GRH RW DUD WHH FRYHUD H OHD H UHIHU WR R U SROLF FR WUDFW RU HH R U SOD DGPL L WUDWRU IRU D H SOD DWLR RI W H GHOD HG HIIHFWLYH GDWH SURYL LR W DW DSSOLH WR R U SOD R RYHUD H DPR W IRU LIH D G UD FH IRU R D G R U GHSH GH W LOO UHG FH WR RI W H RUL L DO DPR W H R UHDF D H D G LOO UHG FH WR RI W H RUL L DO DPR W H R UHDF D H RYHUD H PD RW EH L FUHD HG DIWHU D UHG FWLR DR R R D R U FRYHUD H D G R U GHSH GH W FRYHUD H GHU W H SROLF H G R W H HDUOLH W RI 7 H GDWH W H SROLF RU SOD L FD FHOOHG 7 H GDWH R R OR HU DUH L D HOL LEOH UR S 7 H GDWH R U HOL LEOH UR S L R OR HU FRYHUHG 7 H OD W GD RI W H SHULRG IRU LF R PDGH D UHT LUHG FR WULE WLR 7 H OD W GD R DUH DFWLYHO HPSOR HG OH FRYHUD H L FR WL HG G H WR D FRYHUHG OD RII OHDYH RI DE H FH L M U RU LFN H D GH FULEHG L W H FHUWLILFDWH RI FRYHUD H DGGLWLR FRYHUD H IRU D R H GHSH GH W LOO H G R W H HDUOLH W RI 7 H GDWH R U FRYHUD H GHU D SOD H G 7 H GDWH R U GHSH GH W FHD H WR EH D HOL LEOH GHSH GH W RU D SR H W H GDWH RI D GLYRUFH RU D OPH W RU GHSH GH W W H GDWH RI R U GHDW P LOO SURYLGH FRYHUD H IRU D SD DEOH FODLP W DW RFF U LOH R D G R U GHSH GH W DUH FRYHUHG GHU W H SROLF RU SOD 7 L L IRUPDWLR L RW L WH GHG WR EH D FRPSOHWH GH FULSWLR RI W H L UD FH FRYHUD H DYDLODEOH 7 H SROLF RU LW SURYL LR PD YDU RU EH DYDLODEOH L RPH WDWH 7 H SROLF D H FO LR D G OLPLWDWLR LF PD DIIHFW D EH HILW SD DEOH RU FRPSOHWH GHWDLO RI FRYHUD H D G DYDLODELOLW SOHD H UHIHU WR ROLF RUP HW DO RU FR WDFW R U P UHSUH H WDWLYH LIH OD L L D FLDO H DO 5H R UFH HUYLFH SURYLGHG E HDOW GYRFDWH DUH DYDLODEOH LW HOHFW P L UD FH RIIHUL 7HUP D G DYDLODELOLW RI HUYLFH DUH EMHFW WR F D H 6HUYLFH SURYLGHU GRH RW SURYLGH OH DO DGYLFH SOHD H FR OW R U DWWRU H IRU LGD FH 6HUYLFH DUH RW YDOLG DIWHU FRYHUD H WHUPL DWH OHD H FR WDFW R U P UHSUH H WDWLYH IRU GHWDLO P FRPSOLH LW WDWH FLYLO LR D G GRPH WLF SDUW HU OD H DSSOLFDEOH GHU ULWWH E P LIH UD FH RPSD RI PHULFD RUWOD G 0DL H k P UR S OO UL W UH HUYHG P L D UH L WHUHG WUDGHPDUN D G PDUNHWL EUD G RI P UR S D G LW L UL E LGLDULH 1 25 0 2 6 Unum LI D 23
Redondo Manufacturing RCSS Short Term Disability Insurance can pay you a weekly benefit if you have a covered disability that keeps you from working How does it work If a covered illness or injury keeps you from working Short Term Disability Insurance can replace part of your income while you recover As long as you remain disabled you can receive payments for up to 12 weeks You re generally considered disabled if you re unable to do important parts of your job and your income suffers as a result Why is this coverage so valuable You can use the money however you choose It can help you pay for your rent or mortgage groceries out of pocket medical expenses and more What s covered This insurance may cover a variety of conditions and injuries Here are Unum s top reasons for short term disability claims 1 Normal pregnancy Injuries excluding back Joint disorders Cancer Digestive disorders This plan does not cover pre existing conditions See the disclosure section to learn more Consider your weekly expenses Food _______ Transportation _______ gas car payments repairs Child care elder care _______ Mortgage rent _______ Utilities _______ electric water cable phone Medical costs co pays medications _______ Insurance health life car home _______ Total weekly expenses _______ 1 Unum internal data 2018 Note Causes are listed in ranked order EN 1977 6 20 FOR EMPLOYEES 24
Short Term Disability Insurance How much coverage can I get You You are eligible for coverage if you are an active employee in the United States working a minimum of 30 hours per week Coverage amounts Cover 60 of your weekly income up to a maximum benefit of 1 500 per week The weekly benefit may be reduced or offset by other sources of income See the Legal Disclosures for more information Coverage is guaranteed as long as a certain number of employees purchase coverage If you don t sign up now but decide to apply later you may have to answer medical questions Elimination period EP This is the number of days that must pass between your first day of a covered disability and the day you can begin to receive your disability benefits Your benefits would begin after you become disabled for 7 days Benefit duration BD The maximum number of weeks you can receive benefits while you re disabled You have a 12 week benefit duration Calculate your cost For step 2 Enter your rate from the Rate Chart based on your age Choose the age you will be when your coverage becomes effective on 12 01 2020 Disability worksheet 1 Calculate your weekly disability benefit ________ 52 ________ x 60 Your annual earnings Your weekly Max of earnings income covered 2 Calculate your cost per paycheck ________ 10 ________ x _______ Your weekly benefit amount Your rate __________ Max weekly benefit available if the amount exceeds the plan max of 1 500 enter 1 500 ________ x 12 _______ 12 Your monthly cost Your annual Number of cost paychecks per year __________ Your cost per paycheck Age 15 24 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 Rates 0 490 0 590 0 630 0 660 0 710 0 860 1 090 1 350 1 550 1 880 Billed amount may vary slightly Your rate is based on your age and will increase as you move to the next age band The maximum covered annual income is 130 000 EN 1977 6 20 FOR EMPLOYEES 25
Short Term Disability Insurance Exclusions and limitations Active employee You are considered in active employment if on the day you apply for coverage you are being paid regularly by Redondo Manufacturing RCSS for the required minimum hours each week and you are performing the material and substantial duties of your regular occupation Delayed effective date of coverage Insurance coverage will be delayed if you are not an active employee because of an injury sickness temporary layoff or leave of absence on the date that insurance would otherwise become effective Definition of disability You are considered disabled when Unum determines that due to sickness or injury You are limited from performing the material and substantial duties of your regular occupation and You have a 20 or more loss in weekly earnings You must be under the regular care of a physician in order to be considered disabled The loss of a professional or occupational license or certification does not in itself constitute disability Substantial and material acts means the important tasks functions and operations generally required by employers from those engaged in your usual occupation that cannot be reasonably omitted or modified Unless the policy specifies otherwise as part of the disability claims evaluation process Unum will evaluate your occupation based on how it is normally performed in the national economy not how work is performed for a specific employer at a specific location or in a specific region Pre existing conditions You have a pre existing condition if You received medical treatment consultation care or services including diagnostic measures for the condition or took prescribed drugs or medicines for it in the 3 months just prior to your effective date of coverage and The disability begins in the first 12 months after your effective date of coverage Deductible sources of income Your disability benefit may be reduced by deductible sources of income and any earnings you have while you are disabled including such items as group disability benefits or other amounts you receive or are entitled to receive Workers compensation or similar occupational benefit laws State compulsory benefit laws Automobile liability insurance policy Motor vehicle insurance policy or plan No fault motor vehicle plan Legal judgments and settlements Salary continuation or sick leave plans if applicable Other group or association disability programs or insurance Social Security or similar governmental programs Exclusions and limitations Benefits will not be paid for disabilities caused by contributed to by or resulting from War declared or undeclared or any act of war Active participation in a riot Intentionally self inflicted injuries Loss of professional license occupational license or certification Commission of a crime for which you have been convicted Any period of disability during which you are incarcerated Any occupational injury or sickness this will not apply to a partner or sole proprietor who cannot be covered by law under workers compensation or any similar law Excluded pre existing conditions see definition The loss of a professional or occupational license does not in itself constitute disability Termination of coverage Your coverage under the policy ends on the earliest of the following The date the policy or plan is cancelled The date you no longer are in an eligible group The date your eligible group is no longer covered The last day of the period for which you made any required contributions The last day you are in active employment except as provided under the covered layoff or leave of absence provision Unum will provide coverage for a payable claim that occurs while you are covered under the policy or plan This information is not intended to be a complete description of the insurance coverage available The policy or its provisions may vary or be unavailable in some states The policy has exclusions and limitations which may affect any benefits payable For complete details of coverage and availability please refer to Policy Form C FP 1 et al or contact your Unum representative EN 1977 6 20 FOR EMPLOYEES Underwritten by Unum Life Insurance Company of America Portland Maine 2020 Unum Group All rights reserved Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries 26
Redondo Manufacturing RCSS Accident Insurance can pay you money for covered accidental injuries and their treatment How does it work Accident Insurance can pay a set benefit amount based on the type of injury you have and the type of treatment you need It covers accidents that occur off the job And it includes a range of incidents from common injuries to more serious events Why is this coverage so valuable It can help you with out of pocket costs that your medical plan doesn t cover like co pays and deductibles You re guaranteed base coverage without answering health questions The cost is conveniently deducted from your paycheck You can keep your coverage if you change jobs or retire You ll be billed directly What s included Be Well Benefit Every year each family member who has Accident coverage can also receive 50 for getting a covered Be Well Benefit screening test such as Annual exams by a physician include sports physicals well child visits dental and vision exams Screenings for cancer including pap smear colonoscopy Cardiovascular function screenings Screenings for cholesterol and diabetes Imaging studies including chest X ray mammography Immunizations including HPV MMR tetanus influenza Who can get coverage You If you re actively at work Your spouse Can get coverage as long as you have purchased coverage for yourself Your children Dependent children from birth until their 26th birthday regardless of marital or student status Employees must be legally authorized to work in the United States and actively working at a U S location to receive coverage Spouses and dependent children must reside in the United States to receive coverage How much does it cost Your monthly premium You You and your spouse You and your children Family Option 1 11 35 20 53 30 45 39 63 Active employment You are considered in active employment if on the day you apply for coverage you are being paid regularly for the required minimum 30 hours each week and you are performing the material and substantial duties of your regular occupation Insurance coverage will be delayed if you are not in active employment because of an injury sickness temporary layoff or leave of absence on the date that insurance would otherwise become effective New employees have a 30 day waiting period to be eligible for coverage Please contact your plan administrator to confirm your eligibility date If enrolling and eligible for Medicare age 65 or disabled the Guide to Health Insurance for People with Medicare is available at www medicare gov Pubs pdf 02110 MedicareMedigap guide pdf EN 2073 FOR EMPLOYEES 9 20 29
Accident Insurance Schedule of Benefits Accidental Death and Dismemberment AD D Employee Spouse Children Common Carrier Benefit can pay if the insured individual is injured as a fare paying passenger on a common carrier examples include mass transit trains buses and planes Employee Spouse Children Dismemberment Both Feet Both Hands One Foot One Hand Thumb and Index Finger of the same Hand Coma Coma Loss of Use Hearing Sight of one Eye Sight of both Eyes Speech Paralysis Uniplegia Hemi Paraplegia Triplegia Quadriplegia Hospitalization Admission Admission Hospital ICU Daily Stay amount Daily Stay Hospital ICU amount Short Stay Injury Burns 2nd Degree Burns At least 5 but less than 20 of skin surface 2nd Degree Burns 20 or greater of skin surface 3rd Degree Burns Less than 5 of skin surface 3rd Degree Burns At least 5 but less than 20 of skin surface 3rd Degree Burns 20 or greater of skin surface 50 000 25 000 12 500 50 000 25 000 12 500 50 000 50 000 25 000 25 000 12 500 10 000 25 000 25 000 50 000 25 000 12 500 25 000 37 500 50 000 1 000 1 000 300 300 200 500 1 000 2 000 5 000 10 000 Injury Concussion Concussion Connective Tissue Damage One Connective Tissue tendon ligament rotator cuff muscle Two or more Connective Tissues tendon ligament rotator cuff muscle Dislocations Knee joint other than patella Ankle bone or bones of the foot other than toes Hip joint Collarbone sternoclavicular Elbow joint Hand other than Fingers Lower Jaw Shoulder Wrist joint Collarbone acromioclavicular and separation Finger or Toe Digit Kneecap patella Incomplete Dislocation Payable as a of the applicable Dislocations benefit Eye Injury Eye Injury Fractures Skull except bones of Face or Nose Depressed Hip or Thigh femur Skull except bones of Face or Nose Non depressed Vertebrae body of other than Vertebral Processes Leg mid to upper tibia or fibula Pelvis Bones of the Face or Nose other than Lower Jaw Mandible or Upper Jaw Maxilla Upper Arm between Elbow and Shoulder humerus Upper Jaw Maxilla other than alveolar process Ankle lower tibia or fibula Collarbone clavicle sternum or Shoulder Blade scapula Foot or Heel other than Toes 200 90 150 1 650 1 650 3 375 825 500 500 500 500 500 325 150 500 25 200 4 500 3 375 2 250 1 350 1 350 1 350 675 675 675 450 450 450 Injury Forearm olecranon radius or ulna Hand or Wrist other than Fingers Kneecap patella Lower Jaw Mandible other than alveolar process Vertebral Processes Rib Tailbone coccyx Sacrum Finger or Toe Digit Chip Fracture Payable as a of the applicable Fractures benefit Same bone maximum incurred per accident Maximum payable multiplier for multiple bones Internal Injuries Internal Injuries Lacerations No Repair Repair Less than 2 inches Repair At least 2 inches but less than 6 inches Repair 6 inches or greater Loss of a Digit One Digit other than a Thumb or Big Toe One Digit a Thumb or Big Toe Two or more Digits Knee Cartilage Knee Cartilage Meniscus Injury Ruptured or Herniated Disc One Disc Two or more Discs Recovery At Home Care Physician Follow Up Visits Physician Follow Up Maximum Visits Prescription Drug Prescription Benefit Incidence per covered accident Rehabilitation or Subacute Rehabilitation Unit Therapy Services chiro speech PT occ Therapy Services Maximum Days Surgery Dislocations 450 450 450 450 450 450 225 25 1 Fracture 2 Times 200 50 150 300 600 750 1 125 1 500 150 150 250 100 75 2 Visits 25 1 Per Insured 100 20 15 Days 30
Surgery Dislocation Surgical Repair Payable as a of the applicable Injury benefit Anesthesia Epidural or Regional Anesthesia General Anesthesia Connective Tissue Exploratory without Repair Repair for One Connective Tissue Repair for Two or more Connective Tissues Eye Surgery Eye Surgery Requiring Anesthesia Fractures Fractures Surgical Repair Payable as a of the applicable Injury benefit Surgical Repair same bone maximum incurred per accident Surgical Repair same bone maximum payable multiplier for multiple bones General Surgery Abdominal Thoracic or Cranial Exploratory Incidence per covered accident Hernia Surgery Hernia Surgery Knee Cartilage Knee Cartilage Meniscus Exploratory without Repair Knee Cartilage Meniscus with Repair Outpatient Surgical Facility Outpatient Surgical Facility Ruptured or Herniated Disc Surgery Exploratory without Repair One Disc Two or more Discs Treatment Ambulance Air Ground Durable Medical Equipment Tier 1 arm sling cane medical ring cushion Accident Insurance Schedule of Benefits cont 100 100 250 100 800 1 200 300 100 1 Fracture 2 Times 1 500 150 1 Per Insured 150 150 750 300 125 675 1 000 Treatment Tier 2 bedside commode cold therapy system crutches Tier 3 back brace body jacket continuous passive movement electric scooter Emergency Dental Repair Dental Crown Dental Extraction Filling or Chip Repair Imaging Tier 1 X rays or Ultrasound Tier 2 Bone Scan CAT CT EEG MR MRA or MRI Medical Imaging Incidence allowance covered accident per Tier Lodging Lodging per night Prosthetic Device One Device or Limb Two or more Devices or Limbs Skin Grafts For Burns Payable as a of the applicable Burn benefit Not Burns Less than 20 of skin surface Not Burns 20 or greater of skin surface Treatment Emergency Room Treatment Injections to Prevent or Limit Infection tetanus rabies antivenom immune globulin Pain Management Injections epidural cortisone steroid Transfusions Transportation per trip Treatment in a Physician s Office or Urgent Care Facility initial 100 200 350 115 90 50 200 1 Per Insured Per Tier 150 750 1 500 50 250 500 100 50 100 400 100 75 1 000 300 50 31
Accident Insurance See Schedule of Benefits for a complete listing of what is covered Effective date of coverage Coverage becomes effective on the first day of the month in which payroll deductions begin Exclusions and limitations We will not pay benefits for a claim that is caused by contributed to by or occurs as the result of any of the following committing or attempting to commit a felony being engaged in an illegal occupation or activity injuring oneself intentionally or attempting or committing suicide whether sane or not active participation in a riot insurrection or terrorist activity This does not include civil commotion or disorder Injury as an innocent bystander or Injury for self defense participating in war or any act of war whether declared or undeclared combat or training for combat while serving in the armed forces of any nation or authority including the National Guard or similar government organizations a Covered Loss that occurs while an Insured is legally incarcerated in a penal or correctional institution elective procedures cosmetic surgery or reconstructive surgery unless it is a result of trauma infection or other diseases an occupational Injury any Sickness bodily infirmity or other abnormal physical condition or Mental or Nervous Disorders including diagnosis treatment or surgery for it Infection This exclusion does not apply when the infection is due directly to a cut or wound sustained in a Covered Accident experimental or investigational procedures operating any motorized vehicle while intoxicated operating learning to operate serving as a crew member of any aircraft or hot air balloon including those which are not motor driven unless flying as a fare paying passenger jumping parachuting or falling from any aircraft or hot air balloon including those which are not motor driven travel or flight in any aircraft or hot air balloon including those which are not motordriven if it is being used for testing or experimental purposes used by or for any military authority or used for travel beyond the earth s atmosphere practicing for or participating in any semi professional or professional competitive athletic contests for which any type of compensation or remuneration is received riding or driving an air land or water vehicle in a race speed or endurance contest and engaging in hang gliding bungee jumping sail gliding parasailing parakiting or BASE jumping The Accidental Death and Dismemberment Benefits are also subject to the following Exclusions We will not pay benefits for a claim that is caused by contributed to by or resulting from any of the following being intoxicated and voluntary use of or treatment for voluntary use of any prescription or non prescription drug intoxicant poison fume or other chemical substance unless taken as prescribed or directed by the Insured s Physician Additionally no benefits will be paid for a Covered Loss that occurs prior to the Coverage Effective Date Termination of employee coverage If you choose to cancel your coverage your coverage ends on the first of the month following the date you provide notification to your employer Otherwise your coverage ends on the earliest of the the date this policy is canceled by Unum or your employer the date you are no longer in an eligible group the date your eligible group is no longer covered the date of your death the last day of the period any required premium contributions are made the last day you are in active employment However as long as premium is paid as required coverage will continue in accordance with the Continuation of your Coverage during Absences provision or if you elect to continue coverage for you your Spouse and Children under Portability of Accident Insurance We will provide coverage for a Payable Claim that occurs while you are covered under this certificate Accident Insurance THIS IS A LIMITED BENEFITS POLICY This information is not intended to be a complete description of the insurance coverage available The policy or its provisions may vary or be unavailable in some states The policy has exclusions and limitations which may affect any benefits payable For complete details of coverage and availability please refer to Policy Form GAP16 1 et al or contact your Unum representative Unum complies with state civil union and domestic partner laws when applicable Underwritten by Unum Insurance Company Portland Maine Unum complies with state civil union and domestic partner laws when applicable 2020 Unum Group All rights reserved Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries EN 2073 FOR EMPLOYEES 9 20 32
Redondo Manufacturing RCSS Critical Illness Insurance can pay money directly to you when you re diagnosed with certain serious illnesses How does it work If you re diagnosed with an illness that is covered by this insurance you can receive a lump sum benefit payment You can use the money however you want Why is this coverage so valuable The money can help you pay out of pocket medical expenses like co pays and deductibles You can use this coverage more than once Even after you receive a payout for one illness you re still covered for the remaining conditions and for the reoccurrence of any critical illness with the exception of skin cancer The reoccurrence benefit pays 100 of your coverage amount Diagnoses must be at least 180 days apart or the conditions can t be related to each other What s covered Critical illnesses Heart attack Stroke Major organ failure End stage kidney failure Coronary artery disease Major 50 Coronary artery bypass graft or valve replacement Minor 10 Balloon angioplasty or stent placement Cancer conditions Invasive cancer all breast cancer is considered invasive Non invasive cancer 25 Skin cancer 500 Progressive diseases Amyotrophic Lateral Sclerosis ALS Dementia including Alzheimer s disease Multiple Sclerosis MS Parkinson s disease Functional loss Supplemental conditions Loss of sight hearing or speech Benign brain tumor Coma Permanent Paralysis Occupational HIV Hepatitis B C or D Infectious Diseases 25 Why should I buy coverage now It s more affordable when you buy it through your employer and the premiums are conveniently deducted from your paycheck If you apply during your initial enrollment you can get coverage without a health exam or medical questions Coverage is portable You may take the coverage with you if you leave the company or retire You ll be billed at home Be Well Benefit Every year each family member who has Critical Illness coverage can also receive 50 for getting a covered Be Well Benefit screening test such as Annual exams by a physician include sports physicals wellchild visits dental and vision exams Screenings for cancer including pap smear colonoscopy Cardiovascular function screenings Screenings for cholesterol and diabetes Imaging studies including chest X ray mammography Immunizations including HPV MMR tetanus influenza Who can get coverage You Choose 10 000 or 20 000 of coverage with no medical questions if you apply during this enrollment Your spouse Spouses can get 100 of the employee coverage amount as long as you have purchased coverage for yourself Your children Children from live birth to age 26 are automatically covered at no extra cost Their coverage amount is 50 of yours They are covered for all the same illnesses plus these specific childhood conditions cerebral palsy cleft lip or palate cystic fibrosis Down syndrome and spina bifida The diagnosis must occur after the child s coverage effective date Active employment You are considered in active employment if on the day you apply for coverage you are being paid regularly for the required minimum 30 hours each week and you are performing the material and substantial duties of your regular occupation Insurance coverage will be delayed if you are not in active employment because of an injury sickness temporary layoff or leave of absence on the date that insurance would otherwise become effective New employees have a 30 day waiting period to be eligible for coverage Please contact your plan administrator to confirm your eligibility date If enrolling and eligible for Medicare age 65 or disabled the Guide to Health Insurance for People with Medicare is available at www medicare gov Pubs pdf 02110 Medicare Medigap guide pdf Please refer to the certificate for complete definitions about these covered conditions Coverage may vary by state See exclusions and limitations EN 2050 11 19 FOR EMPLOYEES 33
Age under 25 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 75 79 80 84 85 Age under 25 25 29 30 34 35 39 40 44 45 49 50 54 55 59 60 64 65 69 70 74 75 79 80 84 85 Critical Illness Insurance benefit and cost Monthly costs Employee coverage 10 000 Spouse coverage 10 000 Be Well benefit 50 Employee Spouse 3 74 3 74 4 54 4 54 5 84 5 84 7 44 7 44 10 44 10 44 15 34 15 34 23 94 23 94 33 94 33 94 49 44 49 44 72 54 72 54 106 24 106 24 144 74 144 74 195 44 195 44 303 34 303 34 Monthly costs Employee coverage 20 000 Spouse coverage 20 000 Be Well benefit 50 Employee Spouse 5 54 5 54 7 14 7 14 9 74 9 74 12 94 12 94 18 94 18 94 28 74 28 74 45 94 45 94 65 94 65 94 96 94 96 94 143 14 143 14 210 54 210 54 287 54 287 54 388 94 388 94 604 74 604 74 Your paycheck deduction will include the cost of coverage and the Be Well Benefit Actual billed amounts may vary Some states may require comprehensive medical coverage before purchasing group critical illness insurance Pre existing conditions We will not pay benefits for a claim when the Covered Loss occurs in the first 12 months following an Insured s Coverage Effective Date and the Covered Loss is caused by contributed to by or occurs as the result of any of the following a Pre existing Condition or complications arising from treatment or surgery for or medications taken for a Pre existing Condition An Insured has a Pre existing Condition if within the 12 months just prior to their Coverage Effective Date they have an injury or sickness whether diagnosed or not for which medical treatment consultation care or services or diagnostic measures were received or recommended to be received during that period drugs or medications were taken or prescribed to be taken during that period or symptoms existed The Pre existing Condition provision applies to any Insured s initial coverage and any increases in coverage Coverage Effective Date refers to the date any initial coverage or increases in coverage become effective Pre existing Condition requirements are not applicable to children who are newly acquired after your Coverage Effective Date Date of diagnosis must be after the coverage effective date Exclusions and limitations We will not pay benefits for a claim that is caused by contributed to by or occurs as a result of any of the following committing or attempting to commit a felony being engaged in an illegal occupation or activity injuring oneself intentionally or attempting or committing suicide whether sane or not active participation in a riot insurrection or terrorist activity This does not include civil commotion or disorder injury as an innocent bystander or injury for self defense participating in war or any act of war whether declared or undeclared combat or training for combat while serving in the armed forces of any nation or authority including the National Guard or similar government organizations voluntary use of or treatment for voluntary use of any prescription or nonprescription drug alcohol poison fume or other chemical substance unless taken as prescribed or directed by the Insured s Physician being intoxicated and a Date of Diagnosis that occurs while an Insured is legally incarcerated in a penal or correctional institution Additionally no benefits will be paid for a Date of Diagnosis that occurs prior to the Coverage Effective Date End of employee coverage If you choose to cancel your coverage your coverage ends on the first of the month following the date you provide notification to your employer Otherwise your coverage ends on the earliest of the date this policy is canceled by Unum or your employer date you are no longer in an eligible group date your eligible group is no longer covered date of your death last day of the period any required premium contributions are made or last day you are in active employment However as long as premium is paid as required coverage will continue in accordance with the Continuation of your Coverage during Absences provision or if you elect to continue coverage for you your Spouse and Children under Portability of Critical Illness Insurance Unum will provide coverage for a payable claim that occurs while you are covered under this certificate THIS INSURANCE PROVIDES LIMITED BENEFITS This information is not intended to be a complete description of the insurance coverage available The policy or its provisions may vary or be unavailable in some states The policy has exclusions and limitations which may affect any benefits payable For complete definitions of coverage and availability please refer to Certificate Form GCIC16 1 or contact your Unum representative Underwritten by Unum Insurance Company Portland Maine 2019 Unum Group All rights reserved Unum is a registered trademark and marketing brand of Unum Group and its insuring subsidiaries EN 2050 11 19 FOR EMPLOYEES 34