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AMDOCS > CUSTOMER EXPERIENCE SYSTEMS INNOVATION Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs 1 Amdocs A Place to Grow US Benefit Review 2011 - Champaign

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Amdocs A Place to Grow. US Benefit Review 2011 - Champaign . Benefit Eligibility. If you are a full-time, active Amdocs employee who is regularly scheduled to work at least 30 hours per week, you are eligible for coverage under the Amdocs’ group benefits program. - PowerPoint PPT Presentation

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Page 1: Amdocs A Place to Grow

AMDOCS > CUSTOMER EXPERIENCE SYSTEMS INNOVATION

Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs1

Amdocs

A Place to Grow

US Benefit Review 2011 - Champaign

Page 2: Amdocs A Place to Grow

AMDOCS > CUSTOMER EXPERIENCE SYSTEMS INNOVATION

Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs2

> If you are a full-time, active Amdocs employee who is regularly scheduled to work at least 30 hours per week, you are eligible for coverage under the Amdocs’ group benefits program.

> You have 31-days from your date of hire to enroll into the benefit programs. Enrollment is not automatic.

Benefit Eligibility

Page 3: Amdocs A Place to Grow

AMDOCS > CUSTOMER EXPERIENCE SYSTEMS INNOVATION

Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs3

> You can also choose coverage for your eligible dependents. Eligible members of your family include:

> Your spouse> Your eligible children> Your children who are physically or mentally disabled> Your domestic partner and their eligible dependents

> Children are eligible up to the age of 26 regardless of student or marital status

> Child cannot be eligible for another employer sponsored plan> It does not apply to dependents of the child (spouse or child)> Cost – will not be treated differently than other eligible dependent children> This phrase applies to children that are between the ages of 19 and 26. Under the

Healthcare Reform Act, we are required to extend coverage for adult children up to the age of 26, regardless of their student or marital status. However, if the adult child is eligible to participate in another employer’s plan, the adult child cannot be enrolled in the Amdocs plan. An example would be if the child has a job that offers benefits. Another example would be child is married and the spouse is working a job that offers benefits. This condition for coverage applies to all medical, dental and vision plans offered by Amdocs.

> You must provide the Social Security Number (SSN) for all eligible dependant enrolled in the Amdocs benefit plans

Dependent Eligibility

Page 4: Amdocs A Place to Grow

AMDOCS > CUSTOMER EXPERIENCE SYSTEMS INNOVATION

Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs4

> Amdocs offers insurance coverage for Domestic Partners and eligible children of the domestic partner

> A Declaration will need to be completed by both the employee and Partner, confirming that eligibility criteria has been met. The form will be sent once elections have been updates in Benefits Self Service

> Eligible Domestic Partners include: > Same sex partners > Opposite sex partners when one partner is at least over the age of 62 > Eligible Domestic Partner Children

> Employee contribution rates for the additional coverage will be taken from each paycheck on a post-tax basis. This deduction will be in addition to current pre-tax deductions for each coverage type that is selected.

> For tax reasons, the dollar value for the health, dental and vision coverage will be treated as taxable income for the taxable income for these benefits is subject to withholdings for Federal income tax, State income tax as well as FICA. Payroll will withhold the appropriate POST-Tax deduction for each pay period. The taxable income will be reported on the W2 issued to the employee for the years in which the coverage is provided

Domestic Partner Coverage

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs5

Impact of Health Care Reform Grandfathered Status Statement> The Amdocs Medical Plan believes the Amdocs Medical Plan is a “grandfathered

health plan” under the Patient Protection and Affordable Care Act (the Affordable Care Act). As permitted by the Affordable Care Act, a grandfathered health plan can preserve certain basic health coverage that was already in effect when that law was enacted. Being a grandfathered health plan means that your plan may not include certain consumer protections of the Affordable Care Act that apply to other plans, for example, the requirement for the provision of preventive health services without any cost sharing. However, grandfathered health plans must comply with certain other consumer protections in the Affordable Care Act, for example, the elimination of lifetime limits on benefits

> Questions regarding which protections apply and which protections do not apply to a grandfathered health plan and what might cause a plan to change from grandfathered health plan status can be directed to the plan administrator at St. Louis Benefits Department at 1-866-426-8003. You may also contact the Employee Benefits Security Administration, U.S. Department of Labor at 1-866-444-3272 or www.dol.gov/ebsa/healthreform. This website has a table summarizing which protections do and do not apply to grandfathered health plans

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs6

> The administrator is Health Alliance (www.healthalliance.org)> Eligibility begins on date of hire> A Health Alliance form, located on the

Champaign website, must be completed/returned to the St. Louis office if you elect coverage from Health Alliance.

> Two Options> HMO> PPO

Medical Plan Options

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AMDOCS > CUSTOMER EXPERIENCE SYSTEMS INNOVATION

Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs7

> No Annual Deductible for In-Network Services

> Must select Primary Care Physician> Doctor’s Visit - $15 co-pay> Emergency Room - $125 co-pay, which is waived if admitted> Hospital Services (inpatient or outpatient) - paid 100%> Lifetime maximum benefit is unlimited> Out of Network Benefit – no coverage unless its an emergency

> Annual Out of Pocket Limit > Employee $1000> Family $3000

HMO Plan

Page 8: Amdocs A Place to Grow

AMDOCS > CUSTOMER EXPERIENCE SYSTEMS INNOVATION

Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs8

Preferred Provider Organization (PPO)

> Do not have to select a Primary Care Physician > Doctor’s Visit - $15 co-pay> Emergency Room - $125 co-pay, which is waived if admitted> Hospital Services (inpatient or outpatient) - paid 100%> Lifetime maximum benefit unlimited

> Annual Deductible (In-Network)> Employee $250> Family $500

> Out of Network> Plan pays 80% after employee deductible and is subject to reasonable and customary charges

Annual Deductible Out of Network> Employee $500> Family $1000

Annual Out of Pocket Limit Out of Network> Employee $1200> Family $2400

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs9

> Prescription Coverage under the HMO and PPO Plans

> In Network (30 day supply) - pays 100% after $5 co-pay for generic, or $15 preferred brand, or $35 for non-preferred brand (subject to limitations)

> Mail Order (90-day supply) - Pays 100% after $13.75 co-pay for generic, $41.25 preferred brand, or $96.25 for non-preferred

> Out of Network – 50% co-insurance

Prescription Coverage - HMO and PPO Plans

Page 10: Amdocs A Place to Grow

AMDOCS > CUSTOMER EXPERIENCE SYSTEMS INNOVATION

Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs10

What’s the difference between HMO & PPO?

HMO PPO

Select a Primary Care Physician (PCP)

Yes No

In-Network Deductible $0 $250/Person$500/Family

Doctor’s visit $15 co-pay $15 co-pay

Inpatient Hospital Services 100% Coverage $0 Co-Pay

100% Coverage $0 Co-Pay

Emergency Room $125 co-pay $125 co-pay

Pharmacy Retail $5/$15/$35 $5/$15/$35

Lifetime Limit Unlimited Unlimited

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs11

> Administered by CIGNA Dental> www.cigna.com

> Eligibility begins date of hire

> Employee may choose a provider from:> CIGNA Core Network> CIGNA Radius Network> Non-Contracted (Out of Network) Provider

> Annual Deductible > $50 for individual> $150 for family> Waived for preventive care

Dental Plan

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs12

Dental Plan (cont.)

BenefitCIGNA Core or

Radius Networks Out-of-Network

Preventative 100% 100%

Basic Services 85% 85%

Major Services 50% 50%

Orthodontics 50% 50%

UCR ProtectionProtection from

amounts over usual and customary charges

NO protection from amounts over usual

and customary charges

> Examples of Preventive Services are:> Oral Exam (limit to 2x per year)> Bitewing X-rays (not more than 2x per year)> Prophylaxis (limited to 2 treatments per year)

> If you choose a Non-Contracted provider employee may have to file claim for reimbursement. Claims will be subject to usual & customary rates.

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs13

Dental Plan (cont.)

> Orthodontic Treatment > Plan pays 50% after deductible> $1,000 Maximum lifetime benefit> Covers children up to age 19> Treatment in progress will not be covered

> $1,500 annual maximum benefit for other than orthodontic treatment

> Wellness Plus Program – If participants get 2 routine exams/cleanings per year their annual maximum benefit will increase by $100 for the following calendar year, up to a maximum of $1800.

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs14

> Administered by Davis Vision> Davis Vision Member Services: 1-800-999-5431> Davis Vision Website: www.davisvision.com

> Eligibility begins date of hire

> Two options for coverage are available> Basic Vision Plan – no cost to employee> Voluntary Vision Plan – employee pays cost of plan

> Frequency of visits> Once every 12 months (from last date of service)> Plan pays for either lenses & frames or contacts once in a 12 month

period

> Out of network coverage is available. Benefits are paid at a lesser rate

Vision Plan Options

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs15

Vision Plan Options (cont.)

Basic Vision Plan In-Network Benefits

Services Co-pay Patient Price

Eye Exam$10 $0.00 after co-pay

Glasses Co-pay Patient Price

Standard Frames -Priced up to $70 Retail -Priced above $70 Retail

Fee based on cost of frame Varies by cost of frame

Standard Lenses Fee based on cost of frame Varies by type of lens

Contact Lenses Co-pay Patient Price

Contact Lens Evaluation n/a 15% off Usual & Customary charges

Conventionaln/a 20% off Usual & Customary charges

Disposable/Planned Replacementn/a 10% off Usual & Customary charges

Page 16: Amdocs A Place to Grow

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs16

Vision Plan Options (cont.)

Voluntary Vision Plan In-Network Benefits

Services Co-pay Patient Price

Eye Exam$10 $0.00 after co-pay

Glasses Co-pay Patient Price

Frame Allowancen/a Up to $130 PLUS 20% discount for amount over

$130

Standard Lenses$25 $0.00

Contact Lenses Co-pay Patient Price

Contact Lens Evaluation$25.00 n/a

Conventionaln/a Up to $130 PLUS 15% discount for amount over

$130

Disposable/Planned Replacement n/a $0.00 (up to 4 boxes)

Page 17: Amdocs A Place to Grow

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs17

Addition Benefits Programs

> Life Insurance - Administered by MetLife > Eligibility begins date of hire> Basic (employer provided)

> Employee only coverage equal to 1.5x annual base salary, up to $1 million

> Optional (employee paid) – can elect coverage for employee, spouse or children. *Guarantee issue applies only when coverage is first offered

> Employee - may choose from $75,000 to $1,000,000 in additional coverage. Guaranteed issue of $300,000*. If you elect over $300,000 in additional coverage, evidence of insurability will be required. Maximum level of coverage - $1 Million.

> Spouse - may choose $10,000 increments up to $100,000. Guaranteed issue of $30,000*. If elect over $30,000, evidence of insurability will be required.

> Child(ren) - may elect $5,000 or $10,000 coverage per child age 2 weeks to 19 years (age 25 if full time student). Child coverage covers all children.

> The cost of employee and spousal optional life coverage will increase as the employee ages. Additional information can be found in the appendix.

Please note that if your spouse also works for Amdocs you may not carry spousal Optional Life Insurance on each other.  Children of Amdocs employees may only be covered by one parent for Optional Life Insurance.

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs18

> Accidental Death & Dismemberment Insurance > Eligibility begins date of hire

> Basic (employer provided)> Employee only coverage equal to 1.5x annual base salary

> You may elect Optional Accidental Death & Dismemberment (employee paid)

> Employee – can elect from 1 to 10x salary, up to a maximum of $2 Million> Family – Employee elects from 1 to 10x salary. Spousal benefit is equal to

50% of employee election. Each child has a benefit of $10,000 (children age 2 weeks to 19 years - age 25 if full-time student)

> No evidence of insurability required

Addition Benefits Programs (Cont.)

Please note that if your spouse also works for Amdocs you may not carry Optional Accidental Death & Dismemberment Insurance on each other.  Children of Amdocs employees may only be covered by one parent for Optional Accidental Death & Dismemberment Insurance.

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs19

Additional benefits provided by Amdocs at no cost – noenrollment required

> Disability – Administered by CIGNA Leave Solutions

> Short Term Disability – up to 26 weeks> Starts on 8th calendar day of illness – 2nd day for injury related to an accident> Pays 100% of base earnings for the first 11 weeks, following elimination

period> Pays 70% of base earnings for weeks 13 through 26

> Long Term Disability – Disability that exceeds 26 weeks> For employees in bands 1-3: pays 60% of base monthly earnings to a

maximum benefit of $5,000 per month> For employees in bands 4 & up: pays 60% of base monthly earnings to a

maximum benefit of $10,000 per month

Additional Benefit Programs (Cont.)

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs20

> Employee Assistance Program > Administered by Ceridian LifeBalance®

> Free, confidential assistance to support you with all the issues of daily living > Counseling (including addiction and recovery)> Eldercare, childcare> info on “how to” – lease cars, apartment listings, general tax information, etc.> Financial> Legal> Health and Wellness

> Contact LifeBalance® at 1-877-510-0556 or go online to www.lifebalance.net user ID: amdocs password: us

> Voluntary Home and Auto Discount Program > Administered by MetLife

> May be eligible for discounts on your home or auto insurance> If interested in a free, no obligation quote contact MetLife at 800-GET MET 8

(438-6388)

Additional Benefit Programs (Cont.)

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs21

Flexible Spending Account (FSA)

> Claims Administrator is Conexis> www.conexis.org> Member services: 866-279-8385

> Account Options: 1) Health Care FSA 2) Dependent Care FSA

> Enrollment for these plans will start the 1st of the month following your enrollment. Example: You enroll through Benefits Self Service on January 15th, your benefits are effective the 1st of February.

> Employee Contribution Amounts

Minimum Maximum> Health Care $240/year $5,000/year> Dependent Care $240/year $5,000/year per family

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs22

> Health Care FSA

> Benefit – Eligible contributions are deducted from paycheck on pre-tax basis – placed into a separate account

> Eligible Expenses – Medical, dental and vision expenses not covered by existing insurance

> Conexis Elite Card – Can be used at point of service to pay for eligible health care expenses - no need to file paper claims for reimbursement

> Dependant Care FSA

> To Qualify – both spouses must be working full time; or 1 spouse working full-time & 1 spouse a full-time student; or single parent with primary custody

> Eligible Expenses – those that enable you and your spouse to work, or enable your spouse to attend school full time

> This includes daycare and before and after school care for children up to age 13

Flexible Spending Account (FSA)

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs23

> The Flexible Spending Accounts through Conexis have a grace period for the filing of previous year claims

> Employees will have until March 15th of the following year to use the Healthcare & Dependent care funds remaining in their current year’s account with Conexis. This grace period extends the amount of time in which eligible expenses can be reimbursed to the employee

> “Use it or Lose it” Feature – Employees will have until March 31st of the following year to file claims. Unused funds will not be returned to the employee and may will NOT be carried forward

Flexible Spending Account Grace Period

Page 24: Amdocs A Place to Grow

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs24

> Claims Administrator is Conexis> www.conexis.org> Member services: 866-279-8385

> Options:> Parking Plan –

> Maximum Monthly Reimbursement: $230.00> Parking claims must be submitted for reimbursement within 180 days of

the expense

> Transit Plan – includes, but not limited to subway and bus fare. Does not include tolls.> Maximum Monthly Reimbursement: $230.00 > Transit passes MUST be ordered through Conexis’ on-line system> Transit passes not purchased through on-line system will NOT be

reimbursed> Additional information on eligible expenses is available from Conexis

Transit Reimbursement Account

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs25

> Critical Illness> Cash benefit paid in a lump sum upon first diagnosis> Covered conditions include: Heart Attack, Stroke, Cancer,

Major Organ Transplant, End Stage Renal Failure and Coronary By-pass Surgery

> Has a wellness benefit for annual health screenings> Family coverage available

> Accident> No medical questions – guarantee issue> Benefit payment based on injury> Wellness benefit for annual health screenings> Family coverage is available> Pre-existing limitations may apply

> Hospital Indemnity> No medical questions – guarantee issue> Covers hospital admission for sickness or injury> Family coverage is available> Pre-existing limitations may apply

Voluntary Benefit Programs – Continental American

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Retirement Savings 401(k) Plan

> Plan Administrator> Prudential Retirement Services

> Eligibility > Begins after receipt of first paycheck and you will be able to

enroll approximately 3-5 business days after you have received it

> Enrollment> Contact Prudential Retirement at 1-877-PRU-2100 or go on-

line at www.prudential.com/online/retirement to enroll or make changes

> Beneficiary Designation forms> Located on the new hire website> Participants must complete and return to the St. Louis office

Page 27: Amdocs A Place to Grow

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs27

Retirement Savings (401k) Plan (cont’d.)

Note: For 2011, if you have contributed to other 401(k) plans during the calendar year, you are responsible for monitoring your total annual contributions to ensure you do not exceed contribution limits.

> Contributions> Up to 50% of your pay (subject to tax law limits)> 2011 employee contribution limit is $16,500 and the

employee compensation limit is $245,000

> Company Matching Contribution> 0.50 per dollar contributed, up to 6% of your total eligible

compensation . (i.e. If you are putting in 6% or more into the Amdocs 401k plan the company will contribute 3%)

> Vesting – 20% per full year of employment> 100% vested after 5 years of service

Page 28: Amdocs A Place to Grow

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Retirement Savings (401k) Plan (cont’d.)

Note: If you will not be contributing over $16,500 through the Amdocs payroll in 2011 you will not qualify for Catch up contributions under the Amdocs 401k plan. If you are eligible for Catch up you will need to make sure that you do not contribute more than $22,000 between your previous employer’s 401k plan and the Amdocs 401k for the 2011 plan year.

> Catch Up Provision> Must be at least 50 years of age (or will turn 50 in the

calendar year) to be eligible> May elect to contribute up to an additional $5,500 for 2011> Can make Catch Elections online at

www.prudential/retirement/online or by calling Prudential at 1-877-778-2100

> Your catch-up contributions will rollover from year to year and will be taken at the same time as your regular employee contribution.

> Company will not match Catch Up contributions

Page 29: Amdocs A Place to Grow

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs29

Recognition of Worldwide Service with Amdocs

> Amdocs is recognizing world wide service with all Amdocs business groups for vesting purposes in the 401k plan.

> Example, an employee worked for Amdocs Israel for 2 years then transferred to Amdocs US. This employee would be 40% vested in the 401k plan.

> Amdocs will immediately vest an employee at 100% upon transfer to another Amdocs business group even if they do not have 5 years of service with Amdocs.

> As long as an employee is actively employed in any business group of Amdocs they can not take a distribution of their 401k plan or rollover the money into an IRA of their choice. This means, for example, if any employee transfers from the US BG to Israel BG their money must remain in the Amdocs 401k plan.

> A distribution or rollover can only be taken if the employee terminates with ALL Amdocs business groups or reaches age 59 ½.

Retirement Savings (401k) Plan (cont’d.)

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> What is Benefits Self Service?> A tool that will allow employees to view their benefit information on-line> Accessible through the Amdocs Portal or through Webgate> Will eliminate the need to complete paper forms to enroll or make

changes to benefit choices

> What can employees do in Benefits Self Service?> Allows employees to

> View their current benefit choices at any time> Make updates during open enrollment

> Make updates if you have a qualifying event> Examples are

> marriage> divorce> birth of a child> change of employment status for spouse

Amdocs – Benefits Self Service

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs31

> Complete Instructional manuals are available through the Portal or through Webgate on the US Benefits website under Human Resources> Steps to take to get to Benefits Self Service Instructional

manuals> Visit North American Human Resources> Select “Benefits United States and Canada”> Select “United States Benefits”> Select “Benefits Self Service Info”> Review “New Hire Manual”

> Portal User section is for employees at Amdocs sites

> Webgate User section is for employees logging in through:> Web-Based Services or VPN Access

Accessing Instructional Manuals for Benefits Self Service

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To Access Benefits Self Service Through Portal

Employee Self Service

Instructional Manuals:

Human Resources North America

Employee Self Service

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs33

To Access Benefits Self Service Through Webgate

Human Resources North AmericaEmployee Self

Service

Instructional Manuals:Human Resources

USA

http://webgate.amdocs.com/

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How Do I Access Benefits Self Service?

To update dependents

under your profile

Benefits for US

My Personal Details

Page 35: Amdocs A Place to Grow

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Information Security Level 2 – Sensitive © 2010 – Proprietary and Confidential Information of Amdocs35

Thank you for your time!

Please go to Employee Self Service (https://selfservice/) to enroll in the Amdocs Benefit Plans. Remember you must enter the SSN for any dependants that are covered under the Amdocs Medical Plans.

St. Louis Benefits Department

Email: [email protected] Free: 1-866-406-8003Fax: 314-212-8359

Questions?

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Appendix - 2011 Rates

Plan Option 2011 Rate

  Health Alliance HMO Plan Employee Only $25.00

Employee + 1 $68.00

Employee + Family $118.00 Health Alliance PPO Plan Employee Only $29.00

Employee + 1 $91.50

Employee + Family $149.00

 CIGNA  Dental Plan Employee Only $3.00

Employee + 1 $6.50Employee + Family $10.50

  Basic Vision Plan Employee Only $0.00

Employee + 1 $0.00

Employee + Family $0.00  Voluntary Vision Plan Employee Only $3.13

Employee + 1 $5.63

Employee + Family $8.75

Rates are based on pre-tax deductions taken each pay period.

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Appendix - 2011 Domestic Partner RatesCoverage Health Alliance HMO Health Alliance PPO CIGNA Dental Voluntary Vision

Pre-tax Post-tax Pre-tax Post-tax Pre-tax Post-tax Pre-tax Post-tax

Employee and Domestic Partner or Domestic Partner child 43.00 25.00 62.50 29.00 3.50 3.00 2.50 3.13

Employee + Domestic Partner and 1 Domestic Partner child 68.00 50.00 91.00 58.00 4.50 6.00 2.49 6.26

Employee + Domestic Partner and 2 Domestic Partner Children 43.00 75.00 62.00 87.00 1.50 9.00 0.00 8.75

Employee + Domestic Partner and 3 or more Domestic Partner Children 18.00 100.00 33.00 116.00 0.00 10.50 0.00 8.75

Employee + 1 and Domestic Partner or Domestic Partner child 93.00 25.00 120.00 29.00 7.50 3.00 5.62 3.13

Employee + 1 and Domestic Partner and 1 Domestic Partner Child 68.00 50.00 91.00 58.00 4.50 6.00 2.49 6.26

Employee + 1 and Domestic Partner and 2 Domestic Partner Children 43.00 75.00 62.00 87.00 1.50 9.00 0.00 8.75

Employee + 1 and Domestic Partner and 3 Domestic Partner Children or more 18.00 100.00 33.00 116.00 0.00 10.50 0.00 8.75

Employee + Family and Domestic Partner or Domestic Partner child(ren) 93.00 25.00 120.00 29.00 7.50 3.00 5.62 3.13

Employee + Family and Domestic Partner and 1 Domestic Partner child 68.00 50.00 91.00 58.00 4.50 6.00 2.49 6.26

Employee + Family and Domestic Partner and 2 Domestic Partner children 43.00 75.00 62.00 87.00 1.50 9.00 0.00 8.75

Employee + Family and Domestic Partner and 3 Domestic Partner children or more 18.00 100.00 33.00 116.00 0.00 10.50 0.00 8.75

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Rates per $1000 of coverage Rates based on employee’s date of birth Divide by 2 to get cost each paycheck Child coverage is $1.00 per month for each $5,000 of coverage

Appendix - Optional Life Insurance

Age Rate Age Rate< 30 0.06 30 to 34 0.07

35 to 39 0.11 40 to 44 0.17

40 to 49 0.27 50 to 54 0.44

54 to 59 0.72 60 to 64 0.95

65 to 69 1.47 70 + 2.63

Optional Life Insurances rates for both Employee and Spouse will increase as the employee crosses into the next age band in the chart. The increase will take effect as of January 1st of the following calendar year after crossing into the next age band , or if a qualifying event occurs prior to January 1st. Examples of a qualifying event would include a salary change, marriage, divorce, or birth of a child. In which case, the increase would take effect as of the date of the qualifying event.

The Optional Life Insurance offered through MetLife is a Term Life Policy. Term life insurance, as an employee benefit ,works differently than in the individual life insurance market.  In the individual market a person will pay premium for a set term and at the end of the term the insurance typically goes away.  In the group world, the "term" would be as long as the employee is employed at this employer and is electing to pay premium. Since the rates are presented in 5 year age bands, the premium increases as a person ages.

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Appendix – Optional AD&D Rates

> Rates per $1000 of coverage

> Divide by 2 to get per paycheck amount

Coverage Rate

Employee Only 0.023 per $1000 of coverage elected

Family 0.038 per $1000 of coverage elected

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Appendix – Voluntary Plan Rates

Rates based on each pay period

Coverage RateCritical Illness Based on age and amount of coverage

Accident EmployeeEmp + SpouseEmp + Child(ren)Family

$6.48$9.97

$13.46$16.94

Hospital Indemnity EmployeeEmp + SpouseEmp + Child(ren)Family

$15.30$31.57$21.06$37.31