VISION INSURANCE – ABC Company offers vision insurance through EyeMed Eye Med: - $10 copayment for annual eye examination - Contact Lenses & Lenses coverage every 12 months - Frames coverage every 24 months - Extra Discounts and Savings offered when enrolling in the Eye Med Vision Plan - In network and out of network options VISION INSURANCE – Biweekly Employee Contributions DENTAL BLUE HIGH PLAN Employee $2.42 Employee + Spouse $1.00 Employee + Child(ren) $1.05 Family $1.54 ADDITIONAL BENEFITS LIFE & DISABILITY INSURANCE – Sunlife - Group Life and Accidental Death & Dismemberment (AD&D): 3x annual earnings, up to $650,000.00 - Short Term Disability: 100% pay for maternity leave, otherwise 75% of total weekly earnings - Long Term Disability: 60% of monthly base salary, maximum amount of $13,000 coverage FLEXIBLE SPENDING ACCOUNTS – Benefit Resource, Inc. - Reserve funds for medical or dependent care expenses without paying taxes on your contributions - Runs on ABC Company’s Plan Year November - October - Medical FSA: up to $2,750 annually (not available if enrolled in HSA), annual election is available after first biweekly contribution - Limited Purpose FSA: up to $2,750 annually for Dental & Vision Expenses (available if enrolled in HSA) - Dependent Care FSA: up to $5,000 annually per family 2022 BENEFIT SUMMARY
ABC Company Longform Benefit Summary Page 2 Page 4