Goodwill 2017 Benefits Overview

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2 Goodwill 2017 Benefits Overview BELOW IS A BRIEF OUTLINE OF IN-NETWORK BENEFITS For additional details and Out of Network benefits, please refer to the Summary Plan Descriptions at Blue Cross Blue Shield of Kansas City: PPO Medical Plans Eligible for employees working 30+ hours per week. Preferred-Care Blue Network PPO 2000 Premium Plan PPO 6500 Value Plan Deductible: Individual $2,000 $6,500 Deductible: Family $6,000 $13,000 Member Co-Insurance Covered at 100% After Deductible Covered at 100% After Deductible Out-of-Pocket Maximum: Individual $2,000 $6,500 Out-of-Pocket Maximum: Family $6,000 $13,000 Preventive Care Covered at 100% Covered at 100% Office Visit (PCP / Specialist) $30 Copay / $60 Copay Covered at 100% After Deductible Urgent Care $60 Copay Covered at 100% After Deductible Emergency Room Covered at 100% After Deductible Covered at 100% After Deductible Hi Tech Diagnostics (MRI, MRA, etc.) Covered at 100% After Deductible Covered at 100% After Deductible Inpatient Hospital Covered at 100% After Deductible Covered at 100% After Deductible Outpatient Hospital Covered at 100% After Deductible Covered at 100% After Deductible Retail Prescriptions: Tier 1/ Tier 2/ Tier 3 $10 / $30 / $50 $12 for tier 1 / Covered at 100% Mail Order Prescriptions: Tier 1/ Tier 2/ Tier 3 $30 / $90 / $150 After Deductible for Tier 2 and 3 $30 for tier 1 / Covered at 100% After Deductible for Tier 2 and 3 Health Risk Assessment Incentive Visit A Healthier You on to take your Health Risk Assessment today for the opportunity to reduce your monthly premiums by $25 each month. You and your covered spouse may complete this assessment. Out of Pocket Maximum includes deductible, coinsurance, and copayments. Ameriflex: Flexible Spending Account You can reallocate your annual compensation to pay for eligible health costs that may not be covered by your benefit plan and/or dependent care expenses. In essence, you will be paying for these expenses on a pre-tax basis. This is a voluntary plan and the amount you designate as your Annual Salary Reallocation should be conservative. Participants can roll over up to $500 of unused FSA dollars to the next year. Medical Expenses: Set aside up to $2,600 pre-tax to pay for unreimbursed qualified healthcare expenses Dependent Care Expenses: Set aside up to $5,000 (or $2,500 if married filing separately) for qualified dependent care Delta Dental of Kansas: Dental Plan Premier & PPO Networks Preventive 100% Deductible: Individual $50 (applies to Basic & Major only) Deductible: Family $150 (applies to Basic & Major only) Basic 80% Major 50% Annual Benefit Maximum $1,000 per person Orthodontia Not Covered

3 Assurant / SunLife: Vision Plan VSP Signature Network Frequency Benefit Examination Every 12 months $10 Copay Single Vision Lenses Every 12 months $25 Copay Lined Bifocal Lenses Every 12 months $25 Copay Line Trifocal Lenses Every 12 months $25 Copay Frames Every 24 months $130 Allowance, 20% off balance over $130 Contact Lenses Every 12 months $130 Allowance Lasik Discount Once Per Lifetime 15% off retail price, 5% off promotional price USAble: Voluntary Life and Accidental Death & Dismemberment Life and AD&D Coverage $10,000 for employee only Life and AD&D Coverage $25,000 for executive class All Life and AD&D amounts are subject to an age reduction schedule. MetLife: Voluntary Life and Accidental Death & Dismemberment Eligible for employees working 30+ hours per week. Benefit Increments Guarantee Issue Maximum Employee Coverage Up to 5 times base salary $10,000 $150,000 $500,000 Spouse Coverage Up to 50% of employee coverage $5,000 $50,000 $250,000 Child(ren) coverage Up to 50% of employee coverage for amounts of $1,000,$2,000, $4,000, $5,000 or $10,000 To purchase Spouse &/or Child(ren) coverage, you must have coverage on yourself. Guarantee Issue is applicable at initial eligibility only. MetLife: Voluntary Short Term Disability Eligible for employees working 30+ hours per week. Elimination Period 14 th day Accident or Sickness Short Term Disability Benefit 60% of weekly earnings to a maximum of $1,000 Benefit Duration 11 Weeks Assurant / SunLife: Voluntary Accident and Critical Illness Type of Plan Benefit Accident Insurance Coverage: Off the Job (Including Wellness Benefit) Critical Illness Insurance Coverage: (Including Wellness Benefit) Fixed benefits based on the type of injury & treatment received. Pays cash dollars directly to you regardless of medical insurance benefits. $50 per year wellness benefit for each covered individual for a covered health screening. Lump sum benefit (depending on the level of coverage selected) upon diagnosis of a critical illness; Heart Attack, Stroke, Cancer. Pays cash dollars directly to you regardless of medical insurance benefits. $50 per year wellness benefit for each covered employee and spouse for a covered health screening.

4 Goodwill 2017 Benefits Overview PTO Grid for 2017 Years of Service PTO A PTO B PTO C Part-Time Employees (after one year of service) Full-Time Employees Retail Management (with required 45 hour work week) Type of Coverage Employee Semi-Monthly Rates Medical: PPO 2000 Premium Plan Employee Only $55.85 Employee & Spouse $ Employee & Child(ren) $ Family $ Medical: PPO 6500 Value Plan Employee Only $22.28 Employee & Spouse $51.25 Employee & Child(ren) $42.34 Family $62.39 Dental: Employee Only $12.94 Employee & Spouse $25.21 Employee & Child(ren) $24.12 Family $36.78 Vision: Employee Only $3.95 Employee & Spouse $7.86 Employee & Child(ren) $8.46 Family $12.48 CONTACT INFORMATION Blue Cross Blue Shield of Kansas City Delta Dental of Kansas Assurant / SunLife USAble MetLife Ameriflex New Directions Behavioral Health Contact for questions about benefits and enrollments Contact for questions about claims, issues, and coverage Medical Dental Vision, Voluntary Benefits Basic Life/AD&D Voluntary Life/AD&D, Disability Flexible Spending Account Employee Assistance Program (816) Extension 252 benefits@mokangoodwill.org Kyla Boyd-Seward (913) kboyd-seward@trussadvantage.com Kara Vincent (913) kvincent@trussadvantage.com or This is a brief description of your benefits. If a discrepancy exists, benefits outlined in the carrier certificate will prevail.

5 Goodwill 2017 Rate Grids Supplement to Benefit Overview MetLife: Voluntary Life and AD&D Premiums Employee Life and AD&D Semi-Monthly Premiums Premiums are based on the employee's age on each policy anniversary Benefit in 000 s thru Age $ $ $ $ $ $ $ $ $ $ $ $ $ $ Coverage available up to $500,000 depending on employee salary. To calculate rate, multiply available rate by your desired election amount or contact Human Resources. AD&D cost required in all available Life Insurance policies. Spouse Life and AD&D Semi-Monthly Premiums Premiums are based on the employee's age on each policy anniversary Benefit in 000 s Thru Age $ $ $ $ $ $ $ $ $ $ Coverage available up to 50% of employee elected amount. To calculate rate, multiply available rate by your desired election amount or contact Human Resources. AD&D cost required in all available Life Insurance policies. Child Amount for Voluntary Life $1,000 $5,000 $10,000 Child Life and AD&D Premium *Employee must also be enrolled in coverage to elect for Child Life and AD&D.

6 USAble: Voluntary Life Premiums USAble All Staff Coverage: Voluntary Life and AD&D $10,000 of coverage $1.60 semi-monthly deduction USAble Executives Only Coverage: Voluntary Life and AD&D $25,000 of coverage $4.00 semi-monthly deduction MetLife: Short Term Disability Premiums MAXIMUM WEEKLY BENEFIT AGE SCHEDULE WITH SEMI-MONTHLY DEDUCTION THRU $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $1, *Coverage available up to 60% of your weekly income. Coverage is rounded to the nearest $50. Assurant: Accident Premiums Semi-Monthly Accident Premiums Employee Only $7.94 Employee & Spouse $10.40 Employee & Child(ren) $12.29 Family $14.75

7 Assurant: Critical Illness Premium SEMI-MONTHLY Critical Illness Premiums - Employee, Non-Tobacco Employee Age $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 Thru Age 29 $2.10 $4.20 $6.30 $8.40 $10.50 $12.60 $14.70 $16.80 $18.90 $ $3.40 $6.80 $10.20 $13.60 $17.00 $20.40 $23.80 $27.20 $30.60 $ $5.45 $10.90 $16.35 $21.80 $27.25 $32.70 $38.15 $43.60 $49.05 $ $10.40 $20.80 $31.20 $41.60 $52.00 $62.40 $72.80 $83.20 $93.60 $ $15.08 $30.15 $45.23 $60.30 $75.38 $90.45 $ $ $ $ $17.65 $35.30 $52.95 $70.60 $88.25 $ $ $ $ $ SEMI-MONTHLY Critical Illness Premiums - Employee, Tobacco Employee Age $5,000 $10,000 $15,000 $20,000 $25,000 $30,000 $35,000 $40,000 $45,000 $50,000 Thru Age 29 $3.08 $6.15 $9.23 $12.30 $15.38 $18.45 $21.53 $24.60 $27.68 $ $5.68 $11.35 $17.03 $22.70 $28.38 $34.05 $39.73 $45.40 $51.08 $ $9.63 $19.25 $28.88 $38.50 $48.13 $57.75 $67.38 $77.00 $86.63 $ $19.20 $38.40 $57.60 $76.80 $96.00 $ $ $ $ $ $25.73 $51.45 $77.18 $ $ $ $ $ $ $ $27.20 $54.40 $81.60 $ $ $ $ $ $ $ SEMI-MONTHLY Critical Illness Premiums - Spouse, Non-Tobacco Employee Age $2,500 5,000 $7,500 $10,000 $12,500 $15,000 $17,500 $20,000 $22,500 $25,000 Thru Age 29 $1.14 $2.28 $3.42 $4.55 $5.69 $6.83 $7.97 $9.10 $10.24 $ $1.75 $3.50 $5.25 $7.00 $8.75 $10.50 $12.25 $14.00 $15.75 $ $2.73 $5.45 $8.18 $10.90 $13.63 $16.35 $19.08 $21.80 $24.53 $ $5.08 $10.15 $15.23 $20.30 $25.38 $30.45 $35.53 $40.60 $45.68 $ $7.28 $14.55 $21.83 $29.10 $36.38 $43.65 $50.93 $58.20 $65.48 $ $8.53 $17.05 $25.58 $34.10 $42.63 $51.15 $59.68 $68.20 $76.73 $85.25 SEMI-MONTHLY Critical Illness Premiums - Spouse, Tobacco Employee Age $2,500 5,000 $7,500 $10,000 $12,500 $15,000 $17,500 $20,000 $22,500 $25,000 Thru Age 29 $1.62 $3.23 $4.84 $6.45 $8.07 $9.68 $11.29 $12.90 $14.52 $ $2.84 $5.68 $8.52 $11.35 $14.19 $17.03 $19.87 $22.70 $25.54 $ $4.75 $9.50 $14.25 $19.00 $23.75 $28.50 $33.25 $38.00 $42.75 $ $9.34 $18.68 $28.02 $37.35 $46.69 $56.03 $65.37 $74.70 $84.04 $ $12.48 $24.95 $37.43 $49.90 $62.38 $74.85 $87.33 $99.80 $ $ $13.17 $26.33 $39.49 $52.65 $65.82 $78.98 $92.14 $ $ $ SEMI-MONTHLY Child Premiums for all children, not per child $2,500 $0.22 $5,000 $0.43

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