Employee Benefit Insurance Plans Pat O’Neill O'NEILL BENEFITS GROUP BROKERAGE

Plan Administrators Medical Dental Vision CIGNA Healthcare Dental Delta Dental Plan of Colorado Vision Vision Service Plan (VSP) Life, Short and Long Term Disability UNUM/Provident

Eligibility For new hires: 30 hours full-time employment First of the month following date of hire and last day of the month for termination. 30 hours full-time employment Spouse and dependent children to age 19 or 24th birthday if full-time student Employer funding 100% of single coverage Partial dependent coverage

Monthly Medical Premiums Coverage Employee Company EMPLOYEE ONLY NO COST $276.73 EMPLOYEE + SPOUSE $100 $425.79 EMPLOYEE + CHILDREN $184 $258.77 EMPLOYEE + FAMILY $552.10

Delta Dental of Colorado DPO Plan Dental Plan Benefits Delta Dental of Colorado DPO Plan

Vision Service Plan Member Doctor Non-Member Doctor Exam Paid in full* Up to $35* Single Vision Lenses Up to $25* Bifocal Lenses Up to $40* Trifocal Lenses Up to $55* Lenticular Lenses Up to $80* Frames $90-$100 retail* Up to $45* Contacts (in lieu of glasses) Medically Necessary Up to $210* Elective Up to $105

Life Insurance Benefit Amount Maximum Benefit Non-Medical Maximum One Times Annual Salary plus $10,000 Maximum Benefit $170,000 Non-Medical Maximum $150,000 Reduces at age 70

Long Term Disability Elimination Period (deductible) Monthly Benefit 90 days Monthly Benefit 60% of monthly earnings to $10,000/mo Own occupation definition Pays to age 65 Pre-existing Conditions 12 month exclusion

O’Neill Benefits Group Brokerage OBGB 4450 Arapahoe, Suite 210 Boulder, Colorado Southeast corner of Foothills Parkway and Arapahoe Avenue in the Viewpoint Office Complex Pat O’Neill - Broker Customer Service (303) 433-9929