Applied Technology Group - 2021 Employee Benefits Guide FINAL

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VOLUNTARY ACCIDENT INSURANCE CARRIER: USAble Life COVERAGE & OPTIONS SURGERY BASIC SELECT ULTRA Tendon/Ligament $500 $600 $800 Torn Knee (surgical repair) $500 $600 $800 Ruptured Disc $500 $600 $800 Torn Rotator Cuff $500 $600 $800 WELLNESS BENEFIT BASIC SELECT ULTRA Annual benefit amount $60 $75 $105 OPTIONAL RIDERS OPTION 1 EMPLOYEE SPOUSE CHILD Common Carrier Accidental Death $75,000 $75,000 $18,750 Other Accidental Death $50,000 $50,000 $6,250 OPTION 2 EMPLOYEE SPOUSE CHILD Common Carrier Accidental Death $150,000 $150,000 $37,500 Other Accidental Death $100,000 $100,000 $12,500 This Rider also provides benefits for: ● Accidental Dismemberment ● Child Education ● Paralysis ● Coma ● Child Care Center ● Repatriation ● Spouse’s Training ● Additional benefits if a seatbelt is worn or airbag deployed at the time of accidental death Semi-Monthly Rates NO RIDERS BASIC SELECT ULTRA Employee $5.87 $6.93 $8.70 Employee + Spouse $11.20 $26.42 $16.62 1 Parent Family $12.35 $13.21 $18.73 2 Parent Family $17.68 $21.07 $26.65 28
VOLUNTARY CANCER INSURANCE CARRIER: TransAmerica Cancer Insurance supplements your existing medical insurance in case you are diagnosed with cancer; medical insurance alone may not be enough to cover your expenses. The plan pays a cash benefit during the term of your coverage following a positive diagnosis of an internal cancer. WHY PURCHASE CANCER INSURANCE? You and your loved ones can rest a little easier knowing you have protection in place to help avoid depleting your bank accounts or taking on additional debt to cover day-to-day living expenses. ● ● ● ● Help cover medical plan deductibles, co-pays and other out-of-pocket costs Help cover everyday living expenses such as groceries, rent and mortgage payments Hire extra help for around the house, such as in-home caregivers Pay for travel to treatment facilities away from home as well as family visits Hospital Benefits Plan Option 1 - 1.00 Units Plan Option 2 - 1.00 Units Policy Pays Hospital Confinement $100 $100 per day of covered confinement Extended Benefits $200 $200 Attending Physician $20 $20 per day; begins on day 91 of continuous confinement; in lieu of all other benefits (except surgery and anesthesia) per day while hospital confined; one visit per 24-hour period Inpatient Drugs and Medicines $15 $15 per day while hospital confined Private Duty Nurse $100 $100 Ambulance $100 $100 Extended Care Facility $100 $100 per day while hospital confined; must be authorized by the attending physician; cannot be hospital staff or a family member for service by a licensed ambulance service for transportation to a hospital; admittance required per day; up to the number of days for the prior hospital stay; admittance must be within 14 days of hospital discharge Government or Charity Hospital $100 $100 per day of covered confinement; in lieu of all other benefits Hospice Care $100 $100 per day of hospice care; 100-day lifetime maximum; not payable while hospital confined 29
Page 1: 2021 BENEFITS ENROLLMENT GUIDE Appl
Page 4 and 5: BENEFITS OVERVIEW 4
Page 6 and 7: BENEFITS OVERVIEW ELIGIBILITY Full-
Page 8 and 9: MEDICAL INSURANCE 8
Page 10 and 11: TELEMEDICINE /VIRTUAL VISITS 10
Page 12 and 13: FLEXIBLE SPENDING ACCOUNTS 12
Page 14 and 15: FLEXIBLE SPENDING ACCOUNTS CARRIER:
Page 16 and 17: DENTAL INSURANCE CARRIER: Delta Den
Page 18 and 19: GROUP LIFE & VOLUNTARY LIFE 18
Page 20 and 21: VOLUNTARY LIFE INSURANCE CARRIER: U
Page 22 and 23: DISABILITY INSURANCE 22
Page 24 and 25: LONG TERM DISABILITY INSURANCE CARR
Page 26 and 27: ADDITIONAL VOLUNTARY BENEFITS 26
Page 30 and 31: VOLUNTARY CANCER INSURANCE CARRIER:
Page 32 and 33: VOLUNTARY CRITICAL ILLNESS INSURANC
Page 34 and 35: VOLUNTARY HOSPITAL INDEMNITY INSURA
Page 36: Applied Technology Group, Inc. 501-

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