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1 Redlands Chris an Migrant Associa on Employee Benefits MEDICAL DENTAL VISION LIFE AND AD&D FAMILY TERM LIFE SHORT TERM DISABILITY LONG TERM DISABILITY EMPLOYEE ASSISTANCE PROGRAM 403(B) THRIFT PLAN This Guide is only intended to offer an outline of benefits. All details and contract obliga ons of plans are stated in the group contract/insurance documents, including any disclosures (whether regarding grandfathering of plans or others) required by the new health reform law, the Pa ent Protec on and Affordable Care Act (PPACA). In the event of a conflict between this guide and the group contract / insurance documents, the group contract/insurance documents will prevail. Please contact your Human Resources Department for further informa on.

2 Medical: Blue Cross Blue Shield Preven ve Care (Includes adult/child wellness, immuniza ons, mammograms, colonoscopy) Primary Care Office Visit Specialist Visit Preferred HMO 45 BlueCare Network Open Access Value Plan 3900 BlueOp ons Network In Network Only In Network Out of Network Covered 100%, No Ded. Covered 100%, No Ded. $15 copay $35 copay $15 copay $35 copay 50%, Ded. waived Allergy Tes ng/injec ons $10 copay $10 copay Diagnos c Laboratory X ray Complex Imaging (CT, PET) Convenience Clinic Urgent Care Emergency Room Inpa ent Hospital Inpa ent Physician Charges Outpa ent Surgery Outpa ent Physician Charges Ind Lab/Diag Center/Hosp $25 / $25/ $100 copay $25 / $25 /$100 copay Dr office/diag Center/Hosp $50/$50/$100 $15 copay $50 copay $350 copay 20% a er Ded. $100 copay Included in copay Ind Lab/Diag Center/Hosp 100% / 30% a er Ded./$250 copay Dr office/diag Center/Hosp $200/$200/$250 $15 copay $2,000 per admission $250 copay Deduc ble (Individual/Family) Coinsurance Out of pocket Maximum $1,500 ($3,000) 20% $2,000 ($4,000) $1,500 ($3,000) 30% $4,000 ($8,000) $4,500 ($9,000) 50% $20,000 ($20,000) Life me Maximum Unlimited Unlimited Unlimited Prescrip ons (Step Therapy) Tier 1 Tier 2 Tier 3 Tier 4 $20 copay $40 copay $60 copay 20% $25 copay $45 copay $65 copay 20% Mail Order (90 days) $0 / $100 / $150 / 20% $0 / $115 / $165 / 20% Online Customer Service: or Toll Free Payroll Deduc ons: Medical (24x per year) Preferred HMO 45 Open Access Value Plan Less than $25,000 $25,000+ Less than $25,000 $25,000+ Employee Only $ $ $ $ Employee & Spouse $ $ $ $ Employee & Child(ren) $ $ $ $ Employee & Family $ $ $ $

3 Dental Insurance: Blue Cross Blue Shield Dental Care DHMO Plan BlueDental Care Network In Network Only Dental PPO Plan Blue Dental Plus Network In Network Out of Network Deduc ble None $50 ($150) $50 ($150) Preven ve Services See Fee Schedule 0% (no Ded.) 0% (no Ded.) Basic Services See Fee Schedule 20% a er Ded. 20% a er Ded. Major Services See Fee Schedule Calendar Year Maximum Unlimited $1,500 $1,500 Customer Service: Payroll Deduc ons: Dental (24x per year) Dental Care DHMO Plan Dental PPO Plan Employee Only $ 6.57 $ Employee + One $ $ Employee & Family $ $ We designed Blue365 to support you as you make healthy choices every day and throughout your life. Blue365 gives you access to special savings on health related products and services from leading na onal companies. Every day, 365 days a year, you make important choices about your health and the health of your loved ones. Now Blue365 brings you a wider range of healthy op ons, all in one convenient place. Health and Wellness Discounts: Weight and Nutri on Fitness Vision and Hearing Discounts Alterna ve Medicine Mind/Body Dental Care Wellness Products Health Life Products For more informa on go to 365 healthy deals 2

4 Group Term Life Insurance: Mutual of Omaha Employee: $0.97 per payroll $40,000 Life Benefit; $80,000 (Accidental Death) Your Benefit will reduce by 50% at age 70 Includes: Conversion privilege, Waiver of premium (see cer ficate of coverage for more informa on) If you decline ini ally, you must complete an Evidence of Insurability form. Certain underwri ng guidelines and restric ons may apply. To qualify for coverage Employees must be ac vely at work or in a non disability status. Family Term Life Insurance: Abacus Series Employee Paid Benefit Employees: $10,000 increments to a maximum of $500,000 (Coverage in excess of $500,000 not to exceed 5 mes annual salary). Minimum coverage is $20,000 Spouses: $5,000 increments to a maximum of $250,000 not to exceed 50% of employee s coverage. Minimum coverage is $10,000 Child(ren): $10,000 New hires who enroll within their ini al eligibility period are Guaranteed to be issued coverage up to $180,000 for employee and $50,000 for spouse. If you decline ini ally, you must complete an Evidence of Insurability form. Certain underwri ng guidelines and restric ons may apply. To qualify for coverage Employees and Spouses must be ac vely at work or in a non disability status. 3

5 Short Term Disability: Abacus Series Employee Paid Benefit Wai ng Periods Benefit Dura on Benefit Amounts 0 days for Injury, 7 days for Sickness 13 weeks Employees can choose between $75 to $700 per week, not to exceed 60% of annual income Guaranteed issue up to 60% of your annual salary All pre exis ng condi ons are covered a er 12 months of coverage Par al disability benefit pays 50% of the benefit for up to 13 weeks Includes waiver of premium Long Term Disability: Mutual of Omaha Employer Paid Benefit This Coverage is Paid 100% by RCMA Elimina on Period Benefit Dura on 90 days ADEA Schedule Benefit Amounts 60% of monthly earnings to a maximum of $5,000 Own Occupa on 24 months 4

6 Vision Insurance: CompBenefits Vision Insurance Plan Frequency Vision Exam Lenses/Contacts Frames (1 pair) VisionCare Doctors Every 12 months Every 12 months Every 24 months Non Panel Doctors Every 12 months Every 12 months Every 24 months Vision Exam $10 copay, then covered in full Reimbursed up to $30 after $10 copay. Materials copay (Lenses & Frames) Lenses Single Bifocal Trifocal Frames $15 copay $15 copay Covered in full a er mee ng Materials copay Covered in full (within selec on) a er mee ng Materials copay $100 allowance outside of selec on Reimbursed up to $20 after $15 copay Reimbursed up to $40 after $15 copay. Reimbursed up to $60 after $15 copay. Reimbursed up to $70 after $15 copay (within selection) Reimbursed up to $30 after $15 copay. outside of selection Contacts Up to $80 a er Materials copay Reimbursed up to $80 after $15 copay Lasik Surgery Par cipant will pay no more than $1,800 per eye Total Employee Pays is $25 ($10 exam copay/$15 Materials (Lenses, Frames) copay. Unless employee chooses frames/lenses not in the selec on, then difference is employee s responsibility. Customer Service: or Payroll Deduc ons: Vision (24x per year) Vision Plan Employee Only $ 3.35 Employee & Family $

7 EAP: Mutual of Omaha All employees may receive confiden al professional assistance in resolving personal, work related, and family ma ers through the Employee Assistance Program. Toll Free Provided at no charge and is available to employees 24 hours a day May be used by any member of the household Includes 3 free face to face visits Unlimited phone counseling sessions 403(b) Thri Plan: Principal Financial Re rement Plan through RCMA All RCMA employees are eligible to save money pre taxed by contribu ng to the 403B thri plan To receive the employer match, you must be at least 21 years of age, and have completed one (1) year of service with at least 1000 hours of work Notes: 6

8 The Rollason Center 402 W. Main Street Immokalee, Florida Phone (239) (800) Fax: (239) Lorena Hernandez, HRIS and Benefits Manager Dee Dee Cruz, Benefits Specialist Debbie Harper, Vice President / Account Management Supervisor Benefit Ques ons, Issues & Claims Tel Nancy Boyer, Assistant Account Manager Benefit Ques ons, Issues & Claims Tel For Assistance en Español: Reanna Hipps, Account Manager Benefit Ques ons, Issues & Claims Tel BB&T J. Rolfe Davis Insurance 850 Concourse Parkway South, Suite 200 Maitland, Florida (407) (800) Fax (888)

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