Vilhauer Enterprises

Employee Benefit Guide for Plan YearJanuary 1 - December 31, 2019

Welcome to your Vilhauer Enterprises Benefit Guide. Vilhauer Enterprises takes great pride in offering an excellent selection of benefits to all full-time employees. This guide provides quick access to information about your employee benefits program, which is an important part of your total compensation package. Please take a few moments to familiarize yourself with the benefit programs available to you as part of the Vilhauer Enterprises family.

EmployeeBenefit Guide

Plan YearJanuary 1 – December 31, 2019

DISCLAIMER: The information in this Enrollment Guide is intended for illustrative and

informational purposes only. The information contained herein was taken from various

summary plan descriptions, certificates of coverage and benefit information. Every effort

was taken to accurately report your benefits; however, discrepancies and errors are always

possible. It is not intended to alter or expand rights or liabilities set forth in the official

plan documents or contracts. It is not an offer to contract nor are there any express or

implied guarantees. In case of a discrepancy between this information and the actual plan

documents, the actual plan documents will prevail. If you have any questions about this

summary, please contact Human Resources.

What’s Inside

Eligibility & Enrollment Guidelines 3

Payroll Deduction Options 3

Medical Plans 4

Telemedicine Plan 5

tooth Dental Plan 6

Vision Plan 7

Life Insurance Plans 8

WHEELCHAIR NEW! Employer Paid Short Term Disability 9

401(k) Retirement Plan 10

Other Voluntary Benefits 11

Accident Care 12

Specified Critical Illness 13

Hospital Confinement Indemnity Insurance 13

Cancer Insurance 14

Voluntary Short Term Disability 14

Contacts 15

building Carrier Contacts 15Cover photo courtesy of Zach Stinton.

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Eligibility & Enrollment GuidelinesFull-time employees of Vilhauer Enterprises are eligible to enroll in the benefit plans on the first day of the month following completion of their corresponding waiting period. Employees who do not elect coverage at this initial eligibility date will only be able to enroll during the next open enrollment period, or if they experience an applicable qualifying event.

Open enrollment is the one opportunity during the year when you may make changes to your current benefit elections for both yourself and any eligible dependents without having a qualifying event. Examples of qualifying events include: marriage, divorce, birth or adoption of a child, loss of a dependent, court order, loss of other coverage, or significant change in employment status of you or your spouse. If you experience one of these qualifying events, please contact Human Resources within 30 days of the event.

Payroll Deduction OptionsAs a participant of the medical, dental and/or vision plans, you will have the option to pay for your portion of the plan premiums with pre-tax deductions or with post-tax deductions.

Pre-Tax Election:

◗Allows member to pay for plan premiums with pre-tax payroll deductions. This may

decrease the member’s overall tax liability.

◗Requires the member to maintain coverage during the entire plan year, not allowing

changes or cancellations of coverage unless there is a qualified family change.

Post-Tax Election:

◗Requires member to pay for plan premiums with post-tax payroll deductions.

◗Allows the member to cancel coverage at any time. The member could not re-enroll

until the next open enrollment.

IMPORTANT: Your deductions for this plan will be AUTOMATICALLY taken Pre-Tax unless you opt out in writing and submit to Human Resources prior to the start of coverage.

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Medical PlansYour medical benefits are administered by BlueCross BlueShield of Texas using the BlueChoice Network. Vilhauer Enterprises employees have two medical plan options:

PLAN BENEFITS MMB4 PLAN MM20 PLANCopays

Primary Care Physician $40 $30

Specialist $40 $30

Urgent Care $65 $55

Prescription Drugs

Generic $20 $20

Preferred Brands $40 $40

Non-Preferred Brands $60 $60

Calendar year Deductible

Individual $5,000 $2,000

Family $10,000 $6,000

Out of Pocket Limit (Includes Deductible & Prescription Out of Pocket Limit)

Individual $5,600 $5,000

Family $10,200 $10,200

Prescription Out of Pocket Limit

Individual $1,000 $1,000

Family $3,000 $3,000

Member Coinsurance

Preventive Care Covered at 100% Covered at 100%

Lab and X-ray 30% coinsurance, after deductible

Covered at 100%

Diagnostic Imaging (MRI, MRA, Pet Scans, CT Scans, etc.)

30% coinsurance, after deductible

25% coinsurance, after deductible

Hospital Services 30% coinsurance, after deductible

25% coinsurance, after deductible

Emergency Services 30% coinsurance after $100 copay

25% coinsurance after $100 copay

Weekly Employee Medical Contributions

Employee Only $18.78 $45.54

Employee + Child/ren $119.05 $179.70

Employee + Spouse $167.15 $238.50

Employee + Family $263.28 $372.66

In-network benefits are illustrated. Refer to your BlueCross BlueShield plan documents for plan details, including out-of-network benefits, and in-network providers.

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Telemedicine Plan

0914

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GET THE CARE YOU NEED

Teladoc doctors can treat many medical conditions, including:

• Cold & flu symptoms• Allergies• Bronchitis• Urinary tract infection• Respiratory infection• Sinus problems• And more!

WHEN CAN I USE TELADOC?

Teladoc does not replace your primary care physician. It is a convenient and affordable option for quality care.

• When you need care now• If you’re considering the ER or

urgent care center for a non-emergency issue

• On vacation, on a business trip, oraway from home

• For short-term prescription refills

10E-100A

With your consent, Teladoc is happy to provide information about your Teladoc consult to your primary care physician.

Facebook.com/Teladoc Teladoc.com/mobile

© 2016 Teladoc, Inc. All rights reserved. Teladoc and the Teladoc logo are trademarks of Teladoc, Inc. and may not be used without written permission. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA controlled substances, non-therapeutic drugs and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. © 2016 Teladoc, Inc. Todos los derechos reservados. Teladoc y el logotipo de Teladoc son marcas de Teladoc, Inc. y no pueden ser utilizados sin permiso por escrito. Teladoc no sustituye al médico de atención primaria. Teladoc no garantiza que una receta se escribe. Teladoc opera sujeta a la regulación estatal y pueden no estar disponibles en ciertos estados. Teladoc no prescribir sustancias controladas DEA, las drogas no terapéuticas y algunos otros medicamentos que pueden ser perjudiciales debido a su potencial de abuso. Médicos Teladoc reservamos el derecho de negar la atención por el mal uso potencial de los servicios.

Talk to a anytime

through the convenience of phone or video consults. It's an affordable alternative to costly urgent care and ER visits when you need care now.

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tooth Dental PlanVilhauer Enterprises offers all full-time employees a dental insurance plan administered by Blue Cross Blue Shield of Texas. Employees may elect to purchase coverage for themselves and their dependents.

PLAN BENEFITSCalendar Year Deductible

Individual $50

Family $150

Dental Services

Preventive Care (e.g. Cleanings) 100%, Deductible Waived

Basic Care (e.g. Fillings) 80%, After Deductible

Major Care (e.g. Crowns, Dentures) 50%, After Deductible

Orthodontia (Child Only Up To Age 19) 50%, After Deductible

Maximums

Annual Maximum Benefit $2,000 Per Covered Person

Orthodontia Lifetime Max $2,000 Per Individual

Weekly Employee Dental Contributions

Employee Only $9.16

Employee + Children $22.49

Employee + Spouse $19.93

Employee + Family $35.72

The dental policy covers one exam and cleaning every six months at no cost to you when visiting in-network providers.

You may choose any dentist you wish. However, if you choose to see an in-network provider you will not be balance billed for anything over the usual, reasonable, and customary allowed amount by Blue Cross Blue Shield.

You can locate in-network dentists at www.bcbstx.com, click “Find a Doctor or Hospital.”

Benefits are illustrated in summary form. Please refer to Blue Cross Blue Shield’s dental plan documents for complete coverage details.

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Vision PlanVilhauer Enterprises also offers a vision insurance plan to all employees through Dearborn National using the EyeMed Network of vision providers. Employees may elect to purchase coverage for themselves and their dependents.

IN-NETWORK OUT-OF-NETWORKEye Exam

Eye Exam $10 Copay $30 allowance

Lenses

Single Vision 100% after $10 Copay Up to $25 allowance

Bifocal 100% after $10 Copay Up to $40 allowance

Trifocal 100% after $10 Copay Up to $55 allowance

Frames

Frames Up to $130 allowance $65 allowance

Contact Lenses (in lieu of Glasses)

Fitting and Evaluation Up to $40 copay -

Contact Lenses $130 allowanceUp to $104 overall contacts allowance

Frequencies

Exams Once every 12 months

Lenses Once every 12 months

Frames Once every 24 months

Contacts Once every 12 months

Weekly Employee Vision Contributions

Employee Only $1.69

Employee + Child(ren) $3.38

Employee + Spouse $3.21

Employee + Family $4.97

NOTE: See your plan summary for discounts on laser vision correction!

You must utilize an EyeMed provider to receive in-network benefits. You can locate providers at www.DearbornNational.com/Vision or by calling Dearborn at 844-323-8302.

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Life Insurance PlansGROUP TERM LIFE AND AD&D

Vilhauer Enterprises provides employees with Basic Term Life and Accidental Death & Dismemberment coverage through Dearborn National. This coverage is provided for all active full-time employees at

no cost!

BASIC LIFE AND AD&D BENEFITS

Life Benefit $25,000

AD&D Benefit $25,000

VOLUNTARY TERM LIFE

Vilhauer Enterprises also offers active full time employees the option to purchase Term Life Insurance coverage through Dearborn National. This voluntary coverage would be in addition to the Basic Group Life coverage. Rates are based on age and coverage amounts

VOLUNTARY TERM LIFE BENEFITS GI AMOUNT* Employee Benefit $10,000 increments to a maximum of $500,000 $100,000

Spouse Benefit $5,000 increments to a maximum of 50% of employee coverage up to $250,000

$25,000

Child Benefit $1,000 increments to a maximum of $10,000 $10,000

Voluntary Term Life premium rates are based on age and coverage amounts. See your Plan Document for rate table. Employees must be actively at work and dependents must not be disabled on the effective date of coverage for coverage to be issued.

*Guarantee Issue (GI) only applies at open enrollment for 1/1/19 and initial eligibility

Please be sure you have a current designation of beneficiary form on file!

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WHEELCHAIR NEW! Employer Paid Short Term DisabilityYour Short Term Disability coverage is through Dearborn National. This coverage is designed to protect a portion of your income should you become disabled for a short period of time. All active full-time employees are eligible for the following benefits. This benefit is employer-paid and is offered at no cost to you!

DEARBORN NATIONAL BENEFITWeekly Benefit *

(excludes overtime & bonuses) 60%

Weekly Maximum Benefit $1,000

Elimination Period14 days = Illness | 14 days = Injury

(must occur away from work)

Maximum Benefit Period 11 Weeks

Guarantee Issue Yes

Pre-Existing Limitation 3/12

*Your disability benefit may be reduced by deductible sources of income and any earnings

you have while disabled (ie: Social Security, etc)

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401(k) Retirement PlanVilhauer Enterprises provides all full time employees with a 401(k) retirement plan through One America. Aside from any contributions you elect to contribute to your retirement account, the plan allows Vilhauer Enterprises to make discretionary matching and profit sharing contributions, as determined by the employer on an annual basis.

The plan allows you to make both pre-tax and post-tax (Roth) contributions to your 401(k) account through payroll deduction. The IRS dictates the maximum dollar limit you can contribute. You have complete control over how your money is invested!

VESTING

You are always 100% vested in your own contributions to your 401(k) account. This means you own the money you put in the plan. However, contributions made by your employer are subject to a vesting schedule. The longer you are employed with Vilhauer Enterprises, the more ownership you acquire over the employer contributions to your account.

YEARS OF SERVICE VESTING PERCENTAGELess than 2 years 0%

2 years 20%

3 years 40%

4 years 60%

5 years 80%

6 years 100%

To enroll or make changes to your contributions please contact Human Resources.

Notes: To access account information please visit www.oneamerica.com or call customer service at 1-800-249-6269.

*Please refer to your plan documents for detailed information.

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Other Voluntary BenefitsVilhauer Enterprises offers full time employees various additional voluntary benefits through Colonial Life. These optional insurance coverages include: Accident Care, Critical Illness, Hospital Confinement, Cancer,and Short Term Disability policies. The rates illustrated are subject to change.

NOTES:

◗ Members may submit or access claim information online at

www.coloniallife.com. You may also call Colonial Life customer ser-

vice at 1-800-325-4368 or Vilhauer Enterprises’ Colonial

Representative, Sandra Driver at 972-429-5490.

◗ You may request that Colonial Life send you any applicable claim

benefits by overnight delivery and deduct the fee from your claim

payment by selecting “overnight” in the Optional Service section

of the claim form.

◗ When sending a claim form or other information, please keep a copy

of your information for your records.

◗ To submit a wellness screening or cancer screening claim, please

call the toll-free Customer Service number 1-800-325-4368 with the

medical information.

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Accident Care The Accident Care policy pays specific benefit amounts for covered accidents resulting in injuries such as broken bones, burns, concussions, and joint dislocations. The coverage also provides limited benefits for: transportation/lodging, accident hospital care, accident follow-up care, accidental dismemberment, catastrophic accident, and accidental death.

Additionally, this plan offers a Health Screening Benefit that pays $50 per covered person per calendar year if the covered person undergoes any of the health screening tests included in the policy.

WEEKLY PAYROLL DEDUCTIONS

Coverage Tier Accident Care

Employee $4.88

Spouse $4.88

EE/Spouse $6.68

EE/1 Parent Family $7.53

SP/1 Parent Family $7.53

2 Parent Family $9.34

* Please consult policy documents for exclusions and limitations. If any discrepancies exist, the policy documents prevail.

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Specified Critical Illness

The critical illness plan pays a specific lump sum payment directly to the covered individual if he or she is diagnosed with a Specified Critical Illness while the policy is in force. Specific Critical Illnesses include heart attack, stroke, major organ failure, end stage renal failure, permanent paralysis, coma, blindness, and others. Additionally, this plan offers a Health Screening Benefit that pays $50 per covered person per year if the covered person undergoes any of the approved health screening tests, including: chest x-ray, colonoscopy, mammography, and echocardiogram.

WEEKLY PAYROLL DEDUCTIONS

Deductions are based on tobacco/non-tobacco status, age, and benefit amount selected.

Hospital Confinement Indemnity InsuranceThis medical bridge plan pays set amounts directly to the policyholder for hospitalization and listed outpatient surgical procedures. The benefits include: $1,000 per hospital confinement, $500-$1,000 per outpatient surgical procedure, and $100 per day in a rehabilitation unit. An added Wellness Screening benefit pays $50 when a covered person undergoes one of the listed wellness screening tests, including: stress test, serum cholesterol test, electrocardiogram, chest x-ray, and PSA.

WEEKLY PAYROLL DEDUCTIONS

Age Name Insured NI/Spouse NI/Children NI/Spouse/Children

17-49 $5.01 $9.40 $6.51 $10.90

50-59 $6.88 $12.95 $8.38 $14.45

60-64 $8.84 $16.67 $10.34 $18.17

65-74 $11.17 $21.09 $12.67 $22.59

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Cancer InsuranceThe cancer insurance policy offers two levels of coverage: Level 2 & Level 3. The plan will pay set benefit amounts for cancer screenings, inpatient services, cancer treatments, transportation/lodging, surgical procedures, and extended care. Please consult policy description for detailed benefit differences between Level 2 and Level 3.

WEEKLY PAYROLL DEDUCTIONSLevel 2 Level 3

Employee $5.00 $6.15

Employee & Spouse $7.81 $10.25

One Parent Family $5.07 $6.25

Two Parent Family $7.88 $10.35

Voluntary Short Term DisabilityShort Term Disability is designed to replace up to 40% of your income in the event that you are unable to work for a short period of time due to an illness or accident occurring off the job. Once you have been unable to work for 7 days due to an illness, or immediately after an accident, Short Term Disability would begin to pay a monthly benefit, which will last until you are able to return to work, or a maximum of 3 months.

VOLUNTARY SHORT TERM DISABILITYElimination Period 0/7

Issue Age Monthly Rates (per $100 of benefit, up to 40% of income)

17-49 $2.80

50-64 $3.32

65-74 $4.02

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Contacts

VILHAUER ENTERPRISES

Administration 972-782-4443

Marsh & McLennan Agency

Yanina Trejo Kiechler, Senior Account Manager

866.765.7264 | Direct: 806.794.3246 yanina.kiechler@marshmma.com

building Carrier Contacts

MEDICAL & DENTAL BENEFITSBlue Cross Blue Shield of Texas 800-521-2227 | bcbstx.com

VISION BENEFITSDearborn National 844-323-8302 | dearbornnational.com/vision

LIFE & DISABILITY BENEFITSDearborn National 800-348-4512 | dearbornnational.com

401(K)OneAmerica 800-249-6269 | oneamerica.com

VOLUNTARY BENEFITSColonial Life 800-325-4368 | coloniallife.com

10750 John W. Elliot Frisco, Tx 75033

P: 972-782-4443