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Completed:

EOEALH20240319-151701698-50839

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Employee:

Confirmation Number:

John Laskey

Wingfoot Enterprises, Inc.

Medical Benefits Weekly Premium Total: $0.00

Fixed Indemnity

Coverage Level: Waive

Weekly Premium: $0.00

Our Fixed Indemnity Medical plan pays a flat amount for each covered claim such as doctor’s office visits, x-rays, lab work, in and out-patient benefits, emergency room visits, urgent care, and other day-to-day claims. It helps cover out-of-pocket costs with no deductibles and no co-pays and is our most popular plan option because of its highly usable benefits. Dental

Coverage Level: Waive

Weekly Premium: $0.00

Pays 80% of exam costs after $50 deductible. Plan includes coverage for regular exams, X-rays, fillings, oral surgery, crowns, and even dentures. Associates have the option to see any dentist they wish but will pay less if the dentist is in-network. Vision

Coverage Level: Waive

Weekly Premium: $0.00

Offsets cost of eye exams, lenses, frames, and contacts. Our Vision plan pays: 100% for eye examinations with a $10 co-pay, 100% up to $110 for frames then 20% of the remaining balance, 100% for plastic lenses with a $25 co-pay, 100% for disposable contact lenses up to $110. Life

Coverage Level: Waive

Weekly Premium: $0.00

$10,000 Employee, $5,000 Spouse/Child(ren), $1,000 Infant. For associates up to age 65, our Term Life plan pays beneficiary $10,000. This plan automatically covers spouse and dependents (at lower amounts, see below). Short Term Disability

Coverage Level: Waive

Weekly Premium: $0.00

Pays 60% of salary up to $150 per week. Begins after 7 days of disability, pays up to 26 weeks (not available to employees who work in CA, HI, NJ, NY, or RI). MEC Benefits Monthly Premium Total: $0.00

Coverage Level: Waive

Monthly Premium: $0.00

The Minimum Essential Coverage (MEC) plan meets the Affordable Care Act’s definition of minimum coverage, providing benefits for testing, screening and wellness. Associates are able to select a different coverage level than the selected Fixed Indemnity and ancillary coverage level. This plan does not provide any coverage for sickness or accidents. Minimum Essential Coverage

What comes next?

When do my benefits go into effect?

Within 24-48 hours of enrollment completion you should receive your login credentials to your employee benefit dashboard. If you have any questions or concerns, you may visit https://www.esceportal.com/ALS/ to reach out to one of our technical support agents by clicking the CHAT NOW! icon on screen. We're available Monday through Friday, 8:00 AM EDT to 8:30 PM EDT. If you have questions about the benefits being offered to you by your employer, please call 1-888-***-****.

For the Minimum Essential Coverage (MEC), your coverage will go into effect the First of the Month following payment. For all other plans, your coverage goes into effect the first Monday following your payroll deduction.