WIXLIB

2021 Employee Benefits Guide - Masonic HomesBenefit Changescontinued.EventAction RequiredResults If Action Not TakenNew Hire:Make elections within 30 days of eligibility.Documentation is required.You and your dependents are not eligibleuntil the next annual Open Enrollment.Marriage:Your new spouse must be added to your electionswithin 30 days of the marriage date. A copy of themarriage certificate must be presented.Your spouse is not eligible until the nextannual Open Enrollment period.Divorce:The former spouse must be removed within 30 daysof the divorce. Proof of the divorce will be required. Acopy of the divorce decree must be presented.Benefits are not available for the divorcedspouse and will be recouped if paiderroneously.Birth or adoption of achild:The new dependent must be enrolled in yourelections within 30 days of the birth and adoption,even if you already have family coverage. A copy ofthe birth certificate, footprints, or hospital dischargepapers must be presented. Once you receive thechild’s Social Security Number, be sure to contactAssuredPartners to update your child’s insuranceinformation record.The new dependent will not be coveredon your health insurance until the nextannual Open Enrollment period.Death of a spouse ordependent:Remove the dependent from your elections within 30days from the date of death. Death certificate mustbe presented.You could pay a higher premium thanrequired and you may be overpaying forcoverage.Your spouse gains orloses employment thatprovides health benefits:Add or drop health benefits from your elections within30 days of the event date. A letter from the employeror insurance company must be presented.You need to wait until the next annualOpen Enrollment period to make anychange.Loss of coverage with aspouse:Change your elections within 30 days from the lossof coverage. A letter from the employer must beprovided.You will be unable to enroll in the benefitsuntil the next annual Open Enrollmentperiod.Changing from full-timeto part-time employment(without benefits) or frompart-time to full-time(with benefits):Change your elections within 30 days from theemployment status change in order to receiveCOBRA information or to enroll in benefits as a fulltime employee. Documentation from the employermust be provided.Benefits may not be available to you oryour dependents if you wait to enroll inCOBRA. Full-time employees will haveto wait until the annual Open Enrollmentperiod.If you Experience a Life Event Status ChangeYou must update your elections within 30 days of your life event status change or you will not be able to make changesuntil the next annual open enrollment. If adding or removing dependents, you are required to submit specific documentsto AssuredPartners. The change will be inactive until proper documentation is received and approved. For assistanceprocessing life event status changes, you can contact Human Resources, Jessica Cox-Lush at 502-753-8849 or emailBenefitsHR@masonicky.com.5

6Masonic Homes - 2021 Employee Benefits GuideMedical CoverageMasonic Homes is proud to offer you a choice between two differentmedical plans. Coverage under both plans includes comprehensivemedical care and prescription drug coverage. The plans also offermany resources and tools to help you maintain a healthy lifestyle.Below is a brief description of these plans.Anthem BCBS High PlanAnthem BCBS Low PlanBuild a StrongRelationship with YourPrimary Care PhysicianMost doctors went into the practice ofmedicine so that they could build strongemotional bonds with patients and guidethem through health challenges.Here are 3 tips to building a strongrelationship with a new primary carephysician, or improving the bond with yourcurrent one:1. Know what’s important to you in aphysician.If you’re looking for a new doctor, be surethis is someone with whom you will havegood interpersonal chemistry, that they’recommitted to your well-being, and thattheir office is well organized.2. Get your doctor familiar with yourhealth history.Help your doctors to get to know youbetter by collecting your medical records,writing down your family’s health history,and sharing this information with everynew physician you meet.3. A sk the right questions to build rapportand get on the road to better health.To maximize the time you have together,write down your health questions for yourphysician beforehand.Both of these plans are a High Deductible Health Plan, or a HDHPfor short. These plans function like a Preferred Provider Organization(PPO), but features a low monthly premium in exchange for a higherdeductible. The benefit of these plans is that you will be eligible toenroll in and contribute to a Health Savings Account (HSA). With anHSA your contributions are pre-tax so any amount you contribute isdeducted from your taxable income at the end of the year. The moneyin your HSA can be spent on eligible healthcare expenses includingcopays, prescriptions, dental treatment, and more.As with a PPO, both you and your family can see any health careprovider in the Network network, including specialists, without areferral. You are not required to choose a primary care physician.Out-of-Network ProvidersYou may choose to seek care outside the Anthem BCBS networkwithout a referral, however you will pay a higher deductible andcoinsurance for care received from an out-of-network physician, facilityor other health care professional. In addition, Anthem BCBS onlypays a portion of those charges and it is your responsibility to pay theremainder if you choose to seek care outside the network. The amountyou are required to pay, which could be significant, contributes to aseparate out-of-network out-of-pocket maximum. It’s recommendedthat you ask the out-of-network physician or health care professionalabout their billed charges before you receive care.

2021 Employee Benefits Guide - Masonic HomesMedical Plan ComparisonAnthem BCBS High PlanIn-Network,You Pay:Deductible(Individual / Family)Anthem BCBS Low PlanOut-of-Network, YouPay:In-Network,You Pay:Out-of-Network, YouPay: 2,800 / 5,000 2,800 / 5,000 5,000 / 10,000 10,000 / 20,000Out-Of-Pocket Maximum(Individual / Family) 2,800 / 5,000 5,000 / 10,000 5,000 / 10,000 20,000 / 40,000Preventive ServicesWell-Child CareAdult Physical ExaminationBreast Cancer ScreeningPap TestNo charge30% after deductibleNo charge30% after deductiblePhysician Home andOffice Services0% after deductible30% after deductible0% after deductible30% after deductibleUrgent Care Centers0% after deductible30% after deductible0% after deductible30% after deductibleEmergency Room(waived if admitted)0% after deductible0% after deductible0% after deductible0% after deductibleInpatient / OutpatientProfessional Services0% after deductible30% after deductible0% after deductible30% after deductibleInpatient Facility Services0% after deductible30% after deductible0% after deductible30% after deductibleOutpatient Surgery0% after deductible30% after deductible0% after deductible30% after deductibleHospital / Alternative CareFacility0% after deductible30% after deductible0% after deductible30% after deductiblePrescription Drugs0% after deductible30% after deductible0% after deductible30% after deductibleNetwork Retail Pharmacy(30-Day Supply)Generic, Brand Preferred,Brand Non-preferred,Specialty0% after deductible30% after deductible0% after deductible30% after deductibleAnthem Rx Home Delivery(90-Day Supply)Generic, Brand Preferred,Brand Non-preferred,Specialty0% after deductibleNot covered0% after deductibleNot coveredThis summary is for informational purposes only. For specific benefit information, please refer to the applicable insurance contract.Plan Cost Per PayAnthem BCBS High PlanAnthem BCBS Low PlanEmployee Only 112.10 56.84Employee Spouse 206.51 114.03Employee Child(ren) 198.26 109.70Family 303.11 166.037

8Masonic Homes - 2021 Employee Benefits GuideHealth Savings AccountsAnthem BCBS High PlanAnthem BCBS Low PlanMasonic Homes Kentucky will match 10% of your annual HSAcontribution. The match will not exceed 500.If you enroll in either plan, you are eligible to open and use aHealth Savings Account (HSA). An HSA is a financial accountthat you can use to accumulate tax-free funds to pay forqualified health care expenses, as defined by the IRS. Theaccount is similar to a traditional savings account with adebit card. The money in the account is owned by you andis fully portable. Funds can accumulate over time and rollover each year. If you use the funds for qualified health careexpenses, you will pay no taxes. If you use the money for otherexpenses, you will pay a tax and a penalty fee. When enrolledin a MHKY Medical plan and Health Savings Account (HSA), How You SaveWith an HSAAs an HSA user, you will save inseveral ways:· HSA contributions are not taxed· You earn tax-free interest on HSAbalances· HSA funds used for qualifiedmedical expenses are not taxedPlease keep in mind that there is a two-step applicationprocess to complete in order to open an HSA. Thisapplication must be completed every year regardless ofwhether you have an existing account. This applicationis time sensitive. For this year's Open Enrollment, the cutoff to submit your HSA application is 12/09/2020. Ongoingin 2021, you must submit the application within your 30-dayeligibility window. Once completed, please email your HSAapplication to Jessica Cox-Lush at jecoxlush@masonicky.com. HSA Funds RemainYours to GrowWith an HSA, you own the accountand all contributions. Unlike flexiblespending accounts (FSAs), the entireHSA balance rolls over each year andremains yours even if you changehealth plans, retire or leave thecompany. You Can WinWith an HSARegardless of your personal medicalsituation, an HSA can empower youto maximize savings while building areserve for the future.Use your HSA for qualified medical expensesHSA funds can be used for a variety of qualified medical, dentaland vision expenses; for yourself, your spouse, and your qualifieddependents. Eligible expenses include:······ B irth control Chiropractor C ontact lenses Dental treatment Prescription eyeglasses Hearing aids······ hysical examsP Prescriptions Stop-smoking programs Surgery (non-cosmetic) Therapy and more.2021 HSA Annual Contribution Limits (Total combined Employee and Employer contribution limit)individualall other 3,600 forcoveragecoverage tiers 7,200 forYou can choose to contribute to your HSA on a before-tax basis, up to the IRS annual maximums. If you are or will be age55 or over during the calendar year, you may also make a “catch-up” HSA contribution of an additional 1,000 each year.Note: As a taxpayer, it is your responsibility to ensure that your HSA contributions do not exceed the maximum possible for your specific tax situation.Please consult your attorney, CPA or tax adviser about your specific tax situation before deferring monies to your Health Savings Account. The benefitsof an HSA, who is qualified to have an HSA, etc. can be found in IRS Publication 969, beginning on page 2. https://www.irs.gov/pub/irs-pdf/p969.pdf

2021 Employee Benefits Guide - Masonic HomesDental CoverageDelta Dental PPOThe dental plan offers flexibility to see the provider of your choiceeach time you seek dental care. You can find a network dentistonline at www.deltadentalky.com, or by calling 1-800-955-2030.Delta Dental PPOPPO NetworkPremier NetworkOut-of-NetworkCalendar Year Maximum(per person) 1,500 1,500 1,500Calendar Year DeductibleIndividual / Family 50 / 150 100 / 300 100 / 300Preventive & Diagnostic CareOral Exams, Cleanings, Routine X-Rays,Fluoride Application100%100%100%Basic Restorative CareFillings and Crown Repair,Lab Testing and DiagnosticConsultation, Oral Surgery80%80%80%Major ServicesPeriodontal Services, EndodonticServices, Bridges, Resin, Metal,Porcelain Crowns, Inlays, Onlays,Posts, and Dentures50%50%50%Orthodontic Services — to age 1950%50%50% 1,000 1,000 1,000Lifetime Orthodontic MaximumDependent Children are eligible for coverage to age 26, regardless of student status. This summary is for informational purposes only. For specificbenefit information, please refer to the applicable insurance contract.Plan Cost Per PayDelta Dental PPOEmployee Only 8.17Employee One Dependent 17.82Family 33.35Out-of-Network Providers & Balance BillingUnder the Dental PPO, the plan pays the same amount to out-of-network providers as it would for in-network providers. Pleasenote that providers that do not participate with your insurance plan can “balance bill” you for any difference between their chargeand what the plan pays. Therefore, using non-participating providers may result in significant patient liability.9

10Masonic Homes - 2021 Employee Benefits GuideVision CoverageAnthem Blue VisionThe Blue Vision provider network is comprised of over 30,000 doctorsat more than 25,000 locations nationwide. They offer a generous mix ofindependent practitioners and retail locations including 1-800 CONTACT,LensCrafters, Pearle Vision, Sears Optical, Target Optical, and JC PenneyOptical. While benefits and savings are typically greater from in-networkproviders, members are free to visit a non-network provider. Below is abrief summary of the vision plan.Anthem Blue VisionIn-NetworkOut-of-Network 10 42 AllowanceSingle Vision 10 40 AllowanceBifocal 10 60 AllowanceTrifocal 10 80 Allowance100% 210 Allowance 130 Allowance 15% off balance 108 Allowance 130 allowance 20% off balance 45 AllowanceEye Exam (every 12 monthsLenses (every 12 months)Contact Lenses (in lieu of a complete set of glasses)Medically NecessaryElectiveFrames (every 24 months)When using non-network providers, you will be responsible for paying the difference between what the Plan pays and what theprovider charges.This Summary is for informational purposes only. For specific benefit information, please refer to the applicable Insurance Contract.Plan Cost Per PayAnthem Blue VisionEmployee Only 3.61Employee Spouse 6.32Employee Child(ren) 6.86Family 10.47

2021 Employee Benefits Guide - Masonic HomesFlexible Spending AccountsEligibility Based on Medical Plan ElectionFlexible Spending Accounts (FSA’s) offer another way to save money onhealth care and dependent care expenses. You may submit expensesincurred by any of your dependents, whether or not they are covered bythe insurance plans you have through your employer. Employees neednot be enrolled in either medical plan to participate in FSAs.If you enroll, you fund the accounts via a payroll deduction each payperiod. Money that you contribute to your FSAs is not subject to socialsecurity taxes, federal, and in most cases, state income taxes.LPFSA AnnualContribution Limit: 2,750Note: If you areenrolled in the HSA, youare only eligible for thelimited FSA for Dentaland Vision purposes.The FSA Plan Yearis January 1 untilDecember 31.Limited Purpose Flexible Spending Accounts (LPFSA)A “Limited Purpose FSA” is an option for employees that currently use a Health Savings Account.This type of FSA can be used for dental, vision, and post-deductible medical and prescription drugexpenses. You can contribute up to 2,750 for the 2021 plan year into your LPFSA.Please keep in mind that there is an application process to complete in order to open an FSA.This application must be completed every year regardless of whether you have anexisting account. This application is time sensitive. For this year's Open Enrollment, thecut off to submit your FSA application is 12/09/2020. Ongoing in 2021, you must submitthe application within your 30-day eligibility window. Once completed, please email your HSAapplication to Jessica Cox-Lush at jecoxlush@masonicky.com.DCFSA AnnualContribution Limit:Dependent Care Flexible Spending Account (DCFSA)Or 2,500 if you aremarried and file aseparate tax return.Only the portion of expenses which enable you to remain employed are eligible. Educationalexpenses are not eligible. 5,000You may use pre-tax dollars from your DCFSA to pay expenses for care when the servicesenable you and your spouse to work outside of the home. These include expenses for the careof a dependent child, spouse or elderly parent inside your home. Also included are baby-sitters,nursery schools, and day care centers.11

12Masonic Homes - 2021 Employee Benefits GuideBasic Life AD&D InsuranceBasic Life InsuranceLife insurance provides financial protection for your family in the eventof your passing. Masonic Homes offers all full-time eligible employeesworking 30 or more hours per week life and accidental death anddismemberment insurance through MetLife. Masonic Homes coversthe full cost of this benefit.Basic Life Benefit Amount: 1X an employee's annual salary with aminimum of 5,000 and a max of 300,000Your benefit amount will reduce at age 65 by 35% and to 50% oforiginal benefit amount at age 70.Plan Cost: 100% Employer PaidVoluntary LifeIncrease Your CoverageYou may elect to increase your life insurance coverage for yourself,your spouse and your dependent children – all at an affordablegroup rate provided by MetLife. This coverage comes in thefollowing increments:Employee Voluntary LifeBenefit Amount: increments of 10,000Guaranteed Issue: 100,000Maximum Benefit: the lesser of 5x Annual Base Earnings or 500,000Spousal Voluntary LifeBenefit Amount: increments of 5,000Guaranteed Issue: 25,000Maximum Benefit: 100,000Spouse amount not to exceed 50% of the employee benefit amount.Dependent Child Voluntary LifeBenefit Amount: 10,000Guaranteed Issue: 10,000Maximum Benefit: 10,000*The guaranteed issue amount is only a valid offer during an employee's first eligibilitywindow. If you do not elect it during that time then you will not be guaranteed this amount atfuture enrollment and will be subject to health questionnaires.Portability Options forBasic & Voluntary LifePortability is available when anInsured Person's employmentterminates for a reason other thansickness or injury or retirementat the Social Security NormalRetirement Age (SSNRA). TheInsured Person's coverage mustbe enforce for at least 12 monthsin a row just prior to the dateemployment ends.This person has the option tocontinue all or part of his orher insurance enforce whenemployment ends withoutEvidence of Insurability. To continueinsurance, application and the firstpremium payment must be madewithin the time period specified inthe policy. Coverage can continueuntil the earlier of the date themaster policy terminates or up to36 Months.For information on Portability,please contact MetLife at1-800-438-6388 or emailBenefitsHR@masonicky.com.

Short-Term DisabilityTo ensure your income will continue if you are unable to work due to a disability that extendsfor more than 14 consecutive days, Masonic Homes provides short-term disability (STD)through MetLife to employees with at least one year of service. Benefits are payable for anon-occupational injury or illness that keep you from performing the normal duties of yourjob. If a medical condition is job-related, it is considered Workers’ Compensation rather thanSTD. Benefit Becomes effective after 1 year of service.Benefit Payment Starts After: 14-day waiting periodBenefit Amount:Employees with less than 5 years of service, 60% of basic earningsEmployees with 5-10 years of service, 85% of basic earningsEmployees with 10 or more years of service, 100% of basic earningsBenefit Duration: 12 weeks, paid up to 10 weeksPlan Cost: 100% Employer PaidLong-Term DisabilityLong-Term Disability (LTD) insurance helps replace a portion of your income i

2 Masonic Homes - 2021 Employee Benefits Guide Open Enrollment Period Masonic Homes' annual enrollment period will be held Nobember 23 through December 6, 2020. Full-time employees with a regular schedule of 30 hours per week are