Page 2 - 2022 US Benefits Guide FINAL

YOUR APPLIED BENEFITS

We understand the important role that benefits play in the lives of you and your family. Annually
during open enrollment in the fall, you have an opportunity to make changes to your benefits package
to ensure you and your family have the right coverage.

This benefits guide can help familiarize you with Applied’s benefit options. It also provides useful tips,
tools and resources to help you think through your options and make wise decisions. As you prepare
to enroll:

 Consider your benefit coverage needs for the upcoming year. For example, is your family financially
protected if you can’t work due to an accident or illness?
 Consider other available coverage.
 Gather information you’ll need. If you are covering dependents, you will need their dates of birth
and Social Security numbers. In addition, you may need to provide legal documentation verifying
their eligibility — such as a marriage license or birth certificate.
Getting the most value from your benefits depends on how well you understand your plans and how
you choose to use them. Be sure to read this entire guide for important information about your benefit
options.

TABLE OF CONTENTS

This guide contains the
3 Benefit Basics 17 Voluntary plans
following notices:
4 Eligibility 18 Additional benefits Children’s Health Insurance Program
(CHIP)
Newborns’ and Mothers’ Health
5 Medical and pharmacy plan 19 401(k) Retirement Savings Plan Protection Act
Women’s Health and Cancer Rights Act
Patient Protection Disclosure
10 Savings accounts 20 Benefit costs Medicare Part D Coverage
HIPAA Special Enrollment
HIPAA Notice of Privacy Practices
14 Dental plan 21 Glossary COBRA Rights
Wellness Program Notice
GINA Notice
15 Vision plan 22 Contact information Health Insurance Marketplace Exchange
Notice
16 Life insurance and disability 23 Annual Notices San Francisco Health Care Ordinance

If you have Medicare or will become eligible for Medicare in the next 12 months, a Federal law gives you more choices
about your prescription drug coverage. Please see pages 24-25 for more details.

Enrolling In Your Benefits

Access UKGPro Click on the click on the following: Elect the benefits Save or submit Print a copy of your
via Single Sign UKGPro Icon Menu > Myself > you want your elections elections for your records
on: Benefits > Manage My
https://appliedsy Benefits > Get Started
stems.okta.com/
app/UserHome

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