Page 2 - 2020-2021 Kyocera Benefits Brief

2020 BENEFIT S IN BRIEF

Our benefit program is designed with you in mind. Kyocera would not exist
without you, and that’s why we are committed to keeping you and your family
healthy and happy by providing a comprehensive benefits program.

BENEFIT BASICS
These changes are effective April 1, 2020 and remain in effect until the plan year ends on March 31, 2021.

MEDICAL
All Kyocera employees have the PPO Plan option for your medical care needs.

PPO PLAN
DESCRIPTION
In-Network Out-of-Network
Calendar Year Deductible $600 single/ $1,800 family $1,200 single/ $3,600 family
Calendar Year Out-of-Pocket Max. $2,000 single/ $6,000 family $4,000 single/ $12,000 family
Lifetime Maximum Unlimited
$25 copay*; Specialist $40 copay*; 60%
Office Visit LiveHealth Online $15 copay,
limited to 6 per year LiveHealth Online - Not Covered
Urgent Care $25 copay* 60% after deductible
Preventative Care / Not covered / 60% for well women
Routine Physicals 100%* exams & mammograms only
Preventive Not covered (except flu shots,
Immunizations which are covered in full*)
Travel Immunizations 100% Not Covered
Well Baby 100%* 60%
Maternity/Prenatal 100%* 60%
X-ray & Lab/Nuclear Medicine 100%*/80% 60%
Chiropractic & Acupuncture $25 copay/ 30 visits per 50% up to $30/visit
Services calendar year max.* 10 visits per calendar year max
Hospitalization 80% after $200 copay per admit 60% after $350 copay per admit
Emergency Room Services 100% after $100 copay* (80% after $500 copay 100% after $100 copay* (60% after $500 copay
for non-emergency use)
for non-emergency use)
Prescription Drugs
(30-day supply) 100% after copay: $10 generic/$40 preferred/$70 non-preferred
Advantage 90 100% after copay: $25 generic/$100 preferred/$175 non-preferred
Network Prescription
Mail Order
Prescription Drugs
(90-day supply) 100% after copay: $20 generic/$80 preferred/$140 non-preferred
Specialty Drugs (30 day supply) 100% after $150 copay
Calendar year Rx Out of Pocket No-max if filling prescriptions
Max $2,400 individual/$7,200 family outside of OptumRx
*Deductible waived
VISION BENEFITS

BENEFIT DESCRIPTION COPAY FREQUENCY
Your Coverage with a VSP Doctor
WellVision Exam • Focuses on your eyes and overall wellness $25 Every 12 months
Prescription Glasses $25 See frame and lenses
Frame • $100 allowance for a wide selection of frames Included in
• $120 allowance for featured frame brands Prescription Glasses Every 12 months
• 20% off amount over your allowance
Lenses • Single vision, lined bifocal, and lined trifocal lenses Included in Every 12 months
• Polycarbonate lenses for dependent children Prescription Glasses
Lens Options • Standard progressive lenses $55
• Premium progressive lenses $95 - $105
• Custom progressive lenses $150 - $175 Every 12 months
• Average 20-25% off other lens options
Contacts • $100 allowance for contacts; copay does not apply Up to $60 Every 12 months
(instead of glasses) • Contact lens exam (fitting and evaluation)

2 Kyocera International Inc. Group • Benefits Guide 2020