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ANGELES CONTRACTOR, INC.(ACI)



        OPEN ENROLLMENT OVERVIEW




        AND SUMMARY




        2019 SUMMARY OF EMPLOYEE BENEFITS CHANGES

        Angeles Contractor, Inc. will renew our employee benefit Medical Plan with no changes in plan. However, current
        plan benefit will be slightly changed with renewal plan from 08/01/2019. Please review “Plan change highlights”.

        HMO 1 UHC HMO Advantage Platinum Plan Benefit Changes20-40/20% (BH-GY)
        HMO 2 UHC HMO Advantage Gold Plan Benefit Changes 30-60/20%/250 Ded (BH-G2)

        The following employee contributions will become effect on 08/01/2019, and will be reflected on your July paycheck.

                                            HMO-Advantage Platinum 20-40/20%



                  HMO-Advantage      Angeles Contractor, Inc.         You Pay              You Pay for Dependent
                Platinum 20-40/20%




                 Monthly Premium
          Age          Rates                Pays 80%                   20%                         100%


                                           per Month*               per Month*                  per Month*




                  *If you enroll with your spouse and/or children, you must pay the full premium for
                          your spouse and/or children in addition to your cost of share below.


          <15         $263.99                $211.19                  $52.80                      $263.99
          15          $287.45                $229.96                  $57.49                      $287.45
          16          $296.42                $237.14                  $59.28                      $296.42
          17          $305.40                $244.32                  $61.08                      $305.40

          18          $315.06                $252.05                  $63.01                      $315.06
          19          $324.72                $259.78                  $64.94                      $324.72
          20          $334.73                $267.78                  $66.95                      $334.73
          21         $$345.08                $276.06                  $69.02                      $345.08
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