Page 291 - Aida Hovsepian Onboarding

Short-Term Disability

Plan design and rates

Short-Term Disability plan design
Eligible employees All Full-Time United .states Employees working in the UnitedStates who arescheuId to work a minimum of 30
hours per week
Effective Date January T..20.19
" ' ' - '
- ';:r.f. -' .1'''.:.'i'• ' ' , ' .
-• '
I '' --P- '::::- r•-• i."4:4aral.: ?--',, ' ,
Class description All Eligible finbiovees:
Waitin Period First of thernonithfolloWl .,: '4) A 1ofernpbynent

Beriefit amount 60%
Maximum We,ekly benefit $1,500
Minimum weekly benefit 535'
Injurystart ;date 13:daYs
Ski:nest Stattglate "VS clajfs
Firstay,liosioitarization NO
Maximum Benefit Period 14:Weeles
Partial Disability benefit ReturotoWork
Zeres1Day ReSidnal No
PnUmLtation Noite:
Contributions 13 - xxi4liailtiPl0/
i :
Participatioivrequito 100%:
ErnPloyeroOritribUtiorr%. 10%

10400..in kJ* p:4171:

• A:00Mb tatevaratitee from the Effective Date
• RdI.rnaternfJth.efage
• Nonoccupationat coverage
• Coverage vvill be continued on a premium-paying basis for a petiod of 1 monthts) during a layoff.
• Coverage will be continued on a premium payingbasis for a period of 1 month(s) during a leave of absence approved by the
policyholder.
• Earnings definition: EaltiritS are defined as the earnings reported by the employer immediately prior to the first date of ArS -atillity.
Earnings include deductions made for pre-tax contributions to a-qualfied deferred compensation plan, Section 1 zs plan or
flexible spending account. Earnings do not include overtime, or any othercaripensatiork

Croup Short-Term Disability oaverage is underwritten by Sun Life Assurance Company of Canada.(Wellesley His 0.14) under Policy Pqrrn Wiles3PLH01 MP.
Gli-tF0 .
October 30, 2018.

Proposal for Centralized Supply Chain Services LLC as ID: 120g371

Page 13 of 39 rev. 06090615 GGOT-128/3