Page 5 - Volcom Benefit Summary 2018 Texas

ENROLLMENT INFORMATION

Who May Enroll
If you are a regular full-time employee working at least 30 hours per week, you and your eligible dependents may participate
in Volcom’s benefits program. Your eligible dependents include:
• Legally married spouse (marriage certificate may be required)
• Legal domestic partner - same sex or opposite sex above age 62 only (affidavit may be required)
• Children under age 26 regardless of student or marital status

When You Can Enroll
As an eligible employee, you may enroll at the following times:
• As a new hire, you may participate in Volcom’s benefit plans on the first day of the month following the completion of
30 days of employment
• During annual open enrollment
• Within 30 days of a qualified change in family status as defined by the IRS - see Changes to Enrollment

Paying for Your Coverage
The Life, AD&D, Long Term Disability, and Employee Assistance Program benefits are provided at no cost to you and are
paid entirely by Volcom. You and the company share in the cost of the Medical, Dental, and Vision benefits you elect. The
Voluntary Life, Voluntary AD&D, and Supplemental Benefits you elect will be paid by you at discounted group rates. Your
Medical, Dental, and Vision contributions are deducted before taxes are withheld (with the exception of contributions toward
domestic partner coverage due to IRS regulation), which saves you tax dollars. Paying for benefits before‐tax means that
your share of the costs are deducted before taxes are determined, resulting in more take‐home pay for you. As a result,
the IRS requires that your elections remain in effect for the entire year. You cannot drop or change coverage unless you
experience a status change.

Changes to Enrollment
Our benefit plans are effective November 1st through October 31st of each year. There is an annual open enrollment period
each year, during which you can make new benefit elections for the following November 1st effective date. The Flexible
Spending Accounts are effective January 1st through December 31st of each year. Please note that Flexible Spending
Account elections do not roll-over from year to year, therefore, you are required to re-enroll in this benefit on an annual basis.

Once you make your benefit elections, you cannot change them during the year unless you experience a qualified change
in family status as defined by the IRS. Examples include, but are not limited to the following:
• Marriage, divorce, legal separation or annulment
• Birth or adoption of a child
• A qualified medical child support order
• Death of a spouse or child
• A change in your dependent’s eligibility status
• Loss of coverage from another health plan
• Change in your residence or workplace (if your benefit options change)
• Loss of coverage through Medicaid or Children’s Health Insurance Program (CHIP)
• Becoming eligible for a state’s premium assistance program under Medicaid or CHIP
ANNUAL NOTICES

! Please note that coverage for a new spouse or newborn child is not automatic. If you experience a change
in family status, you have 30 days to update your coverage. Please contact the People’s Department
immediately to complete the appropriate election forms as needed. If you do not update your coverage
within 30 days from the family status change, you must wait until the next annual open enrollment period
to update your coverage.

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