Page 6 - Veritone EE California and Colorado Benefit Guide_2020

CONTRIBUTIONS

Your cost per month

Medical HMO Options Option 1 Option 2 Option 3 IRS CODE Section 125

Plan Kaiser CA HMO Anthem CA HMO Kaiser CO HMO The Veritone employee benefit plans
are designed under Section 125 of the
Employee Only $90.71 $107.14 $115.00 IRS Code. This allows you to take
Employee + Spouse $209.54 $235.69 $265.65 advantage of federal laws by
Employee + Child(ren) $185.05 $192.84 $234.60 purchasing some of your benefits with
Employee + Family $274.86 $332.11 $348.46 pre-tax dollars. Under Section 125,
Medical PPO Options Option 4 Option 5 Option 6 your Medical, Dental, Vision, and
Flexible Spending Account
Plan PPO $500 PPO $1,500 HSA PPO contributions are deducted before taxes

Employee Only $296.86 $145.33 $107.54 are withheld which saves you tax
Employee + Spouse $653.09 $319.73 $236.87 dollars. Paying for benefits before-tax
Employee + Child(ren) $534.35 $261.60 $193.57 means that your share of the costs is
Employee + Family $920.26 $450.53 $333.38 deducted before taxes are determined,
resulting in more take-home pay for
Dental Options Option 1 Option 2 you. As a result, the IRS requires that

Plan PPO High PPO Low your elections remain in effect for the
entire year. You cannot drop or change
Employee Only $13.69 $7.17 coverage unless you experience a
Employee + Spouse $27.76 $15.65 qualifying event. You may waive
Employee + Child(ren) $30.94 $15.08 participation in the Section 125 Plan
Employee + Family $43.89 $21.75 and elect to pay all contributions with
after-tax dollars. Contact the People
Vision Option
Operations Department if you wish to
Plan PPO pay for your benefits with after-tax
dollars.
Employee Only $1.30
Employee + Spouse $2.60
Employee + Child(ren) $2.66
Employee + Family $3.96

6 EMPLOYEE BENEFITS