Page 7 - Veritone EE Guide 07-19

Who can enroll? When can I enroll?

Veritone employees As an Eligible Employee

· Regular, full-time employees working at least 30 hours per week · As a new hire, you may participate in the
company’s benefits on the first day of the month
Dependents · following or coinciding with your date of hire
Each year, during open enrollment
· Your legally married spouse · Within 30 days of a qualifying event as defined by
· Your domestic partner the IRS
· Your children, stepchildren or children of your domestic partner to age 26, regardless · You may enroll in Voluntary Life/AD&D insurance at
of marital or student status any time, subject to proof of good health and
· Any children for whom you are required to provide coverage under a Qualified Medical carrier approval
Child Support Order
· Your unmarried children, step-children or children of your domestic partner of any age,
if they are incapable of self-care due to a physical or mental disability
Benefits Plan Year:
Your spouse, domestic partner and children can be enrolled July 1 - June 30

in our medical, dental, vision and voluntary life insurance

plans.

Required Information
At enrollment you are required to enter the Social Security Number for all covered
dependents. Health Care Reform law requires the company to report this information to
the IRS each year to show that you and your dependents have coverage and are not
subject to a penalty. This information will be securely submitted to the IRS and will
remain confidential.