Page 6 - Veritone EE OOS Benefit Guide_2020

CONTRIBUTIONS

Your cost per month

Medical Options Option 1 Option 2 Option 3 IRS CODE Section 125
The Veritone employee benefit plans
Plan PPO $500 PPO $1,500 HSA PPO are designed under Section 125 of the
Employee Only $296.86 $145.33 $107.54 IRS Code. This allows you to take
Employee + Spouse $653.09 $319.73 $236.87 advantage of federal laws by
Employee + Child(ren) $534.35 $261.60 $193.57 purchasing some of your benefits with
Employee + Family $920.26 $450.53 $333.38 pre-tax dollars. Under Section 125,
your Medical, Dental, Vision, and
Dental Options Option 1 Option 2 Flexible Spending Account

Plan PPO High PPO Low contributions are deducted before taxes
are withheld which saves you tax
Employee Only $13.69 $7.17 dollars. Paying for benefits before-tax
Employee + Spouse $27.76 $15.65 means that your share of the costs is
Employee + Child(ren) $30.94 $15.08 deducted before taxes are determined,
Employee + Family $43.89 $21.75 resulting in more take-home pay for
you. As a result, the IRS requires that
Vision Option
your elections remain in effect for the
Plan PPO entire year. You cannot drop or change
coverage unless you experience a
Employee Only $1.30
Employee + Spouse $2.60 qualifying event. You may waive
Employee + Child(ren) $2.66 participation in the Section 125 Plan
Employee + Family $3.96 and elect to pay all contributions with
after-tax dollars. Contact the People
Operations Department if you wish to
pay for your benefits with after-tax
For your convenience, your age-banded Voluntary Life/AD&D premiums have dollars.

been pre-calculated for you in Paycom.

6 EMPLOYEE BENEFITS