Page 14 - Veritone's EE Guide final

Employee Contributions

This chart provides the monthly contributions for our Employee Benefit plans. Your cost for coverage will vary depending on the
option and level of coverage you choose. Employee contributions for Medical, Dental, and Vision are deducted from your paycheck
with pre-tax dollars. This means that contributions are taken from your earnings before taxes, resulting in lower taxes and
increased take home pay. For your convenience, your age-banded Voluntary Life and AD&D and Voluntary Short Term Disability
premiums have been pre-calculated for you in Paycom.

Medical Kaiser Anthem Blue Anthem Blue Anthem Blue Anthem Blue
Permanente Cross Cross Cross Cross
HMO HMO PPO $500 PPO $1,500 HSA

Employee Only $76.98 $83.09 $130.42 $102.14 $75.57
Employee + Spouse $177.79 $182.79 $286.93 $224.71 $166.27
Employee + Child(ren) $157.02 $149.56 $234.76 $183.86 $136.03
Employee + Family $233.24 $257.57 $404.30 $316.64 $234.28

Dental Anthem Blue Cross Anthem Blue Cross
PPO High Plan PPO Low Plan

Employee Only $13.13 $6.88
Employee + Spouse $26.62 $15.01
Employee + Child(ren) $29.67 $14.46
Employee + Family $42.08 $20.86
Vision Blue View Vision
PPO

Employee Only $1.37
Employee + Spouse $2.74
Employee + Child(ren) $2.80
Employee + Family $ 4.17

The following benefits are provided to you at no charge and are paid by Veritone:
• Basic Life/AD&D
• Travel Assistance
• Resource Advisor

Short and Long Term Disability are also paid by Veritone. However, you have the option to pay for this benefit yourself with post-
tax payroll contributions to receive a tax-free benefit at the time of disability.

The following benefits are available to you at discounted group rates. Should you elect these benefits, you will pay 100% of the
cost:
• Optional Life with AD&D

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