Page 6 - Work Life and Benefits Booklet 2020 SW

MEDICAL YOUR COST PER SHIPWORKS’ COST DENTAL & VISION YOUR COST PER SHIPWORKS’ COST
PAYCHECK PER PAYCHECK PAYCHECK PER PAYCHECK

Aetna Medical OAMC/PPO Delta Dental PPO
Employee Only $34.23 $343.75 Employee Only $1.00 $16.56

Employee + Spouse $66.23 $765.32 Employee + 1 $5.00 $31.90
Employee + Child(ren) $57.20 $660.96 Employee + 2 or more $10.00 $61.60
Employee + Family $93.14 $1,154.18 EyeMed Vision

Aetna Medical HSA PPO Employee Only $1.09 $1.95
Employee Only $10.00 $279.34 Employee + 1 $2.72 $3.06

Employee + Spouse $32.50 $604.04 Employee + 2 or more $5.44 $3.04
Employee + Child(ren) $22.50 $527.23
Employee + Family $42.50 $912.31

IRS CODE Section 125
The ShipWorks employee benefit plans are designed under Section 125 of the IRS Code. This allows you to take advantage of federal laws by purchasing some of
your benefits with pre-tax dollars. Under Section 125, your Medical, Dental, Vision, Flexible Spending and Health Savings account contributions are deducted before
taxes are withheld which saves you tax dollars. Paying for benefits before-tax means that your share of the costs is deducted before taxes are determined, resulting
in more take-home pay for you. Due to this tax advantage, the IRS requires that your elections remain in effect for the entire year. You cannot drop or change
coverage unless you experience a qualifying event. If you wish to waive participation in the Section 125 Plan and elect to pay with after-tax dollars, contact the
Human Resources Department.