Page 29 - Volcom Benefit Summary 2019 National 1
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CONTRIBUTIONS






        This chart compares the per paycheck 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. Contributions for domestic partner coverage are taken after-tax
        due to IRS regulations.

                                                      EMPLOYEE COST PER PAYCHECK
         MEDICAL OPTIONS
           Option 1: HSA PPO Plan               Under 5 Years          From 5 to 10 Years         Over 10 Years
                                                 Employment               Employment              Employment
              Employee Only                          $68.20                  $56.59                   $36.27
              Employee + Spouse                    $181.67                  $156.17                 $111.55
              Employee + Child(ren)                $151.42                  $129.39                   $90.85
              Employee + Family                    $294.96                 $259.74                  $198.11
           Option 2: PPO Buy-Up Plan            Under 5 Years          From 5 to 10 Years         Over 10 Years
                                                 Employment               Employment              Employment
              Employee Only                        $122.87                 $105.06                    $87.25
              Employee + Spouse                    $262.06                 $222.95                   $183.84
              Employee + Child(ren)                $233.13                 $199.34                   $165.56
              Employee + Family                    $426.83                 $372.80                   $318.77
         DENTAL OPTIONS
           DPPO Plan
              Employee Only                                                 $13.99
              Employee + Spouse                                             $43.75
              Employee + Child(ren)                                         $51.20
              Employee + Family                                             $67.57
         VISION

              Employee Only                                                  $1.31
              Employee + 1                                                   $3.16
              Employee + 2 or More                                           $6.07
         BASIC LIFE AND AD&D / GLOBAL TRAVELER PLAN / LONG TERM DISABILITY /
         TRAVEL ASSISTANCE PROGRAM / EMPLOYEE ASSISTANCE PROGRAM
              Employee Only                                               No Charge
         VOLUNTARY LIFE AND AD&D / SUPPLEMENTAL BENEFITS
              Employee / Dependents                      100% of Cost. For your convenience, your voluntary
                                                         premiums have been pre-calculated for you in ADP.




















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