Employee Benefits 2020-2021They are also accessible through a convenient phone app available on the...

Effective April 1 2020

EmployeeBenefits2020-2021

22 | P E N N O N I 2 0 2 0 2 1 B E N E F I T S H A N D B O O K

This guide describes the benefit plans available to you as an employee of Pennoni The details of these plans are contained in the official Plan documents including some insurance contracts This guide is meant only to cover the major points of each plan It does not contain all of the details that are included in the Plan or the Summary Plan Descriptions (SPDs) (as described by the Employee Retirement Income Security Act)

If there is ever a question about one of these plans or if there is a conflict between the information in this guide and the formal language of the Plan documents the formal wording of the Plan documents will govern

Please note that the benefits described in this guide may be changed at any time and do not represent a contractual obligation on the part of Pennoni Associates Inc

Need additional information Have a question about one of your benefits Keep this brochure handy for a quick reference for all your benefit needs If you still have questions please contact Benefit Harbor

3P E N N O N I 2 0 2 0 2 1 B E N E F I T S H A N D B O O K | 3

Table of ContentsExperts to Help You 4

Basic Benefits 5

Who Pays What 5

Core Benefits 6

Medical and Prescription Benefits 7

Plan A 8-10

Plan B 11-13

Telemedicine 14

Wellness Rewards 14

Dental Benefits 15

Vision Benefits 15

Vacation BuySell 16

Long Term Disability Buy-up Option 16

Flexible Spending Programs 17

Supplemental Life and ADampD Benefits 18

Accident Critical Illness and Cancer Insurance 19

Retirement Benefits 20

Emergency Travel Assistance and Identity Theft Protection 21

Continuing Education and Professional Memberships 22

PennoniGIVES 23

Contact Information 24


Health Advocate Health Advocate is a service provided by Pennoni at no cost to you Health Advocate experts make healthcare easier

by supporting you and your family members with a wide range of health and insurance-related issues all through a single toll-free number

Top reasons to call Health Advocate

You can contact Health Advocate by the following methods Call toll-free 1-866-695-8622 E-mail answersHealthAdvocatecom Go on the website HealthAdvocatecomPennoni They are also accessible through a convenient phone app available on the Apple App Store or Google Play A HIPAA authorization form may be necessary when seeking assistance

Benefit Harbor Benefit Harbor is your benefit information source for the Pennoni Benefits Plan Voice mail is available

for calls received after hours and on the major holidays when Benefit Harbor is closed

You can access your enrollment and benefits information online The website is designed to provide you with the resources and tools you need to make the most of your Benefits Plan elections

bull My Profile - includes your contact and dependent information bull My Benefits - allows you to enroll in your benefits print benefit statements and designate your beneficiaries bull My Forms and Resources - contains forms communication material and links to provider websites

Access Benefit Harbor Online wwwmypennonibenefitscom Login Your user ID is your Pennoni network user name (excluding pennoni) Example JSmith or jadams Your temporary password is your birth year + last 4 digits of your SSN

Example If you were born in 1975 and the last 4 digits of your SSN are 2345 then your temporary password is 19752345

You will be required to change your password when logging in for the first time It will reset every open enrollment period

Access Benefit Harbor Over the Phone For log-in help enrollment questions or general information call Benefit Harbor at 1-888-464-7309 Counselors are

available Monday through Thursday 900am to 900pm and Friday 900am to 700pm

Annual Notices can be found in the Forms section of Benefit Harborrsquos website

Carebridge Employee Assistance Program Carebridge Convenience Services can maximize you and your familyrsquos time and efforts when you seek information

and resources to address needs in areas such as

Experts to Help You

bull Resolve claims and billing issuesbull Make appointmentsbull Transfer medical records

bull Work with insurance companiesbull Find the right doctorsbull Answer benefit questions

bull Pet Care bull Grocery Shoppingbull Travelbull Transportationbull Stress

bull Relationshipsbull Family amp Parentingbull Personal Financesbull EducationSchools

Specialists are available 24 hours a day 7 days a week Call 1-800-437-0911 You may also e-mail clientservicecarebridgecom or visit the website wwwMyLifeResourcecom Pennonirsquos access code is 7J6BH

bull Relocationbull Life Balance bull Time Managementbull Legal Assistance

bull Clarify tests and treatmentsbull Help with eldercare


The Pennoni Flexible Benefits Plan is designed to recognize the diverse needs of our workforce Our plan continues to provide competitive and comprehensive benefit options that allow you to design a plan based on your individual needs

We encourage you to review your options before making your benefit elections Only you can determine which benefits are the best fit for you and your family We want you to understand your options in order to make informed decisions

EligibilityAll employees classified as full-time are eligible to participate in the Benefits Plans the first of the month following 30 days of service Your spouse or dependent children are also eligible for some benefits

Benefit BasicsOnce you elect your Pennoni benefit options your elections remain in effect for the entire plan year bull Plan Year April 1 2020 through March 31 2021 bull You may only change coverage due to a qualified ldquolife eventrdquo and must do so within 31 days of the event Pennoni

encourages you to review your benefits and make your selections wisely

Life EventsPlease remember that you must contact Benefit Harbor within 31 days of the event to make any changes You will be asked to provide documentation of your life event All life events are effective the first of the month following the date of the event except for birth and adoption which are effective the date of the event

The Plan recognizes the following as qualified Life Events bull Change in status which may include marital number of dependents employment change in

residence dependent satisfies or ceases to satisfy eligibility requirements bull Spousersquos or Dependentrsquos Open Enrollment bull Dependent care change bull Cost or coverage change within the employerrsquos plan bull HIPAA special enrollment rights bull Judgment decree or court order bull Enrollmentceasing to be enrolled in Medicare or Medicaid bull FMLA special requirements

Basic Benefits

Your Benefits and Your CostsPennoni provides a large selection of benefits that help protect your health wealth and well being The company provides some benefits at no cost to you some you pay for and other benefit costs are split between Pennoni and you This mix-and-match benefits program helps you create the best benefits program that fits your needs and your lifestyle

Benefit Who Pays Tax Status MedicalPrescription Coverage Pennoni amp You Pre-Tax Dental Coverage Pennoni amp You Pre-Tax Vision Coverage You Pre-Tax Basic LifeADampD Insurance Pennoni NA Supplemental LifeADampD Insurance You After-Tax Accident Insurance You After-Tax Critical Illness and Cancer You After-Tax Short-Term Disability Pennoni NA Long-Term Disability Pennoni NA Long-Term Disability Buy-up You Pre-Tax Employee Assistance Plan Pennoni NA Vacation BuySell You After-Tax Flexible Spending Accounts You Pre-Tax Qualified Transportation Benefit Options You Pre-Tax Pennoni Traditional 401(k) Plan amp Roth 401K Plan

You You

Tax Deferred After-Tax

Employee Stock Ownership Plan Pennoni Tax Deferred

$$$$$$$

$$$$ $$

$

Who Pays What

6

Core BenefitsPennoni provides the following benefits to all eligible full-time employees Upon meeting eligibility you are automatically enrolled in these benefits at no cost to you


Basic Life Insurance bull 1 x your annual base salary (up to $50000) SunLife 1-800-247-6875

Basic Accidental Death amp Dismemberment (ADampD) Insurance

bull 1 x your annual base salary (up to $50000) SunLife 1-800-247-6875

Short-Term Disability bull Covers 66 23 of weekly compensationbull Weekly maximum benefit of $2500bull Benefit begins on the first calendar day of an accidenteighth

calendar day for an illness and continues to the earlier of recovery or 13 weeks

SunLife 1-877-SUN-FMLA

Long-Term Disability bull Covers 60 monthly compensationbull Monthly maximum benefit of $7500bull Benefit begins after 90 days of continuous disability and

continues until the earlier of recovery or retirement age (whichever comes first)


Employee Assistance Program (EAP)

bull Confidential counseling sessions (up to 5 per year at no cost to you)

bull WorkLife Balance resourcesbull Financial Legal and Educational Resourcesbull Child care and Elder carebull 24-hour7 days a week access via telephone or internet

Carebridge Corporation 1-215-222-3000

Time-off Pennoni Employees are eligible for a variety of time off options such as Holidays Vacation Sick Leave Short- and Long-Term Disability Military Leave Jury Duty Bereavement Leave Leave under the Family Medical Leave Act (FMLA) Please review the Employee Handbook available on the Portal for more information about eligibility

Vacationbull Vacation time is accrued bi-weeklybull Your vacation time should be used to spend time away

from work to renew and refreshHolidaysbull Pennoni recognizes 8 paid holidays each year which

includes one employee selected holiday bull Additional holidays may be recognized at the discretion of

managementSick Timebull Paid sick leave is granted to full-time employees at the

discretion of management

Pennoni 215-222-3000

Employee Stock Ownership Plan (ESOP)

bull Company stock purchased on your behalfbull Fully vested after 6 years in the plan partial after 2 yearsbull Automatic enrollment upon meeting plan requirementsbull Online Access to your account with ESOP Navigator

Pennoni 215-222-3000

Medical and Prescription BenefitsIn addition to the core benefits you have the opportunity to build a benefits plan that meets your needs and the needs of your family Pennoni is committed to providing a range of benefits from which you can choose You are responsible for a percentage of or the total cost of these benefits

Medical CoveragePennoni offers two Independence Blue Cross Personal Choice Preferred Provider Organization Plans - PPO Plan A and PPO Plan B Both Plans utilize the nationwide BlueCardreg PPO Provider Network This network provides you with access to In-Network doctors across the country

PPO plans are least expensive when you use In-Network providers When you do so a greater percentage of your expenses are covered and your out-of-pocket costs are reduced However you can opt to use Non-Network or Out-of-Network doctors or facilities and still receive comprehensive coverage When you do seek care Out-of-Network you will incur higher deductibles and have a greater amount of coinsurance When utilizing out of network providers the member is responsible for any prior authorization The reimbursement rate for out of network services is much less and you can be balance billed the difference To locate an in-network provider select the National BlueCard PPO Network

Both PPO plans have an out-of-pocket maximum An out-of-pocket maximum is the most you will have to pay for your health care expenses during a plan period for covered services received from providers that participate in the planrsquos network No matter what you will not pay more than this amount each year Any care for covered services you get after you meet your out-of-pocket maximum will be covered 100 percent by Independence The in-network out of pocket maximums are as follows

Medical Prescription PlanThe Pennoni PPO Plans A and B are compared on the following pages - each plan is shown with both the in-network and out-of-network benefits

Bi-weekly CostPlan A Plan B

Single $10124 $5866Employee amp Child(ren) $17869 $10353Employee amp Spouse $20248 $11732

Family $28348 $16425

In-Network Out-of-Pocket Maximums

Plan A Plan BIndividual $1500 $3000Family $3000 $6000

What yoursquoll payIn-Network

Retail Pharmacy 30-day supply

Mail Order 90-day supply

Generics $10 $20Preferred Brands $20 $40

Nonpreferred Brands $35 $70

7

Independence Blue Cross 877-585-5734 | wwwibxcom RxBenefits 800-334-8134 | wwwexpress-scriptscom

Prescription Drug CoveragePrescription drug coverage is included as part of both PPO Plan A and PPO Plan B Our healthcare plan partners with RxBenefits to improve customer service for our prescription drug benefits RxBenefits is a Pharmacy Benefit Administrator (PBA) that has expertise in helping participants navigate through issues related to purchasing prescription medicine

The plan utilizes a three-tiered Formulary Prescription Drug Program Generic drugs are available at the lowest co-pay rate brand-name drugs that appear on the Formulary Drug List are available at a lower co-pay than other brand-name drugs Please note that if you choose to buy a brand-name drug when a generic equivalent is available you will be required to pay the generic drug co-pay plus the difference in cost between the generic and brand-name drug

You can access a copy of the most current Preferred Drug List at Express-Scriptscom or by contacting the RxBenefits Member Services Department at 1-800-334-8134

Select Maintenance Choice Members have the option of filling their maintenance prescriptions in 90-day supplies at mail order to benefit from a lower copay You can get up to two fills (original and 1 refill) from your local participating pharmacy You may choose to continue filling 30-day supplies at retail but you will pay a higher copay With Maintenance Choice you can avoid paying more for your long-term medication(s) by having 90-day supplies filled through mail service Maintenance medications are those that you take for ongoing medical conditions like diabetes high blood pressure and asthma

An ldquoindividualrdquo out-of-pocket maximum applies only when an individual is enrolled without any dependents A ldquofamilyrdquo out-of-pocket maximum applies when an individual and one or more dependents are enrolled Once an individual meets the individual out-of-pocket maximum benefits for that individual are covered in full Once the ldquofamilyrdquo out-of-pocket maximum is met benefits for all family members are covered in full

P E N N O N I 2 0 2 0 2 1 B E N E F I T S H A N D B O O K | 7

Reference ID 1003113004012019

Medical Benefit HighlightsPersonal Choice Plan A - High Option Pennoni Associates

Covered Services Your Costs (You pay)Benefits per Contract Year In-Network Out-of-Network

Deductible (Embedded)1IndividualFamily $500$1000 $1000$2000

Out-of-Pocket Maximum (Embedded)2IndividualFamily $1500$3000 $3000$6000

Coinsurance 10 20 Preventive Services In-Network Out-of-NetworkPreventive Care No charge no deductible 20 after deductiblePreventive Colonoscopy

Preventive Plus Providers No charge no deductible Not coveredHospital Based No charge no deductible 20 after deductible

Physician Services In-Network Out-of-NetworkPrimary Care Physician (PCP) Office Visit $15 no deductible 20 after deductibleSpecialist Office Visit $30 no deductible 20 after deductibleRetail Health Clinic Visit $15 no deductible 20 after deductibleTelemedicine (through MDLivereg) $15 no deductible Not coveredUrgent Care Visit $35 no deductible 20 after deductible Therapy Services In-Network Out-of-NetworkPhysical Therapy

Freestanding $30 no deductible 20 after deductibleHospital Based $30 no deductible 20 after deductible

Occupational TherapyFreestanding $30 no deductible 20 after deductibleHospital Based $30 no deductible 20 after deductible

Speech Therapy $30 no deductible 20 after deductible Emergency Services In-Network Out-of-NetworkEmergency Room (copay waived if admitted)

$100 no deductible Covered at In-Network level

Emergency Ambulance No charge no deductible Covered at In-Network levelNon-Emergency Ambulance No charge no deductible 20 after deductible Hospital Services In-Network Out-of-NetworkInpatient Hospital Services (In-Network 365 daysyear Out-of-Network 70 daysyear)3

10$250Day max of 5 copays per admission after deductible

20 after deductible


P L A N A

Reference ID 1003113004012019

Maternity Hospital Services3 10$250Day max of 5 copays per admission after deductible

20 after deductible

Inpatient Professional Services (includes Maternity)

10 after deductible 20 after deductible

Outpatient Surgery In-Network Out-of-Network

Freestanding 10 after deductible 20 after deductibleHospital Based 10 after deductible 20 after deductible

Outpatient Professional Services 10 after deductible 20 after deductible Outpatient Diagnostics In-Network Out-of-NetworkDiagnostic Medical (EKG) 10 after deductible 20 after deductibleRoutine Radiology (X-Ray)


Advanced Imaging (MRIMRACTCTA Scan PET Scan)


Outpatient Lab and Pathology In-Network Out-of-Network

Freestanding No charge no deductible 20 after deductibleHospital Based No charge no deductible 20 after deductible

Other Medical Services In-Network Out-of-NetworkSpinal Manipulations $30 no deductible 20 after deductibleAcupuncture (18 visitsyear)4 $30 no deductible 20 after deductibleStandard Injectables 10 after deductible 20 after deductibleAllergy Injections 10 after deductible 20 after deductibleBiotechSpecialty Injectables 10 after deductible 20 after deductibleChemotherapy 10 after deductible 20 after deductibleDialysis 10 after deductible 20 after deductibleSkilled Nursing Facility 10 after deductible 20 after deductibleHome Health 10 after deductible 20 after deductibleHospice 10 after deductible 20 after deductibleDurable Medical Equipment (DME) 10 after deductible 20 after deductibleMental Health ndash Outpatient (includes serious mental illness and substance abuse)

$30 no deductible 20 after deductible

Mental Health ndash Inpatient (includes serious mental illness and substance abuse)3


20 after deductible


P L A N A

Reference ID 1003113004012019

1 Embedded deductible Each covered family member only needs to satisfy his or her individual deductible not the entire family deductible prior to receiving plan benefits

2 Embedded out-of-pocket maximum Each covered family member only needs to satisfy his or her individual out-of-pocket maximum not the entire family out-of-pocket maximum

3 Inpatient hospital out of network day limit combined for all inpatient medical maternity mental health serious mental illness and substance abuse services

The Personal Choicereg Preferred Provider Organization (PPO) gives you freedom of choice by allowing you to select your own doctors and hospitals You maximize your coverage by accessing care through Personal Choices network of hospitals doctors and specialists or by accessing care through preferred providers who participate in the BlueCardreg PPO program If you access care from a provider who does not participate in our network you will have higher out-of-pocket costs and may have to submit your claim for reimbursement

This summary represents only a partial listing of benefits and exclusions of the Medical Program described in this summary If your employer purchases another program the benefits and exclusions may differ Also benefits and exclusions may be further defined by medical policy As a result this managed care plan may not cover all of your health care expenses Read your contractmember benefit booklet carefully for a complete listing of terms limitations and exclusions of the program For more information about your coverage or to get a copy of the complete terms of coverage visit wwwibxcomLGBooklet or call 1-800-ASK-BLUE (TTY 711)

Benefits may be changed by Independence Blue Cross to comply with applicable federalstate laws and regulations

Certain services require preapprovalprecertification by the health plan prior to being performed To obtain a list of services that require authorization please log on to httpwwwibxcompreapproval or call the phone number that is listed on the back of your identification card

Benefits underwritten or administered by QCC Insurance Company a subsidiary of Independence Blue Cross - Independent licensees of the Blue Cross and Blue Shield Association wwwibxcom

1 0 | P E N N O N I 2 0 2 0 2 1 B E N E F I T S H A N D B O O K

P L A N A

Reference ID 1003590704012020

Medical Benefit HighlightsPersonal Choice Pennoni Associates Inc Plan B - Base Option




Coinsurance 20 30 Preventive Services In-Network Out-of-NetworkPreventive Care No charge no deductible 30 no deductiblePreventive Colonoscopy

Preventive Plus Providers No charge no deductible Not coveredHospital Based No charge no deductible 30 no deductible

Physician Services In-Network Out-of-NetworkPrimary Care Physician (PCP) Office Visit $15 no deductible 30 after deductibleSpecialist Office Visit $30 no deductible 30 after deductibleRetail Health Clinic Visit $15 no deductible 30 after deductibleTelemedicine (through MDLivereg) $15 no deductible Not coveredUrgent Care Visit $35 no deductible 30 after deductible Therapy Services In-Network Out-of-NetworkPhysical Therapy (30 visitsyear)3


Occupational Therapy (30 visitsyear)3


Speech Therapy (20 visitsyear)4 $30 no deductible 30 after deductible Emergency Services In-Network Out-of-NetworkEmergency Room (copay waived if admitted)


Emergency Ambulance No charge no deductible Covered at In-Network levelNon-Emergency Ambulance 20 after deductible 30 after deductible

P E N N O N I 2 0 2 0 2 1 B E N E F I T S H A N D B O O K | 1 1

P L A N B

Reference ID 1003590704012020

Hospital Services In-Network Out-of-NetworkInpatient Hospital Services (In-Network 365 daysyear Out-of-Network 70 daysyear)5


Observation Services $100 no deductible 30 after deductibleMaternity Hospital Services5 20 after deductible 30 after deductibleInpatient Professional Services (includes Maternity)










Other Medical Services In-Network Out-of-NetworkSpinal Manipulations (20 visitsyear)4 $30 no deductible 30 after deductibleAcupuncture (18 visitsyear)4 $30 no deductible 30 after deductibleStandard Injectables No charge no deductible 30 after deductibleAllergy Injections No charge no deductible 30 after deductibleBiotechSpecialty Injectables

HomeOffice $100 no deductible 30 after deductibleOutpatient $100 no deductible 30 after deductible

Chemotherapy 20 after deductible 30 after deductibleDialysis 20 after deductible 30 after deductibleSkilled Nursing Facility (120 daysyear)4 20 after deductible 30 after deductibleHome Health 20 after deductible 30 after deductibleHospice 20 after deductible 30 after deductibleDurable Medical Equipment (DME) 30 after deductible 30 after deductible


P L A N B

Reference ID 1003590704012020

Mental Health ndash Outpatient (includes serious mental illness and substance abuse)






3 Cognitive Therapy Occupational Therapy and Physical Therapy combined visit limit in and out-of-network

4 Combined in and out of network








P L A N B

10

Wellness Taking small steps every day can add up to big changes in your health Pennonirsquos medical insurance offers wellness programs that support you and your family in improving and maintaining good health by earning points rewards and reimbursements These programs are available for you and each family member enrolled in Pennonirsquos medical plan through Independence Blue Cross including your spouse and children

Wellness Rewards ProgramBy simply getting preventive screenings exercising or visiting your doctor you and your family members can each earn points that are redeemable for up to $200 in gift cards Take healthy actions at your own pace and watch your points grow The points that you earn for your healthy habits are redeemable for gift cards to hundreds of restaurants and retailers

Healthy Lifestylestrade Solutions ReimbursementsGet rewarded for taking small steps every day that can add up to big changes in your health Healthy Lifestyles Solutions reimbursements offer you

Up to $150 back on your fitness center feesWith Independence Blue Crossrsquo fitness program you can get up to $150 back by going to an approved fitness center 120 times during a 365-day period (example June 2020 through May 2021) The Fitness Program rewards you for incorporating a well-rounded exercise program into your routine To be eligible for the fitness center reimbursement you must choose a full-service fitness center that offers a variety of cardiovascular flexibility and resistance training in a supervised setting

$150 back on an approved weight management programNo one said weight loss is easy but support from others can make the challenge feel more manageable Enroll in Weight Watchersreg Weight Watchersreg Online or an approved weight management program at any network hospital and you can get encouragement to manage your weight for the long haul The Healthy Lifestyles Solutions Weight Management Program will reimburse you up to $150 for the cost of an approved weight management program

$150 back for programs to help you quit tobaccoYou probably know many of the reasons why you should quit smoking mdash it can help you breathe easier live longer and protect the health of those around you Quitting isnrsquot easy and many people try more than once before they succeed but itrsquos worth it To help you quit for good our Healthy Lifestyles Solutions Tobacco Cessation Program will reimburse you up to $150 for completing an approved tobacco cessation program If yoursquore 18 or older and your program costs less than $150 you can apply the difference toward reimbursement of nicotine replacement products or medications prescribed to you to help you quit

Begin earning points rewards and reimbursements by logging into ibxpresscom

With telemedicine from MDLIVE you have 247 access to a US board-certified and licensed primary care doctor via HIPAA-secure video phone and mobile app who can treat non-emergency medical conditions such as

bull Colds and flu bull Allergies bull Asthma bull Pink eye bull Ear infections bull Sinus problems bull Respiratory infections bull Joint aches and pains bull Vomiting and nausea

Using MDLIVE is a convenient option when itrsquos not possible to visit your doctorrsquos office retail clinic or urgent care center The co-pay is the same as a primary care doctor visit (a $15 co-pay) but with a great deal more convenience However to use MDLive you must register first

Donrsquot wait until yoursquore sick mdash activate your account ndash and receive 15 Wellness Reward points for doing so

You have several ways to register

bull Visit mdlivecomibx bull Download the MDLIVE app on your smartphone bull Call 1-877-764-6605

Telemedicine

Wellness Rewards


Dental Benefits

Dental Benefits are provided through Delta Dental and utilizes the Delta Dental Premier Network of Dentists Pennonirsquos Dental Plan covers four main types of expenses

bull Preventive and diagnostic care like routine exams and cleaning fluoride treatments sealants and x-rays

bull Basic treatment such as simple fillings and extractions root canals oral surgery and gum disease treatment

bull Major treatment such as crowns and dentures bull Orthodontia bull Pre-determination is required for certain treatment plans

Benefit Delta Dental Base Plan (In-Network) Delta Dental Buy-up Plan (In-Network)

Single Annual Deductible Family Annual Deductible

$50$100

$50$100

Preventative amp Diagnostic Care 100 (No Deductible) 100 (No Deductible)Basic restorative oral surgery endodontics and periodontics 80 (After Deductible) 90 (After Deductible)Major restorative prosthodontics and implants 50 (After Deductible) 50 (After Deductible)Orthodontia $1500 per person per lifetime $2000 per person per lifetimeAnnual Maximum Benefit $1500 per person per year $2000 per person per year

Dental Base Plan Bi-weekly Cost

Buy-up Plan Bi-weekly Cost

Single $372 $687Employee amp Child(ren) $2334 $3163

Employee amp Spouse $1714 $2416Family $3810 $5041

Delta Dental 800-932-0783 | wwwdeltadentalcomAdditional Information on Pennoni Portal

1 1

These charts for dental and vision benefits show how much you pay for certain products and services Keep in mind if your doctor charges more than the planrsquos ldquoreasonable and customaryrdquo charge you may be required to pay the extra amountDependent age limit for both dental and vision is to age 26

Vision Bi-weekly Cost

Single $444Employee amp Child(ren) $726

Employee amp Spouse $711Family $1170

Benefit VSP (In-Network) VSP (Out-of-Network)

Exams (every 12 months) $10 co-pay Reimbursed up to $45

Glasses (frames every 12 months lenses every 12 months) $25 materials co-pay

Reimbursed up to $79 for glasses reimbursement for lenses varies from

$30 to $65 depending on type of lenses

Contacts in lieu of frames and glasses $25 materials Co-pay Reimbursed up to $105

Vision Benefits are provided through VSP Under this plan you may use the eye care professional of your choice but when you use a participating provider you will receive higher levels of coverage

Vision Benefits

VSP 800-877-7195 | wwwvspcomAdditional Information on Pennoni Portal

Taking care of your teeth and eyes is as important as taking care of the rest of your body Thatrsquos why Pennoni offers dental and vision plans that cover routine check-ups and additional services needed for your health

For dependents to age 19


1 112

Vacation Buy Vacation Sell ProgramThe Pennoni Vacation BuySell Program is a wonderful opportunity for employees to be able to buy or sell vacation time as they deem fit for the upcoming year

bull You may buy one week of vacation

bull You may sell one week of vacation after you begin accruing 3 weeks of vacation annually

bull You must elect this benefit during the open enrollment period if you are interested in participating in this plan You will not be permitted to make any mid-year elections so plan ahead

bull You must meet the eligibility requirements as of April 1 2020 or you must wait until next open enrollment

bull The BuySell amount will be set based on your salary as of April 1 2020 and will not be adjusted during the year The cost will be deducted (vacation buy) or added (vacation sell) to your paycheck on an after-tax basis over 26 pay periods

bull Vacation purchased through the Vacation Buy program must be used in one week increments Partial reimbursement requests will not be accepted

bull You may not elect both Vacation Buy and Vacation Sell in the same plan year

Long-Term Disability Buy-Up PlanEmployees may ldquobuy-uprdquo to a higher benefit percentage of 66 23

The cost is $040 per $100 of covered monthly earnings An example of how the buy-up option works is below $80000 annual salary 12 months = $6667 covered monthly earnings 60 benefit (provided by Pennoni as a Core Benefit) = $4000month 6667 benefit (Buy-Up option employee pays for additional 667 of coverage) = $4445month Difference $445month (or $5340 annually)

Cost for additional benefit = $040 x covered monthly earnings ($6667) $100 = $2667month or $320year for the additional monthly benefit of $445

If your salary is in excess of $150000 the buy-up is not advantageous since you are already at the maximum benefit of $7500 For any salary below $150000 the buy up is a consideration but you would determine if was beneficial based on your circumstances


Flexible Spending AccountsSpending Accounts work like a savings account - each pay period a pre-tax payroll deduction is deposited to your Medical andor Dependent Care Spending Account When you need money to cover an eligible expense you make a pre-tax ldquowithdrawalrdquo by using your flexible benefits debit card or completing a claim form and providing proper documentation (pharmacy receipts detailed bills or explanation of benefits [EOB]) You may elect to have your reimbursement check deposited directly into your checking or savings account

Please note Unlike our other benefits there is no ldquopassive electionrdquo at open enrollment time when it comes to medical and dependent care flexible spending accounts Each open enrollment period if you want to have either the medical andor dependent care FSA benefit for the upcoming plan year you must elect it again The enrollment system will not keep the same FSA election that you had in place in the previous plan year ndash you must if you want the medical andor dependent care FSA freshly elect them during the open enrollment time period

Flexible Spending Programs

Account Used For Contributions

Medical SpendingMost medical dental and vision expenses(like co-payments deductibles eyeglassesand certain Over-the-Counter medications)

Up to $2750 annual contribution The runout period for claim submissions is through June 30 the following year There is a maximum $500 rollover all unused contributions in excess of this are forfeited Annual election at Open Enrollment

Dependent Care Spending

Dependent care expenses (like daycare after-school programs or elder care programs) so you and your spouse can go to work or go to school full-time

Up to $5000 annual contribution (runout period through June 30) and no rollover Expenses must be incurred during plan year (April through March) The runout period for claim submissions is June 30 of the following year No Rollover available and all unused contributions are forfeited Annual Election at Open Enrollment

1 3

Transit Account For anyone who uses mass transit as part of the daily commute to work It covers fees for trains buses or vanpools

Parking Account For anyone who parks at or near their place of employment orthe parking lot of a mass transit or train station

For spending account support call (833) 283-7694 | wwwibxpresscom

Both Transit and Parking accounts have the following features

bull Up to $270month contribution with rollover Most plans maintain rollover only if you remain in the plan Pennoni currently offers perpetual rollover as long as someone remains employed

bull Elections can be adjusted if commuting patterns change bull Ongoing full monthly contributions available on the first of the month Because you may only

use $270 per month it is important that you time your monthly purchases Funds are available in your commuter account as of the 1st day of the month You may purchase transit passes on the first of the month of each month or you may wait until the end of the month to pre-purchase your transit pass for the following month We recommend that you adopt one of the practices that best suits your needs and follow this practice throughout the year Any attempts to buy multiple passes equating to more than $270 per month will result in an inaccessible account

bull Transit and Parking are separate FSA accounts You may elect both but Transit FSA funds may not be used for parking and vice versa

Bicycle Commuter Program bull Employees who regularly use their bicycle for transportation between their home and work

location are eligible for up to a $20 per month taxable reimbursement to use towards expenses related to their commute

bull This benefit may not be elected if you have elected either mass transit or parking expense reimbursement

Qualified Transportation Benefit OptionsPennoni offers Commuter benefits that help you save money by allowing you to use pre-tax money for eligible expenses Participants can pay for related expenses using your FSA debit card online submissions or completing reimbursement forms which are available via ibxpresscom


If you want additional protection for you and your family you can buy Supplemental andor Accidental Death amp Dismemberment Insurance

Life and Supplemental ADampD Benefits

Cost of coverage is dependent on the age of the employee and spouse and it is calculated at the time of election Rates increase per the schedule on the right

Employee Cost for Supplemental Life Insurance for Employee SpouseBenefit Amount $1000 x Per Pay Rate for Employee Age (see chart) = Bi-weekly Cost

Accidental Death amp Dismemberment (ADampD) insurance provides extra financial protection if you or your dependents suffer from a covered accidental injury or accidental death

Age as of April 1 2020 Employee SpouseUnder 30 $00351 $00411

30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --

Supplemental Life Available Coverage

For you $10000 increments The lesser of up to five times annual earnings up to $500000 maximum benefit $200000 Guaranteed Issue

For your Spouse (Must also purchase employee coverage)

$5000 increments $250000 maximum benefit or 100 of employee amount (whichever is less) $30000 Guaranteed Issue

For your Child(ren) (Must also purchase employee coverage) $2500 increments $10000 maximum benefit

Supplemental ADampD Available Coverage

For you $10000 increments $500000 maximum benefitAmounts more than $250000 cannot exceed 10x annual salary


$5000 increments $300000 maximum benefit or 100 of employee amount (whichever is less)

For your Child(ren) (Must also purchase employee coverage)

Flat benefit of $50000 for each eligible childEmployee Cost for Supplemental Life Insurance for Dependent ChildrenBenefit Amount $1000 x $00462 = Per Pay Cost

13

Sun Life 800-247-6875 | wwwmysunlifebenefitscom

14

Supplemental Life Insurance Consider supplementing your employer-paid life insurance if your income is needed to cover household or day-to-day expenses or if you share responsibility for a significant debt with someone else



Accident Insurance Available Coverage

Available for you and your family Provides 24 hour coverage Pays out a flat $ benefit amount based on the covered injury incurred

Covered claims have reimbursements that range from $20 to $40000 Please refer to the plan design summary for specifics on this plan

Accident Critical Illness amp Cancer Insurance

Critical Illness amp Cancer Available Coverage

Provides a lump sum benefit upon diagnosis of a covered condition All coverage is Guaranteed Issue (No Evidence of Insurability needed) However the policty does include a pre-exisit-ing condition clause that is in effect for a period after you first elect coverage Please refer to the certificates on the Benefit Harbor website for more information Coverage for spousedependents is contingent on employee select-ing coverage

Benefit amounts that can be selected range from $5000 to $20000 for the employee and from $5000 to $10000 in increments of $2500 for spouses and a flat $5K for dependents(s) Please refer to the plan design summary for specifics on this plan Separate rates for smokers and non-smokers

Age as of April 1 2020

Employee Non-Smoker Employee Smoker

Spouse Non-Smoker Spouse Smoker

Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184

Employee Cost for Critical Illness and Cancer Insurance for DependentSame cost whether one dependent or multiple dependentsBenefit Amount $1000 X dependent rate (see chart) = Bi-weekly cost

For both plans the following rules will applyNo double dipping - No person may be considered to be a dependent child of more than one employee and no person may be considered both a spouse and an employee

Age as of April 1 2020 Dependent

All Age Bands $04154

Employee Cost for Accident Insurance Bi-weekly cost

Single $460 Employee amp Child(ren) $723

Employee amp Spouse $752

Family $1196

Employee Cost for Critical Illness and Cancer Insurance for Employee Spouse Benefit Amount $1000 X Bi-weekly Rate for Employee Age (see Chart) = Bi-weekly cost

15P E N N O N I 2 0 2 0 2 1 B E N E F I T S H A N D B O O K | 1 9

Retirement BenefitsPennoni provides you with two opportunities to save for retirement No matter what your age now is the time to save for your retirement years by participating in your employer-sponsored retirement plans

Pennoni Traditional 401(k) Plan amp Roth 401K PlanThe Pennoni 401(k) Retirement Options are federally qualified tax-deferred retirement savings plans With a Traditional 401(k) Plan your contribution and your investment return are not taxed for Federal Withholding Tax or some State Income Tax purposes until you withdraw your balance This deferral of taxes enables your balance to grow faster than it would if it were in a normal savings account The Roth 401K Plan allows you to make after tax contributions to the plan and never pay taxes on the earnings The two options give you greater flexibility in planning your retirement portfolio

Note Some states including Pennsylvania require you to pay State Income Tax on your contribution to the plan

bull If you are age 21 and older you are eligible to participate in the 401(k) Retirement Plan as soon as administratively feasible following 30 days of service New employees are automatically enrolled at a 3 contribution rate You may change or cancel your contribution at any time

bull You can contribute in one-percent increments up to the IRS maximum limit For those over 50 years of age an additional ldquocatch-uprdquo contribution can be made once the IRS maximum limit is reached

bull A diverse selection of investment options is available which allows you to select the fund(s) which best meet your personal retirement needs

bull You will be sent enrollment information prior to your eligibility date Once you are eligible to participate you may enroll in the Plan at any time

bull To access your account online go to wwwretirementdirectionscom Your default user name is your social security number Your default password is the MMDDYYYY of your birthday

Vested Interest 800-374-4631 M-F 8am-10pm EST

Employee Stock Ownership Plan (ESOP)The Pennoni ESOP is a federally qualified tax-deferred retirement savings plan The plan was adopted in 1994 and allows employees to be owners of the company without investing their own money The Pennoni ESOP Trust owns 100 of the shares of Pennoni Each eligible employee as a participant in the ESOP therefore participates in ownership of the company

bull You are eligible for the Pennoni ESOP if you are on the payroll as of December 31 and have worked 1000 hours in the plan year Enrollment is automatic once you satisfy the eligibility requirements

bull You are fully vested in the Plan after 6 years in the ESOP Vesting means your ownership of the dollars in your Plan account The vesting schedule is as follows

bull Value of the shares are determined by an independent appraiser each year

bull Statements are generated once per year and are available online at httpspennoniesopnavigatorcom Your user name is your email address pennonicom

For the ESOP Navigator system your temporary password is the letter p followed by your year of birth followed by the last four digits of your SSN For example if you were born in 1977 and the last four digits of your SSN are 2345 your temporary password is p19772345

YEARS OF ESOP PARTICIPATION VESTED

Less than 2 02 203 404 605 80

6 or more 100


17

Emergency Travel Assistance amp Identity Theft ProtectionEmergency Travel Assistance If you have a medical emergency while you are more than 100 miles away from home you donrsquot have to face it alone With one simple phone call you can be connected to Assist Americarsquos staff of medically trained multilingual professionals who can advise you in a medical emergency 24x7 No matter where you are in the world they will help you access or receive

bull pre-qualified English-speaking professionals working in hospitals pharmacies and dental offices bull medical consultation evaluation and referral bull hospital admission assistance bull critical care monitoring bull emergency medical evacuation bull transportation to return home or to a rehabilitation facility bull prescription assistance bull legal and interpreter services and more

This is not medical insurance No claims for reimbursement will be accepted All services must be arranged and provided by Assist America Spouse business travel excluded Optional coverage for trips longer than 90 days

If you or your family member has a medical emergency and are more than 100 miles from home call or e-mail

medservicesassistamericacom 800-872-1414 within the US

609-986-1234 Outside the US Membership Number 01-AA-SUL-100101

Identity Theft ProtectionIdentity theft is a serious crime Each year millions of Americans have their personal financial information stolen and must spend a significant amount of time and money to restore their records If you ever become a victim of identity theft you donrsquot have to face it alone You have the support of a comprehensive Identity Theft Protection program through Assist Americarsquos SecurAssist Identity Protection program It provides

bull 24x7 telephone support and step-by-step guidance by anti-fraud experts bull a case worker assigned to you to help you notify the credit bureaus and file paperwork to correct your credit reports bull help canceling stolen cards and reissuing new cards and bull help notifying financial institutions and government agencies

You can also help stop identity theft before it happens

bull You can securely store information from credit cards bank cards and documents in one safe centralized location If any information ever becomes lost or stolen retrieval is easy and the resolution process can begin

bull You can register for identity fraud protection surveillance of up to 10 credit or debit cards bull Registered cards are monitored using sophisticated real-time early warning technology that monitors underground chat

rooms across cyberspace where thieves are selling and trading stolen personal information bull You receive early warning of potential threats and are notified if your identity has been misused

If you are the victim of financial or medical identity fraud or if yoursquod like to store your card information in one central location call

877-409-9597 Membership Number 01-AA-SUL-100101

To proactively protect your credit cards register them for Identity Fraud Protection surveillance wwwsecurassistcomsunlife Access Code 18327


18

Continuing Education amp Professional Memberships

Educational AssistanceFull Time employees are encouraged to broaden their job-related knowledge by enrolling in outside educational courses and training All employees whether degreed or not should maintain their technical knowledge at a high level of proficiency for them to perform effectively As an incentive Pennoni offers education assistance to those meeting the requirements Employees wishing to request educational assistance must complete the Education Assistance Request and Agreement Form (HR02) and submit the form to hisher supervisor Visit the Pennoni Portal for more information on eligibility and reimbursement

Continuing Education and ParticipationEmployees are expected to maintain technical competence and professional development through continuing education programs that will benefit them and the Company Communicative skills can also be developed by participating on committees chairing meetings andor writing papers and articles or holding office Reimbursement all or in part will be at the discretion of management Visit the Pennoni Portal for more information on continuing education units and approval for attendance

Professional Registration Licenses and Other Company-Paid FeesEmployees are required to possess and maintain professional competence Professional certification and registration demonstrates that competence Reimbursement will be available to Full Time employees for annual professional registration fee certification andor license in one state and one discipline Additional registrations recommended by the Regional Vice President and approved by the COO or hisher designate may also be reimbursed Visit the Pennoni Portal for more information on reimbursements and exam policies

ProfessionalTechnical MembershipEmployees are encouraged to belong to and participate in the activities of professional organizations in order to expand their personal knowledge and experience Such participation should include the preparation of professional and technical papers for publication and presentation at meetings

Membership Dues Annual dues will be paid for Full Time employees in one society of hisher major discipline The Company will pay for any additional memberships if it will benefit the Company The COO or hisher designate must approve additional memberships pursuant to recommendation by the Regional Vice President Employees who join these organizations at Company expense are expected to participate in the activities of the organization

Internal Training ProgramsPennoni offers internal training programs focused on introducing new employees to the consulting industry the foundations of Project Management and advanced Project Management skills For more information on the courses being offered please visit the Portal gt HR gt Learning and Development gt In-House Trainings

Internal Career Tracks and CertificationsPennoni offers a three-tiered certification career track in Project Management and Technical Excellence Interested employees should review the application and certification criteria matrix located on the Portal Newly certified employees receive a framed certificate a spot bonus and are recognized in our internal and external publications A list of current certified employees can be also be found on the Portal gt HR gt PM and TE Career Track


19

PennoniGIVES

Since the firmrsquos inception in 1966 Pennoni has made giving time talent and treasure (resources) to charitable and community-based organizations a fundamental part of our culture Through the PennoniGIVES (Giving by Investing in our Volunteering EmployeeS) program staff can apply for and receive grants to use in their philanthropic efforts with an organization in which they actively participate The program was established to provide financial support for specific projects where employees are directly involved PennoniGIVES is a part of Pennonirsquos overall charitable contributions program The program is administered by a committee of employees who themselves have demonstrated a strong commitment to volunteering

Employees may request a contribution by completing an application and sending it to Human Resources along with any necessary documentation The application will be reviewed by the committee for approval

Visit the Portal for more information


P A R T N E R S F O R W H A T rsquo S P O S S I B L E

Primary Contact Hours of Operation Website Phone Number

Benefit Harbor M-Th 900am - 900pm EST Fri 900am - 700pm EST wwwmypennonibenefitscom 888-464-7309

Plan Administrator Website Phone Number

Medical Benefits Independence Blue Cross wwwibxcom 877-585-5734

MDlive Independence Blue Cross mdlivecomibx 877-764-6605

Prescription Benefits RxBenefits wwwexpress-scriptscom 800-334-8134

Health Insurance Concierge Health Advocate HealthAdvocatecomPennoni 866-695-8622

Dental Benefits Delta Dental wwwdeltadentalcom 800-932-0783

Vision Benefits VSP wwwvspcom 800-877-7195

Basic LifeADampD Insurance Sun Life wwwmysunlifebenefitscom 800-247-6875

Supplemental Life Insurance Sun Life wwwmysunlifebenefitscom 800-247-6875

Supplemental ADampD Insurance Sun Life wwwmysunlifebenefitscom 800-247-6875

Family Medical Leave Sun Life FMLA Source httpsfmlasunlife-usacom 877-SUN-FMLA

Short-Term Disability Sun Life httpsfmlasunlife-usacom 877-SUN-FMLA

Long-Term Disability Sun Life httpsfmlasunlife-usacom 877-SUN-FMLA

Long-Term Disability Buy-up Sun Life httpsfmlasunlife-usacom 877-SUN-FMLA

Accident Insurance Sun Life wwwmysunlifebenefitscom 800-247-6875

Critical Illness and Cancer Sun Life wwwmysunlifebenefitscom 800-247-6875

Flexible Spending Accounts IBCAlegius wwwibxpresscom 833-283-7694

Employee Assistance Plan Carebridge wwwmyliferesourcecom Register Access Code 7J6BH 800-437-0911

401(k) Retirement Plan Vested Interest wwwretirementdirectionscom 800-374-4631

ESOP Pennoni httpspennoniesopnavigatorcom 215-222-3000

Contact Information

Bookmark 1

Bookmark 2



This guide describes the benefit plans available to you as an employee of Pennoni The details of these plans are contained in the official Plan documents including some insurance contracts This guide is meant only to cover the major points of each plan It does not contain all of the details that are included in the Plan or the Summary Plan Descriptions (SPDs) (as described by the Employee Retirement Income Security Act)

If there is ever a question about one of these plans or if there is a conflict between the information in this guide and the formal language of the Plan documents the formal wording of the Plan documents will govern

Please note that the benefits described in this guide may be changed at any time and do not represent a contractual obligation on the part of Pennoni Associates Inc

Need additional information Have a question about one of your benefits Keep this brochure handy for a quick reference for all your benefit needs If you still have questions please contact Benefit Harbor



Basic Benefits 5

Who Pays What 5

Core Benefits 6


Plan A 8-10

Plan B 11-13

Telemedicine 14

Wellness Rewards 14

Dental Benefits 15

Vision Benefits 15

Vacation BuySell 16








PennoniGIVES 23



















Experts to Help You

















Basic Benefits



You You



$$$$$$$

$$$$ $$

$

Who Pays What

6






















Pennoni 215-222-3000



Pennoni 215-222-3000








Family $28348 $16425








7








Reference ID 1003113004012019














20 after deductible


P L A N A

Reference ID 1003113004012019


20 after deductible















20 after deductible


P L A N A

Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2




Basic Benefits 5

Who Pays What 5

Core Benefits 6


Plan A 8-10

Plan B 11-13

Telemedicine 14

Wellness Rewards 14

Dental Benefits 15

Vision Benefits 15

Vacation BuySell 16








PennoniGIVES 23



















Experts to Help You

















Basic Benefits



You You



$$$$$$$

$$$$ $$

$

Who Pays What

6






















Pennoni 215-222-3000



Pennoni 215-222-3000








Family $28348 $16425








7








Reference ID 1003113004012019














20 after deductible


P L A N A

Reference ID 1003113004012019


20 after deductible















20 after deductible


P L A N A

Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2



















Experts to Help You

















Basic Benefits



You You



$$$$$$$

$$$$ $$

$

Who Pays What

6






















Pennoni 215-222-3000



Pennoni 215-222-3000








Family $28348 $16425








7








Reference ID 1003113004012019














20 after deductible


P L A N A

Reference ID 1003113004012019


20 after deductible















20 after deductible


P L A N A

Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2











Basic Benefits



You You



$$$$$$$

$$$$ $$

$

Who Pays What

6






















Pennoni 215-222-3000



Pennoni 215-222-3000








Family $28348 $16425








7








Reference ID 1003113004012019














20 after deductible


P L A N A

Reference ID 1003113004012019


20 after deductible















20 after deductible


P L A N A

Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


6






















Pennoni 215-222-3000



Pennoni 215-222-3000








Family $28348 $16425








7








Reference ID 1003113004012019














20 after deductible


P L A N A

Reference ID 1003113004012019


20 after deductible















20 after deductible


P L A N A

Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2









Family $28348 $16425








7








Reference ID 1003113004012019














20 after deductible


P L A N A

Reference ID 1003113004012019


20 after deductible















20 after deductible


P L A N A

Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


Reference ID 1003113004012019














20 after deductible


P L A N A

Reference ID 1003113004012019


20 after deductible















20 after deductible


P L A N A

Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


Reference ID 1003113004012019


20 after deductible















20 after deductible


P L A N A

Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


Reference ID 1003113004012019










P L A N A

Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


Reference ID 1003590704012020















P L A N B

Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


Reference ID 1003590704012020

















P L A N B

Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


Reference ID 1003590704012020
















P L A N B

10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


10














Telemedicine

Wellness Rewards


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


Dental Benefits







$50$100

$50$100







1 1












Vision Benefits





1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


1 112























1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2











1 3




















30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2








30-34 $00392 $0045735-39 $00480 $0056340-44 $00738 $0086845-49 $01260 $0148250-54 $02091 $0245555-59 $03258 $0383160-64 $05086 $0598265-69 $09129 $0912970+ $16338 --












13


14














Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2













Under Age 29 $02123 $02215 $02123 $02215

30-39 $03323 $03785 $03323 $0378540-49 $06692 $096 $06692 $096

50-59 $137 $246 $137 $24660-69 $276 $582 $276 $582

70-74 $445 $931 $445 $931

75-79 $585 $1100 $585 $110080 amp Over $664 $1184 $664 $1184








Family $1196



















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


















Less than 2 02 203 404 605 80

6 or more 100


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


17

















18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


18










19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2


19

PennoniGIVES




























Contact Information

Bookmark 1

Bookmark 2

























Contact Information

Bookmark 1

Bookmark 2


Employee Benefits 2020-2021They are also accessible through a convenient phone app available on the...

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Transcript of Employee Benefits 2020-2021They are also accessible through a convenient phone app available on the...