Common use of Participation Levels Option A – CORE PLAN Clause in Contracts

Participation Levels Option A – CORE PLAN. Employees who elect Option A to participate in the County sponsored medical plan will receive the County health benefits flex contribution (as specified below) to be utilized to purchase their selected medical plan and cannot be cashed out. In the event that an employee selects a medical plan that results in an excess County contribution, that excess contribution will be deemed a non-health flex contribution that may be taken as taxable income or applied to pre-tax dental, vision or other alternative approved benefits. Should an employee decline County sponsored medical coverage, such employee will receive a cash-in-lieu payment if the employee complies with the requirements outlined in Option B below. The County will pay to Employee's Flexible Benefit Account the following amounts for employees who election Option A:  Employee Only $462.78  Employee Plus One $921.30  Family $1,207.41 The above amounts include the PEMHCA minimum which is paid outside of the County’s Section 125 plan. Employees, regardless of medical plan participation status, are eligible to enroll in the County’s dental and/or vision programs. Employee contributions for dental and vision will be deducted from employee’s regular payroll on a pre-tax basis. Employees that have elected Option A can also elect to participate in optional benefits. If the employee has any surplus Flexible Benefit Account credits after making all elections required to participate in the health insurance, the employee can use that surplus toward the Flexible Benefit Options listed in the Flexible Benefit Options Exhibit. Employees that wish to participate in the optional benefits in the plan, with the exception of the cash back option, but do not have any surplus credits, can elect to have pre-tax payroll deductions in an amount to cover the cost of their elections. OPTION B - FLEXIBLE BENEFIT OPTIONS Employees who decline County sponsored medical coverage and elect Option B must provide the following in order to receive the cash-in-lieu:

Participation Levels Option A – CORE PLAN. Employees who elect Option A to participate in the County sponsored medical plan will receive the County health benefits flex contribution (as specified below) to be utilized to purchase their selected medical plan and cannot be cashed out. In the event that an employee selects a medical plan that results in an excess County contribution, that excess contribution will be deemed a non-health flex contribution that may be taken as taxable income or applied to pre-tax dental, vision or other alternative approved benefits. Should an employee decline County sponsored medical coverage, such employee will receive a cash-in-lieu payment if the employee complies with the requirements outlined in Option B below. The Effective the pay period beginning September 17, 2022, the County will pay to Employee's Flexible Benefit Account the following amounts for employees who election Option A:  • Employee Only $462.78  520.28 • Employee Plus One $921.30  1,035.76 • Family $1,207.41 1,357.42 The above amounts include the PEMHCA minimum which is paid outside of the County’s Section 125 plan. Employees, regardless of medical plan participation status, are eligible to enroll in the County’s dental and/or vision programs. Employee contributions for dental and vision will be deducted from employee’s regular payroll on a pre-tax basis. Employees that have elected Option A can also elect to participate in optional benefits. If the employee has any surplus Flexible Benefit Account credits after making all elections required to participate in the health insurance, the employee can use that surplus toward the Flexible Benefit Options listed in the Flexible Benefit Options Exhibit. Employees that wish to participate in the optional benefits in the plan, with the exception of the cash back option, but do not have any surplus credits, can elect to have pre-tax payroll deductions in an amount to cover the cost of their elections. OPTION B - FLEXIBLE BENEFIT OPTIONS Employees who decline County sponsored medical coverage and elect Option B must provide the following in order to receive the cash-in-lieu:

Participation Levels Option A – CORE PLAN. Employees who elect Option A to participate in the County sponsored medical plan will receive the County health benefits flex contribution (as specified below) to be utilized to purchase their selected medical plan and cannot be cashed out. In the event that an employee selects a medical plan that results in an excess County contribution, that excess contribution will be deemed a non-health flex contribution that may be taken as taxable income or applied to pre-tax dental, vision or other alternative approved benefits. Should an employee decline County sponsored medical coverage, such employee will receive a cash-in-lieu payment if the employee complies with the requirements outlined in Option B below. The County will pay to Employee's Flexible Benefit Account the following amounts for employees who election Option A:  • Employee Only $462.78  • Employee Plus One $921.30  • Family $1,207.41 The above amounts include includes the PEMHCA minimum which is paid outside of the County’s Section 125 plan. Employees, regardless of medical plan participation status, are eligible to enroll in the County’s dental and/or vision programs. Employee contributions for dental and vision will be deducted from employee’s regular payroll on a pre-tax basis. Employees that have elected Option A can also elect to participate in optional benefits. If the employee has any surplus Flexible Benefit Account credits after making all elections required to participate in the health insurance, the employee can use that surplus toward the Flexible Benefit Options listed in the Flexible Benefit Options Exhibit. Employees that wish to participate in the optional benefits in the plan, with the exception of the cash back option, but do not have any surplus credits, can elect to have pre-tax payroll deductions in an amount to cover the cost of their elections. OPTION Option B - FLEXIBLE BENEFIT OPTIONS Employees who decline County sponsored medical coverage and elect Option B must provide the following in order to receive the cash-in-lieu:

Participation Levels Option A – CORE PLAN. Employees who elect Option A to participate in the County sponsored medical plan will receive the County health benefits flex contribution (as specified below) to be utilized to purchase their selected medical plan and cannot be cashed out. In the event that an employee selects a medical plan that results in an excess County contribution, that excess contribution will be deemed a non-health flex contribution that may be taken as taxable income or applied to pre-tax dental, vision or other alternative approved benefits. Should an employee decline County sponsored medical coverage, such employee will receive a cash-in-lieu payment if the employee complies with the requirements outlined in Option B below. The Effective September 17, 2022 the County will pay to Employee's Flexible Benefit Account the following amounts for employees who election Option A:  Employee Only $462.78  520.27 Employee Plus One $921.30  1,035.76 Family $1,207.41 1,357.42 The above amounts include the PEMHCA minimum which is paid outside of the County’s Section 125 plan. Employees, regardless of medical plan participation status, are eligible to enroll in the County’s dental and/or vision programs. Employee contributions for dental and vision will be deducted from employee’s regular payroll on a pre-tax basis. Employees that have elected Option A can also elect to participate in optional benefits. If the employee has any surplus Flexible Benefit Account credits after making all elections required to participate in the health insurance, the employee can use that surplus toward the Flexible Benefit Options listed in the Flexible Benefit Options Exhibit. Employees that wish to participate in the optional benefits in the plan, with the exception of the cash back option, but do not have any surplus credits, can elect to have pre-tax payroll deductions in an amount to cover the cost of their elections. OPTION Option B - FLEXIBLE BENEFIT OPTIONS Employees who decline County sponsored medical coverage and elect Option B must provide the following in order to receive the cash-in-lieu:

Participation Levels Option A – CORE PLAN. Employees who elect Option A to participate in the County sponsored medical plan will receive the County health benefits flex contribution (as specified below) to be utilized to purchase their selected medical plan and cannot be cashed out. In the event that an employee selects a medical plan that results in an excess County contribution, that excess contribution will be deemed a non-non- health flex contribution that may be taken as taxable income or applied to pre-pre- tax dental, vision or other alternative approved benefits. Should an employee decline County sponsored medical coverage, such employee will receive a cash-in-lieu payment if the employee complies with the requirements outlined in Option B below. The Effective the pay period beginning August 20, 2022, the County will pay to Employee's Flexible Benefit Account the following amounts for employees who election Option A:  Employee Only $462.78  607.10 Employee Plus One $921.30  1,119.00 Family $1,207.41 1,438.42 The above amounts include includes the PEMHCA minimum which is paid outside of the County’s Section 125 plan. Employees, regardless of medical plan participation status, are eligible to enroll in the County’s dental and/or vision programs. Employee contributions for dental and vision will be deducted from employee’s regular payroll on a pre-pre- tax basis. Employees that have elected Option A can also elect to participate in optional benefits. If the employee has any surplus Flexible Benefit Account credits after making all elections required to participate in the health insurance, the employee can use that surplus toward the Flexible Benefit Options listed in the Flexible Benefit Options Exhibit. Employees that wish to participate in the optional benefits in the plan, with the exception of the cash back option, but do not have any surplus credits, can elect to have pre-tax payroll deductions in an amount to cover the cost of their elections. OPTION B - FLEXIBLE BENEFIT OPTIONS Employees who decline County sponsored medical coverage and elect Option B must provide Premium Holiday: In the event that a “premium holiday” is declared by the County’s health plan administrator or provider in which health plan premiums are not required to be paid for a period of time, the following in order to receive the cash-in-lieushall occur:

Participation Levels Option A – CORE PLAN. Employees who elect Option A to participate in the County sponsored medical plan will receive the County health benefits flex contribution (as specified below) to be utilized to purchase their selected medical plan and cannot be cashed out. In the event that an employee selects a medical plan that results in an excess County contribution, that excess contribution will be deemed a non-non- health flex contribution that may be taken as taxable income or applied to pre-pre- tax dental, vision or other alternative approved benefits. Should an employee decline County sponsored medical coverage, such employee will receive a cash-in-lieu payment if the employee complies with the requirements outlined in Option B below. The County will pay to Employee's Flexible Benefit Account the following amounts for employees who election Option A:  Employee Only $462.78  543.78 Employee Plus One $921.30  1,002.30 Family $1,207.41 1,288.41 The above amounts include includes the PEMHCA minimum which is paid outside of the County’s Section 125 plan. Employees, regardless of medical plan participation status, are eligible to enroll in the County’s dental and/or vision programs. Employee contributions for dental and vision will be deducted from employee’s regular payroll on a pre-pre- tax basis. Employees that have elected Option A can also elect to participate in optional benefits. If the employee has any surplus Flexible Benefit Account credits after making all elections required to participate in the health insurance, the employee can use that surplus toward the Flexible Benefit Options listed in the Flexible Benefit Options Exhibit. Employees that wish to participate in the optional benefits in the plan, with the exception of the cash back option, but do not have any surplus credits, can elect to have pre-tax payroll deductions in an amount to cover the cost of their elections. OPTION B - FLEXIBLE BENEFIT OPTIONS Employees who decline County sponsored medical coverage and elect Option B must provide Premium Holiday: In the event that a “premium holiday” is declared by the County’s health plan administrator or provider in which health plan premiums are not required to be paid for a period of time, the following in order to receive the cash-in-lieushall occur:

Participation Levels Option A – CORE PLAN. Employees who elect Option A to participate in the County sponsored medical plan will receive the County health benefits flex contribution (as specified below) to be utilized to purchase their selected medical plan and cannot be cashed out. In the event that an employee selects a medical plan that results in an excess County contribution, that excess contribution will be deemed a non-health flex contribution that may be taken as taxable income or applied to pre-tax dental, vision or other alternative approved benefits. Should an employee decline County sponsored medical coverage, such employee will receive a cash-in-lieu payment if the employee complies with the requirements outlined in Option B below. The County will pay to Employee's Flexible Benefit Account the following amounts for employees who election Option A:  Employee Only $462.78  Employee Plus One $921.30  Family $1,207.41 The above amounts include the PEMHCA minimum which is paid outside of the County’s Section 125 plan. Employees, regardless of medical plan participation status, are eligible to enroll in the County’s dental and/or vision programs. Employee contributions for dental and vision will be deducted from employee’s regular payroll on a pre-tax basis. Employees that have elected Option A can also elect to participate in optional benefits. If the employee has any surplus Flexible Benefit Account credits after making all elections required to participate in the health insurance, the employee can use that surplus toward the Flexible Benefit Options listed in the Flexible Benefit Options Exhibit. Employees that wish to participate in the optional benefits in the plan, with the exception of the cash back option, but do not have any surplus credits, can elect to have pre-tax payroll deductions in an amount to cover the cost of their elections. OPTION Option B - FLEXIBLE BENEFIT OPTIONS Employees who decline County sponsored medical coverage and elect Option B must provide the following in order to receive the cash-in-lieu: