ClearVue Glass & Mirror Company Benefits Guide 2026

Open Enrollment 2026 BENEFITS GUIDE ClearVue Glass & Mirror Company

W E L C O M E This booklet and plan summaries do not constitute a contract of employment . If there is a discrepancy between these summaries and the written legal plan documents , the plan documents shall prevail . For the 2026 - 2027 plan year , ClearVue Glass & Mirror Company has worked hard to build a competitive total rewards package that includes a variety of plans to help address your health needs and create peace of mind for you and your family . This benefits guide is a summary description of your 2026 - 2027 benefits plan options . Intended to help inform you about the benefits offered , plan premiums , and how and when to enroll , we encourage you to take time to understand all of your options before completing your enrollment . Be sure to save this guide as a benefits resource you can refer to throughout the year .

2 0 2 6 - 2 0 2 7 O P E N E N R O L L M E N T July 15 - 22 th nd Open Enrollment is the one time of year you are eligible to add or delete dependents from your coverage , change your coverage level , or change your benefit elections without experiencing a qualifying change in status event . The benefits and coverage you select during this enrollment period will be effective August 1 , 2026 , and will remain in effect through July 31 , 2027 . If you have questions regarding benefits or open enrollment , please contact Stacey Rowe , email address Srowe @ cvgco . com , phone 404 - 524 - 5616 ext . 1007 . HOW TO ENROLL During this year ' s open enrollment , we are utilizing an active enrollment process . This means that ALL employees must log into Employee Navigator . Whether you are enrolling in coverage for the first time , electing to continue your current coverage , or waiving coverage , you will need to log in and mark elections in th e portal . The Employee Navigator portal will open July 15 , and you will have until end of day on July 22 to complete your enrollment . Follow the steps below to log in and get started . th nd 1 . Log In with your credentials and complete required tasks Company Identifier : Clearvue - Glass 2 . Start Enrollment to select your benefits 3 . Review the benefits you selected on the enrollment summary page 4 . Click Sign & Agree to complete your enrollment by July 22 nd

I M P O R T A N T D E F I N I T I O N S 1 P R E M I U M D E D U C T I B L E C O P A Y The amount you pay out of your paycheck to keep your health insurance active . A fixed amount for a covered health care service , such as a physician office visit or a prescription . The amount an individual or family pays out of pocket before health insurance begins to cover the cost of medical expenses , typically lab work or tests and hospital visits . C O I N S U R A N C E The percentage of cost of a service that you pay after you meet your deductible ; for example , if your plan has 20 % coinsurance for a service costing $ 100 , you pay $ 20 . O U T - O F - P O C K E T M A X I M U M The most you will pay for covered services in a plan year . Your copay , deductibles and coinsurance all count toward this maximum .

E L I G I B I L I T Y E M P L O Y E E S Q U A L I F Y I N G E V E N T S E L I G I B L E D E P E N D E N T S 1 All employees working 30 hours or more per week are eligible for the benefits program . You may insure yourself and eligible family members under the program . Your spouse Your child until he / she attains age 26 Your children of any age may also be eligible if you support them , and they are incapable of self - support due to disability As required by our insurance contracts , you may be required to provide proof of eligibility for your dependents . If your dependent becomes ineligible for coverage during the year , you must contact your plan administrator within 30 days . You may make a change to your benefits if you have a qualified status change such as marriage , divorce , birth / adoption , death , changes in spouse ’ s benefits or eligibility , and more . You must contact your HR Department within 30 days of the qualifying event to make appropriate changes .

2 0 2 6 - 2 0 2 7 U P D A T E S A N G L E H E A L T H / C I G N A N E T W O R K N E W I D C A R D S 1 In 2026 , ClearVue ’ s Medical benefits will be transitioning to the Cigna network and will be administered by Angle Health . Starting in August , it is important to check if your doctor is in the Cigna network . For customer service , or finding a provider in the Cigna network , call Angle Health or visit www . anglehealth . com Your new Medical ID cards and Guardian ID cards will be available digitally through the provider portal . You can log in anytime to print your ID cards or save them to your phone .

MEMBER PORTAL M E D I C A L B E N E F I T S OVERVIEW Health insurance is an important component of ClearVue Glass & Mirror Company ’ s benefits program . A quality health insurance plan provides you with protection against the financial uncertainty that can come with treating a major illness or injury . HOW IT WORKS ClearVue provides three medical plan options , including a High Deductible Health Plan ( HDHP ) as well as the choice of two traditional copay plans . Each plan offers 100 % coverage for preventive care . Plan designs on the next slide . We encourage you to review the Summary of Benefits & Coverage or Summary Plan Description for complete details on exclusions , limitations , and pre - authorization requirements . FIND A PROVIDER Visit www . AngleHealth . com Click on “ Find A Provider .” You will need to know your plan , which can be found on the first page of your medical benefit summary . FIND A PROVIDER 855-937-1855

HDHP W / HSA 4000 CLEARVUE 2500 HSA ELIGIBLE N / A N / A ELIGIBLE Deductible ( Single / Family ) $ 2 , 000 / $ 4 , 000 $ 2 , 500 / $ 5 , 000 $ 4 , 000 / $ 8 , 000 Coinsurance 20 % 20 % 20 % Out - of - Pocket Max ( Single / Family ) $ 4 , 000 / $ 8 , 000 $ 7 , 500 / $ 15 , 000 $ 7 , 000 / $ 14 , 000 Physician / Specialist Visits $ 20 Copay / $ 50 Copay $ 30 Copay / $ 60 Copay After Deductible 20 % After Deductible Preventive Care 100 % Covered by Plan 100 % Covered by Plan 100 % Covered by Plan Hospital | In / Out - Patient 20 % After Deductible 20 % After Deductible 20 % After Deductible Emergency Room $ 250 Copay After Deductible $ 350 Copay After Deductible 20 % After Deductible Urgent Care Centers $ 75 Copay $ 75 Copay 20 % After Deductible MEDICAL PLAN OPTIONS COPAY PLAN 2000

COPAY PLAN 2000 CLEARVUE 2500 Preventive Prescriptions 100 % Covered 100 % Covered 100 % Covered Retail Prescriptions : Generic $ 20 Copay $ 15 Copay 20 % After Deductible Retail Prescriptions : Preferred $ 60 Copay $ 35 Copay 20 % After Deductible Retail Prescriptions : Non - Preferred $ 85 Copay $ 60 Copay After Deductible 20 % After Deductible Retail Prescriptions : Specialty High - Cost 20 % After Deductible 20 % After Deductible 20 % After Deductible MEDICAL PLAN OPTIONS - PHARMACY HDHP W / HSA 4000

CONTRIBUTION LIMITS For the 2026 and 2027 calendar years , the IRS allows you to contribute up to the following amounts into your Health Savings Account : 2026 • Single coverage : $ 4 , 400 • Any tier of Family coverage : $ 8 , 750 2027 • Single coverage : $ 4 , 500 • Any tier of Family coverage : $ 9 , 000 Additional catch - up contribution : Age 55 + : $ 1 , 000 HSA Introduction Pre - tax payroll deductions Tax - free withdrawals for eligible expenses Tax - free growth from interest or investment returns View Qualified Expenses Only those enrolling in the High Deductible Health Plan ( HDHP ), are eligible to set up a Health Savings Account ( HSA ). Health Savings Accounts allow you to set aside pre - tax money to help cover your deductible and pay for other out - of - pocket healthcare expenses for you and your dependents . You can start , stop , or change your contribution amount during the year . You can use funds for yourself , your spouse , and / or eligible tax dependents — whether they are on your medical plan or not . You cannot contribute to an HSA once you ’ ve enrolled in Medicare , but you can use any existing HSA dollars on health expenses , including Medicare premiums . HSA TRIPLE TAX SAVINGS HOW TO USE A HEALTH SAVINGS ACCOUNT H E A L T H S A V I N G S A C C O U N T ** IRS limits are based on a calendar year .

You can use your HSA funds to pay the bill from your doctor . If you pay out of pocket , you can reimburse yourself from your HSA . H D H P A N D H S A C O N S U M E R E X P E R I E N C E Visit your healthcare provider and the office will submit the claim to your health plan . As the administrator of our health plan , Angle Health processes your claim ( s ) and will share the amount you owe with your doctor . Providers in the Cigna network will cost you less than non - contracted providers . Angle Health sends you the Explanation of Benefits ( EOB ), which includes the amount you owe the doctor . Your doctor will then send you a bill , which should match the amount due on the Explanation of Benefits . D O C T O R V I S I T E O B B I L L R E C E I V E D A M O U N T O W E D 1 2 3 4 P A Y W I T H H S A 5

2 WATCH THIS FSA VIDEO TO LEARN MORE VIEW ELIGIBLE EXPENSES LEARN MORE ABOUT YOUR DCA F L E X I B L E S P E N D I N G A C C O U N T S Flexible Spending Accounts ( FSAs ) are set up to pay for many out - of - pocket medical expenses with tax - free dollars . The FSA account holder sets aside a pre - tax dollar amount for the year used to pay for medical expenses . Unused FSA funds can expire at the end of the year , so it is important to calculate expected expenses as accurately as possible prior to adding funds . 1 HEALTHCARE FSA The FSA can be paired with a Copay Plan . Employees who enroll in the HDHP are NOT eligible for the Healthcare FSA . FSA funds can be used on various medical , dental , and vision related expenses – the benefit is to use tax - free dollars on these purchases . The IRS has set the contribution maximum to $ 3 , 400 annually . DEPENDENT CARE ACCOUNT ( DCA ) FSA A DCA can also be paired with BOTH the HDHP and the Copay Plan . A DCA is a tax - free account for dependent care expenses such as daycare , preschool , or day camps for any dependent under the age of 13 or who are physically or mentally incapable of self - care . The IRS has set the contribution maximum at $ 7 , 500 per household and $ 3 , 750 for individuals filing separately .

A N G L E H E A L T H M E M B E R P O R T A L MANAGE YOUR CLAIMS With Angle Health , you can submit and track your claims online . COMPARE CARE & COSTS Our digital tools can help you find doctors in your plan ’ s network and compare care costs up front . DOWNLOAD YOUR ID CARD Your digital ID card is always there when you need it . Did you know you can find a variety of health care tools and resources at www . anglehealth . com or the Angle Health App ?

A D D I T I O N A L W A Y S T O S A V E SAVE MONEY - USE NETWORK PROVIDERS The Cigna network gives you the freedom to choose any doctor , but you get more from your benefits when you use network providers : you pay less out of pocket when rendering services , and the plan pays more of the cost of your services . To find a network doctor , provider , or facility , visit www . anglehealth . com / network - directories PREVENTIVE CARE IS FREE TO YOU Covered preventive care is paid in full by any of the medical plans you choose – no deductible , no copay . Click the link for a list of covered preventive services , along with age recommendations . FAMILY DEDUCTIBLES AND OUT - OF - POCKET MAXIMUMS ARE NON - EMBEDDED There is no individual deductible or out - of - pocket maximum . In other words , if you are on a family plan , the full family deductible must be reached , either by an individual or by the family , for the coinsurance to begin . The same applies to the out - of - pocket maximum . PREVENTIVE CARE SERVICES ANGLE HEALTH REGISTRATION

P H A R M A C Y B E N E F I T S W I T H A N G L E R X OVERVIEW In addition to health insurance , your pharmacy benefits are another component of ClearVue Glass & Mirror Company ’ s benefits program . HOW IT WORKS Show your member ID card and prescription at any network pharmacy to get your prescriptions filled . AngleRx can assist with keeping your drug costs down and affordable when and where you need it . It can provide expert personal advice to learn how to use medication safely and support finding the best providers . MEMBER PORTAL Manage pharmacy benefits by checking drug costs and coverage , viewing prescription history , and finding pharmacies . Click “ Angle Formulary ” to explore coverage . Access your member portal by clicking “ Member Portal ” MEMBER PORTAL ANGLE FORMULARY

LOG IN CREATE AN ACCOUNT D R O N D E M A N D T E L E H E A L T H 24 / 7 access to U . S . licensed doctors by phone or video Doctors can diagnose , treat , & prescribe medication Quality care from wherever you are DOWNLOAD THE APP 24 / 7 VIRTUAL VISITS DIAGNOSE & PRESCRIBE Virtual Care 100% Covered on All Plans!

Employee Only $ 12 . 50 Employee + Spouse $ 20 . 00 Employee + Child ( ren ) $ 21 . 50 Employee + Family $ 29 . 00 Description of Benefits Plan Pays Hospital Admission $ 1 , 000 Dislocation Benefit Up to $ 5 , 000 Fracture Benefit Up to $ 6 , 000 Accident Hospital Confinement - Up to 365 Days $ 250 / Day Accident Hospital ICU Confinement - Up to 15 Days $ 500 / Day Accident Emergency Room Treatment $ 200 Major Diagnostic Examination Benefit $ 200 Physical Therapy Benefit - Up to 10 Days $ 35 / Day Ambulance Benefit $ 200 Traumatic Brain Injury $ 4 , 000 Burns Up to $ 12 , 000 Coma $ 10 , 000 Emergency Dental / Eye Injury Up to $ 300 Child Organized Sports Benefit ( Children Under the Age of 18 ) 25 % Increase to Child Benefits Annual Wellness Benefit for Employee & Covered Spouse $ 125 / Year * * Must Complete Annual Wellness Screenings or Porcedures Injury - Free Benefit - Automatically Pays $ 300 / 5 Years if no accident claims are filed for 5 Years ACCIDENT COVERAGE An unexpected accident can be a serious financial burden . The Guardian Accident Plan : pays benefits directly to you – for deductibles , copays , or anything else . Best of all , the cost can be offset : Guardian pays YOU and your SPOUSE $ 125 * each for a completed wellness exam . * Wellness Benefit covers screenings & procedures such as well visits , mammography , colonoscopy , pap smear , PSA , cholesterol tests , smoking cessation and weight reduction programs , and more . Payable once per calendar year for the covered employee and spouse . Annual Net Cost Monthly Premium Employee Only Annual Premium = $ 150 . 00 Annual Wellness Benefit = $ 125 . 00 * Net Annual Cost = $ 25 . 00 Employee + Spouse Annual Premium = $ 240 . 00 Annual Wellness Benefit = $ 250 . 00 * Net Annual Cost = ($ 10 . 00 ) Employee + Child ( ren ) Annual Premium = $ 258 . 00 Annual Wellness Benefit = $ 125 . 00 * Net Annual Cost = $ 133 . 00 Employee + Family Annual Premium = $ 348 . 00 Annual Wellness Benefit = $ 250 . 00 * Net Annual Cost = $ 98 . 00

Heart Attack / Heart Failure | Coronary Artery Disease ( Bypass ) 100 % | 50 % Invasive Cancer ( Leukemia , Multiple Myeloma ) | Carcinoma In Situ | Bone Marrow Failure 100 % | 30 % | 100 % Organ Failure 100 % Stroke - Moderate | Stroke Severe | Transient Ischemic Attack ( TIA ) 50 % | 100 % | 10 % Blindness and / or Deafness 100 % Amyotrophic Lateral Sclerosis ( Lou Gehrig ’ s Disease ) 100 % Benign Brain Tumor 100 % Alzheimer ’ s Disease | Multiple Sclerosis ( MS ) | Parkinson ’ s Disease - Early Stages 50 % Alzheimer ’ s Disease | Multiple Sclerosis ( MS ) | Parkinson ’ s Disease - Advanced Stages 100 % Crohn ’ s Disease | Lupus | Ulcerative Colitis 30 % Childhood Illness - Type 1 Diabetes | Down Syndrome | Autism | More 100 % of Child Benefit Skin Cancer $ 250 Annual Cancer Screening Benefit for Employee and Covered $ 125 / Year * Spouse & Child ( ren ) * Must Complete Annual Wellness Screenings or Procedures Age Employee Spouse < 30 $ 7 . 00 $ 7 . 00 30 - 39 $ 10 . 50 $ 10 . 50 40 - 49 $ 17 . 50 $ 17 . 50 50 - 59 $ 31 . 50 $ 31 . 50 60 - 69 $ 51 . 00 $ 51 . 00 70 + $ 85 . 50 $ 85 . 50 CRITICAL ILLNESS The Guardian Group Critical Illness Plan reduces the financial risk of a covered serious illness . It pays out directly to YOU , which can help cover your deductible and other out - of - pocket costs . When first eligible , no exams or blood tests are required , and coverage is 100 % portable . Benefits are paid directly to you — or anyone you choose — on top of any other insurance . Description of Benefits Plan Pays Percentage of $ 10 , 000 Benefit 51 Covered Illnesses & Disorders – Please refer to the Benefit Brochure Annual Wellness Benefit = $ 125 . 00 * for Employee and Covered Spouse & Child ( ren ) Spouse Benefit = 100 % of Employee Benefit Child Benefit = 25 % of Employee Benefit Child Benefit Cost is Included in Employee Premium Premium Increases with Employee Age Monthly Premium for $ 10 , 000 Benefit * Critical illness plans include a wellness benefit paid after certain preventive care , such as mammograms , Pap smears , PSA , colonoscopies , blood tests , and EKG screenings .

CANCER COVERAGE The Guardian Cancer Plan is designed to provide you and eligible family members with benefits for costs associated with cancer treatment . Multiple years of cancer treatment means multiple years of deductibles and out - of - pocket costs ! When first eligible , there are no physical exams or blood tests required , and coverage is 100 % portable . Benefits are paid directly to you ! Description of Benefits Initial Cancer Diagnosis $ 1 , 500 Hospital Confinement $ 300 / Day ( 1st 30 Days ) $ 600 / Day ( After 30 Days ) ICU Confinement $ 400 / Day ( 1st 30 Days ) $ 600 / Day ( After 30 Days ) Surgical Benefit Up to $ 2 , 750 Radiation & Chemotherapy Up to $ 5 , 000 Blood , Plasma , Platelets $ 50 / Day , Up to $ 5 , 000 Attending Physician - While Hospital Confined $ 25 / Day , Up to 75 Visits Hospice Care $ 50 / Day , Up to 100 Days / Lifetime Anesthesia 25 % of Surgery Benefit Prosthesis Up To $ 4 , 000 2nd Surgical Opinion $ 200 / Surgical Procedure Skin Cancer Up To $ 600 Ambulance - 2 Trips per Confinement $ 200 / Trip Air Ambulance - 2 Trips per Confinement $ 250 / Trip Immunotherapy $ 500 / Month $ 2 , 500 Lifetime Max Annual Cancer Screening Benefit for $ 125 / Year * Employee & Covered Spouse * Must Complete Annual Wellness Screening or Procedures Plan Pays Employee Only $ 15 . 00 Employee + Spouse $ 29 . 00 Employee + Child ( ren ) $ 17 . 00 Employee + Family $ 31 . 00 Monthly Premium * Wellness Benefit covers screenings & procedures such as mammography , colonoscopy , pap smear , PSA , chest x - ray , and more . Payable once per calendar year for the covered employee & spouse . Employee Only Annual Premium = $ 180 . 00 Annual Wellness Benefit = $ 125 . 00 * Net Annual Cost = $ 55 . 00 Employee + Spouse Annual Premium = $ 348 . 00 Annual Wellness Benefit = $ 250 . 00 * Net Annual Cost = $ 98 . 00 Employee + Child ( ren ) Annual Premium = $ 204 . 00 Annual Wellness Benefit = $ 125 . 00 * Net Annual Cost = $ 79 . 00 Employee + Family Annual Premium = $ 372 . 00 Annual Wellness Benefit = $ 250 . 00 * Net Annual Cost = $ 122 . 00 Annual Net Cost

ACCIDENT , CRITICAL ILLNESS & CANCER CARE What ' s the actual cost if I get my physical ? The right column shows your " net " cost after the wellness benefit for each plan . Accident Premium Critical Illness Premium Cancer Premium Annual Wellness Benefit * ( Combined Amounts ) ** Monthly Out - of - Pocket Age 18 - 29 Employee Only $ 12 . 50 $ 7 . 00 $ 15 . 00 $ 375 $ 3 . 25 Employee + Spouse $ 20 . 00 $ 14 . 00 $ 29 . 00 $ 750 $ 0 . 50 Employee + Child ( ren ) $ 21 . 50 $ 7 . 00 $ 17 . 00 $ 500 *** $ 3 . 83 Family $ 29 . 00 $ 14 . 00 $ 31 . 00 $ 875 *** $ 1 . 08 Age 30 - 39 Employee Only $ 12 . 50 $ 10 . 50 $ 15 . 00 $ 375 $ 6 . 75 Employee + Spouse $ 20 . 00 $ 21 . 00 $ 29 . 00 $ 750 $ 7 . 50 Employee + Child ( ren ) $ 21 . 50 $ 10 . 50 $ 17 . 00 $ 500 *** $ 7 . 33 Family $ 29 . 00 $ 21 . 00 $ 31 . 00 $ 875 *** $ 8 . 08 Age 40 - 49 Employee Only $ 12 . 50 $ 17 . 50 $ 15 . 00 $ 375 $ 13 . 75 Employee + Spouse $ 20 . 00 $ 35 . 00 $ 29 . 00 $ 750 $ 42 . 33 Employee + Child ( ren ) $ 21 . 50 $ 17 . 50 $ 17 . 00 $ 500 *** $ 27 . 27 Family $ 29 . 00 $ 35 . 00 $ 31 . 00 $ 875 *** $ 22 . 08 Age 50 - 59 Employee Only $ 12 . 50 $ 31 . 50 $ 15 . 00 $ 375 $ 27 . 75 Employee + Spouse $ 20 . 00 $ 63 . 00 $ 29 . 00 $ 750 $ 49 . 50 Employee + Child ( ren ) $ 21 . 50 $ 31 . 50 $ 17 . 00 $ 500 *** $ 28 . 33 Family $ 29 . 00 $ 63 . 00 $ 31 . 00 $ 875 *** $ 50 . 08 Age 60 - 69 Employee Only $ 12 . 50 $ 51 . 00 $ 15 . 00 $ 375 $ 47 . 25 Employee + Spouse $ 20 . 00 $ 102 . 00 $ 29 . 00 $ 750 $ 88 . 50 Employee + Child ( ren ) $ 21 . 50 $ 51 . 00 $ 17 . 00 $ 500 *** $ 47 . 83 Family $ 29 . 00 $ 102 . 00 $ 31 . 00 $ 875 *** $ 89 . 08 * A qualified health screening or exam during the plan year is required to receive the Wellness Benefit for each covered person . ** Your net monthly cost after premiums and the Wellness Benefit . Premiums are deducted per pay period ; the benefit is reimbursed as a lump sum . *** Includes a $ 125 wellness benefit for one child . The Family Wellness Benefit depends on how many children complete an annual wellness screening . For illustrative purposes only . Refer to the Guardian brochures for details and exclusions .

HOSPITAL INDEMNITY The Guardian Hospital Indemnity Plan is designed to provide you and eligible family members , with cash benefits when you ' re hospitalized due to a covered illness or injury . When first eligible , there are no physical exams or blood tests required , and coverage is 100 % portable . Benefits are paid directly to you ! Description of Benefits Hospital | ICU Admission $ 1 , 000 | $ 2 , 000 Hospital | ICU Confinement $ 100 | $ 200 Per Day Hospital Short Stay ( 1 Day Per Year ) $ 200 Newborn Nursery Care ( 1 Day Per Year ) $ 100 Newborn Increased Admission | Confinement 25 % Increase to Child Benefit Child Organized Sports 25 % Increase to Child Benefit Annual Health Screening Benefit for $ 50 / Year * Employee , Covered Spouse & Child ( ren ) * Must Complete Annual Wellness Screenings or Procedures Plan Pays Employee Only $ 11 . 55 Employee + Spouse $ 29 . 35 Employee + Child ( ren ) $ 21 . 04 Employee + Family $ 38 . 84 Monthly Premium * Wellness Benefit includes coverage for screenings & procedures such as , mammography , colonoscopy , pap smear , PSA , chest x - ray , and many more . The benefit is payable once per calendar year for the covered employee spouse , and child ( ren ). Employee Only Annual Premium = $ 138 . 60 Annual Wellness Benefit = $ 50 . 00 * Net Annual Cost = $ 88 . 60 Employee + Spouse Annual Premium = $ 352 . 20 Annual Wellness Benefit = $ 100 . 00 * Net Annual Cost = $ 252 . 20 Employee + Child ( ren ) Annual Premium = $ 252 . 48 Annual Wellness Benefit = $ 100 . 00 * Net Annual Cost = $ 152 . 48 Employee + Family Annual Premium = $ 466 . 08 Annual Wellness Benefit = $ 150 . 00 * Net Annual Cost = $ 316 . 08 * Wellness Benefit Annual Net Cost - Shows the Employee + Child ( ren ) and Family with only one child . The benefit is paid to each covered participant after the annual heath screening has been completed . Annual Net Cost

D E N T A L B E N E F I T S HOW IT WORKS The preferred dentist program administered by Guardian is designed to provide the dental coverage you need with the features you want — like the freedom to visit the dentist of your choice , in or out - of - network . Use network providers to receive higher benefits . MANAGE YOUR BENEFITS Go to www . Guardianlife . com to access secure information about your Guardian benefits including access to an image of your ID Card . Your on - line account will be set up within 30 days after your plan effective date . FIND A DENTIST Visit www . Guardianlife . com Click on “ Find A Provider ”; You will need to know your plan , which can be found on the first page of your dental benefit summary . LINK TO DENTAL CARRIER FIND A PROVIDER

D E N T A L B E N E F I T S – R O L L O V E R B E N E F I T S MAXIMUM ROLLOVER - HOW IT WORKS A portion of benefits that you don ’ t use in one benefit year can be carried over for future use . If you reach the annual maximum in a benefit year , you can use any benefits that were previously rolled over to help pay for your dental care . We ’ ll roll over a portion of unused benefits at the beginning of a new benefit year if : We paid benefits for dental services you received during the previous benefit year . The benefits we paid for dental services you received during the previous benefit year didn ’ t exceed the rollover threshold of $ 700 . You were eligible to receive benefits for major services during the previous benefit year . You had the benefit maximum rollover in place with this Plan before 10 / 01 of the previous benefit year . The amount that will be rolled over each benefit year is $ 350 . The maximum amount you can have rolled over at any one time is $ 1 , 250 . Bonus rollover reward We ’ ll add a bonus rollover reward of $ 500 if you used an in - network dentist for all the dental services you received during the benefit year .

Annual Plan Maximum $ 1 , 750 100 % Covered 100 % Covered 60 % Covered 50 % Covered Deductible ( Single / Family ) $ 50 / $ 150 $ 1 , 500 Orthodontia Lifetime Maximum Preventive Services Exams , Cleanings , Fluoride , X - Rays Basic Services Fillings , Extractions , Periodontal Services Major Services Crowns , Bridges & Dentures , In / Outlays , Endodontic Services Orthodontia Services ( Children up to age 19 ) D E N T A L B E N E F I T S $ 1 , 750 100 % Covered 80 % Covered 50 % Covered 50 % Covered $ 50 / $ 150 $ 1 , 500 Plan Option Value NAP

HOW IT WORKS The vision plan administered by Guardian is designed to provide the vision coverage you need with the features you want . Vision care offers you and your family a benefit that covers all routine eye care , including eye exams and eyeglasses ( lenses & frames ) or contacts ( In - Network with VSP ). MANAGE YOUR BENEFITS Go to www . Guardianlife . com to access secure information about your Guardian benefits , including access to an image of your ID Card . Your online account will be set up within 30 days after your plan ' s effective date . FIND A PROVIDER Visit www . Guardianlife . com Click on “ Find A Provider ” VSP is your vision network FIND A PROVIDER Exam Every 12 Months $ 10 Copay Glasses Lenses ( Single / Bifocal / Trifocal / Lenticular ) Every 12 Months $ 10 Copay Glasses Frames Every 24 Months $ 130 Retail Frame Allowance + 20 % off remaining balance Contact Lenses ( Medically Necessary / Elective in lieu of Glasses ) Every 12 Months $ 10 Copay / $ 60 Fitting with $ 130 Allowance V I S I O N B E N E F I T S OR

C O S T O F C O V E R A G E Annual Employee Spend Copays Deductibles Coinsurance Out - of - Pocket Expenses Premium Pre - tax Payroll Deductions HOW YOU PAY FOR HEALTH CARE COSTS Remember , your total health care cost for the year is the combination of your out - of - pocket expenses when you access medical care and the premium contributions you make for coverage . Depending on your personal situation , the plan with the lowest deductibles and copays may not be the best plan for you . Be sure to look at the total cost of your expected care before making your plan decisions for the plan year . TOTAL COST OF CARE

C O S T O F C O V E R A G E DENTAL Premiums Per Pay period VISION Premiums Per Pay Period MEDICAL Premiums Per Pay Period Copay 2000 ClearVue 2500 HDHP 4000 Employee Only $ 50 $ 35 $ 28 Employee + Spouse $ 140 $ 110 $ 90 Employee + Child ( ren ) $ 120 $ 85 $ 68 Family $ 340 $ 285 $ 258 Value NAP Employee Only $ 8 . 32 $ 8 . 32 Employee + Spouse or Child $ 17 . 19 $ 17 . 19 Family $ 17 . 19 $ 17 . 19 Employee Only $ 1 . 37 Employee + Spouse or Child $ 2 . 35 Family $ 2 . 35

G U A R D I A N B E N E F I T S ClearVue Glass & Mirror Company offers additional benefits through Guardian . D E N T A L V I S I O N D I S A B I L I T Y L I F E C R I T I C A L I L L N E S S A C C I D E N T H O S P I T A L I N D E M N I T Y C A N C E R

ClearVue Glass & Mirror Company provides full - time employees with employer - paid basic life insurance and disability income protection at no cost . A D D I T I O N A L B E N E F I T S

E M P L O Y E R P A I D B E N E F I T S B A S I C L I F E A N D A D & D 1 2 L O N G - T E R M D I S A B I L I T Y This plan provides eligible employees with a Long - Term Disability benefit through Guardian at no cost to you . Long - Term Disability benefits are provided as a source of income , in the event that you become disabled from a non - work - related injury or illness . Benefits begin on the 91st day of disability . Benefit Maximum : 60 % of Salary up to $ 6 , 000 per month . Guaranteed Issue : Up to $ 6 , 000 per month . 2 The plan provides eligible employees with a Basic Life and Accidental Death & Dismemberment benefit through Guardian at no cost to you . Employee Benefit : $ 30 , 000 AD & D Benefit : $ 30 , 000 * Benefit reductions start at age 65

V O L U N T A R Y B E N E F I T S V O L U N T A R Y S H O R T - T E R M D I S A B I L I T Y Short - term disability protects your income during a short period of time due to illness , or an accident not related to your job . Benefits begin on the 8 ᵗ ʰ day after an illness or accident . Benefit Maximum : 60 % of your weekly income up to $ 1 , 000 for 12 weeks . V O L U N T A R Y L I F E I N S U R A N C E 1 2 Employees have the option to purchase additional life insurance . Guarantee Issue : $ 150 , 000 – THIS YEAR ONLY AS A NEW PLAN NEXT OPEN ENROLLMENT ENTRANTS WILL SUBMIT EVIDENCE OF INSURABILITY Annual Election Option : Employees can increase benefits annually , up to $ 50 , 000 , not to exceed the Guarantee Issue Maximum : $ 300 , 000 ( may require an EOI ) Increments of $ 10 , 000 up $ 300 , 000 . Coverage reductions apply starting at age 65 Spouse Benefit : Increments of $ 5 , 000 starting at $ 10 , 000 to $ 150 , 000 . ( Cannot exceed 50 % of employee amount . Coverage reductions apply starting at age 65 ) Child ( ren ) Benefit $ 10 , 000 ( Children 14 days to 26 years of age The Guarantee Issue is the dollar amount that will be issued without submitting an EOI ( Evidence of insurability ), such as answering medical questions on an application or completing a medical exam . This only applies this year for applicants signing up for coverage during their initial enrollment period .

WEEKLY BENEFIT AGE <25 AGE 25-29 AGE 30-34 AGE 35-39 AGE 40-44 AGE 45-49 AGE 50-54 AGE 55-59 AGE 60+ $100 $0.79 $0.73 $0.70 $0.68 $0.71 $0.83 $1.03 $1.24 $1.39 $200 $1.58 $1.46 $1.39 $1.35 $1.43 $1.65 $2.07 $2.48 $2.78 $300 $2.36 $2.19 $2.09 $2.03 $2.14 $2.48 $3.10 $3.71 $4.16 $400 $3.15 $2.92 $2.78 $2.70 $2.85 $3.30 $4.13 $4.95 $5.55 $500 $3.94 $3.65 $3.48 $3.38 $3.56 $4.13 $5.16 $6.19 $6.94 $600 $4.73 $4.38 $4.17 $4.05 $4.28 $4.95 $6.20 $7.43 $8.33 $700 $5.51 $5.11 $4.87 $4.73 $4.99 $5.78 $7.23 $8.66 $9.71 $800 $6.30 $5.84 $5.56 $5.40 $5.70 $6.60 $8.26 $9.90 $11.10 $900 $7.09 $6.57 $6.26 $6.08 $6.41 $7.43 $9.29 $11.14 $12.49 $1,000 $7.88 $7.30 $6.95 $6.75 $7.13 $8.25 $10.33 $12.38 $13.88 Premiums Per Pay Period SHORT - TERM DISABILITY C O S T O F C O V E R A G E - S T D R A T E S

EMPLOYEE BENEFIT AGE <30 AGE 30-34 AGE 35-39 AGE 40-44 AGE 45-49 AGE 50-54 AGE 55-59 AGE 60-64 AGE 65-69 AGE 70-74 AGE 75-79 AGE 80+ $10,000 $0.30 $0.33 $0.43 $0.58 $0.90 $1.43 $2.25 $2.80 $4.78 $7.70 $11.80 $17.13 $20,000 $0.60 $0.65 $0.85 $1.15 $1.80 $2.85 $4.50 $5.60 $9.55 $15.40 $23.60 $34.25 $30,000 $0.90 $0.98 $1.28 $1.73 $2.70 $4.28 $6.75 $8.40 $14.33 $23.10 $35.40 $51.38 $40,000 $1.20 $1.30 $1.70 $2.30 $3.60 $5.70 $9.00 $11.20 $19.10 $30.80 $47.20 $68.50 $50,000 $1.50 $1.63 $2.13 $2.88 $4.50 $7.13 $11.25 $14.00 $23.88 $38.50 $59.00 $85.63 $60,000 $1.80 $1.95 $2.55 $3.45 $5.40 $8.55 $13.50 $16.80 $28.65 $46.20 $70.80 $102.75 $70,000 $2.10 $2.28 $2.98 $4.03 $6.30 $9.98 $15.75 $19.60 $33.43 $53.90 $82.60 $119.88 $80,000 $2.40 $2.60 $3.40 $4.60 $7.20 $11.40 $18.00 $22.40 $38.20 $61.60 $94.40 $137.00 $90,000 $2.70 $2.93 $3.83 $5.18 $8.10 $12.83 $20.25 $25.20 $42.98 $69.30 $106.20 $154.13 $100,000 $3.00 $3.25 $4.25 $5.75 $9.00 $14.25 $22.50 $28.00 $47.75 $77.00 $118.00 $171.25 $110,000 $3.30 $3.58 $4.68 $6.33 $9.90 $15.68 $24.75 $30.80 $52.53 $84.70 $129.80 $188.38 $120,000 $3.60 $3.90 $5.10 $6.90 $10.80 $17.10 $27.00 $33.60 $57.30 $92.40 $141.60 $205.50 $130,000 $3.90 $4.23 $5.53 $7.48 $11.70 $18.53 $29.25 $36.40 $62.08 $100.10 $153.40 $222.63 $140,000 $4.20 $4.55 $5.95 $8.05 $12.60 $19.95 $31.50 $39.20 $66.85 $107.80 $165.20 $239.75 $150,000* $4.50 $4.88 $6.38 $8.63 $13.50 $21.38 $33.75 $42.00 $71.63 $115.50 $177.00 $256.88 Premiums Per Pay Period VOLUNTARY LIFE AND AD & D C O S T O F C O V E R A G E - V O L U N T A R Y L I F E A N D A D & D R A T E S *Guaranteed Issue Amount Spouse’s rates are based on the employee’s age.

EMPLOYEE BENEFIT AGE <30 AGE 30-34 AGE 35-39 AGE 40-44 AGE 45-49 AGE 50-54 AGE 55-59 AGE 60-64 AGE 65-69 AGE 70-74 AGE 75-79 AGE 80+ $160,000 $4.80 $5.20 $6.80 $9.20 $14.40 $22.80 $36.00 $44.80 $76.40 $123.20 $188.80 $274.00 $170,000 $5.10 $5.53 $7.23 $9.78 $15.30 $24.23 $38.25 $47.60 $81.18 $130.90 $200.60 $291.13 $180,000 $5.40 $5.85 $7.65 $10.35 $16.20 $25.65 $40.50 $50.40 $85.95 $138.60 $212.40 $308.25 $190,000 $5.70 $6.18 $8.08 $10.93 $17.10 $27.08 $42.75 $53.20 $90.73 $146.30 $224.20 $325.38 $200,000 $6.00 $6.50 $8.50 $11.50 $18.00 $28.50 $45.00 $56.00 $95.50 $154.00 $236.00 $342.50 $210,000 $6.30 $6.83 $8.93 $12.08 $18.90 $29.93 $47.25 $58.80 $100.28 $161.70 $247.80 $359.63 $220,000 $6.60 $7.15 $9.35 $12.65 $19.80 $31.35 $49.50 $61.60 $105.05 $169.40 $259.60 $376.75 $230,000 $6.90 $7.48 $9.78 $13.23 $20.70 $32.78 $51.75 $64.40 $109.83 $177.10 $271.40 $393.88 $240,000 $7.20 $7.80 $10.20 $13.80 $21.60 $34.20 $54.00 $67.20 $114.60 $184.80 $283.20 $411.00 $250,000 $7.50 $8.13 $10.63 $14.38 $22.50 $35.63 $56.25 $70.00 $119.38 $192.50 $295.00 $428.13 $260,000 $7.80 $8.45 $11.05 $14.95 $23.40 $37.05 $58.50 $72.80 $124.15 $200.20 $306.80 $445.25 $270,000 $8.10 $8.78 $11.48 $15.53 $24.30 $38.48 $60.75 $75.60 $128.93 $207.90 $318.60 $462.38 $280,000 $8.40 $9.10 $11.90 $16.10 $25.20 $39.90 $63.00 $78.40 $133.70 $215.60 $330.40 $479.50 $290,000 $8.70 $9.43 $12.33 $16.68 $26.10 $41.33 $65.25 $81.20 $138.48 $223.30 $342.20 $496.63 $300,000 $9.00 $9.75 $12.75 $17.25 $27.00 $42.75 $67.50 $84.00 $143.25 $231.00 $354.00 $513.75 Premiums Per Pay Period VOLUNTARY LIFE AND AD & D C O S T O F C O V E R A G E - V O L U N T A R Y L I F E A N D A D & D R A T E S Spouse’s rates are based on the employee’s age. CHILD(REN) Benefit RATE $10,000 $0.60

All full - time employees are automatically ( even if you are not enrolled in medical benefits ) provided access to Guardian ’ s Employee Assistance Program with ComPsych . The EAP is a confidential resource available 24 / 7 / 365 to help you deal with a variety of life stages and concerns . Visit guidanceresources . com Web ID “ Guardian ” or call 855 - 239 - 0743 . GET HELP CLINICAL Confidential assistance for a range of concerns including addictions , depression , anxiety , stress , relationships , and parenting . WELLNESS Telephone based wellness coaching for tobacco cessation , weight loss management , fitness and exercise , stress management , parenting , and relationship support . WORK - LIFE Assistance for daily challenges at home and work including financial , legal , child / elder care , and identity theft . E M P L O Y E E A S S I S T A N C E P R O G R A M

G U A R D I A N + C A R R O T Those enrolled in the Hospital Indemnity Plan with Guardian have access to fertility health & family building services through the Carrot Program . Across various stages of life , these wellness services can help support employees ’ needs . Dependents ( age 18 + ) can also benefit from this resource . F E R T I L I T Y M E N O P A U S E & L O W T E S T O S T E R O N E U R O L O G L Y M A T E R N I T Y Multi - Dimensional Approach Up to 3 education sessions , per plan year for emotional support , nutrition , pelvic health , lactation & more . With CarrotMatch , finding providers that fit your needs . Unlimited small group sessions . 24 / 7 support from Carrot ’ s Care Team . Unlimited virtual access to education resources & videos through Carrot Academy . CARROT SUPPORT & EDUCATION FOR : A N D M O R E !

HOW DOES IT WORK ? Guardian embeds cancer support services directly into your LTD offering , giving you access to feel supported , informed , and confident as you navigate your diagnosis . The Guardian + Osara Health offering connects you to cancer support resources through a personalized , empathetic approach . It helps you focus on your holistic wellness throughout your treatment , ultimately empowering you on your journey back to a fulfilling lifestyle . of people diagnosed with cancer in the US are of traditional working age .1 Features of the Cancer Coach offering Throughout a 6 - 12 - week program , employees can learn how to communicate more effectively with their medical team and set meaningful health goals . Employees will have access to : 1 45% G U A R D I A N + O S A R A H E A L T H Holistic support , education , and guidance with scheduled calls over 6 to 12 weeks D E D I C A T E D H E A L T H C O A C H Track symptoms and help to take control of your diagnosis . O S A R A H E A L T H A P P Help make positive behavior changes M O T I V A T I O N A L A R T I C L E S Modules covering key areas of cancer self - management W E E K L Y D I G I T A L E D U C A T I O N CANCER COACHING OFFERINGS Included with your LONG - TERM DISABILITY with Guardian , you have access to comprehensive cancer support services through Osara Health . Cancer is impacting more lives ; together we can help support them .

Medical : Angle Health 855 - 937 - 1855 | www . Anglehealth . com Pharmacy : AngleRx 844 - 636 - 7506 | www . Rx . Anglehealth . com Dental , Vision : Guardian 888 - 600 - 1600 | www . Guardianlife . com Basic Life , Voluntary Life / AD & D , STD , LTD , Critical Illness , Hospital Indemnity , Cancer and Accident : Guardian 888 - 600 - 1600 | www . Guardianlife . com Telemedicine : Dr + On Demand 800 - 997 - 6196 | support @ includedhealth . com Employee Assistance Program : Guardian / ComPsych 855 - 239 - 0743 | www . GuidanceResources . com Health Savings Account : Admin America 770 - 992 - 5959 | www . Adminamerica . com FSA & Dependent Care FSA : OneSource PEO 678 - 990 - 8679 | Traci . gagnon @ onesourcepeo . com ClearVue ’ s Human Resources : Stacey Rowe 404 - 524 - 5616 x 1007 | SRowe @ cvgco . com C O N T A C T S