Employee Bi-Weekly Cost Contributions Effective March 1, 2025 Medical Coverage HSA PPO (26 biweekly pays) (26 biweekly pays) Employee Only $38.73 $72.29 Employee + Spouse $258.16 $309.79 Employee + Child(ren) $219.43 $258.16 Family $361.42 $413.06 Dental & Vision Coverage Voluntary Dental Voluntary Vision (26 biweekly pays) (26 biweekly pays) Employee Only $15.54 $3.65 Employee + Spouse $31.56 $6.14 Employee + Child(ren) $42.15 $6.26 Family $59.60 $9.91 Life, Short-Term, and Long-Term Disability & More… Coverage Employee Cost Basic Group Term Life/AD&D – New York Life There is no cost to the employee Voluntary Life – New York Life Rates vary based on age Voluntary STD – New York Life Rates vary based on salary and age Voluntary LTD – New York Life Rates vary based on salary and age Additional STD (7-30) – Allstate Rates vary based on salary and age Accident Insurance – Allstate Rates vary based on plan elected Critical Illness Insurance – Allstate Rates vary based on salary and age Cancer Insurance – Allstate Rates vary based on salary and age Hospital Indemnity Insurance – Allstate Rates vary based on plan elected Page 6 | Duncan Supply Company, Inc.| Plan Year 2025 Open Enrollment This booklet provides only a summary of your benefits. All services described within are subject to the definitions, limitations, and exclusions set forth in each insurance carrier or provider’s contract.