Overview of Benefit Contributions Contributions Effective January 1, 2025, per Pay Period Cigna Medical Premiums Coverage Level Traditional Plan HDHP 3500 HDHP 4500 Employee Only $80.23 $65.99 $51.52 Employee + Spouse $194.78 $158.59 $126.70 Employee + Child(ren) $162.47 $132.29 $104.46 Family $257.76 $209.82 $166.12 Delta Dental Premiums Coverage Level Standard Low Premier High Plan Plan Employee Only $12.32 $18.03 Employee + Spouse $26.18 $38.34 Employee + Child(ren) $26.71 $36.16 Family $40.89 $56.63 VSP Vision Premiums Coverage Level 26 Biweekly Pay Periods Employee Only $3.72 Employee + Spouse $7.44 Employee + Child(ren) $7.97 Family $8.71 Life/AD&D/Short & Long-Term Disability Coverage Level 26 Biweekly Pay Periods Basic Life/AD&D (1x salary) No cost to eligible employee Short-Term Disability No cost to eligible employee Long-Term Disability No cost to eligible employee Voluntary Life/AD&D Employee pays 100% of cost Critical Illness/Accident Employee pays 100% of cost Page 4 | Inotiv | Plan Year 2025 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.