Mayor and City Council
November 19, 2025

November 19, 2025
City of San Bernardino
2026 Final Renewal Rates & Benefits
2 2026 Financial Overview
Line of Coverage Current Renewal$ D% DKaiser (PRISM): HMO408$6,011,796$6,905,340$893,54414.9%Anthem (PRISM): HMO Traditional165 $2,611,344 $2,998,500$387,156 14.8%Anthem (PRISM): HMO Select 65 $920,172 $1,056,684$136,512 14.8%Anthem (PRISM): PPO14 $241,632 $277,464$35,832 14.8%Kaiser (PRISM): HMO - Early Retiree7 $98,280 $112,896$14,616 14.9%Anthem (PRISM): HMO Traditional - Early Retiree3 $77,340 $88,812$11,472 14.8%Anthem (PRISM): HMO Select - Early Retiree1 $14,544 $16,704$2,160 14.9%Anthem (PRISM): PPO - Early Retiree1 $24,936 $28,632$3,696 14.8%In Rate GuaranteeDelta Dental (PRISM): DHMO160 $51,366 $51,366$0 0.0%Delta Dental (PRISM): DPPO - Core203 $162,632 $166,302$3,670 2.3%Delta Dental (PRISM): DPPO - Buy Up 257$237,257 $242,668$5,411 2.3%In Rate GuaranteeVSP: Vision - Core242 $42,576 $42,576$0 0.0%In Rate GuaranteeVSP: Vision - Buy Up336 $69,672 $69,672$0 0.0%In Rate GuaranteeLincoln (PRISM) - Basic Life/AD&D$70,891 $70,891$0 0.0%In Rate GuaranteeLincoln (PRISM) - Long Term Disability$51,560 $51,560$0 0.0%In Rate GuaranteeLincoln (PRISM) - Short Term Disability $17,982 $17,982$0 0.0%Lincoln (PRISM) - PFL$27,321 $27,321$0 0.0%In Rate GuaranteeConcern (PRISM) - EAP$16,383 $16,383$0 0.0%ConcernPlus (PRISM) - EAP$42,570 $0-$42,570 -100.0%TOTAL ANNUAL PREMIUM $10,790,253 $12,241,752 $1,451,499 13.45% 3 Medical Financial Overview (Actives & Retirees)Line of Coverage Current Renewal$ D% DKaiser (PRISM): HMO408 $6,011,796 $6,905,340$893,544 14.9%Anthem (PRISM): HMO Traditional165 $2,611,344 $2,998,500$387,156 14.8%Anthem (PRISM): HMO Select 65 $920,172 $1,056,684$136,512 14.8%Anthem (PRISM): PPO14 $241,632 $277,464$35,832 14.8%Kaiser (PRISM): HMO - Early Retiree7 $98,280 $112,896$14,616 14.9%Anthem (PRISM): HMO Traditional - Early Retiree3 $77,340 $88,812$11,472 14.8%Anthem (PRISM): HMO Select - Early Retiree1 $14,544 $16,704$2,160 14.9%Anthem (PRISM): PPO - Early Retiree1 $24,936 $28,632$3,696 14.8%TOTAL ANNUAL PREMIUM $10,000,044 $11,485,032 4 Kaiser - HMO RenewalCalendar Year Deductible Individual / FamilyNoneEmbedded / AggregateN/AAnnual Out-of-Pocket MaximumIndividual / Family$1,500 / $3,000Embedded / AggregateEmbeddedPhysician Office Visit$20 / Visit Specialist CopayPreventative CareNo ChargeVirtual Physician VisitNo ChargeLab and X-RayCT, MRI, PET scansNo ChargeOther lab and x-ray testsNo ChargeHospitalizationInpatientOutpatient$20 / Procedure $50 / Visit(waived if admitted)Urgent Care Services$20 / Visit$15 / Visit (20 visits per calendar year)(Physician referred; Nausea & pain only)PRESCRIPTION DRUGSGeneric / Brand / SpecialtyRetail - 30 day supply$10 / $30 / 20% up to $150Mail Order - up to 100 day supply$20 / $60 / Not CoveredACTIVE MONTHLY RATESEEsCurrentRenewalEE Only209$738.00$848.00EE + 180$1,450.00$1,665.00EE + Family119$1,939.00$2,227.00408MONTHLY PREMIUM$500,983$575,445ANNUAL PREMIUM$6,011,796$6,905,340EARLY RETIREE MONTHLY RATESEEsCurrentRenewalEE Only7$1,170.00$1,344.00EE + 10$2,305.00$2,647.00EE + Family0$3,088.00$3,546.007MONTHLY PREMIUM$8,190$9,408ANNUAL PREMIUM$98,280$112,896ACTIVE / EARLY RETIREE TOTALCurrentRenewalTOTAL MONTHLY PREMIUM$509,173$584,853TOTAL ANNUAL PREMIUM$6,110,076$7,018,236ANNUAL DOLLAR CHANGE$908,160ANNUAL PERCENT CHANGE14.9%This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern. $20 / Visit
Medical Plan Benefits
Emergency RoomChiropractic CareAcupuncture Care$20 / Visit No ChargeKaiser (PRISM): Medical HMOCurrent / Renewal 5 Anthem – Traditional & Select HMO RenewalCalendar Year Deductible Individual / FamilyEmbedded / AggregateAnnual Out-of-Pocket MaximumIndividual / FamilyEmbedded / AggregatePhysician Office VisitSpecialist CopayPreventative CareVirtual Physician VisitLab and X-RayCT, MRI, PET scansOther lab and x-ray testsHospitalizationInpatientOutpatientPRESCRIPTION DRUGSRetail - 30 day supplyMail Order - up to 90 day supplyACTIVE MONTHLY RATESEEsCurrentRenewalEE Only85$776.00$891.00EE + 122$1,523.00$1,749.00EE + Family58$2,037.00$2,339.00165MONTHLY PREMIUM$217,612$249,875ANNUAL PREMIUM$2,611,344$2,998,500EARLY RETIREE MONTHLY RATESEEsCurrentRenewalEE Only2$1,388.00$1,594.00EE + 10$2,737.00$3,143.00EE + Family1$3,669.00$4,213.003MONTHLY PREMIUM$6,445$7,401ANNUAL PREMIUM$77,340$88,812ACTIVE / EARLY RETIREE TOTALCurrentRenewalTOTAL MONTHLY PREMIUM$224,057$257,276TOTAL ANNUAL PREMIUM$2,688,684$3,087,312ANNUAL DOLLAR CHANGE$398,628ANNUAL PERCENT CHANGE14.8%01 Tiers 1-4: Cost if you use a non-network provider: 50% coinsurance up to $250 per prescription (Retail only)2 Tier 4 - Specialty Drugs: covers up to 30 day supply (Retail & Mail Order); Max limit to $250 per perscriptionThis document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.

Acupuncture Care (30 visit limit combined with chiropractic) Emergency Room$10 / Visit$5 / $15 / $25 / $45 / 30% with $250 maxTier 1a / Tier 1b / Tier 2 / Tier 3 / Tier 4 1,2$12.50 / $37.50 / $75 / $135 / 30% with $250 maxChiropractic Care (30 visit limit combined with acupuncture) Urgent Care Services(waived if admitted)No Charge$10 / Visit$20 / VisitNo ChargeNo ChargeNo ChargeNo Charge$50 / Visit(waived if admitted)$20 / Visit Current / RenewalAnthem (PRISM): Traditional HMONone$20 / Visit $20 / Visit Medical Plan BenefitsN/A$1,500 / $3,000EmbeddedMedical HMO - Narrow NetworkEffective: January 1, 2026Calendar Year Deductible Individual / FamilyEmbedded / AggregateAnnual Out-of-Pocket MaximumIndividual / FamilyEmbedded / AggregatePhysician Office VisitSpecialist CopayPreventative CareLab and X-RayCT, MRI, PET scansOther lab and x-ray testsHospitalizationInpatientOutpatientPRESCRIPTION DRUGSRetail - 30 day supplyMail Order - up to 90 day supplyACTIVE MONTHLY RATESEEsCurrentRenewalEE Only32$676.00$776.00EE + 18$1,328.00$1,525.00EE + Family25$1,777.00$2,041.0065MONTHLY PREMIUM$76,681$88,057ANNUAL PREMIUM$920,172$1,056,684EARLY RETIREE MONTHLY RATESEEsCurrentRenewalEE Only1$1,212.00$1,392.00EE + 10$2,387.00$2,741.00EE + Family0$3,201.00$3,676.001MONTHLY PREMIUM$1,212$1,392ANNUAL PREMIUM$14,544$16,704ACTIVE / EARLY RETIREE TOTALCurrentRenewalTOTAL MONTHLY PREMIUM$77,893$89,449TOTAL ANNUAL PREMIUM$934,716$1,073,388ANNUAL DOLLAR CHANGE$138,672ANNUAL PERCENT CHANGE14.8%01 Tiers 1-4: Cost if you use a non-network provider: 50% coinsurance up to $250 per prescription (Retail only)2 Tier 4 - Specialty Drugs: covers up to 30 day supply (Retail & Mail Order); Max limit to $250 per perscription Acupuncture Care (30 visit limit combined with chiropractic) $20 / Visit This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern. (waived if admitted)$20 / Visit$125 / Visit$10 / Visit$5 / $20 / $30 / $50 / 30% up to $250 max$12.50 / $50 / $90 / $150 / 30% up to $250 max$250 / Admit$10 / Visit (30 visit limit combined with acupuncture) Tier 1a / Tier 1b / Tier 2 / Tier 3 / Tier 4 1,2Urgent Care Services(waived if admitted)NoneN/AChiropractic Care Medical Plan BenefitsEmergency Room$50 / VisitAnthem (PRISM): Select Network HMOCurrent / RenewalEmbedded$2,000 / $4,000No ChargeNo Charge$40 / Visit No Charge 6 Anthem - PPO RenewalAnthem (PRISM): Medical PPOCurrent / RenewalIn-NetworkOut-of-NetworkCalendar Year Deductible Individual / Family$500 / $1,000Embedded / AggregateEmbeddedAnnual Out-of-Pocket MaximumIndividual / Family$2,000 / $4,000Embedded / AggregateEmbeddedPhysician Office Visit$20 (ded waived)40%Specialist Copay$20 (ded waived)40%Preventative CareNo charge (ded waived)40%Lab and X-RayCT, MRI, PET scans10%40% (limited to $800 max/test)Other lab and x-ray tests10%40% (limited to $350 max/day)HospitalizationInpatient10%40% (limited to $600 max/day; copay Outpatient10%40% (limited to $350 max/day)$50 + 10%(Copay Waived if Admitted) Urgent Care Services$20 / Visit (ded waived)40%10%40%(24 visits per calendar year)10%40%(12 visits per calendar year)PRESCRIPTION DRUGSTier 1 / Tier 2 / Tier 3Retail - 30 day supply$10 / $20 / $35$10 / $20 / $35Mail Order - 90 day supply$15 / $30 / $50Not CoveredACTIVE MONTHLY RATESEEsCurrentRenewalEE Only12$1,167.00$1,340.00EE + 10$2,290.00$2,630.00EE + Family2$3,066.00$3,521.0014MONTHLY PREMIUM$20,136$23,122ANNUAL PREMIUM$241,632$277,464EARLY RETIREE MONTHLY RATESEEsCurrentRenewalEE Only1$2,078.00$2,386.00EE + 10$4,095.00$4,703.00EE + Family0$5,488.00$6,302.001MONTHLY PREMIUM$2,078$2,386ANNUAL PREMIUM$24,936$28,632ACTIVE / EARLY RETIREE TOTALCurrentRenewalTOTAL MONTHLY PREMIUM$22,214$25,508TOTAL ANNUAL PREMIUM$266,568$306,096ANNUAL DOLLAR CHANGE$39,528ANNUAL PERCENT CHANGE14.8%This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.

Emergency RoomAcupuncture CareChiropractic Care
Medical Plan Benefits
7IRS Regulated PlanDeductible ChangeIncrease in Calendar Year DeductibleNew In-Network Deductible $1700/$3400Anthem HDHP Renewal Medical HDHPEffective: January 1, 2026Anthem (PRISM): Medical HDHP (High HDHP I)Option 1In-NetworkOut-of-NetworkCalendar Year Deductible Individual / Family$1,700/$3,400$3,400/$6,800Embedded / AggregateAggregateAnnual Out-of-Pocket MaximumIndividual / Family$8,300 / $16,500$16,600 / $33,200Embedded / AggregateEmbeddedPhysician Office Visit20%40%Specialist Copay20%40%Lab and X-RayCT, MRI, PET scans20%40%Other lab and x-ray tests20%40%HospitalizationInpatient20%40%Outpatient20%40%Urgent Care Services20%40%20%40%(30 visits per calendar year)20%40%(20 visits per calendar year)PRESCRIPTION DRUGSGeneric / Brand Formulary / Brand Non-FormularyRetail - 30 day supply20%Mail Order - 90 day supply20%ACTIVE MONTHLY RATESCurrent Renewal EE Only$958.00$1,100.00EE + 1 $1,880.00 $2,159.00EE + Family$2,517.00$2,891.00MONTHLY PREMIUM$0ANNUAL PREMIUM$0ANNUAL DOLLAR CHANGEANNUAL PERCENT CHANGEEARLY RETIREE MONTHLY RATESCurrent Renewal EE Only$1,706.00$1,959.00EE + 1$3,362.00$3,861.00EE + Family$4,506.00$5,175.00MONTHLY PREMIUM$0ANNUAL PREMIUM$0ANNUAL DOLLAR CHANGEANNUAL PERCENT CHANGE 20%
Medical Plan Benefits
Emergency RoomChiropractic CareAcupuncture Care
8 Delta Dental - Core & Buy-Up PlanDental Plan Benefits Delta Dental (PRISM): Dental PPO- Core Delta Dental (PRISM): Dental PPO- Buy UpCurrent / Renewal Current / RenewalCalendar Year MaximumPer Member $1,000 $2,000Calendar Year Deductible $50 per person $50 per person(Waived for Diagnostic & Preventive) (Waived for Diagnostic & Preventive)Diagnostic and PreventiveOral Exam X-RaysTeeth Cleaning Fluoride Treatment Basic ServicesFillingsPeriodontics (Gum disease)Routine ExtractionsEndodontics (Root Canal)Oral SurgeryMajor ServicesSurgical ExtractionsBridgeworkDenturesCrownsOrthodontics Adult & Child Adult & ChildBenefit Percentage 80% 80%Lifetime Maximum $2,000 $2,000Rate Guarantee1 Year(1/1/2025 - 12/31/2025)1 Year(1/1/2026 - 12/31/2026)1 Year(1/1/2025 - 12/31/2025)1 Year(1/1/2026 - 12/31/2026)MONTHLY RATESEEsCurrent RenewalEEsCurrent RenewalEmployee Only93$34.90 $35.70136$43.00 $44.00Employee + 1 Dependent36$75.20 $76.9045$93.40 $95.50Employee + Family74$102.70 $105.0076$127.90 $130.80203 257TOTAL MONTHLY PREMIUM $13,553 $13,859 $19,771 $20,222TOTAL ANNUAL PREMIUM $162,632 $166,302 $237,257 $242,668ANNUAL DOLLAR CHANGE $3,670 $5,411ANNUAL PERCENT CHANGE 2.3% 2.3%This summary is for informational purpose only. It does not amend, extend, or alter the current policy in any way. In the event information in this summary differs from the Plan Document, the Plan Document will prevail.

Individual / Family50% 50%80%50%80%50%80%80%100% 80% 100%Out-of-NetworkIn-NetworkIn-NetworkOut-of-Network80% 9 Delta Dental - DHMO Delta Dental (PRISM): Dental HMOCurrent / RenewalDiagnostic and Preventive ADA CodePeriodic Oral Evaluation 120 No ChargeX-Rays 210 No ChargeTeeth Cleaning 1110 No ChargeTopical Fluoride 1208 No ChargeSealants - per tooth 1351 $10RestorativeAmalgam Filling 1-4 Surfaces 2140-61 $0Resin - one surface, anterior 2330 $0Endodontics (Root Canal Therapy)Pulp Cap 3110 No ChargeTherapeutic Pulpotomy 3220 $0Root Canal Therapy - anterior 3310 $55PeriodonticsGingivectomy - per quadrant 4210 $130Osseous Surgery - per quadrant 4260 $280Scaling and Root Planning - per quadrant 4341 $25Oral SurgeryExtractions - Impacted tooth: soft tissue 7220 $50Extractions - Impacted tooth: partial bony 7230 $70Extractions - Impacted tooth: full bony 7240 $90ProsthodonticsComplete - Upper or Lower 5110-20 $145Immediate - Upper or Lower 5130-40 $165Partial Denture - Upper or Lower 5213-14 $160Crown and BridgeInlay / Onlay 2510-30 $0Crown - Porcelain/Ceramic Substrate 2740 $240Crown - Porcelain Fused to High Noble Metal 2750 $240Crown - Full Cast High Noble Metal 2790 $210Orthodontics - comprehensiveChild to age 19 8080 $1,700Member over age 19 8090 $1,900RATE GUARANTEE 2 Years(1/1/2023 - 12/31/2024)2 Years(1/1/2025 - 12/31/2026)MONTHLY RATESEEsCurrentRenewalEmployee Only83$16.80 $16.80Employee + 1 Dependent35$29.90 $29.90Employee + Family42$43.80 $43.80160TOTAL MONTHLY PREMIUM $4,281 $4,281TOTAL ANNUAL PREMIUM $51,366 $51,366ANNUAL DOLLAR CHANGE $0ANNUAL PERCENT CHANGE0.0%This summary is for informational purpose only. It does not amend, extend, or alter the current policy in any way. In the event information in this summary differs from the Plan Document, the Plan Document will prevail.

Dental Plan Benefits
10 VSP - Core & Buy-Up PlanPRISM VSP: Vision- Core PRISM VSP: Vision- Buy UpCurrentCurrentIn-Network Non-Network In-Network Non-NetworkCopayPlan pays up to:CopayPlan pays up to:Exam $10 $45 $10 $45LensesSingle $10 $30 $10 $30Bifocal $10 $50 $10 $50Trifocal $10 $65 $10 $65Contact Lenses*$130 Allowance $105 $150 Allowance $105Frames$130 Allowance + 20% discount$70$175 Allowance+20% discount$70Frequency of ServicesEye Examination 12 months 12 monthsLenses 12 months 12 monthsFrames 12 months 12 monthsContact Lenses* 12 months 12 months* In lieu of framesRate Guarantee2 Years(1/1/2026 - 12/31/2028) 2 Years(1/1/2026 - 12/31/2028) MONTHLY RATESEEsCurrentEEsCurrentEmployee Only 122$8.60175$10.30Employee + 1 Dependent 47$16.2065$19.50Employee + 2 or More Dependents73$23.8096$28.50242 336TOTAL MONTHLY PREMIUM $3,548 $5,806TOTAL ANNUAL PREMIUM $42,576 $69,672 Vision Plan Benefits
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.

Increase in Weekly Maximum Benefit from $1,620 to $1,7502026 PRISM Paid Family Leave (PFL) 11 EligibilityEligibility All Eligible Full-Time EmployeesPaid Family Leave (PFL)Benefit Duration 8 WeeksBenefit Amount 60%f your weekly wages earned in the highest quarter of base period, up to $$1,750.Covered MembersChild, Spouse, Domestic Partner, Parent, Grandparent, Grandchild, In-Laws, and SiblingsElimination Period Benefits are payable immediatelyRate Guarantee1 Year (1/1/25-12/31/25)1 Year (1/1/26-12/31/26)MONTHLY RATESEEsCurrentRenewalRate per $100 of Monthly Covered Payroll764$0.380 $0.380INSURANCE VOLUMEMonthly Covered Payroll $599,137MONTHLY PREMIUM $2,277 $2,277ANNUAL PREMIUM $27,321 $27,321 PFML SERVICES PRISM Lincoln Financial PFL
12 Lincoln - Basic Life and AD&D

13 Lincoln - STDPRISM Lincoln Financial PRISM Lincoln Financial PRISM Lincoln FinancialCurrent Current CurrentEligibility Eligibility Classes All Eligible Management, Executive Management, Police Management, Middle Management, Confidential and Elected Officials, except City Council Members working 30 hours per weekAll Eligible Management, Executive Management, Police Management, Middle Management, Confidential and Elected Officials, except City Council Members working 30 hours per weekAll Eligible Management, Executive Management, Police Management, Middle Management, Confidential and Elected Officials, except City Council Members working 30 hours per weekSTD Benefits Maximum Weekly Benefit$1,250$1,250$1,250Weekly Benefit Percentage60%60%60%Maximum Benefit Duration26 Weeks26 Weeks26 WeeksElimination Period - Accident30 Days14 Days7 DaysElimination Period - Sickness30 Days14 Days7 DaysElimination Period - Maternity30 Days14 Days7 DaysElimination Period - 1st Day Hospitalization30 Days14 Days7 DaysPaid Family Leave BenefitsEligibility All Eligible Employees All Eligible Employees All Eligible Employees Benefit Percentage 60% to 70% 60% to 70% 60% to 70%Maximum Weekly Benefit$1,540$1,540$1,540Maximum Benefit Duration8 weeks 8 weeks 8 weeks AdministrationFICA Match Included Included IncludedW-2 Reporting Included Included IncludedSelf Bill or List Bill List Bill List Bill List BillRate Guarantee3 Years (1/1/2024-12/31/2026)3 Years (1/1/2024-12/31/2026)3 Years (1/1/2024-12/31/2026)MONTHLY RATESCurrentCurrentCurrentRate per $100 of Monthly Covered Payroll$0.125$0.330$0.376INSURANCE VOLUMEMonthly Covered Payroll$1,198,776$1,198,776$1,198,776MONTHLY PREMIUM$1,498$3,956$4,507ANNUAL PREMIUM$17,982$47,472$54,0890 Short Term Disability Plan Benefits
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern. 14 Lincoln - LTDPRISM Lincoln FinancialCurrentEligibilityClass 1All Eligible Management, Executive Management, Police Management, Middle Management, and Confidential with the Exception of Council Members and EDA working a min of 30 Hours per WeekClass 2All Eligible Employees Classified as General Unit regularly working a min of 30 Hours per WeekClass 3All Eligible Elected Officials working a min of 30 hours per weekElimination PeriodClass 1: 180 DaysClass 2: 90 DaysClass 3: 180 DaysClass 1: 60%Class 2: 50%Class 3: 60%Maximum Monthly BenefitClass 1-3: $5,000Own Occupation Definition1 YearMaximum Benefit DurationRBD to age 65, or SSNRA Pre-Existing Condition3/12Mental & Substance Abuse24 monthsFICA MatchIncludedW-2 ProductionIncludedSelf Bill or List BillSelf BillRate Guarantee3 Years (1/1/2024-12/31/2026)MONTHLY RATES CurrentRate per $100 of Monthly Covered Payroll $0.158INSURANCE VOLUMEMonthly Covered Payroll $2,719,418MONTHLY PREMIUM $4,297ANNUAL PREMIUM $51,560 Long Term Disability Plan Benefits
Monthly Benefit Percentage
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern. 15 Lincoln - Voluntary LifeVoluntary Life PRISM Lincoln FinancialPlan BenefitsCurrentEligibilityAll full-time active employees workingat least 30 hours each weekEmployee Life BenefitMaximum 4x annual salary $500,000 Minimum 1x annual salary or $10,000Increments of: 1x annual salaryGuaranteed Issue Amount 4x annual salary $350,000 Spouse Life BenefitMaximum 100% of EE's benefit, up to $250,000Minimum $5,000Increments of: $5,000Guaranteed Issue Amount 100% of EE's benefit, up to $50,000Dependent Life BenefitMaximum $10,000Minimum $2,000Increments of: $1,000Guaranteed Issue Amount $10,000Age % of Original Benefit70 50%75 25%Waiver of Premium IncludedPortability IncludedSelf Bill or List Bill List BillRate Guarantee3 Years (1/1/2024-12/31/2026)CurrentEmployee & SpouseUnder age 20 $0.042Age 20-24 $0.042Age 25-29 $0.042Age 30-34 $0.050Age 35-39 $0.070Age 40-44 $0.139Age 45-49 $0.202Age 50-54 $0.406Age 55-59 $0.518Age 60-64 $1.021Age 65-69 $1.021Age 70-74 $1.021Age 75+ $1.021Child Rate per $1,000 $0.100 Benefit Reduction ScheduleMonthly Rates per $1,000
This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern. 16 Lincoln - Voluntary AD&DPRISM Lincoln FinancialCurrentEligibilityAll full-time active employees workingat least 30 hours each weekEmployee Life Benefit Family PlansSpouse & Child(ren)Spouse Only Child(ren) OnlyMinimum$25,000 Maximum $250,000 Increments of:Employee may select a Principal Sum equal to $25,000; $50,000; $75,000; $100,000; $150,000; $200,000 or $250,000.Rate GuaranteeMonthly Rate per $1,000 CurrentEmployee Only $0.030Employee + Family $0.033This document is intended as a quick reference, not a comprehensive description. Limitations and exclusions can be found in the official plan documents. In case of any discrepancies, the official plan documents will govern.3 Years (1/1/2024-12/31/2026) 50% of Employee's benefit15% of Employee's benefitAge % of Original Benefit8015%6565%7040%7525% Voluntary AD&D Plan Benefits
Benefit Reduction Schedule
EmployeeSpouse Benefit:40% of Employee's benefitChild Benefit:10% of Employee's benefit 17 Colonial Life – Accident Plan

18 Colonial – Critical Illness Plan

19 Pet Solutions/WishboneVoluntary Pet InsuranceEffective: January 1, 2026Pet Benefit SolutionsCurrentRenewalWishboneTotal PetBenefit Limits $25,000 N/ADeductibles $250 N/AReimbursements 90% 25%Network Any Licensed Vet In-Network OnlyWellness Wellness Buy-Up Discount IncludedPre-Exisitng Conditions Not Covered CoveredTelehealth YesClaim Turn around < 5 days Discount at CheckoutDeduction Method Direct Bill / Payroll PayrollOther Lost Pet RecoveryMember-only pricing (40% off) on brand name prescriptions, products, food, treats, and toys and free shipping from petcarex.comLost Pet RecoveryRate Guarantee1 Year(1/1/2026-12/31/2026)1 Year(1/1/2026-12/31/2026)EEsWishbone1 Pet10$11.75 $11.752 + Pets7$18.50 $18.5017MONTHLY PREMIUM $247 $247ANNUAL PREMIUM $2,964 $2,964ANNUAL DOLLAR CHANGE$0ANNUAL PERCENTAGE CHANGE0.0%*Wishbone rates are based on breed and zip codeMonthly Rates* Benefits
Total Pet
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