Employee Health & Welfare Benefits

September 1, 2012 – August 31, 2013

Numi Benefits Philosophy

The health and well-being of our employees is of paramount importance.

We seek to provide our employees with quality health benefits at low or no cost and, to the extent possible, assist in covering dependents.

Our Goals• For our workforce to feel safe and secure in knowing that their

healthcare needs are provided for.• To share in the growth of the company by extending coverage and

other benefits as it becomes financially feasible.• To reduce complexity and make our benefits as easy to understand

as possible.

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The Programs - Medical

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Base Plans : Kaiser HMO $30 CopayBlue Shield Spectrum 750 ValueLolo Center Membership plus your choice of:

Blue Shield 1500 ValueKaiser HMO $30/$1500 Deductible

These plans are free to all employees who qualify for benefits. Numi will cover dependents at 25% of the cost of the base plan.

Kaiser HMO $30 Copay - Base Plan

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Blue Shield 750 Value – Base Plan

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Lolo Center

Integrative Health Practice located at 1211 Embarcadero, Oakland (Over Starbucks)

Membership Model – Numi Pays Membership, you pay reduced prices for services

•Acupuncture & Herbal Medicine - $28 initial visit/$14 follow-up•Chiropractic & Rehabilitation - - $28 initial visit/$14 follow-up•Massage Therapy - $39 (1hr), $19 (30 min), $9 (15 min)

•Medical doctor - - $28 initial visit/$14 follow-up•Naturopathic doctor - $39 (1 hour)

Combine this Membership with the Blue Shield 1500 Value, Kaiser HMO $30/$1500 or take Lolo Center alone (with proof of other

medical overage) fully covered by the company.

Disclaimer: Numi, Inc. does not endorse specific practitioners offered by Lolo Center or any other health plan, but is simply presenting this as one option for health care for its employees seeking an alternative approach to traditional medicine..

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Blue Shield Spectrum 1500 Value – Available with Lolo Center or as Buy-Down Plan

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Kaiser HMO $30/$1500 Deductible – Available with Lolo Center or as Buy-Down Plan

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Blue Shield Premier PPO 20 - Buy-Up Plan

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Example

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Base PlanJane covers herself and her spouse. Jane is less than 30 years old and prefers a medical PPO plan, so she chooses the Blue Shield Spectrum 750 Value Plan. The monthly premium for Jane is $226 and the cost for her spouse is $392. The company pays the full $226 for her and an additional $98 per month for her spouse. Jane will owe $294 per month (pre-tax).

Buy-UpIf Jane wants a more comprehensive plan, she may “buy-up” to the Blue Shield Premier PPO 20 Plan. The monthly rate for Jane is $369 and an additional $638 for her spouse. Jane must now pay $143 for herself and $540 for her spouse or a monthly total of $683 (pre-tax).

Buy-DownJane wants to control her costs more so she elects the Blue Shield 1500 Value Plan which is less expensive but not as robust. This plan costs $170 for her and $292 for her spouse. Jane can use the cost savings of XXX to help offset the additional cost of her spouse. We add the $170 to the $154 the company will pay for dependent coverage and the company pays a total of $324 toward the dependent coverage. Jane will owe $138 per month (pre-tax).

Dental & Vision

Numi will Pay for 100% of Premium for Employee Only Coverage for Dental & Vision Benefits

Dental PPO with MetLife will stay the same.

Vision plan will remain the same.

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Dental Insurance - MetLife

Coverage In Network Out of NetworkIndividual Deductible

$50 $50

Family Deductible $150 $150Annual Maximum $1500 $1500

Preventive Services 100% deductible waived

100% deductible waived

Basic Services 80% 80% of UCRMajor Services 50% 50% of UCR

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Vision Insurance – VSP Direct

Benefit Coverage

Vision Exam 12 months

Lenses 12 months

Frames 24 months

BENEFITS THROUGH A VSP PROVIDER  

(amount covered, less copays) $20 copay for exam; $20 copay for materials 

Vision Exam Covered in full

Lenses (Pair)  

- Single Vision Covered in full

- Bifocal Covered in full

- Trifocal Covered in full

Frames Covered up to $130 retailContact Lenses (in lieu of other eyewear benefits)

Reimbursement up to $130; in lieu of lenses and frame

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Life Insurance - MetLife

The company will provide each benefit eligible employee with $30,000 of life insurance.

Please remember to fill out a beneficiary form and keep it up-to-date.

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Employee Assistance Program (EAP) - MHN

Free to all employees and their family members

Get 3 counseling visits per incidentHelp with financial issues and budgeting

Legal assistanceHelp finding child and elder care

1-800-693-2488www.members.mhn.comCompany code: numitea

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What if I do not take medical insurance?

If you do not take Numi medical insurance or Lolo Center alone, and can provide proof of other health coverage, you will receive $30 per month (post-tax) in your pay check.

Feel free to use this to buy Aflac, additional life insurance or nothing at all.

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It Wouldn’t Be Open Enrollment Without the Forms

CONSIDER YOUR OPTIONS, FILL OUT AND RETURN ALL FORMS TO HR BY WEDNESDAY, AUGUST 15th.

Everyone – Numi Benefit Enrollment/Waiver Form

If you are currently in the Blue Shield 500 Value Plan and staying in 750 Value, no forms needed. Also, no change needed if you are in the 1500 Value Plan.

If you are currently in the Buy-up Plan (500 Standard), you will need to choose a plan and fill out a Blue Shield Change Form.

If you are currently enrolled with Kaiser and want to make a change of plans from the HMO $30 Copay to the HMO $30/$1500 Deductible or vice versa, then a Kaiser Change Form is required.

If you are on any plans and wish to add or drop dependents, you will need to fill out a change form for each plan affected.

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Where Can I Find Everything I Need

Integra’s website specifically for Numi:http://www.integra-insurance.com/myibenefits/

ID: Numi Tea Password: Numitea01

On the Z Drive: Z:\General\HR\Benefit Forms & Info 9-11 through 8-12

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Q & A

Questions?

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