Open Enrollment is here!

At Fresh Mark, we believe that you, our employees, are our most important asset. Helping you and your families achieve and maintain good health—physical, emotional and financial—is the reason Fresh Mark offers you this benefits program.

Open Enrollment is your annual opportunity to enroll in benefits if previously waived, add or drop eligible dependents from coverage, elect a Flexible Spending or Dependent Care Account, or waive coverage. We are providing you with access to this microsite, so all your benefits information is right at your fingertips and easily accessible. You will find an overview of each benefit under the Benefits tab. This information will help you understand the benefits that are available to you and how to best use them. Please review it carefully and make sure to ask any important questions that you would like to have addressed.

For more detailed information, please refer to your plan benefit booklets or summary plan descriptions (SPDs). The plan benefit booklets determine how all benefits are paid.

Resources

Open Enrollment Guide

Medical - PPO SBC

Medical - HDHP SBC

Open Enrollment Presentation

Voluntary Opt-Out Form

FSA/HRA Election Form

Notices and Information Packet

How to make a change, elections or waive benefits?

Use the following resources to complete Open Enrollment for 2025.

Open Enrollment Guide
Voluntary Opt-Out Form
FSA/HRA Election Form

Log on to the UKG portal to make your 2025 plan elections or to waive coverage. Complete the enrollment process in its entirety print the final election screen for your records. Make sure if there are any documents that need completed through the open enrollment process, that you download those, complete them and either upload them to UKG or provide to Human Resources.

In order to complete enrollment, you will need the following information:

Names, Social Security Numbers and Dates of Birth for any dependents you wish to enroll for January 1^st, 2025. Click submit to finalize your changes.

What Must You Know?

This year we will have what is referred to as a PASSIVE Enrollment. A Passive Enrollment means that if you take no action your current benefits will rollover except for, FSA and Dependent Care. Those need to be elected every year. You are also required to:

Update Family or Beneficiary Information
Enroll or re-enroll in a Flexible Spending Account or Dependent Care Benefits
Review all contact information making sure all is correct

Who Can You Cover?

Who Is Eligible?

Regular full-time employees working 30 or more hours per week are eligible for the benefits outlined in the summary plan description. You can enroll the following family members in our medical and vision plans.

Your spouse (the person who you are legally married to under state law), some plan exclusions may apply. Fresh Mark’s plan has a Spousal Carve Out. This means that if your spouse is eligible for other coverage through their employer, she/he will not be permitted to have coverage through the Fresh Mark Benefits Plan. If you are covering your spouse for 2025, you are required to complete the Spousal Attestation Form and upload it to UKG.
Your children (including a Child under your Legal Guardianship, Adoptive Child or a stepchild living in the residence of the employee):
Under the age of 26 are eligible to enroll in medical coverage. They do not have to live with you or be enrolled in school. They can be married and/or living and working on their own.
Over age 26 ONLY if they are incapacitated due to a disability and primarily dependent on you for support and such child was covered by this plan prior to the limiting age.
Named in a Qualified Medical Child Support Order (QMCSO) as defined by federal law.

Please refer to the Summary Plan Description for complete details on how benefits eligibility is determined.

Who Is Not Eligible?

Family members who are not eligible for coverage include (but are not limited to):

Parents, grandparents, and siblings.
Employees who work less than 20 hours per week, interns, temporary employees or contract employees.

Qualifying Event?

Coverage for new employees begins on the first day of the month following satisfaction of their eligibility period. Open enrollment is the one time each year that employees can make changes to their benefit elections without a qualifying life event. An employee may make a new election upon the occurrence of certain events described below as they pertain to the applicable benefits. Make sure to notify Human Resource right away if you do have a qualifying life event. You have 30 days to make a change (add or drop) to your coverage election when a qualifying event occurs. A qualifying event includes (but is not limited to):

Birth or adoption of a baby or child
Change in Employment Status
Marriage
Loss of other healthcare coverage
Divorce or Legal Separation
Eligibility for new healthcare coverage

Allstate Identity Theft Protection

Identity theft and cybercrime can happen to anyone:

1 in 4 Americans have experienced cybercrime.1
Even someone who knows how to minimize their risk. That’s why Fresh Mark offers

Allstate Identity Protection Pro+ Cyber as a benefit.

Get comprehensive identity monitoring and fraud resolution designed to help you protect yourself and your family against today’s digital threats, plus cybersecurity features designed to identify and address vulnerabilities before they can be exploited.

For over 90 years, Allstate has been protecting what matters most. Prepare for what’s next with:

Identity, financial account, and credit monitoring
Cyber protection for mobile devices
24/7 support, plus up to $1 million in fraud expense reimbursement† — or up to$2 million for families∆

PLANS AND PRICING

Allstate Identity Protection Pro+ Cyber

$9.00 per person / month
$16.45 per family / month

Call: 1.800.789.2720

Medical Plan Highlights

New Medical Plan offered in 2025

Fresh Mark is excited to offer a High Deductible Plan that is compatible with a Health Savings Account.

Medical coverage provides you with benefits that help keep you healthy like preventive care screenings and access to urgent care. It also provides important financial protection if you have a serious medical condition. Fresh Mark offers you coverage through Medical Mutual of Ohio. Plan Highlights are below.

PPO Plan	In-Network	Out-of-Network
Annual Deductible (Individual/Family)	$300/$750	Varies by Plan
Embedded or Aggregate Deductible	Embedded	Embedded
Employer Coinsurance %	80%	50%
Maximum Out-of-Pocket (Individual/Family)	Varies by Plan	Varies by Plan
Office Visit (PCP)	Deductible & Coinsurance	Deductible & Coinsurance
Office Visit (Specialist)	Deductible & Coinsurance	Deductible & Coinsurance
Urgent Care Visit	Deductible, & 80% Coinsurance	Deductible, & 80% Coinsurance
ER Visit	Deductible, then $100 Copay (waived if admitted), then 80%	Deductible, then $100 Copay (waived if admitted), then 80%
Inpatient Visit	Deductible & Coinsurance	Deductible & Coinsurance
Outpatient Surgery Visit	Deductible & Coinsurance	Deductible & Coinsurance
Ambulance	Deductible & Coinsurance	Deductible, & 80% Coinsurance

What is a High-Deductible Health Plan

A high-deductible health plan, also called a consumer-driven health plan, is health coverage with lower premiums but higher out-of-pocket cost when you need care. HDHPs are designed to safeguard against catastrophic out-of-pocket cost for covered treatments and services.

The IRS sets strict requirements around the deductible minimums and out-of-pocket maximums. The deductible must be met before the health plan pays for health care services beyond preventative care like annual physicals. Preventative care services are paid in full when received by an In-Network provider.

HDHP Plan	In-Network	Out-of-Network
Annual Deductible (Individual/Family)	$3,400/$6,800	$6,400/$12,800
Coinsurance (after deductible)	100%	50%
Maximum Out-of-Pocket (Individual/Family)	$3,400/$6,800	$9,600/$19,200
Preventative Care	100%, no deductible	50%
Emergency Use of ER (copay waived if admitted)	Deductible	Deductible then 50%
Office Visit	Deductible	Deductible then 50%
Specialist	Deductible	Deductible then 50%
Urgent Care	Deductible	Deductible then 50%

Medical Employee’s Monthly Contributions

Coverage Level	PPO	HDHP
Employee	$43.33	$10.83
Employee + Spouse	$86.67	$21.67
Employee + Child	$86.67	$21.67
Employee + Children	$119.17	$32.50
Family	$119.17	$32.50

Health Savings Account (HSA)

A Health Savings Account (HSA) is an interest-bearing checking account that you can fund with pre-tax contributions and is owned by you. You can use the money in your HSA to pay for your Qualified Medical Expenses including your prescriptions, medical, dental and vision expenses. You can even use the money to pay for COBRA premiums and retirement healthcare expenses. Once you have $1,000 in your HSA, you can begin to invest those dollars, increasing your tax-free earning potential!

The HSA is administered by Medical Mutual. Fresh Mark will make a contribution to your HSA if you open an account. The annual contribution is $500 if on Employee only coverage $750 if on Employee +1 Coverage and $1,000 in on Family coverage. Please note the Fresh Mark contribution amount will be contributed on a prorated basis throughout the year. You can also contribute to the account up to the IRS limits of $4,300 single or $8,550 family. And, unlike the HRA, the monies belong to you and grow for your retirement. There is no use it or lose it.

To be eligible to open an HSA account you must meet the following criteria:

You cannot be covered by any other medical plan that is not an HSA-compatible health plan, including your spouse’s medical plan or health care flexible spending account
Be enrolled in the Medical Mutual HDHP Plan
Cannot be enrolled in Medicare. However, you may withdraw money from your HSA after you enroll in Medicare to help pay for medical expenses, including Medicare premiums (this does not include Medigap) as long as you are age 65 or older
Cannot be eligible to be claimed as a dependent on another individual’s tax return
Be a U.S. resident and not a resident of American Samoa
If you are a veteran, you may not have received veterans’ health benefits within the last three months

Vision Plan Highlights

Routine vision exams are important, not only for correcting vision but because they can detect other serious health conditions. We offer you a vision plan through Vision Service Plan (VSP). Vision coverage is available to all qualified employees. If you do not wish to be enrolled for vision coverage, you can waive this option by completing the waiver section on the electronic enrollment form located in the Resource section above.

VSP	In-Network	Out-of-Network
Routine Eye Exam (Once/year)	$5	Up to $50
Eyeglass Frames (One pair/year)	$5 (Includes Frames & Lenses) $150 Allowance	Up to $60
Eyeglass Lenses Single Lenses Lined Bifocal Lenses Lined Trifocal Lenses	$5 (Includes Frames & Lenses)	Up to $50 Up to $75 Up to $100
Contact Lenses Exam	Up to $60	–
Contact Lenses (Instead of eyeglasses) Elective conventional Non-elective (Medically necessary)	$130 Allowance	Up to $105

Life Insurance

As an employee of Fresh Mark you are provided with a competitive life insurance policy which is fully paid for by the company. See Human Resource for additional details on benefits.

If you are adding dependent life insurance and it is not their initial enrollment period then they will need to complete the Evidence of Insurance form.

Download Evidence of Insurance form here.

Important Plan Notices

Annually our Plan is required to provide you with notices on the following topics:

Women’s Health and Cancer Rights Act
Newborns’ and Mothers’ Health Protection Act
Michelle’s Law
HIPPA Notice of Special Enrollment Rights
Notice of Grandfathered Plan Status
Availability of Privacy Practices Notice
Paperwork Reduction Act Statement
Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP)
Medicare Part D Notice

All the above notices can be located under the Important Information tab within this microsite. You can access them through the link within the Resource Box.

Voluntary Opt-Out Provision

Fresh Mark provides employees eligible for medical coverage with the ability to opt-out of (or waive) medical coverage for the 2025 Plan Year (January 1, 2025 – December 31, 2025) as long as they have coverage under another employer sponsored medical plan.*

Currently you will have the option to elect medical benefits or opt out of the medical plan, provided you have other group coverage. When making your annual elections on the UKG, please select either the medical plan or the opt out plan. Selecting both options may delay your proper election for 2025.

You will need to select how you would like to receive these funds. Selecting the Cash Out Option will provide benefits on a prorated basis via a monthly payment of $58.33. You can receive the full amount by placing those dollars into the Opt Out Flexible Spending Account (FSA) or Opt Out Dependent Care Account (DCA). If you decide to set aside your own pre-tax dollars into the FSA or DCA, you will want to be sure to select the separate enrollment fields titled 2025 Flexible Spending Account or 2025 Dependent Care Account.

If you elect to receive your Opt-Out Payment in cash, it will be taxable when paid. If you elect to allocate your Opt-Out Payment to your Health Care Flexible Spending Account, you may still contribute, from pre-tax wages, up to the federal limit of $3,200. However, if you elect to allocate your Opt-Out Payment to your Dependent Care Flexible Spending Account, the amount allocated from your Opt-Out Payment must be included when determining the amount, you can contribute from pre-tax wages.

All amounts contributed to your Dependent Care Flexible Spending Account, both from pre-tax wages and any employer contributions, including allocation of your Opt-Out Payment, must not exceed $5,000 ($2,500 if you are married and file your federal taxes as “married filing separately”).

If you are electing to opt out of benefits, you must complete the 2025 opt out form and upload the completed document to this portal. You can access the form via this link, then refer to the upload section of the portal for instructions on how to upload your form.

*Note that the other coverage must provide minimum essential coverage. In addition, coverage obtained in the individual market does not qualify as “other coverage” for this purpose. If you opt out of vision coverage, this waiver credit will not apply and is only applicable for waiver of medical benefits.