MEDICAL The table below shows the weekly costs you share with Trilogy to participate in one of our medical plans. All three medical plans are within the Anthem network and all cover the same services, specialty care, and emergency services as well as 100% preventive care. Smart Choice 2500 Coverage Level Deductible Max Employee Trilogy Out-of-Pocket Premium Premium Employee Only $2,500 $5,000 $41.00 $142.98 Employee + Child(ren) $3,300/$5,000* $7,500 $81.00 $236.96 Employee + Spouse $3,300/$5,000* $7,500 $150.00 $250.97 Family $3,300/$5,000* $7,500 $196.00 $393.94 *$3,300 deductible per individual for those with EE+SP, EE+CH or Family coverage. Smart Choice 3500 Coverage Level Deductible Max Employee Trilogy Out-of-Pocket Premium Premium Employee Only $3,500 $6,000 $34.00 $142.98 Employee + Child(ren) $6,000 $8,500 $67.00 $236.96 Employee + Spouse $6,000 $8,500 $134.00 $250.97 Family $6,000 $8,500 $172.00 $393.94 Smart Choice 4500 Coverage Level Deductible Max Employee Trilogy Out-of-Pocket Premium Premium Employee Only $4,500 $7,000 $27.00 $142.98 Employee + Child(ren) $7,000 $10,000 $55.00 $236.96 Employee + Spouse $7,000 $10,000 $120.00 $250.97 Family* $7,000 $10,000 $150.00 $393.94 12