1Airgas 2021 Benefits at a Glance
• Medical (including prescription drugs)• Dental• Vision• Health Savings Account option• Voluntary Benefits• Basic Life & AD&D Insurance• Optional Life & AD&D Insurance• Spouse and Dependent Life Insurance• Basic Short-term Disability with
Enhanced Maternity Benefit
• Short-term Disability Buy-Up• Basic Long-term Disability• Long-term Disability Buy-Up• Flexible Spending Accounts (Health
Care and Dependent Care Accounts)• Employee Assistance Program• Pre-Tax Commuter Transportation• 401(k) Retirement Plan• Other Benefits
you drive. you decide.
2021 BENEFITS AT A GLANCE AN OVERVIEW OF AIRGAS BENEFITS
5Airgas 2021 Benefits at a Glance
HEALTH-RELATED BENEFITSPlan Coverage Who Pays
Health Savings Account
Associates that enroll in the Bronze HSA Plan for their medical coverage have the option to open a tax-advantaged Health Savings Account. The HSA can be used to pay for current or future medical, dental and vision expenses, even into retirement. Annual pre-tax maximum contributions of $3,600 (individual) and $7,200 (family), per IRS regulations. If you will be age 55 or older by December 31, 2021, you can make catch-up contributions of an additional $1,000 per account holder per calendar year. Funds in the HSA roll over on an annual basis. Offers investment options for balances in excess of $1,000.
Associate funds the account with pre-tax payroll deductions
Flexible Spending Accounts
Annual pre-tax payroll deduction program for paying eligible unreimbursed medical, dental, hearing, vision and dependent care expenses. Annual pre-tax maximums of $2,750 for healthcare and $5,000 for dependent care. Unused funds are forfeited if not used for expenses incurred by the end of calendar year per IRS regulations. Associates save on both federal and state taxes on the amounts funded in these accounts.
Associate funds the account with pre -tax payroll deductions
Employee Assistance Work/Life Balance Program
Confidential service available 24 hours a day, 7 days a week, 365 days a year through LifeWorks to help associates and their immediate family members resolve personal issues and problems including but not limited to relationship, childcare, eldercare, legal, financial, stress, alcohol and drug abuse, anxiety or depression. Call 1-888-267-8126 to talk to someone or go online at login.lifeworks.com (username and password: airgas) for access to hundreds of articles, audio recordings, toolkits, and more.
Airgas pays
Teladoc Get non-emergency medical care from a board-certified doctor via phone or online video consultation, 24/7, 365 days a year. It is ideal for routine care and common illnesses and when you can’t get to your regular doctor. Under the Platinum, Gold, Core, and Silver plans, you pay a $10 copay per consultation; under the Bronze HSA Plan, you pay the full cost ($40) until you meet the deductible. Available to all associates and dependents covered by Blue Cross Blue Shield (except HMSA Hawaii). Note: Teladoc is a telemedicine service offered to BCBS members. Associates enrolled in non-BCBS medical plans may have other telemedicine options available; check with your provider for more information.
Airgas and associates share the cost
Livongo A diabetes management program offered at no cost to associates and their family members who have diabetes and are covered through an Airgas medical plan administered by BCBS. The program provides members with a connected blood glucose meter, online access to blood glucose readings, free unlimited test strips and lancets, and coaching by phone, text message, and mobile app.
Airgas pays
Sleepio A digital sleep improvement program to help users take control of their sleep and feel more energized throughout the day. Learn cognitive and behavioral techniques to sleep and feel better. Available to associates and dependents enrolled in an Airgas medical plan administered by BCBS.
Airgas pays
Daylight An app-based program to help users address worry and anxiety. Learn proven strategies to get negative thoughts out of your head, face difficult emotions and be more present for the good stuff. Available to associates and dependents enrolled in an Airgas medical plan administered by BCBS.
Airgas pays
RETIREMENT BENEFITSPlan Who is Eligible When Participation Begins Explanation Who Pays
401(k) Plan All associates Eligibility is immediate. Auto enrollment at 2% for new associates. Associates can change their contribution amount and investment options at any time. Associates begin receiving company match after one year of employment.
Tax deferred retirement savings plan with various investment options. Participants can contribute 1% - 75% of their base pay on a pre-tax or post-tax basis in a regular 401(k) or Roth 401(k) account through payroll deductions. Vesting is immediate. In-service withdrawals, plan loans and qualified rollover contributions are permitted. Annual withholding limit for 2021: $19,500. If you will be age 50 or older by December 31, 2021, you can make catch-up contributions of an additional $6,500 to your 401(k).
Airgas and Associate: Airgas will match 50% of the first 6% of associate contributions per pay after completing one year of employment.
OTHER BENEFITSPlan Who is Eligible When Participation Begins Explanation Who Pays
Pre-Tax Commuter Transportation
All associates except those covered by certain collective bargaining agreements.
After you have worked continuously for 30 days
Associate can elect pre-tax deductions that are placed in an account to use when purchasing transportation or parking passes (up to $270 per month, for each, as allowed by the IRS).
Associate funds the account with pre-tax payroll deductions
Automobile, Personal Property and Homeowner’s Insurance
Associates regularly scheduled to work 30 hours or more per week.
After 30 days of employment Access to automobile, homeowner’s and personal property insurance at group rates through MetLife, which may be lower than your current coverage depending on your state.
Associate pays (No payroll deductions will be taken for elected coverage - billing will be direct to you.)
6Airgas 2021 Benefits at a Glance
Educational Assistance
Available to full-time associates regularly scheduled to work 30 hours or more per week.
After six months of employment Up to 100% reimbursement for tuition, registration fees, books and supplies for satisfactory completion of job-related courses as approved by your HR Manager.
Airgas pays
Scholarship Program
Dependent, unmarried children, up to age 23. Eligible dependents must be enrolled in or planning to enroll in a full-time course of study at an accredited two or four year college, university, community college, or vocational technical school.
Applications must be postmarked by May 1. Winners are notified by June 15.
Up to 20 awards are granted each year. Awards range from $1,000 to $2,000 annually.
Airgas pays
2021 ASSOCIATE MONTHLY CONTRIBUTIONSThe tables below list your monthly payroll contributions for the Core medical plan, the two dental options and the vision plan. Each table lists the three salary bands and the cost for each benefit within each band. The medical pricing below is the incremental cost for each level: employee, spouse, and each child covered. If you cover dependent children, the cost is based on how many you cover. Contributions for other medical plans are available on the YBR enrollment website.Spousal Surcharge: A surcharge of $100/month will apply if your spouse or domestic partner has coverage available elsewhere, but you elect to cover him or her under your Airgas coverage. The surcharge, if applicable, is in addition to the rates shown here.If you cover only yourself and earn $67,000 or less, your cost for the Core Plan is $112.49 per month. If you choose to cover your spouse and two children, your total monthly cost to cover you and your family is $592.46 per month (contributions for dependent children are capped at three):
Employee ($112.49) + Spouse ($301.75) + 1st Child ($89.11) + 2nd Child ($89.11) = $592.46 per monthDepending on where you live, you may be able to choose between the BCBS plans or a fully-insured HMO or PPO plan. The alternative plan costs will be based on the HMO/PPO premium, your salary band, and if you choose to cover dependents. When you enroll, personalized pricing will be available for you. Please note, if you elect a carrier other than BCBS, your prescription drug coverage will be administered by the HMO or PPO you elect.
CORE MEDICAL PLAN – BLUE CROSS BLUE SHIELD WITH CVS CAREMARK PRESCRIPTION DRUG SERVICESUnitized Pricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $112.49 $140.74 $197.25
Spouse $301.75 $377.55 $529.16
Child (capped at 3) $89.11 $111.50 $156.27
AETNA DENTAL, BASIC OPTIONPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $8.44 $11.94 $22.12
Employee + Spouse $17.39 $24.59 $45.58
Employee + 1 Child* $14.99 $21.55 $38.92
Family + 1 Child* $23.94 $34.20 $62.38
AETNA DENTAL, PREMIUM OPTIONPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $18.36 $25.83 $28.95
Employee + Spouse $37.83 $53.20 $59.64
Employee + 1 Child* $33.31 $46.87 $63.95
Family + 1 Child* $52.78 $74.24 $98.59*Note: Additional costs associated with covering more than one dependent child. Detailed cost information is provided at the time of benefits enrollment.
EYEMED VISION CARE, ACCESS PLANPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $6.47 $6.47 $6.47
Employee + Spouse $11.93 $11.93 $11.93
Employee + Child(ren) $11.61 $11.61 $11.61
Family $16.11 $16.11 $16.11
2Airgas 2021 Benefits at a Glance
Platinum* Gold* Core* Silver* Bronze HSA**
RETAIL
Generic copay $9 $9 30% up to $50 per prescription
30% up to $50 per prescription You pay 20% with
no deductible for most preventive
medications; otherwise, you pay 20% after you meet
your deductible
Brand formulary copay $35 $35 30% up to $150 per prescription
30% up to $150 per prescription
Brand non-formulary copay $70 $70 30% up to $300 per prescription
30% up to $300 per prescription
Mail order(up to 90-day supply)
2x retail copay
2x retail copay
30% up to 2x retail maximum
30% up to 2x retail maximum
Rx Out-of-pocket maximum(individual/family) $2,100 / $4,200 $2,100 / $4,200 $2,100 / $4,200 $2,100 / $4,200
Applies to Bronze HSA Plan out-of-pocket maximum
Platinum Gold Core Silver Bronze HSA
Deductible*(individual/family) $500 / $1,000 $750 / $1,500 $1,000 / $2,000 $1,250 / $2,500 $1,500 / $3,000
Coinsurance %(after the deductible has been met)
You pay 10%Plan pays 90%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
Out-of-pocket maximum**(individual/family) $2,500 / $5,000 $3,000 / $6,000 $3,500 / $7,000 $4,000 / $8,000 $6,550 / $13,100
Preventive care (e.g., annual exam) 100% 100% 100% 100% 100%
PCP copay You pay $20 You pay $25 You pay $25 You pay $40
Covered at 80% after deductible
Specialist copay You pay $25 You pay $35 You pay $35 You pay $50
Hospital inpatient Plan pays 90% after deductible
Plan pays 80% after deductible
Plan pays 80% after deductible
Plan pays 80% after deductible
ER copay (waived if admitted) You pay $500 You pay $500 You pay $500 You pay $500
Walk-in clinic copay You pay $20 You pay $25 You pay $25 You pay $40
Urgent care copay You pay $25 You pay $35 You pay $35 You pay $50
WHO IS ELIGIBLE? All associates regularly scheduled to work 30 hours or more per week and certain dependents of covered associates.
WHEN DOES COVERAGE BEGIN? After you have worked 30 consecutive days with the Company.
* Deductibles do not apply to prescription drug benefits under the Platinum, Gold, Core and Silver Plans.** Prescription drug costs count toward the Deductible in the Bronze HSA Plan EXCEPT approved preventive and maintenance medications; these medications are not subject to the Deductible and are paid at the coinsurance rate.Notes: 1. Airgas prescription drug coverage is administered by CVS Caremark for those electing a BCBS plan. 2. Prior authorization requirements and coverage limits may apply to certain drugs.
* For the Platinum, Core, Silver, and Gold Plans, the family Deductible can be met by a combination of family members; however, no single individual within the family will be subject to more than the individual Deductible amount.** For the Platinum, Core, Silver, and Gold Plans, the family Out-of-Pocket Maximum can be met by a combination of family members; however no single individual within the family will be subject to more than the individual Out-of-Pocket Maximum. For the Bronze HSA Plan, the family Out-of-Pocket Maximum can be met by a combination of family members; however, no single individual within the family will be subject to more than the individual Out-of-Pocket Maximum. Note: There are no copays in the Bronze HSA Plan.
AIRGAS MEDICAL PLANSAirgas offers five medical plan options through Blue Cross Blue Shield (BCBS). You may enroll yourself and your eligible dependents. If you enroll in an Airgas medical plan, you will have access to the BlueCard® PPO provider network with more than 720,000 network doctors and 6,000 network hospitals. With the BCBS plan options:• Your paycheck contributions will vary with the amount of coverage that
you choose.• If you elect the Bronze HSA Plan, you have the option to open a Health
Savings Account (HSA) administered by Smart-Choice Accounts™. You contribute pre-tax dollars to the HSA, which can be used to pay for eligible healthcare costs (including your deductible and
coinsurance), or saved to pay for healthcare costs later, even into retirement.
A surcharge of $100/month will apply if a spouse or domestic partner has coverage available elsewhere, but elects Airgas coverage. When you enroll, the answer will be assumed to be “yes.” You must change it to “no” if it does not apply.Regional Health Maintenance Organizations (“HMOs”) or Preferred Provider Organizations (“PPOs”) may be available to you, based on your residency. You will be notified when enrolling if a regional HMO or PPO is available in your area.
Who Pays? Airgas and associates share the cost
PRESCRIPTION DRUGS (YOUR COST)
3Airgas 2021 Benefits at a Glance
AIRGAS DENTAL PLANSYou may enroll yourself and your eligible dependents in the Basic Plan or Premium Plan, or you may choose no dental coverage. The dental plan is available to you even if you choose medical coverage through an HMO/PPO or decline medical coverage altogether.
AIRGAS VISION PLANYou may enroll yourself and your eligible dependents in vision coverage through EyeMed vision care. You don’t have to be enrolled in an Airgas medical plan to receive vision coverage. You pay the full cost for vision care coverage for yourself and any dependents you choose to cover. What follows is a general description of the vision care plan.
* Deductible does not apply to preventive services. Note: If you go to an out-of-network dentist, you (or your dentist) must file a claim for reimbursement. Benefit payment percentages are based on reasonable charges.
Dental Coverage Basic Plan Premium Plan
Your Deductible(The amount you pay before the plan pays benefits)
$50/individual$150/family
$50/individual$150/family
Coinsurance(The amount the plan pays once the deductible is met)
• Preventive/Diagnostic Services* (exams, cleanings, bitewing X-rays, fluoride treatment)• Basic Services (fillings, extractions, root canals, oral surgery)• Major Services (crowns, bridgework, full and partial dentures)
100%50%50%
100%80%50%
Annual Maximum $2,500 $2,500
Orthodontia Not Covered50% to a $1,500
lifetime maximum per family member
Who Pays? Airgas and associates share the cost
Who Pays? Associate pays
Vision Service In-Network(What You Pay)
Out-of-Network(Your Reimbursement)
Exam (with dilation as necessary)Once every 12 months $10 copay $35
FramesOnce every 12 months
$0 copay; $150 allowance, 20% off balance over $150 $75
Standard Plastic Lenses• Single vision• Bifocal• Trifocal• Standard progressive• Premium progressive
Once every 12 months
$20 copay$20 copay$20 copay$20 copay
$20 copay and 80% of charge less $120 allowance
$25$40$55$55$55
Contact Lenses (in lieu of standard plastic lenses)• Conventional contacts• Disposable contacts• Medically necessary
Once every 12 months
$0 copay, $150 allowance,15% off balance over $150$0 copay, $150 allowance, plus balance over $150
$0 copay, paid in full
$120$120$200
Laser Vision CorrectionFind a LASIK location at eyemedlasik.com. 15% off retail price or 5% off promotional price N/A
4Airgas 2021 Benefits at a Glance
VOLUNTARY BENEFITSPlan Coverage Who Pays
Hospital Indemnity Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent are admitted or confined to a hospital. You have the choice of two comprehensive plans: the Low Plan and the High Plan.
Associate pays
Accident Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent experiences a covered accident. Benefits are paid based on the injury you experience and the medical services required.
Associate pays
Critical Illness Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent is diagnosed with a covered condition. You may elect $15,000, $30,000, or $45,000 of coverage.
Associate pays
LIFE INSURANCE AND AD&D BENEFITSPlan Coverage Who Pays
Basic Life Insurance
A fully-insured benefit provided by the company through The Hartford, the plan provides 1 times annual benefit base (annual base salary plus annualized prior year’s commissions) up to a maximum benefit of $50,000.
Airgas pays
Optional Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase additional coverage of 1-4 times annual benefit base with cost varying based on age. Evidence of insurability (EOI) is required if enrolling after initial offering (at time of hire or eligibility), or increasing more than one coverage level during any subsequent annual enrollment.
Associate pays
Spouse Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase coverage in amounts of $10,000, $25,000, $50,000, $75,000 and $100,000. Evidence of insurability (EOI) is required if initial election is greater than $50,000, or if increasing more than one coverage level during any subsequent annual enrollment.
Associate pays
Child Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase coverage in amounts of $5,000, $10,000, $15,000, $20,000 and $25,000 per child.
Associate pays
Basic AD&D A fully-insured benefit provided by the company through The Hartford, the plan pays benefits for accidental loss of life or loss of hand, foot or eye, speech or hearing. The plan provides 1 times annual benefit base (annual base salary plus annualized prior year’s commissions) up to a maximum benefit of $50,000.
Airgas pays
Optional AD&D A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase additional coverage of 1-4 times annual benefit base. Optional coverage for family is available in amounts based on your elected optional coverage amounts.
Associate pays
DISABILITY BENEFITSPlan Coverage Who Pays
Short-term Disability Insurance
A fully-insured benefit provided by the company through The Hartford and integrated with Long-term Disability. The plan pays a benefit of 50% of your weekly pay as defined by the plan (minimum: the greater of $300/week or 10% of the weekly benefit before deduction of other income benefits; $3,000/maximum per week) minus disability income from other sources including sick/banked sick time for up to 25 weeks. Coverage is provided for a maximum of up to the earlier of 25 weeks or when your disability ends.
Airgas pays
Short-term Disability Buy-Up
A fully-insured benefit provided through The Hartford, the plan is designed to supplement the Airgas-provided Short-term Disability benefit and allows employees to purchase additional Short-term Disability coverage, to a total of 60% of your weekly pay as defined by the plan ($3,000/maximum per week) minus disability income from other sources including sick/banked sick time for up to 25 weeks.
Associate pays
Maternity Benefit
Associates with a minimum of 1 year of service at the time of disability are eligible for an enhanced company-paid maternity benefit. The maternity benefit will pay an associate on maternity leave up to 50% of current salary for up to 6 weeks from the date of birth. The combination of the Short-term Disability benefit and the Airgas Maternity Benefit cannot exceed 100% of an associate's current weekly salary. If it exceeds 100%, the maternity benefit will be reduced so as not to exceed this amount. This benefit is administered and paid by Airgas in addition to the Short-term disability benefit paid through The Hartford.
Airgas pays
Long-term Disability Insurance
A fully-insured benefit provided by the company through The Hartford, the plan provides coverage in the event of disability, paying 50% of monthly earnings as defined by the plan minus disability income from other sources, to a maximum benefit of $2,500 per month for both non-work related and work-related illness and/or injury.
Airgas pays
Long-term Disability Buy-Up
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase enhanced coverage up to 60% of monthly earnings as defined by the plan minus disability income from other sources to a maximum benefit of $10,000 per month for both non-work related and work-related illness and/or injury.
Associate pays
2Airgas 2021 Benefits at a Glance
Platinum* Gold* Core* Silver* Bronze HSA**
RETAIL
Generic copay $9 $9 30% up to $50 per prescription
30% up to $50 per prescription You pay 20% with
no deductible for most preventive
medications; otherwise, you pay 20% after you meet
your deductible
Brand formulary copay $35 $35 30% up to $150 per prescription
30% up to $150 per prescription
Brand non-formulary copay $70 $70 30% up to $300 per prescription
30% up to $300 per prescription
Mail order(up to 90-day supply)
2x retail copay
2x retail copay
30% up to 2x retail maximum
30% up to 2x retail maximum
Rx Out-of-pocket maximum(individual/family) $2,100 / $4,200 $2,100 / $4,200 $2,100 / $4,200 $2,100 / $4,200
Applies to Bronze HSA Plan out-of-pocket maximum
Platinum Gold Core Silver Bronze HSA
Deductible*(individual/family) $500 / $1,000 $750 / $1,500 $1,000 / $2,000 $1,250 / $2,500 $1,500 / $3,000
Coinsurance %(after the deductible has been met)
You pay 10%Plan pays 90%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
Out-of-pocket maximum**(individual/family) $2,500 / $5,000 $3,000 / $6,000 $3,500 / $7,000 $4,000 / $8,000 $6,550 / $13,100
Preventive care (e.g., annual exam) 100% 100% 100% 100% 100%
PCP copay You pay $20 You pay $25 You pay $25 You pay $40
Covered at 80% after deductible
Specialist copay You pay $25 You pay $35 You pay $35 You pay $50
Hospital inpatient Plan pays 90% after deductible
Plan pays 80% after deductible
Plan pays 80% after deductible
Plan pays 80% after deductible
ER copay (waived if admitted) You pay $500 You pay $500 You pay $500 You pay $500
Walk-in clinic copay You pay $20 You pay $25 You pay $25 You pay $40
Urgent care copay You pay $25 You pay $35 You pay $35 You pay $50
WHO IS ELIGIBLE? All associates regularly scheduled to work 30 hours or more per week and certain dependents of covered associates.
WHEN DOES COVERAGE BEGIN? After you have worked 30 consecutive days with the Company.
* Deductibles do not apply to prescription drug benefits under the Platinum, Gold, Core and Silver Plans.** Prescription drug costs count toward the Deductible in the Bronze HSA Plan EXCEPT approved preventive and maintenance medications; these medications are not subject to the Deductible and are paid at the coinsurance rate.Notes: 1. Airgas prescription drug coverage is administered by CVS Caremark for those electing a BCBS plan. 2. Prior authorization requirements and coverage limits may apply to certain drugs.
* For the Platinum, Core, Silver, and Gold Plans, the family Deductible can be met by a combination of family members; however, no single individual within the family will be subject to more than the individual Deductible amount.** For the Platinum, Core, Silver, and Gold Plans, the family Out-of-Pocket Maximum can be met by a combination of family members; however no single individual within the family will be subject to more than the individual Out-of-Pocket Maximum. For the Bronze HSA Plan, the family Out-of-Pocket Maximum can be met by a combination of family members; however, no single individual within the family will be subject to more than the individual Out-of-Pocket Maximum. Note: There are no copays in the Bronze HSA Plan.
AIRGAS MEDICAL PLANSAirgas offers five medical plan options through Blue Cross Blue Shield (BCBS). You may enroll yourself and your eligible dependents. If you enroll in an Airgas medical plan, you will have access to the BlueCard® PPO provider network with more than 720,000 network doctors and 6,000 network hospitals. With the BCBS plan options:• Your paycheck contributions will vary with the amount of coverage that
you choose.• If you elect the Bronze HSA Plan, you have the option to open a Health
Savings Account (HSA) administered by Smart-Choice Accounts™. You contribute pre-tax dollars to the HSA, which can be used to pay for eligible healthcare costs (including your deductible and
coinsurance), or saved to pay for healthcare costs later, even into retirement.
A surcharge of $100/month will apply if a spouse or domestic partner has coverage available elsewhere, but elects Airgas coverage. When you enroll, the answer will be assumed to be “yes.” You must change it to “no” if it does not apply.Regional Health Maintenance Organizations (“HMOs”) or Preferred Provider Organizations (“PPOs”) may be available to you, based on your residency. You will be notified when enrolling if a regional HMO or PPO is available in your area.
Who Pays? Airgas and associates share the cost
PRESCRIPTION DRUGS (YOUR COST)
3Airgas 2021 Benefits at a Glance
AIRGAS DENTAL PLANSYou may enroll yourself and your eligible dependents in the Basic Plan or Premium Plan, or you may choose no dental coverage. The dental plan is available to you even if you choose medical coverage through an HMO/PPO or decline medical coverage altogether.
AIRGAS VISION PLANYou may enroll yourself and your eligible dependents in vision coverage through EyeMed vision care. You don’t have to be enrolled in an Airgas medical plan to receive vision coverage. You pay the full cost for vision care coverage for yourself and any dependents you choose to cover. What follows is a general description of the vision care plan.
* Deductible does not apply to preventive services. Note: If you go to an out-of-network dentist, you (or your dentist) must file a claim for reimbursement. Benefit payment percentages are based on reasonable charges.
Dental Coverage Basic Plan Premium Plan
Your Deductible(The amount you pay before the plan pays benefits)
$50/individual$150/family
$50/individual$150/family
Coinsurance(The amount the plan pays once the deductible is met)
• Preventive/Diagnostic Services* (exams, cleanings, bitewing X-rays, fluoride treatment)• Basic Services (fillings, extractions, root canals, oral surgery)• Major Services (crowns, bridgework, full and partial dentures)
100%50%50%
100%80%50%
Annual Maximum $2,500 $2,500
Orthodontia Not Covered50% to a $1,500
lifetime maximum per family member
Who Pays? Airgas and associates share the cost
Who Pays? Associate pays
Vision Service In-Network(What You Pay)
Out-of-Network(Your Reimbursement)
Exam (with dilation as necessary)Once every 12 months $10 copay $35
FramesOnce every 12 months
$0 copay; $150 allowance, 20% off balance over $150 $75
Standard Plastic Lenses• Single vision• Bifocal• Trifocal• Standard progressive• Premium progressive
Once every 12 months
$20 copay$20 copay$20 copay$20 copay
$20 copay and 80% of charge less $120 allowance
$25$40$55$55$55
Contact Lenses (in lieu of standard plastic lenses)• Conventional contacts• Disposable contacts• Medically necessary
Once every 12 months
$0 copay, $150 allowance,15% off balance over $150$0 copay, $150 allowance, plus balance over $150
$0 copay, paid in full
$120$120$200
Laser Vision CorrectionFind a LASIK location at eyemedlasik.com. 15% off retail price or 5% off promotional price N/A
4Airgas 2021 Benefits at a Glance
VOLUNTARY BENEFITSPlan Coverage Who Pays
Hospital Indemnity Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent are admitted or confined to a hospital. You have the choice of two comprehensive plans: the Low Plan and the High Plan.
Associate pays
Accident Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent experiences a covered accident. Benefits are paid based on the injury you experience and the medical services required.
Associate pays
Critical Illness Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent is diagnosed with a covered condition. You may elect $15,000, $30,000, or $45,000 of coverage.
Associate pays
LIFE INSURANCE AND AD&D BENEFITSPlan Coverage Who Pays
Basic Life Insurance
A fully-insured benefit provided by the company through The Hartford, the plan provides 1 times annual benefit base (annual base salary plus annualized prior year’s commissions) up to a maximum benefit of $50,000.
Airgas pays
Optional Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase additional coverage of 1-4 times annual benefit base with cost varying based on age. Evidence of insurability (EOI) is required if enrolling after initial offering (at time of hire or eligibility), or increasing more than one coverage level during any subsequent annual enrollment.
Associate pays
Spouse Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase coverage in amounts of $10,000, $25,000, $50,000, $75,000 and $100,000. Evidence of insurability (EOI) is required if initial election is greater than $50,000, or if increasing more than one coverage level during any subsequent annual enrollment.
Associate pays
Child Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase coverage in amounts of $5,000, $10,000, $15,000, $20,000 and $25,000 per child.
Associate pays
Basic AD&D A fully-insured benefit provided by the company through The Hartford, the plan pays benefits for accidental loss of life or loss of hand, foot or eye, speech or hearing. The plan provides 1 times annual benefit base (annual base salary plus annualized prior year’s commissions) up to a maximum benefit of $50,000.
Airgas pays
Optional AD&D A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase additional coverage of 1-4 times annual benefit base. Optional coverage for family is available in amounts based on your elected optional coverage amounts.
Associate pays
DISABILITY BENEFITSPlan Coverage Who Pays
Short-term Disability Insurance
A fully-insured benefit provided by the company through The Hartford and integrated with Long-term Disability. The plan pays a benefit of 50% of your weekly pay as defined by the plan (minimum: the greater of $300/week or 10% of the weekly benefit before deduction of other income benefits; $3,000/maximum per week) minus disability income from other sources including sick/banked sick time for up to 25 weeks. Coverage is provided for a maximum of up to the earlier of 25 weeks or when your disability ends.
Airgas pays
Short-term Disability Buy-Up
A fully-insured benefit provided through The Hartford, the plan is designed to supplement the Airgas-provided Short-term Disability benefit and allows employees to purchase additional Short-term Disability coverage, to a total of 60% of your weekly pay as defined by the plan ($3,000/maximum per week) minus disability income from other sources including sick/banked sick time for up to 25 weeks.
Associate pays
Maternity Benefit
Associates with a minimum of 1 year of service at the time of disability are eligible for an enhanced company-paid maternity benefit. The maternity benefit will pay an associate on maternity leave up to 50% of current salary for up to 6 weeks from the date of birth. The combination of the Short-term Disability benefit and the Airgas Maternity Benefit cannot exceed 100% of an associate's current weekly salary. If it exceeds 100%, the maternity benefit will be reduced so as not to exceed this amount. This benefit is administered and paid by Airgas in addition to the Short-term disability benefit paid through The Hartford.
Airgas pays
Long-term Disability Insurance
A fully-insured benefit provided by the company through The Hartford, the plan provides coverage in the event of disability, paying 50% of monthly earnings as defined by the plan minus disability income from other sources, to a maximum benefit of $2,500 per month for both non-work related and work-related illness and/or injury.
Airgas pays
Long-term Disability Buy-Up
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase enhanced coverage up to 60% of monthly earnings as defined by the plan minus disability income from other sources to a maximum benefit of $10,000 per month for both non-work related and work-related illness and/or injury.
Associate pays
2Airgas 2021 Benefits at a Glance
Platinum* Gold* Core* Silver* Bronze HSA**
RETAIL
Generic copay $9 $9 30% up to $50 per prescription
30% up to $50 per prescription You pay 20% with
no deductible for most preventive
medications; otherwise, you pay 20% after you meet
your deductible
Brand formulary copay $35 $35 30% up to $150 per prescription
30% up to $150 per prescription
Brand non-formulary copay $70 $70 30% up to $300 per prescription
30% up to $300 per prescription
Mail order(up to 90-day supply)
2x retail copay
2x retail copay
30% up to 2x retail maximum
30% up to 2x retail maximum
Rx Out-of-pocket maximum(individual/family) $2,100 / $4,200 $2,100 / $4,200 $2,100 / $4,200 $2,100 / $4,200
Applies to Bronze HSA Plan out-of-pocket maximum
Platinum Gold Core Silver Bronze HSA
Deductible*(individual/family) $500 / $1,000 $750 / $1,500 $1,000 / $2,000 $1,250 / $2,500 $1,500 / $3,000
Coinsurance %(after the deductible has been met)
You pay 10%Plan pays 90%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
You pay 20%Plan pays 80%
Out-of-pocket maximum**(individual/family) $2,500 / $5,000 $3,000 / $6,000 $3,500 / $7,000 $4,000 / $8,000 $6,550 / $13,100
Preventive care (e.g., annual exam) 100% 100% 100% 100% 100%
PCP copay You pay $20 You pay $25 You pay $25 You pay $40
Covered at 80% after deductible
Specialist copay You pay $25 You pay $35 You pay $35 You pay $50
Hospital inpatient Plan pays 90% after deductible
Plan pays 80% after deductible
Plan pays 80% after deductible
Plan pays 80% after deductible
ER copay (waived if admitted) You pay $500 You pay $500 You pay $500 You pay $500
Walk-in clinic copay You pay $20 You pay $25 You pay $25 You pay $40
Urgent care copay You pay $25 You pay $35 You pay $35 You pay $50
WHO IS ELIGIBLE? All associates regularly scheduled to work 30 hours or more per week and certain dependents of covered associates.
WHEN DOES COVERAGE BEGIN? After you have worked 30 consecutive days with the Company.
* Deductibles do not apply to prescription drug benefits under the Platinum, Gold, Core and Silver Plans.** Prescription drug costs count toward the Deductible in the Bronze HSA Plan EXCEPT approved preventive and maintenance medications; these medications are not subject to the Deductible and are paid at the coinsurance rate.Notes: 1. Airgas prescription drug coverage is administered by CVS Caremark for those electing a BCBS plan. 2. Prior authorization requirements and coverage limits may apply to certain drugs.
* For the Platinum, Core, Silver, and Gold Plans, the family Deductible can be met by a combination of family members; however, no single individual within the family will be subject to more than the individual Deductible amount.** For the Platinum, Core, Silver, and Gold Plans, the family Out-of-Pocket Maximum can be met by a combination of family members; however no single individual within the family will be subject to more than the individual Out-of-Pocket Maximum. For the Bronze HSA Plan, the family Out-of-Pocket Maximum can be met by a combination of family members; however, no single individual within the family will be subject to more than the individual Out-of-Pocket Maximum. Note: There are no copays in the Bronze HSA Plan.
AIRGAS MEDICAL PLANSAirgas offers five medical plan options through Blue Cross Blue Shield (BCBS). You may enroll yourself and your eligible dependents. If you enroll in an Airgas medical plan, you will have access to the BlueCard® PPO provider network with more than 720,000 network doctors and 6,000 network hospitals. With the BCBS plan options:• Your paycheck contributions will vary with the amount of coverage that
you choose.• If you elect the Bronze HSA Plan, you have the option to open a Health
Savings Account (HSA) administered by Smart-Choice Accounts™. You contribute pre-tax dollars to the HSA, which can be used to pay for eligible healthcare costs (including your deductible and
coinsurance), or saved to pay for healthcare costs later, even into retirement.
A surcharge of $100/month will apply if a spouse or domestic partner has coverage available elsewhere, but elects Airgas coverage. When you enroll, the answer will be assumed to be “yes.” You must change it to “no” if it does not apply.Regional Health Maintenance Organizations (“HMOs”) or Preferred Provider Organizations (“PPOs”) may be available to you, based on your residency. You will be notified when enrolling if a regional HMO or PPO is available in your area.
Who Pays? Airgas and associates share the cost
PRESCRIPTION DRUGS (YOUR COST)
3Airgas 2021 Benefits at a Glance
AIRGAS DENTAL PLANSYou may enroll yourself and your eligible dependents in the Basic Plan or Premium Plan, or you may choose no dental coverage. The dental plan is available to you even if you choose medical coverage through an HMO/PPO or decline medical coverage altogether.
AIRGAS VISION PLANYou may enroll yourself and your eligible dependents in vision coverage through EyeMed vision care. You don’t have to be enrolled in an Airgas medical plan to receive vision coverage. You pay the full cost for vision care coverage for yourself and any dependents you choose to cover. What follows is a general description of the vision care plan.
* Deductible does not apply to preventive services. Note: If you go to an out-of-network dentist, you (or your dentist) must file a claim for reimbursement. Benefit payment percentages are based on reasonable charges.
Dental Coverage Basic Plan Premium Plan
Your Deductible(The amount you pay before the plan pays benefits)
$50/individual$150/family
$50/individual$150/family
Coinsurance(The amount the plan pays once the deductible is met)
• Preventive/Diagnostic Services* (exams, cleanings, bitewing X-rays, fluoride treatment)• Basic Services (fillings, extractions, root canals, oral surgery)• Major Services (crowns, bridgework, full and partial dentures)
100%50%50%
100%80%50%
Annual Maximum $2,500 $2,500
Orthodontia Not Covered50% to a $1,500
lifetime maximum per family member
Who Pays? Airgas and associates share the cost
Who Pays? Associate pays
Vision Service In-Network(What You Pay)
Out-of-Network(Your Reimbursement)
Exam (with dilation as necessary)Once every 12 months $10 copay $35
FramesOnce every 12 months
$0 copay; $150 allowance, 20% off balance over $150 $75
Standard Plastic Lenses• Single vision• Bifocal• Trifocal• Standard progressive• Premium progressive
Once every 12 months
$20 copay$20 copay$20 copay$20 copay
$20 copay and 80% of charge less $120 allowance
$25$40$55$55$55
Contact Lenses (in lieu of standard plastic lenses)• Conventional contacts• Disposable contacts• Medically necessary
Once every 12 months
$0 copay, $150 allowance,15% off balance over $150$0 copay, $150 allowance, plus balance over $150
$0 copay, paid in full
$120$120$200
Laser Vision CorrectionFind a LASIK location at eyemedlasik.com. 15% off retail price or 5% off promotional price N/A
4Airgas 2021 Benefits at a Glance
VOLUNTARY BENEFITSPlan Coverage Who Pays
Hospital Indemnity Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent are admitted or confined to a hospital. You have the choice of two comprehensive plans: the Low Plan and the High Plan.
Associate pays
Accident Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent experiences a covered accident. Benefits are paid based on the injury you experience and the medical services required.
Associate pays
Critical Illness Insurance
This plan, offered through MetLife, provides a lump-sum benefit if you or a covered dependent is diagnosed with a covered condition. You may elect $15,000, $30,000, or $45,000 of coverage.
Associate pays
LIFE INSURANCE AND AD&D BENEFITSPlan Coverage Who Pays
Basic Life Insurance
A fully-insured benefit provided by the company through The Hartford, the plan provides 1 times annual benefit base (annual base salary plus annualized prior year’s commissions) up to a maximum benefit of $50,000.
Airgas pays
Optional Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase additional coverage of 1-4 times annual benefit base with cost varying based on age. Evidence of insurability (EOI) is required if enrolling after initial offering (at time of hire or eligibility), or increasing more than one coverage level during any subsequent annual enrollment.
Associate pays
Spouse Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase coverage in amounts of $10,000, $25,000, $50,000, $75,000 and $100,000. Evidence of insurability (EOI) is required if initial election is greater than $50,000, or if increasing more than one coverage level during any subsequent annual enrollment.
Associate pays
Child Life Insurance
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase coverage in amounts of $5,000, $10,000, $15,000, $20,000 and $25,000 per child.
Associate pays
Basic AD&D A fully-insured benefit provided by the company through The Hartford, the plan pays benefits for accidental loss of life or loss of hand, foot or eye, speech or hearing. The plan provides 1 times annual benefit base (annual base salary plus annualized prior year’s commissions) up to a maximum benefit of $50,000.
Airgas pays
Optional AD&D A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase additional coverage of 1-4 times annual benefit base. Optional coverage for family is available in amounts based on your elected optional coverage amounts.
Associate pays
DISABILITY BENEFITSPlan Coverage Who Pays
Short-term Disability Insurance
A fully-insured benefit provided by the company through The Hartford and integrated with Long-term Disability. The plan pays a benefit of 50% of your weekly pay as defined by the plan (minimum: the greater of $300/week or 10% of the weekly benefit before deduction of other income benefits; $3,000/maximum per week) minus disability income from other sources including sick/banked sick time for up to 25 weeks. Coverage is provided for a maximum of up to the earlier of 25 weeks or when your disability ends.
Airgas pays
Short-term Disability Buy-Up
A fully-insured benefit provided through The Hartford, the plan is designed to supplement the Airgas-provided Short-term Disability benefit and allows employees to purchase additional Short-term Disability coverage, to a total of 60% of your weekly pay as defined by the plan ($3,000/maximum per week) minus disability income from other sources including sick/banked sick time for up to 25 weeks.
Associate pays
Maternity Benefit
Associates with a minimum of 1 year of service at the time of disability are eligible for an enhanced company-paid maternity benefit. The maternity benefit will pay an associate on maternity leave up to 50% of current salary for up to 6 weeks from the date of birth. The combination of the Short-term Disability benefit and the Airgas Maternity Benefit cannot exceed 100% of an associate's current weekly salary. If it exceeds 100%, the maternity benefit will be reduced so as not to exceed this amount. This benefit is administered and paid by Airgas in addition to the Short-term disability benefit paid through The Hartford.
Airgas pays
Long-term Disability Insurance
A fully-insured benefit provided by the company through The Hartford, the plan provides coverage in the event of disability, paying 50% of monthly earnings as defined by the plan minus disability income from other sources, to a maximum benefit of $2,500 per month for both non-work related and work-related illness and/or injury.
Airgas pays
Long-term Disability Buy-Up
A fully-insured benefit provided through The Hartford, the plan provides associates the option to purchase enhanced coverage up to 60% of monthly earnings as defined by the plan minus disability income from other sources to a maximum benefit of $10,000 per month for both non-work related and work-related illness and/or injury.
Associate pays
1Airgas 2021 Benefits at a Glance
• Medical (including prescription drugs)• Dental• Vision• Health Savings Account option• Voluntary Benefits• Basic Life & AD&D Insurance• Optional Life & AD&D Insurance• Spouse and Dependent Life Insurance• Basic Short-term Disability with
Enhanced Maternity Benefit
• Short-term Disability Buy-Up• Basic Long-term Disability• Long-term Disability Buy-Up• Flexible Spending Accounts (Health
Care and Dependent Care Accounts)• Employee Assistance Program• Pre-Tax Commuter Transportation• 401(k) Retirement Plan• Other Benefits
you drive. you decide.
2021 BENEFITS AT A GLANCE AN OVERVIEW OF AIRGAS BENEFITS
5Airgas 2021 Benefits at a Glance
HEALTH-RELATED BENEFITSPlan Coverage Who Pays
Health Savings Account
Associates that enroll in the Bronze HSA Plan for their medical coverage have the option to open a tax-advantaged Health Savings Account. The HSA can be used to pay for current or future medical, dental and vision expenses, even into retirement. Annual pre-tax maximum contributions of $3,600 (individual) and $7,200 (family), per IRS regulations. If you will be age 55 or older by December 31, 2021, you can make catch-up contributions of an additional $1,000 per account holder per calendar year. Funds in the HSA roll over on an annual basis. Offers investment options for balances in excess of $1,000.
Associate funds the account with pre-tax payroll deductions
Flexible Spending Accounts
Annual pre-tax payroll deduction program for paying eligible unreimbursed medical, dental, hearing, vision and dependent care expenses. Annual pre-tax maximums of $2,750 for healthcare and $5,000 for dependent care. Unused funds are forfeited if not used for expenses incurred by the end of calendar year per IRS regulations. Associates save on both federal and state taxes on the amounts funded in these accounts.
Associate funds the account with pre -tax payroll deductions
Employee Assistance Work/Life Balance Program
Confidential service available 24 hours a day, 7 days a week, 365 days a year through LifeWorks to help associates and their immediate family members resolve personal issues and problems including but not limited to relationship, childcare, eldercare, legal, financial, stress, alcohol and drug abuse, anxiety or depression. Call 1-888-267-8126 to talk to someone or go online at login.lifeworks.com (username and password: airgas) for access to hundreds of articles, audio recordings, toolkits, and more.
Airgas pays
Teladoc Get non-emergency medical care from a board-certified doctor via phone or online video consultation, 24/7, 365 days a year. It is ideal for routine care and common illnesses and when you can’t get to your regular doctor. Under the Platinum, Gold, Core, and Silver plans, you pay a $10 copay per consultation; under the Bronze HSA Plan, you pay the full cost ($40) until you meet the deductible. Available to all associates and dependents covered by Blue Cross Blue Shield (except HMSA Hawaii). Note: Teladoc is a telemedicine service offered to BCBS members. Associates enrolled in non-BCBS medical plans may have other telemedicine options available; check with your provider for more information.
Airgas and associates share the cost
Livongo A diabetes management program offered at no cost to associates and their family members who have diabetes and are covered through an Airgas medical plan administered by BCBS. The program provides members with a connected blood glucose meter, online access to blood glucose readings, free unlimited test strips and lancets, and coaching by phone, text message, and mobile app.
Airgas pays
Sleepio A digital sleep improvement program to help users take control of their sleep and feel more energized throughout the day. Learn cognitive and behavioral techniques to sleep and feel better. Available to associates and dependents enrolled in an Airgas medical plan administered by BCBS.
Airgas pays
Daylight An app-based program to help users address worry and anxiety. Learn proven strategies to get negative thoughts out of your head, face difficult emotions and be more present for the good stuff. Available to associates and dependents enrolled in an Airgas medical plan administered by BCBS.
Airgas pays
RETIREMENT BENEFITSPlan Who is Eligible When Participation Begins Explanation Who Pays
401(k) Plan All associates Eligibility is immediate. Auto enrollment at 2% for new associates. Associates can change their contribution amount and investment options at any time. Associates begin receiving company match after one year of employment.
Tax deferred retirement savings plan with various investment options. Participants can contribute 1% - 75% of their base pay on a pre-tax or post-tax basis in a regular 401(k) or Roth 401(k) account through payroll deductions. Vesting is immediate. In-service withdrawals, plan loans and qualified rollover contributions are permitted. Annual withholding limit for 2021: $19,500. If you will be age 50 or older by December 31, 2021, you can make catch-up contributions of an additional $6,500 to your 401(k).
Airgas and Associate: Airgas will match 50% of the first 6% of associate contributions per pay after completing one year of employment.
OTHER BENEFITSPlan Who is Eligible When Participation Begins Explanation Who Pays
Pre-Tax Commuter Transportation
All associates except those covered by certain collective bargaining agreements.
After you have worked continuously for 30 days
Associate can elect pre-tax deductions that are placed in an account to use when purchasing transportation or parking passes (up to $270 per month, for each, as allowed by the IRS).
Associate funds the account with pre-tax payroll deductions
Automobile, Personal Property and Homeowner’s Insurance
Associates regularly scheduled to work 30 hours or more per week.
After 30 days of employment Access to automobile, homeowner’s and personal property insurance at group rates through MetLife, which may be lower than your current coverage depending on your state.
Associate pays (No payroll deductions will be taken for elected coverage - billing will be direct to you.)
6Airgas 2021 Benefits at a Glance
Educational Assistance
Available to full-time associates regularly scheduled to work 30 hours or more per week.
After six months of employment Up to 100% reimbursement for tuition, registration fees, books and supplies for satisfactory completion of job-related courses as approved by your HR Manager.
Airgas pays
Scholarship Program
Dependent, unmarried children, up to age 23. Eligible dependents must be enrolled in or planning to enroll in a full-time course of study at an accredited two or four year college, university, community college, or vocational technical school.
Applications must be postmarked by May 1. Winners are notified by June 15.
Up to 20 awards are granted each year. Awards range from $1,000 to $2,000 annually.
Airgas pays
2021 ASSOCIATE MONTHLY CONTRIBUTIONSThe tables below list your monthly payroll contributions for the Core medical plan, the two dental options and the vision plan. Each table lists the three salary bands and the cost for each benefit within each band. The medical pricing below is the incremental cost for each level: employee, spouse, and each child covered. If you cover dependent children, the cost is based on how many you cover. Contributions for other medical plans are available on the YBR enrollment website.Spousal Surcharge: A surcharge of $100/month will apply if your spouse or domestic partner has coverage available elsewhere, but you elect to cover him or her under your Airgas coverage. The surcharge, if applicable, is in addition to the rates shown here.If you cover only yourself and earn $67,000 or less, your cost for the Core Plan is $112.49 per month. If you choose to cover your spouse and two children, your total monthly cost to cover you and your family is $592.46 per month (contributions for dependent children are capped at three):
Employee ($112.49) + Spouse ($301.75) + 1st Child ($89.11) + 2nd Child ($89.11) = $592.46 per monthDepending on where you live, you may be able to choose between the BCBS plans or a fully-insured HMO or PPO plan. The alternative plan costs will be based on the HMO/PPO premium, your salary band, and if you choose to cover dependents. When you enroll, personalized pricing will be available for you. Please note, if you elect a carrier other than BCBS, your prescription drug coverage will be administered by the HMO or PPO you elect.
CORE MEDICAL PLAN – BLUE CROSS BLUE SHIELD WITH CVS CAREMARK PRESCRIPTION DRUG SERVICESUnitized Pricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $112.49 $140.74 $197.25
Spouse $301.75 $377.55 $529.16
Child (capped at 3) $89.11 $111.50 $156.27
AETNA DENTAL, BASIC OPTIONPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $8.44 $11.94 $22.12
Employee + Spouse $17.39 $24.59 $45.58
Employee + 1 Child* $14.99 $21.55 $38.92
Family + 1 Child* $23.94 $34.20 $62.38
AETNA DENTAL, PREMIUM OPTIONPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $18.36 $25.83 $28.95
Employee + Spouse $37.83 $53.20 $59.64
Employee + 1 Child* $33.31 $46.87 $63.95
Family + 1 Child* $52.78 $74.24 $98.59*Note: Additional costs associated with covering more than one dependent child. Detailed cost information is provided at the time of benefits enrollment.
EYEMED VISION CARE, ACCESS PLANPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $6.47 $6.47 $6.47
Employee + Spouse $11.93 $11.93 $11.93
Employee + Child(ren) $11.61 $11.61 $11.61
Family $16.11 $16.11 $16.11
1Airgas 2021 Benefits at a Glance
• Medical (including prescription drugs)• Dental• Vision• Health Savings Account option• Voluntary Benefits• Basic Life & AD&D Insurance• Optional Life & AD&D Insurance• Spouse and Dependent Life Insurance• Basic Short-term Disability with
Enhanced Maternity Benefit
• Short-term Disability Buy-Up• Basic Long-term Disability• Long-term Disability Buy-Up• Flexible Spending Accounts (Health
Care and Dependent Care Accounts)• Employee Assistance Program• Pre-Tax Commuter Transportation• 401(k) Retirement Plan• Other Benefits
you drive. you decide.
2021 BENEFITS AT A GLANCE AN OVERVIEW OF AIRGAS BENEFITS
5Airgas 2021 Benefits at a Glance
HEALTH-RELATED BENEFITSPlan Coverage Who Pays
Health Savings Account
Associates that enroll in the Bronze HSA Plan for their medical coverage have the option to open a tax-advantaged Health Savings Account. The HSA can be used to pay for current or future medical, dental and vision expenses, even into retirement. Annual pre-tax maximum contributions of $3,600 (individual) and $7,200 (family), per IRS regulations. If you will be age 55 or older by December 31, 2021, you can make catch-up contributions of an additional $1,000 per account holder per calendar year. Funds in the HSA roll over on an annual basis. Offers investment options for balances in excess of $1,000.
Associate funds the account with pre-tax payroll deductions
Flexible Spending Accounts
Annual pre-tax payroll deduction program for paying eligible unreimbursed medical, dental, hearing, vision and dependent care expenses. Annual pre-tax maximums of $2,750 for healthcare and $5,000 for dependent care. Unused funds are forfeited if not used for expenses incurred by the end of calendar year per IRS regulations. Associates save on both federal and state taxes on the amounts funded in these accounts.
Associate funds the account with pre -tax payroll deductions
Employee Assistance Work/Life Balance Program
Confidential service available 24 hours a day, 7 days a week, 365 days a year through LifeWorks to help associates and their immediate family members resolve personal issues and problems including but not limited to relationship, childcare, eldercare, legal, financial, stress, alcohol and drug abuse, anxiety or depression. Call 1-888-267-8126 to talk to someone or go online at login.lifeworks.com (username and password: airgas) for access to hundreds of articles, audio recordings, toolkits, and more.
Airgas pays
Teladoc Get non-emergency medical care from a board-certified doctor via phone or online video consultation, 24/7, 365 days a year. It is ideal for routine care and common illnesses and when you can’t get to your regular doctor. Under the Platinum, Gold, Core, and Silver plans, you pay a $10 copay per consultation; under the Bronze HSA Plan, you pay the full cost ($40) until you meet the deductible. Available to all associates and dependents covered by Blue Cross Blue Shield (except HMSA Hawaii). Note: Teladoc is a telemedicine service offered to BCBS members. Associates enrolled in non-BCBS medical plans may have other telemedicine options available; check with your provider for more information.
Airgas and associates share the cost
Livongo A diabetes management program offered at no cost to associates and their family members who have diabetes and are covered through an Airgas medical plan administered by BCBS. The program provides members with a connected blood glucose meter, online access to blood glucose readings, free unlimited test strips and lancets, and coaching by phone, text message, and mobile app.
Airgas pays
Sleepio A digital sleep improvement program to help users take control of their sleep and feel more energized throughout the day. Learn cognitive and behavioral techniques to sleep and feel better. Available to associates and dependents enrolled in an Airgas medical plan administered by BCBS.
Airgas pays
Daylight An app-based program to help users address worry and anxiety. Learn proven strategies to get negative thoughts out of your head, face difficult emotions and be more present for the good stuff. Available to associates and dependents enrolled in an Airgas medical plan administered by BCBS.
Airgas pays
RETIREMENT BENEFITSPlan Who is Eligible When Participation Begins Explanation Who Pays
401(k) Plan All associates Eligibility is immediate. Auto enrollment at 2% for new associates. Associates can change their contribution amount and investment options at any time. Associates begin receiving company match after one year of employment.
Tax deferred retirement savings plan with various investment options. Participants can contribute 1% - 75% of their base pay on a pre-tax or post-tax basis in a regular 401(k) or Roth 401(k) account through payroll deductions. Vesting is immediate. In-service withdrawals, plan loans and qualified rollover contributions are permitted. Annual withholding limit for 2021: $19,500. If you will be age 50 or older by December 31, 2021, you can make catch-up contributions of an additional $6,500 to your 401(k).
Airgas and Associate: Airgas will match 50% of the first 6% of associate contributions per pay after completing one year of employment.
OTHER BENEFITSPlan Who is Eligible When Participation Begins Explanation Who Pays
Pre-Tax Commuter Transportation
All associates except those covered by certain collective bargaining agreements.
After you have worked continuously for 30 days
Associate can elect pre-tax deductions that are placed in an account to use when purchasing transportation or parking passes (up to $270 per month, for each, as allowed by the IRS).
Associate funds the account with pre-tax payroll deductions
Automobile, Personal Property and Homeowner’s Insurance
Associates regularly scheduled to work 30 hours or more per week.
After 30 days of employment Access to automobile, homeowner’s and personal property insurance at group rates through MetLife, which may be lower than your current coverage depending on your state.
Associate pays (No payroll deductions will be taken for elected coverage - billing will be direct to you.)
6Airgas 2021 Benefits at a Glance
Educational Assistance
Available to full-time associates regularly scheduled to work 30 hours or more per week.
After six months of employment Up to 100% reimbursement for tuition, registration fees, books and supplies for satisfactory completion of job-related courses as approved by your HR Manager.
Airgas pays
Scholarship Program
Dependent, unmarried children, up to age 23. Eligible dependents must be enrolled in or planning to enroll in a full-time course of study at an accredited two or four year college, university, community college, or vocational technical school.
Applications must be postmarked by May 1. Winners are notified by June 15.
Up to 20 awards are granted each year. Awards range from $1,000 to $2,000 annually.
Airgas pays
2021 ASSOCIATE MONTHLY CONTRIBUTIONSThe tables below list your monthly payroll contributions for the Core medical plan, the two dental options and the vision plan. Each table lists the three salary bands and the cost for each benefit within each band. The medical pricing below is the incremental cost for each level: employee, spouse, and each child covered. If you cover dependent children, the cost is based on how many you cover. Contributions for other medical plans are available on the YBR enrollment website.Spousal Surcharge: A surcharge of $100/month will apply if your spouse or domestic partner has coverage available elsewhere, but you elect to cover him or her under your Airgas coverage. The surcharge, if applicable, is in addition to the rates shown here.If you cover only yourself and earn $67,000 or less, your cost for the Core Plan is $112.49 per month. If you choose to cover your spouse and two children, your total monthly cost to cover you and your family is $592.46 per month (contributions for dependent children are capped at three):
Employee ($112.49) + Spouse ($301.75) + 1st Child ($89.11) + 2nd Child ($89.11) = $592.46 per monthDepending on where you live, you may be able to choose between the BCBS plans or a fully-insured HMO or PPO plan. The alternative plan costs will be based on the HMO/PPO premium, your salary band, and if you choose to cover dependents. When you enroll, personalized pricing will be available for you. Please note, if you elect a carrier other than BCBS, your prescription drug coverage will be administered by the HMO or PPO you elect.
CORE MEDICAL PLAN – BLUE CROSS BLUE SHIELD WITH CVS CAREMARK PRESCRIPTION DRUG SERVICESUnitized Pricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $112.49 $140.74 $197.25
Spouse $301.75 $377.55 $529.16
Child (capped at 3) $89.11 $111.50 $156.27
AETNA DENTAL, BASIC OPTIONPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $8.44 $11.94 $22.12
Employee + Spouse $17.39 $24.59 $45.58
Employee + 1 Child* $14.99 $21.55 $38.92
Family + 1 Child* $23.94 $34.20 $62.38
AETNA DENTAL, PREMIUM OPTIONPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $18.36 $25.83 $28.95
Employee + Spouse $37.83 $53.20 $59.64
Employee + 1 Child* $33.31 $46.87 $63.95
Family + 1 Child* $52.78 $74.24 $98.59*Note: Additional costs associated with covering more than one dependent child. Detailed cost information is provided at the time of benefits enrollment.
EYEMED VISION CARE, ACCESS PLANPricing Tier $67,000 and Less $67,000.01 to $115,000 Above $115,000
Employee $6.47 $6.47 $6.47
Employee + Spouse $11.93 $11.93 $11.93
Employee + Child(ren) $11.61 $11.61 $11.61
Family $16.11 $16.11 $16.11