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Solicitation No: 21-R14 Solicitation: Dental Insurance Services 1 ADDENDUM NUMBER ONE (1) MARCH 4, 2021 PLEASE NOTE THE FOLLOWING: 1. All times listed in RFP 21-R14 are Eastern Daylight Time (EDT). 2. Updated census Excel file has been released with this addendum and is available at https://www.golynx.com/corporate-info/doing-business/procurement/dental-insurance-services.stml in the attachments section 3. Updated census is attached at the end of this addendum. ANSWERS TO QUESTIONS: 1. Question: Page 5 of the RFP states the following: However, we cannot locate an Exhibit L that requires a signature or a form labeled Proposal Form. Please advise what this section is truly referencing. ANSWER: Exhibit L represents the current agreement with SAFEGUARD HEALTH PLANS, INC., a MetLife Company and LYNX. Note that Exhibit L does not require a signature to be returned with your proposal. 2. Question: If we do not have a DHMO network, would you be willing to consider a 3-Tier PPO plan? ANSWER: Per the Proposal Requirements listed in the RFP, LYNX is requesting one DHMO and two PPO plans. 3. Question: The RFP shows the out of network allowance is U&C 90 th for the High plan however the booklet shows its U&C 80 th . Can you confirm which is correct? ANSWER: The out of network allowance on the High plan is 90 th U&C. 4. Question: My underwriting is looking for Gender and Zip Code as essential. Can you provide a census with those fields added? ANSWER: Please see attachment to this addendum. 5. Question: We have a comparably priced product that is not a DHMO, rather a MAC plan with a very large network at competitive cost to the DHMO. Can we submit the low-cost MAC plan as an alternative to the DHMO and still be considered? ANSWER: Please see answer #2
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ADDENDUM NUMBER ONE (1) MARCH 4, 2021

Apr 16, 2022

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Page 1: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

Solicitation No: 21-R14 Solicitation: Dental Insurance Services

1

ADDENDUM NUMBER ONE (1) MARCH 4, 2021

PLEASE NOTE THE FOLLOWING:

1. All times listed in RFP 21-R14 are Eastern Daylight Time (EDT).

2. Updated census Excel file has been released with this addendum and is available at https://www.golynx.com/corporate-info/doing-business/procurement/dental-insurance-services.stml in the attachments section

3. Updated census is attached at the end of this addendum.

ANSWERS TO QUESTIONS:

1. Question: Page 5 of the RFP states the following: However, we cannot locate an Exhibit L that requires a signature or a form labeled Proposal Form. Please advise what this section is truly referencing. ANSWER: Exhibit L represents the current agreement with SAFEGUARD HEALTH PLANS, INC., a MetLife Company and LYNX. Note that Exhibit L does not require a signature to be returned with your proposal.

2. Question: If we do not have a DHMO network, would you be willing to consider a 3-Tier PPO plan? ANSWER: Per the Proposal Requirements listed in the RFP, LYNX is requesting one DHMO and two PPO plans.

3. Question: The RFP shows the out of network allowance is U&C 90th for the High plan however the booklet shows its U&C 80th. Can you confirm which is correct? ANSWER: The out of network allowance on the High plan is 90th U&C.

4. Question: My underwriting is looking for Gender and Zip Code as essential. Can you provide a census with those fields added?

ANSWER: Please see attachment to this addendum.

5. Question: We have a comparably priced product that is not a DHMO, rather a MAC plan with a

very large network at competitive cost to the DHMO. Can we submit the low-cost MAC plan as an alternative to the DHMO and still be considered? ANSWER: Please see answer #2

Page 2: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

Solicitation No: 21-R14 Solicitation: Dental Insurance Services

2

6. Question: The Non-Collusion Affidavit does not have a signature line would the top portion where the Vice President indicates his name would be the applicable signature?

ANSWER: Correct.

7. Question: Please provide Exhibit K, Exhibit Q and all exhibits in separate document format ANSWER: Exhibit’s J, K, Q, and R are listed on the LYNX webpage along with the RFP solicitation which incorporates the remaining exhibits. (https://www.golynx.com/corporate-info/doing-business/procurement/dental-insurance-services.stml)

8. Question: Exhibit M is a sample contract. Please confirm if the sample contract should be referenced in this request below or if another document should be list. ANSWER: Exhibit M is, the standard sample contract which LYNX uses. No further references or submission of Exhibit M are required.

9. Question: Please provide zip codes for each employee listed on the census file. ANSWER: Please see answer #4.

10. Question: There is currently not a space for a signature in Exhibit N – Non-Collusion Affidavit. Is a signature and/or notary required? ANSWER: Exhibit N, Non-Collusion Affidavit does not have a signature line. The form must be filled out and the name/title serves as signature. A notary is not required.

11. Question: Please provide detailed plan benefit summaries or plan certs. ANSWER: This information can be found on page 172 in the RFP document.

12. Question: Regarding mandatory qualifications section, page 8 says “The Proposer has provided evidence of a minimum A or above financial strength rating by A.M. Best agency, and is in a financial size category of Class VII or higher. Ratings of A- are not sufficient.” Please indicate if LYNX will accept a proposal from dental carries that have financial rating of A- or better? ANSWER: Confirmed. LYNX will accept an A- rating.

Page 3: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

Solicitation No: 21-R14 Solicitation: Dental Insurance Services

3

13. Question: Can you let me know what the Total number of Employees who are Eligible for the

Dental?

ANSWER: Approximately 1100 benefit eligible employees.

14. Question: Claims data furnished has 940 enrolled lives between the 3 plans, while the submitted

census only show 609 employees enrolled. Have you truly lost 1/3 of the employees covered in last 3 months?

ANSWER: LYNX has not had a significant employee count. Please see answer #4.

15. Question: Any particular reason you are shopping these coverages at this time? ANSWER: The contract term with the incumbent has been exhausted.

Page 4: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

Solicitation No: 21-R14 Solicitation: Dental Insurance Services

4

ATTACHMENTS

Page 5: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

Employee Number Pay Group Ben Plan Description Ben Plan Option Description

0997 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

1499 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

1610 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

1716 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

1804 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

1846 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

2027 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

2442 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

2625 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

2676 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

2722 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

3179 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

3465 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

3604 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

3614 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

3748 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

3868 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

3888 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

3909 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

4125 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

4140 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

4182 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

4194 Admin Dental DHMO Employee & 1 Dependent-Dental DHMO

5153 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

5267 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

5393 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

5816 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

5918 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

5952 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

6029 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

6134 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

6145 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

6162 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

6199 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

6337 Union Dental DHMO Employee & 1 Dependent-Dental DHMO

0571 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

0762 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

0788 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1060 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1187 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1195 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1298 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1300 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1303 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1360 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1444 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1491 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1496 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

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Page 6: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

1564 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1583 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1586 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1654 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1658 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1731 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1734 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1744 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1788 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1811 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1858 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1895 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1947 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2055 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2378 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2381 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2416 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2421 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2427 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2457 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2526 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2546 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2629 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2662 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2680 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

2732 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

3228 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

3418 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

3665 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

3759 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

3763 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

3830 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

3872 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

3914 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

3979 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4092 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4130 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4131 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4157 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4209 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4219 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4244 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4250 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

4252 Admin Dental High PPO Employee & 1 Dependent-Dental High PPO

5022 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5029 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5094 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5163 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5166 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5179 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5194 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

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Page 7: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5236 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5339 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5403 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5540 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5576 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5642 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5668 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5713 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5727 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5821 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5828 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5832 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

5894 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6046 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6122 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6222 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6243 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6281 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6281 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6306 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6307 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6313 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6332 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

6345 Union Dental High PPO Employee & 1 Dependent-Dental High PPO

1022 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1097 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1249 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1273 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1557 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1593 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1608 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1696 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1732 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1749 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1822 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

1974 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2123 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2239 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2265 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2297 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2428 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2545 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2587 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2689 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2713 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

2717 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3180 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3293 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3449 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3726 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3849 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 3 - 54

Page 8: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

3851 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3860 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3871 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3891 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3987 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

3992 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

4004 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

4052 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

4062 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

4197 Admin Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5157 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5176 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5210 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5242 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5699 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5716 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5752 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5847 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5962 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

5981 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

6074 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

6140 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

6239 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

6266 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

6329 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

6359 Union Dental Low PPO Employee & 1 Dependent-Dental Low PPO

0735 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

0735 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

0938 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

0938 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1145 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1145 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1350 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1350 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1350 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1474 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1474 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1474 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1474 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1502 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1502 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1592 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1592 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1592 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1868 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

1868 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2150 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2150 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2150 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2355 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2355 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

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Page 9: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

2359 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2359 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2455 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2455 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2527 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2527 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2585 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2585 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2585 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2688 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2707 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

2707 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

3342 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3342 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3342 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3398 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3398 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3706 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3706 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3746 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3746 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3746 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3746 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3820 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3820 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3820 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3824 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3824 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3824 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3867 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3867 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3867 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3892 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3892 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3940 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3940 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3940 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3983 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

3983 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

4043 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

4043 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

4086 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

4086 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

4086 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

4086 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

4086 Admin Dental DHMO Employee & 2+ Dependents-Dental DHMO

5025 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5025 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5065 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5065 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5065 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

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Page 10: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5130 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5130 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5130 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5145 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5145 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5200 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5200 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5200 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5200 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5338 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5338 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5338 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5338 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5338 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5383 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5383 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5383 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5383 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5508 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5508 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5530 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5530 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5530 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5578 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5578 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5578 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5681 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5681 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5782 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5782 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5782 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5782 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5813 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5813 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5813 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5969 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5969 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5969 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5969 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

5969 Union Dental DHMO Employee & 2+ Dependents-Dental DHMO

0845 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

0845 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

0845 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

0861 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

0861 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1071 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1071 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 6 - 54

Page 11: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

1071 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1071 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1075 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1075 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1165 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1165 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1165 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1367 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1367 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1367 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1367 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1367 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1703 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1703 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1703 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1703 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

1780 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2207 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2207 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2207 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2207 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2388 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2388 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2404 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2404 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2404 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2409 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2409 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2409 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2417 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2417 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2417 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2622 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2622 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 7 - 54

Page 12: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

2622 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2639 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2639 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2639 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2647 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2647 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2647 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2647 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2661 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2661 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2661 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2715 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2715 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2715 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2715 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

2715 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

3461 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3461 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3598 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3598 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3810 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3810 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3825 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3825 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3825 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3827 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3827 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3862 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3862 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3862 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3862 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3862 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3862 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3862 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 8 - 54

Page 13: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

3889 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3889 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

3889 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4012 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4012 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4044 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4044 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4044 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4044 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4045 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4045 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4045 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4046 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4046 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4046 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4046 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4066 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4066 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4066 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4177 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4177 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4202 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4202 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

4246 Admin Dental High PPO Employee & 2+ Dependents-Dental High PPO

5038 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5038 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5038 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5049 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5049 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5049 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5139 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5139 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5203 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5203 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 9 - 54

Page 14: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5261 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5261 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5261 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5401 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5401 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5401 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5401 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5405 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5405 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5489 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5489 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5489 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5489 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5489 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5489 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5504 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5504 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5504 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5504 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5566 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5566 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5582 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5582 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5685 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5685 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5690 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5690 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5764 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5764 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5764 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5812 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5812 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5908 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

5908 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 10 - 54

Page 15: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5908 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6006 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6006 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6006 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6006 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6006 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6224 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6224 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6224 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6289 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6289 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6289 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6327 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6327 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6327 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6331 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6331 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

6331 Union Dental High PPO Employee & 2+ Dependents-Dental High PPO

0737 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

0737 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

0737 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

0737 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

0769 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

0769 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

0769 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1065 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1065 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1132 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1132 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1132 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1132 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1136 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1136 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1450 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 11 - 54

Page 16: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

1450 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1594 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1594 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1594 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1870 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1870 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1870 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1961 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1961 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

1961 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2057 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2057 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2057 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2149 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2149 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2149 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2149 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2195 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2195 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2254 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2254 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2254 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2254 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2344 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2344 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2344 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2403 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2403 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2403 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2403 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2549 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2549 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2590 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

2590 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 12 - 54

Page 17: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

2590 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3127 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3127 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3310 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3310 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3310 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3375 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3375 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3525 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3525 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3525 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3693 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3693 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3693 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3712 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3712 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3712 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3732 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3732 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3877 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3877 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3882 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3882 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3893 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3893 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3938 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3938 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4080 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4080 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4116 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4116 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4116 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4116 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4124 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 13 - 54

Page 18: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

4124 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4124 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4124 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4124 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4124 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4248 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4248 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

4248 Admin Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5257 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5257 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5257 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5257 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5257 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5346 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5346 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5346 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5357 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5357 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5357 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5441 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5441 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5441 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5446 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5446 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5499 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5499 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5499 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5500 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5500 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5649 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5649 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5649 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5649 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5703 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 14 - 54

Page 19: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5703 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5703 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5722 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5722 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5722 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5744 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5744 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5744 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5751 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5751 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

5751 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

6157 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

6157 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

6157 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

6182 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

6182 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

6288 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

6288 Union Dental Low PPO Employee & 2+ Dependents-Dental Low PPO

0742 Union Dental DHMO Employee Only-Dental DHMO

0937 Union Dental DHMO Employee Only-Dental DHMO

1061 Union Dental DHMO Employee Only-Dental DHMO

1183 Union Dental DHMO Employee Only-Dental DHMO

1555 Union Dental DHMO Employee Only-Dental DHMO

1604 Union Dental DHMO Employee Only-Dental DHMO

1643 Union Dental DHMO Employee Only-Dental DHMO

1668 Union Dental DHMO Employee Only-Dental DHMO

1681 Union Dental DHMO Employee Only-Dental DHMO

1754 Union Dental DHMO Employee Only-Dental DHMO

1792 Union Dental DHMO Employee Only-Dental DHMO

1799 Union Dental DHMO Employee Only-Dental DHMO

1802 Union Dental DHMO Employee Only-Dental DHMO

1942 Union Dental DHMO Employee Only-Dental DHMO

1976 Union Dental DHMO Employee Only-Dental DHMO

1981 Union Dental DHMO Employee Only-Dental DHMO

1989 Union Dental DHMO Employee Only-Dental DHMO

2119 Union Dental DHMO Employee Only-Dental DHMO

2184 Union Dental DHMO Employee Only-Dental DHMO

2317 Union Dental DHMO Employee Only-Dental DHMO

2516 Union Dental DHMO Employee Only-Dental DHMO

2548 Union Dental DHMO Employee Only-Dental DHMO

2583 Union Dental DHMO Employee Only-Dental DHMO

2592 Union Dental DHMO Employee Only-Dental DHMO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 15 - 54

Page 20: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

2611 Union Dental DHMO Employee Only-Dental DHMO

2616 Union Dental DHMO Employee Only-Dental DHMO

2627 Union Dental DHMO Employee Only-Dental DHMO

2657 Union Dental DHMO Employee Only-Dental DHMO

2671 Union Dental DHMO Employee Only-Dental DHMO

2672 Union Dental DHMO Employee Only-Dental DHMO

2675 Union Dental DHMO Employee Only-Dental DHMO

2677 Union Dental DHMO Employee Only-Dental DHMO

2681 Union Dental DHMO Employee Only-Dental DHMO

2724 Union Dental DHMO Employee Only-Dental DHMO

2737 Union Dental DHMO Employee Only-Dental DHMO

3599 Admin Dental DHMO Employee Only-Dental DHMO

3708 Admin Dental DHMO Employee Only-Dental DHMO

3885 Admin Dental DHMO Employee Only-Dental DHMO

3935 Admin Dental DHMO Employee Only-Dental DHMO

3952 Admin Dental DHMO Employee Only-Dental DHMO

3962 Admin Dental DHMO Employee Only-Dental DHMO

3994 Admin Dental DHMO Employee Only-Dental DHMO

4025 Admin Dental DHMO Employee Only-Dental DHMO

4031 Admin Dental DHMO Employee Only-Dental DHMO

4037 Admin Dental DHMO Employee Only-Dental DHMO

4040 Admin Dental DHMO Employee Only-Dental DHMO

4055 Admin Dental DHMO Employee Only-Dental DHMO

4060 Admin Dental DHMO Employee Only-Dental DHMO

4073 Admin Dental DHMO Employee Only-Dental DHMO

4102 Admin Dental DHMO Employee Only-Dental DHMO

4105 Admin Dental DHMO Employee Only-Dental DHMO

4127 Admin Dental DHMO Employee Only-Dental DHMO

4147 Admin Dental DHMO Employee Only-Dental DHMO

4147 Admin Dental DHMO Employee Only-Dental DHMO

4158 Admin Dental DHMO Employee Only-Dental DHMO

4159 Admin Dental DHMO Employee Only-Dental DHMO

4172 Admin Dental DHMO Employee Only-Dental DHMO

4180 Admin Dental DHMO Employee Only-Dental DHMO

4185 Admin Dental DHMO Employee Only-Dental DHMO

4186 Admin Dental DHMO Employee Only-Dental DHMO

4200 Admin Dental DHMO Employee Only-Dental DHMO

4211 Admin Dental DHMO Employee Only-Dental DHMO

4212 Admin Dental DHMO Employee Only-Dental DHMO

4220 Admin Dental DHMO Employee Only-Dental DHMO

4229 Admin Dental DHMO Employee Only-Dental DHMO

5006 Union Dental DHMO Employee Only-Dental DHMO

5089 Union Dental DHMO Employee Only-Dental DHMO

5148 Union Dental DHMO Employee Only-Dental DHMO

5165 Union Dental DHMO Employee Only-Dental DHMO

5237 Union Dental DHMO Employee Only-Dental DHMO

5312 Union Dental DHMO Employee Only-Dental DHMO

5345 Union Dental DHMO Employee Only-Dental DHMO

5351 Union Dental DHMO Employee Only-Dental DHMO

5368 Union Dental DHMO Employee Only-Dental DHMO

5396 Union Dental DHMO Employee Only-Dental DHMO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 16 - 54

Page 21: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5396 Union Dental DHMO Employee Only-Dental DHMO

5402 Union Dental DHMO Employee Only-Dental DHMO

5413 Union Dental DHMO Employee Only-Dental DHMO

5419 Union Dental DHMO Employee Only-Dental DHMO

5438 Union Dental DHMO Employee Only-Dental DHMO

5440 Union Dental DHMO Employee Only-Dental DHMO

5478 Union Dental DHMO Employee Only-Dental DHMO

5486 Union Dental DHMO Employee Only-Dental DHMO

5506 Union Dental DHMO Employee Only-Dental DHMO

5524 Union Dental DHMO Employee Only-Dental DHMO

5560 Union Dental DHMO Employee Only-Dental DHMO

5696 Union Dental DHMO Employee Only-Dental DHMO

5790 Union Dental DHMO Employee Only-Dental DHMO

5791 Union Dental DHMO Employee Only-Dental DHMO

5800 Union Dental DHMO Employee Only-Dental DHMO

5867 Union Dental DHMO Employee Only-Dental DHMO

5892 Union Dental DHMO Employee Only-Dental DHMO

5931 Union Dental DHMO Employee Only-Dental DHMO

5932 Union Dental DHMO Employee Only-Dental DHMO

5933 Union Dental DHMO Employee Only-Dental DHMO

5963 Union Dental DHMO Employee Only-Dental DHMO

6007 Union Dental DHMO Employee Only-Dental DHMO

6092 Union Dental DHMO Employee Only-Dental DHMO

6094 Union Dental DHMO Employee Only-Dental DHMO

6111 Union Dental DHMO Employee Only-Dental DHMO

6137 Union Dental DHMO Employee Only-Dental DHMO

6138 Union Dental DHMO Employee Only-Dental DHMO

6142 Union Dental DHMO Employee Only-Dental DHMO

6150 Union Dental DHMO Employee Only-Dental DHMO

6152 Union Dental DHMO Employee Only-Dental DHMO

6166 Union Dental DHMO Employee Only-Dental DHMO

6207 Union Dental DHMO Employee Only-Dental DHMO

6244 Union Dental DHMO Employee Only-Dental DHMO

6261 Union Dental DHMO Employee Only-Dental DHMO

6302 Union Dental DHMO Employee Only-Dental DHMO

6320 Union Dental DHMO Employee Only-Dental DHMO

6325 Union Dental DHMO Employee Only-Dental DHMO

6339 Union Dental DHMO Employee Only-Dental DHMO

6342 Union Dental DHMO Employee Only-Dental DHMO

6346 Union Dental DHMO Employee Only-Dental DHMO

0747 Union Dental High PPO Employee Only-Dental High PPO

0750 Union Dental High PPO Employee Only-Dental High PPO

0832 Union Dental High PPO Employee Only-Dental High PPO

0863 Union Dental High PPO Employee Only-Dental High PPO

0875 Union Dental High PPO Employee Only-Dental High PPO

0924 Union Dental High PPO Employee Only-Dental High PPO

0982 Union Dental High PPO Employee Only-Dental High PPO

0993 Union Dental High PPO Employee Only-Dental High PPO

1113 Union Dental High PPO Employee Only-Dental High PPO

1127 Union Dental High PPO Employee Only-Dental High PPO

1131 Union Dental High PPO Employee Only-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 17 - 54

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1138 Union Dental High PPO Employee Only-Dental High PPO

1200 Union Dental High PPO Employee Only-Dental High PPO

1254 Union Dental High PPO Employee Only-Dental High PPO

1278 Union Dental High PPO Employee Only-Dental High PPO

1282 Union Dental High PPO Employee Only-Dental High PPO

1285 Union Dental High PPO Employee Only-Dental High PPO

1373 Union Dental High PPO Employee Only-Dental High PPO

1406 Union Dental High PPO Employee Only-Dental High PPO

1436 Union Dental High PPO Employee Only-Dental High PPO

1464 Union Dental High PPO Employee Only-Dental High PPO

1469 Union Dental High PPO Employee Only-Dental High PPO

1500 Union Dental High PPO Employee Only-Dental High PPO

1514 Union Dental High PPO Employee Only-Dental High PPO

1525 Union Dental High PPO Employee Only-Dental High PPO

1611 Union Dental High PPO Employee Only-Dental High PPO

1612 Union Dental High PPO Employee Only-Dental High PPO

1622 Union Dental High PPO Employee Only-Dental High PPO

1631 Union Dental High PPO Employee Only-Dental High PPO

1636 Union Dental High PPO Employee Only-Dental High PPO

1653 Union Dental High PPO Employee Only-Dental High PPO

1660 Union Dental High PPO Employee Only-Dental High PPO

1684 Union Dental High PPO Employee Only-Dental High PPO

1705 Union Dental High PPO Employee Only-Dental High PPO

1765 Union Dental High PPO Employee Only-Dental High PPO

1781 Union Dental High PPO Employee Only-Dental High PPO

1809 Union Dental High PPO Employee Only-Dental High PPO

1825 Union Dental High PPO Employee Only-Dental High PPO

1869 Union Dental High PPO Employee Only-Dental High PPO

1879 Union Dental High PPO Employee Only-Dental High PPO

1880 Union Dental High PPO Employee Only-Dental High PPO

1890 Union Dental High PPO Employee Only-Dental High PPO

1892 Union Dental High PPO Employee Only-Dental High PPO

1929 Union Dental High PPO Employee Only-Dental High PPO

1931 Union Dental High PPO Employee Only-Dental High PPO

1949 Union Dental High PPO Employee Only-Dental High PPO

1952 Union Dental High PPO Employee Only-Dental High PPO

1956 Union Dental High PPO Employee Only-Dental High PPO

1975 Union Dental High PPO Employee Only-Dental High PPO

1980 Union Dental High PPO Employee Only-Dental High PPO

1984 Union Dental High PPO Employee Only-Dental High PPO

1986 Union Dental High PPO Employee Only-Dental High PPO

1994 Union Dental High PPO Employee Only-Dental High PPO

2099 Union Dental High PPO Employee Only-Dental High PPO

2186 Union Dental High PPO Employee Only-Dental High PPO

2194 Union Dental High PPO Employee Only-Dental High PPO

2288 Union Dental High PPO Employee Only-Dental High PPO

2374 Union Dental High PPO Employee Only-Dental High PPO

2380 Union Dental High PPO Employee Only-Dental High PPO

2392 Union Dental High PPO Employee Only-Dental High PPO

2396 Union Dental High PPO Employee Only-Dental High PPO

2465 Union Dental High PPO Employee Only-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 18 - 54

Page 23: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

2474 Union Dental High PPO Employee Only-Dental High PPO

2502 Union Dental High PPO Employee Only-Dental High PPO

2511 Union Dental High PPO Employee Only-Dental High PPO

2521 Union Dental High PPO Employee Only-Dental High PPO

2524 Union Dental High PPO Employee Only-Dental High PPO

2540 Union Dental High PPO Employee Only-Dental High PPO

2569 Union Dental High PPO Employee Only-Dental High PPO

2580 Union Dental High PPO Employee Only-Dental High PPO

2586 Union Dental High PPO Employee Only-Dental High PPO

2596 Union Dental High PPO Employee Only-Dental High PPO

2600 Union Dental High PPO Employee Only-Dental High PPO

2603 Union Dental High PPO Employee Only-Dental High PPO

2621 Union Dental High PPO Employee Only-Dental High PPO

2624 Union Dental High PPO Employee Only-Dental High PPO

2628 Union Dental High PPO Employee Only-Dental High PPO

2637 Union Dental High PPO Employee Only-Dental High PPO

2642 Union Dental High PPO Employee Only-Dental High PPO

2655 Union Dental High PPO Employee Only-Dental High PPO

2663 Union Dental High PPO Employee Only-Dental High PPO

2664 Union Dental High PPO Employee Only-Dental High PPO

2665 Union Dental High PPO Employee Only-Dental High PPO

2667 Union Dental High PPO Employee Only-Dental High PPO

2673 Union Dental High PPO Employee Only-Dental High PPO

2684 Union Dental High PPO Employee Only-Dental High PPO

2690 Union Dental High PPO Employee Only-Dental High PPO

2695 Union Dental High PPO Employee Only-Dental High PPO

2696 Union Dental High PPO Employee Only-Dental High PPO

2698 Union Dental High PPO Employee Only-Dental High PPO

2699 Union Dental High PPO Employee Only-Dental High PPO

2702 Union Dental High PPO Employee Only-Dental High PPO

2714 Union Dental High PPO Employee Only-Dental High PPO

2726 Union Dental High PPO Employee Only-Dental High PPO

2729 Union Dental High PPO Employee Only-Dental High PPO

2730 Union Dental High PPO Employee Only-Dental High PPO

2734 Union Dental High PPO Employee Only-Dental High PPO

3104 Admin Dental High PPO Employee Only-Dental High PPO

3368 Admin Dental High PPO Employee Only-Dental High PPO

3387 Admin Dental High PPO Employee Only-Dental High PPO

3392 Admin Dental High PPO Employee Only-Dental High PPO

3397 Admin Dental High PPO Employee Only-Dental High PPO

3656 Admin Dental High PPO Employee Only-Dental High PPO

3688 Admin Dental High PPO Employee Only-Dental High PPO

3717 Admin Dental High PPO Employee Only-Dental High PPO

3722 Admin Dental High PPO Employee Only-Dental High PPO

3777 Admin Dental High PPO Employee Only-Dental High PPO

3784 Admin Dental High PPO Employee Only-Dental High PPO

3790 Admin Dental High PPO Employee Only-Dental High PPO

3791 Admin Dental High PPO Employee Only-Dental High PPO

3795 Admin Dental High PPO Employee Only-Dental High PPO

3796 Admin Dental High PPO Employee Only-Dental High PPO

3863 Admin Dental High PPO Employee Only-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 19 - 54

Page 24: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

3896 Admin Dental High PPO Employee Only-Dental High PPO

3904 Admin Dental High PPO Employee Only-Dental High PPO

3907 Admin Dental High PPO Employee Only-Dental High PPO

3910 Admin Dental High PPO Employee Only-Dental High PPO

3915 Admin Dental High PPO Employee Only-Dental High PPO

3939 Admin Dental High PPO Employee Only-Dental High PPO

3982 Admin Dental High PPO Employee Only-Dental High PPO

3986 Admin Dental High PPO Employee Only-Dental High PPO

3988 Admin Dental High PPO Employee Only-Dental High PPO

3989 Admin Dental High PPO Employee Only-Dental High PPO

4007 Admin Dental High PPO Employee Only-Dental High PPO

4017 Admin Dental High PPO Employee Only-Dental High PPO

4032 Admin Dental High PPO Employee Only-Dental High PPO

4065 Admin Dental High PPO Employee Only-Dental High PPO

4075 Admin Dental High PPO Employee Only-Dental High PPO

4115 Admin Dental High PPO Employee Only-Dental High PPO

4128 Admin Dental High PPO Employee Only-Dental High PPO

4134 Admin Dental High PPO Employee Only-Dental High PPO

4162 Admin Dental High PPO Employee Only-Dental High PPO

4165 Admin Dental High PPO Employee Only-Dental High PPO

4170 Admin Dental High PPO Employee Only-Dental High PPO

4217 Admin Dental High PPO Employee Only-Dental High PPO

4221 Admin Dental High PPO Employee Only-Dental High PPO

4230 Admin Dental High PPO Employee Only-Dental High PPO

4234 Admin Dental High PPO Employee Only-Dental High PPO

4237 Admin Dental High PPO Employee Only-Dental High PPO

4239 Admin Dental High PPO Employee Only-Dental High PPO

4242 Admin Dental High PPO Employee Only-Dental High PPO

5011 Union Dental High PPO Employee Only-Dental High PPO

5016 Union Dental High PPO Employee Only-Dental High PPO

5036 Union Dental High PPO Employee Only-Dental High PPO

5047 Union Dental High PPO Employee Only-Dental High PPO

5062 Union Dental High PPO Employee Only-Dental High PPO

5088 Union Dental High PPO Employee Only-Dental High PPO

5099 Union Dental High PPO Employee Only-Dental High PPO

5103 Union Dental High PPO Employee Only-Dental High PPO

5113 Union Dental High PPO Employee Only-Dental High PPO

5120 Union Dental High PPO Employee Only-Dental High PPO

5123 Union Dental High PPO Employee Only-Dental High PPO

5137 Union Dental High PPO Employee Only-Dental High PPO

5140 Union Dental High PPO Employee Only-Dental High PPO

5170 Union Dental High PPO Employee Only-Dental High PPO

5175 Union Dental High PPO Employee Only-Dental High PPO

5177 Union Dental High PPO Employee Only-Dental High PPO

5240 Union Dental High PPO Employee Only-Dental High PPO

5265 Union Dental High PPO Employee Only-Dental High PPO

5269 Union Dental High PPO Employee Only-Dental High PPO

5289 Union Dental High PPO Employee Only-Dental High PPO

5310 Union Dental High PPO Employee Only-Dental High PPO

5335 Union Dental High PPO Employee Only-Dental High PPO

5350 Union Dental High PPO Employee Only-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 20 - 54

Page 25: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5353 Union Dental High PPO Employee Only-Dental High PPO

5374 Union Dental High PPO Employee Only-Dental High PPO

5376 Union Dental High PPO Employee Only-Dental High PPO

5406 Union Dental High PPO Employee Only-Dental High PPO

5412 Union Dental High PPO Employee Only-Dental High PPO

5416 Union Dental High PPO Employee Only-Dental High PPO

5443 Union Dental High PPO Employee Only-Dental High PPO

5454 Union Dental High PPO Employee Only-Dental High PPO

5462 Union Dental High PPO Employee Only-Dental High PPO

5465 Union Dental High PPO Employee Only-Dental High PPO

5467 Union Dental High PPO Employee Only-Dental High PPO

5484 Union Dental High PPO Employee Only-Dental High PPO

5493 Union Dental High PPO Employee Only-Dental High PPO

5495 Union Dental High PPO Employee Only-Dental High PPO

5503 Union Dental High PPO Employee Only-Dental High PPO

5511 Union Dental High PPO Employee Only-Dental High PPO

5546 Union Dental High PPO Employee Only-Dental High PPO

5575 Union Dental High PPO Employee Only-Dental High PPO

5577 Union Dental High PPO Employee Only-Dental High PPO

5586 Union Dental High PPO Employee Only-Dental High PPO

5595 Union Dental High PPO Employee Only-Dental High PPO

5599 Union Dental High PPO Employee Only-Dental High PPO

5601 Union Dental High PPO Employee Only-Dental High PPO

5610 Union Dental High PPO Employee Only-Dental High PPO

5612 Union Dental High PPO Employee Only-Dental High PPO

5617 Union Dental High PPO Employee Only-Dental High PPO

5625 Union Dental High PPO Employee Only-Dental High PPO

5725 Union Dental High PPO Employee Only-Dental High PPO

5738 Union Dental High PPO Employee Only-Dental High PPO

5745 Union Dental High PPO Employee Only-Dental High PPO

5754 Union Dental High PPO Employee Only-Dental High PPO

5760 Union Dental High PPO Employee Only-Dental High PPO

5762 Union Dental High PPO Employee Only-Dental High PPO

5765 Union Dental High PPO Employee Only-Dental High PPO

5811 Union Dental High PPO Employee Only-Dental High PPO

5811 Union Dental High PPO Employee Only-Dental High PPO

5830 Union Dental High PPO Employee Only-Dental High PPO

5835 Union Dental High PPO Employee Only-Dental High PPO

5840 Union Dental High PPO Employee Only-Dental High PPO

5864 Union Dental High PPO Employee Only-Dental High PPO

5871 Union Dental High PPO Employee Only-Dental High PPO

5879 Union Dental High PPO Employee Only-Dental High PPO

5904 Union Dental High PPO Employee Only-Dental High PPO

5905 Union Dental High PPO Employee Only-Dental High PPO

5912 Union Dental High PPO Employee Only-Dental High PPO

5915 Union Dental High PPO Employee Only-Dental High PPO

5916 Union Dental High PPO Employee Only-Dental High PPO

5921 Union Dental High PPO Employee Only-Dental High PPO

5925 Union Dental High PPO Employee Only-Dental High PPO

5934 Union Dental High PPO Employee Only-Dental High PPO

5946 Union Dental High PPO Employee Only-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 21 - 54

Page 26: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5953 Union Dental High PPO Employee Only-Dental High PPO

5973 Union Dental High PPO Employee Only-Dental High PPO

5977 Union Dental High PPO Employee Only-Dental High PPO

5979 Union Dental High PPO Employee Only-Dental High PPO

5984 Union Dental High PPO Employee Only-Dental High PPO

5986 Union Dental High PPO Employee Only-Dental High PPO

5989 Union Dental High PPO Employee Only-Dental High PPO

5991 Union Dental High PPO Employee Only-Dental High PPO

6011 Union Dental High PPO Employee Only-Dental High PPO

6015 Union Dental High PPO Employee Only-Dental High PPO

6017 Union Dental High PPO Employee Only-Dental High PPO

6021 Union Dental High PPO Employee Only-Dental High PPO

6026 Union Dental High PPO Employee Only-Dental High PPO

6030 Union Dental High PPO Employee Only-Dental High PPO

6038 Union Dental High PPO Employee Only-Dental High PPO

6041 Union Dental High PPO Employee Only-Dental High PPO

6044 Union Dental High PPO Employee Only-Dental High PPO

6076 Union Dental High PPO Employee Only-Dental High PPO

6096 Union Dental High PPO Employee Only-Dental High PPO

6101 Union Dental High PPO Employee Only-Dental High PPO

6102 Union Dental High PPO Employee Only-Dental High PPO

6109 Union Dental High PPO Employee Only-Dental High PPO

6109 Union Dental High PPO Employee Only-Dental High PPO

6118 Union Dental High PPO Employee Only-Dental High PPO

6131 Union Dental High PPO Employee Only-Dental High PPO

6141 Union Dental High PPO Employee Only-Dental High PPO

6175 Union Dental High PPO Employee Only-Dental High PPO

6185 Union Dental High PPO Employee Only-Dental High PPO

6192 Union Dental High PPO Employee Only-Dental High PPO

6203 Union Dental High PPO Employee Only-Dental High PPO

6214 Union Dental High PPO Employee Only-Dental High PPO

6229 Union Dental High PPO Employee Only-Dental High PPO

6232 Union Dental High PPO Employee Only-Dental High PPO

6232 Union Dental High PPO Employee Only-Dental High PPO

6234 Union Dental High PPO Employee Only-Dental High PPO

6237 Union Dental High PPO Employee Only-Dental High PPO

6267 Union Dental High PPO Employee Only-Dental High PPO

6273 Union Dental High PPO Employee Only-Dental High PPO

6274 Union Dental High PPO Employee Only-Dental High PPO

6282 Union Dental High PPO Employee Only-Dental High PPO

6292 Union Dental High PPO Employee Only-Dental High PPO

6293 Union Dental High PPO Employee Only-Dental High PPO

6296 Union Dental High PPO Employee Only-Dental High PPO

6298 Union Dental High PPO Employee Only-Dental High PPO

6309 Union Dental High PPO Employee Only-Dental High PPO

6311 Union Dental High PPO Employee Only-Dental High PPO

6312 Union Dental High PPO Employee Only-Dental High PPO

6323 Union Dental High PPO Employee Only-Dental High PPO

6324 Union Dental High PPO Employee Only-Dental High PPO

6326 Union Dental High PPO Employee Only-Dental High PPO

6355 Union Dental High PPO Employee Only-Dental High PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 22 - 54

Page 27: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

6357 Union Dental High PPO Employee Only-Dental High PPO

6363 Union Dental High PPO Employee Only-Dental High PPO

6367 Union Dental High PPO Employee Only-Dental High PPO

6374 Union Dental High PPO Employee Only-Dental High PPO

6378 Union Dental High PPO Employee Only-Dental High PPO

0678 Union Dental Low PPO Employee Only-Dental Low PPO

0759 Union Dental Low PPO Employee Only-Dental Low PPO

0776 Union Dental Low PPO Employee Only-Dental Low PPO

0797 Union Dental Low PPO Employee Only-Dental Low PPO

0954 Union Dental Low PPO Employee Only-Dental Low PPO

1063 Union Dental Low PPO Employee Only-Dental Low PPO

1125 Union Dental Low PPO Employee Only-Dental Low PPO

1180 Union Dental Low PPO Employee Only-Dental Low PPO

1345 Union Dental Low PPO Employee Only-Dental Low PPO

1349 Union Dental Low PPO Employee Only-Dental Low PPO

1364 Union Dental Low PPO Employee Only-Dental Low PPO

1372 Union Dental Low PPO Employee Only-Dental Low PPO

1385 Union Dental Low PPO Employee Only-Dental Low PPO

1388 Union Dental Low PPO Employee Only-Dental Low PPO

1396 Union Dental Low PPO Employee Only-Dental Low PPO

1424 Union Dental Low PPO Employee Only-Dental Low PPO

1430 Union Dental Low PPO Employee Only-Dental Low PPO

1494 Union Dental Low PPO Employee Only-Dental Low PPO

1524 Union Dental Low PPO Employee Only-Dental Low PPO

1548 Union Dental Low PPO Employee Only-Dental Low PPO

1588 Union Dental Low PPO Employee Only-Dental Low PPO

1618 Union Dental Low PPO Employee Only-Dental Low PPO

1626 Union Dental Low PPO Employee Only-Dental Low PPO

1637 Union Dental Low PPO Employee Only-Dental Low PPO

1669 Union Dental Low PPO Employee Only-Dental Low PPO

1674 Union Dental Low PPO Employee Only-Dental Low PPO

1730 Union Dental Low PPO Employee Only-Dental Low PPO

1746 Union Dental Low PPO Employee Only-Dental Low PPO

1773 Union Dental Low PPO Employee Only-Dental Low PPO

1776 Union Dental Low PPO Employee Only-Dental Low PPO

1778 Union Dental Low PPO Employee Only-Dental Low PPO

1784 Union Dental Low PPO Employee Only-Dental Low PPO

1810 Union Dental Low PPO Employee Only-Dental Low PPO

1813 Union Dental Low PPO Employee Only-Dental Low PPO

1816 Union Dental Low PPO Employee Only-Dental Low PPO

1827 Union Dental Low PPO Employee Only-Dental Low PPO

1833 Union Dental Low PPO Employee Only-Dental Low PPO

1844 Union Dental Low PPO Employee Only-Dental Low PPO

1884 Union Dental Low PPO Employee Only-Dental Low PPO

1886 Union Dental Low PPO Employee Only-Dental Low PPO

1918 Union Dental Low PPO Employee Only-Dental Low PPO

1928 Union Dental Low PPO Employee Only-Dental Low PPO

1945 Union Dental Low PPO Employee Only-Dental Low PPO

2041 Union Dental Low PPO Employee Only-Dental Low PPO

2101 Union Dental Low PPO Employee Only-Dental Low PPO

2191 Union Dental Low PPO Employee Only-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 23 - 54

Page 28: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

2248 Union Dental Low PPO Employee Only-Dental Low PPO

2257 Union Dental Low PPO Employee Only-Dental Low PPO

2466 Union Dental Low PPO Employee Only-Dental Low PPO

2468 Union Dental Low PPO Employee Only-Dental Low PPO

2518 Union Dental Low PPO Employee Only-Dental Low PPO

2534 Union Dental Low PPO Employee Only-Dental Low PPO

2536 Union Dental Low PPO Employee Only-Dental Low PPO

2538 Union Dental Low PPO Employee Only-Dental Low PPO

2539 Union Dental Low PPO Employee Only-Dental Low PPO

2552 Union Dental Low PPO Employee Only-Dental Low PPO

2560 Union Dental Low PPO Employee Only-Dental Low PPO

2563 Union Dental Low PPO Employee Only-Dental Low PPO

2571 Union Dental Low PPO Employee Only-Dental Low PPO

2574 Union Dental Low PPO Employee Only-Dental Low PPO

2597 Union Dental Low PPO Employee Only-Dental Low PPO

2602 Union Dental Low PPO Employee Only-Dental Low PPO

2604 Union Dental Low PPO Employee Only-Dental Low PPO

2610 Union Dental Low PPO Employee Only-Dental Low PPO

2612 Union Dental Low PPO Employee Only-Dental Low PPO

2617 Union Dental Low PPO Employee Only-Dental Low PPO

2618 Union Dental Low PPO Employee Only-Dental Low PPO

2632 Union Dental Low PPO Employee Only-Dental Low PPO

2636 Union Dental Low PPO Employee Only-Dental Low PPO

2674 Union Dental Low PPO Employee Only-Dental Low PPO

2691 Union Dental Low PPO Employee Only-Dental Low PPO

2703 Union Dental Low PPO Employee Only-Dental Low PPO

2710 Union Dental Low PPO Employee Only-Dental Low PPO

2718 Union Dental Low PPO Employee Only-Dental Low PPO

2721 Union Dental Low PPO Employee Only-Dental Low PPO

2721 Union Dental Low PPO Employee Only-Dental Low PPO

2731 Union Dental Low PPO Employee Only-Dental Low PPO

2733 Union Dental Low PPO Employee Only-Dental Low PPO

2735 Union Dental Low PPO Employee Only-Dental Low PPO

2736 Union Dental Low PPO Employee Only-Dental Low PPO

3000 Admin Dental Low PPO Employee Only-Dental Low PPO

3161 Admin Dental Low PPO Employee Only-Dental Low PPO

3269 Admin Dental Low PPO Employee Only-Dental Low PPO

3681 Admin Dental Low PPO Employee Only-Dental Low PPO

3812 Admin Dental Low PPO Employee Only-Dental Low PPO

3858 Admin Dental Low PPO Employee Only-Dental Low PPO

3859 Admin Dental Low PPO Employee Only-Dental Low PPO

3878 Admin Dental Low PPO Employee Only-Dental Low PPO

3906 Admin Dental Low PPO Employee Only-Dental Low PPO

3926 Admin Dental Low PPO Employee Only-Dental Low PPO

3946 Admin Dental Low PPO Employee Only-Dental Low PPO

3948 Admin Dental Low PPO Employee Only-Dental Low PPO

3950 Admin Dental Low PPO Employee Only-Dental Low PPO

3965 Admin Dental Low PPO Employee Only-Dental Low PPO

3995 Admin Dental Low PPO Employee Only-Dental Low PPO

4006 Admin Dental Low PPO Employee Only-Dental Low PPO

4011 Admin Dental Low PPO Employee Only-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 24 - 54

Page 29: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

4015 Admin Dental Low PPO Employee Only-Dental Low PPO

4021 Admin Dental Low PPO Employee Only-Dental Low PPO

4063 Admin Dental Low PPO Employee Only-Dental Low PPO

4064 Admin Dental Low PPO Employee Only-Dental Low PPO

4069 Admin Dental Low PPO Employee Only-Dental Low PPO

4072 Admin Dental Low PPO Employee Only-Dental Low PPO

4090 Admin Dental Low PPO Employee Only-Dental Low PPO

4098 Admin Dental Low PPO Employee Only-Dental Low PPO

4120 Admin Dental Low PPO Employee Only-Dental Low PPO

4121 Admin Dental Low PPO Employee Only-Dental Low PPO

4129 Admin Dental Low PPO Employee Only-Dental Low PPO

4133 Admin Dental Low PPO Employee Only-Dental Low PPO

4150 Admin Dental Low PPO Employee Only-Dental Low PPO

4151 Admin Dental Low PPO Employee Only-Dental Low PPO

4169 Admin Dental Low PPO Employee Only-Dental Low PPO

4179 Admin Dental Low PPO Employee Only-Dental Low PPO

4198 Admin Dental Low PPO Employee Only-Dental Low PPO

4201 Admin Dental Low PPO Employee Only-Dental Low PPO

4203 Admin Dental Low PPO Employee Only-Dental Low PPO

4206 Admin Dental Low PPO Employee Only-Dental Low PPO

4208 Admin Dental Low PPO Employee Only-Dental Low PPO

4226 Admin Dental Low PPO Employee Only-Dental Low PPO

4227 Admin Dental Low PPO Employee Only-Dental Low PPO

4243 Admin Dental Low PPO Employee Only-Dental Low PPO

4245 Admin Dental Low PPO Employee Only-Dental Low PPO

4249 Admin Dental Low PPO Employee Only-Dental Low PPO

4253 Admin Dental Low PPO Employee Only-Dental Low PPO

5009 Union Dental Low PPO Employee Only-Dental Low PPO

5013 Union Dental Low PPO Employee Only-Dental Low PPO

5021 Union Dental Low PPO Employee Only-Dental Low PPO

5034 Union Dental Low PPO Employee Only-Dental Low PPO

5053 Union Dental Low PPO Employee Only-Dental Low PPO

5054 Union Dental Low PPO Employee Only-Dental Low PPO

5055 Union Dental Low PPO Employee Only-Dental Low PPO

5056 Union Dental Low PPO Employee Only-Dental Low PPO

5057 Union Dental Low PPO Employee Only-Dental Low PPO

5060 Union Dental Low PPO Employee Only-Dental Low PPO

5068 Union Dental Low PPO Employee Only-Dental Low PPO

5078 Union Dental Low PPO Employee Only-Dental Low PPO

5090 Union Dental Low PPO Employee Only-Dental Low PPO

5154 Union Dental Low PPO Employee Only-Dental Low PPO

5158 Union Dental Low PPO Employee Only-Dental Low PPO

5162 Union Dental Low PPO Employee Only-Dental Low PPO

5164 Union Dental Low PPO Employee Only-Dental Low PPO

5172 Union Dental Low PPO Employee Only-Dental Low PPO

5189 Union Dental Low PPO Employee Only-Dental Low PPO

5283 Union Dental Low PPO Employee Only-Dental Low PPO

5318 Union Dental Low PPO Employee Only-Dental Low PPO

5321 Union Dental Low PPO Employee Only-Dental Low PPO

5331 Union Dental Low PPO Employee Only-Dental Low PPO

5337 Union Dental Low PPO Employee Only-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 25 - 54

Page 30: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

5386 Union Dental Low PPO Employee Only-Dental Low PPO

5431 Union Dental Low PPO Employee Only-Dental Low PPO

5432 Union Dental Low PPO Employee Only-Dental Low PPO

5433 Union Dental Low PPO Employee Only-Dental Low PPO

5449 Union Dental Low PPO Employee Only-Dental Low PPO

5453 Union Dental Low PPO Employee Only-Dental Low PPO

5463 Union Dental Low PPO Employee Only-Dental Low PPO

5480 Union Dental Low PPO Employee Only-Dental Low PPO

5481 Union Dental Low PPO Employee Only-Dental Low PPO

5507 Union Dental Low PPO Employee Only-Dental Low PPO

5527 Union Dental Low PPO Employee Only-Dental Low PPO

5533 Union Dental Low PPO Employee Only-Dental Low PPO

5554 Union Dental Low PPO Employee Only-Dental Low PPO

5555 Union Dental Low PPO Employee Only-Dental Low PPO

5573 Union Dental Low PPO Employee Only-Dental Low PPO

5574 Union Dental Low PPO Employee Only-Dental Low PPO

5615 Union Dental Low PPO Employee Only-Dental Low PPO

5616 Union Dental Low PPO Employee Only-Dental Low PPO

5658 Union Dental Low PPO Employee Only-Dental Low PPO

5667 Union Dental Low PPO Employee Only-Dental Low PPO

5674 Union Dental Low PPO Employee Only-Dental Low PPO

5684 Union Dental Low PPO Employee Only-Dental Low PPO

5689 Union Dental Low PPO Employee Only-Dental Low PPO

5702 Union Dental Low PPO Employee Only-Dental Low PPO

5733 Union Dental Low PPO Employee Only-Dental Low PPO

5734 Union Dental Low PPO Employee Only-Dental Low PPO

5736 Union Dental Low PPO Employee Only-Dental Low PPO

5737 Union Dental Low PPO Employee Only-Dental Low PPO

5795 Union Dental Low PPO Employee Only-Dental Low PPO

5817 Union Dental Low PPO Employee Only-Dental Low PPO

5829 Union Dental Low PPO Employee Only-Dental Low PPO

5841 Union Dental Low PPO Employee Only-Dental Low PPO

5860 Union Dental Low PPO Employee Only-Dental Low PPO

5878 Union Dental Low PPO Employee Only-Dental Low PPO

5880 Union Dental Low PPO Employee Only-Dental Low PPO

5887 Union Dental Low PPO Employee Only-Dental Low PPO

5888 Union Dental Low PPO Employee Only-Dental Low PPO

5895 Union Dental Low PPO Employee Only-Dental Low PPO

5907 Union Dental Low PPO Employee Only-Dental Low PPO

5923 Union Dental Low PPO Employee Only-Dental Low PPO

5951 Union Dental Low PPO Employee Only-Dental Low PPO

5954 Union Dental Low PPO Employee Only-Dental Low PPO

5970 Union Dental Low PPO Employee Only-Dental Low PPO

5982 Union Dental Low PPO Employee Only-Dental Low PPO

5994 Union Dental Low PPO Employee Only-Dental Low PPO

5996 Union Dental Low PPO Employee Only-Dental Low PPO

6024 Union Dental Low PPO Employee Only-Dental Low PPO

6027 Union Dental Low PPO Employee Only-Dental Low PPO

6035 Union Dental Low PPO Employee Only-Dental Low PPO

6045 Union Dental Low PPO Employee Only-Dental Low PPO

6050 Union Dental Low PPO Employee Only-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 26 - 54

Page 31: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

6067 Union Dental Low PPO Employee Only-Dental Low PPO

6073 Union Dental Low PPO Employee Only-Dental Low PPO

6077 Union Dental Low PPO Employee Only-Dental Low PPO

6077 Union Dental Low PPO Employee Only-Dental Low PPO

6093 Union Dental Low PPO Employee Only-Dental Low PPO

6108 Union Dental Low PPO Employee Only-Dental Low PPO

6149 Union Dental Low PPO Employee Only-Dental Low PPO

6160 Union Dental Low PPO Employee Only-Dental Low PPO

6170 Union Dental Low PPO Employee Only-Dental Low PPO

6191 Union Dental Low PPO Employee Only-Dental Low PPO

6215 Union Dental Low PPO Employee Only-Dental Low PPO

6219 Union Dental Low PPO Employee Only-Dental Low PPO

6233 Union Dental Low PPO Employee Only-Dental Low PPO

6238 Union Dental Low PPO Employee Only-Dental Low PPO

6268 Union Dental Low PPO Employee Only-Dental Low PPO

6283 Union Dental Low PPO Employee Only-Dental Low PPO

6310 Union Dental Low PPO Employee Only-Dental Low PPO

6314 Union Dental Low PPO Employee Only-Dental Low PPO

6316 Union Dental Low PPO Employee Only-Dental Low PPO

6321 Union Dental Low PPO Employee Only-Dental Low PPO

6322 Union Dental Low PPO Employee Only-Dental Low PPO

6333 Union Dental Low PPO Employee Only-Dental Low PPO

6335 Union Dental Low PPO Employee Only-Dental Low PPO

6350 Union Dental Low PPO Employee Only-Dental Low PPO

6354 Union Dental Low PPO Employee Only-Dental Low PPO

6356 Union Dental Low PPO Employee Only-Dental Low PPO

6376 Union Dental Low PPO Employee Only-Dental Low PPO

6377 Union Dental Low PPO Employee Only-Dental Low PPO

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 27 - 54

Page 32: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

Employee Gender Home Address Zip Benefit Dependent Offering Birth Date

Benefit Dependent Offering Relationship

Type Id

M 32835 7/20/1999 Child

M 34743 9/26/1963 Spouse

M 32828 11/6/1969 Spouse

M 32810 10/29/1964 Spouse

M 32837 5/5/1980 Spouse

M 32738 8/27/1975 Spouse

M 32818 3/4/1962 Spouse

M 32862 6/9/1968 Spouse

M 32738 4/18/1988 Spouse

M 32824 12/8/1964 Spouse

M 32703 6/9/1975 Spouse

M 32832 8/19/1954 Spouse

M 32810 7/9/1962 Spouse

M 34761 9/9/1951 Spouse

M 32829 5/16/1957 Spouse

M 34715 8/17/1990 Spouse

F 32809 8/4/1989 Spouse

M 34787 6/8/1962 Spouse

M 34744 3/12/1989 Spouse

M 32818 11/11/1960 Spouse

F 32818 11/16/2013 Child

F 32724 8/17/1986 Spouse

F 32810 10/9/1968 Spouse

M 32703 1/9/1981 Spouse

M 34744 10/16/1965 Spouse

M 32817 11/10/1975 Spouse

M 32730 8/18/1985 Spouse

M 34746 5/22/1981 Spouse

M 34743 6/28/1976 Spouse

F 32810 7/9/1986 Spouse

M 32712 9/25/2009 Child

M 34758 8/27/1999 Child

M 32801 12/7/2000 Child

M 32811 10/4/1987 Spouse

M 32807 10/31/2004 Child

M 32817 4/16/1954 Spouse

M 32837 10/17/1967 Spouse

M 32828 11/18/1958 Spouse

F 32751 3/18/1998 Child

M 32819 6/18/2003 Child

M 32807 4/16/1958 Spouse

M 32839 5/8/1978 Spouse

M 34759 12/13/1970 Spouse

M 32812 7/28/1966 Spouse

M 32822 9/30/1956 Spouse

M 32825 2/10/1966 Spouse

M 32703 1/29/1970 Spouse

M 32765 1/29/1962 Spouse

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 28 - 54

Page 33: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 32725 8/20/1969 Spouse

M 34758 11/19/1967 Spouse

M 32821 12/14/1950 Spouse

M 34772 12/28/1969 Spouse

M 34715 6/30/1964 Spouse

M 32809 10/14/1962 Spouse

F 32812 9/10/2004 Child

M 34758 11/21/1955 Spouse

F 34746 2/27/1968 Spouse

M 34741 9/5/1997 Child

M 34746 1/16/1979 Spouse

M 33868 4/28/1975 Spouse

M 32828 3/1/1949 Spouse

M 32828 7/20/1959 Spouse

M 32703 4/20/1962 Spouse

M 32807 2/16/1987 Spouse

M 32829 2/7/1958 Spouse

M 32839 3/15/1965 Spouse

M 34759 8/9/1971 Spouse

M 32822 11/27/1974 Spouse

M 34758 1/15/1985 Spouse

M 32810 9/7/2011 Child

M 34759 5/30/1972 Spouse

M 32792 10/25/1947 Spouse

M 32818 11/29/2010 Child

F 34758 10/30/1995 Child

M 32806 12/12/1957 Spouse

M 32837 9/14/1964 Spouse

M 34743 11/28/1960 Spouse

F 32835 1/8/1973 Spouse

F 32824 4/16/1955 Spouse

M 32828 9/11/1978 Spouse

F 34741 4/12/2002 Child

F 34761 12/16/2008 Child

M 34772 7/13/1967 Spouse

M 34761 7/9/1957 Spouse

M 34786 5/24/1959 Spouse

M 32703 2/1/1954 Spouse

F 32725 4/15/2006 Child

M 34711 1/16/1993 Spouse

M 32812 10/28/1990 Spouse

F 32811 10/18/1966 Spouse

F 32828 6/12/2013 Child

F 32713 7/25/1961 Spouse

M 32808 10/30/1962 Spouse

M 32825 7/19/1971 Spouse

M 34759 1/14/1960 Spouse

M 32818 8/24/1995 Child

M 32832 9/26/1958 Spouse

M 32818-5651 3/5/1954 Spouse

M 32817 6/14/1970 Spouse

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 29 - 54

Page 34: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 32817 9/5/1957 Spouse

M 32701 4/28/1983 Spouse

F 32926 10/25/1966 Spouse

F 34746 4/7/1969 Spouse

M 32712 5/21/1958 Spouse

M 32804 6/29/1961 Spouse

M 32811 11/14/1997 Child

F 33897 8/22/1984 Spouse

M 34758 7/17/1967 Spouse

M 32822 10/14/1983 Spouse

F 34741 5/19/2002 Child

M 32839 4/10/1951 Spouse

M 34772 9/17/1962 Spouse

M 34711 5/25/1970 Spouse

F 32807 6/15/1972 Spouse

M 32807 3/27/1963 Spouse

F 32819 11/12/2002 Child

F 34741 11/12/2002 Child

F 34741 8/2/2020 Child

M 32810 12/9/1978 Spouse

M 34759 8/8/1954 Spouse

M 34744 6/16/1971 Spouse

F 34744 6/5/2006 Child

M 34786

M 34787 6/22/1995 Child

M 32712 12/25/1971 Spouse

M 32825 9/21/1948 Spouse

M 34743 9/20/2001 Child

M 32825 4/4/1967 Spouse

M 32765 8/16/1979 Spouse

M 32808 10/11/1995 Child

M 34758 9/7/1967 Spouse

M 32701 6/20/1971 Spouse

M 32708 8/3/1965 Spouse

M 34759 3/10/1970 Spouse

F 32817 9/16/1997 Child

M 32825 12/2/1998 Child

M 34741 6/14/1964 Spouse

M 32712 5/24/1971 Spouse

M 32822 8/10/1998 Child

M 34711 9/20/1965 Spouse

F 34761 9/13/1965 Spouse

M 34744 5/1/1970 Spouse

M 32708 12/27/1984 Spouse

M 32822 7/23/1992 Spouse

M 34714 7/15/2009 Child

M 32709 7/18/1974 Spouse

M 32817 1/4/1961 Spouse

M 32825 7/10/1963 Spouse

M 34758 11/21/1966 Spouse

M 32725 11/25/1963 Spouse

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 30 - 54

Page 35: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 34758 8/10/2000 Child

F 34743 8/20/1960 Spouse

M 34711 10/5/1956 Spouse

F 32803 10/16/1972 Spouse

F 32819 12/8/1966 Spouse

F 32810 12/29/1977 Spouse

F 32725 9/12/1972 Spouse

M 32822 6/13/1983 Spouse

F 34741 3/4/1999 Child

M 34761 9/28/1960 Spouse

M 34759 11/21/1966 Spouse

M 34758 10/24/1968 Spouse

M 32825 3/5/1960 Spouse

M 34744 11/2/1963 Spouse

M 34747 10/16/1980 Spouse

F 34746 1/11/2006 Child

F 34711 10/16/2002 Child

M 32808 7/29/1978 Spouse

M 32810 9/8/1984 Spouse

M 32738 3/2/2006 Child

M 32808 11/19/2003 Child

M 34741

M 34743 7/7/2001 Child

F 32812 2/20/1999 Child

M 32825 12/28/1960 Spouse

F 32839

M 32714 6/15/1968 Spouse

M 32714 12/30/1995 Child

M 34743 6/10/1968 Spouse

M 34743 5/2/1997 Child

M 32825 9/25/1967 Spouse

M 32825 12/5/1995 Child

M 32825 2/23/1986 Spouse

M 32825 9/8/2011 Child

M 32825 10/24/2014 Child

M 34759 9/21/1998 Child

M 34759 10/18/2001 Child

M 34759 10/9/2002 Child

M 34759 4/21/2007 Child

M 32825 12/5/1964 Spouse

M 32825 7/21/1998 Child

M 34761 6/9/1972 Spouse

M 34761 12/4/1997 Child

M 34761 8/29/2002 Child

M 34787 1/18/2002 Child

M 34787 11/8/2004 Child

M 32818 7/12/1975 Spouse

M 32818 4/2/1997 Child

M 32818 3/5/2008 Child

M 34746 12/18/1968 Spouse

M 34746 9/15/1996 Child

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 31 - 54

Page 36: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 32825 11/14/1981 Spouse

M 32825 4/4/2006 Child

M 32714 5/9/1966 Spouse

M 32714 3/23/2002 Child

M 32825 7/25/1965 Spouse

M 32825 1/7/1998 Child

M 34772 4/13/1973 Spouse

M 34772 3/12/1995 Child

M 34772 12/14/1999 Child

M 32818

M 34741 9/6/2008 Child

M 34741 8/18/2009 Child

M 32825 3/25/1978 Spouse

M 32825 4/20/2001 Child

M 32825 5/5/2005 Child

M 32730 12/22/1976 Spouse

M 32730 8/7/2004 Child

M 34741 11/11/1970 Spouse

M 34741 5/28/1995 Child

F 34743 12/28/1962 Spouse

F 34743 3/27/1997 Child

F 34743 1/23/2001 Child

F 34743 2/14/2003 Child

M 34761 11/12/1969 Spouse

M 34761 4/9/1997 Child

M 34761 9/8/2004 Child

M 32837 9/2/1972 Spouse

M 32837 10/8/1996 Child

M 32837 1/21/2006 Child

F 32712 1/12/1979 Spouse

F 32712 9/25/2001 Child

F 32712 3/23/2003 Child

M 32712 10/21/1959 Spouse

M 32712 2/1/2000 Child

M 32825 1/21/1977 Spouse

M 32825 9/14/1997 Child

M 32825 12/21/2000 Child

F 32828 5/7/1997 Child

F 32828 2/10/2001 Child

M 32725 10/12/1961 Spouse

M 32725 12/18/1996 Child

M 32832 7/15/1985 Spouse

M 32832 6/6/2003 Child

M 32832 9/24/2004 Child

M 32832 11/10/2007 Child

M 32832 10/7/2009 Child

M 33881 4/16/1969 Spouse

M 33881 7/20/2006 Child

M 34746 12/31/1971 Spouse

M 34746 1/18/1995 Child

M 34746 1/25/1996 Child

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 32 - 54

Page 37: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 32712 8/15/1967 Spouse

M 32712 10/27/1996 Child

M 32712 4/5/2003 Child

M 32765 10/7/1965 Spouse

M 32765 8/8/1996 Child

M 34771 9/24/1975 Spouse

M 34771 6/20/1996 Child

M 34771 6/19/2000 Child

M 34771 2/20/2004 Child

M 32825 1/9/1971 Spouse

M 32825 1/10/1995 Child

M 32825 9/20/1996 Child

M 32825 10/13/1998 Child

M 32825 11/26/2006 Child

M 34746 4/5/1975 Spouse

M 34746 11/10/1998 Child

M 34746 8/23/2002 Child

M 34746 2/9/2007 Child

F 32808 9/27/2011 Child

F 32808 5/23/2014 Child

M 34759 3/9/1971 Spouse

M 34759 6/11/1996 Child

M 34759 6/16/2000 Child

M 33837 8/20/1968 Spouse

M 33837 4/19/1996 Child

M 33837 11/27/2003 Child

M 32825 4/6/1971 Spouse

M 32825 10/19/1999 Child

M 33837 5/18/1979 Spouse

M 33837 4/28/2002 Child

M 33837 6/18/2005 Child

M 33837 11/11/2007 Child

M 32808 10/7/1973 Spouse

M 32808 2/12/1997 Child

M 32808 11/18/2001 Child

M 32778 2/16/1984 Spouse

M 32778 8/26/2005 Child

M 32778 8/3/2008 Child

M 32778 10/3/2013 Child

M 32778 1/29/2018 Child

M 32818 6/26/1997 Child

M 32818 9/5/1997 Child

M 32818 2/19/2001 Child

M 32726 1/28/1973 Spouse

M 32726 10/6/1998 Child

M 34741 10/14/1982 Spouse

M 34741 4/1/1997 Child

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 33 - 54

Page 38: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 34741 1/12/2000 Child

M 34741 6/25/2005 Child

M 34743 9/16/1996 Child

M 34743 12/21/2000 Child

M 34744 11/21/1978 Spouse

M 34744 3/3/1998 Child

M 34744 3/19/2003 Child

M 32828 12/10/1966 Spouse

M 32828 1/25/1975 Spouse

M 32828 10/5/1995 Child

M 32828 5/2/1997 Child

M 32828 11/27/2000 Child

M 34787 5/3/1972 Spouse

M 34787 3/9/1998 Child

M 34787 5/21/2004 Child

M 34787 6/24/2005 Child

M 32703

M 32837 10/29/1975 Spouse

M 32837 7/26/1995 Child

M 32837 4/21/1997 Child

M 32837 3/5/2008 Child

M 34711 2/9/1966 Spouse

M 34711 8/22/1999 Child

M 32725 7/17/1982 Spouse

M 32725 9/16/2001 Child

M 32725 10/20/2015 Child

M 32811 12/2/1995 Child

M 32811 4/9/2001 Child

M 32811 10/21/2003 Child

M 32811 12/11/1964 Spouse

M 32811 2/19/1997 Child

M 32811 12/20/2002 Child

M 33837 12/14/1970 Spouse

M 33837 5/22/1995 Child

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 34 - 54

Page 39: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 33837 3/23/2000 Child

M 32824 5/16/1982 Spouse

M 32824 11/11/2018 Child

M 32824 4/1/2020 Child

M 33897 8/29/1975 Spouse

M 33897 11/9/1995 Child

M 33897 12/5/2000 Child

M 33897 6/13/2002 Child

M 32808 3/14/1992 Spouse

M 32808 4/2/2015 Child

M 32808 3/23/2017 Child

M 32822 2/13/1981 Spouse

M 32822 2/20/2003 Child

M 32822 5/19/2005 Child

M 32822 8/26/2012 Child

M 32822 12/8/2014 Child

M 34761 10/7/1966 Spouse

M 34761 10/16/1996 Child

M 32703 2/28/1960 Spouse

M 32703 10/2/1996 Child

M 32703 12/10/1971 Spouse

M 32703 9/3/1999 Child

F 32703 1/11/1977 Spouse

F 32703 1/9/2007 Child

F 32703 6/5/2009 Child

M 34771 2/26/1977 Spouse

M 34771 7/3/2019 Child

M 32703 5/8/1975 Spouse

M 32703 7/18/1998 Child

M 32703 4/14/2000 Child

M 32703 10/28/2002 Child

M 32703 3/8/2005 Child

M 32703 5/12/2012 Child

M 32703 8/11/2013 Child

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 35 - 54

Page 40: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 32724 1/26/1971 Spouse

M 32724 9/6/1996 Child

M 32724 1/5/1999 Child

F 34787 3/12/1968 Spouse

F 34787 3/18/1997 Child

M 34743 1/11/1975 Spouse

M 34743 5/15/2002 Child

M 34743 7/22/2010 Child

M 34743 3/15/2012 Child

M 32832 4/6/1977 Spouse

M 32832 6/10/2003 Child

M 32832 1/18/2006 Child

M 32720 9/28/1979 Spouse

M 32720 11/5/2009 Child

M 32720 8/1/2015 Child

M 32720 8/30/2017 Child

F 32708 3/9/1968 Spouse

F 32708 6/8/2000 Child

F 32708 10/5/2001 Child

M 33837 9/28/1958 Spouse

M 33837 7/1/1997 Child

M 34736 8/31/1993 Spouse

M 34736 10/28/2019 Child

M 32771

M 32746 11/27/1995 Child

M 32746 7/25/1997 Child

M 32746 12/18/2009 Child

M 34786 2/2/1973 Spouse

M 34786 2/9/1998 Child

M 34786 3/18/2003 Child

M 34787 7/3/1970 Spouse

M 34787 2/10/1996 Child

M 34758 10/23/1976 Spouse

M 34758 10/28/1996 Child

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Page 41: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 32832

M 32832 4/21/1969 Spouse

M 32832 12/1/1998 Child

M 34746 1/6/1985 Spouse

M 34746 7/2/2013 Child

M 34746 1/29/2015 Child

M 34746 9/2/2018 Child

F 32808 12/23/1966 Spouse

F 32808 1/22/2000 Child

M 32818 7/26/1983 Spouse

M 32818 10/13/1999 Child

M 32818 10/9/2001 Child

M 32818 9/24/2013 Child

M 32818 6/2/2015 Child

M 32818 7/11/2017 Child

M 32808 4/13/1979 Spouse

M 32808 8/15/2000 Child

M 32808 9/23/2001 Child

M 32808 1/6/2007 Child

M 32808 11/5/1961 Spouse

M 32808 7/13/1997 Child

M 34741 2/25/1971 Spouse

M 34741 1/23/2014 Child

M 34746 5/7/1965 Spouse

M 34746 10/4/2001 Child

M 32703 5/3/1962 Spouse

M 32703 8/20/2001 Child

M 32829 6/14/1966 Spouse

M 32829 7/11/2001 Child

M 32829 11/27/2007 Child

F 32810 9/5/2002 Child

F 32810 1/16/2007 Child

M 34759 1/3/1970 Spouse

M 34759 2/4/1996 Child

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 37 - 54

Page 42: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 34759 2/1/2001 Child

M 32808 7/21/1999 Child

M 32808 11/13/2007 Child

M 32808 8/24/2011 Child

M 32808 1/2/2013 Child

M 32808 11/5/2014 Child

M 32822 3/6/1974 Spouse

M 32822 8/18/2002 Child

M 32822 4/14/2004 Child

M 32818 3/16/1972 Spouse

M 32818 10/18/1997 Child

M 32818 7/12/2000 Child

M 34746 11/2/1969 Spouse

M 34746 5/20/1998 Child

M 34746 8/2/1999 Child

F 34744 5/19/2003 Child

F 34744 1/8/2008 Child

F 34744 12/13/2009 Child

M 32811 6/24/1962 Spouse

M 32811 7/22/1996 Child

M 32811 10/21/1999 Child

M 32811 10/31/2000 Child

M 32712 1/27/1963 Spouse

M 32712 10/17/1996 Child

M 32712 2/22/1999 Child

M 34761 9/7/1968 Spouse

M 34761 6/8/2006 Child

M 32707 10/1/1968 Spouse

M 32707 1/6/1999 Child

M 32707 10/19/2000 Child

M 32707 5/1/2002 Child

M 32738 1/9/1962 Spouse

M 32738 4/19/1998 Child

M 34741

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 38 - 54

Page 43: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 34741 7/29/1964 Spouse

M 33837 1/2/1972 Spouse

M 33837 10/15/2005 Child

M 33837 6/14/2013 Child

M 32738 10/25/1964 Spouse

M 32738 5/12/2002 Child

M 32738 12/30/2003 Child

M 32825 9/7/1970 Spouse

M 32825 4/27/2000 Child

M 32825 2/27/2003 Child

M 32811 1/25/1981 Spouse

M 32811 10/4/2003 Child

M 32811 9/24/2005 Child

M 32757 10/8/1979 Spouse

M 32757 3/8/2011 Child

M 32757 6/14/2013 Child

M 32757 9/10/2015 Child

M 34761 3/27/1965 Spouse

M 34761 9/29/2003 Child

M 32835 2/2/1967 Spouse

M 32835 9/17/2003 Child

M 32835 8/23/2004 Child

M 32835 7/22/2006 Child

M 34715 8/16/1974 Spouse

M 34715 11/2/2002 Child

M 34715 7/21/2004 Child

M 34711 10/25/1967 Spouse

M 34711 7/16/1996 Child

M 34711 10/8/1998 Child

M 34711 1/21/2002 Child

M 32818 3/6/1974 Spouse

M 32818 7/24/2002 Child

M 34772 6/7/1979 Spouse

M 34772 5/2/1998 Child

3/2/2021 4:23 PM | lynx.banderson | Confidential | Copyright © 2021 by Ceridian HCM, Inc. All rights reserved. 39 - 54

Page 44: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

M 34772 2/26/2001 Child

M 32826 2/28/1965 Spouse

M 32826 2/26/2008 Child

M 32765 3/3/1970 Spouse

M 32765 11/1/2002 Child

M 32765 12/29/2006 Child

F 32809 5/9/2001 Child

F 32809 12/21/2002 Child

M 32817 9/17/1997 Child

M 32817 12/5/2000 Child

M 32817 2/2/2008 Child

M 34787 2/14/1979 Spouse

M 34787 12/22/2007 Child

M 34787 9/15/2010 Child

F 34711 3/8/1965 Spouse

F 34711 9/24/1999 Child

F 34711 9/24/2003 Child

M 32771 10/13/1974 Spouse

M 32771 3/22/2003 Child

F 32832 2/25/1987 Spouse

F 32832 6/24/2017 Child

M 32835 12/29/1987 Spouse

M 32835 7/20/2019 Child

M 32746 11/15/1976 Spouse

M 32746 10/22/2008 Child

F 34769 11/6/1979 Spouse

F 34769 4/16/2008 Child

M 32804 5/27/2002 Child

M 32804 4/13/2004 Child

M 34758 2/26/1982 Spouse

M 34758 9/23/2004 Child

M 34758 12/5/2014 Child

M 34758 5/16/2016 Child

F 32817 12/28/1978 Spouse

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Page 45: ADDENDUM NUMBER ONE (1) MARCH 4, 2021

F 32817 8/10/1999 Child

F 32817 10/30/2001 Child

F 32817 8/16/2007 Child

F 32817 4/26/2013 Child

F 32817 11/19/2014 Child

F 32817 5/30/1979 Spouse

F 32817 4/2/2009 Child

F 32817 12/30/2013 Child

M 32839 5/16/1981 Spouse

M 32839 9/27/1987 Spouse

M 32839 11/11/2000 Child

M 32839 11/20/2000 Child

M 32839 1/10/2003 Child

M 32703 10/1/1965 Spouse

M 32703 9/7/2001 Child

M 32703 8/26/2003 Child

M 34743 10/14/1966 Spouse

M 34743 8/25/1992 Child

M 34743 8/13/1998 Child

M 32811 10/10/2004 Child

M 32811 8/13/2009 Child

M 32811 10/18/2010 Child

M 34741 4/11/1976 Spouse

M 34741 3/14/2003 Child

M 32824 10/8/1998 Child

M 32824 10/15/2002 Child

M 32824 12/2/2008 Child

M 32818 1/13/1981 Spouse

M 32818 12/5/2004 Child

M 32757 7/25/1972 Spouse

M 32757 9/26/1995 Child

M 32757 1/25/2000 Child

M 32757 7/1/2003 Child

M 32839 6/2/1974 Spouse

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M 32839 9/16/1995 Child

M 32839 7/29/2008 Child

M 32789 6/26/1977 Spouse

M 32789 4/16/1997 Child

M 32789 3/24/2002 Child

M 34744 2/4/1975 Spouse

M 34744 3/11/1997 Child

M 34744 8/19/2004 Child

M 34746 11/19/1973 Spouse

M 34746 9/13/1997 Child

M 34746 11/14/2006 Child

M 32861 9/27/1982 Spouse

M 32861 6/29/2008 Child

M 32861 12/23/2017 Child

M 34744 11/24/1984 Spouse

M 34744 3/21/2003 Child

M 32824 4/4/2010 Child

M 32824 5/23/2012 Child

M 34744

M 32792

M 32804

M 32738

M 32819

F 32825

F 32837

M 32817

F 32825

M 34786

M 32818

M 32805

M 32746

M 32818

M 32818

M 33897

M 32805

M 32725

M 33837

M 34743

M 32712

M 32835

M 32757

M 32806

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M 32725

M 32608

M 32725

M 34772

M 33811

F 34711

M 32808

M 32707

M 34746

M 33881

M 32818

M 32746

F 32757

F 32808

M 33897

F 32839

M 32714

M 32803

F 32805

F 32824

F 32817

F 32773

M 34772

M 32703

F 32836

M 32824

F 32835

M 32836

F 32765

F 32765

F 32707

M 32801

F 32771

M 32725

M 32803

M 32818

F 32811

M 32712

M 34772

F 32822

F 34741

M 34711

M 34759

M 32832

F 32839

M 34787

M 32807

M 32701

M 34759

F 34772

M 34734

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M 34734

M 32825

M 32805

M 32809

M 34771

M 32822

M 34741

M 34741

F 32127

F 34769

M 34744

M 32765

M 34758

M 32808

M 32818

M 32817

M 34746

F 32835

M 32809

M 32714

F 32822

M 32839

M 33540

F 34759

M 34746

M 32811

M 32808

M 32824

F 32703

M 32811

F 34741

F 32792

M 34787

M 32839

F 32714

F 34788

M 34759

M 32839

M 34759

F 32811

M 32747

M 32714

M 34744

M 32810

F 32821

M 34787

F 32817

M 32817

F 34715

M 34769

F 34746

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M 32837

M 32839

F 32810

M 32807

M 34743

F 34736

F 32812

M 32812

F 32861

M 34761

M 32839

F 32776

M 32812

M 34746

M 32703

M 32824

M 32714

M 32824

F 32855-0350

M 32805

M 32804

M 32824

M 34741

M 32825

M 32839

M 34743

M 32810

F 32857

F 32810

F 32811

M 34471

M 32712

F 34743

M 32822

M 32867

M 34743

M 34743

M 32822

F 34744

M 32825

M 32822

M 32811

M 34734

M 32807

M 32733

M 32825

M 32765

M 32869

M 32714

M 32720

M 34746

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M 34746

F 32707

M 32809

M 34758

M 32779

M 32810

M 32701

M 32808

M 32807

M 32190

M 34744-4978

M 32810

M 34746

M 34736

M 32833

M 32828

M 32811

M 32824

M 33859

M 32820

M 32805

M 32839

M 32725

M 32712

F 32811

M 34743

M 32820

F 32825

M 32713

F 33896

M 32810

M 34758

F 32811

M 32837

M 32703

F 32708

F 32806-1618

F 32809

M 32701

F 32818

F 34787

M 32703

M 34711

F 34746

M 34471

M 34743

F 32810

F 32779

M 32701

M 32839

M 32835

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F 32776

M 32803

F 32822

M 32773

M 32835

M 34761

F 32806

M 32811

M 32771

F 32738

M 34787

F 34743

F 32811

M 32828

F 32703

F 34761

F 06106

M 34746

M 32811

F 32805

M 32703

F 32707

M 32808

M 32810

F 32819

M 32808

M 32801

F 32811

M 32822

M 32839

M 34744

M 33837

M 34744

M 34772

M 32714

F 32808

M 32811

F 32811

M 33837-4107

M 34736

M 32822

M 32828

M 34759

M 34746

M 32808

M 32738

M 32825

M 32824

M 32808

F 32868

M 33844

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M 32832

M 34761

M 32808

F 32808

M 32822

M 32806

M 34758

F 32868

F 32822

F 32806

M 32807

M 32701

F 32118

M 32808

M 32746

M 32725

F 32773

M 32773

F 32703

M 32701

M 32836

F 32805

M 32778

F 32805

F 32807

F 34741

M 32804

M 34744

M 32828

M 34758

F 32814

M 32822

M 32708

M 33837

F 32807

F 32807

F 32812

F 32825

M 32872

M 32839

M 34759

M 32811

M 33881

F 32730

M 34746

M 32811

M 32806

F 32811

F 32792

F 32757

M 32839

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M 34746

M 32807

F 34759

M 32701

M 32773

M 32821

M 32765

M 32771

M 34758

F 32730

M 34746

M 32811

M 34744

M 32707

F 33898

F 33897

M 32807

M 32805

F 32807

M 32808

F 34746

M 32808

M 32808

F 32792

F 32822

M 32792

M 32806

F 32839

F 33610

F 32805

F 34759

F 32926

M 32714

M 32714

M 32724

M 33837

F 34747

F 33023

M 32839

F 32811

F 32824

F 32701

M 32807

M 32824

M 32828

F 32818

F 32771

F 32701

M 32810

F 32804

F 32808

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F 32822

F 32822

M 32824

M 34714

F 32833

M 34771

F 32805

F 32707

M 32822

F 32712

M 32808

F 32792

M 32817

M 32806

F 32822

M 32725

M 32825

M 32818

M 34743

F 32818

M 32837

M 34771

M 32808

M 34742

F 32861

M 32714

M 32817

M 32808

M 34741

F 32837

M 32818

M 32744

M 34746

M 34769

M 33898-3906

M 32825

M 34746

M 33896

M 32738

M 32808

M 32868

M 34741

M 32808

M 32839

M 34741

M 32822

M 32707

M 32757

M 32811

M 32168

M 32750

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M 34761

M 32806

M 32825

F 32818

M 32804

M 32824

F 32757

M 34736

M 32817

M 34787

M 34772

M 32809

M 32725

M 32833

M 32808

M 32822

M 32801

M 34761

M 32818

M 34746

M 32714

M 34759

M 32738

M 33897

M 34743

M 34758

M 33837

M 32703

M 32818

M 32818

F 32726

F 34787

M 34741

M 32818

M 34761

M 32818

M 32835

M 32818

M 32817

F 32746

M 34743

F 32744

M 34741

F 32714

M 32825

F 34771

F 32707

F 32826

M 32801

F 32808

M 32751

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M 34761

F 32839

M 34761

M 32789

F 32750

F 32703

F 32909

M 32712

F 32751

F 32822

M 32812

M 32825

M 32812

F 34736

M 32811

F 32814

M 32904

M 32701

F 32832

F 32792

F 32712

M 32725

F 34746

F 32703

F 32714

M 32825

F 32824

M 34758

F 32808

M 33868

M 32808

M 32808

F 32835

M 34771

M 34761

M 32779

F 32825

M 34759

M 32809

M 34746

M 32707

M 34714

M 32701

M 32792

M 32807

M 34759

M 32822

F 32805

M 32808

F 32806

F 34746

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F 32822

M 34746

M 34772

M 34788

M 34759

F 32810

F 32810

M 32807

M 32922

M 32703

F 32738

M 34742

M 34744

M 34715

M 34744

F 32818

F 32701

M 32810

M 32826

F 34744

F 32792

M 32817

M 32712

M 32810

M 32703

M 32714

F 34758

M 34714

M 32808

F 32828

F 32811

M 32805

M 32811

M 34787

M 34746

M 32808

M 32839

M 34481

F 33897

M 34714

M 34736

M 32712

M 32805

M 32839

M 34743

F 32730

M 34744

M 32812

M 32808

M 34743

M 32810

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M 34787

F 32839

F 32825

F 32825

M 32725

M 33844

M 32839

M 32822

F 32825

M 32839

M 34761

M 32712

F 32811

F 34761

F 32818

M 32839

M 32826

F 32771

M 32807

M 34787

M 32835

M 34769

M 32808

M 32837

M 32839

M 32837

F 32808

F 32773

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