EMPLOYEE

SEPARATION
INFORMATION
The following packet is intended to provide you with
information to ensure a smooth transition. Please retain this
copy after your separation. Should you have questions
during your transition or after your exit, please direct your
inquires to [email protected]

Human Resources
June 2022
 SEPARATION INFORMATION – FAQS
Helpful information designed to ease Employee transitions and answer commonly asked
questions related to what to expect when exiting the company. NOTE: The official Benefits
Summary Plan Documents will control in case of any difference between them and the
information provided here.

Medical, Dental, and Vision Benefits

What will happen to my Medical (Aetna), Dental (Delta Dental of OH) and Vision (EyeMed)?
Any current medical, dental or vision coverage will be effective through the last day of the
month in which your employment ends. Any claims incurred after this date will be denied unless
you elect continuation of your coverage under the Consolidated Omnibus Budget Reconciliation
Act (COBRA).

Am I eligible for the Consolidated Omnibus Budget Reconciliation Act (COBRA)?

COBRA is a federal law that requires employers to offer employees, their spouses and
dependent children who are currently covered by a Romanoff medical, dental, and/or vision
insurance plan the opportunity to continue benefits for a limited period of 18 or 36 months.
Federal law also requires an employer that is subject to COBRA requirements to notify its group
health plan administrator within 30 days after an employee’s termination, or if employment
hours are reduced resulting in a loss of coverage. Within 14 days of that notification, the plan
administrator is required to notify the individual of his or her COBRA rights.

Terminated employees, and/or any covered dependents, which are losing coverage under the
plan due to a Qualifying Event, will receive a COBRA Qualifying Event notice from Discovery
Benefits. Your COBRA Qualifying Event notice will be mailed directly to your home address
following your termination of coverage.

Instructions, costs and deadlines for enrollment will be included in edition to this notice. After
you have received your COBRA election packet, you must return the completed COBRA election
form directly to Discovery by fax or mail.

You are allowed a 60-day election window to decide if you want to continue your group
coverage through COBRA; the deadline to make your COBRA election will be noted on your
COBRA Qualifying Event notice. Please be aware that COBRA reinstatement can take up to 10
business days to process from the date your election and first premium payment have been
made; once the reinstatement is processed, your coverage will be retroactively reinstated to
your loss of coverage date.

A copy of the 2023-2024 plan year COBRA rates will be provided to you in advance as part of this
packet. If you or your spouse are eligible for Medicare, your Romanoff COBRA medical coverage
will be secondary to Medicare Parts A and B regardless of whether you have actually enrolled in
Medicare coverage. When your employment terminates and you elect COBRA medical coverage,
you should enroll in Medicare Parts A and B.

If you, or your spouse, become eligible for Medicare while you are enrolled in COBRA medical
coverage, you must enroll in Medicare Parts A and B. You will no longer be eligible to participate
in COBRA medical coverage.
Accident, Critical Illness and Hospital Indemnity Insurance (Aetna)
Any current coverage for each of these will be effective through the last day day of the month
in which your employment ends.

Group Life, Voluntary Life, Short Term Disability and Long Term Disability Insurance
(Hartford)
The current coverage levels for each of these will be effective through the last day your
employment. This document provides you with notice that you may be eligible to port or
convert your voluntary life coverage(s). To be eligible for coverage continuation, you must have
been actively at work on the date employment ended and notify the insurance company within
31 days of your last day of employment.

For information, please visit www.thehartford.com to review your options for continuing your
coverage through portability or conversion, calculate the rates, and obtain the necessary
forms.

Please use Policy Number: 898018. For assistance, please call 1-800-523-2233.

RETIREMENT SAVINGS PLAN 401(K)

Your active participation in the 401(k) Plan ceases upon your termination date.

The date of your termination will be submitted to Principal within 7 days. Once Principal has
processed this information you will be able to request a distribution of your account from the
Plan. All requests for distributions are made through Principal. They can be reached at 1-800-
986-3343 or, log in at www.principal.com.

Vesting: Your vested account balance can be accessed by calling Principal or log in at
www.principal.com.

Account Balance: You can withdraw, rollover, or leave your vested balance in the Romanoff
Plan (if your vested account balance is greater than $5,000). A vested account balance less
than $1,000 will be automatically distributed to you between 60-120 days from your termination
date, unless you contact Principal and direct them to roll your vested balance over to another
account. If your vested balance is between $1,000 and $5,000, contact Principal for help with
your distribution options or anything related to your Romanoff Retirement Plan account Outside
of their website at www.principal.com or by phone at 1-800-986-3343.

BENECO
Your active participation in the Beneco ceases upon your termination date.

The date of your termination will be submitted to Beneco within 7 days. Six months after your
termination date, you will be able to request a distribution of your account from Beneco. All
requests for distributions are made through Beneco. They can be reached at
[email protected], or 1-855-566-7940 or, log in at www.beneco.com.
VACATION/PTO
Employees who are eligible for PTO while employed at Romanoff forfeit all available hours upon
termination.

FINAL PAYCHECK
Upon separation, Payroll will process your final time sheet and will prorate any allowances to calculate
your final paycheck. Your final paycheck will be deposited via direct deposit on the Friday following
the last pay period worked.

For those terminating employment during 2023, you can expect your W-2 to be sent by Jan 31st of 2024.
A copy will be mailed to your home address on file at time of distribution. Please remember to
report any changes of address to HR or Payroll after termination to minimize any delays in getting your
W-2 to your home the following year.

The Payroll team can assist with any payroll-related matters now or after separation. Please
email [email protected] for questions or assistance with payroll.

COMPANY PROPERTY
All company property such as Laptops, iPads, Power Cords & Peripherals, Gas Cards, Corporate
Cards, Keys, etc. should be returned to your Manager or HR on your last day of employment.
Company property can also be defined as Intellectual Property, trade secrets or Competitive
Advantages and will continue to be protected from unauthorized disclosure via the
Confidentiality & Non-Disclosure Agreement (CDA) entered when hired at Romanoff. Please
remember that the terms of any CDA agreement remain in place for 12 months after your
separation. If you have questions about the Property returns or need further assistance, please
contact [email protected].

VERIFICATION OF EMPLOYMENT
In accordance with Company policy, Romanoff does not disclose the reason for separation for
any employee, nor do we provide letters of reference for any employee.

Please direct all requests for Employment Verification to employment

[email protected].

UNEMPLOYMENT BENEFITS
If you have been involuntarily terminated you may be eligible for State Unemployment Benefits
in the state where you worked. Questions regarding your eligibility for state unemployment
benefits should be directed to the State’s Unemployment Claims office.

HUMAN RESOURCES
The Human Resources team is available to answer questions and/or facilitate resolutions on
any employee’s behalf. Please direct your inquiries to [email protected].
ESOP ACCOUNT
In the event the circumstances of your employment termination are not related to disability,
death or retirement, (age 65 as defined by the plan), distribution notifications are mailed to
each participant 6 years after their termination date. Participants will receive a distribution
once annually for five years.

Although no longer active in the ESOP, participants will continue to receive an annual
personalized account certificate (3rd quarter) until the final distribution is paid in full.

The percentage you will receive from funds in your account is directly related to your years of
service. ‘Years of service’ is defined as a plan year during which an employee completes 1000
hours or more of service. Your annual, personalized ESOP certificate will notify you of your
vestige.

APPRENTICESHIP REPAYMENT
In the event an Employee does not fulfill their obligation to remain with Romanoff for three (3) years
beyond the current school year, (for any reason), the Employee agrees to repay Romanoff
the full amount of one year's tuition and expenses.

In the event the Employee’s final paycheck amount is insufficient to fully reimburse Romanoff for the
tuition and expenses, the Employee agrees to repay any remaining amount of the Expenses to
Romanoff in full within 30 days of the date of the termination of Employee’s employment.

TOOL LOAN REPAYMENT

I understand that if my employment is terminated for any reason before the total amount is
completely repaid, the balance outstanding will be due prior to receipt of my final paycheck. I also
understand failure to return company property, the replacement cost of the item(s) will be deducted from
my final paycheck.
 Aetna:
Website: www.aetna.com
Phone: 1-800-872-3862
Group Number 141443

EyeMed:
Website: www.eyemed.com
Phone: 1-866-939-3633
Group Number 1006965

Delta Dental:
Website: www.deltadentaloh.com
Phone: 1-800-524-0149
Group Number 1176

Principal:
Website: www.principal.com
Phone: 1-800-986-3343

Additional questions may be forwarded to [email protected].