Pulmonx 2025 Benefits Guide : simplebooklet.com

At Pulmonx, we believe that a healthy, happy, andfinancially secure workface is at the cornerstone of oursuccess. Our benefits and wellness program is built onthree core pillars of health: Physical Health, EmotionalHealth, and Financial Health. These pillars are designed to empower you to live yourbest life, both inside and outside of the workplace. Thisguide is organized to provide you with the highlights ofour comprehensive benefits program, “Pillars of Health”. The symbol of “Pillars of Health” represents lungs, as thefoundation of our business and products. The symbol isalso holding hands, representing caring and community,and an apple which symbolizes optimal health. Togetherthey are an amalgam of healthy living, community &caring. The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.In addition to this guide, we have provided many more resources which may be reviewed at ourwebsite www.pulmonxbenefits.com.If you would like to discuss any of our benefits in more detail, you are encouraged to reach out toour U.S. HR team at HRPulmonxUS@pulmonx.com or contact our partners at OneDigital bysending an email to your dedicated Senior Client Advocate sabrina.dokes@onedigital.com orcalling 925-407-1178, during business hours: Monday through Friday, 8am to 5pm PST.Our goal is to ensure Pulmonx provides a comprehensive health and welfare program for ouremployees and for each Pulmonx employee to know and understand our benefits and resourcesavailable. Please take the time to review so you have the knowledge to select the best coverageoptions for you and your family.

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You must request a change to your benefits within 30days of your life event (60 days for changesinvolving Medicaid eligibility). Documentation will be required.Enroll nowQualifying life events allow you to change yourcoverage outside of the Open Enrollment period.These include:marriage or divorce, birth or adoption, dependent child reaching limiting age,death of a covered dependent, and a change in eligibility through Medicare,Medicaid, or a spouse or parent's coverage.3. If you have a qualifying life eventOpen Enrollment is your one chance each year toreview your coverage options and make changes toyour benefits.Your choices are in effect from January – Decemberof the following year unless you have a qualifying lifeevent.Your benefit plans are in effect January 1 –December 31 each year. In general, there are threescenarios you can make benefit selections:Making Benefit SelectionsEligibility Enrolling in coverageYou are eligible to enroll in group benefits effectiveon your date of hire if you work 20 or more hours perweek; this is your effective date. Be sure to submityour selections during your enrollment window. Whenyou are eligible to participate in benefits, electionsyou make generally become effective on your dateof hire. Your benefit selections will be in effect throughDecember 31. 1. When you are first eligible2. At Open EnrollmentFor youYou are eligible to enroll in group benefits effective onyour date of hire if you work 20 or more hours per week.Covering your familyYou may also add coverage for your eligibledependents when you elect coverage for yourself.Your Spouse or PartnerYou may cover your legal spouse or domestic partner.Note: The value of health care coverage provided for adomestic partner or any enrolled dependent children ofyour domestic partner is treated as income to you forfederal tax purposes (and in most cases, state taxpurposes).Pulmonx will report the value of the coverage as incometo you on your Form W-2 and will withhold applicabletaxes. The amounts taxable to you can be substantial. Itis recommended you consult with your tax advisor formore information on how this affects you.Your ChildrenDependent children include: natural child, stepchild,adopted child, or foster child. Children are eligible upto age 26, unless considered disabled.Enrolling online is simple and secure. Eligible employees will enroll forbenefits through ADP. Upon logging in, a New/Open Enrollment wizardwill pop up and you can begin the process by following the prompts.You can access and review benefits by navigating to Myself > Benefits >Enrollments.Employees will use ADP to make changes to their benefits during OpenEnrollment, or whenever there is a qualifying life event. How to enroll:

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AD&D (Accidental deathand dismemberment) A plan that provides benefits in theevent of an accidental death ordismemberment (generally, anaccident that results in death, lossof part of the body, or the loss ofthe use of part of the body).Balance billingWhen you use an out-of-networkmedical or dental provider, theymay bill you the differencebetween what they charge andthe amount your insurance pays.Medical: balance billing is inaddition to – and does not counttowards – your out-of-pocketmaximum.BeneficiaryA person designated by aparticipant, or by the terms of anemployee benefit plan, which isor may become entitled to abenefit under the plan. Evidence of insurabilityMany insurance companiesrequire prospective clients/individuals to prove that they arein good health and are thereforegood insurance risks before thecompany will cover them.Explanation of benefits(EOB)A statement from a plan explainingwhat portion of a claim was paid. HIPAA AuthorizationUnder HIPAA, a document thatauthorizes the use or disclosure ofan individual’s ProtectedInformation by a Covered Entityfor any purpose described in thedocument and meets specificrequirements. In-networkIn-network care is always yourlowest-cost option. Networks aregroups of medical, dental, andvision providers, pharmacies, andfacilities that agree to discountthe cost of their care or service.Helpful Terms & ResourcesWe removed as much jargon as possible.But you’ll probably still encounter some terms as you enroll in and use yourbenefits, and we want you to be prepared!COBRAFederal law (ConsolidatedOmnibus Budget ReconciliationAct of 1985) requiring certainemployers that offer group healthplans to provide continuationcoverage to employees and theirdependents who incur certainqualifying events. Coinsurance or costsharingThe portion of covered healthcare costs for which you arefinancially responsible.Coinsurance does not includedeductibles or copays. CopayA flat fee you pay each time youreceive a copay-eligiblemedical, dental, or vision serviceor prescription medication. DeductibleThe amount you’re responsible forpaying in care expenses beforethe medical or dental plan startspaying deductible-eligibleexpenses.

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Out-of-pocket maximumThe most you’ll pay for coveredin-network medical care in ayear. This includes yourdeductible, any coinsurance orcopays, and prescription drugs. The out-of-pocket maximum doesnot include your premium (theamount you pay for coverage),non-covered expenses, or out-of-network care that’s been balancebilled.Pre/Prior-authorizationSome specialty medicalproviders, services andprescriptions require priorauthorization from your insurancecompany. These may include - butare not limited to - surgery,imaging (CT, MRI) and certainprescription medications.Primary care physicianA primary care physician (PCP) isyour main medical doctor –usually a general practitioner(GP), family doctor, internist,OB/GYN, or pediatrician (forchildren).Reasonable andCustomary (R&C) or Usual,Reasonable, andCustomary (UCR) A term used in many health plans,defined as the price at or belowwhich the majority of health-careprofessionals of similar expertisecharge for similar procedureswithin a specific geographicarea. Annual NoticesDownload nowHow to handle medical bills(2:04)Helpful Terms & ResourcesWe removed as much jargon as possible.But you’ll probably still encounter some terms as you enroll in and use your benefits,and we want you to be prepared!We’re required to tell you aboutcertain rights and responsibilities youhave as an employee of Pulmonx. You can request a paper copy at nocharge from:Pulmonx Human Resources1-650-364-0400HRPulmonxUS@pulmonx.com Learn moreNegotiated ratesThe costs for health care servicesnegotiated between theinsurance carrier and in-networkhealth care providers.Negotiated rates are usually lessthan usual, customary andreasonable (UCR) charges.Out-of-network providerA state-licensed health careprovider who has not contractedwith a health care plan (medical,dental or vision plan) and has notagreed to certain rates. In mostcases, you pay more and receivea lower level of benefits when youuse out-of-network providers. Seeyour plan for coverage details. Have questions? Your advocate is here to help youwith all things benefits.

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In-network care HMO (CA only) HDHP HMO $1650 (CA only)Network name:Kaiser PermanenteKaiser PermanenteAnnual Deductible (DED)[Calendar year]None$1,650 individual coverage$1,650 individual in a family up to$3,300 family maximumOut-of-pocket maximum$2,000 individual coverage$2,000 individual in a family up to$4,000 family maximum$3,300 individual coverage$3,300 individual in a family up to$6,600 family maximumPre-tax accountavailabilityHealthcare FSAHealth Savings Account (HSA)See the HSA page for contribution amounts.Preventive carePrimary care visitSpecialist visitVirtual visit100% covered$20 copay$20 copay100% covered100% coveredDED then you pay 10%DED then you pay 10%DED then you pay 0%Urgent careEmergency roomInpatient hospital careOutpatient surgery$20 copay$200 copay$200/admission$100/surgeryDED then you pay 10%DED then you pay 10%DED then you pay 10%DED then you pay 10%Prescription drugsPrescription deductibleTier 1Tier 2Tier 3Tier 4(30 days)Does not apply$15 copay $30 copay $30 copay You pay 30% up to $250(30 days)Combined with medicalDED then $10 copayDED then $30 copayDED then $30 copayDED then you pay 20% up to $250Your cost for coverageEmployee onlyEmployee + spouseEmployee + child(ren)Employee + familySemi-Monthly$52.50$187.50$162.50$252.50Semi-Monthly$20.00$117.50$92.50$155.00See plan detailsSee plan detailsMental health supportLocate an in-network providerMedical InsuranceBoth plans cover in-network preventive care at 100%, prescriptiondrugs, and include an annual limit on your expenses. The differencesare: what you pay for the plan, what you pay when you get care, andyour annual maximum cost for care (out-of-pocket maximum).Select from two medical options throughKaiser Permanente (California Only).The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.

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Register on www.kp.org to access all theresources Kaiser has to offer. Below are a few.Kaiser ResourcesThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Make an appointment for therapy or counseling. Call your local medical centerto schedule an appointment at the mental health, behavioral health, or psychiatrydepartment.Get care advice 24/7. Find your local 24/7 phone number athealthy.kaiserpermanente.org/get-care.For emergency care. If you think you have a medical or psychiatric emergency,call 911 or go to the nearest hospital.Choose How You Get CareHealthy Lifestyle Programs: Online wellness programs are available to help youeat healthier, lose weight, quit smoking, reduce stress, and manage ongoingconditions such as diabetes or depression.Health Classes: Choose from health classes and support groups offered atKaiser facilities. Visit kp.org/classes to see what’s available in your area.Wellness Coaching: Work with a personal wellness coach by phone at no costto explore options for meeting your health goals. Start here:kp.org/wellnesscoach.Wellness ResourcesMental Health: Mental health services include assessment, treatment, andsupport for a variety of mental, emotional, and substance use conditions. AtKaiser Permanente, adults, families, teens, and children can get clinical andsupport services for a wide range of issues. Visit kp.org/mentalhealth to accesslocal resources.Mind/Body: Practicing self-care is good for the mind, body, and spirit. Get tipsfor meditation, dealing with everyday stressors and finding simple ways to takecare of yourself. Visit kp.org/mindbody.Mental Health & Wellness: Check out additional Kaiser wellness resources atKaiser Health and Wellness Resources.Behavioral Health: Kaiser offers a number of support programs to help you andyour loved ones if you need assistance with managing a variety of behavioralhealth needs. Behavioral & Mental Health ResourcesWellness CoachingMental HealthOnline ResourcesKaiser Permanente App: Finddoctors and locations, view upcomingappointments, message your doctor’soffice with non-urgent questions. Visitkp.org/mobile.Headspace Care: A program basedon cognitive behavioral therapyoffering guided resources and toolsfor a range of mental health needsand challenges.Calm App: A meditation andmindfulness app that can help usersdevelop self-care skills.DiscountsRegular workouts can help improveyour mood, sharpen your mind, andhelp you feel healthier and happieroverall. That’s why we teamed up withfitness industry leader ClassPass tomake it easy for you to exercise fromthe comfort of home. Self-care AppsClassPassKaiser AppVirtual CareMaternity CareAway From HomeMake an appointment for therapy or counseling. Call your local medical centerto schedule an appointment at the mental health, behavioral health, or psychiatrydepartment.Get care advice 24/7. Find your local 24/7 phone number athealthy.kaiserpermanente.org/get-care.Maternity Kaiser ID Cards:Only new Kaiser members or members whomake Kaiser plan changes will receive anew Kaiser ID card. You can also downloada softcopy, save to your digital wallet onyour phone and share with your enrolleddependents.

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In-network careOA 20 PPO 20-350Network name:Open Access PlusOpen Access PlusAnnual Deductible (DED)[Calendar year]None$350 individual coverage$350 individual in a family up to$750 family maximumOut-of-pocket maximum$2,500 individual coverage$2,500 individual in a family up to$5,000 family maximum$3,000 individual coverage $3,000 individual in a family up to$6,000 family maximumPre-tax account availabilityHealthcare FSAHealthcare FSAPreventive carePrimary care visitSpecialist visitVirtual visit100% covered$20 copay$25 copay100% covered100% covered$20 copay$30 copay100% coveredUrgent careEmergency roomInpatient hospital careOutpatient surgery$20 copay$150 copay$325/admission$200/surgery$20 copayDED then you pay 10%DED then you pay 10%DED then you pay 10%Prescription drugsPrescription deductibleTier 1Tier 2Tier 3Tier 4(30 days)Does not apply$10 copay $30 copay $60 copay You pay 20% up to $250(30 days)Does not apply$10 copay $30 copay $50 copay You pay 30% up to $250Out-of-network careAnnual deductible Out-of-pocket maximum Balance billing appliesN/AN/ABalance billing applies$350 / $750 $10,250 / $20,500Your cost for coverageEmployee onlyEmployee + spouseEmployee + child(ren)Employee + familySemi-Monthly$42.50$185.00$150.00$262.50Semi-Monthly$65.00$245.00$180.00$330.00See plan detailsMental health supportLearn moreMedical InsuranceAll plans cover in-network preventive care at 100%, prescriptiondrugs, and include an annual limit on your expenses. The differencesare: what you pay for the plan, what you pay when you get care, how out-of-network care is covered, andyour annual maximum cost for care (out-of-pocket maximum).Select from four medical options through Cigna (national).Locate an in-network providerThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.See plan details

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In-network carePPO 30-750HDHP PPO $1650Network name:Open Access PlusOpen Access PlusAnnual Deductible (DED)[Calendar year]$750 individual coverage$750 individual in a family up to$2,250 family maximum$1,650 individual coverage$3,300 family maximumOut-of-pocket maximum$5,250 individual coverage$5,250 individual in a family up to$10,500 family maximum$3,500 per person $7,000 family maximumPre-tax account availabilityHealthcare FSAHealth Savings Account (HSA)ER Contributions: EE Only - $850 ER Contributions: EE+ Family - $1,700Preventive carePrimary care visitSpecialist visitVirtual visit100% covered$30 copay$40 copay100% covered100% coveredDED then you pay 10%DED then you pay 10%DED then you pay 10%Urgent careEmergency roomInpatient hospital careOutpatient surgery$30 copayDED then you pay 20%DED then you pay 20%DED then you pay 20%DED then you pay 10%DED then $150 copayDED then you pay 10%DED then you pay 10%Prescription drugsPrescription deductibleTier 1Tier 2Tier 3Tier 4(30 days)Does not apply$10 copay $30 copay $50 copay You pay 30% up to $250(30 days)Combined with medicalDED then $10 copayDED then $25 copayDED then $40 copayDED then you pay 30% up to $250Out-of-network careAnnual deductible Out-of-pocket maximum Balance billing applies$1,500 / $4,500 $10,500 / $21,000Balance billing applies$3,300 / $6,600 $6,000/ $12,000Your cost for coverageEmployee onlyEmployee + spouseEmployee + child(ren)Employee + familySemi-Monthly$25.00$162.50$120.00$230.00Semi-Monthly$12.50$127.50$95.00$155.00See plan detailsSee plan detailsMental health supportMedical InsuranceAll plans cover in-network preventive care at 100%, prescriptiondrugs, and include an annual limit on your expenses. The differencesare: what you pay for the plan, what you pay when you get care, how out-of-network care is covered, andyour annual maximum cost for care (out-of-pocket maximum).Select from four medical options through Cigna (national).The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Locate an in-network providerLearn more

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Cigna HappifyUsing Happify is fun, free, quick and easy. Simply answer a fewsimple questions, play the games and activities, and earnpoints for completed activities. Sign up and download the freeapp today at happify.com/Cigna.Cigna TalkspaceTalkspace is an online therapy platform that makes it easy andconvenient for you to hold sessions with a licensed behavioral therapistfrom anywhere, at any time. No commutes or long waits. Withtalkspace, you can send private messages to, or hold live videosessions with, your dedicated therapist through a secure digital appplatform. Visit talkspace.com/cignaCignaResourcesRegister on www.mycigna.com to access allthat Cigna has to offer. Below are a fewhighlights.The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Learn MoreLearn MoreLearn MoreTelehealth/Virtual careAccess quality care in the convenience of your own home, on your lunch break, or on the way to your child’s soccergame! Whether it's a nagging cough, middle-of-the-night fever, or a suspicious-looking mole or rash — telehealth throughMDLIVE is here when you need it. Connect with a board-certified physician 24 hours a day, 7 days a week.Cigna is partnered with MDLIVE to offer a comprehensive suite of convenient virtual care options — available byphone or video whenever it works for you. MDLIVE board-certified doctors, dermatologists, psychiatrists andlicensed therapists have an average of over 10 years of experience, and provide personalized care for hundreds ofmedical and behavioral health needs.Connect with video or phone, whenever it’s convenient for you. Best of all, virtual care from MDLIVE board-certifieddoctors is available to you and your eligible dependents as part of your health benefits.MDLIVE doctors are available to help with:Primary care, including preventive/wellness screenings.Urgent care for minor medical conditions, prescriptions as needed.Behavioral care, talk therapy and psychiatry from the privacy of home.Dermatology, customized care for skin, hair and nail conditions.MDLIVE licensed professionals can help you manage mental and behavioral health conditions including:AnxietyDepressionAddictionGrief and moreAccess MDLIVE by logging into myCigna.com and clicking on“Talk to a doctor.” You can also call MDLIVE at 1-888-726-3171.

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Wellbeing Solution with VirginPulseThe Cigna Healthcare Wellness Experience, together withVirgin Pulse®, is included in your health plan, at no additionalcost to you. It is designed to help you make small, everydaychanges for your well-being and focus on the areas you wantto improve the most. Visit myCigna.com® or the myCigna®app to access features like: Daily content cards, Digitalcoaching, and recommendations for healthy habits.Active & FitBreak a sweat without breaking the bank. As a Cigna member, through the Health Rewards Discountprogram, you have access to the Active & Fit Direct program, which allows you to choose from 10,000+participating fitness centers nationwide for $25 a month. To get started go tohttps://discoverhealthyrewards.sites.cigna.com/CignaResourcesThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Cigna Identity ProtectionCigna members have access to identity protection services from IdentityForce to proactively monitor, alert, andhelp fix any identity theft compromises. This benefit is available to Cigna members, and their dependents (up toage 18), at no additional cost.Visit: https://cigna.identityforce.com/starthereCall: 1-833-580-2523Employees enrolled in a Cigna medical plan who have provided their email addresses on myCigna.com® willreceive a registration link via email from IdentityForce.Learn MoreLearn MoreLearn MoreCigna ID Cards:Cigna does not automatically providephysical ID Cards. Access your digital IDcard through myCigna.com® and themyCigna® app. For quick accessregister online at myCigna.com®. If youwish to request a physical ID card, youmay do so through your online accountor by calling Cigna directly.Omada - weight management programLearn MoreEligible Cigna members have access to the Omada weightmanagement program. Work one-on-one with a healthcoach, eat healthier without counting calories. All memberseligible for Omada will receive a smart scale. Register onthe myCigna.com website or app.

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Current & Hired between January 1, 2025 - June 30, 2025Employee OnlyEmployee + DependentPulmonxcontributes up to:$850$1,700Hired between July 1, 2025 - December 31, 2025Employee OnlyEmployee + DependentPulmonxcontributes up to:$425$850*Tax-free contributions, earnings and payments at the Federallevel (for qualified expenses). HSAs can be taxable at the statelevel – for example, HSAs are subject to state income tax inCalifornia. Consult with your tax advisor for more information.You will receive a benefits card from igoe whichgives you easy access to funds in your tax-advantaged benefit accounts as a stored value card(similar to a gift card). Simply swipe the card at thepoint of sale. Transactions will only be allowed up tothe balance that is available in your account and isdesigned to work at eligible merchant locations thataccept MasterCard. Remember to obtain a detailedreceipt for all transactions.Using your moneySpend your HSA balance on health careexpenses (medical, prescription, dental, andvision) for you and your tax dependents, ORLet your balance grow for retirement.The money in your HSA is always yours and availablefor qualified health care expenses - even if youchange jobs or health plans. Before retirement, anyfunds used for non-healthcare expenses are subjectto tax penalties. Keep your receipts!Growing your money + tax savingsHSA dollars go into your igoe account tax-free*,grow tax-free, and come out tax-free when you usethem for qualified health expenses. You may also beable to invest part of your balance once it meets acertain level.In retirementAt age 65, you can withdraw the funds in your HSAfor any use (not just health care!) without taxpenalties; regular income tax will still apply. EligibilityLearn how HSAs can helpyou save for today andtomorrow.Learn moreLearn MoreHealth SavingsAccount (HSA)Pulmonx contributes to your Health Savings Account (HSA)when you elect the Cigna or Kaiser HDHP medical plan andmeet IRS requirements. You may also contribute tax-free* funds to save for currentand future health expenses:ContributionsHSA funds In order to make – or receive – contributions to aHealth Savings Account (HSA), you must:be enrolled in a qualified High Deductible HealthPlan (HDHP),not be covered under any other non-HDHPhealth coverage, including a full health care FSAthrough your spouse,not be anyone else’s tax dependent, and not be enrolled in Medicare A or B, Tricare, or VAbenefits.An HSA through igoe is paired with thePulmonx High Deductible Health Plans (HDHP).Save pre-tax* money for health care expenses – or retirement!The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Contribution Limits (Employer + Employee)Employee OnlyEmployee + Dependent2025 IRS maximumcontribution $4,300 $8,550Catch-upcontribution (55+)$1,000$1,000

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Pay for eligible child or disabled adult care while you work or attend school.Dependent care FSA2025 maximum contribution$5,000Married filing separately: contribute up to $2,500 per person.Only the amount you’ve actually contributed is available for use at any one time.Estimate carefully! Unused funds will be forfeited at the end of the year per IRS regulations.Enrollment and contribution elections are made on a monthly basis, not annual.Pay for eligible medical, prescription, dental, andvision expenses. Pay for eligible dental and vision expenses whenyou're also contributing to an HSA. Health care and dependent care expenses can add up. Paying withtax-free funds can help. Enroll in one or more flexible spendingaccounts (FSAs) depending on your needs.Pay for qualifying expenses with tax-free money usingyour Flexible Spending Account through igoe.2025 maximum contribution$3,300Annual rollover amount$660Enrolled in an HDHP plan and eligible for HSA contributions? You’re not eligible for a health care FSA;you can contribute to a limited purpose FSA instead.2025 maximum contribution$3,300Annual rollover amount$660Health care FSA Limited purpose FSAThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.FlexibleSpendingAccounts (FSAs)More InfoMore InfoMore InfoEligible ExpensesYou will receive a benefits card from igoe which gives you easy access to funds in your tax-advantaged benefitaccounts as a stored value card (similar to a gift card). Simply swipe the card at the point of sale. Transactions willonly be allowed up to the balance that is available in your account and is designed to work at eligible merchantlocations that accept MasterCard. Remember to obtain a detailed receipt for all transactions.

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Only the amount you’ve actually contributed is available for use at any one time.Pulmonx provides a Commuter Benefits Account through igoe which is a pre-tax option available for eligibletransit or parking costs. The Commuter Benefits plan allows employees to set aside pre-tax dollars each month topay for qualified, work-related transit and parking expenses.Eligible expenses include:Transit: pass, token fare card, voucher that entitles the employee to transportation or mass transit for purposes ofcommuting to and from work.Parking: business premises, parking lot, location from which an employee carpools to work.Ineligible expenses include:Tolls, gas, mileage, carpool, taxi faresParking & Transit Debit CardYou will receive a benefits card from igoe which gives you easy access to funds in your tax-advantaged benefitaccounts as a stored value card (similar to a gift card). Simply swipe the card at the point of sale. Transactionswill only be allowed up to the balance that is available in your account and is designed to work at eligiblemerchant locations that accept MasterCard. Remember to obtain a detailed receipt for all transactions.Clipper Card – Bay Area ParticipantsYour debit card can be used to add funds to the Clipper Card. The Clipper Card is accepted by most Bay Areatransit providers. When you use your igoe debit card as your primary method to add funds to your Clipper Card, itis important that you provide Clipper with a secondary payment option just in case there are not enough fundsavailable on your igoe debit card to fulfill an order.Enrollment and contribution elections are made on a monthly basis, not annual.Pay for eligible transit and parking expenses related to work.Pay for qualifying expenses with tax-free money usingthe igoe commuter benefit.Monthly maximum contribution$325Commuter and Transit BenefitThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Commuter &Transit Benefits

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Emotional HealthProgramsEAP features:Confidential. No one at Pulmonx will ever know you called orwhat was discussed.Available 24/7/365. Life doesn't happen during office hours.The EAP is here when you need them.Family care is included. Anyone living in your home is eligiblefor EAP services at no cost.24/7/365 access to care. 1-888-628-4824www.guidanceresources.comUsername: LFGsupportPassword: LFGsupport1Our Employee Assistance Program (EAP) is a confidential servicewith access to guidance and resources at no cost for: mental health concerns (including substance abuse oraddiction),adoption, parenting, or caregiving needs,financial or legal support,familial relationships and friendships,coping with day-to-day challenges, andso much more.Essentially, if it's part of your life, our EAP is here for you.Access support online, through live chat, or over the phone.24/7/365.Everyone needs support sometimes (even superheroes)Care for your mind – and your life – with supportthrough Lincoln Financial Group.Confidential care designed for all that life brings.When needed, each person can receive up to 5 face-to-face (orvirtual) visits with a licensed counselor per issue per year. At no cost.Additional visits - if needed - will go through your health insurance.The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Access no-cost monthly resources designed to support yourwellbeing, understand your benefits, and manage your finances. Topics include:tips to connect with your child(ren), ways to ditch debt for good, and what to do when a medical bill arrives.Access nowManaging work, family, relationships,finances — or mental health conditions— can be tough. Our Employee Assistance Program(EAP) provides you and your family withno-cost, confidential assistance with allthings related to your life. 24/7/365.Mental health care is healthcare.Information when you need itOn-demand supportAccess on-demand mental healthresources on a platform built with yourmobile device in mind. The Mental Health Hub includes:Tips for managing day-to-day stressors,Resources for times of crisis, Practical information about mentalhealth, and more!Access now

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Stay in-network to avoid balance billing (the difference between what anout-of-network provider charges and the amount your insurance pays). You'll get in-network preventive care at 100% along withcoverage for basic and major dental services.Orthodontic care is covered.Your dental coverage is through Cigna.Dental InsuranceLearn about dental carecategoriesDental PPONetwork name:CignaIn-networkOut-of-networkAnnual Deductible (DED)$50 per person $150 family max$50 per person $150 family maxAnnual maximum benefit$2,500 per person $2,500 per person Preventive care100% coveredBasic careDED then you pay 10%DED then you pay 20%Major careDED then you pay 40%DED then you pay 50%Implant coverage:Available (DED then you pay 40%)Available (DED then you pay 50%)Orthodontic careCoverageLifetime max benefit50% covered (Child & Adult)$1,500 lifetime max benefitYour cost for coverageEmployee onlyEmployee + 1 DependentEmployee + 2 or More DependentsSemi-Monthly$5.00$10.00$15.00See plan detailsThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.In order to take full advantage of your dental plan, we recommend that you verify a dentist’s participation status before each appointment.There are two ways to check dental participation: online through the provider search function located at www.mycigna.com or by callingcustomer service at 1-800-244-6224.In-network versus out-of-network: To pay the least out-of-pocket always use in-network dentists. If you choose to visit an out- of-networkprovider, your out-of-pocket costs may be higher as Cigna Dental will only pay up to their contract allowances which may be lower thanyour dentist’s actual fees. Out-of-network dentists may balance bill you the difference between the contracted allowance and their fee.Pre-treatment estimates: Pre-treatment estimates are not required, however, we recommend that you request a pre-treatment estimatebefore beginning any dental procedures beyond preventive care. Your dental provider may submit a pre-treatment plan to the dentalinsurance company which outlines the services that will be provided to you. The dental insurance company will then estimate what portion ofthe services will be covered and what portion will be considered your responsibility.Locate an in-network providerSee Dental SBC

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Vision Service Plan (VSP)Network name:VSP Signature NetworkIn-networkOut-of-networkAnnual eye exam (ever y 12 months)$10 copayUp to $50 Materials copay(lenses & frames)$25 copayN/ALenses (ever y 12 months)No charge after copay for the following lenses:Single Vision; Lined Bifocal; Lined Trifocal; andLenticular.Single Vision: Up to $50Lined Bifocal: Up to $75Lined Trifocal: Up to $100Lenticular: Up to $125Frames(ever y 12 months)$150 allowanceUp to $70 Contact lenses(ever y 12 months)Elective: $150 allowanceMedically necessary: 100% covered Elective: $105 allowanceMedically necessary: $210 allowanceYour cost for coverageEmployee onlyEmployee + 1 DependentEmployee + 2 or More DependentsSemi-Monthly$0.00$0.00$0.00See plan detailsYour vision plan covers either glasses (lenses and frames) or contact lenses each year. If you receive contact lenses, they will be instead of your glasses benefit.You'll get an annual exam with coverage for lenses and frames, orcontacts in lieu of glasses.*Vision coverage is bundled with dental and elected together.Vision InsuranceYour vision coverage is through Vision Service Plan (VSP).The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.You may elect vision coverage through VSP for your eyewear and eye care needs. In order to take full advantage of your vision plan, werecommend that you visit in-network providers. You may find in-network providers online at www.vsp.com or by calling Customer Service at 1-800-877-7195. If you decide to receive services from an out-of-network vision provider, you will be responsible for paying for those servicesup front. You may then request reimbursement from VSP based on a reimbursement schedule.*Glasses or contacts are covered as in-network (as outlined above) with an $80 frame allowance at Costco and $150 frame allowance atWalmart/Sam’s Club. For eye exams, eye care providers contract independently with VSP, so always check www.vsp.com to see if theprovider is in-network or out-of-networkLocate an in-network provider

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Basic lifeBasic AD&DPulmonx provides2x your annual salary up to $500,0002x your annual salary up to $500,000See plan detailsSee plan detailsEOIFor youFor your spouseFor your child(ren)Age 26Coverageincrements$10,000$5,000$10,000Coveragemaximum$500,000, not toexceed 5x ofemployee’s salary50% of employee’sbenefit amount, not toexceed 2.5x ofemployee’s salary14 days - 6 months: $2506 months to age 26:$10,000Medicalquestion limit$200,000$30,000Does not applyPulmonx provides life and AD&D insurance at no cost to you.Life insurance and Accidental Death and Dismemberment (AD&D) insurance provide funds for those who have lost someone or for those who are seriously injured. Life insurance pays funds to your designated beneficiaries after your death, while AD&D pays an amount equal to your life insurance in the event of an accidental death or for certain accidental injuries. It’s very important that you have a current beneficiary designated in ADP,especially after experiencing a life event such as marriage or divorce. Financial peace of mind through Lincoln Financial Group.Life and AD&DInsuranceMake sure to designate a beneficiary for your life insurance coverage toensure your family is cared for according to your wishes.Basic life and AD&D insuranceWhat's AD&D?Accidental death anddismemberment (AD&D)insurance may pay:your beneficiary if youpass away due to anaccidentyou a partial benefit if youlose specified bodilyfunctions (sight, limbs, etc.)The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.The value of Company-paidlife insurance coverage over$50,000 is considered taxableincome under federal tax law.This “imputed income” will beincluded in your annual grossincome reported on your W-2form.Voluntary life and AD&D insuranceYou may also purchase additional coverage for you, your spouse, and youreligible child(ren). Imputed Income:When you’re first eligible (anew hire), you can purchaseadditional life insurance up tothis limit without any medicalquestions required. Medical questions andapproval will be required forall future increase andpurchase requests.Check out the EOI link(Evidence of Insurability) formore information.Medical Question Limit:

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Benefits beginAfter 7 days of inability to work Coverage amount60% of your income up to $3,500 per weekPayments may continueUp to 26 weeks if you’re unable to return toworkShort term disability provides income replacement for employeeswho become unable to work due to injury or illness, includingpregnancy. Benefits received under this plan will be offset bybenefits you receive, or are entitled to receive, under any state orfederal compulsory benefit act or law, such as state disability,workers’ compensation and Social Security. Pulmonx provides this coverage at no cost to you.Short-term disabilitySee plan detailsIf you continue to be disabled for more than 180 days, you may beeligible to receive disability benefits on a monthly basis under ourLong Term Disability (LTD) plan offered through Lincoln FinancialGroup. You will continue to receive payments under the LTD plan aslong as you are deemed “disabled” until you reach Social SecurityNormal Retirement Age (SSNRA). Benefits will be offset by othersources of disability income you receive. Pulmonx provides this coverage at no cost to you.Long-term disabilitySee plan detailsPre-existing condition limitations Benefits beginAfter 180 days of inability to work (once short-term disability ends)Coverage amount66.67% of your income up to $14,000 per monthPayments may continueLater of Age 65 or SSNRAWish you knew more aboutfinances? Now you can - atno cost!Disability InsuranceProtect your paycheck with disability insurance throughLincoln Financial Group.Disability coverage insures your paycheck, replacing a portion ofyour income if you’re unable to work due to a covered illness or injury.See your benefit summary to learn more about the definition of"unable to work".If you make a disability claim within thefirst year of being covered, check yourplan details to see how pre-existingcondition limitations might impact yourcoverage.Learn moreThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.*Income includes base salary,commissions and bonuses.

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The supplemental health plan options offered by Lincoln Financial Group isyour financial cushion when faced with unexpected health issues. These are100% employee paid and are meant to supplement your medical coverage, notreplace it, to help you pay for copays, deductibles and even non-medicalexpenses, like lost wages. They are very affordable.SupplementalHealth: Your OptionsThe information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.See plan detailsSee plan detailsSee plan detailsAccident coverage through Lincoln Financal Group can promote peace ofmind and help deliver financial security if you, or a covered member, suffer froman accidental injury. It pays you a cash benefit to help with your expenses –your deductible or copays, transportation, groceries and more. The money isyours to use as you choose. See the plan details for a description of coveredaccidents.Accident Hospital Indemnity coverage through Lincoln Financal Group provides a fixeddaily benefit for each day you or a covered family member is hospitalized. Thebenefit is paid directly to you, to help cover your deductibles, coinsurance,copays, or even non-medical costs. It is designed to ease the financial burdenof a hospital admission, ensuring you can focus on recovery without worryingabout bills.Hospital IndemnityCritical illness coverage through Lincoln Financal Group pays you a cash lump-sum benefit if you or a covered family member is diagnosed with a serious illnesscovered by the policy. The benefit can help cover our medical out-of-pocketcosts, or other financial burdens that arise due to the illness.Critical IllnessIf you elect theAccident or HospitalIndemnity coverage,each of these include ahealth assessmentbenefit payable to youin the amount of $50. This can include:Annual PhysicalDental examEye examChild immunizationsSee plan summary fordetails.Learn moreLearn moreLearn more

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See plan detailsHere is how to register youraccount.Log into your account atempowermyretirement.com Go to our plan website and selectRegister.1. Choose the I do not have a PIN tab2. Follow the prompts to create yourusername and password.3.Learn moreRetirement 401(K)The information shown in this presentation is an illustrative summary only. The underlying plan contract or document governs all aspects of the plan. Final ratesare dependent on actual enrollment, insurance carrier or plan rules, plan selection, and eligibility criteria. Please refer to the plan document, contract, and othernotices contained in this document, applications, and other corresponding communications for additional information.Learn how investing andsaving actually works - andcan work for you.Set your future self up for financial stabilitywith a 401(K) through Empower Retirement.You can join our 401(K) plan at any time - there is no waitingperiod.Choose from pre-tax (traditional) or after-tax (Roth)contributions, depending on your need. You can change yourcontribution amount or pre- or after-tax election at any time.The basicsThe IRS maximum 401(K) contribution for 2025 is $23,500. Ifyou’re over age 50, or will be turning 50 during 2025, you cancontribute a catch-up contribution of $7,500 in addition to themaximum limit. Starting January 1, 2025, the years you turn ages60, 61, 62 and 63 you can save an extra $10,000 or 150 percentof the regular catch-up amount in 2025 catch-up contributions.If you do not want to contribute up to the higher 60-63 “catch-up”, it is your responsibility to monitor your contributions andmake your election change. This can be done online onEmpower’s website, by phone by calling Empower, or by paperform. It may take one or two payroll cycles to have the changesreflection on your paycheck. Note that the standard limitresumes the year you turn 64. Also, starting January 1, 2026, if youearned over $145,000 in FICA compensation last year, catch-upcontributions must be made as Roth contributions. Not sure whether to select pre-tax (traditional) or after-tax(Roth)? Check with your financial advisor to determine the bestchoice for you. The basic differences:Pre-tax: your contributions come out of your paycheckbefore Federal and state taxes but after FICA (Medicareand Social Security) taxes. You’ll pay regular income taxwhen you withdraw your money at retirement.Roth (after-tax): your contributions come out of yourpaycheck after taxes. When you withdraw your funds atretirement, they’re tax-free.Contributions401(K) Change DatesYou can change your deferralpercentage (the amount of money youare contributing to the plan) at anytime.You can stop your contributions at anytime.You can change the funds in which youare invested as often as you like, aslong as the fund in question does nothave short-term redemption feesassociated with it.

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Kaiser HMO (California Only)Employee Only$52.50$473.15Employee + Spouse/Domestic Partner$187.50$968.93Employee + Child(ren)$162.50$888.80Employee + Family$252.50$1,324.45Kaiser HDHP HMO $1,650 (California Only)Employee Only$20.00$386.56Employee + Spouse/Domestic Partner$117.50$776.92Employee + Child(ren)$92.50$720.62Employee + Family$155.00$1,064.68Cigna OA-20Employee Only$42.50$424.84Employee + Spouse/Domestic Partner$185.00$889.89Employee + Child(ren)$150.00$644.49Employee + Family$262.50$1,092.79Cigna PPO 20-350Employee Only$65.00$427.23Employee + Spouse/Domestic Partner$245.00$887.11Employee + Child(ren)$180.00$656.78Employee + Family$330.00$1,097.45Cigna PPO 30-750Employee Only$25.00$433.45Employee + Spouse/Domestic Partner$162.50$891.92Employee + Child(ren)$120.00$659.36Employee + Family$230.00$1,099.49Cigna HDHP PPO $1,650Employee Only$12.50$377.74Employee + Spouse/Domestic Partner$127.50$770.05Employee + Child(ren)$95.00$568.41Employee + Family$155.00$976.69Cigna Dental PPO & VSP VisionEmployee Only$5.00$26.86Employee + 1 Dependent$10.00$48.38Employee + 2 or more Dependents$15.00$79.322025 Employee Cost SummaryWhen you elect medical and/or dental & vision coverage through Pulmonx, your per pay period contributions noted below are deducted from yourpay before income and social security taxes are withheld. This means that you will not have to pay federal income tax, Social Security tax or Medicaretax on the amount of your premium payments that are paid each pay period. You may wish to consult your legal and/or tax advisor regarding theactual tax savings you may realize. Domestic partner contributions are post-tax and the employer contribution for domestic partners is imputed asincome, per IRS. Total Per Pay Period Cost - Effective 1/1/2025 Employee Cost Employer Cost

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Medical InsuranceKaiser Permanente (California Only)Group: 6424211-800-464-4000www.kp.orgMedical InsuranceCignaGroup: 006515251-866-494-2111www.mycigna.comMD Live: 1-888-726-3171Health Savings Account (HSA),Flexible Spending Accounts (FSA),and Commuter Benefitsigoe1-800-633-8818www.goigoe.comEmployee Assistance Program (EAP)Lincoln Financial GroupUsername: LFGsupportPassword: LFGsupport1 1-888-628-4824www.guidanceresources.comDental InsuranceCignaGroup: 06515251-800-244-6224www.mycigna.comVision InsuranceVision Service Plan (VSP)Group: 300378001-800-877-7195www.vsp.comLife and AD&D InsuranceLincoln Financial GroupGroup: 101693851-800-423-2765www.lfg.comDisability InsuranceLincoln Financial GroupGroup: 10257535 (STD)Group: 10169386 (LTD)1-800-423-2765www.lfg.comSupplemental Health Plans(Hospital, Accident and CriticalIllness)Lincoln Financial GroupGroup: PULMONXINC1-800-423-2765www.lfg.com401(K) Group Retirement AccountEmpower RetirementGroup: 370197-011-800-338-4015www.empowermyretirement.comPulmonx HR1-650-364-0400HRPulmonxUS@pulmonx.com1-925-407-1178sabrina.dokes@onedigital.comMonday - Friday, 8am-8pm ESTBilingual (Spanish) assistance is availableContact InformationYour advocate, Sabrina Dokes, is here to help you with claims, IDcards, coverage questions, and more!

Pulmonx 2025 Benefits Guide

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