Page 15 - WJ Bradley Annual Enrollment

W.J. Bradley

Your 2015 Benefit Rates Beneit Rates

Medical/Prescription Drug Monthly Contributions
Plan $1,500 Ded. $2,500 Ded.
Employee Only $147.91 $129.28
Employee + Spouse $447.97 $391.54
Employee + Child(ren) $308.20 $269.39
Employee + Family $629.12 $549.88

Monthly Dental Vision
Contributions
Employee Only $20.25 $7.53
Employee + Spouse $62.37 $15.28
Employee + Child(ren) $79.35 $16.01
Employee + Family $121.49 $20.24

Age Supplemental Employee Disability
Life, AD&D, and Dependent
Spouse Life (Monthly Rate Per Short-Term Long-Term
Disability
$1,000) (Per $10 of Disability
(Per $100
Non-Smoker Smoker Covered of Covered
Beneit) Salary)
0 – 29 $0.047 $0.093 $0.355 $0.133
30 – 34 $0.047 $0.093 $0.342 $0.19
35 – 39 $0.075 $0.147 $0.316 $0.266
40 – 44 $0.120 $0.257 $0.316 $0.342
45 – 49 $0.173 $0.393 $0.355 $0.589
50 – 54 $0.348 $0.766 $0.408 $0.789
55 – 59 $0.557 $1.139 $0.526 $1.093
60 – 64 $0.639 $1.203 $0.631 $0.96
65 – 69 $1.148 $1.967 $0.724 $0.694
70 – 74 $2.968 $4.534 $0.724 $0.694
75 – 99 $11.759 $17.638 $0.724 $0.694

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