Page 20 - Avatar 2022 Flipbook

2022 BENEFIT PAYROLL DEDUCTIONS

Medical: Highmark Blue Cross Blue Shield

Plan B: Employee
Plan A: Employee Cost Cost Plan C: Employee Cost Plan D: Employee Cost
Tier
Monthly Bi-Weekly Monthly Bi-Weekly Monthly Bi-Weekly Monthly Bi-Weekly

Individual $100.05 $46.18 $33.00 $15.23 $140.46 $64.83 $195.30 $90.14

Employee+ $196.38 $90.64 $48.00 $22.15 $311.63 $143.83 $469.90 $216.88
Child(ren)
Employee $203.64 $93.99 $50.00 $23.08 $323.38 $149.25 $526.14 $242.83
+ Spouse

Family $276.30 $127.52 $70.00 $32.31 $437.98 $202.14 $604.26 $278.89

Dental: United Concordia Vision: Highmark/Davis Vision

Employee Cost Per Month Employee Cost Per Month
United Concordia
Dental Plan Bi- Type of Coverage Bi-
Monthly Monthly
Weekly Weekly

Individual $6.35 $2.93 Individual $1.48 $0.78

Employee+ Child(ren) $12.40 $5.72 Employee+ Child(ren) $3.16 $1.68

Employee + Spouse $13.02 $6.01 Employee + Spouse $3.16 $1.68

Family $19.08 $8.81 Family $3.16 $1.68

2022 Avatar Benefit Guide Page 20