Page 4 - 2022 New Relic Guide

Summary of Your Your Health Pre-Tax Spending Life/AD&D Where to Find
Summary of Your
How to Get Started Dental & Vision 401(k) Additional Benefits
Contributions
Contributions Benefits Accounts Disability Support

SUMMARY OF SEMI-MONTHLY

PAYROLL DEDUCTIONS

This is an overview of the cost to you for any of the health benefits listed in this booklet. More information on each of these plans is
described in detail in the following pages.

EMPLOYEE ONLY EMPLOYEE + SPOUSE EMPLOYEE + CHILD(REN) EMPLOYEE + FAMILY
MEDICAL PLANS

Kaiser HMO (CA only) $13.50 $110.50 $94.50 $175.00

Kaiser HMO (Oregon only) $13.00 $90.00 $74.50 $167.00
Cigna PPO OAP $250/$500 $20.50 $177.00 $106.00 $253.00

Cigna HDHP OAP $1,800/$3,600 $15.00 $145.00 $85.00 $205.00

DENTAL PLAN
MetLife Dental $1.50 $9.00 $13.50 $21.50

VISION PLAN

VSP Vision $0.50 $1.50 $1.50 $3.50

Note: Employees located in Texas, Oklahoma and Missouri have the ability to enroll in a Limited Abortion Plan.
Please visit nerdlife.datanerd.us/new-relic/mo-ok-tx-specific-healthcare-information for more information about the plan and rates.
All contributions will be deducted on a pre-tax basis unless you inform PeopleOps you would like contributions on an after-tax basis. Domestic partner contributions are taken on a post-
tax basis. Contributions made by the employer for domestic partner coverage will be subject to imputed income for the employee. Contact AskPeopleOps@newrelic.com for more
information on domestic partner coverage and taxation. These rates are subject to change due to underwriting.

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2022 US Benefits Guide