Page 17 - LADACIN 2022-23 Benefit Guide
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Your Premium Cost
Per Paycheck Cost
Employee Only $101.93
EE + Spouse $237.50
Medical- EPO
EE+ Child(ren) $177.48
Family $320.94
Employee Only $127.25
EE + Spouse $254.89
Medical- HDHP
EE+ Child(ren) $190.26
Family $344.45
Employee Only $13.70
Dental- DMO EE + One $26.08
Family $41.90
Employee Only $14.94
Dental- PPO EE + One $31.63
Family $50.56
Employee Only $1.05
EE + Spouse $1.68
Vision
EE+ Child(ren) $1.71
Family $2.79
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