Page 5 - Rubrik 2022 Benefits Guide
P. 5
EMPLOYEE CONTRIBUTIONS
Rubrik pays the full cost of many of your benefits. The cost for employee and dependent health coverage is shared by you and
Rubrik. Your benefit contributions will be taken as a semi-monthly, pretax salary reduction as outlined in the charts below.
Medical
UMR HDHP UMR PPO Kaiser HMO
CA ONLY
Contribution
Employee Only $20.50 $44.00 $26.00
Employee + Spouse/DP* $61.00 $113.00 $66.00
Employee + Child(ren) $47.50 $90.00 $59.50
Employee + Family $90.50 $167.00 $92.50
Dental
Base Buy-Up
Contribution
Employee Only $5.00 $17.00
Employee + Spouse/DP* $10.00 $33.50
Employee + Child(ren) $12.00 $40.00
Employee + Family $16.50 $56.00
Vision
Base Buy-Up
Contribution
Employee Only $1.00 $5.50
Employee + Spouse/DP* $1.50 $10.50
Employee + Child(ren) $1.50 $11.50
Employee + Family $2.50 $18.00
* DP = Domestic Partner. Consult an accountant for taxation and imputed income rules applicable to domestic partners and children of domestic partners.
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