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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