Page 27 - Zenoss, Inc 2022 Flipbook

Benefit costs – deductions per month

Your monthly payroll contributions for medical, dental and vision benefits are shown here.

Buy Up Plan
Medical Plan
UnitedHealthcare Premium Zenoss Pays Employee Pays
Employee Only $515.55 $427.30 $88.25
Employee + Spouse $1,247.63 $836.81 $410.82
Employee + Child(ren) $933.14 $638.50 $294.64
Employee + Family $1,716.78 $1,134.40 $582.38
Core Plan
Employee Only $488.30 $413.86 $74.44
Employee + Spouse $1,181.68 $822.84 $358.84
Employee + Child(ren) $883.82 $626.45 $257.37
Employee + Family $1,626.04 $1,117.32 $508.72
HDHP with HSA
Employee Only $417.47 $361.07 $56.40
Employee + Spouse $1,010.27 $698.18 $312.09
Employee + Child(ren) $755.62 $530.42 $225.20
Employee + Family $1,390.16 $949.63 $440.53

Zenoss Annual Contribution to HSA
Employee Only $750
Employee + Spouse $1,500
Employee + Child(ren) $1,500
Employee + Family $1,500

Dental Base Plan Dental Buy Up Plan

United United
Dental Healthcare Zenoss Employee Healthcare Zenoss Employee
Pays
Pays
Pays
Pays
Premium Premium
Employee Only $38.91 $27.01 $11.90 $42.84 $28.80 $14.04
Employee + Spouse $77.82 $53.73 $24.09 $85.68 $57.10 $28.58
Employee + Child(ren) $94.51 $69.02 $25.49 $112.07 $78.37 $33.70
Employee + Family $140.84 $98.63 $42.21 $164.14 $112.28 $51.86

Vision UnitedHealthcare Premium Zenoss Pays Employee Pays
Employee Only $10.63 $8.59 $2.04
Employee + Spouse $20.17 $16.74 $3.43
Employee + Child(ren) $23.66 $20.16 $3.50
Employee + Family $33.29 $27.76 $5.53

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