Page 20 - 2021 ASG Benefit Guide
P. 20
Benefit costs
Your semi-monthly payroll contributions for medical, dental and vision benefits are shown here.
Medical HDHP / HSA 4000 HDHP / HSA 2000 Choice Plus Plan
Employee Only $40.63 $71.55 $171.38
Employee + Spouse $70.67 $117.66 $274.21
Employee + Child(ren) $45.55 $88.12 $219.63
Family $115.71 $175.53 $390.75
Dental MetLife Dental Plan
Employee Only $9.53
Employee + Spouse $24.98
Employee + Child(ren) $28.34
Family $42.68
Vision EyeMed Vision Plan
Employee Only $2.60
Family $6.57
20
