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HEALTH PLANSTIER LEVEL Oxford Liberty EPOLow PlanOxford Liberty PPOMid PlanOxford Freedom PPOHigh PlanEMPLOYEE $80.12 $90.87 $123.30EMPLOYEE + SPOUSE $180.31 $205.05 $279.63EMPLOYEE + CHILD(REN) $153.34 $174.31 $237.54FAMILY $257.39 $292.88 $399.88DENTAL PLANTIER LEVEL DPPO Plus Premier 3AEMPLOYEE $8.55EMPLOYEE + 1 DEPENDENT $16.41EMPLOYEE + 2 OR MORE DEPENDENTS $27.89VISION PLANTIER LEVEL BrillianceEMPLOYEE $2.34EMPLOYEE + 1 DEPENDENT $5.59EMPLOYEE + 2 OR MORE DEPENDENTS $7.53BENEFITS COST PER PAYCHECKPlease submit your enrollment using thelink and QR code.https://form.jotform.com/25009527723615628
