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Bi-weekly CostEarnings under 55KAnnuallyEarnings between $55-89,999K AnnuallyEarnings above 90KAnnuallyEmployee $34.66 $44.67 $54.68Employee +Spouse/Domestic Partner $81.16 $96.62 $120.58Employee + Child(ren) $70.31 $83.45 $107.40Family $115.28 $139.27 $172.54Bi-weekly CostEarnings under 55KAnnuallyEarnings between $55-89,999KAnnuallyEarnings above 90KAnnuallyEmployee $81.31 $93.74 $107.13Employee +Spouse/Domestic Partner $179.83 $199.92 $231.49Employee + Child(ren) $158.79 $176.01 $206.61Family $256.35 $286.97 $330.019Questions on how to Enroll?contact Service@thecacompanies.com for assistance.Please submit your enrollment using the link and QR code.https://form.jotform.com/250434767339161Low Plan Cigna HDHPQHigh Plan Cigna OAPMedicalInsuranceCostPerPaycheckBenefit cost is deducted bi-weekly via payroll deduction.Medical insurance premiumsare deducted per pay period.Medical Plans & Prescription Benefits (cont.)