Page 15 - 2017 US Benefits Guide - for all Capgemni employees in the FS SBU
P. 15
Medical Plan Rates
Semi-Monthly Employee Contribution
Coverage Level Premier PPO Basic PPO
You Only $26.90 $11.68
You + Spouse/Domestic Partner $60.52 $28.03
You + Child(ren) $51.88 $24.03
You + Family $89.15 $43.55
Coverage levels can include any eligible dependents defined under the Benefits Eligibility section.
The rates shown do not apply to COBRA participants.
CAPGEMINI 2017 BENEFITS GUIDE 12
Semi-Monthly Employee Contribution
Coverage Level Premier PPO Basic PPO
You Only $26.90 $11.68
You + Spouse/Domestic Partner $60.52 $28.03
You + Child(ren) $51.88 $24.03
You + Family $89.15 $43.55
Coverage levels can include any eligible dependents defined under the Benefits Eligibility section.
The rates shown do not apply to COBRA participants.
CAPGEMINI 2017 BENEFITS GUIDE 12
