Page 10 - 2016 Enrollment
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10
Contributions
As stated in the wellness section, employees who participate in the wellness program and earn at least 100 points
are eligible for the wellness contributions for the 2016 calendar year. All other employees are subject to the
regular medical contributions for the 2016 plan year.
PPO Bi-weekly Medical Contribution PPO Bi-weekly Wellness Medical Contribution
Salary between Salary between
Salary Under $35,000– Salary Over Salary Under $35,000– Salary Over
$35,000 $70,000 $70,000 $35,000 $70,000 $70,000
Employee (Ee) $99.47 $104.20 $107.26 $87.93 $92.66 $95.72
Ee/spouse $305.38 $320.96 $331.54 $293.84 $309.42 $320.00
Ee/child(ren) $279.37 $293.49 $303.28 $267.83 $281.95 $291.69
Family $324.51 $341.35 $352.06 $312.98 $329.81 $340.52
HSA Bi-weekly Medical Contribution HSA Bi-weekly Wellness Medical Contribution
Salary Under Salary between Salary Over Salary Under Salary between Salary Over
$35,000–
$35,000–
$35,000 $70,000 $70,000 $35,000 $70,000 $70,000
Employee (Ee) $83.50 $87.37 $89.88 $71.96 $75.84 $78.34
Ee/spouse $252.03 $264.78 $273.43 $240.49 $253.24 $261.89
Ee/child(ren) $230.74 $242.29 $250.26 $219.20 $230.76 $238.72
Family $267.68 $281.46 $290.23 $256.14 $269.91 $278.70
Eligibility Reminder
If you are hired as a full-time employee working 30 or more hours per week, you are eligible for the medical plan
the irst day of the month following 30 days.
If you are hired as a part-time, variable-hour, or seasonal employee and are expected to work less than 30 hours
per week, then your hours will be considered over a 12-month measurement period. At the end of the 12-month
measurement period, if it is determined you have worked an average of 30 hours per week, then you will be
offered beneits for the following 12 month period, deemed the stability period.
You may enroll your eligible dependents for coverage once you are eligible. Your eligible dependents include your
legal spouse, or domestic partner, and your children up to age 26, regardless of student, dependent, or marital
status.
Employee Benefits
Contributions
As stated in the wellness section, employees who participate in the wellness program and earn at least 100 points
are eligible for the wellness contributions for the 2016 calendar year. All other employees are subject to the
regular medical contributions for the 2016 plan year.
PPO Bi-weekly Medical Contribution PPO Bi-weekly Wellness Medical Contribution
Salary between Salary between
Salary Under $35,000– Salary Over Salary Under $35,000– Salary Over
$35,000 $70,000 $70,000 $35,000 $70,000 $70,000
Employee (Ee) $99.47 $104.20 $107.26 $87.93 $92.66 $95.72
Ee/spouse $305.38 $320.96 $331.54 $293.84 $309.42 $320.00
Ee/child(ren) $279.37 $293.49 $303.28 $267.83 $281.95 $291.69
Family $324.51 $341.35 $352.06 $312.98 $329.81 $340.52
HSA Bi-weekly Medical Contribution HSA Bi-weekly Wellness Medical Contribution
Salary Under Salary between Salary Over Salary Under Salary between Salary Over
$35,000–
$35,000–
$35,000 $70,000 $70,000 $35,000 $70,000 $70,000
Employee (Ee) $83.50 $87.37 $89.88 $71.96 $75.84 $78.34
Ee/spouse $252.03 $264.78 $273.43 $240.49 $253.24 $261.89
Ee/child(ren) $230.74 $242.29 $250.26 $219.20 $230.76 $238.72
Family $267.68 $281.46 $290.23 $256.14 $269.91 $278.70
Eligibility Reminder
If you are hired as a full-time employee working 30 or more hours per week, you are eligible for the medical plan
the irst day of the month following 30 days.
If you are hired as a part-time, variable-hour, or seasonal employee and are expected to work less than 30 hours
per week, then your hours will be considered over a 12-month measurement period. At the end of the 12-month
measurement period, if it is determined you have worked an average of 30 hours per week, then you will be
offered beneits for the following 12 month period, deemed the stability period.
You may enroll your eligible dependents for coverage once you are eligible. Your eligible dependents include your
legal spouse, or domestic partner, and your children up to age 26, regardless of student, dependent, or marital
status.
Employee Benefits
