Page 27 - 2015 Advia CU Benefits & Notices

Advia CU - MI 2015

Employee Contributions - 2015

The chart below reflects the required 26 bi-weekly pre-tax contributions for the enrollment in our medical,
dental and vision plans.

Coverage (per pay) Single Employee + Employee + Family
0.00 Spouse Child(ren) 380.60
BCBSM Low Deductible PPO Plan 0.00 249.98 338.22
BCBSM High Deductible HRA 0.00 n/a 128.56
PPO Plan 216.11
BCN HMO HRA Plan n/a
67.79
28.04

BCN HMO HSA Plan 0.00 79.72 38.30 141.85
Met Life Dental 0.00 17.99 20.60 42.08
VSP Vision (Core Plan) 0.00 2.17 3.12 6.97
VSP Vision (Voluntary Buy Up) 3.14 7.46 17.06 14.34

For More Information About Our Coverage

800-637-2227 www.bcbsm.com
800-662-6667 www.bcbsm.com

800-275-4638 www.metlife.com

800-877-7195 www.vsp.com

800-247-6875 www.sunlife.com/us
866-346-5800 www.healthequity.com

269-342-1700 www.beneworld.com

Liz Richard x7417 www.thesalusgroup.com
Jim Fournier x7424

866-991-9907 AdviaAssist@thesalusgroup.com

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