Page 18 - 2013-14 MFCU benefits & Notices

Members First CU 2013-14

Employee Contributions

The chart below reflects the required pre-tax bi-weekly contributions for the enrollment in our medical,
dental and vision plans from 09/01/2013 to 09/01/2014.

Employee + Employee +
Coverage (per pay) Single Family
Spouse/Dep Child(ren)
BCBSM HRA PPO 14/0 Plan 0.00 299.91 n/a 428.39
(includes Vision) NON-EXEMPT

BCBSM HRA PPO 14/0 Plan 0.00 0.00 n/a 0.00
(includes Vision) MGMT

MMA MetLife Dental PPO Plan 0.00 16.19 n/a 34.24

MMA MetLife Dental PPO Plan (if 37.12 33.32 n/a 51.37
you receive the OPT OUT benefit)

For More Information About Our Coverage

800-637-2227 www.bcbsm.com

800-842-6513 www.metlife.com

800-356-2644 www.cunamutual.com

800-877-7195 www.vsp.com

800-346-2126 www.ebcflex.com

Mike Bindus x1013 www.thesalusgroup.com
866-991-9907

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