Page 17 - Think Goodness Enrollment Guide
P. 17
BENEFIT COSTS
Your per pay period (26) payroll contributions for medical, dental and vision benefits are shown here.
Medical Open Access Plus HSA Local Plus HSA Open Access Plus PPO LocalPlus PPO
Employee Only $20.64 $17.94 $72.69 $63.21
Employee/Spouse $131.63 $114.46 $289.81 $252.01
Employee/Children $119.68 $104.07 $262.89 $228.60
Family $185.34 $161.16 $411.27 $357.64
Dental Base Plan Buy-Up Plan
Employee Only $6.96 $9.77
Employee/Spouse $14.17 $20.16
Employee/Children $16.89 $23.84
Family $27.69 $38.85
Vision EyeMed
Employee Only $2.79
Employee/Spouse $5.30
Employee/Children $5.58
Family $8.21
17
