Page 5 - Watermark Retirement Communities 2022 Benefits Guide Logan Square Union Before
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     Benefit Costs
        Your per pay period payroll contributions for medical, dental and vision benefits are shown here:
         Medical Premiums for the Consumer Plan
          Coverage Categories       UHC Monthly Bill        Watermark Cost Per Pay Period   Associate Cost Per Pay Period
           Associate Only               $620.11                      $256.20                       $30.00
         Associate + Spouse            $1,357.77                     $256.20                      $370.46
         Associate + Child(ren)        $1,235.25                     $256.20                      $313.91
         Associate + Family            $1,914.13                     $256.20                      $627.24
         Medical Premiums for the Select Plan
          Coverage Categories       UHC Monthly Bill        Watermark Cost Per Pay Period   Associate Cost Per Pay Period
         Associate Only                 $715.79                      $256.20                       $74.16
         Associate + Spouse            $1,574.76                     $256.20                      $470.61
         Associate + Child(ren)        $1,431.60                     $256.20                      $404.53
         Associate + Family            $2,218.96                     $256.20                      $767.93
         Medical Premiums for the Enhanced Plan
          Coverage Categories       UHC Monthly Bill        Watermark Cost Per Pay Period   Associate Cost Per Pay Period
         Associate Only                $1,151.91                     $256.20                      $275.45
         Associate + Spouse            $2,534.19                     $256.20                      $913.42
           Associate + Child(ren)      $2,303.81                     $256.20                      $807.09
          Associate + Family           $3,570.90                     $256.20                      $1,391.90
                Dental             MetLife Monthly Bill    Watermark Cost Per Pay Period   Associate Cost Per Pay Period
         Associate Only                  $29.97                       $13.83                       $0.00
         Associate + Spouse              $58.94                       $13.83                       $13.37
         Associate + Child(ren)          $51.77                       $13.83                       $10.06
         Associate + Family              $79.21                       $13.83                       $22.73
                Vision              UHC Monthly Bill        Watermark Cost Per Pay Period   Associate Cost Per Pay Period
          Associate Only                 $4.76                        $0.00                         $2.20
           Associate + Spouse            $8.18                        $0.00                         $3.78
         Associate + Child(ren)          $9.84                        $0.00                         $4.54
         Associate + Family              $12.17                       $0.00                         $5.62
          All other benefits rates are based on salary and/or age and can be found online at
        www.mywatermarkbenefits.com or by contacting the Watermark Benefits call center.
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