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Dental & Vision
Premium Cost Sharing
Dental
[UHC DENTAL PPO]
PPO
Dental Plan
UHC Dental
Monthly Per Paycheck
Enrollment Tier
Employee Cost Employee Cost
Employee only $32.47 $0.00
Employee + Spouse $64.94 $32.47
Employee + Child(ren) $71.36 $38.89
Employee + Family $109.02 $76.55
Vision
[ HUMANA ]
PPO
Vision Plan
Humana
Monthly Per Paycheck
Enrollment Tier
Employee Cost Employee Cost
Employee only $4.75 $0.00
Employee + Spouse $9.50 $4.75
Employee + Child(ren) $9.02 $4.27
Employee + Family $14.18 $9.43
*Rate is valid effective 8/1/2018-7/31/2019
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