Page 445 - outbind://23/
P. 445
Dental & Vision
Premium Cost Sharing
Dental
PPO
Dental Plan
UHC Dental
Monthly Per Paycheck
Enrollment Tier
Employee Cost Employee Cost
$34.89 $0.00
Employee only
$69.78 $34.89
Employee + Spouse
$76.68 $41.79
Employee + Child(ren)
$117.15 $47.37
Employee + Family
Vision
PPO
Vision Plan
Humana
Monthly Per Paycheck
Enrollment Tier
Employee Cost Employee Cost
$5.03 $0.00
Employee only
$10.06 $5.03
Employee + Spouse
$9.56 $4.53
Employee + Child(ren)
$15.02 $9.99
Employee + Family
7
