Page 563 - outbind://23/
P. 563

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                             $82.26
                 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
   558   559   560   561   562   563   564   565   566   567   568