Page 23 - GBS OE Brochure - Generic Hospitality

Salary Band Under $23,000
Team Member Only
Team Member + Spouse Team Member + Child(ren) Team Member + Family
Kaiser HMO Medical Plan
$27.61 $60.76 $55.23 $82.85
$34.67
$76.25
$69.31
$103.98 $62.82
$138.20
$125.64
$188.46 $76.90
$169.18
$153.80
$230.69
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Cigna Gold Medical Plan
$125.90 $271.28 $237.49 $380.58
$135.45
$292.28
$256.63
$409.33 $173.73
$376.54
$333.21
$524.12 $192.83
$418.62
$371.49
$581.51
DPPO Dental Plan
$22.25
$43.94
$49.13
$80.00
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Cigna Gold In-Network Medical Plan
$176.54 $383.22 $340.21 $532.23
$189.05
$410.58
$365.20
$569.74 $226.56
$493.38
$440.26
$682.36 $251.59
$548.42
$490.31
$757.48
DHMO Dental Plan
$8.80
$16.44
$20.20
$30.46
Vision Plan
$2.14
$3.10
$5.56
$23,000 - $49,999
Team Member Team Member Team Member Team Member
$50,000 - $99,999
Team Member Team Member Team Member Team Member
$100,000 or more
Team Member Team Member Team Member Team Member
Cigna Dental
Team Member Team Member Team Member Team Member
Only
+ Spouse
+ Child(ren) + Family
Only
+ Spouse
+ Child(ren) + Family
Only
+ Spouse
+ Child(ren) + Family
Only
+ Spouse
+ Child(ren) + Family
UnitedHealthcare Vision
Team Member Only Team Member + One Team Member + Family
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