Page 17 - Skyline Windows | 2022 Benefits Guide
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WEEKLY DENTAL PLAN PREMIUMS
Dental Select Managed Care (S100B)
Coverage Tier
Employee + Spouse Employee + Family
Dental PPO Coverage Tier
Employee + Spouse Employee + Family
Weekly Rate
$4.58 $8.59
Weekly Rate
$21.61 $34.75
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Employee Only
$2.63
Employee + Child(ren)
$6.05
Employee Only
$11.03
Employee + Child(ren)
$25.44
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