Page 5 - P&A Group Benefits Enrollments Guide

2017 Employee Bi-Weekly Contributions

Medical Employee Bi-Weekly Deductions
Employee Only Employee & Employee & Employee &
Spouse Child(ren) Family

Core H.S.A
Plan $106.15 $233.53 $161.35 $329.07

Buy Up Plan $136.87 $301.11 $208.04 $424.29

Dental Employee Bi-Weekly Deductions

Employee Only Employee & Employee & Employee &
Spouse Child(ren) Family
Low Plan
$6.02 $12.03 $17.71 $24.20

Buy Up Plan
$10.45 $20.92 $22.27 $33.20

Vision Employee Bi-Weekly Deductions

Employee Only Employee & Employee & Employee &
Spouse Child(ren) Family
Community
$3.21 $5.43 $5.08 $9.31
Eye Care

Voluntary Long Term Disability Employee Bi-Weekly Deductions
Age 0-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69

Rate $0.0008 $0.0010 $0.0014 $0.0020 $0.0029 $0.0041 $0.0065 $0.0105 $0.0153 $0.0153

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