Page 6 - DataMax Benefits Enrollments Guide

2017 Employee

Cost per Month

Medical Employee Cost per Month- Core Plan (Effective 10/1/17)

Employee + Employee + Employee +
Employee
Spouse Child(ren) Family

$148.00 $636.27 $563.03 $1,173.36

Medical Employee Cost per Month - Buy Up Plan (Effective 10/1/17)

Employee + Employee + Employee +
Employee
Spouse Child(ren) Family

$230.00 $800.07 $714.56 $1,427.14

Voluntary Dental Employee Cost per Month

Employee + Employee + Employee +
Employee
Spouse Child(ren) Family

$39.11 $78.22 $93.84 $141.55

Voluntary Vision Employee Cost per Month (Effective 10/1/17)

Employee + Employee + Employee +
Employee
Spouse Child(ren) Family

$6.03 $12.07 $13.82 $21.30

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