Page 8 - Jones and Frank Benefits Enrollments Guide

2018 Medical Plan Employee

Contributions

Medical - UHC (Wellness/Non-Tobacco) CORE PLAN BUY UP PLAN
Weekly Bi-weekly Weekly Bi-weekly
Coverage Tier (Hourly) (Salary) (Hourly) (Salary)
Deduction Deduction Deduction Deduction
Employee $25.87 $51.73 $47.62 $95.24
Employee + Spouse $162.71 $325.42 $213.31 $426.61
Employee + Children $104.36 $208.73 $148.41 $296.82
Family $211.76 $423.53 $284.21 $568.43

Medical - UHC (Non-Wellness/Tobacco) CORE PLAN BUY UP PLAN
Weekly Bi-weekly Weekly Bi-weekly
Coverage Tier (Hourly) (Salary) (Hourly) (Salary)
Deduction Deduction Deduction Deduction
Employee $47.79 $95.58 $69.54 $139.09
Employee + Spouse $190.40 $380.80 $241.00 $482.00
Employee + Children $132.06 $264.11 $176.10 $352.20
Family $239.46 $478.91 $311.91 $623.81

Medical - UHC (Wellness/Tobacco) CORE PLAN BUY UP PLAN
Weekly Bi-weekly Weekly Bi-weekly
Coverage Tier (Hourly) (Salary) (Hourly) (Salary)
Deduction Deduction Deduction Deduction
Employee $42.02 $84.04 $63.77 $127.55
Employee + Spouse $178.86 $357.72 $229.46 $458.92
Employee + Children $120.52 $241.04 $164.56 $329.13
Family $227.92 $455.84 $300.37 $600.74

Medical - UHC (Non-Wellness/Non-
CORE PLAN BUY UP PLAN
Tobacco)
Weekly Bi-weekly Weekly Bi-weekly
Coverage Tier (Hourly) (Salary) (Hourly) (Salary)
Deduction Deduction Deduction Deduction
Employee $31.63 $63.27 $53.39 $106.78
Employee + Spouse $174.25 $348.49 $224.84 $449.69
Employee + Children $115.90 $231.81 $159.95 $319.90
Family $223.30 $446.61 $295.75 $591.51

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