Page 2 - Demo IPC benefits flip

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Indiana Packers realizes the importance of giving our team members flexible options when it comes to healthcare. Rates for three separate healthcare plans are outlined below, as well as two dental and vision options. Please see the Team Member Benefits Overview Brochure for medical, dental and vision coverage.
EMPLOYEE CONTRIBUTIONS
Medical Plan Options
Medical Insurance (UMR)
PREMIER-PLAN A
VALUE-PLAN B
CDHP-PLAN C
Weekly
Monthly
Weekly
Monthly
Weekly
Monthly
Employee**
$25.16
$109.01
$15.75
$68.26
$10.16
$44.03
Employee + 1**
$52.53
$227.65
$32.80
$142.14
$21.14
$91.62
Family (Employee+2 or more)**
$85.97
$372.54
$54.24
$235.02
$34.95
$151.43
Spousal fee
(When spouse has access to primary coverage through employer)
$45.00
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Coverage details can be found on the back of this insert, as well as the Team Member Benefits Overview Brochure
*Certain restrictions apply; see your benefits department for details **Rates subject to change on an annual basis
Bi-Weekly Paid Employees must double the weekly contribution for their cost calculation. See your local Benefits Specialist for more information.
Dental Plan Options
Coverage details can be found in the Team Member Benefits Overview Brochure
Vision Plan Options
Dental Insurance (Delta Dental)
PREMIER-PLAN A
VALUE-PLAN B
Weekly
Monthly
Weekly
Monthly
EE Single
$4.46
$19.33
$2.51
$10.89
EE+1 (Employee + 1)
$7.13
$30.90
$4.03
$17.46
EE+2 or more (Employee+2 or more)
$13.49
$58.46
$8.39
$36.34
Vision Insurance (VSP)
PREMIER-PLAN A
VALUE-PLAN B
Weekly
Monthly
Weekly
Monthly
EE Single
$2.28
$9.88
$1.14
$4.94
EE+1 (Employee + 1)
$4.56
$19.76
$2.28
$9.88
EE+2 or more (Employee+2 or more)
$7.34
$31.81
$3.67
$15.90
Coverage details can be found in the Team Member Benefits Overview Brochure
MEDICAL COVERAGE QUESTIONS : IPC: 765.564.7212 | benefits@inpac.com SFG: 270.852.6311 | benefits@sfgtrust.com
RATE CARD
| IPC & SFG | 2020