Page 18 - Benefits Guide

Employee Benefits Guide
Employee Contributions
Bi-Weekly Rates
Medical
SMART Value HDHP
SMART Choice HDHP
SMART Premium Plan
Employee Only
$22.87
$90.00
$163.21
Employee + Spouse
$126.92
$245.54
$389.75
Employee + Child(ren)
$94.70
$184.62
$313.91
Employee + Family
$168.46
$328.62
$534.39
Dental
Dental Base Plan
Dental Buy-Up Plan
Employee Only
$9.83
$23.35
Employee + Spouse
$19.67
$45.85
Employee + Child(ren)
$22.12
$49.75
Employee + Family
$31.96
$71.62
Vision
Vision Base Plan
Vision Buy-Up Plan
Employee Only
$1.91
$3.64
Employee + Spouse
$4.10
$7.82
Employee + Child(ren)
$3.42
$6.53
Employee + Family
$5.62
$10.70
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