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EMPLOYEE CONTRIBUTIONS

This chart compares the weekly contributions for our Employee Benefit plans. Your cost for coverage will vary depending on the
option and level of coverage you choose.

Medical

EBA&M / Anthem Blue Cross EBA&M / Anthem Blue Cross
Exclusive Core Exclusive Buy-Up

Employee Only $21.17 $34.02
Employee + Spouse $67.69 $101.75
Employee + Child(ren) $56.77 $80.55
Employee + Family $ 95.69 $ 144.54

Dental
MetLife TDA MetLife MetLife
California DHMO Arizona DHMO Low DPPO High DPPO
Employee Only $1.59 $1.23 $3.41 $8.47
Employee + 1 Dependent $2.92 $2.39 $7.49 $22.40
Employee + 2 or More Dependents $4.37 $3.45 $14.90 $34.32

Vision
MES Vision
PPO

Employee Only $0.67
Employee + Spouse $1.34
Employee + Child(ren) $1.18
Employee + Family $1.72

The following benefits are provided to you at no charge and are paid by Burlingame Industries:
• Employee Assistance Program
• Basic Life/AD&D
• Short Term Disability
• Long Term Disability

The following benefits are available to you at discounted group rates. Should you elect these benefits, you will
pay 100% of the cost:
• Voluntary Life/AD&D

Payroll Direct Deposit

The direct deposit program allows for the automatic deposit of your net earnings into a checking or savings account at the financial
institution of your choice. This program is available to all employees. If you are interested in participating, you must complete an
authorization agreement form at the Human Resources office.

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