Page 15 - Charles E Thomas EE Guide 12-19

EMPLOYEE CONTRIBUTIONS

Your Cost Per Paycheck

This chart compares the per paycheck contributions for our Employee Benefit plans. Your cost for coverage will vary depending on
the option and level of coverage you choose. Employee contributions for Medical, Dental, and Vision are deducted from your
paycheck with pre-tax dollars. This means that contributions are taken from your earnings before taxes, resulting in lower taxes
and increased take home pay. For your convenience, your age-banded Voluntary Life/AD&D premiums have been pre-calculated
for you in Ease. CET contributes $375 per employee towards medical benefits.

Medical : 24 Payroll Deductions per Year

United United United United United United
Healthcare Healthcare Healthcare Healthcare Healthcare Healthcare
HMO Advantage Focus HMO Alliance Select Plus Select Plus
20-30/20% HMO 15-30/750A HMO BILS PPO PRY PPO
20-30/20% 25-40/30%
Plan

Employee Only $159.40 $130.68 $122.24 $64.71 $548.68 $251.07
Employee + 1 $540.98 $480.68 $462.95 $342.14 $1,358.48 $733.49
Employee + Family $853.19 $767.04 $741.71 $569.13 $2,021.04 $1,128.20

Dental & Vision: 12 Payroll Deductions per Year
Guardian
DHMO Guardian Guardian
Plan Dental PPO Dental Vision

Employee Only $14.14 $68.36 $6.14
Employee + 1 $24.94 $144.74 $10.69
Employee + Family $38.28 $250.18 $18.81

The following benefits are provided to you at no The following benefits are available to you at
charge and are paid by Charles E. Thomas: discounted group rates. Should you elect these
• Employee Assistance Program benefits, you will pay 100% of the cost:
• Basic Life/AD&D • Voluntary Life/AD&D
• Will Prep Services
• College Tuition Rewards

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