Page 15 - Iron Chef EE Guide 12-17

Employee Contributions

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 and AD&D premiums have been pre-
calculated for you in EaseCentral.

Medical Option 1 Anthem Blue Cross Dental Option 1 Anthem Blue Cross
5900 HMO Medical DHMO Dental

Employee Only $59.18 Employee Only $5.40
Employee + Spouse $221.49 Employee + One $10.80
Employee + Child(ren) $167.38 Employee + Family $17.54
Employee + Family $343.22
Medical Option 2 Anthem Blue Cross Dental Option 2 Anthem Blue Cross
1500 HMO Medical PPO Dental
Employee Only $72.74 Employee Only $18.14
Employee + Spouse $251.33 Employee + Spouse $37.04
Employee + Child(ren) $191.80 Employee + Child(ren) $44.18
Employee + Family $385.28 Employee + Family $65.03
Medical Option 3 Anthem Blue Cross Vision Anthem Blue Cross
1000 35/20 PPO Medical Vision
Employee Only $149.12 Employee Only $4.17
Employee + Spouse $419.36 Employee + Spouse $7.09
Employee + Child(ren) $329.28 Employee + Child(ren) $7.51
Employee + Family $ 622.04 Employee + Family $11.27

The following benefits are provided to you at no charge and are paid by Iron Chef:
• Basic Life and AD&D

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
• Accident
• Critical Illness

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