Page 15 - Oremor EE Guide 01-17_Updated 11.17.16

Employee Contributions

This chart compares the monthly contribu ons for our Employee Benefit plans. Your cost for coverage will vary depending on the
op on and level of coverage you choose.

Medical Options
Anthem Blue Cross Anthem Blue Cross Kaiser Permanente
Network PPO PPO HMO
Employee Only $118.00 $600.00 $203.00
Employee + Spouse $558.00 $1,300.00 $727.00
Employee + Child(ren) $451.00 $1,500.00 $604.00
Employee + Family $869.00 $2,200.00 $1,015.00
Dental Options
California Dental Network Principal Financial Group
DHMO DPOS
Employee Only $5.00 $30.00
Employee + Spouse $10.00 $65.00
Employee + Child(ren) $10.00 $68.00
Employee + Family $ 15.00 $104.00
Vision
EyeMed
Employee Only $7.50
Employee + Spouse $15.00
Employee + Child(ren) $14.25
Employee + Family $ 22.04

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 and AD&D
 Voluntary Short Term Disability
 Voluntary Long Term Disability

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