Page 16 - Razer Benefits Guide 1-18 TEXAS

EMPLOYEE CONTRIBUTIONS

EMPLOYEE COST PER PAYCHECK
MEDICAL VOLUNTARY AD&D
AETNA HSA PPO* All Ages $0.019

Employee Only $19.46 VOLUNTARY LIFE AND AD&D (Per $1,000)
Employee + Spouse $104.58 AGE EMPLOYEE/SPOUSE
Employee + Child(ren) $94.86 Under 20 $0.023
Employee + Family $150.79 20-29 $0.029
*Razer contributes $38.46 to employee, and $76.92 30-34 $0.037
to family HSA bank accounts each pay-period. 35-39 $0.042
AETNA PPO 40-44 $0.050
Employee Only $27.75 45-49 $0.076
Employee + Spouse $149.15 50-54 $0.121
Employee + Child(ren) $135.27 55-59 $0.198
Employee + Family $215.05 60-64 $0.305
DENTAL 65-69 $0.586
CIGNA PPO 70-74 $1.031
75-99
$2.08
Employee Only $2.52 Child(ren) at $10K $0.115
Employee + Spouse $12.62
Employee + Child(ren) $13.22
Employee + Family $20.25
VISION
Employee Only $0.00
Employee + Spouse $2.15
Employee + Child(ren) $2.19
Employee + Family $3.54
EAP / BASIC LIFE AND AD&D / STD / LTD /
TRAVEL ASSISTANCE
No Charge
PET INSURANCE
BI-WEEKLY PREFERRED SELECT
RATES PROGRAM PROGRAM
1 Pet $4.89 $4.04
2 Pets $9.32 $7.66
3 Pets $13.66 $11.22
Each $4.29 $3.55
Additional Pet

16