Page 15 - Arktura EE Guide 12-17 - Final Sent 11.3.17

BENEFITS

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.

MEDICAL OPTIONS BLUE SHIELD KAISER SILVER BLUE SHIELD BLUE SHIELD BLUE SHIELD
SILVER TRIO HMO GOLD HMO GOLD PPO PLATINUM PPO
HMO

Employee Only
Employee + Spouse See Ease Central for Employee and Dependent Age-Specific Rates
Employee + Child(ren)
Employee + Family
DENTAL OPTIONS UNITED CONCORDIA UNITED CONCORDIA
DHMO DPPO

Employee Only $4.20 $18.78
Employee + Spouse $8.26 $45.14
Employee + Child(ren) $9.14 $46.98
Employee + Family $13.29 $ 74.54
VISION OPTION EYEMED
PPO

Employee Only $3.26
Employee + Spouse $6.19
Employee + Child(ren) $6.52
Employee + Family $ 9.59
BASIC LIFE AND HARTFORD
AD&D

Employee Only Paid by Arktura
EMPLOYEE HARTFORD
ASSISTANCE
PROGRAM

Employee + Family Paid by Arktura
VOLUNTARY LIFE AND HARTFORD
AD&D / VOLUNTARY
LONG TERM
DISABILITY
Employee 100% of Cost. For your convenience,
your voluntary premiums have been
pre-calculated for you in Ease Central.

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