Page 11 - JONS EE Guide 08-18 - final English

EMPLOYEE CONTRIBUTIONS PER PAYCHECK

This chart compares the bi-weekly (26) 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 InfinityHR.

Health Net Health Net Health Net
Medical Salud HMO ExcelCare EOA PPO
Employee Only $43.95 $196.27 $413.07
Employee + 1 Dependent $218.20 $545.70 $1,011.84
Employee + Family $339.43 $788.77 $1,428.33
Cigna Cigna
Dental DHMO PPO
Employee Only $3.80 $18.77
Employee + 1 Dependent $6.09 $35.63
Employee + Family $8.93 $57.20
Guardian
Vision PPO

Employee Only $2.99
Employee + 1 Dependent $4.55
Employee + Family $7.99
Cost Per $1,000 Benefit Unit

Supplemental Life Employee Spouse Child(ren)

Age
20-24 $0.024 $0.024 $0.084
25-29 $0.036 $0.036
30-34 $0.048 $0.048
35-39 $0.048 $0.048
40-44 $0.058 $0.058
45-49 $0.096 $0.096
50-54 $0.173 $0.173
55-59 $0.317 $0.317
60-64 $0.470 $0.470
65-69 $0.778 $0.778
70-74 $1.430 $1.430
75+ $4.990 $4.990
Supplemental AD&D Employee Spouse Child(ren)
All Ages $0.012 Not Covered Not Covered

The following benefits are provided to you at no charge and are paid by JONS Marketplace:
 Employee Assistance Program
 Basic Life and AD&D (Executives, Directors, Salaried Managers, and Salaried Employees)

The following benefits are available to you at discounted group rates. Should you elect these benefits, you will
pay 100% of the cost:
 Supplemental Benefits (Voluntary Life and AD&D, Voluntary Accident, Voluntary Short Term Disability)

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