Page 15 - Galassos EE Guide 10-18_ENG_FINAL

EMPLOYEE CONTRIBUTIONS

This chart compares the weekly contributions for our Employee Benefit plans. Your cost for coverage will vary depending on the
option and level of coverage you choose.

Medical

EBA&M (Anthem Blue Cross)
Network PPO Plan
Employee Only $18.00
Employee + Spouse / Domestic Partner $76.00
Employee + Child(ren) $67.00
Employee + Family $116.00
Dental

Delta Dental Delta Dental
High DPPO Plan Low DPPO Plan
Employee Only $11.00 $5.00
Employee + Spouse / Domestic Partner $19.00 $9.00
Employee + Child(ren) $22.00 $11.00
Employee + Family $28.00 $13.00
Vision

VSP
PPO Vision
Employee Only $1.89
Employee + Spouse / Domestic Partner $3.24
Employee + Child(ren) $3.30
Employee + Family $5.33
The following benefits are provided to you at no charge and are paid by Galasso’s Bakery:
• Employee Assistance Program
• Basic Life and AD&D
• Long Term Disability (taxed benefit)
• Travel Assistance Program

The following benefits are available to you at discounted group rates. Should you elect these benefits, you will
pay 100% of the cost:
• Vision Benefit
• Voluntary Life and AD&D
• Long Term Disability (non-taxed benefit)

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