Page 16 - Catasys Benefit Guide 2019-2020

Employee Contributions

Employee Monthly Cost Employee Cost Per Paycheck

Anthem Blue Cross HMO
− Employee $133.90 $61.80
− Employee + Spouse $294.58 $135.96
− Employee + Child(ren) $241.02 $111.24
− Employee + Family $415.10 $191.58
Anthem Blue Cross PPO 250
− Employee $261.03 $120.48
− Employee + Spouse $574.27 $265.05
− Employee + Child(ren) $469.86 $216.86
− Employee + Family $809.20 $373.48
Anthem Blue Cross PPO 1500
− Employee $216.96 $100.14
− Employee + Spouse $477.32 $220.30
− Employee + Child(ren) $390.53 $180.25
− Employee + Family $672.59 $310.43

Anthem Blue Cross HSA 1500
− Employee $204.41 $94.35
− Employee + Spouse $449.71 $207.56
− Employee + Child(ren) $367.94 $169.82
− Employee + Family $633.68 $292.47
Guardian DHMO Dental
− Employee $6.19 $2.86
− Employee + Spouse $12.24 $5.65
− Employee + Child(ren) $15.08 $6.96
− Employee + Family $21.10 $9.74

Guardian DPPO Dental
− Employee $17.30 $7.99
− Employee + Spouse $33.98 $15.68
− Employee + Child(ren) $37.78 $17.44
− Employee + Family $54.51 $25.16
Guardian Vision
− Employee $7.31 $3.37
− Employee + Spouse $12.29 $5.67
− Employee + Child(ren) $12.53 $5.78
− Employee + Family $19.83 $9.15

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