Page 15 - 2017 MegaPath Benefits Guide_FINALV2

MONTHLY EMPLOYEE CONTRIBUTIONS

This chart compares the monthly employee contributions for the benefit plans. Your cost for coverage will vary depending on the
option and level of coverage you choose. For your convenience, your age-banded Supplemental Life and AD&D and premiums have
been pre-calculated for you which you can access through the UltiPro system.

Medical
Anthem Blue Cross PPO Kaiser Permanente HMO
Employee Only $105.00 $133.35
Employee + Spouse $326.00 $408.87
Employee + Child(ren) $286.00 $374.43
Employee + Family $475.00 $546.64
Dental

Employee Only $11.66
Employee + Spouse $26.25
Employee + Child(ren) $22.89
Employee + Family $ 39.90
Vision
Employee Only $2.00
Employee + Spouse $3.00
Employee + Child(ren) $3.00
Employee + Family $ 5.00

The following benefits are provided to you at no charge and are paid by MegaPath:
 Employee Assistance Program
 Basic Life and AD&D
 Short Term Disability
 Long Term Disability

The following benefits are available to you at discounted group rates. Should you elect these benefits, you will
pay 100% of the cost:
 Supplemental Life and AD&D

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