Page 11 - FINAL Crane Country Day School 2017-18 Benefits Guide

Health Plan Contributions 11

Crane Country Day School pays the majority of health plan premium costs for employees. Your monthly contri-
butions are divided between your semi-monthly paychecks and are deducted on a pre-tax basis.

Medical Plans You Pay Per Month Per Pay Check Breakdown
Anthem Value HMO $20/$40
Employee Only $0.00 $0.00
Employee + Spouse $807.22 $403.61
Employee + Child(ren) $538.14 $269.07
Employee + Family $1,412.64 $706.32
Anthem Classic $750 PPO
Employee Only $0.00 $0.00
Employee + Spouse $953.93 $476.97
Employee + Child(ren) $635.96 $317.98
Employee + Family $1,669.39 $834.70
Anthem Solutions $3,500 HDHP
Employee Only $0.00 $0.00
Employee + Spouse $459.00 $229.50
Employee + Child(ren) $188.00 $94.00
Employee + Family $637.00 $318.50
Anthem Lumenos $2,000 H.S.A.
Employee Only $0.00 $0.00
Employee + Spouse $738.70 $369.35
Employee + Child(ren) $492.47 $246.24
Employee + Family $1,292.72 $646.36
Dental Plan
Anthem Dental PPO $4,000
Employee Only $0.00 $0.00
Employee + Spouse $48.28 $24.14
Employee + Child(ren) $48.28 $24.14
Employee + Family $102.04 $51.02

Vision Plan
Anthem Vision PPO
Employee Only $0.00 $0.00
Employee + Spouse $4.84 $2.42
Employee + Child(ren) $5.54 $2.77
Employee + Family $11.76 $5.88

Supplemental Voluntary Life Rates

Coverage Age bands Monthly Rate per $1,000
Under 25 $0.038
25-29 $0.034
30-34 $0.047
35-39 $0.072
40-44 $0.108
Optional Supplemental Life Employee and 45-49 $0.168
Spouse (based on employee age) 50-54 $0.267
55-59 $0.409
60-64 $0.604
65-69 $0.969
70-74 $2.285
Over 74 $6.087
Optional Supplemental AD&D (employee only) $0.020 per $1000
Optional Supplemental Dependent Child(ren) $0.21 per $1000
(covers all dependent children)