Page 15 - CW Driver Benefit Guide 2019 SPG
P. 15
PREMIUM COSTS
The weekly employee costs for each plan are listed below.
WEEKLY EMPLOYEE COST
Medical Option 1: Kaiser Permanente HMO
Employee Only $9.99
Employee + Spouse $36.65
Employee + Child(ren) $33.31
Employee + Family $49.97
Medical Option 2: Anthem Blue Cross HMO
Employee Only $10.30
Employee + Spouse $42.49
Employee + Child(ren) $34.76
Employee + Family $59.87
Medical Option 3: Anthem Blue Cross PPO HRA
Employee Only $12.31
Employee + Spouse $84.63
Employee + Child(ren) $69.24
Employee + Family $119.26
Dental Option 1: Anthem Blue Cross DHMO
Employee Only $0.00
Employee + Spouse $0.00
Employee + Child(ren) $1.15
Employee + Family $3.52
Dental Option 2: Anthem Blue Cross PPO
Employee Only $2.66
Employee + Spouse $11.75
Employee + Child(ren) $9.86
Employee + Family $18.92
Vision: Anthem Blue Cross Vision
Employee Only $0.00
Employee + 1 Dependent $0.00
Employee + 2 or More Dependents $0.00
EAP: Anthem Blue Cross
Employee + Household No Cost
Basic Life and AD&D: Hartford / Anthem Blue Cross
Hartford: 1x Salary No Cost
Anthem Blue Cross: $15,000 No Cost
Voluntary Benefits
Employee 100% of Cost paid by Employee
Spouse 100% of Cost paid by Employee
Child(ren) 100% of Cost paid by Employee
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