Page 15 - Lake Avenue Church Benefits Guide 2018 5.22

Employee Contributions

This chart compares the monthly contributions for our Employee Benefit plans. Your cost for coverage will vary depending on the
option and level of coverage you choose. Employee contributions for Medical, Dental, and Vision are deducted from your paycheck
with pre-tax dollars. This means that contributions are taken from your earnings before taxes, resulting in lower taxes and
increased take home pay.

Medical Anthem Blue Cross Anthem Blue Cross Anthem Blue Cross
Value Ded HMO Value HMO Classic PPO
Select Network Select Network

Employee Only $41.35 $66.02 $268.74
Employee + Spouse $90.97 $145.25 $591.20
Employee + Child(ren) $74.43 $118.84 $483.70
Employee + Family $128.18 $204.66 $833.05
Dental Anthem Blue Cross
Dental Complete
Employee Only $10.00
Employee + Spouse $20.00
Employee + Child(ren) $30.00
Employee + Family $40.00

Vision Anthem Blue Cross
Blue View Vision

Employee Only $0.20
Employee + Spouse $0.40
Employee + Child(ren) $0.50
Employee + Family $0.60

Supplemental Benefits MetLife MetLife MetLife
Accident Hospital Low Hospital High
Employee Only $19.11 $26.00 $42.73
Employee + Spouse $29.47 $51.05 $83.76
Employee + Child(ren) $33.41 $40.60 $66.78
Employee + Family $41.38 $63.79 $104.74

The following benefits are provided to you at no charge
and are paid by Lake Avenue Church:
• Basic Life and AD&D Insurance
• Short Term Disability
• Long Term Disability
• Resource Advisor

The following benefits are available to you at discounted
group rates. Should you elect these benefits, you will
pay 100% of the cost:
• Voluntary Life and AD&D Insurance Benefit
• Voluntary Legal & Identity Theft Plans
• Voluntary Supplemental Plans

For Critical Illness, your premium is based on your Issue
Age, meaning your initial rate is based on your age at
the time your coverage becomes effective and your
rates will not increase due to age.
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