Page 5 - HM Benefits Guide 2019 CA
P. 5

Employee Contributions







                                                               Your  Cost Per Paycheck
                Medical
                                             Anthem           Anthem            Anthem           Kaiser
                                               HMO           PPO (Low)        PPO (High)          HMO
                Employee Only                 $0.00            $0.00            $20.77            $0.00
                Employee + Spouse             $0.00            $0.00            $46.15            $0.00
                Employee + Child(ren)         $0.00            $0.00            $34.62            $0.00
                Employee + Family             $0.00            $0.00            $64.62            $0.00
                Dental & Vision

                                            PPO (Low)        PPO (High)
                                              Dental           Dental           Vision
                Employee Only                 $0.00              $7.15           $0.00
                Employee + Spouse             $0.00            $14.62           $0.00
                Employee + Child(ren)         $0.00            $17.28           $0.00
                Employee + Family             $0.00            $24.13           $0.00
                Accident & Critical Illness
                                                                               Hospital
                                          Group Accident   Critical Illness   Indemnity
                Employee Only                 $4.94          Age Rated -        $11.04
                Employee + Spouse             $9.22        See PlanSource       $24.29
                Employee + Child(ren)         $10.14        for Your Age-       $19.39
                Employee + Family             $12.70        Specific Rate       $32.65



                Additional Benefits                Additional Benefits
                Paid by Happy Money                Paid by You (if elected)
                •   Employee Assistance Program    •   Supplemental Life/AD&D
                •   Travel Assistance              •   Group Accident
                •   Basic Life/AD&D                •   Critical Illness
                •   Short Term Disability          •   Hospital Indemnity
                •   Long Term Disability


               IRS Code Section 125
               Happy Money’s employee benefit plans are designed under Section 125 of the IRS Code. This allows
               you to take advantage of federal laws by purchasing some of your benefits with pre-tax dollars. Under
               Section 125, your Medical, Dental, Vision, and Flexible Spending Account contributions are deducted
               before taxes are withheld which saves you tax dollars. Paying for benefits before-tax means that your
               share of the costs are deducted before taxes are determined, resulting in more take-home pay for you.
               As a result, the IRS requires that your elections remain in effect for the entire year. You may waive
               participation in the Section 125 Plan and elect to pay all contributions with after-tax dollars. Contact
               the Human Resources Department if you wish to pay for your benefits with after-tax dollars.






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