Page 7 - Incipio EE Guide 01-18 Non-CA Bi-Weekly
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EMPLOYEE CONTRIBUTIONS
This chart compares the per-paycheck 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. Please see ADP for Voluntary Life and AD&D premiums.
MEDICAL OPTIONS
ANTHEM
PPO 2500 DEDUCTIBLE
(PRUDENT BUYER)
Employee Only $0.00
Employee + Spouse $78.43
Employee + Child(ren) $64.17
Employee + Family $110.51
ANTHEM
PPO 500 DEDUCTIBLE
(PRUDENT BUYER)
Employee Only $55.81
Employee + Spouse $201.20
Employee + Child(ren) $164.62
Employee + Family $283.52
DENTAL OPTIONS
UNITED CONCORDIA
DPPO
Employee Only $12.49
Employee + Spouse $24.98
Employee + Child(ren) $26.73
Employee + Family $40.71
VISION OPTION
ANTHEM
PPO
Employee Only $4.27
Employee + Spouse $7.26
Employee + Child(ren) $7.68
Employee + Family $11.53
The following benefits are provided to you at no charge and are paid by Incipio:
• Basic Life and AD&D
• Long Term Disability
• Employee Assistance Plan & Travel Assistance Services
The following benefits are available to you at discounted group rates.
• Voluntary Life and AD&D
• Supplemental Benefits
• Pet Insurance
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