Page 25 - Burnham EE Guide 01-20
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OTHER BENEFITS EMPLOYEE CONTRIBUTIONS
The tables below show the per-paycheck contributions for our employee benefit plans. Your cost for coverage
varies depending on the option and level of coverage you choose.
Burnham contributes 85% of the employee premiums and 50% of the dependent premiums for Medical, Dental
and Vision. Our online enrollment portal and the tables below illustrate employee contributions after Burnham’s
contributions have been made toward the premiums.
Shared Cost Benefits
Plan Contribution Per Paycheck
Medical Options Kaiser HMO Aetna HMO Aetna OAMC POS Aetna HSA
Employee Only $42.02 $30.86 $41.14 $35.51
Employee + Spouse $210.08 $154.28 $205.68 $177.54
Employee + Child(ren) $182.07 $113.14 $150.83 $130.20
Employee + Family $322.12 $246.85 $329.09 $284.07
Dental & Vision Options Dental Vision
Employee Only $4.66 $0.81
Employee + Spouse $21.83 $2.66
Employee + Child(ren) $25.26 $2.75
Employee + Family $42.88 $5.45
Burnham-Paid Benefits
Plan Coverage For
Employee Assistance Program Employee + Household
Basic Life and AD&D Insurance Employee Only
Long Term Disability Insurance Employee Only
Legal Benefits Employee + Household
Employee-Paid Benefits
Plan Employee Cost
Voluntary Life and AD&D Insurance Refer to our Online Enrollment Portal or see Rate Sheet
InfoArmor Identity Theft Protection Refer to our Online Enrollment Portal or see Rate Sheet
Universal Life with LTC Refer to our Online Enrollment Portal or see Rate Sheet
Critical Illness with Cancer Refer to our Online Enrollment Portal or see Rate Sheet
Voluntary Short Term Disability Insurance Refer to our Online Enrollment Portal or see Rate Sheet
Flexible Spending Accounts Employee Determined
Commuter Benefit Program Employee Determined
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