Page 10 - Bobit Benefit Guide 2018 FINAL

Associate Contributions

Note regarding medical, dental and vision contributions:
Associate contributions for medical, dental and vision are listed below by monthly amount (divide by two for per pay period
amounts). These particular contributions are deducted from paychecks with pre-tax dollars. This results in lower taxes and
increased take home pay.

Find your state category MEDICAL/DENTAL/VISION
for CATEGORY 1 DISABILITY & LIFE
Medial/Dental/Vision Medical HMO / DHMO / Vision Supplemental Life

Associate $104 Associate Age Rate Per $1,000
CATEGORY 1 Associate + Child(ren) $420
AZ CA Associate + Spouse $460 <25 $0.057
CO CT Associate + Family $680 25-29 $0.068
FL GA
IL IN Medical HMO / DPPO / Vision 30-34 $0.079
KS NC Associate $104 35-39 $0.102
NJ SC Associate + Child(ren) $480
TN TX Associate + Spouse $530 40-44 $0.131
Associate + Family $750
CATEGORY 2 45-49 $0.197
AL AR Medical PPO / DHMO / Vision 50-54 $0.302
DE IA
KY LA Associate $315 55-59 $0.565
MA MD Associate + Child(ren) $750
Associate + Spouse $820 60-64 $0.866
MI MN
Associate + Family $1,150
MO MS 65-69 $1.667
NE NV Medical PPO / DPPO / Vision
NY OH 70+ $2.704
OK OR Associate $315
PA UT Associate + Child(ren) $830 Buy-Up Long Term Disability
VA WI Associate + Spouse $900 $0.26 per $100 of monthly coverage
Associate + Family $1,230
CATEGORY 3
Any state not listed in MEDICAL/DENTAL/VISION Voluntary Short Term Disability
Categories 1 or 2 CATEGORIES 2 & 3
Associate Rate Per $10 weekly
Medical PPO / DHMO / Vision - Cat. 2
Medical PPO / DPPO / Vision - Cat. 2 & 3 Age Benefit

Associate $220 CA, HI, NJ, RI, Puerto Rico
Associate + Child(ren) $690 Under 50 $0.369
Associate + Spouse $760
50-54 $0.37
Associate + Family $1,110
55-59 $0.453
DENTAL/VISION ONLY 60-64 $0.534
65 and over $0.586
Dental DHMO & Vision—Categories 1 & 2
All Other States
Associate $18
Under 50 $0.423
Associate + Child(ren) $46
Associate + Spouse $56 50-54 $0.424
Associate + Family $78 55-59 $0.519
60-64 $0.612
Dental PPO & Vision—All Categories
65 and over $0.671
Associate $54
Associate + Child(ren) $114
Associate + Spouse $122
Associate + Family $172

10