Page 5 - Arrowhead Credit Union Benefit Guide 2019 - Final

Medical Blue Shield of California Blue Shield of California Blue Shield of California
HMO HMO PPO
LOW PLAN - $25-25% HIGH PLAN - $20-$500

Employee Only $16.60 $32.38 $69.49
Employee + 1 Dependent $127.16 $161.89 $258.87
Employee + Family $187.06 $232.03 $347.26
Dental DHMO PPO

Employee Only $1.18 $16.10
Employee + 1 Dependent $4.44 $40.74
Employee + Family $8.09 $66.69
Vision EyeMed

Employee Only $0.61
Employee + 1 Dependent $2.43
Employee + Family $4.23
Life / Disability Mutual of Omaha

Basic Life Insurance Paid entirely by Arrowhead
Basic AD&D Insurance Paid entirely by Arrowhead
Short Term Disability Paid entirely by you
Long Term Disability Paid entirely by Arrowhead
Voluntary Life / AD&D Paid entirely by you

Voluntary Products AFLAC
Accident Advantage Paid entirely by you
Cancer Protection Assurance Paid entirely by you
Critical Care Protection (Specified Paid entirely by you
Health)
Hospital Confinement Paid entirely by you
Additional Benefits

Employee Assistance Program Paid entirely by Arrowhead
Health Advocate Paid entirely by Arrowhead
Section 125 Cafeteria Plan
Medical, dental and vision premium contribution amounts are governed by Section 125 of the Internal
Revenue Code. Arrowhead Credit Union Section 125 Cafeteria Plan allows health-related premium
contributions to be taken out of your paycheck on a pre-tax basis.

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