Page 14 - MMI Benefit Guide 2018 FINAL

Contributions

This chart compares the per paycheck and monthly contributions for our employee benefit plans. Your cost for coverage will vary
depending on the option and level of coverage you choose. For your convenience, your age-banded Voluntary Life and AD&D and
Voluntary Short Term Disability premiums have been pre-calculated for you in ADP.

For bi-weekly employees there is no deduction on the 3rd paycheck for months that have 3 pay dates, therefore calculations are
based on 24 pay dates per year.

Employee Rate Employee Rate Employer Rate
Per Paycheck Cost (24) Monthly Cost Monthly Cost

Medical Kaiser HMO—No. & So CA
Employee $48.04 $96.08 $369.28
Employee + Spouse $159.78 $319.57 $657.70
Employee + Child(ren) $152.18 $304.35 $626.39
Employee + Family
$243.48 $486.96 $1,002.21
Medical Kaiser HMO—CO

Employee $113.81 $227.61 $511.39
Employee + Spouse $255.20 $510.40 $1,031.60
Employee + Child(ren) $249.41 $498.82 $1,008.18
Employee + Family $359.04 $718.08 $1,457.92

Medical Kaiser HMO—OR
Employee $50.29 $100.59 $532.05
Employee + Spouse $209.40 $418.81 $846.47
Employee + Child(ren) $188.46 $376.93 $761.82
Employee + Family $314.11 $628.21 $1,269.71
Medical Anthem HMO—CA

Employee $98.67 $197.34 $473.90
Employee + Spouse $239.23 $478.46 $998.28
Employee + Child(ren) $195.73 $391.47 $816.77
Employee + Family $337.10 $674.20 $1,406.66

Medical Anthem Exclusive PPO—Non CA
Employee $48.04 $96.08 $577.51
Employee + Spouse $214.87 $429.75 $1052.14
Employee + Child(ren) $175.81 $351.61 $860.85
Employee + Family $302.78 $605.55 $1,482.57
Medical Anthem BC PPO—CA and Non CA

Employee $136.25 $272.50 $484.45
Employee + Spouse $299.75 $599.50 $1,065.77
Employee + Child(ren) $245.25 $490.50 $872.00
Employee + Family $422.38 $844.75 $1,501.78

14