Page 7 - Tender Greens EE Guide 01-20 Non-CA.pub
P. 7
Contributions
Team Member Portion
Plan (Per Pay Period)
Medical Options
PPO HDHP
Team Member Only $45
Team Member + Spouse $134
Team Member + Child(ren) $109
Team Member + Family $194
PPO
Team Member Only $130
Team Member + Spouse $336
Team Member + Child(ren) $245
Team Member + Family $467
Dental Option
Team Member Only $6
Team Member + Spouse $16
Team Member + Child(ren) $19
Team Member + Family $27
Vision Option
Team Member Only $1
Team Member + Spouse $3
Team Member + Child(ren) $3
Team Member + Family $5
The following benefits are provided to you at no charge and The following benefits are available to you at discounted group
are paid by Tender Greens: rates. Should you elect these benefits, you will pay 100% of the
Basic Life/AD&D cost:
Employee Assistance Program Voluntary Life/AD&D
Travel Assistance Voluntary Short Term Disability
Will Preparation Assistance Voluntary Long Term Disability
For your convenience, your age-banded Voluntary Life/AD&D, Short
Term Disability and Long Term Disability premiums have been
pre-calculated for you in UltiPro.
Team Member Benefits
Team Member Benefits 7 7