|
|
|
|
|
|
|
| CommunityCare: Std Option HMO Plan |
$356.46 |
$866.19 |
$1,044.42 |
$1,151.36 |
$534.69 |
$641.63 |
| CommunityCare: Alt Option HMO Plan |
$245.84 |
$597.38 |
$720.31 |
$794.05 |
$368.77 |
$442.51 |
| GlobalHealth: Std Option HMO Plan |
$169.18 |
$446.67 |
$535.80 |
$588.81 |
$258.31 |
$311.32 |
| GlobalHealth: Alt Option HMO Plan |
$153.81 |
$406.08 |
$487.14 |
$535.30 |
$234.87 |
$283.03 |
| PacifiCare Std Option HMO Plan |
$316.81 |
$772.32 |
$930.61 |
$1,025.64 |
$475.10 |
$570.13 |
| PacifiCare Alt Option HMO Plan |
$218.49 |
$532.63 |
$641.79 |
$707.33 |
$327.65 |
$393.19 |
| HealthChoice High |
$207.45 |
$522.56 |
$627.88 |
$685.06 |
$312.77 |
$369.95 |
| HealthChoice Basic |
$180.76 |
$456.98 |
$550.13 |
$600.43 |
$273.91 |
$324.21 |
| HealthChoice USA |
$317.92 |
$635.84 |
$740.25 |
$796.85 |
$422.33 |
$478.93 |
| HealthChoice S-Account |
$176.57 |
$436.30 |
$524.08 |
$571.02 |
$264.35 |
$311.29 |
|
|
|
|
|
|
|
| Dental |
Employee |
Employee & Spouse |
Employee, Spouse & Child |
Employee, Spouse & Children |
Employee & Child |
Employee & Children |
|
|
|
|
|
|
|
| Assurant Heritage Plus Prepaid |
$5.42 |
$9.51 |
$13.02 |
$16.53 |
$8.93 |
$12.44 |
| Assurant Freedom Preferred |
$13.31 |
$26.54 |
$36.46 |
$53.22 |
$23.23 |
$39.99 |
| Assurant Heritage Secure Prepaid |
$3.32 |
$6.08 |
$8.48 |
$10.87 |
$5.72 |
$8.11 |
| CIGNA Dental Prepaid |
$4.27 |
$7.07 |
$10.34 |
$14.14 |
$7.54 |
$11.34 |
| Delta Dental PPO-POS |
$14.37 |
$28.74 |
$41.25 |
$60.38 |
$26.88 |
$46.01 |
| Delta's Choice PPO |
$6.43 |
$21.03 |
$35.75 |
$56.76 |
$21.15 |
$42.16 |
| Delta Dental Premier |
$16.39 |
$32.78 |
$47.04 |
$68.87 |
$30.65 |
$52.48 |
| HealthChoice Dental |
$13.77 |
$27.54 |
$39.02 |
$57.34 |
$25.25 |
$43.57 |
|
|
|
|
|
|
|
| Vision |
Employee |
Employee & Spouse |
Employee, Spouse & Child |
Employee, Spouse & Children |
Employee & Child |
Employee & Children |
|
|
|
|
|
|
|
| CompBenefits |
$3.12 |
$5.46 |
$7.11 |
$7.52 |
$4.77 |
$5.18 |
| PVCS |
$4.27 |
$7.96 |
$11.88 |
$12.92 |
$8.19 |
$9.23 |
| Spectera |
$3.78 |
$6.45 |
$8.57 |
$9.67 |
$5.90 |
$7.00 |
| Superior |
$3.22 |
$6.40 |
$9.45 |
$9.45 |
$6.27 |
$6.27 |
| VSP |
$4.04 |
$6.75 |
$9.34 |
$12.58 |
$6.63 |
$9.87 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Benefit Allowance |
Base Amount |
Dependent |
Benefit Allowance |
Life |
$2.10 |
| Employee |
$278.44 |
|
$278.44 |
Disability |
|
$4.20 |
| Plus Child |
$278.44 |
$99.56 |
$378.00 |
Supplemental Life |
$2.10 |
| Plus Children |
$278.44 |
$158.09 |
$436.53 |
|
|
|
| Plus Spouse |
$278.44 |
$292.10 |
$570.54 |
Dependent Life |
|
| Spouse & 1 Child |
$278.44 |
$391.66 |
$670.10 |
Low Option |
$1.20 |
| Spouse & 2 Children |
$278.44 |
$450.19 |
$728.63 |
Standard Option |
$1.99 |