| CARRIER |
|
PLAN |
|
EMPLOYEE |
|
MONTHLY |
MONTHLY |
MONTHLY |
WEEKLY |
BI WEEKLY |
|
|
PERCENTAGE |
|
RATE |
EMPLOYER |
EMPLOYEE |
DEDUCT. |
DEDUCT |
|
|
52 weeks |
26 weeks |
|
|
| BC/BS PPO |
|
INDIVIDUAL |
|
50% |
|
$ 532.95 |
$
266.48 |
$
266.48 |
$61.49 |
$
122.99 |
|
|
FAMILY |
|
50% |
|
$ 1,234.67 |
$
617.34 |
$ 732.13 |
###### |
$
337.91 |
|
|
|
|
|
|
|
|
|
|
|
|
|
| BC/BS HMO BLUE |
|
INDIVIDUAL |
|
30% |
|
$ 461.75 |
$
323.23 |
$
138.53 |
$31.97 |
$ 63.93 |
|
| $10/$50 co-pay |
|
FAMILY |
|
30% |
|
$ 1,069.72 |
$
748.80 |
$
320.92 |
$74.06 |
$
148.12 |
|
|
|
|
|
|
|
|
| BC/BS HMO Blue |
|
INDIVIDUAL |
|
30% |
|
$ 386.19 |
$
270.33 |
$
115.86 |
$26.74 |
$ 53.47 |
|
| $1000/$2500 Ded Plan |
|
FAMILY |
|
30% |
|
$ 894.65 |
$
626.26 |
$
268.40 |
$61.94 |
$
123.87 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| MEDICARE
SUPPLEMENT |
|
|
|
|
|
|
|
|
|
|
| BC/BS MEDEX 3 |
|
INDIVIDUAL |
|
50% |
|
$ 292.80 |
$
146.40 |
$
146.40 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
MONTHLY |
WEEKLY |
BI WEEKLY |
|
|
EMPLOYEE |
DEDUCT. |
DEDUCT |
|
|
|
52 weeks |
26 weeks |
|
|
|
| Altus Dental |
|
Employee only |
|
100% |
|
$ 35.43 |
0 |
$ 35.43 |
$
8.18 |
$ 16.35 |
|
|
Emp & Child |
|
100% |
|
$ 59.19 |
0 |
$ 59.19 |
$13.66 |
$ 27.32 |
|
|
Emp & Spouse |
|
100% |
|
$ 64.99 |
0 |
$ 64.99 |
$15.00 |
$ 30.00 |
|
|
Emp Spouse & Child |
|
100% |
|
$ 95.26 |
0 |
$ 95.26 |
$21.98 |
$ 43.97 |
|
|
Emp & Child |
|
100% |
|
$ 111.03 |
0 |
$ 111.03 |
$25.62 |
$ 63.45 |
|
|
Emp & Child |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| Basic Life |
|
$2,000 |
|
100% |
|
$ 1.38 |
0 |
$ 1.38 |
|
|
|
|
|
|
|
|
|
|
|
|
| Optional Life |
|
$5,000 |
|
100% |
|
$ 3.90 |
|
$ 3.90 |
|
|
|
|
$5000 w/dependent |
|
100% |
|
$ 8.24 |
|
$ 8.24 |
|
|
|
|
$10,000 |
|
100% |
|
$ 7.80 |
|
$ 7.80 |
|
|
|
|
$10000 w/dependent |
|
100% |
|
$ 12.14 |
|
$ 12.14 |
|
|
|
|
$15,000 |
|
100% |
|
$ 11.70 |
|
$ 11.70 |
|
|
|
|
$15000 w/dependent |
|
100% |
|
$ 16.04 |
|
$ 16.04 |
|
|
|
|
$20,000 |
|
100% |
|
$ 15.60 |
|
$ 15.60 |
|
|
|
|
$20000 w/dependent |
|
100% |
|
$ 19.94 |
|
$ 19.94 |
|
|
|
|
$30,000 |
|
100% |
|
$ 23.40 |
|
$ 23.40 |
|
|
|
|
$30000 w/dependent |
|
100% |
|
$ 27.74 |
|
$ 27.74 |
|
|
|
|
|
|
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|
|
| Other Life Insurance |
|
rates vary |
|
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| LTD Insurance |
|
rates vary |
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