|
|
EMPLOYEE
CONTRIBUTIONS |
|
If
you are enrolled for coverage, the
following amounts will be deducted from your paycheck each month. |
| |
Employee |
Employee/Spouse |
Employee/Child |
Employee/
2
Children |
Family |
|
Medical |
$0 |
$233.80 |
$87.35 |
$174.85 |
$321.70 |
|
Dental |
$0 |
$27.75 |
$15.10 |
$28.30 |
$56.05 |
|
Vision |
$0 |
$6.30 |
$3.25 |
$3.25 |
$9.55 |
|
Basic
Life/AD&D |
$0 |
$0 |
$0 |
$0 |
$0 |
|
Dependent
Life |
$0 |
$0 |
$0 |
$0 |
$0 |
|
LTD |
$0 |
$0 |
$0 |
$0 |
$0 |
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Disclaimer.
©1999-2001 Instant Benefits Network,
Inc.
All
Rights Reserved.
|
