BI-WEEKLY PAYROLL DEDUCTIONS
MEDICAL
Plan 1
Plan 2
Plan 3
Plan 4
Employee Only
$46.15
$55.38
$110.77 $396.92 $281.54 $493.85
$138.46 $475.38 $378.46 $655.38
Employee + Spouse
$206.77 $117.23 $253.85
$235.38 $143.08 $304.62
Employee + Child(ren)
Family
DENTAL
DHMO (PRE-PAID)
PPO PLAN
Employee Only
$6.22
$13.21 $30.79 $27.98 $45.56
Employee + Spouse
$10.89 $13.48 $17.11
Employee + Child(ren)
Family
VISION
Vision
Employee Only
$3.19 $5.84 $6.86 $9.33
Employee + Spouse
Employee + Child(ren)
Family
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