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Benefits Costs Summary

Note: CIS of Atlanta will continue to cover 100% of the costs for 1) Vision, 2) Medical Bridge, 3) Basic Term Life insurance, Dependent Life,

Short-Term Disability and Long-Term Disability for the

employee only

.

MetLife

EyeMed

Lincoln

NEW

NEW

Election

Medical

(Platinum)

NEW

Medical

(Gold)

Dental

Vision

Medical Bridge

($2,000)

Medical Bridge

($3,000)

Life/STD/LTD

Employee

104.77

118.18

7.37

-

-

-

-

Employee and Spouse

209.54

236.36

14.64

1.18

6.25

8.59

Varies

Employee and Child(ren)

193.83

218.63

17.23

1.31

2.56

3.41

Varies

Family

298.60

336.81

26.83

2.54

8.81

12.00

Varies

MetLife

EyeMed

Lincoln

Election

Medical

(Platinum)

Medical

(Gold)

Dental

Vision

Medical Bridge

($2,000)

Medical Bridge

($3,000)

Life/STD/LTD

Employee

52.39

59.09

3.68

-

-

-

-

Employee and Spouse

104.77

118.18

7.32

0.59

3.12

4.29

Varies

Employee and Child(ren)

96.91

109.32

8.62

0.66

1.28

1.71

Varies

Family

149.30

168.40

13.41

1.27

4.41

6.00

Varies

* For 2 pay periods there will be no deductions

Kaiser

Kaiser

Employee Monthly Cost

Employee Per Pay Period Cost (24 pay periods*)

Colonial

Colonial

3