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7

Medical Plan Costs

As an employee of Sandberg Phoenix & von Gontard P.C., the Firm will pay 85% of the premium for single coverage and 20% for

dependent coverage in the Base Plan. An employee may choose to participate in the Buy-Up Plan; however, you will be responsible

for the difference in premium between the Base Plan and the Buy-Up Plan. The Firm will pay 100% of the premium for single coverage

and 20% for dependent coverage in the HSA Plan.

Below are the monthly costs associated with each of the three medical plan options being offered for 2016. In addition to the lower

costs associated with the UHC HSA plan option, the Firm will put a $175 contribution each quarter of the 2016 calendar year into your

established Health Savings Account. In order to receive the quarterly contribution, the HSA must be established on the first day of the

quarter.

Sandberg Phoenix & von Gontard P.C. pays for all of the expenses associated with a Premium Only Plan, which allows each

employee to take the premiums they pay for their medical, dental, and vision insurance out of their paycheck on a pre-tax basis. This

can save you considerable money as the savings are based upon your individual tax bracket.

PPO Base Plan Monthly Cost

Type of Coverage

Employee

Employee

$75.56

Employee & Spouse

$518.90

Employee & Child(ren)

$438.30

Employee & Family

$841.34

PPO Buy-Up Plan Monthly Cost

Type of Coverage

Employee

Employee

$140.74

Employee & Spouse

$655.80

Employee & Child(ren)

$562.14

Employee & Family

$1,030.38

PPO HSA Plan Monthly Cost

Type of Coverage

Employee

Employee

$0.00

Employee & Spouse

$400.40

Employee & Child(ren)

$327.60

Employee & Family

$691.58