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CONTRIBUTIONS—COOLRAY
Medical Coverage Tier
Payroll Frequency
Monthly Bi-Weekly
Monthly Bi-Weekly Monthly Bi-Weekly
Monthly Bi-Weekly
Employee Only
$120.00
$55.38
$212.06
$97.87
$278.69
$128.63
$346.06
$159.72
Employee + Spouse
$337.34
$155.70
$526.15
$242.84
$677.40
$312.65
$692.12
$319.44
Employee + Child(ren)
$316.38
$146.02
$499.91
$230.73
$642.43
$296.51
$622.90
$287.49
Family
$499.36
$230.47
$787.23
$363.34 $1,011.62 $466.90 $1,038.17 $479.16
Dental Coverage Tier
Payroll Frequency Monthly Bi-Weekly Monthly Bi-Weekly
Employee Only
$21.60
$9.97
$16.96
$7.83
Employee + Spouse
$50.81
$23.45
$41.24
$19.03
Employee + Child(ren)
$53.22
$24.56
$43.21
$19.94
Family
$86.94
$40.13
$72.57
$33.49
Vision Coverage Tier
Payroll Frequency
Employee Only
Employee + Spouse
Employee + Child(ren)
Family
$7.34
$13.96
$14.70
$21.61
Low PPO Plan
PPO Plan
Monthly
Bi-Weekly
$3.39
$6.44
$6.78
$9.97
Medical Insurance - Employee Bi-Weekly Contributions
Dental Insurance - Employee Monthly Contributions
Vision Insurance - Employee Monthly Contributions
Bronze Plan
Silver Plan
Gold Plan
Platinum Plan
High PPO Plan