Medical
| Semi-Monthly Contributions | Employee Pays |
|---|---|
| Employee Only | $xx.xx |
| Employee + Spouse/Domestic Partner | $xx.xx |
| Employee + Child(ren) | $xx.xx |
| Employee + Family | $xx.xx |
Dental
| Semi-Monthly Contributions | Employee Pays |
|---|---|
| Employee Only | $xx.xx |
| Employee + Spouse/Domestic Partner | $xx.xx |
| Employee + Child(ren) | $xx.xx |
| Employee + Family | $xx.xx |
Vision
| Semi-Monthly Contributions | Employee Pays |
|---|---|
| Employee Only | $xx.xx |
| Employee + Spouse/Domestic Partner | $xx.xx |
| Employee + Child(ren) | $xx.xx |
| Employee + Family | $xx.xx |