EML BENEFIT SCHEDULE EFFECTIVE AUGUST 1, 2005
Biweekly Deductions
MEDICAL - HMO BC / BS monthly premium EML's biweekly contribution Employee's biweekly contribution
Employee Only $327.56 $75.59 $75.59
Employee + Spouse $819.36 $75.59 $302.58
+ Child $0.00
Employee + Child(ren) $666.91 $75.59 $232.21
Employee + Family $1,158.71 $75.59 $459.20
MEDICAL -  PPO BC / BS monthly premium EML's biweekly contribution Employee's biweekly contribution
Employee Only $337.74 $77.94 $77.94
Employee + Spouse $844.80 $77.94 $311.97
+ Child $77.94 $0.00
Employee + Child(ren) $687.62 $77.94 $239.42
Employee + Family $1,194.69 $77.94 $473.46
VOLUNTARY DENTAL Fort Dearborn monthly premium EML's biweekly contribution Employee's biweekly contribution
Employee Only $30.50 $0.00 $14.08
Employee + Spouse $61.00 $0.00 $28.15
Employee + Child(ren) $62.90 $0.00 $29.03
Employee + Family $105.60 $0.00 $48.74
VOLUNTARY VISION AVS monthly premium EML's biweekly contribution Employee's biweekly contribution
Employee Only $8.90 $0.00 $4.11
Employee + Spouse $15.54 $0.00 $7.17
Employee + Child(ren) $16.14 $0.00 $7.45
Employee + Family $22.90 $0.00 $10.57
Basic $20,000 Life/AD&D Fort Dearborn Life 100% 0%
Voluntary Short Term Disability Fort Dearborn Life 0% 100%
Voluntary Long Term Disability Fort Dearborn Life 0% 100%
Voluntary Life/Dependent Life Fort Dearborn Life 0% 100%