| EML BENEFIT SCHEDULE EFFECTIVE AUGUST 1,
2005 |
|
Biweekly Deductions |
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| 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 |
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| 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% |
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