BENEFITS CENTER
Medical Benefits
Compare the available Platinum Control medical benefit options below.
OPTION 1
PPO Plan
PROVIDER
BlueCross BlueShield — MTBCP019
WAITING PERIOD
1st of month following 30 days
COST BREAKDOWN
Employee Only
Per Paycheck $60.25
TOTAL / YR EMPLOYER EMPLOYER
$7,832.52 $6,266.02 $1,566.50
Employee + Child(ren)
Per Paycheck $183.02
TOTAL / YR EMPLOYER EMPLOYER
$18,162.12 $13,403.60 $4,758.52
Employee + Spouse
Per Paycheck $212.53
TOTAL / YR EMPLOYER EMPLOYER
$17,317.80 $11,792.02 $5,525.78
Employee + Family
Per Paycheck $370.06
TOTAL / YR EMPLOYER EMPLOYER
$27,647.28 $18,025.72 $9,621.56
COVERAGE INFORMATION
OPTION 2
High Deductible PPO Plan
PROVIDER
BlueCross BlueShield — MTBCP015
Employee Only
Per Paycheck $0.00
TOTAL / YR EMPLOYER EMPLOYER
$5,161.68 $5,161.68 $0.00
Employee + Child(ren)
Per Paycheck $65.46
TOTAL / YR EMPLOYER EMPLOYER
$11,969.16 $10,267.20 $1,701.96
WAITING PERIOD
1st of month following 30 days
COST BREAKDOWN
Employee + Spouse
Per Paycheck $60.11
TOTAL / YR EMPLOYER EMPLOYER
$11,412.60 $9,849.74 $1,562.86
Employee + Family
Per Paycheck $65.46
TOTAL / YR EMPLOYER EMPLOYER
$18,219.96 $14,955.40 $3,264.56
COVERAGE INFORMATION
