Year:
Pay Frequency:
Age:
Option
Carrier
Coverage
Rate
Health
293.60
Dental
0.00
Vision
0.00
Supplemental Life
0.00
Dependent Life
0.00
Basic Life
2.10
Disability
5.18
Savings Accounts
Flexible Spending Account
0.00
Dependent Care Account
0.00
Totals
Total Benefit Cost
300.88
Benefit Allowance
336.55
35.67
*This amount may vary from actual because of possible tax implications.