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���� �������� I����I��� ��t� ��n�rif�uti�r�� � �r`emlums �v�r�ri��r: <br />Note: 3 Tiers (Single, Single + I,Family); 3 Plan Choices (100% after co-pay, 80%- <br />20% after deductible, high deductible with HRA); EE's = Employees; numbers of <br />EE's choosing each type of coverage below are estimates. <br />MONTHLY <br />RATES: 1N LE C� EEnavs S1NGLE+ <br />EE ontribution (receives) for Premium <br />Premium to in le EE <br />57 EE's overa e 21 EE's <br />Partners <br />100% <br />Health <br />Partners <br />80% <br />Partners <br />High <br />Deductible <br />w HRA <br />� EE Davs for FAMILY <br />�tribution Single+ 1 Premium <br />in le t Coverage <br />(49 EE's) <br />C� EE Davs for <br />ontribution <br />to Familv overa e <br />$371.28 $411.00 ( $39.72), $699.99 $525.00 $174.99, EE's pay $1,032.56 $735.00 $297.56, EE's <br />EE's make $34.90 more pay $53.95 <br />up to $4.81 compared to 2004 more compared <br />more than in premiums to 2004 <br />2004*see premiums <br />note below <br />$310.46 $411 fJ0 � ( $100.54), $585.32 $525.00 $60.32 , EE's pay $863.41 $735.00 $128.41, EE's <br />EB's make $35.45 more pay $54.65 <br />� 4p �t compared to 2004 more compared <br />more than in premiums to 2004 <br />2004* see premiums <br />note Ue1ow <br />$299.46 $411fJ0 [ flll 3{]. 43f�.54 '��:�i3O $39.59,EE's pay $824.49 $735.00 $89.49,EE's <br />EE's make $14.72 more pay $15.73 <br />up to $15.42 compared to 2004 more compared <br />more than in premiums for 80% to 2004 <br />2004 80% plan premiums for <br />lan � 80% lan <br />� Those 1 �at "opt out' � tiwould sti11 receive $ 284.00/mo. for 2005. <br />'� �Note: The City uses this "cashback" to single employees to pay for their dental insurance, the cost of which <br />is $3100 in 2005. (Family dental coverage is paid entirely by the employee.) Hence, actual in-pocket cash to <br />the single employee depends on whether they take dental coverage in 2005. <br />�i <br />