Employee Contributions Medical Per Paycheck Deductions $7,000 HDHP Base $2,000 OAP Buy-Up Employee Only $0.00 $123.83 Employee & Spouse $560.71 $845.54 Employee & Child(ren) $345.05 $567.97 Family $905.77 $1,289.66 Dental & Vision Per Paycheck Deductions Dental Vision Employee Only $18.83 $3.27 Employee & Spouse $43.88 $6.22 Employee & Child(ren) $36.91 $6.54 Family $62.67 $9.61 19 Medical Plans Cigna Group #: 0651438 Customer Service: 800-997-1654 www.mycigna.com Life & AD&D & Disability Plans The Hartford Group #: 889245G Customer Service: 888-563-1124 www.thehartford.com Dental Plan Principal Group #: 1156118 Customer Service: 800-247-4695 www.principal.com HSA & FSA Plans EBC Group #: MedTrust Customer Service: 800-346-2126 www.ebcflex.com Vision Plan Principal – Using VSP Group #: 1156118 Customer Service: 800-877-7195 www.vsp.com Accident/Critical Illness The Hartford Group #: 889245G Customer Service: 888-563-1124 www.thehartford.com Contact List Remember, our Human Resources Department is available to answer questions throughout the year.