| Program 1 | Program 2 | Program 3 | |
|---|---|---|---|
| Annual Medical Bill Sharing Limit: | $50,000 | $100,000 | $150,000 |
| Medical Bill Sharing Percentage after AMR/AFR: | 70% | 75% | 80% |
| Annual Member Responsibility (AMR): | $5,000 | $2,500 | $1,500 |
| Annual Family Responsibility (AFR): | $10,000 | $5,000 | $3,000 |
| Maximum Number of Contributions per Family: | 6 | 6 | 6 |
| *Those with Medicare A & B will have half of the listed Annual Member Responsibility (AMR) Amount | |||
| Dental | Vision | |||
|---|---|---|---|---|
| Annual Bill Sharing Limit: | $8,000 | $1,000 | ||
| Bill Sharing Percentage after AMR: | 80% | 80% | ||
| Annual Member Responsibility (AMR): | $150 | $150 | ||
| Additional Dental Surgery AMR: | $400 | N/A | ||
| Additional Orthodontic AMR: | $400 | N/A | ||
| Maximum Number of Contributions per Family: | 6 | 6 | ||
| Monthly Contribution per Person, All Ages*: | $45 | $17 | ||
| *Children ages 3 and below can be exempt from Dental and Vision by request | ||||
| Age | Monthly |
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| Age | Monthly |
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| Age | Monthly |
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Family Cost Calculator |
Optional Additionsselect checkboxes to enable |
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|---|---|---|---|---|---|---|---|---|---|
| Family Member | Age (as of December 31) | Program 1 | Program 2 | Program 3 | |||||
| Monthly | Monthly | Monthly | Monthly | Monthly | |||||
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| Monthly Total With Optional Additions: | |||||||||