PR - 4.2024 Employee Benefits Guide (FINAL)

MEDICAL PLAN

COVERAGE LEVEL

LIBERTY HIGH PLAN

METRO EPO LOW PLAN

Employee

$173.61

$114.87

Employee + Spouse

$365.10

$241.57

Employee + Child(ren)

$302.95

$200.45

Employee + Family

$540.19

$347.14

MEDICAL PLAN FOR EMPLOYEES WITH ONLY ONE-PLAN OPTION COVERAGE LEVEL LIBERTY HIGH PLAN Employee $116.17 Employee + Spouse $277.64 Employee + Child(ren) $231.18 Employee + Family $367.09 *Please note: if you are not eligible for the Metro EPO plan because you live outside of NY or NJ, these will be your bi-weekly contributions.

DENTAL PLANS

COVERAGE LEVEL

DMO PLAN

PPO PLAN

Employee

$5.87

$17.54

Employee + One Dependent

$11.44

$34.19

Employee + Family

$18.77

$56.11

VISION PLAN

COVERAGE LEVEL Employee

$1.99

Employee + One Dependent

$3.77

Employee + Family

$5.53

For addi Ɵ onal plan informa Ɵ on, please refer to your detailed plan design. In the event of a discrepancy, the carrier Plan Document shall prevail.

QUESTIONS? Call Bene fi tsVIP at 866.293.9736

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