Employee Deductions

Medical Plan	Tier	Employee Per 24 Pays
PA OAMC Premier 3500 80/50 PY V26	Employee Only	$155.66
	Employee + Spouse	$706.16
	Employee + Child(ren)	$488.53
	Family	$972.72

Medical Plan	Tier	Employee Per 24 Pays
PA OAMC 3000 HSA 100/50 T PY V26	Employee Only	$37.47
	Employee + Spouse	$452.01
	Employee + Child(ren)	$299.14
	Family	$649.89

Guardian Dental	Tier	Employee Per 24 Pays
PPO	Employee Only	$16.13
	Family	$45.34

NVA Vision	Tier	Employee Per 24 Pays
Vision	Employee Only	$2.42
	Employee + Spouse	$4.83
	Employee + Child(ren)	$4.88
	Family	$7.79