Cost Breakdown You and UnityPoint Health (UPH) share the cost of your bene昀椀ts. You pay your share of most bene昀椀t costs before federal, state and Social Security taxes are calculated. UNITYPOINT HEALTH PAYS FOR YOU PAY FOR YOU AND UNITYPOINT › Health Savings Account › HEALTH SHARE THE Health Savings Account (Employer Contribution) (Employee Contributions) COST OF › › Basic Life and AD&D Insurance › Health Insurance* Vision Insurance › › Short-Term Disability › Dental Insurance Voluntary Life and AD&D Insurance › Long-Term Disability › Legal Insurance & Identity Theft › Protection Employee Assistance Program (EAP) › › Flexible Spending Paid Leave (Bereavement, Jury Duty, Parental Leave, etc.) Accounts (FSA) › › Critical Illness Insurance OnPoint for Health Wellness Program LISTED BELOW › › Hospital Indemnity Insurance Education Assistance All premiums › › Accident Insurance Paid Time Off (PTO) listed below are › › Pet Insurance 401(k) Employer Match deducted over › 401(k) Employee Contributions 26 pay periods Health Insurance EMPLOYEE ONLY EMPLOYEE + EMPLOYEE + FAMILY CHILD(REN) SPOUSE/DP Network Plan Full-Time Rates $79.82 $154.71 $188.09 $257.94 Part-Time Rates $119.73 $232.07 $282.13 $386.91 Health Savings Plan Full-Time Rates $47.05 $92.55 $112.50 $154.27 Part-Time Rates $71.63 $138.81 $168.75 $231.41 Premium amounts shown above do not include the working spouse surcharge. For more information, please refer to the Enrollment and Eligibility section. Dental Insurance Basic Plan – Full & Part Time Rates $5.89 $13.20 $11.58 $17.50 Premier Plan – Full & Part Time Rates $9.54 $21.63 $19.05 $28.85 Vision Insurance Full & Part Time Rates $3.29 $7.16 $6.32 $9.38 *UnityPoint Health pays for the majority of these costs | 46 |