Your Cost in 2023 Below is a summary of your 2023 deductions for the Medical, Dental and Vision plans. Empire Blue Cross Blue Shield Costs: Below are your semi-monthly medical and Rx contributions based on the plan you choose to enroll in for the 2023 plan year: Medical Plans Employee Employee + Employee + Employee + Only Spouse Children Family Total Blue HSA $40.00 $230.00 $187.50 $380.00 Deductible First $85.00 $367.50 $310.00 $600.00 Delta Dental Costs: Below are your semi-monthly dental contributions based on the plan you choose to enroll in for the 2023 plan year: Dental Plan Employee Employee + Employee + Employee + Only Spouse Child(ren) Family Dental PPO $21.50 $42.38 $37.47 $53.81 DHMO $9.12 $15.37 $17.32 $25.49 EyeMed Vision Costs: Below are your semi-monthly vision contributions based on the plan you choose to enroll in for the 2023 plan year: Vision Plan Employee Employee + Employee + Employee + Only Spouse Child(ren) Family DHMO $1.87 $3.55 $3.73 $5.49 19