|
DENTAL/VISION MONTHLY PREMIUMS
| Economy Plan Monthly Rates |
| Single Only |
$16.36
|
| Insured & One (Spouse or Child) |
$29.92
|
| Insured & 2 or more |
$43.16
|
| Value Plan Monthly Rates |
| Single Only |
$20.00
|
| Insured & One (Spouse or Child) |
$37.00
|
| Insured & 2 or more |
$55.00
|
| Standard Plan Monthly Rates |
| Single Only |
$28.60
|
| Insured & One (Spouse or Child) |
$52.50
|
| Insured & 2 or more |
$76.65
|
| Royal Plan Monthly Rates |
| Single Only |
$36.37
|
| Insured & One (Spouse or Child) |
$66.86
|
| Insured & 2 or more |
$98.15
|
*Above rates include appropriate fees.
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