HWS: Aetna Medical Plan - Administrative Hourly Premium Share

EXCELLUS MEDICAL PLAN ADMINISTRATIVE HOURLY PREMIUM SHARE

2016	Single	Employee + Spouse or Domestic Partner	Employee + Child/ren	Family with Spouse or Domestic Parnter	Family/Spouse or Domestic Partner Employed at HWS Both Benefits Eligible
Excellus Blue PPO	14.05	29.37	26.13	41.59	41.59
Excellus Blue PPO HDHP	11.33	23.67	21.06	33.52	33.52

2016

Single

Employee + Spouse or Domestic Partner

Employee + Child/ren

Family with Spouse or Domestic Parnter

Family/Spouse or Domestic Partner Employed at HWS

Both Benefits Eligible

Excellus Blue PPO

14.05

29.37

26.13

41.59

Excellus Blue PPO HDHP

11.33

23.67

21.06

33.52

PLEASE NOTE

The amounts shown are the deductions per payperiod.

Wages are paid on a bi-weekly basis, or normally 26 paydates in a calendar year. Employee deductions for elected benefits are deducted on a 24 paydate biweekly schedule, or two times in a month. These biweekly deductions will be taken on a pre-tax basis, tax laws permitting.