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Cost of Benefits
While [ABC] pays the majority of the medical, dental, and vision premiums for you and your dependents, you also contribute to your health care premiums. You can select different coverage levels for medical, dental, and vision insurance based on your individual needs.][While [ABC] pays the majority of the medical and dental premiums, you also contribute to your health care premiums. Please note, your medical enrollment includes vision coverage.]
Your [per pay period] [bi-weekly (26)] [semi-monthly (24)] [monthly] payroll deductions for medical, dental, and vision coverage are shown below:
Your Medical Cost
Coverage Level | Medical Plan 1 | Medical Plan 2 | Medical Plan 3 |
| Employee Only | $0.00 | $0.00 | $0.00 |
| Employee + Sp/DP | $0.00 | $0.00 | $0.00 |
| Employee + Child(ren) | $0.00 | $0.00 | $0.00 |
| Employee + Family | $0.00 | $0.00 | $0.00 |
Your Dental Cost
Coverage Level | Dental Plan 1 | Dental Plan 2 | Dental Plan 3 |
| Employee Only | $0.00 | $0.00 | $0.00 |
| Employee + Sp/DP | $0.00 | $0.00 | $0.00 |
| Employee + Child(ren) | $0.00 | $0.00 | $0.00 |
| Employee + Family | $0.00 | $0.00 | $0.00 |
Your Vision Cost
Coverage Level | Vision Plan 1 | Vision Plan 2 |
| Employee Only | $0.00 | $0.00 |
| Employee + Sp/DP | $0.00 | $0.00 |
| Employee + Child(ren) | $0.00 | $0.00 |
| Employee + Family | $0.00 | $0.00 |