Contributions

Blue Cross Dental PPO

You

You + spouse

You + child(ren)

You + spouse + child(ren)

$18

$38

$43

$61

First Commonwealth

You

You + spouse

You + child(ren)

You + spouse + child(ren)

$7

$13

$14

$20

Blue Cross Dental PPO

You

You + spouse

You + child(ren)

You + spouse + child(ren)

$28.50

$61.50

$69.50

$98.50

First Commonwealth

You

You + spouse

You + child(ren)

You + spouse + child(ren)

$11.50

$21

$22

$32

NOTE: Part Time status is defined as employees scheduled to work at least 17.5 hours per week or at least a 50% appointment but less than 100%.

You

You+Spouse

You+Child(ren)

You+Spouse+Child(ren)

Blue Cross Dental PPO

$39

$85

$96

$136

First Commonwealth

$16

$29

$30

$44

You

You+Spouse

You+Child(ren)

You+Spouse+Child(ren)

Blue Cross Dental PPO

$39.78

$86.70

$97.92

$138.72

First Commonwealth

$16.32

$29.58

$30.60

$44.88

You

You+Spouse

You+Child(ren)

You+Spouse+Child(ren)

Blue Cross Dental PPO

$39

$85

$96

$136

First Commonwealth

$16

$29

$30

$44

Blue Cross Dental PPO

You

You + spouse

You + child(ren)

You + spouse + child(ren)

$0

$20

$25

$43

First Commonwealth

You

You + spouse

You + child(ren)

You + spouse + child(ren)

$0

$6

$7

$13