BENEFIT COSTS
The Suquamish Tribe is covering most of your benefit costs . Your basic life insurance coverage and long term disability benefits are fully paid by The Suquamish Tribe . In addition , The Suquamish Tribe covers the greater portion of you and your dependent ’ s medical , dental and vision premiums . This table shows how much of the premiums are paid by The Suquamish Tribe and what part is your responsibility .
Costs for coverage of domestic partners and their children might not be deducted on a pre-tax basis . If your domestic partner is not an eligible tax dependent as defined in Section 152 of the Internal Revenue Code , then a portion of your contribution will be deducted after-tax and the company ’ s contribution for domestic partner coverage will be taxable income to you and reported as imputed income on your paycheck . For more information , please contact Human Resources .
Monthly Cost Medical Plan
Dental Base Plan
Dental Buy-Up Plan
Vision Employee only Total Monthly Cost $ 980.98 $ 45.03 $ 47.21 $ 6.09
The Suquamish Tribe Pays
$ 860.98 $ 45.03 $ 45.16 $ 6.09
Your Monthly Cost $ 120.00 $ 0.00 $ 2.05 $ 0.00 Employee plus Spouse Total Monthly Cost $ 2,341.05 $ 74.97 $ 79.27 $ 9.75
The Suquamish Tribe Pays
$ 1,970.84 $ 35.82 $ 36.07 $ 5.91
Your Monthly Cost $ 370.21 $ 39.15 $ 43.20 $ 3.84 Employee plus Child ( ren ) Total Monthly Cost $ 2,156.95 $ 74.97 $ 91.14 $ 9.96
Employee plus Family
The Suquamish Tribe Pays
$ 1,867.22 $ 35.82 $ 36.78 $ 5.91 Your Monthly Cost $ 289.73 $ 39.15 $ 54.36 $ 4.05 Total Monthly Cost $ 3,418.87 $ 104.91 $ 123.20 $ 16.05
The Suquamish Tribe Pays
$ 2,839.41 $ 26.61 $ 27.70 $ 5.61 Your Monthly Cost $ 579.46 $ 78.30 $ 95.50 $ 10.44
Prepared by Gallagher for the Employees of The Suquamish Tribe 4