LDA is not a Tax Dependent
| Coverage Option |
Monthly Premium |
Employer Pays |
Employee Pays |
Pre Tax Deduction |
Post Tax Deduction |
Monthly Imputed Income |
| Employee |
$500 |
$450 |
$50 |
$50 |
$0 |
$0 |
| Employee + LDA |
$1,000 |
$900 |
$100 |
$50 |
$50 |
$450 |
| Employee + Family + LDA |
$1,500 |
$1,350 |
$150 |
$100 |
$50 |
$450 |
LDA is a Tax Dependent
| Coverage Option |
Monthly Premium |
Employer Pays |
Employee Pays |
Pre Tax Deduction |
Post Tax Deduction |
Monthly Imputed Income |
| Employee |
$500 |
$450 |
$50 |
$50 |
$0 |
$0 |
| Employee + LDA |
$1,000 |
$900 |
$100 |
$100 |
$0 |
$0 |
| Employee + Family + LDA |
$1,500 |
$1,350 |
$150 |
$150 |
$0 |
$0 |
LDA is not a Tax Dependent
| Coverage Option |
Monthly Premium |
Employer Pays |
Employee Pays |
Pre Tax Deduction |
Post Tax Deduction |
Monthly Imputed Income |
| Employee |
$500 |
$450 |
$50 |
$50 |
$0 |
$0 |
| Employee + LDA |
$1,000 |
$450 |
$550 |
$50 |
$500 |
$0 |
| Employee + Family + LDA |
$1,500 |
$450 |
$1,050 |
$550 |
$500 |
$0 |
LDA is a Tax Dependent
| Coverage Option |
Monthly Premium |
Employer Pays |
Employee Pays |
Pre Tax Deduction |
Post Tax Deduction |
Monthly Imputed Income |
| Employee |
$500 |
$450 |
$50 |
$50 |
$0 |
$0 |
| Employee + LDA |
$1,000 |
$450 |
$550 |
$550 |
$0 |
$0 |
| Employee + Family + LDA |
$1,500 |
$450 |
$1,050 |
$1,050 |
$0 |
$0 |
