Plan Description Provenance Contribution Employee Contribution per per Month Month Employee only $27.08 $0.00 Employee + Spouse $40.99 $13.91 Employee + Child(ren) $48.62 $21.54 Employee + Family $65.11 $38.03 Vision Insurance Eligible employees have the opportunity to participate in Provenance Consulting’s group vision coverage through VSP. Employees pay 100% of the insurance premium cost. The table below shows the monthly employee contributions. The copayment for an in-network eye exam is $10. The copayment for an in-network set of eye glasses is $25. VSP will cover a basic set of lenses in full and will provide a $150 allowance towards frames. The copayment for in-network contacts is up to $60. VSP provides a $150 allowance towards contacts. Coverage becomes effective the 1st of the month immediately following hire date. Plan Description Provenance Contribution Employee Contribution per per Month Employee only $0.00 $13.04 Employee + Spouse $0.00 $20.88 Employee + Child(ren) $0.00 $21.30 Employee + Family $0.00 $34.36 Flexible Spending Account Eligible employees have the opportunity to participate in Provenance Consulting’s group flexible spending account (FSA) plan. The FSA allows employees to use pre-tax dollars to be reimbursed for insurance deductibles, co-payments, glasses and contact lenses, orthodontia, and other health care related out of pocket expenses not covered by their insurance plans. The FSA plan also allows the use of pre-tax dollars to be reimbursed for day care expenses for children or dependent adults. For health care expenses the minimum contribution is $100 and the maximum contribution is $2,550. For dependent care expenses, the minimum contribution is $100 and the maximum contribution is $5,000. Coverage becomes effective the 1st of the month immediately following hire date.
Plan Description Provenance Contribution per Month Employee Contribution per Month Employee only Employee + Spouse Employee + Child(ren) Employee + Family $27.08 $40.99 $48.62 $65.11 $0.00 $13.91 $21.54 $38.03 Vision Insurance Eligible employees have the opportunity to participate in Provenance Consulting’s group vision coverage through VSP. Employees pay 100% of the insurance premium cost. The table below shows the monthly employee contributions. The copayment for an in-network eye exam is $10. The copayment for an in-network set of eye glasses is $25. VSP will cover a basic set of lenses in full and will provide a $150 allowance towards frames. The copayment for in-network contacts is up to $60. VSP provides a $150 allowance towards contacts. Coverage becomes effective the 1st of the month immediately following hire date. Plan Description Provenance Contribution per Month Employee Contribution per Employee only Employee + Spouse Employee + Child(ren) Employee + Family $0.00 $0.00 $0.00 $0.00 $13.04 $20.88 $21.30 $34.36 Flexible Spending Account Eligible employees have the opportunity to participate in Provenance Consulting’s group flexible spending account (FSA) plan. The FSA allows employees to use pre-tax dollars to be reimbursed for insurance deductibles, co-payments, glasses and contact lenses, orthodontia, and other health care related out of pocket expenses not covered by their insurance plans. The FSA plan also allows the use of pre-tax dollars to be reimbursed for day care expenses for children or dependent adults. For health care expenses the minimum contribution is $100 and the maximum contribution is $2,550. For dependent care expenses, the minimum contribution is $100 and the maximum contribution is $5,000. Coverage becomes effective the 1st of the month immediately following hire date.
2016_Summary_of_Employee_Benefits-1.docx