Monthly medical cost You Pay = Premiums paid by Employee We Pay = Premiums paid by DePauw See Plan Coverage Dependents CDHP #1 CDHP #2 Retiree You Pay: $ 96.55 We Pay: $ 799.26 You Pay: $ 107.80 We Pay: $ 783.76 Retiree + Spouse You Pay: $ 221.47 We Pay: $ 1,636.66 You Pay: $ 245.16 We Pay: $ 1,627.15 Retiree + Child(ren) You Pay: $ 206.91 We Pay: $ 1,431.10 You Pay: $ 227.77 We Pay: $ 1,422.72 Retiree + Spouse, 1 Child You Pay: $342.35 We Pay: $ 2, 400.62 You Pay: $ 377.27 We Pay: $ 2, 386.62 Retiree + Spouse, > 1 Child You Pay: $ 472.77 We Pay: $ 2,270.20 You Pay: $ 507.71 We Pay: $ 2,256.19

2027 Pre-65 Retiree Benefit Guide - Page 2 2027 Pre-65 Retiree Benefit Guide Page 1 Page 3