Employee Cost Four Medical Plan Options Gold Buy-Up PPO Buy-Up PPO Core HDHP Basic HDHP Monthly 20 Deductions Monthly 20 Deductions Monthly 20 Deductions Monthly 20 Deductions Employee Only $551.94 $331.17 $492.01 $295.21 $392.56 $235.54 $150.00 $90.00 Employee + $1,383.98 $830.39 $1,228.17 $736.91 $969.61 $581.77 $754.38 $452.63 Spouse Employee + $1,056.90 $634.14 $938.82 $563.30 $742.92 $445.76 $575.22 $345.14 Child(ren) Family $1,519.09 $911.46 $1,347.69 $808..62 $1,063.27 $637.97 $828.51 $497.11 SEE THE MEDICAL OVERVIEW

Noblesville Schools Bus Driver Benefit Guide - Page 5 Noblesville Schools Bus Driver Benefit Guide Page 4 Page 6