Employee Cost Coverage through Anthem Coverage through PBA Coverage through PBA DENTAL MEDICAL VISION PPO HDHP 24 24 deductions 24 20 24 20 deductions deductions deductions deductions deductions Employee Only $2.50 Employee Only $2.73 Employee + Spouse $14.46 Employee Only $132 $158.40 $85.88 $103.06 Employee + Spouse $2.50 Employee + Employee + Spouse $231 $277.20 $136 $163.20 Employee + $2.50 Child(ren) $16.93 Child(ren) Family $32.54 Employee + Child(ren) $223 $267.60 $128 $153.60 Family $2.50 Family $236 $283.20 $168 $201.60 SEE THIS PLAN SEE THIS PLAN SEE THIS PLAN