| 45 | UNITYPOINT HEALTH PAYS FOR › Health Savings Account (Employer Contribution) › Basic Life and AD&D Insurance › Short-Term Disability › Long-Term Disability › Employee Assistance Program (EAP) › Paid Leave (Bereavement, Jury Duty, Parental Leave, etc.) › OnPoint for Health Wellness Program › Education Assistance › Paid Time Off (PTO) › 401(k) Employer Match YOU PAY FOR › Health Savings Account (Employee Contributions) › Vision Insurance › Voluntary Life and AD&D Insurance › Legal Insurance & Identity Theft Protection › Flexible Spending Accounts (FSA) › Critical Illness Insurance › Hospital Indemnity Insurance › Accident Insurance › Pet Insurance › 401(k) Employee Contributions Cost Breakdown You and UnityPoint Health (UPH) share the cost of your benefits. You pay your share of most benefit costs before federal, state and Social Security taxes are calculated. YOU AND UNITYPOINT HEALTH SHARE THE COST OF › Health Insurance* › Dental Insurance *UnityPoint Health pays for the majority of these costs Health Insurance EMPLOYEE ONLY EMPLOYEE + CHILD(REN) EMPLOYEE + SPOUSE/DP FAMILY Network Plan Full-Time Rates $79.82 $154.71 $188.09 $257.94 Part-Time Rates $119.73 $232.07 $282.13 $386.91 Health Savings Plan Full-Time Rates $47.05 $92.55 $112.50 $154.27 Part-Time Rates $71.63 $138.81 $168.75 $231.41 Premium amounts shown above do not include the working spouse surcharge. For more information, please refer to the Enrollment and Eligibility section. Dental Insurance Basic Plan – Full & Part Time Rates $5.89 $13.20 $11.58 $17.50 Premier Plan – Full & Part Time Rates $9.54 $21.63 $19.05 $28.85 Vision Insurance Full & Part Time Rates $3.29 $7.16 $6.32 $9.38 LISTED BELOW All premiums listed below are deducted over 26 pay periods