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POA ALADS California Care Premier (HMO - with Dental) Information
POA ALADS California Care Premier (HMO - with Dental) Premiums
| Coverage Type | Annual | Monthly | Semi-monthly (24 pay periods)* | ||
|---|---|---|---|---|---|
| Post-tax | Pre-tax | ||||
| Employee only | $9,446 | $787.14 | $0.00 | $393.57 | |
| Employee & Spouse/Domestic Partner | $19,648 | $1,637.33 | $0.00 | $818.67 | |
| Employee & Domestic Partner (post-tax) | $19,648 | $1,637.33 | $425.10 | $393.57 | |
| Employee & 1 Child | $19,648 | $1,637.33 | $0.00 | $818.67 | |
| Employee & Children | $23,741 | $1,978.42 | $0.00 | $989.21 | |
| Family | $23,741 | $1,978.42 | $0.00 | $989.21 | |
| Family (Domestic Partner post-tax) | $23,741 | $1,978.42 | $170.54 | $989.21 | |
* Variances Due to Rounding
**Domestic partners can only be enrolled on a pre-tax basis if they qualify as a tax dependent under IRS guidelines. To enroll your Domestic Partner on a pre-tax basis, submit a Tax Dependent Certification form which can be found on the Flexible Benefits website.