THE FOLLOWING BENEFITS ARE ALL PRE-TAX. MEDICAL - New Network as of 6/1/2012: UNITED HEALTHCARE OPTIONS PPO HCA /Bucket Plan Monthly Rates: $167/mo. Employee Only $396/mo. Employee+Child/ren $443/mo. Employee+Spouse $681/mo. Family -Rates shown do not include G4U (G4U reduces those premiums listed above by $25/mo.) -Did you join the GOOD4U Program? It's free to HCA insureds. -Good4U encourages a balanced, healthier lifestyle intended to give you more, happier birthdays. For details, visit www.anciragood4u.com. -Participating in quarterly challenges can earn you up to $2000 in annual "Bucket Money" (used to buy down your deductible and reduces your out of pocket liability) PLUS Ancira PAYS YOU $25 monthly (first pay check of each month; effectively reduces your HCA premiums by $25 monthly) MPO/Entry Plan* Monthly Rates: $114/mo. Employee Only $173/mo. Employee+Child/ren $216/mo. Employee+Spouse $364/mo. Family *This is a mini-med plan with maximum benefit of $25,000 per calendar year per insured. *If you you were hired before 2/1/09, but have been OFF Ancira insurance since 2/1/10, the Entry Plan is your only medical coverage option through Ancira. *Entry into the HCA Plan is only allowed annually during Open Enrollment following 3-years consecutive enrollment in the Entry Plan. *Join Ancira Good4You Program at no cost to you to REDUCE YOUR MONTHLY PREMIUM BY $25!! DENTAL Network is Guardian Preferred Claims are administered by UMR Rates: $26/mo. Employee Only $45/mo. Employee+Child/ren $45/mo. Employee+Spouse $58/mo. Family VISION Network is Optum Health Claims are administered by UMR Rates: $9/mo. Employee Only $15/mo. Employee+Child/ren $15/mo. Employee+Spouse $22/mo. Family