Resident
Retirees: Dental Retiree Monthly (Installment Bill Fee):  $0.00 = $0.00Dental Retiree Spouse Monthly (Installment Bill Fee):  $7.64 = $7.64Dental Retiree Family Monthly (Installment Bill Fee):  $0.00 = $0.00Dental Retiree Child Monthly (Installment Bill Fee):  $13.72 = $13.72Dental Plus Retiree Monthly (Installment Bill Fee):  $26.60 = $26.60Dental Plus Retiree Spouse Monthly (Installment Bill Fee):  $53.78 = $53.78Dental Plus Retiree Family Monthly (Installment Bill Fee):  $0.00 = $0.00Cobra Dental Plus EE Monthly (Installment Bill Fee):  $40.90 = $40.90Dental Plus Retiree Child Monthly (Installment Bill Fee):  $62.04 = $62.04Health Retiree Monthly (Installment Bill Fee):  $54.74 = $54.74Cobra Health Employee Monthly (Installment Bill Fee):  $641.21 = $641.21Health Carve Retiree Monthly (Installment Bill Fee):  $35.22 = $35.22Retiree Health Carveout with Spouse (Installment Bill Fee):  $188.92 = $188.92SLTD (Installment Bill Fee):  $2.38 = $2.38Health Carve Retiree Spouse Monthly (Installment Bill Fee):  $209.10 = $209.10MSA (Installment Bill Fee):  $41.66 = $41.66MSA Spending Fee (Installment Bill Fee):  $2.32 = $2.32Health Retiree Spouse Monthly (Installment Bill Fee):  $229.28 = $229.28Optional Life (Installment Bill Fee):  $2.80 = $2.80Health Retiree Family Monthly (Installment Bill Fee):  $0.00 = $0.00Health Retiree Child Monthly (Installment Bill Fee):  $106.53 = $106.53Tobacco Retiree Monthly (Installment Bill Fee):  $0.00 = $0.00Tobacco Plus Retiree Monthly (Installment Bill Fee):  $0.00 = $0.00Vision Retiree Monthly (Installment Bill Fee):  $5.94 = $5.94Vision Retiree Spouse Monthly (Installment Bill Fee):  $11.88 = $11.88Vision Retiree Family Monthly (Installment Bill Fee):  $0.00 = $0.00Cobra Vision EE Monthly (Installment Bill Fee):  $6.06 = $6.06Vision Retiree Child Monthly (Installment Bill Fee):  $12.76 = $12.76Non-Resident
Retirees: Dental Retiree Monthly (Installment Bill Fee):  $0.00 = $0.00Dental Retiree Spouse Monthly (Installment Bill Fee):  $7.64 = $7.64Dental Retiree Family Monthly (Installment Bill Fee):  $0.00 = $0.00Dental Retiree Child Monthly (Installment Bill Fee):  $13.72 = $13.72Dental Plus Retiree Monthly (Installment Bill Fee):  $26.60 = $26.60Dental Plus Retiree Spouse Monthly (Installment Bill Fee):  $53.78 = $53.78Dental Plus Retiree Family Monthly (Installment Bill Fee):  $0.00 = $0.00Cobra Dental Plus EE Monthly (Installment Bill Fee):  $40.90 = $40.90Dental Plus Retiree Child Monthly (Installment Bill Fee):  $62.04 = $62.04Health Retiree Monthly (Installment Bill Fee):  $54.74 = $54.74Cobra Health Employee Monthly (Installment Bill Fee):  $641.21 = $641.21Health Carve Retiree Monthly (Installment Bill Fee):  $35.22 = $35.22Retiree Health Carveout with Spouse (Installment Bill Fee):  $188.92 = $188.92SLTD (Installment Bill Fee):  $2.38 = $2.38Health Carve Retiree Spouse Monthly (Installment Bill Fee):  $209.10 = $209.10MSA (Installment Bill Fee):  $41.66 = $41.66MSA Spending Fee (Installment Bill Fee):  $2.32 = $2.32Health Retiree Spouse Monthly (Installment Bill Fee):  $229.28 = $229.28Optional Life (Installment Bill Fee):  $2.80 = $2.80Health Retiree Family Monthly (Installment Bill Fee):  $0.00 = $0.00Health Retiree Child Monthly (Installment Bill Fee):  $106.53 = $106.53Tobacco Retiree Monthly (Installment Bill Fee):  $0.00 = $0.00Tobacco Plus Retiree Monthly (Installment Bill Fee):  $0.00 = $0.00Vision Retiree Monthly (Installment Bill Fee):  $5.94 = $5.94Vision Retiree Spouse Monthly (Installment Bill Fee):  $11.88 = $11.88Vision Retiree Family Monthly (Installment Bill Fee):  $0.00 = $0.00Cobra Vision EE Monthly (Installment Bill Fee):  $6.06 = $6.06Vision Retiree Child Monthly (Installment Bill Fee):  $12.76 = $12.76

Default Period: 0 Month

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