Resident
Retirees: Dental Plus EC (Installment Bill Fee):  $75.76 = $75.76Dental 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):  $61.42 = $61.42Dental 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 = $62.04Cobra Health Employee Monthly (Installment Bill Fee):  $641.21 = $641.21Health Retiree Monthly (Installment Bill Fee):  $54.74 = $54.74Health Carve Retiree Monthly (Installment Bill Fee):  $35.22 = $35.22Retiree Health Carveout with Spouse (Installment Bill Fee):  $229.27 = $229.27Health Retiree Spouse Monthly (Installment Bill Fee):  $229.28 = $229.28Health Carve Retiree Spouse Monthly (Installment Bill Fee):  $209.10 = $209.10Health 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 = $0.00Vision Retiree Child Monthly (Installment Bill Fee):  $12.76 = $12.76Cobra Vision EE Monthly (Installment Bill Fee):  $6.06 = $6.06Non-Resident
Retirees: Dental Plus EC (Installment Bill Fee):  $75.76 = $75.76Dental 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):  $61.42 = $61.42Dental 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 = $62.04Cobra Health Employee Monthly (Installment Bill Fee):  $641.21 = $641.21Health Retiree Monthly (Installment Bill Fee):  $54.74 = $54.74Health Carve Retiree Monthly (Installment Bill Fee):  $35.22 = $35.22Retiree Health Carveout with Spouse (Installment Bill Fee):  $229.27 = $229.27Health Retiree Spouse Monthly (Installment Bill Fee):  $229.28 = $229.28Health Carve Retiree Spouse Monthly (Installment Bill Fee):  $209.10 = $209.10Health 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 = $0.00Vision Retiree Child Monthly (Installment Bill Fee):  $12.76 = $12.76Cobra Vision EE Monthly (Installment Bill Fee):  $6.06 = $6.06

Default Period: 0 Month

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