Opt Out Credit - Cheatsheet
Dental DHMO
Credit
Total Annual (20 pays) Amount left from 750 credit
$ $
12.50 19.33 31.67
$ $ $
250.00 386.60 633.40
$ $ $
500.00 363.40 116.60
PPO Low PPO High
$
Vision
Credit
Total Annual (20 pays) Amount left from 750 credit
Vision care plan $
3.67
$
73.40
$
676.60
*Add total Annual amounts for plans Employee elected, then subtract from the 750 annual credit. This will give you the amount of the credit left that they can use to cover Disabiltiy or put it toward Disability
Example: EE elected the DHMO Dental and vision care plan $250 + 122.40 = $372.40 - $750.00 = $377.60.
Divide this amount by 20 pays $377.60 / 20 = $18.88 per pay that can either cover the cost of Disabilty for the year or go towards the FSA.
Renette’s Opt-Out Calculator can be found in the Smartsheet Attachment: https://app.smartsheet.com/sheets/p3RRpMj2jRHqFxpqwF56G8vFRHFG7gRHpX6r9Xw1
SDOC Open Enrollment, Coverage Effective October 1
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