|

|

|
Date Eligible:
|
1/1/2001
|
Date Enrolled:
|
2/1/2001
|
|
Coverage:
|
1 x Salary

|
Total Amount:
|
$47,424.00
|
|
Cost:
(per pay period)
|
Employee Cost:
|
$3.00
|
Company Cost:
|
$0.00
|
|
|
Note: Place cost note here.
|
|
The helpful hint icon should appear on all Enrollment and Enrollment Information pages if the person is old enough to quality for age-reduction.
|
|