Enrollment Effective Date:	09/13/2001
Coverage:	Employee Cost * Company Cost * 1 x Salary (Base)   $0 $4.00 Base + 1 x Salary   $3.00 $7.00 Base + 2 x Salary   $5.00 $9.00 Base + 3 x Salary   $5.90 $11.00
* Per pay period 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.