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<br />Group Name: <br /> <br />Effective Date: <br /> <br />Cass County Government <br /> <br />January 1, 2009 <br /> <br />SUGGESTED FUNDING LEVEL AT EXPECTED COST <br /> <br />Single <br /> <br />SPD <br /> <br />Family <br /> <br />SC 100 8-07 <br /> <br />$400.68 <br /> <br />705.20 <br /> <br />1,041.78 <br /> <br />SC 100 OOA 8-07 <br /> <br />DSC 225 <br /> <br />$412.08 <br /> <br />$46.60 <br /> <br />725.27 <br /> <br />1,071.44 <br /> <br />121.52 <br /> <br />SUGGESTED FUNDING LEVEL AT MAXIMUM COST <br /> <br />Single <br /> <br />SPD <br /> <br />Family <br /> <br />$469.82 <br /> <br />826.89 <br /> <br />1 ,221.55 <br /> <br />RX: Deemed Creditable <br />Note: Net of BlueCard@ fees. <br /> <br />$483.51 <br /> <br />$55.92 <br /> <br />850.98 <br /> <br />1,257.15 <br /> <br />145.82 <br /> <br />10033 <br />