| Member | Answers |
| Member A | — |
| Member B | #8 Only mandatory if the employee elects the City's health insurance |
| Member C | — |
| Member D | — |
| Member E | — |
| Member F.xls | — |
| Member G | — |
| Member H | — |
| Member I | — |
| Member J | — |
| Member K | We have 4 tiers = EE, EE+SP, EE+CH & EE+Fam - I used the EE+CH Tier for % shown above. FAMILY DHMO = 66% PPO = 76% |
| Member L | — |
| Member M | — |
| Member N | PPO = Employee: $9.69/wk. Emp & Spouse: $22.19/wk. Emp & Chldrn: $22.28/wk. Empl & Fmly: $36.10/wkHMO=Employee: $2.23/wk. Emp & Spouse: $4.47/wk. Empl & Chldrn: $5.19/wk. Empl & Family: $7.42/wk |
| Member O | — |
| Member P | — |
| Member Q | — |
| Member R | Annual $3,000 stipend can be used to cover dental and vision. See Notes for #7. |
| Member S | — |
| Member T | — |
| Member U | — |
| Member V | — |
| Member W | — |
| Member X | — |