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["2019 PREMIUM CALCULATOR FOR WELLNESS INCENTIVE CREDIT"]
["Visit www.Brighterliving.DSM.com to confirm your incentive status  \n(To see when you hit the “Level 3: Premium Credit” milestones, go to “Rewards” tab, use drop down to “Statement.” Click “View by Year,” then click “My Rewards”)"]
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["INSTRUCTIONS:  This tool is for illustrative purposes only.  In order to calculate properly, please follow the steps in order.  Your selections will determine the options available."]
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["2019 PPO COVERAGE *",null,null,"* This calculation does not apply to the CDHP Plan.  CDHP participants' incentive is deposited to their HSA account."]
["STEP 1","Choose your coverage level:","Employee + Spouse/Domestic Partner"]
["STEP 2","Choose your elected benefit option:","Low Option PPO"]
["STEP 3","Choose your payroll frequency:","Bi-Weekly"," "]
[]
["INCENTIVE(S) EARNED"]
["STEP 4","Choose how many quarters YOU earned your incentive (by completing 3+ levels within the quarter)","None"]
["STEP 5","Choose how many quarters your SPOUSE/DP earned your incentive (by completing 3+ levels within the quarter)","None"]
[]
[]
["SPOUSAL SURCHARGE"]
["STEP 6","Does the Spousal Surcharge apply?","No","* The spousal surcharge is an additional premium that will apply if your spouse/DP has access to medical coverage through his/her employer and enrolls in a DSM medical plan."]
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[" ",null,"2019 PREMIUM \nPER CONFIRM STATEMENT \n(WITHOUT EARNED CREDIT)","2019 PREMIUM \nPER 2019 PAY STUB\n(WITH EARNED CREDIT)"," * Your 2019 Premium will be a net amount on your paystub (medical premium - spousal surcharge if applicable -  incentive credit = net amount shown)"]
["STEP 7",{"$f":"VLOOKUP(C10,Data!$C$18:$D$20,2,0)","v":"Biweekly Employee Contribution"},{"$f":"IF(C18=\"No\",VLOOKUP(CONCATENATE(C8,C9,C10),Data!$C$23:$D$46,2,0),VLOOKUP(CONCATENATE(C8,C9,C10),Data!$C$23:$D$46,2,0)+VLOOKUP(C10,Data!$C$18:$F$20,4,0))","v":134.38},{"$f":"C21-(IF(LEFT(C13,1)=\"N\",0,LEFT(C13,1))+IF(LEFT(C14,1)=\"N\",0,LEFT(C14,1)))*VLOOKUP(B21,Data!$D$18:$E$20,2,0)","v":134.38}]
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["DEADLINE:  You and your spouse/domestic partner (DP) have until December 31, 2018 to complete your incentive requirements. If you complete your requirements prior to December 10, 2018, your incentive will be initiated with your first 2019 payroll.  If you complete your requirements after December 10, your incentive will be delayed to the second payroll of 2019."]
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["QUESTIONS:  For questions about the wellness program and incentive, visit the website at www.BrighterLiving.DSM.com or contact Virgin Pulse at 888-671-9395 and via email at support@virginpulse.com.  If you have questions about your benefits, call the DSM Benefits Center at 1-888-353-9740 Mon-Fri from 9 a.m. to 7 p.m. ET & Sat 8 a.m. to 5 p.m.; or email questions to the DSM Benefits Center at DSMbenefitscenter@adp.com.  Please allow 24-48 hours for an email response."]
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["DISCLAIMER: This calculator is a tool intended to assist you with determining your net medical premium after incentive is earned and applied .  Virgin Pulse is responsible to determine the final earned incentive amount.  In the event of any conflict between this tool and the Virgin Pulse wellness program results, the terms of the wellness program will control.  "]
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[null,null,{"$f":"VLOOKUP(C8,Data!$C$4:$D$7,2,0)","v":"empspouse"}]

{"sheet":"Data","index":1,"n_rows":67,"n_cols":11,"rows_kept":67,"cut":false,"hidden":true,"merged":[]}
[null,null,null,"range","emp","empspouse","empchild","family"," "]
[null,null,null,null,"Employee only ","Employee + Spouse/Domestic Partner","Employee + Child(ren)","Family"]
[null,null,"Data - do not delete",null,"None","None","None","None"]
[null,1,"Employee only ","emp","None","1 Quarter","None","1 Quarter"]
[null,2,"Employee + Spouse/Domestic Partner","empspouse","None","2 Quarters","None","2 Quarters"]
[null,3,"Employee + Child(ren)","empchild","None","3 Quarters","None","3 Quarters"]
[null,4,"Family","family","None","4 Quarters","None","4 Quarters"]
[]
[null,null,"High Option PPO"]
[null,null,"Low Option PPO"]
[]
[null,0,"None",0]
[null,1,"1 Quarter",1]
[null,2,"2 Quarters",2]
[null,3,"3 Quarters",3]
[null,4,"4 Quarters",4]
[null,null,null,null,null,"Spousal Surcharge",1200]
[null,null,"Weekly","Weekly Employee Contribution",{"$f":"D67","v":2.8846153846153846},{"$f":"G17/52","v":23.076923076923077}," "]
[null,null,"Bi-Weekly","Biweekly Employee Contribution",{"$f":"D66","v":5.7692307692307692},{"$f":"G17/26","v":46.153846153846153},null,"Yes"]
[null,null,"Monthly","Monthly Employee Contribution",{"$f":"D65","v":12.5},{"$f":"G17/12","v":100},null,"No"]
[]
[]
[null,null,{"$f":"CONCATENATE($C$4,$C$9,C18)","v":"Employee only High Option PPOWeekly"},{"$f":"D56","v":46.09}]
[null,null,{"$f":"CONCATENATE($C$4,$C$9,C19)","v":"Employee only High Option PPOBi-Weekly"},{"$f":"D55","v":92.19}]
[null,null,"Employee only High Option PPOMonthly",{"$f":"D54","v":199.76}]
[null,null,{"$f":"CONCATENATE($C$5,$C$9,C18)","v":"Employee + Spouse/Domestic PartnerHigh Option PPOWeekly"},{"$f":"E56","v":88.32}]
[null,null,{"$f":"CONCATENATE($C$5,$C$9,C19)","v":"Employee + Spouse/Domestic PartnerHigh Option PPOBi-Weekly"},{"$f":"E55","v":176.64}]
[null,null,"Employee + Spouse/Domestic PartnerHigh Option PPOMonthly",{"$f":"E54","v":382.72}]
[null,null,{"$f":"CONCATENATE($C$6,$C$9,C18)","v":"Employee + Child(ren)High Option PPOWeekly"},{"$f":"F56","v":73.739999999999995}]
[null,null,{"$f":"CONCATENATE($C$6,$C$9,C19)","v":"Employee + Child(ren)High Option PPOBi-Weekly"},{"$f":"F55","v":147.49}]
[null,null,"Employee + Child(ren)High Option PPOMonthly",{"$f":"F54","v":319.57}]
[null,null,{"$f":"CONCATENATE($C$7,$C$9,C18)","v":"FamilyHigh Option PPOWeekly"},{"$f":"G56","v":115.96}]
[null,null,{"$f":"CONCATENATE($C$7,$C$9,C19)","v":"FamilyHigh Option PPOBi-Weekly"},{"$f":"G55","v":231.93}]
[null,null,"FamilyHigh Option PPOMonthly",{"$f":"G54","v":502.53}]
[null,null,{"$f":"CONCATENATE($C$4,$C$10,C18)","v":"Employee only Low Option PPOWeekly"},{"$f":"H56","v":35.53}]
[null,null,{"$f":"CONCATENATE($C$4,$C$10,C19)","v":"Employee only Low Option PPOBi-Weekly"},{"$f":"H55","v":71.06}]
[null,null,"Employee only Low Option PPOMonthly",{"$f":"H54","v":153.97999999999999}]
[null,null,{"$f":"CONCATENATE($C$5,$C$10,C18)","v":"Employee + Spouse/Domestic PartnerLow Option PPOWeekly"},{"$f":"I56","v":67.19}]
[null,null,{"$f":"CONCATENATE($C$5,$C$10,C19)","v":"Employee + Spouse/Domestic PartnerLow Option PPOBi-Weekly"},{"$f":"I55","v":134.38}]
[null,null,"Employee + Spouse/Domestic PartnerLow Option PPOMonthly",{"$f":"I54","v":291.16000000000003}]
[null,null,{"$f":"CONCATENATE($C$6,$C$10,C18)","v":"Employee + Child(ren)Low Option PPOWeekly"},{"$f":"J56","v":54.72}]
[null,null,{"$f":"CONCATENATE($C$6,$C$10,C19)","v":"Employee + Child(ren)Low Option PPOBi-Weekly"},{"$f":"J55","v":109.45}]
[null,null,"Employee + Child(ren)Low Option PPOMonthly",{"$f":"J54","v":237.16}]
[null,null,{"$f":"CONCATENATE($C$7,$C$10,C18)","v":"FamilyLow Option PPOWeekly"},{"$f":"K56","v":86.38}]
[null,null,{"$f":"CONCATENATE($C$7,$C$10,C19)","v":"FamilyLow Option PPOBi-Weekly"},{"$f":"K55","v":172.77}]
[null,null,"FamilyLow Option PPOMonthly",{"$f":"K54","v":374.35}]
[]
[]
[]
[]
[null,null,null,"EE","EE + SP","EE + CH","FAM","EE","EE + SP","EE + CH","FAM"]
[null,null,null,"High","High","High","High","Low","Low","Low","Low"]
[null,null,"Medical - High Option (Non-Wellness)",{"$f":"CONCATENATE(C4,C9)","v":"Employee only High Option PPO"},{"$f":"CONCATENATE(C5,C9)","v":"Employee + Spouse/Domestic PartnerHigh Option PPO"},{"$f":"CONCATENATE(C6,C9)","v":"Employee + Child(ren)High Option PPO"},{"$f":"CONCATENATE(C7,C9)","v":"FamilyHigh Option PPO"},{"$f":"D58","v":"Employee only Low Option PPO"},{"$f":"E58","v":"Employee + Spouse/Domestic PartnerLow Option PPO"},"Employee + Child(ren)Low Option PPO","FamilyLow Option PPO"]
[null,null,"Monthly Employee Contribution",199.76,382.72,319.57,502.53,{"$f":"D59","v":153.97999999999999},291.16000000000003,237.16,374.35]
[null,null,"Biweekly Employee Contribution",92.19,176.64,147.49,231.93,71.06,134.38,109.45,172.77]
[null,null,"Weekly Employee Contribution",46.09,88.32,73.739999999999995,115.96,35.53,67.19,54.72,86.38]
[]
[null,null,"Medical - Low Option (Non-Wellness)",{"$f":"CONCATENATE(C4,C10)","v":"Employee only Low Option PPO"},{"$f":"CONCATENATE(C5,C10)","v":"Employee + Spouse/Domestic PartnerLow Option PPO"},{"$f":"CONCATENATE(C6,C10)","v":"Employee + Child(ren)Low Option PPO"},{"$f":"CONCATENATE(C7,C10)","v":"FamilyLow Option PPO"}]
[null,null,"Monthly Employee Contribution",153.97999999999999,291.16000000000003,237.16,374.35]
[null,null,"Biweekly Employee Contribution",71.06,134.38,109.45,172.77]
[null,null,"Weekly Employee Contribution",35.53,67.19,54.72,86.38]
[]
[null,null,null,"1Q","2Q","3Q","4Q"]
[null,null,"Incentive Discount earned",150,{"$f":"D64*2","v":300},{"$f":"D64*3","v":450},{"$f":"D64*4","v":600}]
[null,null,"Monthly",{"$f":"D64/12","v":12.5},{"$f":"D65*2","v":25},{"$f":"D65*3","v":37.5},{"$f":"D65*4","v":50}]
[null,null,"Bi-Weekly",{"$f":"D64/26","v":5.7692307692307692},11.538461538461538,17.307692307692307,23.076923076923077]
[null,null,"Weekly",{"$f":"D64/52","v":2.8846153846153846},5.7692307692307692,8.6538461538461533,11.538461538461538]