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{"sheet":"Choose SIC and Region","index":0,"n_rows":64,"n_cols":6,"rows_kept":64,"cut":false,"hidden":false,"merged":[[60,0,60,5],[61,0,61,5],[63,0,63,5],[62,0,62,5],[31,6,31,10],[32,6,32,10],[44,6,44,10],[24,6,24,10],[44,0,44,1],[53,3,53,4],[53,6,53,10],[51,0,51,1],[54,6,54,10],[47,6,47,10],[39,3,39,4],[25,6,25,10],[55,6,55,10],[45,6,45,10],[46,6,46,10],[54,3,54,4],[58,0,58,1],[59,0,59,1],[58,3,58,4],[56,6,56,10],[57,0,57,1],[48,0,48,1],[59,3,59,4],[35,0,35,1],[32,3,32,4],[33,3,33,4],[29,3,29,4],[5,3,5,5],[57,3,57,4],[37,0,37,1],[36,0,36,1],[5,0,5,2],[11,3,11,5],[23,0,23,5],[22,3,22,5],[18,3,18,5],[19,3,19,5],[56,3,56,4],[56,0,56,1],[55,0,55,1],[53,0,53,1],[47,0,47,1],[50,0,50,1],[54,0,54,1],[26,6,26,10],[27,6,27,10],[29,6,29,10],[55,3,55,4],[30,3,30,4],[31,3,31,4],[49,3,49,4],[50,3,50,4],[30,6,30,10],[36,3,36,4],[46,3,46,4],[40,3,40,4],[45,3,45,4],[43,0,43,5],[40,0,40,1],[41,3,41,4],[52,0,52,5],[49,0,49,1],[42,3,42,4],[48,3,48,4],[47,3,47,4],[51,3,51,4],[46,0,46,1],[45,0,45,1],[24,3,24,4],[34,3,34,4],[28,3,28,4],[41,0,41,1],[30,0,30,1],[44,3,44,4],[32,0,32,1],[39,0,39,1],[33,0,33,1],[24,0,24,1],[25,0,25,1],[26,0,26,1],[38,0,38,1],[26,3,26,4],[34,0,34,1],[38,3,38,4],[42,0,42,1],[0,1,0,5],[28,0,28,1],[27,0,27,1],[37,3,37,4],[1,3,1,5],[2,0,2,2],[29,0,29,1],[2,3,2,5],[6,0,6,2],[8,0,8,2],[10,0,10,2],[22,0,22,2],[1,0,1,2],[3,0,3,2],[11,0,11,2],[9,0,9,2],[35,3,35,4],[6,3,6,5],[7,0,7,2],[3,3,3,5],[20,3,20,5],[31,0,31,1],[27,3,27,4],[25,3,25,4]]}
[null," Rates and SIC Codes"]
["California PPO Rate Area Definitions"]
["Region 1",null,null,"Region 2"]
["ZIP Codes 900–908, 910–928, 930, 932–933, 935–938, 952–953, and 956–958.\nThe following ZIP Codes are excluded from Region 1 but included in Region 2: \n92222, 92227, 92231–92233, 92243–92244, 92249–92251, 92257, 92259, 92266, 92273, 92275, 92281, 92283, 92328, 92384, 92389, 93013, 93014, 93067, 93512–93515, 93517, 93522, 93526, 93529–93530, 93541–93542, 93545–93546, 93549, 95646, 95724, 95728",null,null,"ZIP Codes: 931, 934, 939–951, 954–955, 959–961, 92222, \n92227, 92231–92233, 92243–92244, 92249–92251, 92257, 92259, 92266, 92273, 92275, 92281, 92283, 92328, 92384, 92389, 93013–93014, 93067, 93512–93515, 93517, 93522, 93526, 93529–93530, 93541–93542, 93545–93546, 93549, 95646, 95724, 95728"]
[]
["California DHMO Rate Area Definitions"]
["Region 1 and Region 2",null,null,"Region 3"]
["Los Angeles",null,null,"Alameda","Mariposa","San Francisco"]
["Orange",null,null,"Contra Costa","Riverside","San Mateo"]
[null,null,null,"Fresno","San Bernardino","Santa Clara"]
[null,null,null,"Kern","San Diego","Ventura"]
["Region 4",null,null,"Region 5"]
["Alpine","Marin","San Luis Obispo","Butte","Mendocino","Siskiyou"]
["Amador","Merced","Santa Barbara","Del Norte","Modoc","Sutter"]
["Calaveras","Monterey","Sierra","Glenn","Mono","Tehama"]
["Colusa","Napa","Solano","Humboldt","San Benito","Trinity"]
["El Dorado","Nevada","Sonoma","Lake","Santa Cruz","Yuba"]
["Imperial","Placer","Stanislaus","Lassen","Shasta"]
["Inyo","Plumas","Tuolumne"]
["Kings","Sacramento","Tulare"]
["Madera","San Joaquin","Yolo"]
[]
["SIC Level Classifications"]
["Level 1 Eligible Industries"]
["Advertising \n(except Misc., not classified 7319)",null,"7311-7313","Hospitals",null,"8062-8069"]
["Agriculture, Forestry, Fishing \n(except seasonal employees)",null,"0100-0999","Independent Auto Repair and Services",null,"7532-7599"]
["Auto Rental Agencies",null,"7513-7519","Laundry/Garment Service/Show Repair Services",null,"7211-7219, \n7251"]
["Automobile Parking Services",null,7521,"Manufacturing \n(except Jewelry Manufacturing)",null,"2000-2699"]
["Building Maintenance / Equipment Rental",null,"7349-7359","Manufacturing \n(Chemicals, Allied and Other)",null,"2810-3999"]
["Collection Agencies and Credit Reporting Services",null,"7322-7323","Mining, Oil and Gas Extraction",null,"1000-1499"]
["Communication \n(Radio, Telephone, TV/Radio Broadcasting)",null,"4800-4899","Miscellaneous Repair \n(Welding, etc)",null,"7692-7699"]
["Community Services Organizations / Social Services",null,"8300-8499","New Syndicates",null,7383]
["Computer Programming and Other Computer Services",null,"7371-7379","Photofinishing Labs",null,7384]
["Construction Contractors",null,"1500-1799","Printing and Publishing",null,"2700 - 2799"]
["Direct Mailing, Reproduction, Secretarial Services",null,"7331-7338","Public Administration \n(Cities, Counties, Police, etc)",null,"9000-9720, \n9722-9998"]
["Disinfecting and Pest Control Services",null,7342,"Retail",null,"5200-5510, \n5610-5699, \n5712-5736, \n5912-5999, "]
["Government Funded Groups   ",null,"8300-8499","Public and Private Schools \n(Elmentary and High School)",null,"8200-8299"]
["Electrical Repair \n(Radio, TV, A/C, Refrigerator)",null,"7622-7629","Security Systems, Detectives, Armored Car",null,"7381-7382"]
["Engineering and Management Services",null,"8711-8748","Transportation",null,"4000-4799"]
["Finance \n(Banks, Securities, Credit Agencies)",null,"6000-6299","Utilities",null,"4900-4999"]
["Funeral Services and Crematories",null,7261,"Wholesale Trade",null,"5000-5199"]
["Furniture Repair/Reupholstery",null,7641,"Museum Art Galleries and Gardens  ",null,"8412, 8422"]
["Misc. Computer Services          ",null,7379]
["Level 2 Eligible Industries"]
["Advertising \n(Miscellaneous, not classified)",null,7319,"Medical Groups",null,"8000-8059,\n8082-8099,"]
["Automobile Dealerships",null,"5511-5599","Photographic Studios",null,7221]
["Amusement, Recreation, and Entertainment",null,"7800-7999","Restaurants",null,"5088-5899"]
["Hotels",null,"7000-7099","Tax Return Preparation Services/\nMisc. Personal Svcs",null,"7291-7299"]
["Insurance Carriers/Brokers",null,"6300-6499","Real Estate",null,"6500-6799"]
["Jewelry Manufacturing",null,"3911-3915","Religious Organizations \n(Admin. And Mgmt. staff only)",null,8661]
["Legal",null,"8100-8199","Watch, Clock and Jewelry Repair",null,7631]
["Management Carve-out \n(any industry)  ",null,9999]
["Ineligible Industries"]
["Associations and Trusts1",null,"8600-8660, \n8662-8699,","Religious Organizations \n(except Churches #8661)   ",null,"No SIC"]
["Beauty and Barber Shops",null,"7231-7241","Private Households",null,8811]
["International Affairs",null,9721,"Partnerships",null,"No SIC"]
["Dental Offices, Dental Labs, and Medical Labs",null,"8021, 8071, 8072","Seasonal Employees \n(Christmas/Part-time Help)",null,"No SIC"]
["Employment Agencies",null,"7361-7363","Seasonal Employees \n(Agriculture)",null,"0761-0783"]
["Groups with high turnover2",null,"Varies","Miscellaneous Services not classified elsewhere",null,8999]
["Miscellaneous Business Services",null,7389]
["Ineligible Industries Voluntary PPO"]
["All Industires are eligible"]
["1  Management and administrative staff of associations and trusts are eligible at Level 2.  Use SIC Code 9999."]
["2 A business has high turnover if 20% or more of the average number of its employees during the past 12 months were newly hired for reasons other than the growth of the business."]

{"sheet":"CoPower ONE HMO (Non-Voluntary)","index":1,"n_rows":59,"n_cols":24,"rows_kept":59,"cut":false,"hidden":false,"merged":[[50,0,50,1],[49,0,49,1],[52,0,52,1],[53,2,53,3],[53,4,53,5],[51,0,51,1],[47,0,47,1],[47,3,47,4],[48,3,48,4],[49,3,49,4],[52,3,52,4],[47,5,47,6],[48,5,50,6],[55,0,55,1],[57,0,57,7],[58,0,58,7],[46,0,46,1],[41,0,41,1],[50,3,50,4],[51,3,51,4],[24,0,24,1],[33,0,33,1],[25,2,25,5],[25,6,25,7],[26,2,26,3],[26,4,26,5],[54,0,54,2],[53,0,53,1],[43,0,43,1],[40,0,40,1],[51,5,51,6],[52,5,52,6],[42,0,42,1],[45,0,45,1],[39,0,39,1],[25,0,26,1],[48,0,48,1],[63,6,63,7],[61,6,61,7],[62,6,62,7],[60,6,60,7],[55,6,55,7],[54,6,54,7],[28,6,28,7],[29,6,29,7],[35,2,35,7],[36,2,36,7],[37,6,37,7],[38,6,38,7],[48,7,50,7],[46,5,46,7],[46,2,46,4],[37,2,37,5],[38,2,38,5],[40,2,40,5],[39,6,39,7],[40,6,40,7],[41,6,41,7],[42,6,42,7],[43,6,43,7],[45,5,45,7],[1,14,1,15],[8,1,8,2],[6,17,6,18],[5,3,5,4],[39,2,39,5],[9,6,10,8],[6,3,6,4],[7,1,7,2],[20,1,20,5],[19,0,19,7],[27,0,27,1],[27,2,27,3],[27,4,27,5],[28,14,28,15],[12,0,12,4],[4,1,4,2],[6,1,6,2],[8,6,8,8],[28,2,28,3],[28,4,28,5],[35,0,35,1],[1,19,1,20],[1,21,1,22],[1,23,1,24],[3,21,3,22],[36,0,36,1],[29,14,29,15],[5,17,5,18],[5,19,5,20],[5,21,5,22],[5,23,5,24],[4,17,4,18],[4,19,4,20],[4,21,4,22],[4,23,4,24],[7,19,7,20],[27,6,27,7],[28,0,28,1],[5,1,5,2],[24,2,24,7],[2,17,2,18],[2,19,2,22],[2,23,2,24],[3,17,3,18],[3,19,3,20],[3,23,3,24],[45,3,45,4],[41,2,41,5],[42,2,42,5],[43,2,43,5],[26,14,26,15],[27,14,27,15],[37,0,37,1],[38,0,38,1],[9,1,9,2],[34,0,34,1],[31,3,31,7],[31,0,31,2],[10,1,10,2],[34,2,34,7],[33,2,33,7],[21,1,21,2],[29,0,29,1],[29,2,29,3],[29,4,29,5],[26,6,26,7],[16,0,17,3],[3,6,4,8]]}
["Available for groups with 2-99 enrolling employees.  "]
["Better, Better Plus and Best plans are available to groups with 5-99 enrolling employees.",null,null,null,null,null,null,null,null,null,null,null,null,null,"Enter your Contribution %",null,null,{"$f":"CONCATENATE(B7,B8)","v":"Select your CA DHMO RegionStandard Life Amount"},null,"Good",null,"Better",null,"Best"]
["This Employee Cost Worksheet is for Non-Voluntary CoPower ONE HMO Plans."]
["Rates valid for groups with renewal dates 1/1/19 through 12/31/19.",null,null,null,null,null,{"$f":"IF(G8>99,\"CoPower ONE plans are only available for groups with 2-99 eligible employees.\",\"\")","v":""},null,null,null,null,null,null,null,null,null,null,"Single",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,2,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,5,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,8,FALSE)","v":0}]
["Plan Type","Select your HMO plan type",null,null,null,"Enrolling Employees",null,null,null,null,null,null,null,null,null,null,null,"Two Party",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,3,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,6,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,9,FALSE)","v":0}]
["Eligible Employees","Enter Number of Employees",null,"Number of Single",null,0,{"$f":"IF(GroupSize>4,5,\"2-4\")","v":"2-4"},1,null,null,null,null,null,null,null,null,null,"Three Party+",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,4,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,7,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_HMO,10,FALSE)","v":0}]
["Region","Select your CA DHMO Region",null,"Number of Two Party",null,0,{"$f":"SUM(F6+F7+F8)","v":0},{"$f":"IF(SUM(G7)>1,\"Yes\",\"No\")","v":"No"},null,null,null,null,null,null,null,null,null,"Total Cost",null,{"$f":"SUM((T4*F6)+(T5*F7)+(T6*F8))","v":0},null,{"$f":"SUM((V4*F6)+(V5*F7)+(V6*F8))","v":0},null,{"$f":"SUM((X4*F6)+(X5*F7)+(X6*F8))","v":0}]
["Life Amount","Standard Life Amount",null,"Number of Three Party+",null,0,{"$f":"SUM(F6+F7+F8)","v":0},{"$f":"IF(AND(SUM(G8)>4,HMO_EligibleEEs>4),\"Yes\",\"No\")","v":"No"},null,null,null,null,null,null,null,null,null,0]
["Payroll Frequency","Select your payroll frequency",null,null,null,null,{"$f":"IF(B5=\"CoPower ONE Good\",IF(H7=\"Yes\",,\"Must have a minimum of 2 enrolled for Good plan\"),)","v":0}]
["ER Contribution % (Employee)","Enter Enrolling Employees",null,null,{"$f":"IF(B10=\"Enter your Contribution %\",0,1-B10)","v":{"$error":"#VALUE!"}},{"$f":"IF(B9=\"weekly\",\"52\",IF(B9=\"Biweekly\",\"26\",IF(B9=\"2x Monthly\",\"24\",IF(B9=\"Monthly\",\"12\",0))))","v":0},{"$f":"IF(OR(B5=\"Select your HMO Plan Type\",B5=\"CoPower ONE Good\"),,IF(AND(H8=\"Yes\",HMO_EligibleEEs>4),,\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\"))","v":0}]
["ER Contribution % (Dependent)","Enter Enrolling Employees",null,null,{"$f":"IF(B11=\"Enter your Contribution %\",0,1-B11)","v":{"$error":"#VALUE!"}}]
[]
[{"$f":"IF(OR(AND(OR(HMO_EligibleEEs=\"Enter Number of Employees\",HMO_EligibleEEs<10),OR(B8=\"Enhanced Life $50,000\",B8=\"Enhanced Life $100,000\",B8=\"Enhanced Life $150,000\")),AND((SUM(G8)<10),OR(B8=\"Enhanced Life $50,000\",B8=\"Enhanced Life $100,000\",B8=\"Enhanced Life $150,000\"))),\"Enhanced Life is only available for CoPower ONE plans with 10+ employees.\",)","v":0}]
[]
[]
[]
[{"$f":"IF(HMO_EligibleEEs=\"Enter Number of Employees\",\"\",IF(G8>HMO_EligibleEEs,\"Enrolling Employees are greater than Eligible Employees\",IF(NonVolHMOERContribution_Employee=1,IF(G8<>HMO_EligibleEEs,\"100 % participation required for CoPower ONE Non-Voluntary HMO plan if employer contributes 100 % of employee premium\",\"\"),IF(G8<(0.75*HMO_EligibleEEs),\"At least 75 % participation required for CoPower ONE Non-Voluntary HMO plan.\nPlease change the number of eligible or enrolling employees.\",\"\"))))","v":""}]
[]
[{"$f":"IF(OR(A17=\"100 % participation required for CoPower One Non-Voluntary HMO plan if employer contributes 100 % of employee premium\",A17=\"At least 75 % participation required for CoPower ONE Non-Voluntary HMO plan.\nPlease change the number of eligible or enrolling employees.\",A17=\"Enrolling Employees are greater than Eligible Employees\"),1,\"\")","v":""}]
["CoPower ONE Employee Contribution Worksheet"]
["Company Name:"]
["Effective Date:","Select your effective date"]
[]
[]
["Costs",null,{"$f":"IF($B$5=\"Select your HMO plan type\",\"Select your HMO Plan Type\",IF($B$5=\"CoPower ONE Good\",\"CoPower ONE Good\",IF($B$5=\"CoPower ONE Better\",\"CoPower ONE Better\",IF($B$5=\"CoPower ONE Better Plus\",\"CoPower ONE Better Plus\",IF($B$5=\"CoPower ONE Best\",\"CoPower ONE Best\",\"Select your HMO plan type\")))))","v":"Select your HMO Plan Type"}]
[null,null,{"$f":"IF(B9=\"Select your payroll frequency\",\"Select your Payroll Frequency\",IF(B9=\"Weekly\",\"Per Weekly Pay Period\",IF(B9=\"Biweekly\",\"Per Biweekly Pay Period\",IF(B9=\"2x Monthly\",\"Per Pay Period (Twice a Month)\",IF(B9=\"Monthly\",\"Per Monthly Pay Period\",0)))))","v":"Select your Payroll Frequency"},null,null,null,"Monthly Premium"]
[null,null,"Employee Portion",null,"Employer Portion",null,null,null,null,null,null,"Annual Dependent Cost","Annual Premium",null,"Total"]
["Employee Only",null,{"$f":"IF(OR(AND(OR(HMO_EligibleEEs=\"Enter Number of Employees\",HMO_EligibleEEs<10),OR(Life_HMO=\"Enhanced Life $50,000\",Life_HMO=\"Enhanced Life $100,000\",Life_HMO=\"Enhanced Life $150,000\")),B9=\"select your payroll frequency\",B11=\"Enter your Contribution %\",NonVolHMOERContribution_Employee=\"Enter your Contribution %\",A19=1),0,ROUND(((M28/$F$10)*$E$10),2))","v":0},null,{"$f":"IF(OR(AND(OR(HMO_EligibleEEs=\"Enter Number of Employees\",HMO_EligibleEEs<10),OR(Life_HMO=\"Enhanced Life $50,000\",Life_HMO=\"Enhanced Life $100,000\",Life_HMO=\"Enhanced Life $150,000\")),B9=\"select your payroll frequency\",NonVolHMOERContribution_Employee=\"Enter your Contribution %\",B11=\"Enter your Contribution %\",A19=1),0,ROUND(((M28/$F$10)*NonVolHMOERContribution_Employee),2))","v":0},null,{"$f":"IF(OR($B$6=\"Enter Number of Employees\",$B$7=\"Select your CA DHMO Region\",G10=\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\",G9=\"Must have a minimum of 2 enrolled for Good plan\",A13=\"Enhanced Life is only available for CoPower ONE plans with 10+ employees.\",A19=1),0,IF($B$5=\"Select your HMO plan type\",0,IF($B$5=\"CoPower ONE Good\",T4,IF(OR($B$5=\"CoPower ONE Better\",$B$5=\"CoPower ONE Better Plus\"),V4,IF($B$5=\"CoPower ONE Best\",X4,0)))))","v":0},null,null,null,null,null,{"$f":"G28*12","v":0},null,{"$f":"IF($F$10=0,0,ROUNDDOWN(((M28/$F$10)),2))","v":0}]
["Employee+1",null,{"$f":"IF(OR($B$9=\"Select your payroll frequency\",B10=\"Enter your Contribution %\",B11=\"Enter your Contribution %\",A19=1),0,ROUND($C$28+((L29/$F$10)*$E$11),2))","v":0},null,{"$f":"IF(OR(AND(OR(B6=\"Enter Number of Employees\",B6<10),OR($B$8=\"Enhanced Life $50,000\",$B$8=\"Enhanced Life $100,000\",$B$8=\"Enhanced Life $150,000\")),$B$9=\"select your payroll frequency\",$B$10=\"Enter your Contribution %\",$B$11=\"Enter your Contribution %\",A19=1),0,ROUND(E28+((L29/$F$10)*NonVolHMOERContribution_Dependent),2))","v":0},null,{"$f":"IF(OR($B$6=\"Enter Number of Employees\",$B$7=\"Select your CA DHMO Region\",G10=\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\",G9=\"Must have a minimum of 2 enrolled for Good plan\",A13=\"Enhanced Life is only available for CoPower ONE plans with 10+ employees.\",A19=1),,IF($B$5=\"Select your HMO plan type\",0,IF($B$5=\"CoPower ONE Good\",T5,IF(OR($B$5=\"CoPower ONE Better\",$B$5=\"CoPower ONE Better Plus\"),V5,IF($B$5=\"CoPower ONE Best\",X5,0)))))","v":0},null,null,null,null,{"$f":"M29-M28","v":0},{"$f":"G29*12","v":0},null,{"$f":"IF($F$10=0,0,ROUNDDOWN(((M29/$F$10)),2))","v":0}]
["Employee+2 or more",null,{"$f":"IF(OR($B$9=\"Select your payroll frequency\",B10=\"Enter your Contribution %\",B11=\"Enter your Contribution %\",A19=1),0,ROUND(($C$28+((L30/$F$10)*$E$11)),2))","v":0},null,{"$f":"IF(OR(AND(OR(B6=\"Enter Number of Employees\",B6<10),OR($B$8=\"Enhanced Life $50,000\",$B$8=\"Enhanced Life $100,000\",$B$8=\"Enhanced Life $150,000\")),$B$9=\"select your payroll frequency\",$B$10=\"Enter your Contribution %\",$B$11=\"Enter your Contribution %\",A19=1),0,ROUND(E28+((L30/$F$10)*NonVolHMOERContribution_Dependent),2))","v":0},null,{"$f":"IF(OR($B$6=\"Enter Number of Employees\",$B$7=\"Select your CA DHMO Region\",G10=\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\",G9=\"Must have a minimum of 2 enrolled for Good plan\",A13=\"Enhanced Life is only available for CoPower ONE plans with 10+ employees.\",A19=1),,IF($B$5=\"Select your HMO plan type\",0,IF($B$5=\"CoPower ONE Good\",T6,IF(OR($B$5=\"CoPower ONE Better\",$B$5=\"CoPower ONE Better Plus\"),V6,IF($B$5=\"CoPower ONE Best\",X6,0)))))","v":0},null,null,null,null,{"$f":"M30-M28","v":0},{"$f":"G30*12","v":0},null,{"$f":"IF($F$10=0,0,ROUNDDOWN(((M30/$F$10)),2))","v":0}]
[]
[]
[]
["Benefits",null,{"$f":"IF($B$5=\"Select your HMO plan type\",\"Select your HMO Plan Type\",IF($B$5=\"CoPower ONE Good\",\"CoPower ONE Good\",IF($B$5=\"CoPower ONE Better\",\"CoPower ONE Better\",IF($B$5=\"CoPower ONE Better Plus\",\"CoPower ONE Better Plus\",IF($B$5=\"CoPower ONE Best\",\"CoPower ONE Best\",\"Select your HMO plan type\")))))","v":"Select your HMO Plan Type"}]
["DHMO Dental - Delta Dental",null,"DeltaCare USA"]
["Calendar Maximum",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"None\")","v":0}]
["Deductible",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"None\")","v":0}]
["Diagnostic & Preventive ",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Exams, x-rays, cleanings, and flouride treatments\")","v":0},null,null,null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"No cost\")","v":0}]
["Basic Restorative",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Fillings (amalgan cost per surface)\")","v":0},null,null,null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"No cost\")","v":0}]
["Periodontics",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Scaling and Root planing\")","v":0},null,null,null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"$50 copay\")","v":0}]
["Endodontics",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Root canal – anterior (excluding final restoration)\nRoot canal – molar (excluding final restoration)\")","v":0},null,null,null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"$95 copay\n$335 copay\")","v":0}]
["Oral Surgery",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Extraction, erupted tooth or exposed root\nSurgical removal of erupted tooth requiring removal of bone or sectioning of tooth\nRemoval of impacted tooth – completely boney\")","v":0},null,null,null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"$5 copay\n$45 copay\n$95 copay\")","v":0}]
["Prosthodontics",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Crown – porcelain fused to high noble metal; full cast high noble metal\nComplete denture – maxillary\nMaxillary partial denture – resin base\")","v":0},null,null,null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"$355 copay\n$285 copay\n$245 copay\")","v":0}]
["Orthodontics",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Child\nAdult\")","v":0},null,null,null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"$1,900 copay\n$2,100 copay\")","v":0}]
[]
["Vision - Vision Service Plan",null,"In Network","Out of Network",null,"Frequency"]
["Annual Copayment",null,{"$f":"IF(B5=\"Select your HMO plan type\",0,IF(B5=\"CoPower ONE Good\",\"$25 exam/$25 prescription glasses\",\"$10 exam/$25 prescription glasses\"))","v":0}]
["Eye Exam",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Covered after copayment\")","v":0},{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Reimbursed up to $45\")","v":0},null,"Eye Exam",null,{"$f":"IF(B5=\"Select your HMO plan type\",0,\"12 months\")","v":0}]
["Single-vision Lenses",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Reimbursed up to $30\")","v":0},null,"Lenses",null,{"$f":"IF(B5=\"Select your HMO plan type\",0,IF($B$5=\"CoPower ONE Good\",\"24 months\",\"12 months\"))","v":0}]
["Bifocal Lenses",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Reimbursed up to $50\")","v":0}]
["Trifocal Lenses",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Reimbursed up to $65\")","v":0}]
["Frames",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"$150 allowance\")","v":0},{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Reimbursed up to $70\")","v":0},null,"Frames",null,{"$f":"IF(B5=\"Select your HMO plan type\",0,IF($B$5=\"CoPower ONE Best\",\"12 months\",\"24 months\"))","v":0}]
["Contact Lenses",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"$150 allowance\")","v":0},{"$f":"IF($B$5=\"Select your HMO plan type\",0,\"Reimbursed up to $105\")","v":0},null,"Contact Lenses \n(in lieu of lenses and a frame)",null,{"$f":"IF(B5=\"Select your HMO plan type\",0,IF($B$5=\"CoPower ONE Good\",\"24 months\",\"12 months\"))","v":0}]
[]
["Life - UNUM"]
["Basic Group Term Life \nwith AD&D and EAP",null,{"$f":"IF($B$5=\"Select your HMO plan type\",0,IF($B$8=\"Standard Life Amount\",IF($B$5=\"CoPower ONE Good\",\"$15,000 policy\",IF(OR($B$5=\"CoPower ONE Better\",$B$5=\"CoPower ONE Better Plus\"),\"$20,000 policy\",IF($B$5=\"CoPower ONE Best\",\"$25,000 policy\",\"0\"))),IF($B$8=\"Enhanced Life $50,000\",\"$50,000 policy\",IF($B$8=\"Enhanced Life $100,000\",\"$100,000 policy\",IF($B$8=\"Enhanced Life $150,000\",\"$150,000 policy\",0)))))","v":0}]
[]
["Contact your benefits representative should you have any questions."]
["*Enter your contact information here*"]

{"sheet":"CoPower One PPO Comparison","index":2,"n_rows":60,"n_cols":11,"rows_kept":60,"cut":false,"hidden":true,"merged":[[7,3,7,9],[7,0,7,2],[16,3,16,9],[16,0,16,2],[25,3,25,9],[25,0,25,2],[22,8,22,9],[20,2,20,3],[22,6,22,7],[8,1,8,9],[14,1,14,2],[22,4,22,5],[20,8,20,9],[9,1,9,2],[22,0,22,1],[20,0,20,1],[12,1,12,2],[13,1,13,2],[24,0,24,3],[21,0,21,1],[23,0,23,1],[11,1,11,2],[18,2,18,3],[21,2,21,3],[18,11,20,11],[32,0,32,1],[23,4,23,5],[19,8,19,9],[29,0,29,1],[30,0,30,1],[33,0,33,1],[32,8,32,9],[27,8,27,9],[29,2,29,5],[33,8,33,9],[34,0,34,1],[36,6,36,7],[34,6,34,7],[38,6,38,7],[34,8,34,9],[19,0,19,1],[43,0,43,1],[46,4,46,5],[41,0,41,1],[42,0,42,1],[45,0,45,9],[24,4,24,5],[31,0,31,1],[29,6,29,9],[34,4,34,5],[66,8,66,9],[60,8,60,9],[61,8,61,9],[62,8,62,9],[63,8,63,9],[53,0,53,9],[59,0,59,9],[64,8,64,9],[65,8,65,9],[57,0,57,2],[54,0,54,9],[55,0,55,9],[58,0,58,6],[58,7,58,9],[57,3,57,9],[52,0,52,1],[52,2,52,3],[52,4,52,5],[35,0,35,1],[38,0,38,1],[39,0,39,1],[40,0,40,1],[35,2,35,3],[36,0,36,1],[37,0,37,1],[46,0,46,1],[47,0,47,1],[46,2,46,3],[47,2,47,3],[44,0,44,1],[51,0,51,9],[49,0,49,1],[50,6,50,7],[49,4,49,5],[50,0,50,1],[48,4,48,5],[48,0,48,1],[46,6,46,7],[50,8,50,9],[12,4,12,5],[13,4,13,5],[14,4,14,5],[27,6,27,7],[27,4,27,5],[21,6,21,7],[23,6,23,7],[15,0,15,9],[23,2,23,3],[18,4,18,5],[18,6,18,7],[19,6,19,7],[20,6,20,7],[27,2,27,3],[23,8,23,9],[18,8,18,9],[21,8,21,9],[21,4,21,5],[20,4,20,5],[19,2,19,5],[24,8,24,9],[24,6,24,7],[22,2,22,3],[52,6,52,7],[50,2,50,3],[50,4,50,5],[49,6,49,7],[38,2,38,3],[35,6,35,7],[52,8,52,9],[47,4,47,5],[38,8,38,9],[48,2,48,3],[49,2,49,3],[49,8,49,9],[48,6,48,7],[36,8,36,9],[35,4,35,5],[35,8,35,9],[36,2,36,3],[48,8,48,9],[36,4,36,5],[38,4,38,5],[47,6,47,7],[46,8,46,9],[47,8,47,9]]}
[]
[]
[]
[]
[]
[]
[]
["Company Information"]
["Company Name:",null,null,null,null,null,null,null,null,null,{"$f":"IF(J14=\"Yes\",,\"Must have a minimum of 2 enrolled for Good plan\")","v":"Must have a minimum of 2 enrolled for Good plan"}]
["Effective Date:","Select your effective date",null,null,null,null,null,null,null,null,{"$f":"IF(J15=\"Yes\",,\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\")","v":"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans"}]
[]
["Employees","Select your group size"]
["Region","Select your CA PPO Region",null,null,"Number of Single",null,0,null,{"$f":"IF(GroupSize>4,5,\"2-4\")","v":"2-4"}]
["SIC Level","Select your SIC Level",null,null,"Number of Two Party",null,0,null,{"$f":"SUM(G13+G14+G15)","v":0},{"$f":"IF(SUM(I14)>1,\"Yes\",\"No\")","v":"No"}]
["Life Amount1","Standard Life Amount",null,null,"Number of Three Party+",null,0,null,{"$f":"SUM(G13+G14+G15)","v":0},{"$f":"IF(SUM(I15)>4,\"Yes\",\"No\")","v":"No"}]
[]
["Cost Comparison"]
[]
[{"$f":"CONCATENATE(B13,B14,B15,I13)","v":"Select your CA PPO RegionSelect your SIC LevelStandard Life Amount2-4"},{"$f":"SUM(CPPPO_EECheck)","v":0},"Good",null,"Better",null,"Better Plus",null,"Best"]
[]
["Single",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,2,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,5,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,8,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,11,FALSE)","v":0}]
["Two Party",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,3,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,6,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,9,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,12,FALSE)","v":0}]
["Three Party+",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,4,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,7,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,10,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,13,FALSE)","v":0}]
["Total Cost",null,{"$f":"SUM((C21*G13)+(C22*G14)+(C23*G15))","v":0},null,{"$f":"SUM((E21*G13)+(E22*G14)+(E23*G15))","v":0},null,{"$f":"SUM((G21*G13)+(G22*G14)+(G23*G15))","v":0},null,{"$f":"SUM((I21*G13)+(I22*G14)+(I23*G15))","v":0}]
["Percent Difference between Good, Better and Best",null,null,null,{"$f":"SUM(E24-C24)/C24","v":{"$error":"#DIV/0!"}},null,{"$f":"SUM(G24-E24)/C24","v":{"$error":"#DIV/0!"}},null,{"$f":"SUM(I24-E24)/E24","v":{"$error":"#DIV/0!"}}]
["Benefit Comparison"]
[]
[null,null,"Good",null,"Better",null,"Better Plus",null,"Best"]
[null,null,"In Network","Out of Network","In Network","Out of Network","In Network","Out of Network","In Network","Out of Network"]
["Dental - Delta Dental",null,"Delta Dental PPO2",null,null,null,"Delta Dental PPO + Premier3"]
["Calendar Maximum",null,"$1,000","$750","$1,500","$1,250","$1,500","$1,250","$2,000","$1,500"]
["Deductible",null,"$50","$75","$50","$75","$50","$75","$50","$75"]
["Deductible Waived for Diagnostic & Preventive",null,"Yes","No","Yes","No","Yes","No","Yes"]
["Diagnostic and\nPreventive Services",null,"100%","50%","100%","80%","100%","80%","100%"]
["Basic, Oral Surgery, \nEndodontics and Periodontics",null,"80%","50%","80%",null,"80%",null,"80%"]
["Major Services",null,"50%",null,"50%",null,"50%",null,"50%"]
["Orthodontics-Children Only\n(Available to groups 5+ enrolled)",null,"Not available",null,"50% lifetime max $1,000",null,"50% lifetime max $1,000",null,"50% lifetime max $1,000"]
["Vision - Vision Service Plan"]
["Annual Copayment",null,"$25 exam/$25 materials",null,"$10 exam/$25 materials",null,"$10 exam/$25 materials",null,"$10 exam/$25 materials"]
["Eye Exam",null,"Covered after copayment","Reimbursed \nup to $45","Covered after copayment","Reimbursed \nup to $45","Covered after copayment","Reimbursed \nup to $45","Covered after copayment","Reimbursed \nup to $45"]
["Single-vision Lenses",null,"Covered in full","Reimbursed\nup to $30","Covered in full","Reimbursed\nup to $30","Covered in full","Reimbursed\nup to $30","Covered in full","Reimbursed\nup to $30"]
["Bifocal Lenses",null,"Covered in full","Reimbursed \nup to $50","Covered in full","Reimbursed \nup to $50","Covered in full","Reimbursed \nup to $50","Covered in full","Reimbursed \nup to $50"]
["Trifocal Lenses",null,"Covered in full","Reimbursed\nup to $65","Covered in full","Reimbursed\nup to $65","Covered in full","Reimbursed\nup to $65","Covered in full","Reimbursed\nup to $65"]
["Frames",null,"$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70","$150 allowance","Reimbursed \nup to $70"]
["Contact Lenses",null,"$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105","$150 allowance","Reimbursed\nup to $105"]
["Vision-Frequency"]
["Eye Exam",null,"12 months",null,"12 months",null,"12 months",null,"12 months"]
["Lenses",null,"24 months",null,"12 months",null,"12 months",null,"12 months"]
["Frames",null,"24 months",null,"24 months",null,"24 months",null,"12 months"]
["Contact Lenses \n(in lieu of lenses and a frame)",null,"24 months",null,"12 months",null,"12 months",null,"12 months"]
[null,null,"Good",null,"Better",null,"Better Plus",null,"Best"]
["Life - UNUM"]
["Basic Group Term Life \nwith AD&D and EAP",null,{"$f":"IF($B$15=\"Standard Life Amount\",\"$15,000 policy\",$B$15)","v":"$15,000 policy"},null,{"$f":"IF($B$15=\"Standard Life Amount\",\"$20,000 policy\",$B$15)","v":"$20,000 policy"},null,{"$f":"IF($B$15=\"Standard Life Amount\",\"$20,000 policy\",$B$15)","v":"$20,000 policy"},null,{"$f":"IF($B$15=\"Standard Life Amount\",\"$25,000 policy\",$B$15)","v":"$25,000 policy"}]
["1 Employers with 10 or more enrolling employees have the option of substituting the standard group term life policy amounts with either a $50,000, $100,000 or $150,000 policy for an additional charge."]
["2 Delta Dental PPO: All dentists (in- and out-of-network) are reimbursed at the lesser of the submitted charge or the PPO provider allowed fee."]
["3 Delta Dental PPO + Premier: PPO dentists are reimbursed at the lesser of the submitted charge or the PPO provider allowed fee. Delta Dental Premier dentists are reimbursed at the lesser of the submitted charge or the Premier provider allowed fee. Non-contracted dentists are reimbursed at the lesser of the submitted charge or the fee that satisfies the majority of dentists with the same training and geographical area."]
[]
["Presented by"]
["**Enter your contact information here.**",null,null,null,null,null,null,"License #"]
["This document is not meant to replace a quote and does not include all exclusions, limitations or program guidelines. While the information and rates provided here are believed to be accurate as of the print date, they are subject to change without notice. For the most up-to-date information, contact CoPower. CoPower ONE plans are not available to groups currently insured with UNUM.\n"]

{"sheet":"CoPower ONE PPO (Non-Voluntary)","index":3,"n_rows":64,"n_cols":28,"rows_kept":64,"cut":false,"hidden":false,"merged":[[62,0,62,7],[63,0,63,7],[29,0,30,1],[70,8,70,9],[71,8,71,9],[10,1,10,2],[31,0,31,1],[32,2,32,3],[33,2,33,3],[31,6,31,7],[65,8,65,9],[66,8,66,9],[32,0,32,1],[32,4,32,5],[33,0,33,1],[33,4,33,5],[32,6,32,7],[33,6,33,7],[31,4,31,5],[30,4,30,5],[30,2,30,3],[67,8,67,9],[69,8,69,9],[68,8,68,9],[7,19,7,22],[57,5,57,6],[56,5,56,6],[52,3,52,4],[53,3,53,4],[54,3,54,4],[55,3,55,4],[56,3,56,4],[57,3,57,4],[50,5,50,7],[51,5,51,7],[53,7,55,7],[53,5,55,6],[50,3,50,4],[51,2,51,4],[30,6,30,7],[30,13,30,14],[28,2,28,7],[29,2,29,5],[11,6,12,8],[21,0,21,7],[52,0,52,1],[53,0,53,1],[54,0,54,1],[55,0,55,1],[56,0,56,1],[57,0,57,1],[48,0,48,7],[47,0,47,7],[31,13,31,14],[31,2,31,3],[37,0,37,1],[38,0,38,1],[7,25,7,26],[7,27,7,28],[37,2,37,3],[39,0,39,1],[47,10,48,17],[60,0,60,1],[40,0,40,1],[41,0,41,1],[42,0,42,1],[43,0,43,1],[44,0,44,1],[45,0,45,1],[45,2,45,3],[46,0,46,1],[46,2,46,3],[50,0,50,1],[51,0,51,1],[59,6,59,7],[59,4,59,5],[32,13,32,14],[33,13,33,14],[35,0,35,2],[39,2,39,3],[7,23,7,24],[5,19,5,20],[5,21,5,22],[5,23,5,24],[5,25,5,26],[5,27,5,28],[6,19,6,20],[6,21,6,22],[6,23,6,24],[6,25,6,26],[6,27,6,28],[1,21,1,22],[1,23,1,24],[1,25,1,26],[4,19,4,20],[4,21,4,22],[4,23,4,24],[4,25,4,26],[1,27,1,28],[2,19,2,20],[2,21,2,24],[2,25,2,26],[2,27,2,28],[3,21,3,22],[3,23,3,24],[3,25,3,26],[3,27,3,28],[4,27,4,28],[3,19,3,20],[6,1,6,2],[7,1,7,2],[8,1,8,2],[9,1,9,2],[29,6,29,7],[5,1,5,2],[11,1,11,2],[12,1,12,2],[23,1,23,4],[22,0,22,2],[24,1,24,2],[15,0,15,4],[10,6,10,8],[28,0,28,1],[5,6,6,8],[18,0,19,3]]}
["Available for groups with 2-99 enrolling employees.  "]
["Better, Better Plus and Best plans are available to groups with 5-99 enrolling employees. ",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,{"$f":"CONCATENATE(B8,B9,B10,G8)","v":"Select your CA PPO RegionSelect your SIC LevelStandard Life Amount2-4"},{"$f":"SUM(PPO_EnrolledEEs)","v":0},"Good",null,"Better",null,"Better Plus",null,"Best"]
["This Employee Cost Worksheet is for Non-Voluntary CoPower ONE PPO Plans."]
["Rates valid for groups with renewal dates 1/1/19 through 12/31/19.",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Single",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,2,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,5,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,8,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,11,FALSE)","v":0}]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"Two Party",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,3,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,6,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,9,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,12,FALSE)","v":0}]
["Plan Type","Select your PPO plan type",null,null,null,null,{"$f":"IF(G10>99,\"Note: CoPower ONE plans are only available for groups with 2-99 enrolling employees\",\"\")","v":""},null,null,null,null,null,null,null,null,null,null,null,null,"Three Party+",null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,4,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,7,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,10,FALSE)","v":0},null,{"$f":"VLOOKUP(AreaSIC_Selection,List_RateTable_PPO,13,FALSE)","v":0}]
["Eligible Employees","Enter Number of Employees",null,null,null,"Enrolling Employees",null,null,null,null,null,null,null,null,null,null,null,null,null,"Total Cost",null,{"$f":"SUM((V4*F8)+(V5*F9)+(V6*F10))","v":0},null,{"$f":"SUM((X4*F8)+(X5*F9)+(X6*F10))","v":0},null,{"$f":"SUM((Z4*F8)+(Z5*F9)+(Z6*F10))","v":0},null,{"$f":"SUM((AB4*F8)+(AB5*F9)+(AB6*F10))","v":0}]
["Region","Select your CA PPO Region",null,"Number of Single",null,0,{"$f":"IF(GroupSize>4,5,\"2-4\")","v":"2-4"},null,null,null,null,null,null,null,null,null,null,null,null,"Percent Difference between Good, Better and Best",null,null,null,{"$f":"SUM(X7-V7)/V7","v":{"$error":"#DIV/0!"}},null,{"$f":"SUM(Z7-X7)/V7","v":{"$error":"#DIV/0!"}},null,{"$f":"SUM(AB7-X7)/X7","v":{"$error":"#DIV/0!"}}]
["SIC Level","Select your SIC Level",null,"Number of Two Party",null,0,{"$f":"SUM(F8+F9+F10)","v":0},{"$f":"IF(SUM(G9)>1,\"Yes\",\"No\")","v":"No"}]
["Life Amount","Standard Life Amount",null,"Number of Three Party+",null,0,{"$f":"SUM(F8+F9+F10)","v":0},{"$f":"IF(AND(SUM(G10)>4,PPO_EligibleEEs>4),\"Yes\",\"No\")","v":"No"}]
["Payroll Frequency","Select your payroll frequency",null,null,null,null,{"$f":"IF(B6=\"CoPower ONE Good\",IF(H9=\"Yes\",,\"Must have a minimum of 2 enrolled for Good plan\"),)","v":0}]
["ER Contribution % (Employee)","Enter Enrolling Employees",null,null,{"$f":"IF(B12=\"Enter your Contribution %\",0,1-B12)","v":{"$error":"#VALUE!"}},{"$f":"IF(B11=\"weekly\",\"52\",IF(B11=\"Biweekly\",\"26\",IF(B11=\"2x Monthly\",\"24\",IF(B11=\"Monthly\",\"12\",0))))","v":0},{"$f":"IF(OR(B6=\"Select your PPO Plan Type\",B6=\"CoPower ONE Good\"),,IF(H10=\"Yes\",,\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\"))","v":0}]
["ER Contribution % (Dependent)","Enter Enrolling Employees",null,null,{"$f":"IF(B13=\"Enter your Contribution %\",0,1-B13)","v":{"$error":"#VALUE!"}}]
[]
[]
[{"$f":"IF(OR(AND(OR(PPO_EligibleEEs=\"Enter Number of Employees\",PPO_EligibleEEs<10),OR(B10=\"Enhanced Life $50,000\",B10=\"Enhanced Life $100,000\",B10=\"Enhanced Life $150,000\")),AND(SUM(G10)<10,OR(B10=\"Enhanced Life $50,000\",B10=\"Enhanced Life $100,000\",B10=\"Enhanced Life $150,000\"))),\"Enhanced Life is only available for CoPower ONE plans with 10+ employees.\",)","v":0}]
[]
[]
[{"$f":"IF(PPO_EligibleEEs=\"Enter Number of Employees\",\"\",IF(G10>PPO_EligibleEEs,\"Enrolling Employees are greater than Eligible Employees\",IF(NonVolPPOERContribution_Employee=1,IF(G10<>PPO_EligibleEEs,\"100 % participation required for CoPower ONE Non-Voluntary PPO plan if employer contributes 100 % of employee premium\",\"\"),IF(G10<(0.75*PPO_EligibleEEs),\"At least 75 % participation required for CoPower ONE Non-Voluntary PPO plan. \nPlease change the number of eligible or enrolling employees.\",\"\"))))","v":""}]
[]
[{"$f":"IF(OR(A19=\"100 % participation required for CoPower One Non-Voluntary PPO Plan if employer contributes 100 % of employee premium\",A19=\"At least 75 % participation required for CoPower ONE Non-Voluntary PPO plan. \nPlease change the number of eligible or enrolling employees.\",A19=\"Enrolling Employees are greater than Eligible Employees\"),1,\"\")","v":""}]
["CoPower ONE Employee Contribution Worksheet"]
[]
["Company Name:"]
["Effective Date:","Select your effective date"]
[]
[]
[]
["Costs",null,{"$f":"IF($B$6=\"Select your PPO plan type\",\"Select your PPO Plan Type\",IF($B$6=\"CoPower ONE Good\",\"CoPower ONE Good\",IF($B$6=\"CoPower ONE Better\",\"CoPower ONE Better\",IF($B$6=\"CoPower ONE Better Plus\",\"CoPower ONE Better Plus\",IF($B$6=\"CoPower ONE Best\",\"CoPower ONE Best\",\"Select your PPO plan type\")))))","v":"Select your PPO Plan Type"}]
[null,null,{"$f":"IF(B11=\"Select your payroll frequency\",\"Select your Payroll Frequency\",IF(B11=\"Weekly\",\"Per Weekly Pay Period\",IF(B11=\"Biweekly\",\"Per Biweekly Pay Period\",IF(B11=\"2x Monthly\",\"Per Pay Period (Twice a Month)\",IF(B11=\"Monthly\",\"Per Monthly Pay Period\",0)))))","v":"Select your Payroll Frequency"},null,null,null,"Monthly Premium"]
[null,null,"Employee Portion",null,"Employer Portion",null,null,null,null,null,"Annual Dependent Cost","Annual Premium",null,"Total"]
["Employee Only",null,{"$f":"IF(OR(AND(OR($B$7=\"Enter Number of Employees\",$B$7=\"2-9 Employees\"),OR($B$10=\"Enhanced Life $50,000\",$B$10=\"Enhanced Life $100,000\",$B$10=\"Enhanced Life $150,000\")),$B$11=\"select your payroll frequency\",B12=\"Enter your Contribution %\",B13=\"Enter your Contribution %\",A21=1),0,ROUND(((L32/$F$12)*$E$12),2))","v":0},null,{"$f":"IF(OR(AND(OR($B$7=\"Enter Number of Employees\",$B$7=\"2-9 Employees\"),OR($B$10=\"Enhanced Life $50,000\",$B$10=\"Enhanced Life $100,000\",$B$10=\"Enhanced Life $150,000\")),$B$11=\"select your payroll frequency\",$B$12=\"Enter your Contribution %\",B13=\"Enter your Contribution %\",A21=1),0,ROUND(((L32/$F$12)*NonVolPPOERContribution_Employee),2))","v":0},null,{"$f":"IF(OR($B$7=\"Enter Number of Employees\",$B$8=\"Select your CA PPO Region\",G12=\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\",G11=\"Must have a minimum of 2 enrolled for Good plan\",A16=\"Enhanced Life is only available for CoPower ONE plans with 10+ employees.\",A21=1),,IF($B$6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Good\",V4,IF($B$6=\"CoPower ONE Better\",X4,IF($B$6=\"CoPower ONE Better Plus\",Z4,IF($B$6=\"CoPower ONE Best\",AB4,0))))))","v":0},null,null,null,null,{"$f":"G32*12","v":0},null,{"$f":"IF($F$12=0,0,ROUND(((L32/$F$12)),2))","v":0}]
["Employee+1",null,{"$f":"IF(OR($B$11=\"Select your payroll frequency\",B12=\"Enter your Contribution %\",B13=\"Enter your Contribution %\",A21=1),0,ROUND($C$32+((K33/$F$12)*$E$13),2))","v":0},null,{"$f":"IF(OR(AND(OR($B$7=\"Enter Number of Employees\",$B$7=\"2-9 Employees\",A21=1),OR($B$10=\"Enhanced Life $50,000\",$B$10=\"Enhanced Life $100,000\",$B$10=\"Enhanced Life $150,000\")),$B$11=\"select your payroll frequency\",$B$12=\"Enter your Contribution %\",$B$13=\"Enter your Contribution %\"),0,ROUND($E$32+((K33/$F$12)*B13),2))","v":0},null,{"$f":"IF(OR($B$7=\"Enter Number of Employees\",$B$8=\"Select your CA PPO Region\",G12=\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\",G11=\"Must have a minimum of 2 enrolled for Good plan\",A16=\"Enhanced Life is only available for CoPower ONE plans with 10+ employees.\",A21=1),,IF($B$6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Good\",V5,IF($B$6=\"CoPower ONE Better\",X5,IF($B$6=\"CoPower ONE Better Plus\",Z5,IF($B$6=\"CoPower ONE Best\",AB5,0))))))","v":0},null,null,null,{"$f":"L33-L32","v":0},{"$f":"G33*12","v":0},null,{"$f":"IF($F$12=0,0,ROUND(((L33/$F$12)),2))","v":0}]
["Employee+2 or more",null,{"$f":"IF(OR($B$11=\"Select your payroll frequency\",B12=\"Enter your Contribution %\",B13=\"Enter your Contribution %\",A21=1),0,ROUND($C$32+((K34/$F$12)*$E$13),2))","v":0},null,{"$f":"IF(OR(AND(OR($B$7=\"Enter Number of Employees\",$B$7=\"2-9 Employees\",A21=1),OR($B$10=\"Enhanced Life $50,000\",$B$10=\"Enhanced Life $100,000\",$B$10=\"Enhanced Life $150,000\")),$B$11=\"select your payroll frequency\",$B$12=\"Enter your Contribution %\",$B$13=\"Enter your Contribution %\"),0,ROUND($E$32+((K34/$F$12)*B13),2))","v":0},null,{"$f":"IF(OR($B$7=\"Enter Number of Employees\",$B$8=\"Select your CA PPO Region\",G12=\"Must have a minimum of 5 enrolled for Better, Better Plus and Best plans\",G11=\"Must have a minimum of 2 enrolled for Good plan\",A16=\"Enhanced Life is only available for CoPower ONE plans with 10+ employees.\",A21=1),,IF($B$6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Good\",V6,IF($B$6=\"CoPower ONE Better\",X6,IF($B$6=\"CoPower ONE Better Plus\",Z6,IF($B$6=\"CoPower ONE Best\",AB6,0))))))","v":0},null,null,null,{"$f":"L34-L32","v":0},{"$f":"G34*12","v":0},null,{"$f":"IF($F$12=0,0,ROUND(((L34/$F$12)),2))","v":0}]
[]
[]
[]
["Benefits",null,{"$f":"IF($B$6=\"Select your PPO plan type\",\"Select your PPO Plan Type\",IF($B$6=\"CoPower ONE Good\",\"CoPower ONE Good\",IF($B$6=\"CoPower ONE Better\",\"CoPower ONE Better\",IF($B$6=\"CoPower ONE Better Plus\",\"CoPower ONE Better Plus\",IF($B$6=\"CoPower ONE Best\",\"CoPower ONE Best\",\"Select your PPO plan type\")))))","v":"Select your PPO Plan Type"}]
[null,null,"PPO Dentists","Non-PPO Dentists"]
["Dental - Delta Dental",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,IF(OR($B$6=\"CoPower ONE Good\",$B$6=\"CoPower ONE Better\"),\"Delta Dental PPO*\",\"Delta Dental PPO + Premier*\"))","v":0}]
["Calendar Maximum",null,{"$f":"IF($B$6=\"CoPower ONE Good\",\"$1,000\",IF(OR($B$6=\"CoPower ONE Better\",$B$6=\"CoPower ONE Better Plus\"),\"$1,500\",IF($B$6=\"CoPower ONE Best\",\"$2,000\",0)))","v":0},{"$f":"IF($B$6=\"CoPower ONE Good\",\"$750\",IF(OR($B$6=\"CoPower ONE Better\",$B$6=\"CoPower ONE Better Plus\"),\"$1,250\",IF($B$6=\"CoPower ONE Best\",\"$1,500\",0)))","v":0}]
["Deductible",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"$50\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"$75\")","v":0}]
["Deductible Waived for Diagnostic & Preventive",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Yes\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,IF(B6=\"CoPower ONE Best\",\"Yes\",\"No\"))","v":0}]
["Diagnostic and\nPreventive Services",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"100%\")","v":0},{"$f":"IF($B$6=\"CoPower ONE Good\",\"50%\",IF(OR($B$6=\"CoPower ONE Better\",$B$6=\"CoPower ONE Better Plus\"),\"80%\",IF($B$6=\"CoPower ONE Best\",\"100%\",0)))","v":0}]
["Basic, Oral Surgery, \nEndodontics and Periodontics",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"80%\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Good\",\"50%\",\"80%\"))","v":0}]
["Major Services",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"50%\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"$50\")","v":0}]
["Orthodontics-Children Only\n(Available to groups 5+ enrolled)",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Good\",\"Not available\",\"50% lifetime max $1,000\"))","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Good\",\"50%\",\"80%\"))","v":0}]
[{"$f":"IF($B$6=\"Select your PPO plan type\",0,IF($C$40=\"Delta Dental PPO*\",\"*Delta Dental PPO: All dentists (in- and out-of-network) are reimbursed at the lesser of the submitted charge or the PPO provider allowed fee.\",0))","v":0},null,null,null,null,null,null,null,null,null,"*Delta Dental PPO + Premier: PPO dentists are reimbursed at the lesser of the submitted charge or the PPO provider allowed fee. Delta Dental Premier dentists are reimbursed at the lesser of the submitted charge or the Premier provider allowed fee. Non-contracted dentists are reimbursed at the lesser of the submitted charge or the fee that satisfies the majority of dentists with the same training and geographical area."]
[{"$f":"IF($B$6=\"Select your PPO plan type\",0,IF($C$40=\"Delta Dental PPO + Premier*\",K48,0))","v":0}]
[]
["Vision - Vision Service Plan",null,"In Network","Out of Network",null,"Frequency"]
["Annual Copayment",null,{"$f":"IF(B6=\"Select your PPO plan type\",0,IF(B6=\"CoPower ONE Good\",\"$25 exam/$25 prescription glasses\",\"$10 exam/$25 prescription glasses\"))","v":0}]
["Eye Exam",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Covered after copayment\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Reimbursed up to $45\")","v":0},null,"Eye Exam",null,{"$f":"IF(B6=\"Select your PPO plan type\",0,\"12 months\")","v":0}]
["Single-vision Lenses",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Reimbursed up to $30\")","v":0},null,"Lenses",null,{"$f":"IF(B6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Good\",\"24 months\",\"12 months\"))","v":0}]
["Bifocal Lenses",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Reimbursed up to $50\")","v":0}]
["Trifocal Lenses",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Reimbursed up to $65\")","v":0}]
["Frames",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"$150 allowance\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Reimbursed up to $70\")","v":0},null,"Frames",null,{"$f":"IF(B6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Best\",\"12 months\",\"24 months\"))","v":0}]
["Contact Lenses",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"$150 allowance\")","v":0},{"$f":"IF($B$6=\"Select your PPO plan type\",0,\"Reimbursed up to $105\")","v":0},null,"Contact Lenses \n(in lieu of lenses and a frame)",null,{"$f":"IF(B6=\"Select your PPO plan type\",0,IF($B$6=\"CoPower ONE Good\",\"24 months\",\"12 months\"))","v":0}]
[]
["Life - UNUM"]
["Basic Group Term Life \nwith AD&D and EAP",null,{"$f":"IF($B$6=\"Select your PPO plan type\",0,IF($B$10=\"Standard Life Amount\",IF($B$6=\"CoPower ONE Good\",\"$15,000 policy\",IF(OR($B$6=\"CoPower ONE Better\",$B$6=\"CoPower ONE Better Plus\"),\"$20,000 policy\",IF($B$6=\"CoPower ONE Best\",\"$25,000 policy\",\"0\"))),IF($B$10=\"Enhanced Life $50,000\",\"$50,000 policy\",IF($B$10=\"Enhanced Life $100,000\",\"$100,000 policy\",IF($B$10=\"Enhanced Life $150,000\",\"$150,000 policy\",0)))))","v":0}]
[]
["Contact your benefits representative should you have any questions."]
["*Enter your contact information here*"]

{"sheet":"CoPower ONE HMO (Voluntary)","index":4,"n_rows":55,"n_cols":21,"rows_kept":55,"cut":false,"hidden":false,"merged":[[56,8,56,9],[6,1,6,2],[30,2,30,7],[31,2,31,7],[32,2,32,7],[33,2,33,7],[34,2,34,5],[34,6,34,7],[53,0,53,7],[54,0,54,7],[50,0,50,1],[50,3,50,4],[50,5,50,6],[51,0,51,1],[51,3,51,4],[51,5,51,6],[47,0,47,1],[47,3,47,4],[47,5,49,6],[47,7,49,7],[48,0,48,1],[48,3,48,4],[49,0,49,1],[49,3,49,4],[35,6,35,7],[45,0,45,1],[45,2,45,4],[45,5,45,7],[46,0,46,1],[46,3,46,4],[46,5,46,6],[40,0,40,1],[38,0,38,1],[37,0,37,1],[42,0,42,7],[44,0,44,1],[44,3,44,4],[44,5,44,7],[39,0,39,1],[38,2,38,5],[38,6,38,7],[39,2,39,5],[39,6,39,7],[40,2,40,5],[40,6,40,7],[36,2,36,5],[36,6,36,7],[37,2,37,5],[37,6,37,7],[26,0,26,1],[26,2,26,3],[26,4,26,5],[26,6,26,7],[30,0,30,1],[31,0,31,1],[32,0,32,1],[33,0,33,1],[34,0,34,1],[35,0,35,1],[36,0,36,1],[35,2,35,5],[26,18,26,19],[27,0,27,1],[27,2,27,3],[27,4,27,5],[27,6,27,7],[27,18,27,19],[24,18,24,19],[25,0,25,1],[25,2,25,3],[25,4,25,5],[25,6,25,7],[25,18,25,19],[19,1,19,4],[20,1,20,2],[22,0,22,1],[22,2,22,7],[23,0,24,1],[23,2,23,5],[23,6,23,7],[24,2,24,3],[24,4,24,5],[24,6,24,7],[17,0,17,7],[1,7,3,9],[1,15,1,17],[5,1,5,2],[7,1,7,2],[7,4,7,5],[4,1,4,2],[8,1,8,2],[8,4,8,5],[9,1,9,2],[9,4,9,5],[13,0,14,3]]}
["Available for groups with 2-99 enrolling employees. "]
["This Employee Cost Worksheet is for Voluntary CoPower ONE HMO Plans.",null,null,null,{"$f":"IF(B9=\"Enter your Contribution %\",0,1-B9)","v":0},{"$f":"IF(B8=\"weekly\",\"52\",IF(B8=\"Biweekly\",\"26\",IF(B8=\"2x Monthly\",\"24\",IF(B8=\"Monthly\",\"12\",0))))","v":0},null,{"$f":"IF(J9=\"Yes\",,\"Must have a minimum of 2 enrolled for CoPower ONE HMO Voluntary plans\")","v":"Must have a minimum of 2 enrolled for CoPower ONE HMO Voluntary plans"},null,null,null,null,null,null,null,"Cost Comparison"]
["Rates valid for groups with renewal dates 1/1/19 through 12/31/19.",null,null,null,{"$f":"IF(B10=\"Enter your Contribution %\",0,1-B10)","v":0},null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(CPPPO_EECheck)","v":0},"Regions 1 + 2","Region 3","Region 4","Region 5"]
[]
["Plan Type","CoPower ONE Voluntary (HMO)",null,null,null,null,null,null,{"$f":"IF(GroupSize>4,5,\"2-4\")","v":"2-4"}]
["Eligible Employees","Enter Number of Employees"]
["Region","Select your CA DHMO Region",null,null,null,null,"Enrolling Employees"]
["Payroll Frequency","Select your payroll frequency",null,null,"Number of Single",null,0,null,{"$f":"SUM(G8+G9+G10)","v":0},{"$f":"IF(SUM(I8)>1,\"Yes\",\"No\")","v":"No"},null,null,null,null,null,"Single",null,27,30,31,77]
["ER Contribution % (Employee)","Enter your Contribution %",null,null,"Number of Two Party",null,0,null,{"$f":"SUM(G8+G9+G10)","v":0},{"$f":"IF(AND(SUM(I9)>1,HMOVOL_EligibleEEs>1),\"Yes\",\"No\")","v":"No"},null,null,null,null,null,"Two Party",null,42,46,49,118]
["ER Contribution % (Dependent)","Enter your Contribution %",null,null,"Number of Three Party+",null,0,{"$f":"G10+G9+EECount_PPO_Single","v":0},null,null,null,null,null,null,null,"Three Party+",null,66,72,76,179]
[null,null,null,null,null,0]
[null,null,null,null,null,0]
[]
[{"$f":"IF(HMOVOL_EligibleEEs=\"Enter Number of Employees\",\"\",IF(H10>HMOVOL_EligibleEEs,\"Enrolling Employees are greater than Eligible Employees\",IF(H10<(0.75*HMOVOL_EligibleEEs),\"At least 75 % participation required for CoPower ONE Voluntary HMO plans.\nPlease change the number of eligible or enrolling employees.\",\"\")))","v":""}]
[]
[]
[{"$f":"IF(OR(A14=\"Enrolling Employees are greater than Eligible Employees\", A14=\"At least 75 % participation required for CoPower ONE Voluntary HMO plans.\nPlease change the number of eligible or enrolling employees.\",),1,\"\")","v":""}]
["CoPower ONE Employee Contribution Worksheet"]
[]
["Company Name:"]
["Effective Date:","Select your effective date"]
[]
["Costs",null,"CoPower ONE Voluntary HMO"]
[null,null,{"$f":"IF(B8=\"Select your payroll frequency\",\"Select your Payroll Frequency\",IF(B8=\"Weekly\",\"Per Weekly Pay Period\",IF(B8=\"Biweekly\",\"Per Biweekly Pay Period\",IF(B8=\"2x Monthly\",\"Per Pay Period (Twice a Month)\",IF(B8=\"Monthly\",\"Per Monthly Pay Period\",\"\")))))","v":"Select your Payroll Frequency"},null,null,null,"Monthly Premium"]
[null,null,"Employee Portion",null,"Employer Portion",null,null,null,null,null,null,null,null,null,null,"Annual Dependent Cost","Annual Premium",null,"Total"]
["Employee Only",null,{"$f":"IF(OR(B8=\"select your payroll frequency\",B10=\"Enter your Contribution %\",A17=1),0,ROUND((Q26/F2)*E2,2))","v":0},null,{"$f":"IF(OR(B9=\"Enter your Contribution %\",B10=\"Enter your Contribution %\",B8=\"Select your payroll frequency\",A17=1),,ROUND((Q26/F2)*B9,2))","v":0},null,{"$f":"IF(OR(HMOVOL_EligibleEEs=\"Enter Number of Employees\",VolHMO_Region=\"Select your CA DHMO Region\",A17=1,J9=\"No\"),0,IF(VolHMO_Region=\"Region 1 & 2\",R8,IF(VolHMO_Region=\"Region 3\",S8,IF(VolHMO_Region=\"Region 4\",T8,IF(VolHMO_Region=\"Region 5\",U8,\"0\")))))","v":0},null,null,null,null,null,null,null,null,null,{"$f":"G26*12","v":0},null,{"$f":"IF(F2=0,0,ROUNDDOWN(((Q26/F2)),2))","v":0}]
["Employee+1",null,{"$f":"IF(OR(B8=\"Select your payroll frequency\",B9=\"Enter your Contribution %\",B10=\"Enter your Contribution %\"),0,ROUND($C$26+((P27/F2)*$E$3),2))","v":0},null,{"$f":"IF(OR(B9=\"Enter your Contribution %\",B10=\"Enter your Contribution %\",B8=\"Select your payroll frequency\",A17=1),,ROUND(E26+((P27/F2)*B10),2))","v":0},null,{"$f":"IF(OR(HMOVOL_EligibleEEs=\"Enter Number of Employees\",VolHMO_Region=\"Select your CA DHMO Region\",A17=1,J9=\"No\"),0,IF(VolHMO_Region=\"Region 1 & 2\",R9,IF(VolHMO_Region=\"Region 3\",S9,IF(VolHMO_Region=\"Region 4\",T9,IF(VolHMO_Region=\"Region 5\",U9,\"0\")))))","v":0},null,null,null,null,null,null,null,null,{"$f":"Q27-Q26","v":0},{"$f":"G27*12","v":0},null,{"$f":"IF(F2=0,0,ROUNDDOWN(((Q27/F2)),2))","v":0}]
["Employee+2 or more",null,{"$f":"IF(OR(B8=\"Select your payroll frequency\",B9=\"Enter your Contribution %\",B10=\"Enter your Contribution %\"),0,ROUND($C$26+((P28/F2)*$E$3),2))","v":0},null,{"$f":"IF(OR(B9=\"Enter your Contribution %\",B10=\"Enter your Contribution %\",B8=\"Select your payroll frequency\",A17=1),,ROUND(E26+((P28/F2)*B10),2))","v":0},null,{"$f":"IF(OR(HMOVOL_EligibleEEs=\"Enter Number of Employees\",VolHMO_Region=\"Select your CA DHMO Region\",A17=1,J9=\"No\"),0,IF(VolHMO_Region=\"Region 1 & 2\",R10,IF(VolHMO_Region=\"Region 3\",S10,IF(VolHMO_Region=\"Region 4\",T10,IF(VolHMO_Region=\"Region 5\",U10,\"0\")))))","v":0},null,null,null,null,null,null,null,null,{"$f":"Q28-Q26","v":0},{"$f":"G28*12","v":0},null,{"$f":"IF(F2=0,0,ROUNDDOWN(((Q28/F2)),2))","v":0}]
[]
[]
["Benefits",null,"CoPower ONE Voluntary HMO"]
["DHMO Dental - Delta Dental",null,"DeltaCare USA"]
["Calendar Maximum",null,"None"]
["Deductible",null,"None"]
["Diagnostic & Preventive ",null,"Exams, x-rays, cleanings, and flouride treatments",null,null,null,"No cost"]
["Basic Restorative",null,"Fillings (amalgan cost per surface)",null,null,null,"No cost"]
["Periodontics",null,"Scaling and Root planing",null,null,null,"$50 copay"]
["Endodontics",null,"Root canal – anterior (excluding final restoration)\nRoot canal – molar (excluding final restoration)",null,null,null,"$95 copay\n$335 copay"]
["Oral Surgery",null,"Extraction, erupted tooth or exposed root\nSurgical removal of erupted tooth requiring removal of bone or sectioning of tooth\nRemoval of impacted tooth – completely boney",null,null,null,"$5 copay\n$45 copay\n$95 copay"]
["Prosthodontics",null,"Crown – porcelain fused to high noble metal; full cast high noble metal\nComplete denture – maxillary\nMaxillary partial denture – resin base",null,null,null,"$355 copay\n$285 copay\n$245 copay"]
["Orthodontics",null,"Child\nAdult",null,null,null,"$1,900 copay\n$2,100 copay"]
[]
[]
[]
["Vision - Vision Service Plan",null,"In Network","Out of Network",null,"Frequency"]
["Annual Copayment",null,"$10 exam/$25 prescription glasses"]
["Eye Exam",null,"Covered after copayment","Reimbursed up to $45",null,"Eye Exam",null,"12 months"]
["Single-vision Lenses",null,"Covered in full","Reimbursed up to $30",null,"Lenses",null,"12 months"]
["Bifocal Lenses",null,"Covered in full","Reimbursed up to $50"]
["Trifocal Lenses",null,"Covered in full","Reimbursed up to $65"]
["Frames",null,"$150 allowance","Reimbursed up to $70",null,"Frames",null,"24 months"]
["Contact Lenses",null,"$150 allowance","Reimbursed up to $105",null,"Contact Lenses \n(in lieu of lenses and a frame)",null,"12 months"]
[]
["Contact your benefits representative should you have any questions."]
["*Enter your contact information here*"]

{"sheet":"CoPower ONE PPO (Voluntary)","index":5,"n_rows":54,"n_cols":20,"rows_kept":54,"cut":false,"hidden":false,"merged":[[1,15,1,17],[19,1,19,2],[7,4,7,5],[8,4,8,5],[7,1,7,2],[6,1,6,2],[18,1,18,4],[6,4,6,5],[16,0,16,7],[12,0,13,3],[5,1,5,2],[21,0,21,1],[22,0,23,1],[23,18,23,19],[24,0,24,1],[24,2,24,3],[24,4,24,5],[24,6,24,7],[24,18,24,19],[21,2,21,7],[22,2,22,5],[22,6,22,7],[23,2,23,3],[23,4,23,5],[23,6,23,7],[25,4,25,5],[25,6,25,7],[25,18,25,19],[26,0,26,1],[26,2,26,3],[26,4,26,5],[26,6,26,7],[26,18,26,19],[33,0,33,1],[34,0,34,1],[35,0,35,1],[38,0,38,1],[38,2,38,3],[29,2,29,3],[31,0,31,1],[31,2,31,3],[25,0,25,1],[25,2,25,3],[29,0,29,1],[30,0,30,1],[37,4,39,4],[46,0,46,1],[43,3,43,4],[44,5,44,7],[44,2,44,4],[46,7,48,7],[47,0,47,1],[48,0,48,1],[39,0,39,1],[39,2,39,3],[41,0,41,7],[43,0,43,1],[44,0,44,1],[45,0,45,1],[43,5,43,7],[61,8,61,9],[4,1,4,3],[1,7,3,9],[32,0,32,1],[36,0,37,1],[36,2,36,3],[37,2,37,3],[35,4,36,4],[8,1,8,2],[55,8,55,9],[56,8,56,9],[57,8,57,9],[58,8,58,9],[59,8,59,9],[60,8,60,9],[49,0,49,1],[49,5,49,6],[45,3,45,4],[46,3,46,4],[47,3,47,4],[48,3,48,4],[49,3,49,4],[45,5,45,6],[46,5,48,6],[50,0,50,1],[50,5,50,6],[52,0,52,7],[53,0,53,7],[50,3,50,4]]}
["Available for groups with 5-99 enrolling employees. "]
["This Employee Cost Worksheet is for Voluntary CoPower ONE PPO Plans.",null,null,null,{"$f":"IF(B8=\"Enter your Contribution %\",0,1-B8)","v":0},{"$f":"IF(B7=\"weekly\",\"52\",IF(B7=\"Biweekly\",\"26\",IF(B7=\"2x Monthly\",\"24\",IF(B7=\"Monthly\",\"12\",0))))","v":0},null,{"$f":"IF(J8=\"Yes\",,\"Must have a minimum of 5 enrolled for CoPower ONE PPO Voluntary plans\")","v":"Must have a minimum of 5 enrolled for CoPower ONE PPO Voluntary plans"},null,null,null,null,null,null,null,"Cost Comparison"]
["Rates valid for groups with renewal dates 1/1/19 through 12/31/19.",null,null,null,{"$f":"IF(B9=\"Enter your Contribution %\",0,1-B9)","v":0},null,null,null,null,null,null,null,null,null,null,null,{"$f":"SUM(CPPPO_EECheck)","v":0},"With Ortho",null,"W/O Ortho"]
[]
["Plan Type","Select your Voluntary PPO plan type",null,null,null,null,null,null,{"$f":"IF(GroupSize>4,5,\"2-4\")","v":"2-4"}]
["Eligible Employees","Enter Number of Employees",null,null,null,null,"Enrolling Employees"]
["Payroll Frequency","Select your payroll frequency",null,null,"Number of Single",null,0,null,{"$f":"SUM(G7+G8+G9)","v":0},{"$f":"IF(SUM(I7)>1,\"Yes\",\"No\")","v":"No"},null,null,null,null,null,"Single",null,60,null,60]
["ER Contribution % (Employee)","Enter your Contribution %",null,null,"Number of Two Party",null,0,null,{"$f":"SUM(G7+G8+G9)","v":0},{"$f":"IF(AND(SUM(I8)>4,PPOVOL_EligibleEEs>4),\"Yes\",\"No\")","v":"No"},null,null,null,null,null,"Two Party",null,123,null,112]
["ER Contribution % (Dependent)","Enter your Contribution %",null,null,"Number of Three Party+",null,0,{"$f":"G9+G8+EECount_PPO_Single","v":0},null,null,null,null,null,null,null,"Three Party+",null,188,null,172]
[null,null,null,null,null,0]
[null,null,null,null,null,0]
[]
[{"$f":"IF(PPOVOL_EligibleEEs=\"Enter Number of Employees\",\"\",IF(H9>PPOVOL_EligibleEEs,\"Enrolling Employees are greater than Eligible Employees\",IF(H9<(0.75*PPOVOL_EligibleEEs),\"At least 75 % participation required for CoPower ONE Voluntary PPO plans. \nPlease change the number of eligible or enrolling employees.\",\"\")))","v":""}]
[]
[]
[{"$f":"IF(OR(A13=\"At least 75 % participation required for CoPower One Voluntary PPO Plans. \nPlease change the number of eligible or enrolling employees.\",A13=\"Enrolling Employees are greater than Eligible Employees\"),1,\"\")","v":""}]
["CoPower ONE Employee Contribution Worksheet"]
[]
["Company Name:"]
["Effective Date:","Select your effective date"]
[]
["Costs",null,"CoPower ONE Voluntary PPO"]
[null,null,{"$f":"IF(B7=\"Select your payroll frequency\",\"Select your Payroll Frequency\",IF(B7=\"Weekly\",\"Per Weekly Pay Period\",IF(B7=\"Biweekly\",\"Per Biweekly Pay Period\",IF(B7=\"2x Monthly\",\"Per Pay Period (Twice a Month)\",IF(B7=\"Monthly\",\"Per Monthly Pay Period\",\"\")))))","v":"Select your Payroll Frequency"},null,null,null,"Monthly Premium"]
[null,null,"Employee Portion",null,"Employer Portion",null,null,null,null,null,null,null,null,null,null,"Annual Dependent Cost","Annual Premium",null,"Total"]
["Employee Only",null,{"$f":"IF(OR(B8=\"Enter your Contribution %\",B7=\"Select your payroll frequency\",B9=\"Enter your Contribution %\"),0,ROUND((Q25/F2)*$E$2,2))","v":0},null,{"$f":"IF(OR(B8=\"Enter your Contribution %\",B7=\"Select your payroll frequency\",B9=\"Enter your Contribution %\"),0,ROUND((Q25/F2)*B8,2))","v":0},null,{"$f":"IF(OR($B$5=\"Select your Voluntary PPO plan type\",$I$5=\"2-4\",A16=1),0,IF($B$5=\"CoPower ONE Voluntary (With Ortho)\",R7,IF($B$5=\"CoPower ONE Voluntary (Without Ortho)\",T7,0)))","v":0},null,null,null,null,null,null,null,null,null,{"$f":"G25*12","v":0},null,{"$f":"IF(F2=0,0,ROUND(((Q25/F2)),2))","v":0}]
["Employee+1",null,{"$f":"IF(OR(B7=\"Select your payroll frequency\",B8=\"Enter your Contribution %\",B9=\"Enter your Contribution %\"),0,ROUND($C$25+((P26/F2)*$E$3),2))","v":0},null,{"$f":"IF(OR(B8=\"Enter your Contribution %\",B9=\"Enter your Contribution %\",B7=\"Select your payroll frequency\"),0,ROUND(E25+((P26/F2)*B9),2))","v":0},null,{"$f":"IF(OR($B$5=\"Select your Voluntary PPO plan type\",$I$5=\"2-4\",A16=1),0,IF($B$5=\"CoPower ONE Voluntary (With Ortho)\",R8,IF($B$5=\"CoPower ONE Voluntary (Without Ortho)\",T8,0)))","v":0},null,null,null,null,null,null,null,null,{"$f":"Q26-Q25","v":0},{"$f":"G26*12","v":0},null,{"$f":"IF(F2=0,0,ROUND(((Q26/F2)),2))","v":0}]
["Employee+2 or more",null,{"$f":"IF(OR(B7=\"Select your payroll frequency\",B8=\"Enter your Contribution %\",B9=\"Enter your Contribution %\"),0,ROUND($C$25+((P27/F2)*$E$3),2))","v":0},null,{"$f":"IF(OR(B8=\"Enter your Contribution %\",B9=\"Enter your Contribution %\",B7=\"Select your payroll frequency\"),0,ROUND(E25+((P27/F2)*B9),2))","v":0},null,{"$f":"IF(OR($B$5=\"Select your Voluntary PPO plan type\",$I$5=\"2-4\",A16=1),0,IF($B$5=\"CoPower ONE Voluntary (With Ortho)\",R9,IF($B$5=\"CoPower ONE Voluntary (Without Ortho)\",T9,0)))","v":0},null,null,null,null,null,null,null,null,{"$f":"Q27-Q25","v":0},{"$f":"G27*12","v":0},null,{"$f":"IF(F2=0,0,ROUND(((Q27/F2)),2))","v":0}]
[]
[]
["Benefits",null,"CoPower ONE Voluntary PPO"]
[null,null,"PPO Dentists","Non-PPO Dentists"]
["Dental - Delta Dental",null,"Delta Dental PPO*"]
["Calendar Year Max (per patient)",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"$1,500\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"$1,250\")","v":0}]
["Calendar Year Deductible (per patient)",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"$50\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"$75\")","v":0}]
["Deductible Waived for Diagnostic & Preventive",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Yes\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"No\")","v":0}]
["Diagnostic and\nPreventive Services",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"100%\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"80%\")","v":0},"First 12 Months"]
["Basic, Oral Surgery, \nEndodontics and Periodontics",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Sealants, Simple Restorations, & Simple Extractions: 80%\")","v":0}]
[null,null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Oral Surgery/Endodontics/Periodontics: 50%\")","v":0},null,"Second 12 Months"]
["Major Services",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"50%\")","v":0},{"$f":"IF($B$5=\"Select your PPO plan type\",0,\"$50\")","v":"$50"}]
["Orthodontics-Children Only\n(Available to groups 5+ enrolled)",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,IF($B$5=\"CoPower ONE Voluntary (Without Ortho)\",\"Not available\",\"50% lifetime max $1,000\"))","v":0},{"$f":"IF($B$5=\"Select your PPO plan type\",0,IF($B$5=\"CoPower ONE Good\",\"50%\",\"80%\"))","v":"80%"}]
[]
["*Delta Dental PPO: All dentists (in- and out-of-network) are reimbursed at the lesser of the submitted charge or the PPO provider allowed fee."]
[]
["Vision - Vision Service Plan",null,"In Network","Out of Network",null,"Frequency"]
["Annual Copayment",null,{"$f":"IF(B5=\"Select your Voluntary PPO plan type\",0,\"$10 exam/$25 prescription glasses\")","v":0}]
["Eye Exam",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Covered after copayment\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Reimbursed up to $45\")","v":0},null,"Eye Exam",null,{"$f":"IF(B5=\"Select your Voluntary PPO plan type\",0,\"12 months\")","v":0}]
["Single-vision Lenses",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Reimbursed up to $30\")","v":0},null,"Lenses",null,{"$f":"IF(B5=\"Select your Voluntary PPO plan type\",0,\"12 months\")","v":0}]
["Bifocal Lenses",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Reimbursed up to $50\")","v":0}]
["Trifocal Lenses",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Covered in full\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Reimbursed up to $65\")","v":0}]
["Frames",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"$150 allowance\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Reimbursed up to $70\")","v":0},null,"Frames",null,{"$f":"IF(B5=\"Select your Voluntary PPO plan type\",0,\"24 months\")","v":0}]
["Contact Lenses",null,{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"$150 allowance\")","v":0},{"$f":"IF($B$5=\"Select your Voluntary PPO plan type\",0,\"Reimbursed up to $105\")","v":0},null,"Contact Lenses \n(in lieu of lenses and a frame)",null,{"$f":"IF(B5=\"Select your Voluntary PPO plan type\",0,\"12 months\")","v":0}]
[]
["Contact your benefits representative should you have any questions."]
["*Enter your contact information here*"]

{"sheet":"Lists","index":6,"n_rows":123,"n_cols":16,"rows_kept":123,"cut":false,"hidden":true,"merged":[[97,4,97,6],[97,7,97,9],[97,10,97,12],[92,4,92,6],[92,7,92,9],[92,10,92,12],[0,10,0,12],[92,13,92,15],[0,4,0,6],[0,7,0,9],[0,13,0,15]]}
["List_Area_PPO","List_SIC",null,"List_RateTable_PPO","GOOD",null,null,"BETTER",null,null,"BETTER PLUS",null,null,"BEST"]
["Select your CA PPO Region","Select your SIC Level",null,"Region 21Standard Life Amount5",46,85,128,57,108,178,63,118,197,78,146,239]
["Region 1",1,null,"Region 22Standard Life Amount5",53,98,148,66,124,205,72,138,231,90,169,278]
["Region 2",2,null,"Region 11Standard Life Amount5",45,80,121,56,101,168,63,113,188,76,138,228]
[null,null,null,"Region 12Standard Life Amount5",52,93,141,65,118,195,71,131,220,88,161,264]
[]
[null,null,null,"Region 21Enhanced Life $50,0005",{"$f":"SUM(E2+$E$94)","v":55.8},94.8,137.80000000000001,{"$f":"SUM(H2+$H$94)","v":65.400000000000006},116.4,186.4,{"$f":"SUM(K2+$H$94)","v":71.400000000000006},126.4,205.4,{"$f":"SUM(N2+$K$94)","v":85},153,246]
[null,null,null,"Region 22Enhanced Life $50,0005",62.8,107.8,157.80000000000001,74.400000000000006,132.4,213.4,80.400000000000006,146.4,239.4,97,176,285]
[null,null,null,"Region 11Enhanced Life $50,0005",54.8,89.8,130.80000000000001,64.400000000000006,109.4,176.4,71.400000000000006,121.4,196.4,83,145,235]
[null,null,null,"Region 12Enhanced Life $50,0005",61.8,102.8,150.80000000000001,73.400000000000006,126.4,203.4,79.400000000000006,139.4,228.4,95,168,271]
[]
["List_EffDate","List_LifeAmounts",null,"Region 21Enhanced Life $100,0005",{"$f":"SUM(E2+$E$95)","v":69.8},108.8,151.80000000000001,{"$f":"SUM(H2+$H$95)","v":79.400000000000006},130.4,200.4,{"$f":"SUM(K2+$H$95)","v":85.4},140.4,219.4,{"$f":"SUM(N2+$K$95)","v":99},167,260]
["Select your effective date","Standard Life Amount",null,"Region 22Enhanced Life $100,0005",76.8,121.8,171.8,88.4,146.4,227.4,94.4,160.4,253.4,111,190,299]
["1/1/19","Enhanced Life $50,000",null,"Region 11Enhanced Life $100,0005",68.8,103.8,144.80000000000001,78.400000000000006,123.4,190.4,85.4,135.4,210.4,97,159,249]
["2/1/19","Enhanced Life $100,000",null,"Region 12Enhanced Life $100,0005",75.8,116.8,164.8,87.4,140.4,217.4,93.4,153.4,242.4,109,182,285]
["3/1/19","Enhanced Life $150,000"]
["4/1/19",null,null,"Region 21Enhanced Life $150,0005",{"$f":"SUM(E2+$E$96)","v":83.8},122.8,165.8,{"$f":"SUM(H2+$H$96)","v":93.4},144.4,214.4,{"$f":"SUM(K2+$H$96)","v":99.4},154.4,233.4,{"$f":"SUM(N2+$K$96)","v":113},181,274]
["5/1/19",null,null,"Region 22Enhanced Life $150,0005",90.8,135.80000000000001,185.8,102.4,160.4,241.4,108.4,174.4,267.39999999999998,125,204,313]
["6/1/19",null,null,"Region 11Enhanced Life $150,0005",82.8,117.8,158.80000000000001,92.4,137.4,204.4,99.4,149.4,224.4,111,173,263]
["7/1/19",null,null,"Region 12Enhanced Life $150,0005",89.8,130.80000000000001,178.8,101.4,154.4,231.4,107.4,167.4,256.39999999999998,123,196,299]
["8/1/19"]
["9/1/19",null,null,"Region 21Standard Life Amount2-4",49,91,137,0,0,0,0,0,0,0,0,0]
["10/1/19",null,null,"Region 22Standard Life Amount2-4",57,106,160,0,0,0,0,0,0,0,0,0]
["11/1/19",null,null,"Region 11Standard Life Amount2-4",49,86,131,0,0,0,0,0,0,0,0,0]
["12/1/19",null,null,"Region 12Standard Life Amount2-4",57,101,153,0,0,0,0,0,0,0,0,0]
[]
[null,null,null,"Region 21Enhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 22Enhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
["List_Area_HMO","List_EligibleEEs",null,"Region 11Enhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
["Select your CA DHMO Region","Select your group size",null,"Region 12Enhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
["Region 1 & 2","2-9 Employees"]
["Region 3","10-50 Employees",null,"Region 21Enhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
["Region 4","51-99 Employees",null,"Region 22Enhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
["Region 5",null,null,"Region 11Enhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 12Enhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[]
[null,null,null,"Region 21Enhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 22Enhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 11Enhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 12Enhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[]
[]
[]
[]
[]
["Payroll_Frequency","Plan_Name (HMO)"]
["Select your payroll frequency","Select your HMO plan type",null,"Select your CA PPO RegionSelect your SIC LevelStandard Life Amount5",0,0,0,0,0,0,0,0,0,0,0,0]
["Weekly","CoPower ONE Good",null,"Select your CA PPO Region1Standard Life Amount5",0,0,0,0,0,0,0,0,0,0,0,0]
["Biweekly","CoPower ONE Better",null,"Select your CA PPO Region2Standard Life Amount5",0,0,0,0,0,0,0,0,0,0,0,0]
["2x Monthly","CoPower ONE Better Plus",null,"Select your CA PPO RegionSelect your SIC LevelEnhanced Life $50,0005",0,0,0,0,0,0,0,0,0,0,0,0]
["Monthly","CoPower ONE Best",null,"Select your CA PPO Region1Enhanced Life $50,0005",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO Region2Enhanced Life $50,0005",0,0,0,0,0,0,0,0,0,0,0,0]
["List_EligibleEEs (Vol)","Plan_Name (PPO)",null,"Select your CA PPO RegionSelect your SIC LevelEnhanced Life $100,0005",0,0,0,0,0,0,0,0,0,0,0,0]
["Select your group size","Select your PPO plan type",null,"Select your CA PPO Region1Enhanced Life $100,0005",0,0,0,0,0,0,0,0,0,0,0,0]
["5-9 Employees","CoPower ONE Good",null,"Select your CA PPO Region2Enhanced Life $100,0005",0,0,0,0,0,0,0,0,0,0,0,0]
["10-99 Employees","CoPower ONE Better",null,"Select your CA PPO RegionSelect your SIC LevelEnhanced Life $150,0005",0,0,0,0,0,0,0,0,0,0,0,0]
[null,"CoPower ONE Better Plus",null,"Select your CA PPO Region1Enhanced Life $150,0005",0,0,0,0,0,0,0,0,0,0,0,0]
[null,"CoPower ONE Best",null,"Select your CA PPO Region2Enhanced Life $150,0005",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,null,0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 2Select your SIC LevelStandard Life Amount5",0,0,0,0,0,0,0,0,0,0,0,0]
["Names (for life amount)","Plan_Name (PPO Voluntary)",null,"Region 2Select your SIC LevelEnhanced Life $50,0005",0,0,0,0,0,0,0,0,0,0,0,0]
["2To9Employees","Select your Voluntary PPO plan type",null,"Region 2Select your SIC LevelEnhanced Life $100,0005",0,0,0,0,0,0,0,0,0,0,0,0]
["10To99Employees","CoPower ONE Voluntary (With Ortho)",null,"Region 2Select your SIC LevelEnhanced Life $150,0005",0,0,0,0,0,0,0,0,0,0,0,0]
[null,"CoPower ONE Voluntary (Without Ortho)",null,null,0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 1Select your SIC LevelStandard Life Amount5",0,0,0,0,0,0,0,0,0,0,0,0]
[null,"Plan_Name (HMO Voluntary)",null,"Region 1Select your SIC LevelEnhanced Life $50,0005",0,0,0,0,0,0,0,0,0,0,0,0]
[null,"Select your Voluntary HMO plan type",null,"Region 1Select your SIC LevelEnhanced Life $100,0005",0,0,0,0,0,0,0,0,0,0,0,0]
[null,"CoPower ONE Good",null,"Region 1Select your SIC LevelEnhanced Life $150,0005",0,0,0,0,0,0,0,0,0,0,0,0]
[null,"CoPower ONE Better"]
[null,"CoPower ONE Better Plus",null,"Select your CA PPO RegionSelect your SIC LevelStandard Life Amount2-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,"CoPower ONE Best",null,"Select your CA PPO Region1Standard Life Amount2-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO Region2Standard Life Amount2-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO RegionSelect your SIC LevelEnhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO Region1Enhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO Region2Enhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO RegionSelect your SIC LevelEnhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO Region1Enhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO Region2Enhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO RegionSelect your SIC LevelEnhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO Region1Enhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA PPO Region2Enhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,null,0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 2Select your SIC LevelStandard Life Amount2-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 2Select your SIC LevelEnhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 2Select your SIC LevelEnhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 2Select your SIC LevelEnhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,null,0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 1Select your SIC LevelStandard Life Amount2-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 1Select your SIC LevelEnhanced Life $50,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 1Select your SIC LevelEnhanced Life $100,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[null,null,null,"Region 1Select your SIC LevelEnhanced Life $150,0002-4",0,0,0,0,0,0,0,0,0,0,0,0]
[]
[null,null,null,"Enhanced Life Rates","GOOD",null,null,"BETTER",null,null,"BEST",null,null,"BETTER PLUS"]
[null,null,null,"$50,000",9.8000000000000007,null,null,8.4,null,null,7,null,null,8.4]
[null,null,null,"$100,000",23.8,null,null,22.4,null,null,21,null,null,22.4]
[null,null,null,"$150,000",37.799999999999997,null,null,36.4,null,null,35,null,null,36.4]
[]
[null,null,null,"List_RateTable_HMO","GOOD (2-99)",null,null,"BETTER (5-99)",null,null,"BEST (5-99)"]
[null,null,null,"Region 1 & 2Standard Life Amount",27,41,59,31,46,66,35,50,73]
[null,null,null,"Region 3Standard Life Amount",29,45,65,33,50,73,37,54,79]
[null,null,null,"Region 4Standard Life Amount",31,47,69,35,52,76,39,57,82]
[null,null,null,"Region 5Standard Life Amount",71,113,166,75,118,173,78,122,179]
[]
[null,null,null,"Region 1 & 2Enhanced Life $50,000",{"$f":"SUM(E99+$E$94)","v":36.799999999999997},{"$f":"SUM(F99+$E$94)","v":50.8},68.8,{"$f":"SUM(H99+$H$94)","v":39.4},54.4,74.400000000000006,{"$f":"SUM(K99+$K$94)","v":42},57,80]
[null,null,null,"Region 3Enhanced Life $50,000",38.799999999999997,54.8,74.8,41.4,58.4,81.400000000000006,44,61,86]
[null,null,null,"Region 4Enhanced Life $50,000",40.799999999999997,56.8,78.8,{"$f":"SUM(H101+$H$94)","v":43.4},60.4,84.4,{"$f":"SUM(K101+$K$94)","v":46},64,89]
[null,null,null,"Region 5Enhanced Life $50,000",80.8,122.8,175.8,{"$f":"SUM(H102+$H$94)","v":83.4},126.4,181.4,85,129,186]
[]
[null,null,null,"Region 1 & 2Enhanced Life $100,000",{"$f":"SUM(E99+$E$95)","v":50.8},64.8,82.8,{"$f":"SUM(H99+$H$95)","v":53.4},68.400000000000006,88.4,{"$f":"SUM(K99+$K$95)","v":56},71,94]
[null,null,null,"Region 3Enhanced Life $100,000",52.8,68.8,88.8,55.4,72.400000000000006,95.4,58,75,100]
[null,null,null,"Region 4Enhanced Life $100,000",54.8,70.8,92.8,57.4,74.400000000000006,98.4,60,78,103]
[null,null,null,"Region 5Enhanced Life $100,000",94.8,136.80000000000001,189.8,97.4,140.4,195.4,99,143,200]
[]
[null,null,null,"Region 1 & 2Enhanced Life $150,000",{"$f":"SUM(E99+$E$96)","v":64.8},78.8,96.8,{"$f":"SUM(H99+$H$96)","v":67.400000000000006},82.4,102.4,{"$f":"SUM(K99+$K$96)","v":70},85,108]
[null,null,null,"Region 3Enhanced Life $150,000",66.8,82.8,102.8,69.400000000000006,86.4,109.4,72,89,114]
[null,null,null,"Region 4Enhanced Life $150,000",68.8,84.8,106.8,71.400000000000006,88.4,112.4,74,92,117]
[null,null,null,"Region 5Enhanced Life $150,000",108.8,150.80000000000001,203.8,111.4,154.4,209.4,113,157,214]
[]
[]
[null,null,null,"Select your CA DHMO RegionStandard Life Amount",0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA DHMO RegionEnhanced Life $50,000",0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA DHMO RegionEnhanced Life $100,000",0,0,0,0,0,0,0,0,0]
[null,null,null,"Select your CA DHMO RegionEnhanced Life $150,000",0,0,0,0,0,0,0,0,0]