Centurion Spartan Enrollment : Step 2 SUMMARY FAMILY STATUS PLAN MONTHLY RATE DENTAL PLAN N/A N/A Are you sure you want to opt out of dental? Yes No VISION PLAN N/A N/A Are you sure you want to opt out of vision? Yes No ACCIDENT PLAN N/A N/A Are you sure you want to opt out of accident coverage? Yes No CANCER PLAN N/A N/A Are you sure you want to opt out of cancer coverage? Yes No HOSPITAL PLAN N/A N/A Are you sure you want to opt out of hospital coverage? Yes No LegalShield N/A N/A Are you sure you want to opt out of LegalShield? Yes No MONTHLY SUBTOTAL $0.00 MONTHLY EMPLOYER SUPPLEMENTAL CONTRIBUTION $0.00 EverydayCARE Are you sure you want to opt out of EverydayCARE coverage? Yes No MONTHLY SMOKER ADJUSTMENT $0.00 WEEKLY PAYCHECK DEDUCTION $0.00 NOTE: All Yes/No questions in red above required to continue
