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Indiana State Personnel Department

SPD > Benefits > Open Enrollment > 2015 Rates 2015 Rates

Plan Coverage Bi-Weekly Employee Rate Bi-Weekly Employer Rate Bi-Weekly Total Rate Annual Employee Rate Annual Employer Rate
Wellness Single
Family
$45.98
$70.04
$174.30
$530.04
$220.28
$600.08
$1,195.48
$1,821.04
$4,531.80
$13,781.04
Wellness w/ Non-Tobacco Use Single
Family
$10.98
$35.04
$174.30
$530.04
$185.28
$565.08
$285.48
$911.04
$4,531.80
$13,781.04
CDHP 1 Single
Family
$53.12
$92.84
$183.90
$549.24
$237.02
$642.08
$1,381.12
$2,413.84
$4,781.40
$14,280.24
CDHP 1 w/ Non-Tobacco Use Single
Family
$18.12
$57.84
$183.90
$549.24
$202.02
$607.08
$471.12
$1,503.84
$4,781.40
$14,280.24
CDHP 2 Single
Family
$112.16
$256.58
$199.38
$580.20
$311.54
$836.78
$2,916.16
$6,671.08
$5,183.88
$15,085.20
CDHP 2 Single
Family
$77.16
$221.58
$199.38
$580.20
$276.54
$801.78
$2,006.16
$5,761.08
$5,183.88
$15,085.20
Trad PPO Single
Family
$260.78
$667.88
$222.42
$626.28
$483.20
$1,294.16
$6,780.28
$17,364.88
$5,782.92
$16,283.28
Trad PPO Single
Family
$225.78
$632.88
$222.42
$626.28
$448.20
$1,259.16
$5,870.28
$16,454.88
$5,782.92
$16,283.28
Dental Single
Family
$1.20
$3.16
$10.02
$26.36
$11.22
$29.52
$31.20
$82.16
$260.52
$685.36
Vision Single
Family
$0.17
$2.52
$1.47
$1.64
$1.64
$4.16
$4.42
$65.52
$38.22
$42.64
Flexible Spending Accounts Medical Limited Purpose
Medical (HSA Holders) and/or
Dependent Care Admin Fee
$1.62 $0.00 $1.62 $42.12 $0.00

To view complete rate chart that includes rates for  early retirees, COBRA and the annual total rates: VIEW 2015 Benefits Rates Chart