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Health Plan Rates

PlanCoverage Bi-Weekly Employee Rate Bi-Weekly Employer Rate Bi-Weekly Total Rate Annual Employee Rate Annual Employer Rate Annual Employer HSA Contribution
CDHP 1 Single
Family
$71.00
$143.90
$243.12
$727.02
$314.12
$870.92
$1,846.00
$3,741.40
$6,321.12
$18,902.52
$1,124.76
$2,249.52
CDHP 1 w/ Non-Tobacco Use Incentive Single
Family
$36.00
$108.90
$243.12
$727.02
$279.12
$835.92
$936.00
$2,831.40
$6,321.12
$18,902.52
$1,124.76
$2,249.52
CDHP 2 Single
Family
$84.44
$193.40
$256.08
$752.94
$340.52
$946.34
$2,195.44
$5,028.40
$6,658.08
$19,576.44
$787.80
$1,575.60
CDHP 2 w/ Non-Tobacco Use Incentive Single
Family
$49.44
$158.40
$256.08
$752.94
$305.52
$911.34
$1,285.44
$4,118.40
$6,658.08
$19,576.44
$787.80
$1,575.60
Traditional Single
Family
$138.62
$388.40
$286.38
$813.54
$425.00
$1,201.94
$3,604.12
$10,098.40
$7,445.88
$21,152.04
$0.00
$0.00
Traditional w/ Non-Tobacco Use Incentive Single
Family
$103.62
$353.40
$286.38
$813.54
$390.00
$1,166.94
$2,694.12
$9,188.40
$7,445.88
$21,152.04
$0.00
$0.00
Wellness Incentive Rates
CDHP 1 Single
Family
$56.60
$100.70
$243.12
$727.02
$299.72
$827.72
$1,471.60
$2,618.20
$6,321.12
$18,902.52
$1,124.76
$2,249.52
CDHP 1 w/ Non-Tobacco Use Incentive Single
Family
$21.60
$65.70
$243.12
$727.02
$264.72
$792.72
$561.60
$1,708.20
$6,321.12
$18,902.52
$1,124.76
$2,249.52
CDHP 2 Single
Family
$70.04
$150.20
$256.08
$752.94
$326.12
$903.14
$1,821.04
$3,905.20
$6,658.08
$19,576.44
$787.80
$1,575.60
CDHP 2 w/ Non-Tobacco Use Incentive Single
Family
$35.04
$115.20
$256.08
$752.94
$291.12
$868.14
$911.04
$2,995.20
$6,658.08
$19,576.44
$787.80
$1,575.60
Traditional Single
Family
$124.22
$345.20
$286.38
$813.54
$410.60
$1,158.74
$3,229.72
$8,975.20
$7,445.88
$21,152.04
$0.00
$0.00
Traditional w/ Non-Tobacco Use Incentive Single
Family
$89.22
$310.20
$286.38
$813.54
$375.60
$1,123.74
$2,319.72
$8,065.20
$7,445.88
$21,152.04
$0.00
$0.00
        
Dental Single
Family
$1.32
$3.42
$10.38
$27.30
$11.70
$30.72
$34.32
$88.92
$269.88
$709.80
$0.00
$0.00
Vision Single
Family
$0.48
$3.36
$1.86
$2.40
$2.34
$5.76
$12.48
$87.36
$48.36
$62.40
$0.00
$0.00

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