Health Plan Rates
| Plan | Coverage | 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 |
