| 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 |
$68.06 $135.32 |
$331.80 $983.94 |
$399.86 $1,119.26 |
$1,769.56 $3,518.32 |
$8,626.80 $25,582.44 |
$1,124.76 $2,249.52 |
| CDHP 1 w/ Non-Tobacco Use Incentive | Single Family |
$33.06 $100.32 |
$331.80 $983.94 |
$364.86 $1,084.26 |
$859.56 $2,608.32 |
$8,626.80 $25,582.44 |
$1,124.76 $2,249.52 |
| CDHP 2 | Single Family |
$82.58 $188.66 |
$344.76 $1,009.86 |
$427.34 $1,198.52 |
$2,147.08 $4,905.16 |
$8,963.76 $26,256.36 |
$787.80 $1,575.60 |
| CDHP 2 w/ Non-Tobacco Use Incentive | Single Family |
$47.58 $153.66 |
$344.76 $1,009.86 |
$392.34 $1,163.52 |
$1,237.08 $3,995.16 |
$8,963.76 $26,256.36 |
$787.80 $1,575.60 |
| Traditional | Single Family |
$141.02 $399.08 |
$375.06 $1,070.46 |
$516.08 $1,469.54 |
$3,666.52 $10,376.08 |
$9,751.56 $27,831.96 |
$0.00 $0.00 |
| Traditional w/ Non-Tobacco Use Incentive | Single Family |
$106.02 $364.08 |
$375.06 $1,070.46 |
$481.08 $1,434.54 |
$2,756.52 $9,466.08 |
$9,751.56 $27,831.96 |
$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 |
*Initial contribution as listed above applies to employees with a CDHP effective between January 1, 2027 through June 1, 2027, and with an open HSA. CDHPs effective after June 1, 2027 but before December 1, 2027, and with an open HSA will receive half of the initial contribution.
Spousal Surcharge: Employees who enroll a spouse in the State’s medical plan will be charged a spousal surcharge of $125 per pay period if that spouse has access to health insurance through their own employer but chooses not to enroll in that coverage. The surcharge will be applied automatically unless the employee submits a Request for Waiver and the waiver is approved.
