Header

  Close Menu

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
$68.84
$138.80
$230.16
$690.18
$299.00
$828.98
$1,789.84
$3,608.80
$5,984.16
$17,944.68
$1,124.76
$2,249.52
CDHP 1 w/ Non-Tobacco Use Incentive Single
Family
$33.84
$103.80
$230.16
$690.18
$264.00
$793.98
$879.84
$2,698.80
$5,984.16
$17,944.68
$1,124.76
$2,249.52
CDHP 2 Single
Family
$81.90
$186.54
$243.12
$716.10
$325.02
$902.64
$2,129.40
$4,850.04
$6,321.12
$18,618.60
$787.80
$1,575.60
CDHP 2 w/ Non-Tobacco Use Incentive Single
Family
$46.90
$151.54
$243.12
$716.10
$290.02
$867.64
$1,219.40
$3,940.04
$6,321.12
$18,618.60
$787.80
$1,575.60
Traditional Single
Family
$134.40
$374.64
$273.42
$776.70
$407.82
$1,151.34
$3,494.40
$9,740.64
$7,108.92
$20,194.20
$0.00
$0.00
Traditional w/ Non-Tobacco Use Incentive Single
Family
$99.40
$339.64
$273.42
$776.70
$372.82
$1,116.34
$2,584.40
$8,830.64
$7,108.92
$20,194.20
$0.00
$0.00
Wellness Incentive Rates       
CDHP 1 Single
Family
$54.44
$95.60
$230.16
$690.18
$284.60
$785.78
$1,415.44
$2,485.60
$5,984.16
$17,944.68
$1,124.76
$2,249.52
CDHP 1 w/ Non-Tobacco Use Incentive Single
Family
$19.44
$60.60
$230.16
$690.18
$249.60
$750.78
$505.44
$1,575.60
$5,984.16
$17,944.68
$1,124.76
$2,249.52
CDHP 2 Single
Family
$67.50
$143.34
$243.12
$716.10
$310.62
$859.44
$1,755.00
$3,726.84
$6,321.12
$18,618.60
$787.80
$1,575.60
CDHP 2 w/ Non-Tobacco Use Incentive Single
Family
$32.50
$108.34
$243.12
$716.10
$275.62
$824.44
$845.00
$2,816.84
$6,321.12
$18,618.60
$787.80
$1,575.60
Traditional Single
Family
$120.00
$331.44
$273.42
$776.70
$393.42
$1,108.14
$3,120.00
$8,617.44
$7,108.92
$20,194.20
$0.00
$0.00
Traditional w/ Non-Tobacco Use Incentive Single
Family
$85.00
$296.44
$273.42
$776.70
$358.42
$1,073.14
$2,210.00
$7,707.44
$7,108.92
$20,194.20
$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
$0.42
$3.06
$1.74
$2.22
$2.16
$5.28
$10.92
$79.56
$45.24
$57.72
$0.00
$0.00