| 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 |
$65.66 $127.94 |
$274.02 $814.74 |
$339.68 $942.68 |
$1,707.16 $3,326.44 |
$7,124.52 $21,183.24 |
$1,124.76 $2,249.52 |
| CDHP 1 w/ Non-Tobacco Use Incentive |
Single Family |
$30.66 $92.94 |
$274.02 $814.74 |
$304.68 $907.68 |
$797.16 $2,416.44 |
$7,124.52 $21,183.24 |
$1,124.76 $2,249.52 |
| CDHP 2 |
Single Family |
$79.10 $177.44 |
$286.98 $840.66 |
$366.08 $1,018.10 |
$2,056.60 $4,613.44 |
$7,461.48 $21,857.16 |
$787.80 $1,575.60 |
| CDHP 2 w/ Non-Tobacco Use Incentive |
Single Family |
$44.10 $142.44 |
$286.98 $840.66 |
$331.08 $983.10 |
$1,146.60 $3,703.44 |
$7,461.48 $21,857.16 |
$787.80 $1,575.60 |
| Traditional |
Single Family |
$133.28 $372.44 |
$317.28 $901.26 |
$450.56 $1,273.70 |
$3,465.28 $9,683.44 |
$8,249.28 $23,432.76 |
$0.00 $0.00 |
| Traditional w/ Non-Tobacco Use Incentive |
Single Family |
$98.28 $337.44 |
$317.28 $901.26 |
$415.56 $1,238.70 |
$2,555.28 $8,773.44 |
$8,249.28 $23,432.76 |
$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 |