2017 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 Total Annual Employer Contribution Annual Total Rate
Wellness Single
Family
$50.30
$83.84
$195.48
$591.36
$245.78
$675.20
$1,307.80
$2,179.84
$5,082.48
$15,375.36
$1,251.12
$2,502.24
$6,333.60
$17,877.60
$7,641.40
$20,057.44
Wellness w/ Non-Tobacco Use Single
Family
$15.30
$48.84
$195.48
$591.36
$210.78
$640.20
$397.80
$1,269.84
$5,082.48
$15,375.36
$1,251.12
$2,502.24
$6,333.60
$17,877.60
$6,731.40
$19,147.44
CDHP 1 Single
Family
$64.10
$124.16
$205.08
$610.56
$269.18
$734.72
$1,666.60
$3,228.16
$5,332.08
$15,874.56
$1,001.52
$2,003.04
$6,333.60
$17,877.60
$8,000.20
$21,105.76
CDHP 1 w/ Non-Tobacco Use Single
Family
$29.10
$89.16
$205.08
$610.56
$234.18
$699.72
$756.60
$2,318.16
$5,332.08
$15,874.56
$1,001.52
$2,003.04
$6,333.60
$17,877.60
$7,090.20
$20,195.76
CDHP 2 Single
Family
$148.64
$364.46
$220.56
$641.52
$369.20
$1,005.98
$3,864.64
$9,475.96
$5,734.56
$16,679.52
$599.04
$1,198.08
$6,333.60
$17,877.60
$10,198.24
$27,353.56
CDHP 2 w/ Non-Tobacco Use Single
Family
$113.64
$329.46
$220.56
$641.52
$334.20
$970.98
$2,954.64
$8,565.96
$5,734.56
$16,679.52
$599.04
$1,198.08
$6,333.60
$17,877.60
$9,288.24
$26,443.56
Trad PPO Single
Family
$361.34
$964.28
$243.60
$687.60
$604.94
$1,651.88
$9,394.84
$25,071.28
$6,333.60
$17,877.60
$0.00
$0.00
$6,333.60
$17,877.60
$15,728.44
$42,948.88
Trad PPO w/ Non-Tobacco Use Single
Family
$326.34
$929.28
$243.60
$687.60
$569.94
$1,616.88
$8,484.84
$24,161.28
$6,333.60
$17,877.60
$0.00
$0.00
$6,333.60
$17,877.60
$14,818.44
$42,038.88
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
$269.88
$709.80
$304.20
$798.72
Vision Single
Family
$0.17
$2.52
$1.47
$1.64
$1.64
$4.16
$4.42
$65.52
$38.22
$42.64
$0.00
$0.00
$38.22
$42.64
$42.64
$108.16
Flexible Spending Accounts Medical Limited Purpose
Medical (HSA Holders) and/or
Dependent Care Admin Fee
$0.00 1.62 $1.62 $0.00 $42.12 $0.00 $42.12 $42.12

To view complete rate chart that includes rates for early retirees, COBRA and the annual total rates: View 2017 Benefits Rates Chart