| 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 |
$295.86 $879.60 |
$363.92 $1,014.92 |
$1,769.56 $3,518.32 |
$7,692.36 $22,869.60 |
$1,124.76 $2,249.52 |
| CDHP 1 w/ Non-Tobacco Use Incentive |
Single Family |
$33.06 $100.32 |
$295.86 $879.60 |
$328.92 $979.92 |
$859.56 $2,608.32 |
$7,692.36 $22,869.60 |
$1,124.76 $2,249.52 |
| CDHP 2 |
Single Family |
$82.58 $188.66 |
$308.82 $905.52 |
$391.40 $1,094.18 |
$2,147.08 $4,905.16 |
$8,029.32 $23,543.52 |
$787.80 $1,575.60 |
| CDHP 2 w/ Non-Tobacco Use Incentive |
Single Family |
$47.58 $153.66 |
$308.82 $905.52 |
$356.40 $1,059.18 |
$1,237.08 $3,995.16 |
$8,029.32 $23,543.52 |
$787.80 $1,575.60 |
| Traditional |
Single Family |
$141.02 $399.08 |
$339.12 $966.12 |
$480.14 $1,365.20 |
$3,666.52 $10,376.08 |
$8,817.12 $25,119.12 |
$0.00 $0.00 |
| Traditional w/ Non-Tobacco Use Incentive |
Single Family |
$106.02 $364.08 |
$339.12 $966.12 |
$445.14 $1,330.20 |
$2,756.52 $9,466.08 |
$8,817.12 $25,119.12 |
$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 |