| 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 |