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 | $216.48 $651.30 | $285.32 $790.10 | $1,789.84 $3,608.80 | $5,628.48 $16,933.80 | $1,124.76 $2,249.52 |
| CDHP 1 w/ Non-Tobacco Use Incentive | Single Family | $33.84 $103.80 | $216.48 $651.30 | $250.32 $755.10 | $879.84 $2,698.80 | $5,628.48 $16,933.80 | $1,124.76 $2,249.52 |
| CDHP 2 | Single Family | $81.90 $186.54 | $229.44 $677.22 | $311.34 $863.76 | $2,129.40 $4,850.04 | $5,965.44 $17,607.72 | $787.80 $1,575.60 |
| CDHP 2 w/ Non-Tobacco Use Incentive | Single Family | $46.90 $151.54 | $229.44 $677.22 | $276.34 $828.76 | $1,219.40 $3,940.04 | $5,965.44 $17,607.72 | $787.80 $1,575.60 |
| Traditional | Single Family | $134.40 $374.64 | $259.74 737.82 | $394.14 $1,112.46 | $3,494.40 $9,740.64 | $6,753.24 $19,183.32 | $0.00 $0.00 |
| Traditional w/ Non-Tobacco Use Incentive | Single Family | $99.40 $339.64 | $259.74 737.82 | $359.14 $1,077.46 | $2,584.40 $8,830.64 | $6,753.24 $19,183.32 | $0.00 $0.00 |
| Wellness Incentive Rates | |||||||
| CDHP 1 | Single Family | $54.44 $95.60 | $216.48 $651.30 | $270.92 $746.90 | $1,415.44 $2,485.60 | $5,628.48 $16,933.80 | $1,124.76 $2,249.52 |
| CDHP 1 w/ Non-Tobacco Use Incentive | Single Family | $19.44 $60.60 | $216.48 $651.30 | $235.92 $711.90 | $505.44 $1,575.60 | $5,628.48 $16,933.80 | $1,124.76 $2,249.52 |
| CDHP 2 | Single Family | $67.50 $143.34 | $229.44 $677.22 | $296.94 $820.56 | $1,755.00 $3,726.84 | $5,965.44 $17,607.72 | $787.80 $1,575.60 |
| CDHP 2 w/ Non-Tobacco Use Incentive | Single Family | $32.50 $108.34 | $229.44 $677.22 | $261.94 $785.56 | $845.00 $2,816.84 | $5,965.44 $17,607.72 | $787.80 $1,575.60 |
| Traditional | Single Family | $120.00 $331.44 | $259.74 $737.82 | $379.74 $1,069.26 | $3,120.00 $8,617.44 | $6,753.24 $19,183.32 | $0.00 $0.00 |
| Traditional w/ Non-Tobacco Use Incentive | Single Family | $85.00 $296.44 | $259.74 $737.82 | $344.74 $1,034.26 | $2,210.00 $7,707.44 | $6,753.24 $19,183.32 | $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 |