Bi-Weekly Employee Costs for 2020

Medical, Dental, and Vision plans offered require a contribution from the employees. Employee contributions are taken out of the paycheck automatically on a bi-weekly basis. Below, you can find the employee costs for each of the plans.

Medical, Dental, and Vision

Type of coverage

Single Employee

Employee + Spouse

Employee + Child(ren)

Family

Cigna OAP IN EPO

$50.77

$117.69

$138.46

$230.77

Cigna OAP 500 PPO

$46.15

$106.15

$126.92

$219.23

Cigna OAP 2000 HSA

$6.92
$23.08
$23.08
$69.23

Kaiser

HMO

 $50.77
$117.69
$138.46
$230.77

Dental

$0.00
$6.92
$11.54
$18.46

Vision

$0.00
$1.85
$1.85
$3.69

Voluntary Life/AD&D

Per Paycheck (Bi-Weekly) rates per $1,000 covered earnings.

Age

Under 20

20 - 24

25 - 29

30 - 34

35 - 39

40 - 44

45 - 49

50 - 54

55 - 59

60 - 64

65 - 69

70 - 74

75 - 79

80 +

Employee Rates/

$1,000

$0.030

$0.030

$0.031

$0.038

$0.050

$0.055

$0.078

$0.115

$0.208

$0.283

$0.398

$0.744

$0.960

$0.960

Spouse Rates/

$1,000

$0.030 
$0.030 
$0.031 
$0.038 
$0.050 
$0.055 
$0.078 
$0.115 
$0.208 
$0.283 
$0.398 
$0.744 
$0.960 
$0.960 

Child Voluntary Life & AD&D

Child Voluntary Life & AD&D

Rates/

$1,000

$0.078

As a part of Open Enrollment, you need to select the benefits you would like to have in 2021.