Choice Fund HRA Plan
Choice Fund HSA Plan
Don't Use Tobacco
Uses Tobacco
Don't Use Tobacco
Uses Tobacco
Years of Service & Coverage Level
Your Contribution
MAA Contribution
Your Contribution
MAA Contribution
Your Contribution
MAA Contribution
Your Contribution
MAA Contribution
8-9 Years of Service: Employee Only
$84.35 $287.87 $109.35 $262.87 $43.93 $299.35 $68.93 $274.35 Employee + Spouse $266.43 $478.01 $291.43 $453.01 $188.66 $497.91 $213.66 $472.91 Employee + Child(ren) $167.10 $502.90 $192.10 $477.90 $116.51 $501.39 $141.51 $476.39 Employee + Family $333.10 $783.56 $358.10 $758.56 $246.90 $782.95 $271.90 $757.95 10-14 Years of Service: Employee Only $81.85 $290.37 $106.85 $265.37 $41.43 $301.85 $66.43 $276.85 Employee + Spouse $263.93 $480.51 $288.93 $455.51 $186.16 $500.41 $211.16 $475.41 Employee + Child(ren) $164.60 $505.40 $189.60 $480.40 $114.01 $503.89 $139.01 $478.89 Employee + Family $330.60 $786.06 $355.60 $761.06 $244.40 $785.45 $269.40 $760.45 15-19 Years of Service: Employee Only $76.85 $295.37 $101.85 $270.37 $36.43 $306.85 $61.43 $281.85 Employee + Spouse $258.93 $485.51 $283.93 $460.51 $181.16 $505.41 $206.16 $480.41 Employee + Child(ren) $159.60 $510.40 $184.60 $485.40 $109.01 $508.89 $134.01 $483.89 Employee + Family $325.60 $791.06 $350.60 $766.06 $239.40 $790.45 $264.40 $765.45 20-24 Years of Service: Employee Only $71.85 $300.37 $96.85 $275.37 $31.43 $311.85 $56.43 $286.85 Employee + Spouse $253.93 $490.51 $278.93 $465.51 $176.16 $510.41 $201.16 $485.41 Employee + Child(ren) $154.60 $515.40 $179.60 $490.40 $104.01 $513.89 $129.01 $488.89 Employee + Family $320.60 $796.06 $345.60 $771.06 $234.40 $795.45 $259.40 $770.45 25-29 Years of Service: Employee Only $66.85 $305.37 $91.85 $280.37 $26.43 $316.85 $51.43 $291.85 Employee + Spouse $248.93 $495.51 $273.93 $470.51 $171.16 $515.41 $196.16 $490.41 Employee + Child(ren) $149.60 $520.40 $174.60 $495.40 $99.01 $518.89 $124.01 $493.89 Employee + Family $315.60 $801.06 $340.60 $776.06 $229.40 $800.45 $254.40 $775.45 30-34 Years of Service: Employee Only $61.85 $310.37 $86.85 $285.37 $21.43 $321.85 $46.43 $296.85 Employee + Spouse $243.93 $500.51 $268.93 $475.51 $166.16 $520.41 $191.16 $495.41 Employee + Child(ren) $144.60 $525.40 $169.60 $500.40 $94.01 $523.89 $119.01 $498.89 Employee + Family $310.60 $806.06 $335.60 $781.06 $224.40 $805.45 $249.40 $780.45 35-39 Years of Service: Employee Only $56.85 $315.37 $81.85 $290.37 $16.43 $326.85 $41.43 $301.85 Employee + Spouse $238.93 $505.51 $263.93 $480.51 $161.16 $525.41 $186.16 $500.41 Employee + Child(ren) $139.60 $530.40 $164.60 $505.40 $89.01 $528.89 $114.01 $503.89 Employee + Family $305.60 $811.06 $330.60 $786.06 $219.40 $810.45 $244.40 $785.45 40+ Years of Service: Employee Only $51.85 $320.37 $76.85 $295.37 $11.43 $331.85 $36.43 $306.85 Employee + Spouse $233.93 $510.51 $258.93 $485.51 $156.16 $530.41 $181.16 $505.41 Employee + Child(ren) $134.60 $535.40 $159.60 $510.40 $84.01 $533.89 $109.01 $508.89 Employee + Family $300.60 $816.06 $325.60 $791.06 $214.40 $815.45 $239.40 $790.45
24
Made with FlippingBook. PDF to flipbook with ease