Employee Bi-Weekly Contributions
Medical
Level of Coverage
Medical HDHP
Medical IN
Medical PPO
Employee Only
$62.52
$83.24
$133.19
Employee + Spouse or Domestic Partner
$201.07
$203.89
$290.40
Employee + Child(ren)
$180.86
$184.22
$260.60
Employee + Family
$287.24
$291.27
$414.83
Dental
Level of Coverage
Dental DMHO
Dental Low
Dental High
Employee Only
$6.36
$18.17
$23.19
Employee + One Dependent
$11.86
$35.48
$44.03
Employee + Family
$19.46
$61.56
$79.91
Vision
Level of Coverage
Vision
Employee Only
$2.96
Employee + One Dependent
$5.65
Employee + Family
$9.20
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