Employee Weekly Contributions
Medical
Level of Coverage
Medical HDHP
Medical IN
Medical PPO
Employee Only
$31.26
$41.62
$66.59
Employee + Spouse or Domestic Partner
$100.53
$101.94
$145.20
Employee + Child(ren)
$90.43
$92.11
$130.30
Employee + Family
$143.62
$145.64
$207.42
Dental
Level of Coverage
Dental DHMO
Dental Low
Dental High
Employee Only
$3.18
$9.09
$11.59
Employee + One Dependent
$5.93
$17.74
$22.02
Employee + Family
$9.73
$30.78
$39.96
Vision
Level of Coverage
Vision
Employee Only
$1.48
Employee + One Dependent
$2.83
Employee + Family
$4.60
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