MEDICAL (SEMI-MONTHLY) RATES
SALARY RANGE: BELOW $35,000
Cost for Coverage Amounts shown are per pay check ( 24 payments/year )
Base HDHP H.S.A Plan
Copay H.R.A. Plan
Copay Premium Plan
Employee Only
EE
$ 56.23
$ 91.73
$ 179.53
Employee + Spouse
ES
$ 153.51
$ 225.84
$ 423.00
Employee + Child(ren)
EC
$ 128.21
$ 192.31
$ 366.07
Employee + Family
FAM
$ 194.00
$ 294.16
$ 564.87
SALARY RANGE: $35,000 TO BELOW $50,000
Cost for Coverage Amounts shown are per pay check ( 24 payments/year )
Base HDHP H.S.A Plan
Copay H.R.A. Plan
Copay Premium Plan
Employee Only
EE
$ 64.67
$ 101.22
$ 192.67
Employee + Spouse
ES
$ 171.22
$ 245.77
$ 450.58
Employee + Child(ren)
EC
$ 144.23
$ 210.34
$ 391.03
Employee + Family
FAM
$ 219.30
$ 322.62
$ 604.28
SALARY RANGE: $50,000 AND OVER
Cost for Coverage Amounts shown are per pay check ( 24 payments/year )
Base HDHP H.S.A Plan
Copay H.R.A. Plan
Copay Premium Plan
Employee Only
EE
$ 73.10
$ 110.70
$ 205.81
Employee + Spouse
ES
$ 188.94
$ 265.69
$ 478.17
Employee + Child(ren)
EC
$ 160.26
$ 228.37
$ 415.99
Employee + Family
FAM
$ 244.60
$ 351.09
$ 643.69
REMINDER : If you sign up for the Base HDHP H.S.A Plan AMIkids WILL GIVE YOU $500, pro-rated, into your open and active Health Savings Account. Of course you have to open the account and keep it open to get the money! If you sign up for the Copay H.R.A. Plan AMIkids WILL GIVE YOU up to the first $500 of any deductible related expenses immediately as the claims are incurred. Your doctor submits the claim to BCBS and they will receive up to $500 from AMIkids.
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