Medical & Prescription Rates
RATES WITHOUT WELLNESS DISCOUNT
Base Plan (UMR)
Monthly
Bi-weekly 20 pays Bi-weekly 26 pays
Annually
$1,200.00
$100.00
$60.00
$46.15
Employee Only
$2,400.00
$200.00
$120.00
$92.31
Employee + Spouse
$1,200.00
$100.00
$60.00
$46.15
Employee Child(ren)
$2,400.00
$200.00
$120.00
$92.31
Employee Family
Premium Option 1 (UMR)
Annually
Monthly
Bi-weekly 20 pays Bi-weekly 26 pays
$1,866.24
$155.52
$93.31
$71.78
Employee Only
$3,798.96
$316.58
$189.95
$146.11
Employee + Spouse
$2,465.64
$205.47
$123.28
$94.83
Employee Child(ren)
$4,465.20
$372.10
$223.26
$171.74
Employee Family
Premium Option 2 (Surest)
Monthly
Bi-weekly 20 pays Bi-weekly 26 pays
Annually
$1,513.32
$126.11
$75.67
$58.20
Employee Only
$3,065.40
$255.45
$153.27
$117.90
Employee + Spouse
$1,795.32
$149.61
$89.77
$69.05
Employee Child(ren)
$3,371.52
$280.96
$168.58
$129.67
Employee Family
RATES WITH WELLNESS DISCOUNT
Base Plan (UMR)
Monthly
Bi-weekly 20 pays Bi-weekly 26 pays
Annually
$0
$0
$0
$0
Employee Only
$0
$0
$0
$0
Employee + Spouse
$0
$0
$0
$0
Employee Child(ren)
$0
$0
$0
$0
Employee Family
Premium Option 1 (UMR)
Annually
Monthly
Bi-weekly 20 pays Bi-weekly 26 pays
$666.24
$55.52
$33.32
$25.62
Employee Only
$1,398.96
$116.58
$69.95
$53.80
Employee + Spouse
$1,265.64
$105.47
$63.29
$48.68
Employee Child(ren)
$2,065.20
$172.10
$103.26
$79.42
Employee Family
Premium Option 2 (Surest)
Monthly
Bi-weekly 20 pays Bi-weekly 26 pays
Annually
$313.32
$26.11
$15.67
$12.05
Employee Only
$665.40
$55.45
$33.27
$25.60
Employee + Spouse
$595.32
$49.61
$29.77
$22.90
Employee Child(ren)
$971.52
$80.96
$48.58
$37.37
Employee Family
10 - Employee Benefits Guide
Made with FlippingBook - Online catalogs