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Premium Deductions
DEDUCTION RATES EFFECTIVE
January 1, 2024
Plans
12 Pay
20 Pay*
26 Pay
BlueEdge High Deductible /HSA
Employee Only
$116.00
$69.60
$53.54
BlueEdge High Deductible /HSA
Employee/ Children
$269.00
$161.40
$124.15
BlueEdge High Deductible /HSA
Employee/ Spouse
$336.00
$201.60
$155.08
BlueEdge High Deductible /HSA
Employee/ Family
$488.00
$292.80
$225.23
Blue Choice Low Option PPO
Employee Only
$136.00
$81.60
$62.77
Blue Choice Low Option PPO
Employee/ Children
$307.00
$184.20
$141.69
Blue Choice Low Option PPO
Employee/ Spouse
$386.00
$231.60
$178.15
Blue Choice Low Option PPO
Employee/ Family
$557.00
$334.20
$257.08
Blue Choice High Option PPO
Employee Only
$344.00
$206.40
$158.77
Blue Choice High Option PPO
Employee/ Children
$570.00
$342.00
$263.08
Blue Choice High Option PPO
Employee/ Spouse
$687.00
$412.20
$317.08
Blue Choice High Option PPO
Employee/ Family
$910.00
$546.00
$420.00
All Medical Plans
Tobacco Surcharge
$30.00
$18.00
$13.85
Dental Insurance High Option
Employee Only
$30.00
$18.00
$13.85
Dental Insurance High Option
Employee/ Children
$70.00
$42.00
$32.31
Dental Insurance High Option
Employee/ Spouse
$55.00
$33.00
$25.38
Dental Insurance High Option
Employee/ Family
$93.00
$55.80
$42.92
Dental Insurance Low Option
Employee Only
$16.00
$9.60
$7.38
Dental Insurance Low Option
Employee/ Children
$37.00
$22.20
$17.08
Dental Insurance Low Option
Employee/ Spouse
$29.00
$17.40
$13.38
Dental Insurance Low Option
Employee/ Family
$55.00
$33.00
$25.38
Vision Insurance
Employee Only
$6.70
$4.02
$3.09
Vision Insurance
Employee/ Children
$14.66
$8.80
$6.77
Vision Insurance
Employee/ Spouse
$11.72
$7.03
$5.41
Vision Insurance
Employee/ Family
$17.40
$10.44
$8.03
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*Premium may differ due to rounding. 20 Pay- Biweekly employees who work less than 230 days per year (i.e. bus drivers, bus assistants, food service workers, and KIN)
