-
Premium Deductions
DEDUCTION RATES EFFECTIVE
January 1, 2023
Plans
12 Pay
20 Pay*
26 Pay
BlueEdge High Deductible /HSA
Employee Only
$101.00
$60.60
$46.62
BlueEdge High Deductible /HSA
Employee/ Children
$234.00
$140.40
$108.00
BlueEdge High Deductible /HSA
Employee/ Spouse
$292.00
$175.20
$134.77
BlueEdge High Deductible /HSA
Employee/ Family
$424.00
$254.40
$195.69
Blue Choice Low Option PPO
Employee Only
$118.00
$70.80
$54.46
Blue Choice Low Option PPO
Employee/ Children
$267.00
$160.20
$123.23
Blue Choice Low Option PPO
Employee/ Spouse
$336.00
$201.60
$155.08
Blue Choice Low Option PPO
Employee/ Family
$484.00
$290.40
$223.38
Blue Choice High Option PPO
Employee Only
$299.00
$179.40
$138.00
Blue Choice High Option PPO
Employee/ Children
$496.00
$297.60
$228.92
Blue Choice High Option PPO
Employee/ Spouse
$597.00
$358.20
$275.54
Blue Choice High Option PPO
Employee/ Family
$791.00
$474.60
$365.08
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
-
*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)
