Effective Jan. 1, 2025 through Dec. 31 2025
| $4,000 HDHP Costs | ||||
| Annual Salary Tiers | Coverage Level | Employee Cost | ATU Cost | Total Cost |
|
under $55,000 |
Employee Only Employee and Spouse Employee and Children Employee and Family |
$ - $426.00 $185.00 $543.00 |
$615 .50 $768.22 $671.46 $903.73 |
$615.50 $1,194.22 $856.46 $1,446.73 |
|
$55,000 - under $80,000 |
Employee Only Employee and Spouse Employee and Children Employee and Family |
$34.00 $482.00 $241.00 $587.00 |
$581.00 $712.00 $615.00 $848.00 |
$615.50 $1,194.22 $856.46 $1,446.73 |
|
$80,000 under $125,000 |
Employee Only Employee and Spouse Employee and Children Employee and Family |
$57.00 $515.00 $273.00 $624.00 |
$558.00 $679.00 $583.00 $822.73 |
$615.50 $1,194.22 $856.46 $1,446.73 |
|
$125,000 and over |
Employee Only Employee and Spouse Employee and Children Employee and Family |
$86.00 $527.00 $281.00 $638.00 |
$529.00 $667.22 $575.46 $808.73 |
$615.50 $1,194.22 $856.46 $1,446.73 |
| $3,000 PPO Costs | ||||
| Annual Salary Tiers | Coverage Level | Employee Cost | ATU Cost | Total Cost |
|
under $55,000 |
Employee Only Employee and Spouse Employee and Children Employee and Family |
$ 25.00 $489.00 $230.00 $636.00 |
$630 .24 $782.35 $681.77 $904.23 |
$655.24 $1,271.35 $911.77 $1,540.23 |
|
$55,000 - under $80,000 |
Employee Only Employee and Spouse Employee and Children Employee and Family |
$43.00 $533.00 $273.00 $683.00 |
$612.24 $738.35 $638.77 $857.23 |
$655.24 $1,271.35 $911.77 $1,540.23 |
|
$80,000 under $125,000 |
Employee Only Employee and Spouse Employee and Children Employee and Family |
$73.00 $559.00 $300.00 $710.00 |
$582.24 $712.35 $611.77 $857.23 |
$655.24 $1,271.35 $911.77 $1,540.23 |
|
$125,000 and over |
Employee Only Employee and Spouse Employee and Children Employee and Family |
$100.00 $574.00 $316.00 $726.00 |
$555.24 $967.35 $595.77 $814.23 |
$655.24 $1,271.35 $911.77 $1,540.23 |
| Coverage Level | Employee Cost | ATU Cost | Total Cost |
| Employee Only | $ - | $29.85 | $29.85 |
| Employee and Spouse | $27.31 | $32.91 | $60.22 |
| Employee and Children | $23.61 | $32.51 | $56.12 |
| Employee and Family | $61.13 | $36.71 | $97.84 |
| Coverage Level | Employee Cost |
| Employee Only | $9.00 |
| Employee and Spouse | $16.67 |
| Employee and Children | $18.02 |
| Employee and Family | $25.67 |