Employee-Only |
$ 13.68 |
$ 355.68 |
$ 33.68 |
$ 875.68 |
$ 279.33 |
$ 7,262.71 |
Employee + Spouse |
$ 57.87 |
$ 1,504.62 |
$ 77.87 |
$ 2,024.62 |
$ 550.13 |
$ 14,303.26 |
Employee + Children |
$ 22.80 |
$ 592.80 |
$ 42.80 |
$ 1,112.80 |
$ 456.41 |
$ 11,866.71 |
Employee + Family |
$ 81.28 |
$ 2,113.28 |
$ 101.28 |
$ 2,633.28 |
$ 772.48 |
$ 19,312.00 |
Employee-Only |
$ 30.44 |
$ 791.44 |
$ 50.44 |
$ 1,311.44 |
$ 293.90 |
$ 7,641.49 |
Employee + Spouse |
$ 128.78 |
$ 3,348.28 |
$ 148.78 |
$ 3,868.28 |
$ 547.63 |
$ 14,238.28 |
Employee + Children |
$ 76.13 |
$ 1,979.38 |
$ 96.13 |
$ 2,499.38 |
$ 457.01 |
$ 11,882.26 |
Employee + Family |
$ 180.84 |
$ 4,701.84 |
$ 200.84 |
$ 5,221.84 |
$ 769.01 |
$ 19,994.18 |