Overview
The charts below list the amount you will pay on bi-weekly basis for your medical, dental, and vision coverage. It’s important to review your options and costs, and choose the coverage that’s right for you.
Medical Contributions (Bi-Weekly)
| Enrollment Tier | Blue Shield PPO | Blue Shield PPO Savings (CDHP) | Blue Shield Access+ HMO | Harvard Pilgrim HMO |
|---|---|---|---|---|
| Employee Only | $59.91 | $15.12 | $57.82 | $48.59 |
| Employee + Spouse/DP* | $142.40 | $71.65 | $139.52 | $127.98 |
| Employee + Child(ren) | $120.66 | $52.49 | $115.71 | $104.17 |
| Family | $198.83 | $132.44 | $193.02 | $181.48 |
Dental and Vision Plan Contributions (Bi-Weekly)
| Enrollment Tier | PPO Dental Delta Dental | Vision Plan VSP |
|---|---|---|
| Employee Only | $2.88 | $1.21 |
| Employee + Spouse/DP* | $8.75 | $2.63 |
| Employee + Child(ren) | $10.87 | $2.81 |
| Family | $18.94 | $4.39 |
*Domestic partner premiums are subject to pre- and post-tax costs. In addition, imputed income will be assessed.