JULY 2021 – JUNE 2022
MONTHLY EMPLOYEE CONTRIBUTIONS
If you are looking for 2019-2020 rates, click here
If you are looking for 2020-2021 rates, click here
| MMO PPO/HSA | MMO PPO | SkyCare EPO | MMO MedFlex EPO | Standard Dental* | PPO Dental* | High Option PPO Dental** | VSP | |
| Total Plan Cost (Normal part-time employee rate) | ||||||||
| Single - no incentive | $522 | $776 | $659 | $698 | $27 | $27 | $42 | $9 |
| Single - one incentive | $507 | $761 | $644 | $683 | N/A**** | N/A**** | N/A**** | N/A**** |
| Single - two incentives | $492 | $746 | $629 | $668 | N/A**** | N/A**** | N/A**** | N/A**** |
| Family - no incentive | $1,331 | $2,102 | $1,779 | $1,884 | $53 | $53 | $82 | $24 |
| Family - one incentive | $1,301 | $2,072 | $1,749 | $1,854 | N/A**** | N/A**** | N/A**** | N/A**** |
| Family - two incentives | $1,271 | $2,042 | $1,719 | $1,824 | N/A**** | N/A**** | N/A**** | N/A**** |
| MedAdvantage (Medicare) | N/A | $187.57 | N/A | N/A | $27 ***** | $27 ***** | $42***** | $9 |
| Normal Employee Cost - No Incentive | ||||||||
| Single | $55 | $185 | $152 | $162 | $0 | $0 | $15 | $9 |
| Family | $209 | $677 | $559 | $593 | $0 | $0 | $29 | $24 |
| Normal Employee Cost - One Incentive | ||||||||
| Single | $40 | $170 | $137 | $147 | N/A**** | N/A**** | N/A**** | N/A**** |
| Family | $179 | $647 | $529 | $563 | N/A**** | N/A**** | N/A**** | N/A**** |
| Normal Employee Cost - Two Incentives | ||||||||
| Single | $25 | $155 | $122 | $132 | N/A**** | N/A**** | N/A**** | N/A**** |
| Family | $149 | $617 | $499 | $533 | N/A**** | N/A**** | N/A**** | N/A**** |
| Employer Cost - All Incentives | ||||||||
| Single | $467 | $591 | $507 | $536 | $27 | $27 | $27 | $0 |
| Family | $1,122 | $1,425 | $1,220 | $1,291 | $53 | $53 | $53 | $0 |
| A spousal surcharge, where applicable, adds $650 per month to the family plan premiums stated in the table. |
* Rate paid by employer for participant not selecting a medical plan. PPO and EPO rates include
choice of Standard or PPO Dental.
** Employees covered with a medical plan pay the difference in cost for the High Option PPO Dental.
*** Employer cost remains the same regardless of the incentives earned by the employee.
****Incentives do not apply to dental only and vision coverage only.
***** Participants in the MedAdvantage Plan pay the entire cost for dental.