
2024 Cost of Coverage
Medical Contribution Rates (Biweekly)
| Aetna HDHP Plan with HSA | Biweekly Medical Contributions | |||
|---|---|---|---|---|
| Per Pay Period (26 / year) | Employee | Employee + SP | Employee + Child(ren) | Family |
| Tier 1 Premium Salary less than $59,999 |
$75.75 | $151.50 | $141.50 | $227.25 |
| Tier 2 Premium Salary $60,000 – $149,999 |
$84.50 | $170.00 | $159.75 | $252.50 |
| Tier 3 Premium Salary $150,000 – $249,999 |
$99.75 | $199.50 | $189.00 | $299.25 |
| Tier 4 Premium Salary $250,000 and over |
$111.50 | $222.75 | $212.00 | $334.00 |
| Aetna POS Plan | Biweekly Medical Contributions (Biweekly) | |||
|---|---|---|---|---|
| Per Pay Period (26 / year) | Employee | Employee + SP | Employee + Child(ren) | Family |
| Tier 1 Premium Salary less than $59,999 |
$86.00 | $171.75 | $161.75 | $257.75 |
| Tier 2 Premium Salary $60,000 – $149,999 |
$98.00 | $195.75 | $185.50 | $293.75 |
| Tier 3 Premium Salary $150,000 – $249,999 |
$115.50 | $231.00 | $220.50 | $346.50 |
| Tier 4 Premium Salary $250,000 and over |
$132.50 | $265.00 | $254.50 | $397.50 |
| Per Pay Period (26 / year) | Employee | Employee + SP | Employee + Child(ren) | Family |
|---|---|---|---|---|
| DMO Plan | $4.42 | $8.84 | $9.94 | $14.36 |
| PPO Plan | $19.46 | $38.92 | $43.79 | $63.25 |
| PPO PLUS Plan | $21.44 | $42.93 | $48.24 | $69.69 |
| Per Pay Period (26 / year) | Employee | Employee + SP | Employee + Child(ren) | Family |
|---|---|---|---|---|
| Base Choice VSP Vision Plan | $2.48 | $3.97 | $4.05 | $6.54 |
| Premier VSP Vision Plan | $3.05 | $4.88 | $4.98 | $8.04 |