Page 22 - 2022 CPI Card Benefits Guide
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Cost of Coverage
Bi-weekly Pretax Employee Contributions
to Premiums (26 Payroll Deductions)
Medical
Buy-Up Base HDHP With
PPO Plan PPO Plan HSA Plan
Employee $69.00 $51.50 $22.00
Employee + Spouse $230.00 $196.50 $140.00
Employee + Child(ren) $173.50 $146.00 $107.00
Employee + Family $364.50 $317.50 $237.50
Dental
Employee $8.50
Employee + Spouse $15.50
Employee + Child(ren) $22.00
Employee + Family $28.50
Vision
Employee $1.50
Employee + Spouse $5.00
Employee + Child(ren) $4.25
Employee + Family $6.00
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