Page 20 - 2022 US Benefits Guide FINAL
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BENEFIT COSTS
Your semi-monthly payroll contributions for medical, dental and vision benefits are shown here.
Additional information can be found in the Benefits Prime enrollment tool.
BCBSIL Medical HDHP HDHP – Healthy You! PPO PPO – Healthy You!
Employee Only $88.00 $68.00 $127.00 $107.00
Employee/Spouse $204.00 $184.00 $295.00 $275.00
Employee/Children $188.00 $168.00 $269.00 $249.00
Family $254.00 $234.00 $355.00 $335.00
Kaiser Medical Gold Gold – Healthy You! Platinum Platinum- Healthy You!
Employee Only $74.00 $54.00 $104.00 $84.00
Employee/Spouse $189.00 $169.00 $247.00 $227.00
Employee/Children $167.00 $147.00 $218.00 $198.00
Family $261.00 $241.00 $344.00 $324.00
Dental
Employee Only $10.00
Employee/Spouse $20.00
Employee/Children $19.00
Family $28.50
Vision
Employee Only $3.50
Employee/Spouse $5.50
Employee/Children $6.00
Family $9.50
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