Page 5 - UPDATED - 8-1-24 Heritage School Benefit Guide

Medical Option Rates

Baylor Scott & White (BSW)

2024 Rate Information
Cost is per Employee plus each additional family Member.
(do not calculate cost for more than 3 children).
Then, subtract $600 as your Defined Employer Contribution.

MEDICAL - Baylor Scott & White (BSW) Core Plan
Silver PPO 80 4250
BSW Plus PPO

Age Monthly Cost Age Monthly Cost Age Monthly Cost Age Monthly Cost Age Monthly Cost Age Monthly Cost
<15 $297.12 23 $388.40 32 $459.47 41 $505.69 50 $693.68 59 $1,010.99
15 $323.53 24 $388.40 33 $465.30 42 $514.62 51 $724.36 60 $1,054.11

16 $333.63 25 $389.95 34 $471.51 43 $527.05 52 $758.15 61 $1,091.39
17 $343.73 26 $397.72 35 $474.62 44 $542.59 53 $792.33 62 $1,115.86

18 $354.61 27 $407.04 36 $477.73 45 $560.84 54 $829.23 63 $1,146.54
19 $365.48 28 $422.19 37 $480.83 46 $582.59 55 $866.12 64+ $1,165.19
20 $376.74 29 $434.62 38 $483.94 47 $607.06 56 $906.13

21 $388.40 30 $440.83 39 $490.16 48 $635.03 57 $946.52
22 $388.40 31 $450.15 40 $496.37 49 $662.60 58 $989.63

MEDICAL - Baylor Scott & White (BSW) Buy-Up Plan
Gold PPO 80 1500
BSW Plus PPO

Age Monthly Cost Age Monthly Cost Age Monthly Cost Age Monthly Cost Age Monthly Cost Age Monthly Cost
<15 $342.96 23 $448.31 32 $530.36 41 $583.71 50 $800.69 59 $1,166.96
15 $373.45 24 $448.31 33 $537.08 42 $594.02 51 $836.11 60 $1,216.73

16 $385.10 25 $450.11 34 $544.25 43 $608.36 52 $875.11 61 $1,259.76
17 $396.76 26 $459.07 35 $547.84 44 $626.30 53 $914.56 62 $1,288.01

18 $409.31 27 $469.83 36 $551.43 45 $647.37 54 $957.15 63 $1,323.43
19 $421.86 28 $487.32 37 $555.01 46 $672.47 55 $999.74 64+ $1,344.92

20 $434.87 29 $501.66 38 $558.60 47 $700.72 56 $1,045.92
21 $448.31 30 $508.84 39 $565.77 48 $732.99 57 $1,092.54

22 $448.31 31 $519.60 40 $572.95 49 $764.83 58 $1,142.31

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