Page 10 - OMS Benefits Guide
P. 10
Plan Rates
Base HAP EPO Bronze $5,500 HDHP with Buy-Up HAP HMO Silver $2,500 with
$5,000/$2,500 GAP $5,000/$2,500 GAP
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Tier Cost Per Pay Tier Cost Per Pay
Employee Only $79.00 Employee Only $139.00
Employee + 1 $219.00 Employee + 1 $430.00
Employee + 2 $315.00 Employee + 2 $505.00
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Download your Medical + GAP instructions for use here 10
