Page 11 - 2015 Enrollment Guide
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Employee Medical Premiums (Weekly/Bi-Weekly)
This chart illustrates your weekly and bi-weekly pre-tax contributions for each of the Optimas Medical plans.
Traditional PPO Plan Consumer HSA Plan
Weekly Bi-Weekly Monthly Weekly Bi-Weekly Monthly
Employees Earning <$35K
Employee only $19.04 $38.08 $82.50 $13.96 $27.92 $60.50
Employee + spouse $43.15 $86.31 $187.00 $33.00 $66.00 $143.00
Employee + child(ren) $38.08 $76.15 $165.00 $30.46 $60.92 $132.00
Family $54.58 $109.15 $236.50 $43.15 $86.31 $187.00
Employees Earning between $35K–$50K
Employee only $27.92 $55.85 $121.00 $17.77 $35.54 $77.00
Employee + spouse $63.46 $126.92 $275.00 $43.15 $86.31 $187.00
Employee + child(ren) $54.58 $109.15 $236.50 $39.35 $78.69 $170.50
Family $83.77 $167.54 $363.00 $58.38 $116.77 $253.00
Employees Earning between $50K–$75K
Employee only $34.27 $68.54 $148.50 $22.85 $45.69 $99.00
Employee + spouse $82.50 $165.00 $357.50 $53.31 $106.62 $231.00
Employee + child(ren) $74.88 $149.77 $324.50 $49.50 $99.00 $214.50
Family $110.42 $220.85 $478.50 $72.35 $144.69 $313.50
Employees Earning between 75K–$100K
Employee only $41.88 $83.77 $181.50 $25.38 $50.77 $110.00
Employee + spouse $97.73 $195.46 $423.50 $60.92 $121.85 $264.00
Employee + child(ren) $91.38 $182.77 $396.00 $57.12 $114.23 $247.50
Family $138.35 $276.69 $599.50 $85.04 $170.08 $368.50
Employees Earning >$100K
Employee only $55.85 $111.69 $242.00 $34.27 $68.54 $148.50
Employee + spouse $132.00 $264.00 $572.00 $78.69 $157.38 $341.00
Employee + child(ren) $121.85 $243.69 $528.00 $73.62 $147.23 $319.00
Family $184.04 $368.08 $797.50 $110.42 $220.85 $478.50
Employee Benefits Guide July 2015–June 2016
Employee Medical Premiums (Weekly/Bi-Weekly)
This chart illustrates your weekly and bi-weekly pre-tax contributions for each of the Optimas Medical plans.
Traditional PPO Plan Consumer HSA Plan
Weekly Bi-Weekly Monthly Weekly Bi-Weekly Monthly
Employees Earning <$35K
Employee only $19.04 $38.08 $82.50 $13.96 $27.92 $60.50
Employee + spouse $43.15 $86.31 $187.00 $33.00 $66.00 $143.00
Employee + child(ren) $38.08 $76.15 $165.00 $30.46 $60.92 $132.00
Family $54.58 $109.15 $236.50 $43.15 $86.31 $187.00
Employees Earning between $35K–$50K
Employee only $27.92 $55.85 $121.00 $17.77 $35.54 $77.00
Employee + spouse $63.46 $126.92 $275.00 $43.15 $86.31 $187.00
Employee + child(ren) $54.58 $109.15 $236.50 $39.35 $78.69 $170.50
Family $83.77 $167.54 $363.00 $58.38 $116.77 $253.00
Employees Earning between $50K–$75K
Employee only $34.27 $68.54 $148.50 $22.85 $45.69 $99.00
Employee + spouse $82.50 $165.00 $357.50 $53.31 $106.62 $231.00
Employee + child(ren) $74.88 $149.77 $324.50 $49.50 $99.00 $214.50
Family $110.42 $220.85 $478.50 $72.35 $144.69 $313.50
Employees Earning between 75K–$100K
Employee only $41.88 $83.77 $181.50 $25.38 $50.77 $110.00
Employee + spouse $97.73 $195.46 $423.50 $60.92 $121.85 $264.00
Employee + child(ren) $91.38 $182.77 $396.00 $57.12 $114.23 $247.50
Family $138.35 $276.69 $599.50 $85.04 $170.08 $368.50
Employees Earning >$100K
Employee only $55.85 $111.69 $242.00 $34.27 $68.54 $148.50
Employee + spouse $132.00 $264.00 $572.00 $78.69 $157.38 $341.00
Employee + child(ren) $121.85 $243.69 $528.00 $73.62 $147.23 $319.00
Family $184.04 $368.08 $797.50 $110.42 $220.85 $478.50
Employee Benefits Guide July 2015–June 2016
