Page 6 - Benefit Guide 2022
P. 6
Monthly Medical Premiums
Your monthly payroll contributions for medical and pharmacy are shown here.
Coverage PPO HDHP Low HDHP High
Level
Employee Only
Non-Tobacco $265 $130 $100
Tobacco $315 $180 $150
Employee + Spouse
Non-Tobacco $570 $310 $250
Tobacco $620 $360 $300
Employee + Child(ren)
Non-Tobacco $490 $250 $220
Tobacco $540 $300 $270
Family
Non-Tobacco $800 $430 $370
Tobacco $850 $480 $420
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