Medical Rates

Learn more about subisidies and surcharges

Note: The rates included in this table are monthly, rates in UltiPro will show the bi-weekly amount. Additionally, Subsidies will show in earnings, Surcharges will show in deductions. Your medical deductions will show as the base rates of the plan. Benefits, Subsidies, and Surcharges are on the first 2 paychecks of the month.

PLANS MONTHLY BASE RATE

MONTHLY WELLNESS SUBSIDY

MONTHLY TOBACCO SURCHARGE

MONTHLY LOWEST RATE
Plan 1 Base Rate Employee Spouse Employee Spouse Lowest Rate
Employee $90.60 -$72.48 $51.77 $18.12
Employee + Spouse $190.25 -$76.10 -$76.10 $54.36 $54.36 $38.05
Employee + Child $116.48 -$72.48 $51.77 $44.00
Family $207.08 -$76.10 -$76.10 $54.36 $54.36 $54.88
Plan 2 Base Rate Employee Spouse Employee Spouse Lowest Rate
Employee $125.29 -$109.63 $78.31 $15.66
Employee + Spouse $345.33 -$115.11 -$115.11 $82.22 $82.22 $115.11
Employee + Child $239.62 -$109.63 $78.31 $129.99
Family $425.99 -$115.11 -$115.11 $82.22 $82.22 $195.77
Plan 3 Base Rate Employee Spouse Employee Spouse Lowest Rate
Employee $234.97 -$119.60 $85.44 $115.35
Employee + Spouse $556.22 -$125.60 -$125.60 $89.71 $89.71 $305.02
Employee + Child $476.76 -$119.60 $85.44 $357.14
Family $847.57 -$125.60 -$125.60 $89.71 $89.71 $596.37
Plan 4 Base Rate Employee Spouse Employee Spouse Lowest Rate
Employee $222.80 -$124.77 $89.12 $98.03
Employee + Spouse $580.18 -$131.01 -$131.01 $93.58 $93.58 $318.16
Employee + Child $497.30 -$124.77 $89.12 $372.53
Family $884.07 -$131.01 -$131.01 $93.58 $93.58 $622.05