Overview of Available Plans

Review the benefits available to you and your dependents, compare plan options, and make informed enrollment decisions.

Choosing the Right Plan

Your Benefits at a Glance

Benefit	Plan	Carrier
Medical	Core Plan, Buy Up Plan, HDHP	Aetna
Dental	Dental PPO	Aetna
Vision	Vision Plan	Ameritas

Medical

PlanCore Plan, Buy Up Plan, HDHP

CarrierAetna

Dental

PlanDental PPO

CarrierAetna

Vision

PlanVision Plan

CarrierAmeritas

Premium Summary

Weekly and semimonthly costs are calculated based on wellness participation and salary. Costs are available to view through the enrollment process.

Medical Premiums - Core Plan

Coverage Tier	Salaried (Semi-Monthly)	Hourly (Weekly)
Employee Only	Engaged Tier 1 $20-59.99k$30.00 $60-99.99k$40.00 $100k+$50.00 Engaged Tier 2 $20-59.99k$50.00 $60-99.99k$60.00 $100k+$70.00 Non-Engaged $20-59.99k$292.05 $60-99.99k$310.20 $100k+$328.35	Engaged Tier 1 $20-59.99k$13.85 $60-99.99k$18.46 $100k+$23.08 Engaged Tier 2 $20-59.99k$23.08 $60-99.99k$27.69 $100k+$32.31 Non-Engaged $20-59.99k$134.79 $60-99.99k$143.17 $100k+$151.55
Employee + Spouse	Engaged Tier 1 $20-59.99k$60.00 $60-99.99k$80.00 $100k+$100.00 Engaged Tier 2 $20-59.99k$80.00 $60-99.99k$100.00 $100k+$120.00 Non-Engaged $20-59.99k$346.50 $60-99.99k$382.80 $100k+$419.10	Engaged Tier 1 $20-59.99k$27.69 $60-99.99k$36.92 $100k+$46.15 Engaged Tier 2 $20-59.99k$36.92 $60-99.99k$46.15 $100k+$55.38 Non-Engaged $20-59.99k$159.92 $60-99.99k$176.68 $100k+$193.43
Employee + Children / Family	Engaged Tier 1 $20-59.99k$90.00 $60-99.99k$120.00 $100k+$150.00 Engaged Tier 2 $20-59.99k$110.00 $60-99.99k$140.00 $100k+$170.00 Non-Engaged $20-59.99k$400.95 $60-99.99k$455.40 $100k+$509.85	Engaged Tier 1 $20-59.99k$41.54 $60-99.99k$55.38 $100k+$69.23 Engaged Tier 2 $20-59.99k$50.77 $60-99.99k$64.62 $100k+$78.46 Non-Engaged $20-59.99k$185.05 $60-99.99k$210.18 $100k+$235.32

Employee Only

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$30.00

$60-99.99k$40.00

$100k+$50.00

Engaged Tier 2

$20-59.99k$50.00

$60-99.99k$60.00

$100k+$70.00

Non-Engaged

$20-59.99k$292.05

$60-99.99k$310.20

$100k+$328.35

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$13.85

$60-99.99k$18.46

$100k+$23.08

Engaged Tier 2

$20-59.99k$23.08

$60-99.99k$27.69

$100k+$32.31

Non-Engaged

$20-59.99k$134.79

$60-99.99k$143.17

$100k+$151.55

Employee + Spouse

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$60.00

$60-99.99k$80.00

$100k+$100.00

Engaged Tier 2

$20-59.99k$80.00

$60-99.99k$100.00

$100k+$120.00

Non-Engaged

$20-59.99k$346.50

$60-99.99k$382.80

$100k+$419.10

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$27.69

$60-99.99k$36.92

$100k+$46.15

Engaged Tier 2

$20-59.99k$36.92

$60-99.99k$46.15

$100k+$55.38

Non-Engaged

$20-59.99k$159.92

$60-99.99k$176.68

$100k+$193.43

Employee + Children / Family

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$90.00

$60-99.99k$120.00

$100k+$150.00

Engaged Tier 2

$20-59.99k$110.00

$60-99.99k$140.00

$100k+$170.00

Non-Engaged

$20-59.99k$400.95

$60-99.99k$455.40

$100k+$509.85

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$41.54

$60-99.99k$55.38

$100k+$69.23

Engaged Tier 2

$20-59.99k$50.77

$60-99.99k$64.62

$100k+$78.46

Non-Engaged

$20-59.99k$185.05

$60-99.99k$210.18

$100k+$235.32

Medical Premiums - Buy Up Plan

Coverage Tier	Salaried (Semi-Monthly)	Hourly (Weekly)
Employee Only	Engaged Tier 1 $20-59.99k$45.00 $60-99.99k$55.00 $100k+$65.00 Engaged Tier 2 $20-59.99k$65.00 $60-99.99k$75.00 $100k+$85.00 Non-Engaged $20-59.99k$308.55 $60-99.99k$326.70 $100k+$344.85	Engaged Tier 1 $20-59.99k$20.77 $60-99.99k$25.38 $100k+$30.00 Engaged Tier 2 $20-59.99k$30.00 $60-99.99k$34.62 $100k+$39.23 Non-Engaged $20-59.99k$142.41 $60-99.99k$150.78 $100k+$159.16
Employee + Spouse	Engaged Tier 1 $20-59.99k$90.00 $60-99.99k$110.00 $100k+$130.00 Engaged Tier 2 $20-59.99k$110.00 $60-99.99k$130.00 $100k+$150.00 Non-Engaged $20-59.99k$379.50 $60-99.99k$415.80 $100k+$452.10	Engaged Tier 1 $20-59.99k$41.54 $60-99.99k$50.77 $100k+$60.00 Engaged Tier 2 $20-59.99k$50.77 $60-99.99k$60.00 $100k+$69.23 Non-Engaged $20-59.99k$175.15 $60-99.99k$191.91 $100k+$208.66
Employee + Children / Family	Engaged Tier 1 $20-59.99k$150.00 $60-99.99k$180.00 $100k+$210.00 Engaged Tier 2 $20-59.99k$170.00 $60-99.99k$200.00 $100k+$230.00 Non-Engaged $20-59.99k$450.45 $60-99.99k$504.90 $100k+$559.35	Engaged Tier 1 $20-59.99k$69.23 $60-99.99k$83.08 $100k+$96.92 Engaged Tier 2 $20-59.99k$78.46 $60-99.99k$92.31 $100k+$106.15 Non-Engaged $20-59.99k$207.90 $60-99.99k$233.03 $100k+$258.16

Employee Only

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$45.00

$60-99.99k$55.00

$100k+$65.00

Engaged Tier 2

$20-59.99k$65.00

$60-99.99k$75.00

$100k+$85.00

Non-Engaged

$20-59.99k$308.55

$60-99.99k$326.70

$100k+$344.85

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$20.77

$60-99.99k$25.38

$100k+$30.00

Engaged Tier 2

$20-59.99k$30.00

$60-99.99k$34.62

$100k+$39.23

Non-Engaged

$20-59.99k$142.41

$60-99.99k$150.78

$100k+$159.16

Employee + Spouse

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$90.00

$60-99.99k$110.00

$100k+$130.00

Engaged Tier 2

$20-59.99k$110.00

$60-99.99k$130.00

$100k+$150.00

Non-Engaged

$20-59.99k$379.50

$60-99.99k$415.80

$100k+$452.10

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$41.54

$60-99.99k$50.77

$100k+$60.00

Engaged Tier 2

$20-59.99k$50.77

$60-99.99k$60.00

$100k+$69.23

Non-Engaged

$20-59.99k$175.15

$60-99.99k$191.91

$100k+$208.66

Employee + Children / Family

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$150.00

$60-99.99k$180.00

$100k+$210.00

Engaged Tier 2

$20-59.99k$170.00

$60-99.99k$200.00

$100k+$230.00

Non-Engaged

$20-59.99k$450.45

$60-99.99k$504.90

$100k+$559.35

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$69.23

$60-99.99k$83.08

$100k+$96.92

Engaged Tier 2

$20-59.99k$78.46

$60-99.99k$92.31

$100k+$106.15

Non-Engaged

$20-59.99k$207.90

$60-99.99k$233.03

$100k+$258.16

Medical Premiums - HDHP Plan

Coverage Tier	Salaried (Semi-Monthly)	Hourly (Weekly)
Employee Only	Engaged Tier 1 $20-59.99k$15.00 $60-99.99k$25.00 $100k+$35.00 Engaged Tier 2 $20-59.99k$35.00 $60-99.99k$45.00 $100k+$55.00 Non-Engaged $20-59.99k$83.00 $60-99.99k$249.00 $100k+$314.74	Engaged Tier 1 $20-59.99k$6.92 $60-99.99k$11.54 $100k+$16.15 Engaged Tier 2 $20-59.99k$16.15 $60-99.99k$20.77 $100k+$25.38 Non-Engaged $20-59.99k$38.31 $60-99.99k$114.92 $100k+$145.26
Employee + Spouse	Engaged Tier 1 $20-59.99k$40.00 $60-99.99k$60.00 $100k+$80.00 Engaged Tier 2 $20-59.99k$60.00 $60-99.99k$80.00 $100k+$100.00 Non-Engaged $20-59.99k$320.10 $60-99.99k$356.40 $100k+$392.70	Engaged Tier 1 $20-59.99k$18.46 $60-99.99k$27.69 $100k+$36.92 Engaged Tier 2 $20-59.99k$27.69 $60-99.99k$36.92 $100k+$46.15 Non-Engaged $20-59.99k$147.74 $60-99.99k$164.49 $100k+$181.25
Employee + Children / Family	Engaged Tier 1 $20-59.99k$60.00 $60-99.99k$90.00 $100k+$120.00 Engaged Tier 2 $20-59.99k$80.00 $60-99.99k$110.00 $100k+$140.00 Non-Engaged $20-59.99k$360.11 $60-99.99k$414.56 $100k+$469.01	Engaged Tier 1 $20-59.99k$27.69 $60-99.99k$41.54 $100k+$55.38 Engaged Tier 2 $20-59.99k$36.92 $60-99.99k$50.77 $100k+$64.62 Non-Engaged $20-59.99k$166.21 $60-99.99k$191.34 $100k+$216.47

Employee Only

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$15.00

$60-99.99k$25.00

$100k+$35.00

Engaged Tier 2

$20-59.99k$35.00

$60-99.99k$45.00

$100k+$55.00

Non-Engaged

$20-59.99k$83.00

$60-99.99k$249.00

$100k+$314.74

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$6.92

$60-99.99k$11.54

$100k+$16.15

Engaged Tier 2

$20-59.99k$16.15

$60-99.99k$20.77

$100k+$25.38

Non-Engaged

$20-59.99k$38.31

$60-99.99k$114.92

$100k+$145.26

Employee + Spouse

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$40.00

$60-99.99k$60.00

$100k+$80.00

Engaged Tier 2

$20-59.99k$60.00

$60-99.99k$80.00

$100k+$100.00

Non-Engaged

$20-59.99k$320.10

$60-99.99k$356.40

$100k+$392.70

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$18.46

$60-99.99k$27.69

$100k+$36.92

Engaged Tier 2

$20-59.99k$27.69

$60-99.99k$36.92

$100k+$46.15

Non-Engaged

$20-59.99k$147.74

$60-99.99k$164.49

$100k+$181.25

Employee + Children / Family

Salaried (Semi-Monthly)

Engaged Tier 1

$20-59.99k$60.00

$60-99.99k$90.00

$100k+$120.00

Engaged Tier 2

$20-59.99k$80.00

$60-99.99k$110.00

$100k+$140.00

Non-Engaged

$20-59.99k$360.11

$60-99.99k$414.56

$100k+$469.01

Hourly (Weekly)

Engaged Tier 1

$20-59.99k$27.69

$60-99.99k$41.54

$100k+$55.38

Engaged Tier 2

$20-59.99k$36.92

$60-99.99k$50.77

$100k+$64.62

Non-Engaged

$20-59.99k$166.21

$60-99.99k$191.34

$100k+$216.47

Dental Premiums - Dental PPO

Coverage Tier	Semi-Monthly	Weekly
Employee Only	$6.41	$2.96
Employee + Spouse	$12.81	$5.91
Family	$21.79	$10.05

Employee Only

Semi-Monthly$6.41

Weekly$2.96

Employee + Spouse

Semi-Monthly$12.81

Weekly$5.91

Family

Semi-Monthly$21.79

Weekly$10.05

Vision Premiums - Vision Plan

Coverage Tier	Semi-Monthly	Weekly
Employee Only	$3.20	$1.48
Employee + Spouse	$6.06	$2.80
Employee + Children	$6.56	$3.03
Family	$9.48	$4.38

Employee Only

Semi-Monthly$3.20

Weekly$1.48

Employee + Spouse

Semi-Monthly$6.06

Weekly$2.80

Employee + Children

Semi-Monthly$6.56

Weekly$3.03

Family

Semi-Monthly$9.48

Weekly$4.38