| BASE PLAN - OAK Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $1657.9 | $1657.9 | $0 |
| Medical and Dental | $1637.54 | $1637.54 | $0 |
| Medical and Vision | $1539.4 | $1539.4 | $0 |
| Medical only | $1519.04 | $1519.04 | $0 |
| REDWOOD Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $1725.13 | $1657.9 | $67.23 |
| Medical and Dental | $1704.77 | $1657.9 | $46.87 |
| Medical and Vision | $1606.63 | $1606.63 | $0 |
| Medical only | $1586.27 | $1586.27 | $0 |
| SPRUCE Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $1537.65 | $1537.65 | $0 |
| Medical and Dental | $1517.29 | $1517.29 | $0 |
| Medical and Vision | $1419.15 | $1419.15 | $0 |
| Medical only | $1398.79 | $1398.79 | $0 |
| PINE Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $1437.65 | $1437.65 | $0 |
| Medical and Dental | $1417.29 | $1417.29 | $0 |
| Medical and Vision | $1319.15 | $1319.15 | $0 |
| Medical only | $1298.79 | $1298.79 | $0 |
| MAPLE SINGLE Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $656.49 | $656.49 | $0 |
| Medical and Dental | $636.13 | $636.13 | $0 |
| Medical and Vision | $537.99 | $537.99 | $0 |
| Medical only | $517.63 | $517.63 | $0 |
| MAPLE 2 PARTY Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $1173.74 | $1173.74 | $0 |
| Medical and Dental | $1153.38 | $1153.38 | $0 |
| Medical and Vision | $1055.24 | $1055.24 | $0 |
| Medical only | $1034.88 | $1034.88 | $0 |
| MAPLE FAMILY Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $1587.69 | $1587.69 | $0 |
| Medical and Dental | $1567.33 | $1567.33 | $0 |
| Medical and Vision | $1469.19 | $1469.19 | $0 |
| Medical only | $1448.83 | $1448.83 | $0 |
| SEQUOIA SINGLE Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $770.89 | $770.89 | $0 |
| Medical and Dental | $750.53 | $750.53 | $0 |
| Medical and Vision | $652.39 | $652.39 | $0 |
| Medical only | $632.03 | $632.03 | $0 |
| SEQUOIA 2 PARTY Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $1402.45 | $1402.45 | $0 |
| Medical and Dental | $1382.09 | $1382.09 | $0 |
| Medical and Vision | $1283.95 | $1283.95 | $0 |
| Medical only | $1263.59 | $1263.59 | $0 |
| SEQUOIA FAMILY Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Medical, Dental and Vision | $1907.88 | $1657.9 | $249.98 |
| Medical and Dental | $1887.52 | $1657.9 | $229.62 |
| Medical and Vision | $1789.38 | $1657.9 | $131.48 |
| Medical only | $1769.02 | $1657.9 | $111.12 |