FTE:
%
      
BASE PLAN - OAK Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$1927.28   $1927.28   $0   
Medical and Dental$1906.92   $1906.92   $0   
Medical and Vision$1814.71   $1814.71   $0   
Medical only$1794.35   $1794.35   $0   

 
REDWOOD Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$2006.7   $1927.28   $79.42   
Medical and Dental$1986.34   $1927.28   $59.06   
Medical and Vision$1894.13   $1894.13   $0   
Medical only$1873.77   $1873.77   $0   

 
SPRUCE Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$1785.25   $1785.25   $0   
Medical and Dental$1764.89   $1764.89   $0   
Medical and Vision$1672.68   $1672.68   $0   
Medical only$1652.32   $1652.32   $0   

 
PINE Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$1685.25   $1685.25   $0   
Medical and Dental$1664.89   $1664.89   $0   
Medical and Vision$1572.68   $1572.68   $0   
Medical only$1552.32   $1552.32   $0   

 
MAPLE SINGLE Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$744.38   $744.38   $0   
Medical and Dental$724.02   $724.02   $0   
Medical and Vision$631.81   $631.81   $0   
Medical only$611.45   $611.45   $0   

 
MAPLE 2 PARTY Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$1355.38   $1355.38   $0   
Medical and Dental$1335.02   $1335.02   $0   
Medical and Vision$1242.81   $1242.81   $0   
Medical only$1222.45   $1222.45   $0   

 
MAPLE FAMILY Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$1844.35   $1844.35   $0   
Medical and Dental$1823.99   $1823.99   $0   
Medical and Vision$1731.78   $1731.78   $0   
Medical only$1711.42   $1711.42   $0   

 
SEQUOIA SINGLE Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$879.51   $879.51   $0   
Medical and Dental$859.15   $859.15   $0   
Medical and Vision$766.94   $766.94   $0   
Medical only$746.58   $746.58   $0   

 
SEQUOIA 2 PARTY Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$1625.54   $1625.54   $0   
Medical and Dental$1605.18   $1605.18   $0   
Medical and Vision$1512.97   $1512.97   $0   
Medical only$1492.61   $1492.61   $0   

 
SEQUOIA FAMILY Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee Share
Medical, Dental and Vision$2222.57   $1927.28   $295.29   
Medical and Dental$2202.21   $1927.28   $274.93   
Medical and Vision$2110   $1927.28   $182.72   
Medical only$2089.64   $1927.28   $162.36