| BASE PLAN - Oak Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Employee Only | $833.00 | $833.00 | $0 |
| Employee + Spouse/Partner | $1665.00 | $1665.00 | $0 |
| Employee + Child/Children | $1343.00 | $1343.00 | $0 |
| Employee + Family | $2056.00 | $2056.00 | $0 |
| Spruce Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Employee Only | $651.00 | $651.00 | $0 |
| Employee + Spouse/Partner | $1302.00 | $1302.00 | $0 |
| Employee + Child/Children | $1045.00 | $1045.00 | $0 |
| Employee + Family | $1603.00 | $1603.00 | $0 |
| Pine Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Employee Only | $459.00 | $459.00 | $0 |
| Employee + Spouse/Partner | $919.00 | $919.00 | $0 |
| Employee + Child/Children | $768.00 | $768.00 | $0 |
| Employee + Family | $958.00 | $958.00 | $0 |
| Maple Monthly premiums | |||
|---|---|---|---|
| Benefit Choice | Total Premium | Employer Share | Employee Share |
| Employee Only | $584.00 | $584.00 | $0 |
| Employee + Spouse/Partner | $1168.00 | $1168.00 | $0 |
| Employee + Child/Children | $1054.00 | $1054.00 | $0 |
| Employee + Family | $1551.00 | $1551.00 | $0 |