FTE:
%
      
BASE PLAN - OAK Monthly premiums
Benefit ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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 ChoiceTotal PremiumEmployer ShareEmployee 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