Bi-Weekly Plan Costs

Kaiser HMO (CA Only)

Non-Exempt

Employee Only: $101.00

Employee and Spouse/DP: $257.00

Employee and Child(ren): $230.00

Employee and Family: $402.00

Exempt

Employee Only: $147.00

Employee and Spouse/DP: $359.00

Employee and Child(ren): $318.00

Employee and Family: $523.00

Cigna EPO

Non-Exempt

Employee Only: $101.00

Employee and Spouse/DP: $257.00

Employee and Child(ren): $230.00

Employee and Family: $402.00

Exempt

Employee Only: $147.00

Employee and Spouse/DP: $359.00

Employee and Child(ren): $318.00

Employee and Family: $523.00

Cigna PPO

Non-Exempt

Employee Only: $136.00

Employee and Spouse/DP: $331.00

Employee and Child(ren): $293.00

Employee and Family: $498.00

Exempt

Employee Only: $174.00

Employee and Spouse/DP: $414.00

Employee and Child(ren): $367.00

Employee and Family: $635.00

Cigna HDHP

Non-Exempt

Employee Only: $70.00

Employee and Spouse/DP: $195.00

Employee and Child(ren): $177.00

Employee and Family: $307.00

Exempt

Employee Only: $103.00

Employee and Spouse/DP: $266.00

Employee and Child(ren): $241.00

Employee and Family: $393.00

Cigna Dental Base PPO

Employee Only: $8.75

Employee and Spouse/DP: $25.18

Employee and Child(ren): $34.44

Employee and Family: $50.87

Cigna Dental Buy-Up PPO

Employee Only: $16.03

Employee and Spouse/DP: $39.38

Employee and Child(ren): $52.54

Employee and Family: $75.90

Cigna Dental HMO

Employee Only: $4.14

Employee and Spouse/DP: $10.75

Employee and Child(ren): $10.63

Employee and Family: $19.33

VSP Base Vision

Employee Only: $1.72

Employee and Spouse/DP: $3.79

Employee and Child(ren): $3.90

Employee and Family: $7.34

VSP Buy-Up Vision

Employee Only: $5.21

Employee and Spouse/DP: $8.66

Employee and Child(ren): $8.84

Employee and Family: $14.25

Domestic Partner Coverage

Please note that unless your domestic partner is your tax dependent as defined by the IRS, contributions for domestic partner coverage must be made after-tax. Similarly, the company contribution toward coverage for your domestic partner and his/her dependents will be reported as taxable income on your W-2. Contact your tax advisor for more details on how this tax treatment applies to you. Notify Clyde & Co if your domestic partner is your tax dependent.