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2022 Contribution Costs
BIWEEKLY
Employee Only
Employee Only
Employee and Spouse
Employee and Children
Employee and Family
Employee Only
Employee Only
Employee and Spouse
Employee and Children
Employee and Family
Employee Only
Employee Only
Employee and Spouse
Employee and Children
Employee and Family
Basic HSA
$19.50 $84.00 $67.00 $131.50
$9.75 $42.00 $33.50 $65.75
Dental Basic
$10.48 $20.96 $26.19 $36.67
$5.24 $10.48 $13.10 $18.33
Vision Basic
$3.51 $7.01 $6.31 $10.51
$1.75 $3.51 $3.16 $5.25
HSA Plus
$36.00 $125.00 $100.00 $182.00
$18.00 $62.50 $50.00 $91.00
Dental Choice
$12.55 $25.10 $31.37 $43.92
$6.28 $12.55 $15.69 $21.96
Vision Buy-up
$4.10 $7.61 $6.90 $11.10
$2.05 $3.80 $3.45 $5.55
Basic PPO
$38.16 $132.50 $106.00 $192.92
$19.08 $66.25 $53.00 $96.46
Classic PPO
$67.50 $215.50 $180.00 $281.50
$33.75 $107.75 $90.00 $140.75
Employee and Spouse
Employee and Children
Employee and Family
WEEKLY
BIWEEKLY
Employee and Spouse
Employee and Children
Employee and Family
WEEKLY
BIWEEKLY
Employee and Spouse
Employee and Children
Employee and Family
WEEKLY
Contribution costs I 21
