Health Plans

In-Network

Gold 500 FSA + Vision

Silver 4250 HSA + Vision

Bronze 5000 HSA + Vision

Annual Deductible:

Cell
Cell
Cell

Solo Coverage Only

$500

$4,250

$5,000

Individual Member of Family

$1,000

$8,150

$8,150

Combined Family

$1,000

$8,500

$10,000

Out-of-Pocket Max:

Cell
Cell
Cell

Solo Coverage Only

$6,500

$4,250

$6,900

Individual Member of Family

$13,000

$8,150

$8,150

Combined Family

$13,000

$8,500

$13,800

Monthly Premiums

Medical Pre-Tax

Gold 500 FSA + Vision

Silver 4250 HSA + Vision

Bronze 5000 HSA + Vision

Employee Only

$433.54

$328.07

$265.43

Employee + Spouse

$864.13

$653.19

$527.91

Employee + Children

$799.54

$604.42

$488.54

Employee + Family

$1,230.13

$929.54

$751.02

Dental Insurance

Dental Pre-Tax

Monthly Premium

Employee Only

$42.46

Employee + Spouse

$84.92

Employee + Children

$99.28

Employee + Family

$149.32

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