A listing of monthly premium rates for UVM's medical coverage for 2025 and 2026. Open Enrollment for 2026 benefits will run from October 27 - November 14.
Medical Premium rates vary year to year. Many of UVM's premium rates also vary by an individual's salary band. Please use the charts below to find your monthly premium information.
2026 Premium Rates - Non-Union Employees
PPO 1
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| Base Salary | Employee Cost | UVM Cost | Employee | Employee plus Spouse | Employee plus Children | Employee plus Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| less than $22,880 | 3.00% | 97.00% | $43.48 | $86.95 | $90.37 | $125.43 | $43.48 | $81.95 |
| $22,881 to $24,000 | 4.00% | 96.00% | $57.97 | $115.94 | $120.49 | $167.24 | $57.97 | $109.27 |
| $24,001 to $25,000 | 6.00% | 94.00% | $86.95 | $173.91 | $180.73 | $250.86 | $86.95 | $163.91 |
| $25,001 to $32,000 | 8.00% | 92.00% | $115.94 | $231.87 | $240.98 | $334.48 | $115.94 | $218.54 |
| $32,001 to $40,000 | 12.00% | 88.00% | $173.90 | $347.81 | $361.47 | $501.72 | $173.90 | $327.82 |
| $40,001 to $50,000 | 14.40% | 85.60% | $208.68 | $417.37 | $433.76 | $602.06 | $208.68 | $393.38 |
| $50,001 to $60,000 | 16.80% | 83.20% | $243.47 | $486.93 | $506.05 | $702.41 | $243.47 | $458.94 |
| $60,001 to $70,000 | 19.20% | 80.80% | $278.25 | $556.50 | $578.35 | $802.75 | $278.25 | $524.51 |
| $70,001 to $80,000 | 21.60% | 78.40% | $313.03 | $626.06 | $650.64 | $903.10 | $313.03 | $590.07 |
| $80,001 to $90,000 | 24.00% | 76.00% | $347.81 | $695.62 | $722.93 | $1,003.44 | $347.81 | $655.63 |
| $90,001 to $100,000 | 26.40% | 73.60% | $382.59 | $765.18 | $795.23 | $1,103.79 | $382.59 | $721.20 |
| $100,001 - $110,000 | 28.80% | 71.20% | $417.37 | $834.74 | $867.52 | $1,204.13 | $417.37 | $786.76 |
| $110,001 - $120,000 | 31.20% | 68.80% | $452.15 | $904.31 | $939.81 | $1,304.47 | $452.15 | $852.32 |
| $120,001 - $130,000 | 32.40% | 67.60% | $469.54 | $939.09 | $975.96 | $1,354.65 | $469.54 | $885.11 |
| $130,001 - $140,000 | 33.60% | 66.40% | $486.93 | $973.87 | $1,012.11 | $1,404.82 | $486.93 | $917.89 |
| $140,001 - $150,000 | 34.80% | 65.20% | $504.32 | $1,008.65 | $1,048.25 | $1,454.99 | $504.32 | $950.67 |
| >$150,001 | 36.00% | 64.00% | $521.71 | $1,043.43 | $1,084.40 | $1,505.16 | $521.71 | $983.45 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $1,449.20 | $2,898.42 | $3,012.22 | $4,181.01 | $1,449.20 | $2,731.81 |
PPO 2
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| Base Salary | Employee Cost | UVM Cost | Employee | Employee plus Spouse | Employee plus Children | Employee plus Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| less than $22,880 | 2.60% | 97.40% | $35.46 | $70.93 | $73.71 | $102.31 | $35.46 | $66.85 |
| $22,881 to $24,000 | 3.40% | 96.60% | $46.38 | $92.75 | $96.39 | $133.80 | $46.38 | $87.42 |
| $24,001 to $25,000 | 5.20% | 94.80% | $70.93 | $141.86 | $147.42 | $204.63 | $70.93 | $133.70 |
| $25,001 to $32,000 | 6.90% | 93.10% | $94.11 | $188.23 | $195.62 | $271.53 | $94.11 | $177.41 |
| $32,001 to $40,000 | 10.50% | 89.50% | $143.22 | $286.44 | $297.68 | $413.19 | $143.22 | $269.97 |
| $40,001 to $50,000 | 12.40% | 87.60% | $169.13 | $338.27 | $351.55 | $487.96 | $169.13 | $318.82 |
| $50,001-$80,000 | 15.00% | 85.00% | $204.60 | $409.20 | $425.26 | $590.27 | $204.60 | $385.67 |
| $80,001-$110,000 | 20.50% | 79.50% | $279.62 | $559.24 | $581.19 | $806.71 | $279.62 | $527.09 |
| $110,001+ | 25.50% | 74.50% | $347.82 | $695.64 | $722.95 | $1,003.46 | $347.82 | $655.65 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $1,363.98 | $2,727.98 | $2,835.09 | $3,935.15 | $1,363.98 | $2,571.17 |
HDHP 1
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| Base Salary | Employee Cost | UVM Cost | Employee | Employee plus Spouse | Employee plus Children | Employee plus Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| NO BANDING | 20.00% | 80.00% | $244.23 | $488.46 | $507.64 | $704.62 | $244.23 | $460.39 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $1,221.15 | $2,442.32 | $2,538.21 | $3,523.08 | $1,221.15 | $2,301.93 |
HDHP 2
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| Base Salary | Employee Cost | UVM Cost | Employee | Employee plus Spouse | Employee plus Children | Employee plus Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| NO BANDING | 20.00% | 80.00% | $214.46 | $428.93 | $445.77 | $618.73 | $214.46 | $404.27 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $1,072.31 | $2,144.64 | $2,228.85 | $3,093.67 | $1,072.31 | $2,021.36 |
2026 Premium Rates - Union Employees
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| Base Salary | Employee Cost | UVM Cost | Employee | Employee plus Spouse | Employee plus Children | Employee plus Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $15.00 to $18.99/hr. | 12.00% | 88.00% | $173.90 | $347.81 | $361.47 | $501.72 | $173.90 | $327.82 |
| $19.00 to $23.99/hr. | 14.40% | 85.60% | $208.68 | $417.37 | $433.76 | $602.06 | $208.68 | $393.38 |
| $24.00 to $28.99/hr. | 16.80% | 83.20% | $243.47 | $486.93 | $506.05 | $702.41 | $243.47 | $458.94 |
| $29.00 to $33.99/hr. | 19.20% | 80.80% | $278.25 | $556.50 | $578.35 | $802.75 | $278.25 | $524.51 |
| $34.00 to $38.99/hr. | 21.60% | 78.40% | $313.03 | $626.06 | $650.64 | $903.10 | $313.03 | $590.07 |
| Over $39.00/hr. | 24.00% | 76.00% | $347.81 | $695.62 | $722.93 | $1,003.44 | $347.81 | $655.63 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $1,449.20 | $2,898.42 | $3,012.22 | $4,181.01 | $1,449.20 | $2,731.81 |
United Academics (Part- and Full-Time)
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| Base Salary | Employee Cost | UVM Cost | Employee | Employee plus Spouse | Employee plus Children | Employee plus Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| less than $15,000 | 4.80% | 95.20% | $69.56 | $139.12 | $144.59 | $200.69 | $69.56 | $131.13 |
| $15,001 to $20,000 | 7.20% | 92.80% | $104.34 | $208.69 | $216.88 | $301.03 | $104.34 | $196.69 |
| $20,001 to $30,000 | 9.60% | 90.40% | $139.12 | $278.25 | $289.17 | $401.38 | $139.12 | $262.25 |
| $30,001 to $40,000 | 12.00% | 88.00% | $173.90 | $347.81 | $361.47 | $501.72 | $173.90 | $327.82 |
| $40,001 to $50,000 | 14.40% | 85.60% | $208.68 | $417.37 | $433.76 | $602.06 | $208.68 | $393.38 |
| $50,001 to $60,000 | 16.80% | 83.20% | $243.47 | $486.93 | $506.05 | $702.41 | $243.47 | $458.94 |
| $60,001 to $70,000 | 19.20% | 80.80% | $278.25 | $556.50 | $578.35 | $802.75 | $278.25 | $524.51 |
| $70,001 to $80,000 | 21.60% | 78.40% | $313.03 | $626.06 | $650.64 | $903.10 | $313.03 | $590.07 |
| $80,001 to $90,000 | 24.00% | 76.00% | $347.81 | $695.62 | $722.93 | $1,003.44 | $347.81 | $655.63 |
| $90,001 to $100,000 | 26.40% | 73.60% | $382.59 | $765.18 | $795.23 | $1,103.79 | $382.59 | $721.20 |
| $100,001 - $110,000 | 28.80% | 71.20% | $417.37 | $834.74 | $867.52 | $1,204.13 | $417.37 | $786.76 |
| $110,001 - $120,000 | 31.20% | 68.80% | $452.15 | $904.31 | $939.81 | $1,304.47 | $452.15 | $852.32 |
| $120,001 - $130,000 | 32.40% | 67.60% | $469.54 | $939.09 | $975.96 | $1,354.65 | $469.54 | $885.11 |
| $130,001 - $140,000 | 33.60% | 66.40% | $486.93 | $973.87 | $1,012.11 | $1,404.82 | $486.93 | $917.89 |
| $140,001 - $150,000 | 34.80% | 65.20% | $504.32 | $1,008.65 | $1,048.25 | $1,454.99 | $504.32 | $950.67 |
| $150,001 - $999,999+ | 36.00% | 64.00% | $521.71 | $1,043.43 | $1,084.40 | $1,505.16 | $521.71 | $983.45 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $1,449.20 | $2,898.42 | $3,012.22 | $4,181.01 | $1,449.20 | $2,731.81 |
United Electrical Workers
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| Base Salary | Employee Cost | UVM Cost | Employee | Employee plus Spouse | Employee plus Children | Employee plus Family |
|---|
| $15.00 to $18.99/hr. | 12.00% | 88.00% | $173.90 | $347.81 | $361.47 | $501.72 |
| $19.00 to $23.99/hr. | 14.40% | 85.60% | $208.68 | $417.37 | $433.76 | $602.06 |
| $24.00 to $28.99/hr. | 16.80% | 83.20% | $243.47 | $486.93 | $506.05 | $702.41 |
| Over $29.00/hr. | 19.20% | 80.80% | $278.25 | $556.50 | $578.35 | $802.75 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $1,449.20 | $2,898.42 | $3,012.22 | $4,181.01 | $1,449.20 | $2,731.81 |
UVM Staff United
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| Base Salary | Employee Cost | UVM Cost | Employee | Employee plus Spouse | Employee plus Children | Employee plus Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| less than $22,880 | 3.00% | 97.00% | $43.48 | $86.95 | $90.37 | $125.43 | $43.48 | $81.95 |
| $22,881 to $24,000 | 4.00% | 96.00% | $57.97 | $115.94 | $120.49 | $167.24 | $57.97 | $109.27 |
| $24,001 to $25,000 | 6.00% | 94.00% | $86.95 | $173.91 | $180.73 | $250.86 | $86.95 | $163.91 |
| $25,001 to $32,000 | 8.00% | 92.00% | $115.94 | $231.87 | $240.98 | $334.48 | $115.94 | $218.54 |
| $32,001 to $40,000 | 12.00% | 88.00% | $173.90 | $347.81 | $361.47 | $501.72 | $173.90 | $327.82 |
| $40,001 to $50,000 | 14.40% | 85.60% | $208.68 | $417.37 | $433.76 | $602.06 | $208.68 | $393.38 |
| $50,001 to $60,000 | 16.80% | 83.20% | $243.47 | $486.93 | $506.05 | $702.41 | $243.47 | $458.94 |
| $60,001 to $70,000 | 19.20% | 80.80% | $278.25 | $556.50 | $578.35 | $802.75 | $278.25 | $524.51 |
| $70,001 to $80,000 | 21.60% | 78.40% | $313.03 | $626.06 | $650.64 | $903.10 | $313.03 | $590.07 |
| $80,001 to $90,000 | 24.00% | 76.00% | $347.81 | $695.62 | $722.93 | $1,003.44 | $347.81 | $655.63 |
| $90,001 to $100,000 | 26.40% | 73.60% | $382.59 | $765.18 | $795.23 | $1,103.79 | $382.59 | $721.20 |
| $100,001 - $110,000 | 28.80% | 71.20% | $417.37 | $834.74 | $867.52 | $1,204.13 | $417.37 | $786.76 |
| $110,001 - $120,000 | 31.20% | 68.80% | $452.15 | $904.31 | $939.81 | $1,304.47 | $452.15 | $852.32 |
| $120,001 - $130,000 | 32.40% | 67.60% | $469.54 | $939.09 | $975.96 | $1,354.65 | $469.54 | $885.11 |
| $130,001 - $140,000 | 33.60% | 66.40% | $486.93 | $973.87 | $1,012.11 | $1,404.82 | $486.93 | $917.89 |
| $140,001 - $150,000 | 34.80% | 65.20% | $504.32 | $1,008.65 | $1,048.25 | $1,454.99 | $504.32 | $950.67 |
| >$150,001 | 36.00% | 64.00% | $521.71 | $1,043.43 | $1,084.40 | $1,505.16 | $521.71 | $983.45 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family | Domestic Partner | Domestic Partner w/Non-Dependent Children |
|---|
| $1,449.20 | $2,898.42 | $3,012.22 | $4,181.01 | $1,449.20 | $2,731.81 |
2025 Non-Union Medical Premiums
PPO 1
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In PPO 1, an employee pays a percentage of the total premium based on salary band.
Monthly Premium Cost for Employees
| Base Salary | Cost-Share | Employee | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| Less than $22,880 | 3.00% | $41.41 | $82.81 | $86.06 | $119.46 |
| $22,881 to $24,000 | 4.00% | $55.21 | $110.42 | $114.75 | $159.28 |
| $24,001 to $25,000 | 6.00% | $82.81 | $165.62 | $172.13 | $238.91 |
| $25,001 to $32,000 | 8.00% | $110.42 | $220.83 | $229.50 | $318.55 |
| $32,001 to $40,000 | 12.00% | $165.62 | $331.25 | $344.25 | $477.83 |
| $40,001 to $50,000 | 14.40% | $198.75 | $397.50 | $413.10 | $573.40 |
| $50,001 to $60,000 | 16.80% | $231.87 | $463.75 | $481.96 | $668.96 |
| $60,001 to $70,000 | 19.20% | $265.00 | $530.00 | $550.81 | $764.53 |
| $70,001 to $80,000 | 21.60% | $298.12 | $596.25 | $619.66 | $860.09 |
| $80,001 to $90,000 | 24.00% | $331.25 | $662.50 | $688.51 | $955.66 |
| $90,001 to $100,000 | 26.40% | $364.37 | $728.75 | $757.36 | $1,051.22 |
| $100,001 - $110,000 | 28.80% | $397.49 | $795.00 | $826.21 | $1,146.79 |
| $110,001 - $120,000 | 31.20% | $430.62 | $861.24 | $895.06 | $1,242.36 |
| $120,001 - $130,000 | 32.40% | $447.18 | $894.37 | $929.48 | $1,290.14 |
| $130,001 - $140,000 | 33.60% | $463.74 | $927.49 | $963.91 | $1,337.92 |
| $140,001 - $150,000 | 34.80% | $480.31 | $960.62 | $998.34 | $1,385.70 |
| Over $150,001 | 36.00% | $496.87 | $993.74 | $1,032.76 | $1,433.49 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $1,380.19 | $2,760.40 | $2,868.78 | $3,981.91 |
PPO 2
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Monthly Premium Cost for Employees
In PPO 2, an employee pays a percentage of the total premium based on salary band.
| Base Salary | Cost-Share | Employee | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| Less than $50,000 | 10.50% | $136.64 | $273.28 | $284.01 | $394.20 |
| $50,001 to $80,000 | 15.00% | $194.28 | $388.57 | $403.82 | $560.51 |
| $80,001 to $110,000 | 20.50% | $266.56 | $533.13 | $554.06 | $769.05 |
| Over $110,001 | 25.50% | $331.39 | $662.79 | $688.81 | $956.08 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $1,299.03 | $2,598.08 | $2,700.09 | $3,747.76 |
HDHP 1
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An employee pays 20% of the premium rates for HDHP 1. UVM and the employee split the cost 80/20 regardless of salary.
Monthly Premium Cost for Employees
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $232.60 | $465.20 | $483.47 | $671.06 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $1,163.00 | $2,326.02 | $2,417.34 | $3,355.31 |
HDHP 2
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An employee pays 20% of the premium rates for HDHP 2. UVM and the employee split the cost 80/20 regardless of salary.
Monthly Premium Cost for Employees
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $204.25 | $408.50 | $424.45 | $589.27 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $1,021.25 | $2,042.51 | $2,122.71 | $2,946.35 |
2025 Union Premium Rates
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Monthly Premium Cost for Employees
| Base Salary | Cost-Share | Employee | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $15.00 to $18.99 | 12.00% | $165.62 | $331.25 | $344.25 | $477.83 |
| $19.00 to $23.99 | 14.40% | $198.75 | $397.50 | $413.10 | $573.40 |
| $24.00 to $28.99 | 16.80% | $231.87 | $463.75 | $481.96 | $668.96 |
| $29.00 to $33.99 | 19.20% | $265.00 | $530.00 | $550.81 | $764.53 |
| $34.00 to $38.99 | 21.60% | $298.12 | $596.25 | $619.66 | $860.09 |
| Over $39.00 | 24.00% | $331.25 | $662.50 | $688.51 | $955.60 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $1,380.19 | $2,760.40 | $2,868.78 | $3,981.91 |
United Academics (Full-Time & Part-Time)
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Monthly Premium Cost for Employees
| Base Salary | Cost-Share | Employee | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| less than $15,000 | 4.80% | $66.25 | $132.50 | $137.70 | $191.13 |
| $15,001 to $20,000 | 7.20% | $99.37 | $198.75 | $206.55 | $286.70 |
| $20,001 to $30,000 | 9.60% | $132.50 | $265.00 | $275.40 | $382.26 |
| $30,001 to $40,000 | 12.00% | $165.62 | $331.25 | $344.25 | $477.83 |
| $40,001 to $50,000 | 14.40% | $198.75 | $397.50 | $413.10 | $573.40 |
| $50,001 to $60,000 | 16.80% | $231.87 | $463.75 | $481.96 | $668.96 |
| $60,001 to $70,000 | 19.20% | $265.00 | $530.00 | $550.81 | $764.53 |
| $70,001 to $80,000 | 21.60% | $298.12 | $596.25 | $619.66 | $860.09 |
| $80,001 to $90,000 | 24.00% | $331.25 | $662.50 | $688.51 | $955.66 |
| $90,001 to $100,000 | 26.40% | $364.37 | $728.75 | $757.36 | $1,051.22 |
| $100,001 to $110,000 | 28.80% | $397.49 | $795.00 | $826.21 | $1,146.79 |
| $110,001 to $120,000 | 31.20% | $430.62 | $861.24 | $895.06 | $1,242.36 |
| $120,001 to $130,000 | 32.40% | $447.18 | $894.37 | $929.48 | $1,290.14 |
| $130,001 to $140,000 | 33.60% | $463.74 | $927.49 | $963.91 | $1,337.92 |
| $140,001 to $150,000 | 34.80% | $480.31 | $960.62 | $998.34 | $1,385.70 |
| $150,001 to $999,999+ | 36.00% | $496.87 | $993.74 | $1,032.76 | $1,433.49 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $1,380.19 | $2,760.40 | $2,868.78 | $3,981.91 |
United Electrical Workers
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Monthly Premium Cost for Employees
| Base Salary | Cost-Share | Employee | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $15.00 to $18.99 | 12.00% | $165.62 | $331.25 | $344.25 | $477.83 |
| $19.00 to $23.99 | 14.40% | $198.75 | $397.50 | $413.10 | $573.40 |
| $24.00 to $28.99 | 16.80% | $231.87 | $463.75 | $481.96 | $668.96 |
| Over $29.00 | 19.20% | $265.00 | $530.00 | $550.81 | $764.53 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $1,380.19 | $2,760.40 | $2,868.78 | $3,981.91 |
UVM Staff United
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Employee pays a percentage of the total premium based on salary band.
Monthly Premium Cost for Employees
| Base Salary | Cost-Share | Employee | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| Less than $22,880 | 3.00% | $41.41 | $82.81 | $86.06 | $119.46 |
| $22,881 to $24,000 | 4.00% | $55.21 | $110.42 | $114.75 | $159.28 |
| $24,001 to $25,000 | 6.00% | $82.81 | $165.62 | $172.13 | $238.91 |
| $25,001 to $32,000 | 8.00% | $110.42 | $220.83 | $229.50 | $318.55 |
| $32,001 to $40,000 | 12.00% | $165.62 | $331.25 | $344.25 | $477.83 |
| $40,001 to $50,000 | 14.40% | $198.75 | $397.50 | $413.10 | $573.40 |
| $50,001 to $60,000 | 16.80% | $231.87 | $463.75 | $481.96 | $668.96 |
| $60,001 to $70,000 | 19.20% | $265.00 | $530.00 | $550.81 | $764.53 |
| $70,001 to $80,000 | 21.60% | $298.12 | $596.25 | $619.66 | $860.09 |
| $80,001 to $90,000 | 24.00% | $331.25 | $662.50 | $688.51 | $955.66 |
| $90,001 to $100,000 | 26.40% | $364.37 | $728.75 | $757.36 | $1,051.22 |
| $100,001 - $110,000 | 28.80% | $397.49 | $795.00 | $826.21 | $1,146.79 |
| $110,001 - $120,000 | 31.20% | $430.62 | $861.24 | $895.06 | $1,242.36 |
| $120,001 - $130,000 | 32.40% | $447.18 | $894.37 | $929.48 | $1,290.14 |
| $130,001 - $140,000 | 33.60% | $463.74 | $927.49 | $963.91 | $1,337.92 |
| $140,001 - $150,000 | 34.80% | $480.31 | $960.62 | $998.34 | $1,385.70 |
| Over $150,001 | 36.00% | $496.87 | $993.74 | $1,032.76 | $1,433.49 |
Total Monthly Premium
| Employee Only | Employee + Spouse | Employee + Children | Employee + Family |
|---|
| $1,380.19 | $2,760.40 | $2,868.78 | $3,981.91 |