Plan Costs

Costs below are monthly. Actual payroll deductions will occur bi-weekly.

Anthem Blue Cross HSA 1650

Employee Only: $0.00

Employee and Spouse/DP: $67.78

Employee and Child(ren): $55.45

Employee and Family: $95.51

Anthem Blue Cross Premier PPO 250

Employee Only: $64.04

Employee and Spouse/DP: $234.81

Employee and Child(ren): $192.12

Employee and Family: $397.05

Anthem Blue Cross EPO

Employee Only: $58.02

Employee and Spouse/DP: $212.75

Employee and Child(ren): $174.07

Employee and Family: $359.74

Kaiser HMO (CA)

Employee Only: $46.46

Employee and Spouse/DP: $136.27

Employee and Child(ren): $111.50

Employee and Family: $192.02

Kaiser HMO (HI)

Employee Only: $0.00

Employee and Spouse/DP: $79.56

Employee and Child(ren): $71.60

Employee and Family: $119.34

Guardian DPPO – Base

Employee Only: $0.00

Employee and Spouse/DP: $0.00

Employee and Child(ren): $0.00

Employee and Family: $0.00

Guardian DPPO – Premier

Employee Only: $13.24

Employee and Spouse/DP: $26.89

Employee and Child(ren): $38.58

Employee and Family: $53.02

VSP Vision – Base

Employee Only: $0

Employee and Spouse/DP: $0

Employee and Child(ren): $0

Employee and Family: $0

VSP Vision – Premier

Employee Only: $5.10

Employee and Spouse/DP: $10.20

Employee and Child(ren): $10.91

Employee and Family: $17.44

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 imputed income on your W-2. Contact your tax advisor for more details on how this tax treatment applies to you. Notify Whatnot if your domestic partner is your tax dependent.

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