Part-Time Employee Premiums
2012 Plan Year Benefit Rates
January 1, 2012 - December 31, 2012
Bi-weekly payroll deduction rates
|
Medical - Traditional
|
Well 1
|
Well 2
|
Non-Well
|
|
Employee Only
|
$148.24
|
$168.60
|
$188.37
|
|
Employee + Spouse
|
$350.88
|
$367.65
|
$400.14
|
|
Employee + Child(ren)
|
$262.48
|
$275.03
|
$301.11
|
|
Employee + Family
|
$440.64
|
$461.70
|
$503.56
|
|
Medical - Liberty
|
Well 1
|
Well 2
|
Non-Well
|
|
Employee Only
|
$137.34
|
$153.94
|
$169.53
|
|
Employee + Spouse
|
$325.08
|
$338.24
|
$360.12
|
|
Employee + Child(ren)
|
$243.18
|
$253.02
|
$271.00
|
|
Employee + Family
|
$408.24
|
$424.76
|
$453.20
|
|
Dental
|
Low
Plan
|
High
Plan
|
|
Employee Only
|
$5.71
|
$8.03
|
|
Employee + Spouse
|
$12.54
|
$18.24
|
|
Employee + Child(ren)
|
$13.64
|
$20.50
|
|
Employee + Family
|
$22.73
|
$33.06
|
|
Vision
|
Vision
|
|
Employee Only
|
$3.61
|
|
Employee + Spouse
|
$7.03
|
|
Employee + Child(ren)
|
$7.57
|
|
Employee + Family
|
$8.04
|