Medical, Dental, and Vision Rates
The 2027 employee contribution amounts for medical, dental, and vision plans are provided in the charts below.
Medical Plan Rates
Costs for each medical plan option are based on your salary and your work status—full time (regular employees scheduled to work 30 or more hours per week) or part time (regular employees regularly scheduled to work between 20–29.9 hours per week).
These medical plan rates do not reflect the monthly $50 per person tobacco-use surcharge. Learn more about the tobacco surcharge and available reasonable alternatives for avoiding the surcharge, such as completing a tobacco cessation program.
Medical Plan Full-time Rates
Full-time employee rates for the three salary-based rate bands are listed below:
| Aetna HSA Plan | Aetna POS Plan | Kaiser Permanente Plan | ||||
|---|---|---|---|---|---|---|
| Monthly | Biweekly | Monthly | Biweekly | Monthly | Biweekly | |
| SALARY-BASED RATE BAND 1:< $28.84 hourly/$60,000 annually* | ||||||
| Employee only | $43.00 | $21.50 | $72.00 | $36.00 | $60.00 | $30.00 |
| Employee + child(ren) | $147.00 | $73.50 | $236.00 | $118.00 | $200.00 | $100.00 |
| Employee + spouse | $243.00 | $121.50 | $361.00 | $180.50 | $303.00 | $151.50 |
| Family | $334.00 | $167.00 | $508.00 | $254.00 | $426.00 | $213.00 |
| SALARY-BASED RATE BAND 2: $28.84 to $48.07 hourly/$60,000 to $100,000 annually* | ||||||
| Employee only | $50.00 | $25.00 | $85.00 | $42.50 | $71.00 | $35.50** |
| Employee + child(ren) | $175.00 | $87.50 | $281.00 | $140.50 | $238.00 | $119.00 |
| Employee + spouse | $288.00 | $144.00 | $429.00 | $214.50 | $360.00 | $180.00 |
| Family | $397.00 | $198.50 | $604.00 | $302.00 | $507.00 | $253.50 |
| SALARY-BASED RATE BAND 3: > $48.07 hourly/$100,000 annually* | ||||||
| Employee Only | $59.00 | $29.50 | $99.00 | $49.50 | $83.00 | $41.50 |
| Employee + child(ren) | $205.00 | $102.50 | $330.00 | $165.00 | $278.00 | $139.00 |
| Employee + spouse | $338.00 | $169.00 | $503.00 | $251.50 | $421.00 | $210.50 |
| Family | $466.00 | $233.00 | $707.00 | $353.50 | $593.00 | $296.50 |
* Annual salary based on someone who works 40 hours per week.
**The rate for this plan was incorrectly stated on the rates chart included in the newsletter mailed to employee’s homes. The correct rate for this plan is $35.50.
Medical Plan Part-time Rates
Part-time employee rates for the three salary-based rate bands are listed below:
| Aetna HSA Plan | Aetna POS Plan | Kaiser Permanente Plan | ||||
|---|---|---|---|---|---|---|
| Monthly | Biweekly | Monthly | Biweekly | Monthly | Biweekly | |
| SALARY-BASED RATE BAND 1:< $28.84 hourly/$60,000 annually* | ||||||
| Employee only | $54.00 | $27.00 | $90.00 | $45.00 | $75.00 | $37.50 |
| Employee + child(ren) | $184.00 | $92.00 | $295.00 | $147.50 | $250.00 | $125.00 |
| Employee + spouse | $304.00 | $152.00 | $451.00 | $225.50 | $379.00 | $189.50 |
| Family | $418.00 | $209.00 | $635.00 | $317.50 | $533.00 | $266.50 |
| SALARY-BASED RATE BAND 2: $28.84 to $48.07 hourly/$60,000 to $100,000 annually* | ||||||
| Employee only | $63.00 | $31.50 | $106.00 | $53.00 | $89.00 | $44.50 |
| Employee + child(ren) | $219.00 | $109.50 | $351.00 | $175.50 | $298.00 | $149.00 |
| Employee + spouse | $360.00 | $180.00 | $536.00 | $268.00 | $450.00 | $225.00 |
| Family | $496.00 | $248.00 | $755.00 | $377.50 | $634.00 | $317.00 |
| SALARY-BASED RATE BAND 3: > $48.07 hourly/$100,000 annually* | ||||||
| Employee Only | $74.00 | $3.700 | $124.00 | $62.00 | $104.00 | $52.00 |
| Employee + child(ren) | $256.00 | $128.00 | $413.00 | $206.50 | $348.00 | $174.00 |
| Employee + spouse | $423.00 | $211.50 | $629.00 | $314.50 | $526.00 | $263.00 |
| Family | $583.00 | $291.50 | $884.00 | $442.00 | $741.00 | $370.50 |
* Annual salary based on someone who works 40 hours per week.
Dental Plan Rates
| Aetna PPO Plan | Aetna DMO Plan | |||
|---|---|---|---|---|
| Monthly | Biweekly | Monthly | Biweekly | |
| Employee only | $31.00 | $15.50 | $20.00 | $10.00 |
| 2-Person | $69.00 | $34.50 | $40.00 | $20.00 |
| Family | $113.00 | $56.50 | $66.00 | $33.00 |
| Aetna PPO Plan | Aetna DMO Plan | |||
|---|---|---|---|---|
| Monthly | Biweekly | Monthly | Biweekly | |
| Employee only | $38.75 | $19.38 | $22.22 | $11.11 |
| 2-Person | $83.00 | $41.50 | $45.96 | $22.98 |
| Family | $139.00 | $69.50 | $72.58 | $36.29 |
Vision Plan Rates
| Monthly | Biweekly | |
|---|---|---|
| Employee only | $12.28 | $6.14 |
| Employee + child(ren) | $24.50 | $12.25 |
| Employee + spouse | $23.28 | $11.64 |
| Family | $36.08 | $18.04 |
Pharmacy Benefit Rates
| Tier | Co-Insurance (HSA and POS) | 30-Day Minimum (POS only) | 30-Day Maximum (HSA and POS) |
|---|---|---|---|
| Zero – Preventative | 0% | $0.00 | $0.00 |
| 1 – Generic | 10% | $10.00 | $25.00 |
| 2 – Preferred Brand | 20% | $30.00 | $75.00 |
| 3 – Non-Preferred Brand | 30% | $60.00 | $120.00 |
| 4 – Lifestyle | 40% | $90.00 | $150.00 |
| 5 – Select | 40% | 40% co-insurance (no minimum or maximum) | |
Prime Therapeutics will manage pharmacy benefits for the HSA and POS plans, replacing CVS/Caremark. Learn more.