Per-Pay-Period Plan Costs

UHC PPO 2000

Employee Only: $38.00

Employee and Spouse/DP: $218.00

Employee and Child(ren): $174.00

Employee and Family: $343.00

UHC PPO 1000

Employee Only: $54.00

Employee and Spouse/DP: $311.00

Employee and Child(ren): $251.00

Employee and Family: $496.00

Kaiser HMO

Employee Only: $58.00

Employee and Spouse/DP: $267.00

Employee and Child(ren): $232.00

Employee and Family: $411.00

Principal Dental

Employee Only: $3.00

Employee + 1: $15.00

Employee + 2+: $40.00

Principal Vision

Employee Only: $1.00

Employee and Spouse/DP: $2.00

Employee and Child(ren): $2.00

Employee and Family: $5.00

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