|Blue Plan Option||Green Plan Option||Orange plan Option|
Biweekly per paycheck contribution (full-time employees)
Non-tobacco users will receive a separate Tobacco-Free Health Credit of $18.46 per paycheck, lowering your total contribution.
|Employee & Spouse/Domestic Partner||$288.54||$174.00||$86.09|
|Employee & Children||$261.60||$158.30||$81.10|
|Employee & Family||$396.49||$236.06||$106.24|
Please note : Benefit coverage for non-tax-qualified dependents, which includes domestic partners, must be made on an after-tax basis. In addition, the employer contribution toward the cost of benefit coverage for a non-tax-qualified dependent will be included in your taxable income and income taxes will be withheld from your paycheck each pay period based on this amount. This amount, also known as imputed income, will be included in your annual gross income for federal tax purposes and shown on your Form W-2.
*Your deductions may differ slightly due to rounding.