2015 Monthly Medical Rates *
Salary Range
Gold Plan
Gold Plan
Gold Plan
Gold Plan
Gold Plan
Gold Plan
Gold Plan
Blue Plan
$0.00 – $29,999
$30,000 –
$34,999
$35.000 $44,999
$45,000 –
$63,999
$64,000 –
$88,999
$89,000 $120,999
$121,000 +
All Salaries
Employee
$73
$79
$86
$91
$97
$103
$109
$27
Employee +
Spouse/SSDP
$146
$158
$170
$182
$194
$207
$219
$55
Employee +
Child(ren)
$138
$150
$161
$173
$184
$196
$208
$52
Employee +
Spouse/SSDP +
Child(ren)
$211
$229
$247
$264
$282
$299
$317
$79
Adult Child(ren)
Additional $243/
month
Additional $243/
month
Additional $243/
month
Additional $243/
month
Additional $243/
month
Additional $243/
month
Additional $243/
month
Additional $218/
month
* Assumes 12 month employee.