Health Insurance Bi-Monthly Cost PPO HDHP 12 Month Employee 9 Month Employee 12 Month Employee 9 Month Employee Single Coverage Grandfathered $36.25 $48.33 $30.00 $40.00 Standard $50.00 $66.67 Assistance Plan $0.00 $0.00 Employee + Children Coverage Grandfathered $80.00 $106.67 $100.00 $133.33 Standard $168.00 $224.00 Assistance Plan $118.00 $157.33 Family Coverage Grandfathered $96.75 $129.00 $150.00 $200.00 Standard $225.75 $301.00 Assistance Plan $175.75 $234.33 Dental Insurance Bi-Monthly Cost Coverage Type 12 Month 9 Month Single $14.67 $19.56 Employee + One Dependent $28.75 $38.33 Family $36.73 $48.97 Vision Insurance Bi-Monthly Cost Coverage Type 12 Month 9 Month Single $4.04 $5.39 Employee + One Dependent $8.79 $11.72 Family $14.15 $18.87 LifeLock Bi-Monthly Cost Coverage Type 12 Month 9 Month Single $4.45 $5.93 Family $7.95 $10.60 Premiums are deducted from the first two checks in the month for those paid over 12 months. To calculate 9 month premiums, multiply bimonthly premium by 24 and divide by 18 payroll checks. Health, dental & vision premiums are paid from pre-tax dollars as allowed by Section 125 of the IRS Codes. Insurance is effective the first day of the month following start of employment/eligibility.