Team Member Rates
California
| Medical Coverage (Pre-Tax; Monthly) |
Blue Shield PPO $aver/ HSA Plan | Blue Shield PPO Super $aver/ HSA Plan | Blue Shield HMO Plan | Blue Shield Trio HMO Plan | Kaiser Deductible HMO |
|---|---|---|---|---|---|
| Team Member Only | $265.00 | $120.00 | $312.00 | $124.00 | $251.00 |
| Team Member + Spouse/Registered Domestic Partner | $576.00 | $449.00 | $680.00 | $429.00 | $571.00 |
| Team Member + Child(ren) | $518.00 | $403.00 | $609.00 | $393.00 | $514.00 |
| Family* | $1,100.00 | $800.00 | $1,090.00 | $750.00 | $900.00 |
| Dental Coverage (Pre-Tax; Monthly) | DeltaCare USA DHMO | Delta Dental PPO |
|---|---|---|
| Team Member Only | $0.00 | $16.00 |
| Team Member + Spouse/Registered Domestic Partner | $17.00 | $63.00 |
| Team Member + Child(ren) | $15.00 | $53.00 |
| Family* | $32.00 | $110.00 |
| Vision Coverage (Pre-Tax; Monthly) | VSP Base | VSP Premier |
|---|---|---|
| Team Member Only | $6.00 | $9.00 |
| Team Member + Spouse/Registered Domestic Partner | $15.00 | $22.00 |
| Team Member + Child(ren) | $13.00 | $20.00 |
| Family* | $21.00 | $30.00 |
All States Other Than California
| Medical Coverage (Pre-Tax; Monthly) |
Blue Shield PPO $aver/ HSA Plan | Blue Shield PPO Super $aver/ HSA Plan | Blue Shield EPO Plan | Kaiser HI HMO |
|---|---|---|---|---|
| Team Member Only | $265.00 | $120.00 | $310.00 | $108.00 |
| Team Member + Spouse/Registered Domestic Partner | $576.00 | $449.00 | $666.00 | $545.00 |
| Team Member + Child(ren) | $518.00 | $403.00 | $597.00 | $489.00 |
| Family* | $1,100.00 | $800.00 | $1,060.00 | $900.00 |
| Dental Coverage (Pre-Tax; Monthly) | DeltaCare USA DHMO | Delta Dental PPO |
|---|---|---|
| Team Member Only | $0.00 | $16.00 |
| Team Member + Spouse/Registered Domestic Partner | $17.00 | $63.00 |
| Team Member + Child(ren) | $15.00 | $53.00 |
| Family* | $32.00 | $110.00 |
| Vision Coverage (Pre-Tax; Monthly) | VSP Base | VSP Premier |
|---|---|---|
| Team Member Only | $6.00 | $9.00 |
| Team Member + Spouse/Registered Domestic Partner | $15.00 | $22.00 |
| Team Member + Child(ren) | $13.00 | $20.00 |
| Family* | $21.00 | $30.00 |
California
| Medical Coverage (Pre-Tax; Monthly) |
Blue Shield PPO $aver/ HSA Plan | Blue Shield PPO Super $aver/ HSA Plan | Blue Shield HMO Plan | Blue Shield Trio HMO Plan | Kaiser Deductible HMO |
|---|---|---|---|---|---|
| Team Member Only | $230.00 | $104.00 | $260.00 | $104.00 | $220.00 |
| Team Member + Spouse/Registered Domestic Partner | $500.00 | $390.00 | $570.00 | $360.00 | $500.00 |
| Team Member + Child(ren) | $450.00 | $350.00 | $510.00 | $330.00 | $450.00 |
| Family* | $1,000.00 | $770.00 | $970.00 | $700.00 | $850.00 |
| Dental Coverage (Pre-Tax; Monthly) | DeltaCare USA DHMO | Delta Dental PPO |
|---|---|---|
| Team Member Only | $0.00 | $15.00 |
| Team Member + Spouse/Registered Domestic Partner | $17.00 | $60.00 |
| Team Member + Child(ren) | $15.00 | $50.00 |
| Family* | $32.00 | $105.00 |
| Vision Coverage (Pre-Tax; Monthly) | VSP Base | VSP Premier |
|---|---|---|
| Team Member Only | $6.00 | $9.00 |
| Team Member + Spouse/Registered Domestic Partner | $15.00 | $22.00 |
| Team Member + Child(ren) | $13.00 | $20.00 |
| Family* | $21.00 | $30.00 |
All States Other Than California
| Medical Coverage (Pre-Tax; Monthly) |
Blue Shield PPO $aver/ HSA Plan | Blue Shield PPO Super $aver/ HSA Plan | Blue Shield EPO Plan | Kaiser HI HMO |
|---|---|---|---|---|
| Team Member Only | $230.00 | $104.00 | $270.00 | $100.00 |
| Team Member + Spouse/Registered Domestic Partner | $500.00 | $390.00 | $580.00 | $509.00 |
| Team Member + Child(ren) | $450.00 | $350.00 | $520.00 | $457.00 |
| Family* | $1,000.00 | $770.00 | $980.00 | $872.00 |
| Dental Coverage (Pre-Tax; Monthly) | DeltaCare USA DHMO | Delta Dental PPO |
|---|---|---|
| Team Member Only | $0.00 | $15.00 |
| Team Member + Spouse/Registered Domestic Partner | $17.00 | $60.00 |
| Team Member + Child(ren) | $15.00 | $50.00 |
| Family* | $32.00 | $105.00 |
| Vision Coverage (Pre-Tax; Monthly) | VSP Base | VSP Premier |
|---|---|---|
| Team Member Only | $6.00 | $9.00 |
| Team Member + Spouse/Registered Domestic Partner | $15.00 | $22.00 |
| Team Member + Child(ren) | $13.00 | $20.00 |
| Family* | $21.00 | $30.00 |