Per-Pay-Period Plan Costs

Aetna HDHP

Employee Only: $0.00

Employee and Spouse/DP: $55.50

Employee and Child(ren): $45.50

Employee and Family: $83.00

Aetna POS/PPO

Employee Only: $24.50

Employee and Spouse/DP: $112.50

Employee and Child(ren): $92.00

Employee and Family: $162.50

Aetna EPO

Employee Only: $19.00

Employee and Spouse/DP: $84.00

Employee and Child(ren): $69.00

Employee and Family: $124.50

Kaiser HMO

Employee Only: $17.00

Employee and Spouse/DP: $74.50

Employee and Child(ren): $68.00

Employee and Family: $101.50

Guardian Dental PPO

Employee Only: $0.00

Employee and Spouse/DP: $1.50

Employee and Child(ren): $2.50

Employee and Family: $3.50

Guardian Dental PPO w/ Ortho

Employee Only: $13.00

Employee and Spouse/DP: $24.50

Employee and Child(ren): $26.00

Employee and Family: $39.00

Guardian Vision (Base)

Employee Only: $0.00

Employee and Spouse/DP: $1.50

Employee and Child(ren): $2.50

Employee and Family: $4.00

Guardian Vision (Buy-Up)

Employee Only: $3.00

Employee and Spouse/DP: $5.50

Employee and Child(ren): $7.00

Employee and Family: $10.00

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 Addepar if your domestic partner is your tax dependent.