| Benefit Plan | Employee Only | Employee + Spouse/Domestic Partner | Employee + Child(ren) | Employee + Family |
|---|---|---|---|---|
| Medical | ||||
| Cigna Open Access Plus with HSA – Basic | $16.76 | $115.37 | $60.23 | $147.89 |
| Cigna Open Access Plus with HSA – Enhanced | $38.67 | $169.31 | $89.30 | $213.12 |
| Cigna Open Access Plus | $95.33 | $252.35 | $158.44 | $313.55 |
| Dental | ||||
| Cigna Dental DHMO | $0.92 | $2.59 | $3.02 | $4.51 |
| Cigna Dental DPPO Basic | $2.44 | $8.33 | $10.10 | $13.48 |
| Cigna Dental DPPO Enhanced | $5.20 | $15.78 | $19.15 | $25.55 |
| Vision | ||||
| VSP Vision Plan | $0.46 | $2.91 | $2.97 | $4.79 |