HomeMy WebLinkAbout102-19 - Res. Amending Res. 26-19 Determining the County's 2020 Health Insurance Contributions RESOLUTION NO. /na-/9
AMEND RESOLUTION NO. 26-19 DETERMINING THE COUNTY'S
2020 HEALTH INSURANCE CONTRIBUTIONS
WHEREAS, RCW 36.40.080 states that the Board of County Commissioners shall fix and determine each
item of the budget separately and shall by resolution adopt the budget; and
WHEREAS, RCW 36.16.070 states that the Board shall fix the benefit compensation of all employees; and
WHEREAS, the Board has determined that the County's contribution towards health insurance
premiums for Elected Officials and eligible Non-Represented employees shall increase by $52 per month
for a total contribution of $1,310 (One thousand three hundred and ten dollars) per month, effective
January 1, 2020; and
WHEREAS, the Board has determined that the County's contribution towards health insurance
premiums for Elected Officials, eligible Non-Represented employees, and also those members of the
Collective Bargaining Agreements who participate in PEBB medical insurance to utilize the pooling
method; and
NOW THEREFORE BE IT RESOLVED, effective January 1, 2020, the Board of County Commissioners does
hereby establish the County's health insurance contribution rate for any Collective Bargaining
Agreement (General Services) in place, but not ratified on January 1, 2019 utilizing the pooling method,
and resulting in a distribution as follows:
$963.08 per month for those individuals enrolled in PEBB medical as an employee only (no
dependent coverage). This contribution also covers dental, vision, and basic life insurance.
$1,460.21 per month those individuals enrolled in PEBB medical as an employee with one or
more dependents. This contribution also covers dental, vision, and basic life insurance.
NOW THEREFORE BE IT RESOLVED, effective January 1, 2020, the Board of County Commissioners does
hereby establish the County's health insurance contribution rate for any Collective Bargaining
Agreement (Community & Family Health and Deputy Prosecutors) in place, but not ratified on January
1, 2020 utilizing the pooling method, and resulting in a distribution as follows:
$963.08 per month for those individuals enrolled in PEBB medical as an employee only (no
dependent coverage). This contribution also covers dental, vision, and basic life insurance.
$1,512.21 per month those individuals enrolled in PEBB medical as an employee with one or
more dependents. This contribution also covers dental, vision, and basic life insurance.
NOW THEREFORE BE IT RESOLVED, effective January 1, 2020, the Board of County Commissioners does
hereby establish the County's health insurance contribution rate for any Collective Bargaining
Agreements (Probation, Public Defenders, Elected Officials, and Non Represented) in place and ratified
on January 1, 2020 utilizing the pooling method, and resulting in a distribution as follows:
$963.08 per month per Employee for those individuals enrolled in PEBB medical as an employee
only (no dependent coverage). This contribution also covers dental, vision, and basic life
insurance.
$1,564.21 per month per Employee for those individuals enrolled in PEBB medical as an
employee with one or more dependents. This contribution also covers dental, vision, and basic
life insurance.
Approved this5-'-day of �(�oVP.vu�P✓' 2019
BOARD OF COUNTY COMMISSIONERS
KevinShutty, 4airperson
Sharon Trask, Commissioner
;-e -'01*�<
Rand Neatherlin, Commissioner
Attest:
Me iss r wry, Clerk- of the Board
Approved as to Form:
Tim Whitehead, Chief Deputy Prosecutor
cc: Financial Services, Payroll
Human Resources
All Elected Officials and Department Heads
PEBB
Effective Jan 01,2020 County Pooling Contribution Calculations
NON-UNION EMPLOYEES,ELECTED OFFICIALS,GENERAL SERVICES,PROBATION,COMMUNITY FAMILY HEALTH,DEPUTY PROSECUTORS,&PUBLIC DEFENDERS
Counts as of October 14,2019
2018 Contribution per Employee-
General Services $1,206.00 minus $963.08 Highest Employee only premium = $242.92
2019 Contribution per Employee-
Com&Family Health&Deputy
Prosecutors $1,258.00 minus $963.08 Highest Employee only premium $294.92
2020 Contribution per Employee-
Probation,Public Defenders,Elected
Officials&Non-Represented $1,310.00 minus $963.08 Highest Employee only premium = $346.92
2018 Contribution per Employee-
General Services $242.92 X 29 Employee only premiums = $7,044.68
2019 Contribution per Employee-
Com&Family Health&Deputy
Prosecutors $294.92 X 9 Employee only premiums = $2,654.28
2020 Contribution per Employee-
Probation,Public Defenders,Elected
Officials&Non-Represented $346.92 X 23 Employee only premiums = $7,979.16
1 Medical Waiver $1,206.00 minus $154.36 PEBB dental,vision,life only amount = $1,051.64
2 Medical Waiver $1,206.00 minus $154.36 PEBB dental,vision,life only amount = $1,051.64
1 Medical Waiver $1,310.00 minus $154.36 PEBB dental,vision,life only amount = $1,155.64
2 Medical Waiver _ $1,310.00 minus $154.36 PEBB dental,vision,life only amount = $1,155.64
3 Medical Waiver $1,310.00 minus $154.36 PEBB dental,vision,life only amount = $1,155.64
4 Medical Waiver $1,310.00 minus $154.36 PEBB dental,vision,life only amount = $1,155.64
Total pooling per month for dependent coverage = $24,403.96
$24,403.96 divided by 96 Employee+Dependent Coverages = $254.21
2018 Contribution per Employee-
General Services $1,206.00 + $254.21 Pooling amount per Employee+Dependent Coverages = $1,460.21
2019 Contribution per Employee-
Com&Family Health&Deputy
Prosecutors $1,258.00 + $254.21 Pooling amount per Employee+Dependent Coverages = $1,512.21
2020 Contribution per Employee-
Probation,Public Defenders,Elected
Officials&Non-Represented $1,310.00 + $254.21 Pooling amount per Employee+Dependent Coverages = $1,564.21
Pooled County Contribution for Employee+Dependent Coverage =
Pooled County Contribution for Employee only Coverage = $963.08
Premium #Months Premium
2018 Contribution per Employee-
General Services $1,460.21 12 $ 17,522.50
2019 Contribution per Employee-
Com&Family Health&Deputy
Prosecutors $1,512.21 12 $ 18,146.50
2020 Contribution per Employee-
Probation,Public Defenders,Elected
Officials&Non-Represented $1,564.21 12 $ 18,770.50
2020 Contribution for all Employee — -
Only Coverage $963.08 12 $11,556.96
PUBLIC DEFENDERS,PROBATION,ELECTED OFFICIALS& NON REPRESENTED
PEBB-Medical and Dental 2020
The County premium contribution using the pooling method,effective January 1,2020,by Resolution —All pooled @ 2020 rate of$1,310
Copays Annual Deductibles Max out-of-pocket Employee EE/Spouse EE/Children Full Family
Kaiser Permanente WA PREMIUM $913.45 $1,672.54 $1,482.77 $2,241.85
(Group Health Classic) $15 Primary Care S175/Person $2,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,564.21 $1,564.21 $1,564.21
$30 Specialist $525/Family $4,000/Family EMPLOYEE PAYS(Payroll Deduction) None $108.33 None $677.64
Kaiser Permanente WA PREMIUM $837.01 $1,519.66 $1,349.00 $2,031.65
(Group Health Value) $30 Primary Care $250/Person $3,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,564.21 $1,564.21 $1,564.21
S50 Specialist $750/Family $6,000/Family EMPLOYEE PAYS(Payroll Deduction) None None None $467.44
Kaiser Permanente WA PREMIUM $771.46 $1,383.40 $1,245.00 $1,798.62
(Group HealthCDHP) 10%/Primary Care $1,400/Person $5,100/Person COUNTY POOLED CONTRIBUTION $963.08 $1,564.21 $1,564.21 $1,564.21
10%Specialist $2,800/Family $10,200/Family EMPLOYEE PAYS(Payroll Deduction) None None None $234.41
Kaiser Permanente WA PREMIUM $779.79 $1,405.22 $1,248.87 $1,874.30
(Group Health Sound Choice) 0 Primary Care S125/Person S2,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,564.21 $1,564.21 $1,564.21
(Must live or work in Snohomish,King,
Pierce or Thurston County) 15%Specialist $375 Family $4,000/Family EMPLOYEE PAYS(Payroll Deduction) None None None $310.09
Uniform Medical Plan Classic PREMIUM $841.02 $1,527.67 $1,356.01 $2,042.67
15%Primary Care $250/Person S2,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,564.21 $1,564.21 $1,564.21
15%Specialist $750/Family $4,000/Family EMPLOYEE PAYS(Payroll Deduction) None None None $478.46
Uniform Medical Plan CDHP PREMIUM $769.65 $1,379.78 $1,241.83 $1,793.64
15%Primary Care $1,400/Person $4,200/Person COUNTY POOLED CONTRIBUTION $963.08 $1,564.21 $1,564.21 $1,564.21
15%Specialist S2,800/Family $8,400/Family EMPLOYEE PAYS(Payroll Deduction) None None None 5229.43
Uniform Medical Plan PLUS or PREMIUM $806.27 $1,458.18 $1,295.18 $1,947.12
Uniform Medical Plan Plus UW
Medicine ACN 0%Primary Care S125/Person S2,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,564.21 $1,564.21 $1,564.21
taw .avo w v , uu me,a..uay,
Pierce,Spokane,Yakima,Skagit or Thurston I S%Specialist $375/Family $4,000/Family EMPLOYEE PAYS(Payroll Deduction) None None None $382.91
Tobacco Use Surcharge $25.00 $25.00 $25.00 $25.00
Spouse Waiver Premium Surcharge $0.00 $50.00 $0.00 $50.00
Medical Waived $154.36 $154.36 $154.36 1 $154.36
DENTAL Deductibles Max out-of-pocket VISION BASIC LIFE AND AD&D Insurance
Uniform Dental Group#3000 $50/Person$150/Family You pay amounts Included in medical plan Basic Life $35,000 Basic AD&D $5,000
Delta Dental PPO over$1,750 May enroll in supplemental Term Life Insurance without providing
Delta Care Group#3100 No General Plan You pay any amount over$150 every 24 evidence of insurability If enrolled no later than 60 days after
NONE months for frames,lenses,contacts and becoming eligible.
Managed care w limited dentists Maximum
g / fitting fees combined.Exception:for UMP
Willamette Dental No General Plan Classic,you pay any amount over$65 for May enroll in optional LTD within 31 days of Initial eligibility for
NONE contact lens fitting fees. PEBB benefits.After 31 days must also complete Evidence of
Managed care&their facilities Maximum Insurability form.
COMMUNITY FAMILY HEALTH
PEBB-Medical and Dental 2020
The County premium contribution using the pooling method_effective January 1,2020,by Resolution _.All pooled @ 2019 rate of$1258
Copays Annual Deductibles Max out-of-pocket Employee EE/Spouse EE/Children Full Family
Kaiser Permanente WA PREMIUM $913.45 $1,672.54 $1,482.77 $2,241.85
(Group Health Classic) $15 Primary Care $175/Person $2,000/Person, COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
$30 Specialist $525/Family $4,060/Family EMPLOYEE PAYS(Payroll Deduction) None $160.33 None $729.64
Kaiser Permanente WA PREMIUM $837.01 $1,519.66 $1,349.00 $2,031.65
(Group Health Value) $30 Primary Care $250/Person $3,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
$50 Specialist $750/Family $6,000/Family EMPLOYEE PAYS(Payroll Deduction) None $7.45 None $519.44
Kaiser Permanente WA PREMIUM $771.46 $1,383.40 $1,245.00 $1,798.62
(Group HealthCDHP) t0%/Primary Care $1,400/Person $5,100/Person COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
10%Specialist $2,800/Family $10,200/Family EMPLOYEE PAYS(Payroll Deduction) None None None $286.41
Kaiser Permanente WA PREMIUM $779.79 $1,405.22 $1,248.87 $1,874.30
(Group Health Sound Choice) 0Primary Care $125/Person $2,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
(Must live or work in Snohomish,King,
Pierce or Thurston County) 15%Specialist $375 Family $4,000/Family EMPLOYEE PAYS(Payroll Deduction) None None None $362.09
Uniform Medical Plan Classic PREMIUM $841.02 $1,527.67 $1,356.01 $2,042.67
15%Primary Care $250/Person $2,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
15%Specialist $750/Family $4,000/Family EMPLOYEE PAYS(Payroll Deduction) None $15.46 None $530.46
Uniform Medical Plan CDHP PREMIUM $769.65 $1,379.78 $1,241.83 $1,793.64
15%Primary Care $1,400/1'erson $4,200/Person COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
15%Specialist $2,800/Family $8,400/Family EMPLOYEE PAYS(Payroll Deduction) None None None $281.43
Uniform Medical Plan PLUS or PREMIUM $806.27 $1,458.18 $1,295.18 $1,947.12
Uniform Medical Plan Plus UW
Medicine ACN 0%Primary Care $125/Person $2,000/Person COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
Pierce,Spokane,Yakima,Skagit or Thurston 15%Specialist $375/Family $4,000/Family EMPLOYEE PAYS(Payroll Deduction) None None None $434.91
Tobacco Use Surcharge $25.00 $25.00 $25.00 $25.00
Spouse Waiver Premium Surcharge $0.00 $50.00 $0.00 $50.00
Medical Waived $154.36 $154.36 $154.36 1 $154.36
DENTAL Deductibles Max out-of-pocket VISION BASIC LIFE AND AD&D Insurance
Uniform Dental Group#3000 $50/Person$150/Family You pay amounts Included in medical plan Basic Life $35,000 Basic AD&D $5,000
Delta Dental PPO over$1,750 May enroll in supplemental Term Life Insurance without providing
Delta Care Group#3100 No General Plan You pay any amount over$150 every 24 evidence of insurability if enrolled no later than 60 days after
NONE months for frames,lenses,contacts and becoming eligible.
Managed care w limited dentists Maximum
g � fitting fees combined.Exception:for UMP
Willamette Dental No General Plan Classic,you pay any amount over$65 for May enroll in optional LTD within 31 days of Initial eligibility for
NONE contact lens fitting fees. PEBB benefits.After 31 days must also complete Evidence of
Managed care&their facilities Maximum Insurability form.
DEPUTY PROSECUTING ATTORNEYS
PEBB-Medical Benefits&WCIF-Dental Vision Life Benefits 2020
The County premium contribution using the pooling method,effective January 1,2020,by Resolution .All pooled @ 2019 rate of$1258
Copays annual Deductibles Max out-of-pocket Employee EE/Spouse EF/Children Full Family
Kaiser Permanente WA(Group PREMIUM $826.77 $1,585.86 $1,396.09 $2,155.17
Health Classic) $15 Primary Care S175/Person $2,000/Penon WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
$30 Specialist S525/Family $4,000/Family PREMIUM TOTAL $963.08 $1,722.17 $1,532.40 $2,291.48
COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
EMPLOYEE PAYS(Payroll Deduction) 50.00 $209.96 520.19 $779.27
Kaiser Permanente WA(Group PREMIUM $750.33 $1,432.98 $1,262.32 $1,944.97
Health Value) S30 Primary Cam $250/Pcrson $3,000/Person WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
S50 Specialist $750/Family $6,000/Family PREMIUM TOTAL $886.64 $1,569.29 $1,398.63 $2,081.28
COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
EMPLOYEE PAYS(Payroll Deduction) None $57.08 None $569.07
Kaiser Permanente WA(Group PREMIUM $684.78 $1,296.72 $1,158.32 $1,711.94
health CDHP) l0%RrimaryCan; S1,400/1'erson $5,100/Person WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
10%Specialist $2,800/Family S10,200/Family PREMIUM TOTAL $821.09 $1,433.03 $1,294.63 $1,848.25
COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
EMPLOYEE PAYS(Payroll Deduction) None None None $336.04
Kaiser Permanente WA(Group PREMIUM $693.11 $1,318.54 $1,162.19 $1,787.62
Health Sound Choice) 0Primary Cam $125/Person S2,000/Penon WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
15%Specialist $375 Family S4,000/Family PREMIUM TOTAL $829.42 $1,454.85 $1,298.50 $1,923.93
(Must live or work in Snohomish,King, COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
Pierce or Thurston County) EMPLOYEE PAYS(Payroll Deduction) None None None 5411.72
Uniform Medical Plan Classic PREMIUM $754.34 $1,140.99 $1,269.33 $1,955.99
15%Primary Care $250/Person $2,000/Pemon WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
15%Specialist $750/Family S4,000/Family PREMIUM TOTAL $890.65 $1,277.30 $1,405.64 $2,092.30
COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
EMPLOYEE PAYS(Payroll Deduction) None None None $580.09
Uniform Medical Plan CDHP PREMIUM $682.97 $1,293.10 $1,155.15 $1,706.96
15%Primary Care 51,400/Person $4,200/Pemon WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
15%Specialist $2,800/1'amily $8,400/Family PREMIUM TOTAL $819.28 $1,429.41 $1,291.46 $1,843.27
COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
EMPLOYEE PAYS(Payroll Deduction) None None None 5331.06
Uniform Medical Plan PLUS or PREMIUM $719.59 $1,371.50 $1,208.53 $1,860.44
Uniform Medical Plan Plus UW 0%Primary Cam $125/Person $2,000/Penon WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
Medicine ACN
(Must live in Snohomish,King,Kitsap,Pierce, 15%Specialist S375/Family $4,000/Family PREMIUM TOTAL $855.90 $1,507.81 S1,344.84 $1,996.75
Spokane,Yakima,Skagit or Thurston County)
COUNTY POOLED CONTRIBUTION $963.08 $1,512.21 $1,512.21 $1,512.21
EMPLOYEE PAYS(Payroll Deduction) None None None $484.54
Tobacco Use Surcharge $25.00 $25.00 $25.00 $25.00
Spouse Waiver Premium Surcharge
$0.00 $50.00 $0.00 $50.00
DENTAL VISION LIFE
WCIF Delta Dental-Reduced prelum by$1.92 VSP$175 113asic $24,000
Willamette(Managed Care&theirfacllRles) Frame Dependent $1,000
GENERAL SERVICES
PEBB-Medical Benefits&WCIF-Dental Vision Life Benefits 2020
The County premium contribution using the pooling method,effective January 1,2020,by Resolution .All pooled @ 2018 rate of$1206
Copays Annual Deductibles Max out-of-pocket Employee EE/Spouse EE/Children Full Family
Kaiser Permanente WA(Group PREMIUM $826.77 $1,585.86 $1,396.09 $2,155.17
Health Classic) $15 Primary Care S175/Person S2,000/Person WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
$30 Specialist $525/Family S4,000/Family PREMIUM TOTAL $963.08 $1,722.17 $1,532.40 $2,291.48
COUNTY POOLED CONTRIBUTION $963.08 $1,460.21 $1,460.21 $1,460.21
EMPLOYEE PAYS(Payroll Deduction) $0.00 $261.96 $72.19 $831.27
Kaiser Permanente WA(Group PREMIUM $750.33 $1,432.98 $1,262.32 $1,944.97
Health Value) S30 Primary Care $250/Person $3,000/Person WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
$50 Specialist S750/Family $6,000/Family PREMIUM TOTAL $886.64 $1,569.29 $1,398.63 $2,081.28
COUNTY POOLED CONTRIBUTION $963.08 $1,460.21 $1,460.21 $1,460.21
EMPLOYEE PAYS(Payroll Deduction) None $109.08 None $621.07
Kaiser Permanente WA(Group PREMIUM $684.78 $1,296.72 $1,158.32 51,711.94
HealthCDHP) 10%dPdmaryCam S1,400/Person $5,I00/Person WCIF DENTAL VISION LIFE $136.31 $136.31 5136.31 $136.31
10%Specialist $2,800/Family $10,200/Family PREMIUM TOTAL $821.09 $1,433.03 $1,294.63 $1,848.25
COUNTY POOLED CONTRIBUTION $963.08 $1,460.21 $1,460.21 $1,460.21
EMPLOYEE PAYS(Payroll Deduction) None None None $388.04
Kaiser Permanente WA(Group PREMIUM $693.11 $1,318.54 $1,162.19 $1,787.62
Health Sound Choice) 0 Primary Can; S125/Pcrson $2 oo0/Person WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
15%specialist $375 Family s4,000/Fam;ly PREMIUM TOTAL $829.42 $1,454.85 $1,298.50 $1,923.93
(Must live or work in Snohomish,King, COUNTY POOLED CONTRIBUTION $963.08 $1,460.21 $1,460.21 $1,460.21
Pierce or Thurston County) EMPLOYEE PAYS(Payroll Deduction) None None None $463.72
Uniform Medical Plan Classic PREMIUM $754.34 $1,440.99 $1,269.33 $1,955.99
15%Primary Caro $250/Pcrson S2,000/Pcrson WCIF DENTAL VISION LIFE $136.31 $136.31 $136.31 $136.31
is%specialist 5750/17amily S4,000/Family PREMIUM TOTAL $890.65 $1,577.30 $1,405.64 $2,092.30
COUNTY POOLED CONTRIBUTION $963.08 $1,460.21 $1,460.21 $1,460.21
EMPLOYEE PAYS(Payroll Deduction) None 5117.09 None $632.09
Uniform Medical Plan CDHP PREMIUM $682.97 $1,293.10 $1,155.15 $1,706.96
15%PrimaryCare $1,400/Person $4,200/1'erson WCIF DENTAL VISION LIFE $136.31 5136.31 $136.31 $136.31
15%specialist $2,800/1'amily $8,400/Family PREMIUM TOTAL $819.28 $1,429.41 $1,291.46 $1,843.27
COUNTY POOLED CONTRIBUTION $963.08 $1,460.21 $1,460.21 $1,460.21
EMPLOYEE PAYS(Payroll Deduction) None None None 5383.06
Uniform Medical Plan PLUS or PREMIUM $719.59 $1,371.50 $1,208.53 $1,860.44
Uniform Medical Plan Plus UW 0%Primary Care $125/Person $2,000/Person WCIF DENTAL VISION LIFE $136.31 S136.31 $136.31 $136.31
Medicine ACN
(Must live in Snohomish,King KitPiercy,
Spokane,Yakima,Skagit or Thurstonon County) 15%Specialist $375/Family S4,000/Family PREMIUM TOTAL $855.90 $1,507.81 $1,344.84 $1,996.75
COUNTY POOLED CONTRIBUTION $963.08 $1,460.21 $1,460.21 $1,460.21
EMPLOYEE PAYS(Payroll Deduction) None $47.60 None $536.54
Tobacco Use Surcharge $25.00 $25.00 $25.00 $25.00
Spouse Waiver Premium Surcharge $0.00 $50.00 $0.00 $50.00
DENTAL VISION LIFE
WCIF Delta Dental-Reduce premium by$1.92 VSP$175 Basic $24,000
Willamette(Managed Care&their facilities) Frame IDepenclent $1,000