Employee Costs DENTAL Coverage through VSP Bi-Weekly Premiums SEE THIS PLAN VISION Coverage through Delta Dental Bi-Weekly Premiums SEE THIS PLAN MEDICAL Coverage through Anthem | Bi-Weekly Premiums SEE THIS PLAN HSA Qualified Plan PPO Plan (TF) = Tobacco-Free 10 month (18 pays) 12 month (26 pays) 10 month (18 pays) 12 month (26 pays) Employee Only (TF) $56.75 $39.29 $97.45 $67.46 Employee Only $106.75 $73.91 $147.45 $102.08 Employee + Child(ren) (TF) $107.84 $74.66 $185.18 $128.20 Employee + Child(ren) $157.84 $109.27 $235.18 $162.82 Family (TF) $147.35 $102.01 $252.99 $175.15 Family $197.35 $136.62 $302.99 $209.76 10 month (18 pays) 12 month (26 pays) Employee Only $8.87 $6.14 Employee + Child(ren) $16.84 $11.66 Family $22.98 $15.91 Basic Premier 10 month 12 month 10 month 12 month Employee Only $9.43 $7.87 $18.30 $15.25 Employee + Spouse $18.89 $15.74 $36.63 $30.53 Employee + Child(ren) $20.20 $16.83 $39.17 $32.64 Family $32.30 $26.91 $62.60 $52.17 Tobacco-Free Premium Discount