Monthly Plan Costs

Kaiser HMO (CA) (Salary Below $66,560)

Employee Only: $70.32

Employee and Spouse/DP: $842.02

Employee and Child(ren): $415.51

Employee and Family: $1,455.87

Kaiser HMO (CA) (Salary Above $66,560)

Employee Only: $140.64

Employee and Spouse/DP$877.26

Employee and Child(ren): $433.60

Employee and Family: $1,463.21

UHC Core PPO (Salary Below $66,560)

Employee Only: $79.36

Employee and Spouse/DP: $883.23

Employee and Child(ren): $438.93

Employee and Family: $1,522.65

UHC Core PPO (Salary Above $66,560)

Employee Only: $152.03

Employee and Spouse/DP: $919.36

Employee and Child(ren): $457.20

Employee and Family: $1,529.71

UHC Select Plus (Salary Below $66,560)

Employee Only: $269.45

Employee and Spouse/DP: $1,569.78

Employee and Child(ren): $967.28

Employee and Family: $2,553.63

UHC Select Plus (Salary Above $66,560)

Employee Only: $376.14

Employee and Spouse/DP: $1,676.48

Employee and Child(ren): $967.28

Employee and Family: $2,660.33

Mutual of Omaha Dental

Employee Only: $6.49

Employee and Spouse/DP: $71.52

Employee and Child(ren): $87.21

Employee and Family: $170.59

Mutual of Omaha Vision

Employee Only: $0.43

Employee + 1: $4.31

Employee + 2: $8.14

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 Institute on Aging if your domestic partner is your tax dependent.