Semi-Monthly Plan Costs
Business Services Professionals & Managers
UHC HSA PPO
Employee Only: $5.00
Employee and Spouse/DP: $56.50
Employee and Family: $87.50
UHC PPO 90/70
Employee Only: $73.00
Employee and Spouse/DP: $277.50
Employee and Family: $426.00
UHC PPO 100/50
Employee Only: $114.50
Employee and Spouse/DP: $342.50
Employee and Family: $522.00
MetLife Dental Incentive PPO
Employee Only: $11.05
Employee and Spouse/DP: $29.01
Employee and Family: $64.16
MetLife Dental Passive PPO
Employee Only: $24.79
Employee and Spouse/DP: $54.02
Employee and Family: $111.87
VSP Vision
Employee Only: $6.23
Employee and Spouse/DP: $9.03
Employee and Family: $16.17
Associates/Law Clerks/Directors/CXOs
UHC HSA PPO
Employee Only: $13.00
Employee and Spouse/DP: $81.00
Employee and Family: $125.00
UHC PPO 90/70
Employee Only: $99.00
Employee and Spouse/DP: $329.00
Employee and Family: $510.00
UHC PPO 100/50
Employee Only: $141.00
Employee and Spouse/DP: $406.00
Employee and Family: $609.00
MetLife Dental Incentive PPO
Employee Only: $11.05
Employee and Spouse/DP: $29.01
Employee and Family: $64.16
MetLife Dental Passive PPO
Employee Only: $24.79
Employee and Spouse/DP: $54.02
Employee and Family: $111.87
VSP Vision
Employee Only: $6.23
Employee and Spouse/DP: $9.03
Employee and Family: $16.17
Senior Counsel
UHC HSA PPO
Employee Only: $357.66
Employee and Spouse/DP: $703.54
Employee and Family: $1,143.45
UHC PPO 90/70
Employee Only: $522.93
Employee and Spouse/DP: $1,028.65
Employee and Family: $1,671.84
UHC PPO 100/50
Employee Only: $544.13
Employee and Spouse/DP: $1,070.35
Employee and Family: $1,739.60
MetLife Dental Incentive PPO
Employee Only: $22.09
Employee and Spouse/DP: $40.05
Employee and Family: $75.20
MetLife Dental Passive PPO
Employee Only: $35.83
Employee and Spouse/DP: $65.06
Employee and Family: $122.91
VSP Vision
Employee Only: $6.23
Employee and Spouse/DP: $9.03
Employee and Family: $16.17
Partners
UHC HSA PPO
Employee Only: $357.66
Employee and Spouse/DP: $703.54
Employee and Family: $1,143.45
UHC PPO 90/70
Employee Only: $522.93
Employee and Spouse/DP: $1,028.65
Employee and Family: $1,671.84
UHC PPO 100/50
Employee Only: $544.13
Employee and Spouse/DP: $1,070.35
Employee and Family: $1,739.60
MetLife Dental Incentive PPO
Employee Only: $22.09
Employee and Spouse/DP: $40.05
Employee and Family: $75.20
MetLife Dental Passive PPO
Employee Only: $35.83
Employee and Spouse/DP: $65.06
Employee and Family: $122.91
VSP Vision
Employee Only: $6.23
Employee and Spouse/DP: $9.03
Employee and Family: $16.17
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 Steptoe LLP if your domestic partner is your tax dependent.