AREA

EMPLOYEE ONLY

EMPLOYEE +
SPOUSE

EMPLOYEE +
CHILD(ren)

EMPLOYEE +
FAMILY

1

$91.08

$179.70

$147.54

$303.72

2

$99.24

$194.58

$160.80

$329.52

3

$108.24

$212.10

$175.32

$331.29

4

$117.96

$231.24

$191.10

$387.72

5

$128.64

$252.12

$208.38

$431.58

6

$140.22

$274.74

$227.10

$451.35