| Coverage | Cigna CDHP with HSA | Cigna HMO | Kaiser HMO | SIMNSA HMO | |
|---|---|---|---|---|---|
| Annual Salary under $60,000 | |||||
| Employee Only | Your cost | $58.00 | $63.00 | $58.00 | $7.00 |
| USD cost | $1,182.29 | $1,189.32 | $725.85 | $244.97 | |
| Employee + Spouse | Your cost | $340.00 | $387.00 | $340.00 | $13.00 |
| USD cost | $2,027.52 | $1,918.75 | $1,227.70 | $446.22 | |
| Employee + Child(ren) | Your cost | $293.00 | $310.00 | $293.00 | $10.00 |
| USD cost | $1,837.78 | $1,765.24 | $1,117.93 | $570.91 | |
| Family | Your cost | $493.00 | $521.00 | $492.00 | $19.00 |
| USD cost | $3,295.01 | $3,267.01 | $3,296.01 | $777.56 | |
| Annual Salary between $60,000 – $109,999.99 | |||||
|
Employee Only |
Your cost | $121.00 | $132.00 | $212.00 | $13.00 |
| USD cost | $1,119.29 | $1,120.32 | $662.85 | $238.97 | |
| Employee + Spouse | Your cost | $486.00 | $509.00 | $486.00 | $26.00 |
| USD cost | $1,881.52 | $1,796.75 | $1,081.70 | $433.22 | |
| Employee + Child(ren) | Your cost | $424.00 | $443.00 | $424.00 | $20.00 |
| USD cost | $1,706.78 | $1,632.24 | $986.93 | $560.91 | |
| Family | Your cost | $678.00 | $710.00 | $678.00 | $37.00 |
| USD cost | $3,110.01 | $3,078.01 | $3,110.01 | $759.56 | |
| Annual Salary between $110,000 – $149,999.99 | |||||
|
Employee Only |
Your cost | $231.00 | $252.00 | $231.00 | $68.00 |
| USD cost | $1,009.29 | $1,000.32 | $552.85 | $183.97 | |
| Employee + Spouse | Your cost | $633.00 | $663.00 | $633.00 | $122.00 |
| USD cost | $1,734.52 | $1,642.75 | $934.70 | $337.22 | |
| Employee + Child(ren) | Your cost | $554.00 | $580.00 | $554.00 | $105.00 |
| USD cost | $1,576.87 | $1,495.24 | $856.93 | $475.91 | |
| Family | Your cost | $808.00 | $846.00 | $808.00 | $211.00 |
| USD cost | $2,980.01 | $2,942.01 | $2,980.01 | $575.56 | |
| Annual Salary $150,000 or more | |||||
|
Employee Only |
Your cost | $334.00 | $364.00 | $334.00 | $132.00 |
| USD cost | $906.29 | $888.32 | $449.85 | $119.97 | |
| Employee + Spouse | Your cost | $767.00 | $804.00 | $767.00 | $222.00 |
| USD cost | $1,600.52 | $1,501.75 | $800.70 | $237.22 | |
| Employee + Child(ren) | Your cost | $674.00 | $706.00 | $674.00 | $197.00 |
| USD cost | $1,456.78 | $1,369.24 | $736.93 | $383.91 | |
| Family | Your cost | $978.00 | $1,025.00 | $978.00 | $384.00 |
| USD cost | $2,810.01 | $2,763.01 | $2,810.01 | $412.56 | |
| Plan Option | Employee Only | Employee + Spouse | Employee + Child(ren) | Employee + Family |
|---|---|---|---|---|
| Cigna PPO High | $31.55 | $65.55 | $58.99 | $123.99 |
| Cigna PPO Low | $20.68 | $43.50 | $39.15 | $87.96 |
| Cigna HMO | $7.00 | $11.00 | $15.00 | $22.00 |
| SIMNSA HMO | $0 | $0 | $0 | $0 |
| Plan Option | Employee Only | Employee + Spouse | Employee + Child(ren) | Employee + Family |
|---|---|---|---|---|
| VSP | $12.25 | $17.99 | $20.27 | $32.41 |
| VSP EasyOptions Buy-Up | $14.67 | $21.56 | $24.29 | $38.84 |