Page 1 Page 2 Page 3 Page 4 Page 5 Page 6 Page 7 Page 8 Page 9 Page 10 Page 11 Page 12 Page 13 Page 14 Page 15 Page 16 Page 17 Page 18 Page 19 Page 20 Page 21 Page 22 Page 23 Page 24 Page 25 Page 26 Page 27 Page 28 Page 29 Page 30 Page 31 Page 32 Page 33 Page 34 Page 35 Page 36 Page 37 Page 38 Page 39 Page 40 Page 41 Page 42 Page 43 Page 445 Note: For the 2017 plan year, WSSC will contribute 76% towards the monthly premium for UnitedHealthcare Choice Plus POS , 79% for the UnitedHealthcare EPO and Kaiser HMO plans, 80% for the Delta Dental PPO and Delta Dental HMO, and 0% to the Vision Plan. 2017 Medical, Dental & Vision Plan Rates for Employees Plan & Coverage Level Monthly Rate WSSC Monthly Contribution Employee Monthly Deduction WSSC Semi-monthly Contribution Employee Semi-monthly Deduction United Healthcare Choice Plus POS Individual 1,085.00 $ 824.60 $ 260.40 $ 412.30 $ 130.20 $ 2-Person 2,143.00 $ 1,628.68 $ 514.32 $ 814.34 $ 257.16 $ Family 2,710.00 $ 2,059.60 $ 650.40 $ 1,029.80 $ 325.20 $ United Healthcare Select EPO Individual 745.00 $ 588.55 $ 156.45 $ 294.28 $ 78.23 $ 2-Person 1,491.00 $ 1,177.89 $ 313.11 $ 588.95 $ 156.56 $ Family 2,169.00 $ 1,713.51 $ 455.49 $ 856.76 $ 227.75 $ Kaiser Permanente Individual 537.00 $ 424.23 $ 112.77 $ 212.12 $ 56.39 $ 2-Person 1,073.00 $ 847.67 $ 225.33 $ 423.84 $ 112.67 $ Family 1,626.00 $ 1,284.54 $ 341.46 $ 642.27 $ 170.73 $ Delta Dental PPO Individual 40.00 $ 32.00 $ 8.00 $ 16.00 $ 4.00 $ 2-Person 67.00 $ 53.60 $ 13.40 $ 26.80 $ 6.70 $ Family 99.00 $ 79.20 $ 19.80 $ 39.60 $ 9.90 $ Delta Dental HMO Individual 21.00 $ 16.80 $ 4.20 $ 8.40 $ 2.10 $ 2-Person 34.00 $ 27.20 $ 6.80 $ 13.60 $ 3.40 $ Family 50.00 $ 40.00 $ 10.00 $ 20.00 $ 5.00 $ National Vision Administrators Individual 3.49 $ - $ 3.49 $ - $ 1.75 $ Family 12.23 $ - $ 12.23 $ - $ 6.12 $ 2017 Health, Dental & Vision Plan Rates for Employees