Premium Co-Shares
Premium Co-share effective July 1, 2024 through June 30, 2025.
- PFT and SPAP represented employees may have a salary contribution in addition to a premium co-share.
- Employees represented by Local 634 do not have a payroll contribution for medical coverage.
Tier Level | Keystone 15 | Modified Personal Choice 320 | Personal Choice 20/30/70% | Modified Personal Choice 320 | Personal Choice 20/30/70% |
| 5% of premium per pay cost for all salaries | per pay cost for CASA represented employees with an annual salary of less than $80,000. 8% of premium. | per pay cost for CASA represented employees with an annual salary of less than $80,000. 13% of premium. | per pay cost for CASA represented employees with an annual salary of $80,000 or more. 10% of premium. | per pay cost for CASA represented employees with an annual salary of $80,000 or more. 15% of premium. |
Single | $13.75
| $21.92 | $42.22 | $27.41 | $48.72 |
Employee & Child | $19.26 | $30.70 | $59.11 | $38.37 | $68.21 |
Employee & Children | $24.76 | $39.47 | $76.01 | $49.33 | $87.70 |
Employee & Spouse or Life partner. Spouse or life partner does not have the option of employer health coverage or is an SDP employee | $27.51 | $43.85
| $84.45 | $54.82 | $97.44 |
Family. Spouse or life partner does not have the option of employer health coverage or is an SDP employee | $41.27
| $65.77 | $126.67 | $82.22 | $146.16 |
Employee & Spouse or Life partner with Surcharge | $67.51 | $83.85 | $124.45 | $94.82 | $137.44 |
Family with Spouse or Life Partner Surcharge | $81.27 | $105.77 | $166.67 | $122.22 | $186.16 |
Rates below are for Non Represented employees effective in the July 1, 2024 pay. | No new enrollments of same gender domestic partners as of 10/1/2019. All existing same gender domestic partners are grandfathered. | | | |
| | | | |
Tier Level | Keystone 15 | Personal Choice 20/30/70% | Modified Personal Choice 320 | Personal Choice 20/30/70% |
| 5 % premium for Non Represented employees. | 5 % premium for Non Represented employees. Closed 6/30/2014 . | 8% premium for Non Represented employees. | 13% premium for Non Represented employees. |
Single | $13.76 | $16.24 | $21.92 | $42.22 |
Employee & Child | $19.26 | $22.74 | $30.70 | $59.11 |
Employee & Children | $24.76 | $29.23 | $39.47 | $76.01 |
Employee & Spouse or Life partner | $27.51 | $32.48 | $43.85 | $84.45 |
Family | $41.27 | $48.72 | $65.77 | $126.67 |
Employee & Spouse or Life partner with Surcharge | $67.51 | $72.48 | $83.85 | $124.45 |
Family with Spouse or Life Partner Surcharge | $81.27 | $88.72 | $105.77
| $166.67 |
Tier Level | Keystone 20 | Personal Choice 25/35/50%. | Personal Choice 25/35/50%. | Personal Choice 25/35/50% |
| PFT
1.5% Salary | 0 % premium + 1.5% Salary. Closed to new enrollment. | 3 % premium+1.5% Salary. Closed to new enrollment. | 5 % premium +1.5% Salary. |
Single | $0 | $0 | $9.54 | $15.91 |
Employee & Child | $0 | $0 | $13.36 | $22.28 |
Employee & Children | $0 | $0 | $17.18 | $28.64 |
Employee & Spouse or Life partner | $0 | $0 | $19.09 | $31.82 |
Family | $0 | $0 | $28.64 | $47.73 |
Employee & Spouse or Life partner with Surcharge | $34.62 | $34.62 | $53.71 | $66.44 |
Family with Spouse or Life Partner Surcharge | $34.62 | $34.62 | $63.26 | $82.35 |
Rates below are for SPAP represented employees. | | | |
New premium increases are effective in the July 1, 2024 pay. | | | |
Tier Level | Keystone 20 | Personal Choice 25/35/50% | Personal Choice 25/35/50% | Personal Choice 25/35/50% |
| 1.5% Salary | 0% of premium + 1.5% Salary. Closed to new enrollment. | 3 % of premium +1.5% Salary. Closed to new enrollment. | 5 % of premium+1.5% Salary. |
Single | $0 | $0 | $9.54 | $15.91 |
Employee & Child | $0 | $0 | $13.36 | $22.28 |
Employee & Children | $0 | $0 | $17.18 | $28.64 |
Employee & Spouse or Life partner | $0 | $0 | $19.09 | $31.82 |
Family | $0 | $0 | $28.64 | $47.73 |
Employee & Spouse or Life partner with Surcharge | $34.62 | $34.62 | $53.71 | $66.44 |
Family with Spouse or Life Partner Surcharge | $34.62 | $34.62 | $63.26 | $82.35 |
Premium Co-share effective July 1, 2023 through June 30, 2024.
Refer to the below charts for your union classification. Costs are based on per pay.
- PFT and SPAP represented employees may have a salary contribution in addition to a premium co-share.
- Employees represented by Local 634 do not have payroll contribution for medical coverage.
Rates below are for CASA represented employees. | | | | |
Rates are effective in the July 1, 2023 pay. The Spousal surcharge is $40 per pay. Rates below include the surcharge. |
Tier Level | Keystone 15 | Modified Personal Choice 320 | Personal Choice 20/30/70% | Modified Personal Choice 320 | Personal Choice 20/30/70% |
| 3% of premium per pay cost for all salaries | per pay cost for CASA represented employees with an annual salary of less than $80,000. 8% of premium. | per pay cost for CASA represented employees with an annual salary of less than $80,000. 13% of premium. | per pay cost for CASA represented employees with an annual salary of $80,000 or more. 10% of premium. | per pay cost for CASA represented employees with an annual salary of $80,000 or more. 15% of premium |
Single | $8.01 | $21.29 | $40.99 | $26.61 | $47.30 |
Employee & Child | $11.22 | $29.80 | $57.39 | $37.25 | $66.22 |
Employee & Children | $14.42 | $38.32 | $73.79 | $47.90 | $85.14 |
Employee & Spouse or Life partner. Spouse or life partner does not have the option of employer health coverage or is an SDP employee | $16.02 | $42.57 | $81.99 | $53.22 | $94.61 |
Family. Spouse or life partner does not have the option of employer health coverage or is an SDP employee | $24.04 | $63.86 | $122.99 | $79.83 | $141.91 |
Employee & Spouse or Life partner with Surcharge | $56.03 | $82.57 | $121.99 | $93.22 | $134.61 |
Family with Spouse or Life Partner Surcharge | $64.04 | $103.86 | $162.99 | $119.83 | $181.91 |
Rates below are for Non Represented employees effective in the July 1, 2023 pay. | No new enrollments of same gender domestic partners as of 10/1/2019. All existing same gender domestic partners are grandfathered. | | | |
| | | | |
Tier Level | Keystone 15 | Personal Choice 20/30/70% | Modified Personal Choice 320 | Personal Choice 20/30/70% |
| 5 % premium for Non Represented employees. | 5 % premium for Non Represented employees. Closed 6/30/2014 . | 8% premium for Non Represented employees. | 13% premium for Non Represented employees. |
Single | $13.36 | $15.77 | $21.26 | $40.99 |
Employee & Child | $18.70 | $22.08 | $29.80 | $57.39 |
Employee & Children | $24.04 | $28.38 | $38.32 | $73.79 |
Employee & Spouse or Life partner | $26.71 | $31.54 | $42.57 | $81.99 |
Family | $40.07 | $47.30 | $63.86 | $122.99 |
Employee & Spouse or Life partner with Surcharge | $66.71 | $71.54 | $82.57 | $121.99 |
Family with Spouse or Life Partner Surcharge | $80.07 | $87.30 | $103.86 | $162.99 |
Rates below are for PFT represented employees. | | | | |
New premium increases are effective in the July 1, 2023 pay. | | | | |
Tier Level | Keystone 20 | Personal Choice 25/35/50%. | Personal Choice 25/35/50%. | Personal Choice 25/35/50% |
| PFT
1.5% Salary | 0 % premium + 1.5% Salary. Closed to new enrollment. | 3 % premium+1.5% Salary. Closed to new enrollment. | 5 % premium +1.5% Salary. |
Single | $0 | $0 | $9.27 | $15.45 |
Employee & Child | $0 | $0 | $12.97 | $21.63 |
Employee & Children | $0 | $0 | $16.68 | $27.81 |
Employee & Spouse or Life partner | $0 | $0 | $18.54 | $30.90 |
Family | $0 | $0 | $27.80 | $46.34 |
Employee & Spouse or Life partner with Surcharge | $34.62 | $34.62 | $53.15 | $65.51 |
Family with Spouse or Life Partner Surcharge | $34.62 | $34.62 | $62.42 | $80.96 |
Rates below are for SPAP represented employees. | | | |
New premium increases are effective in the July 1, 2023 pay. | | | |
Tier Level | Keystone 20 | Personal Choice 25/35/50% | Personal Choice 25/35/50% | Personal Choice 25/35/50% |
| 1.5% Salary | 0% of premium + 1.5% Salary. Closed to new enrollment. | 3 % of premium +1.5% Salary. Closed to new enrollment. | 5 % of premium+1.5% Salary. |
Single | $0 | $0 | $9.27 | $15.45 |
Employee & Child | $0 | $0 | $12.97 | $21.63 |
Employee & Children | $0 | $0 | $16.68 | $27.81 |
Employee & Spouse or Life partner | $0 | $0 | $18.54 | $30.90 |
Family | $0 | $0 | $27.80 | $46.34 |
Employee & Spouse or Life partner with Surcharge | $34.62 | $34.62 | $53.15 | $65.51 |
Family with Spouse or Life Partner Surcharge | $34.62 | $34.62 | $64.42 | $80.96 |
Last modified: May 2, 2024