| Actives | Retiree | ||
|---|---|---|---|
| Plan A (with PHA) | Plan A (with PHA) | ||
| Employee | $10.00 | Retiree | $586.00 |
| EE + Spouse | $100.00 | Retiree + Spouse | $1125.00 |
| EE + Child(ren) | $50.00 | Retiree + Child(ren) | $981.00 |
| EE/Family | $275.00 | Retiree + Family | $1390.00 |
| Actives | Retiree | ||
|---|---|---|---|
| Plan A (without PHA) | Plan A (without PHA) | ||
| Employee | $35.00 | Retiree | $611.00 |
| EE + Spouse | $150.00 | Retiree + Spouse | $1175.00 |
| EE + Child(ren) | $75.00 | Retiree + Child(ren) | $1006.00 |
| EE/Family | $325.00 | Retiree + Family | $1440.00 |
| Actives | Retiree | ||
|---|---|---|---|
| Plan B (with PHA) | Plan B (with PHA) | ||
| Employee | $117.00 | Retiree | $713.00 |
| EE + Spouse | $289.00 | Retiree + Spouse | $1371.00 |
| EE + Child(ren) | $202.00 | Retiree + Child(ren) | $1193.00 |
| EE/Family | $512.00 | Retiree + Family | $1700.00 |
| Actives | Retiree | ||
|---|---|---|---|
| Plan B (without PHA) | Plan B (without PHA) | ||
| Employee | $142.00 | Retiree | 738.00 |
| EE + Spouse | $339.00 | Retiree + Spouse | $1421.00 |
| EE + Child(ren) | $227.00 | Retiree + Child(ren) | $1218.00 |
| EE/Family | $562.00 | Retiree + Family | $1750.00 |