Bi-Weekly Benefit Costs
Blue Shield PPO Savings HDHP
Employee Only: $20.91
Employee and Spouse/DP: $229.02
Employee and Child(ren): $197.72
Employee and Family: $305.65
Blue Shield Full PPO
Employee Only: $274.04
Employee and Spouse/DP: $775.88
Employee and Child(ren): $666.44
Employee and Family: $1,021.15
Blue Shield Full EPO
Employee Only: $94.20
Employee and Spouse/DP: $413.38
Employee and Child(ren): $357.01
Employee and Family: $615.89
Blue Shield Trio HMO
Employee Only: $11.07
Employee and Spouse/DP: $160.04
Employee and Child(ren): $156.71
Employee and Family: $240.06
Blue Shield Access+ HMO
Employee Only: $46.59
Employee and Spouse/DP: $270.80
Employee and Child(ren): $256.82
Employee and Family: $391.42
Kaiser CA
Employee Only: $22.68
Employee and Spouse/DP: $183.00
Employee and Child(ren): $179.42
Employee and Family: $269.12
Kaiser NW
Employee Only: $14.88
Employee and Spouse/DP: $120.06
Employee and Child(ren): $117.70
Employee and Family: $176.55
Delta Dental HMO
Employee Only: $3.67
Employee + 1: $9.18
Employee and Family: $12.55
Delta Dental Low DPPO
Employee Only: $4.03
Employee + 1: $8.32
Employee and Family: $11.80
Delta Dental High DPPO
Employee Only: $8.85
Employee + 1: $18.31
Employee and Family: $28.72
EyeMed Base
Employee Only: $0.00
Employee + 1: $0.00
Employee and Family: $0.00
EyeMed Buy Up
Employee Only: $3.13
Employee + 1: $4.95
Employee and Family: $7.51
Domestic Partner Coverage
Please note that unless your domestic partner is your tax dependent as defined by the IRS, contributions for domestic partner coverage must be made after-tax. Similarly, the company contribution toward coverage for your domestic partner and his/her dependents will be reported as taxable income on your W-2. Contact your tax advisor for more details on how this tax treatment applies to you. Notify UMass if your domestic partner is your tax dependent.