Employee

907.82

4.1

889.68

Employee & spouse

1,823.22

4.1

1,786.76

Employee, spouse + one child

2,274.16

4.1

2,228.68

Employee, spouse + two children (full family)

2,646.98

4.1

2,594.06

Employee + one child

1,358.76

4.1

1,331.60

Employee + two children

1,731.58

4.1

1,696.96

No additional charge for three or more children.

Employee

853.12

4.1

836.06

Employee & spouse

1,714.32

4.1

1,680.04

Employee, spouse + one child

2,137.62

4.1

2,094.88

Employee, spouse + two children (full family)

2,489.42

4.1

2,439.64

Employee + one child

1,276.42

4.1

1,250.90

Employee + two children

1,628.22

4.1

1,595.66

No additional charge for three or more children.

Employee

631.28

4.1

618.66

Employee & spouse

1,270.32

4.1

1,244.92

Employee, spouse + one child

1,590.76

4.1

1,558.96

Employee, spouse + two children (full family)

1,853.12

4.1

1,816.06

Employee + one child

951.72

4.1

932.70

Employee + two children

1,214.10

4.1

1,189.82

No additional charge for three or more children.

Employee

866.76

4.1

849.44

Employee & spouse

1,740.84

4.1

1,706.04

Employee, spouse + one child

2,171.44

4.1

2,128.02

Employee, spouse + two children (full family)

2,527.40

4.1

2,476.86

Employee + one child

1,297.36

4.1

1,271.42

Employee + two children

1,653.32

4.1

1,620.26

No additional charge for three or more children.

LEOFF I retirees

775.14

4.4

LEOFF I active

1,461.92

4.1

1,432.70

LEOFF I retired not on
Medicare Parts A & B

1,895.22

4.1

N/A

LEOFF I retired on
Medicare Parts A & B

1,477.76

4.1

N/A