Payroll Services

Health Insurance Premium Table (2017)

Monthly and Semi-Monthly Payroll Deduction Amounts--Coverage Month January 2017

HCA HLTH
PLAN CODE

WSU HLTH
PLAN CODE



HEALTH CARRIERS

RED
GTN

DED
GTN



EMPLOYEE

EMPLOYEE
& SPOUSE

EMPL &
CHILDREN

FULL
FAMILY

C

C

Group Health Classic

142

050

$147
($73.50)

$304
($152.00)

$257
($128.50)

$414
($207.00)

CV

B

Group Health Value

068

069

$69
($34.50)

$148
($74.00)

$121
($60.50)

$200
($100.00)

CHSA

J

Group Health HSA

041

053

$25
($12.50)

$60
($30.00)

$44
($22.00)

$79
($39.50)

C1

N

Group Hlth Sound Choice

217

225

$46
($23.0)

$102
($51.00)

$81
($40.50)

$137
($68.50)

D

D

Kaiser Permanente Classic

078

052

$131
($65.50)

$272
($136.00)

$229
($114.50)

$370
($185.00)

DHSA

M

Kaiser HSA

047

046

$26
($13.00)

$62
($31.00)

$46
($23.00)

$82
($41.00)

U

U

Uniform Medical Plan

154

242

$94
($47.00)

$198
($99.00)

$165
($82.50)

$269
($134.50)

UHSA

R

Uniform Medical HSA

055

059

$25
($12.50)

$60
($30.00)

$44
($22.00)

$79
($39.50)

U1

Q

UMP Plus UW Med

226

229

$66
($33.00)

$142
($71.00)

$116
($58.00)

$192
($96.00)

U2

S

UMP Plus Puget Sound

227

231

$66
($33.00)

$142
($71.00)

$116
($58.00)

$192
($96.00)

( ) = Semi-monthly rate

 

 
 
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