2021 employee per paycheck contributions: Grades 15-19
Employee only
Medical
Plan
Cost
UnitedHealthcare $300 Deductible
$23
UnitedHealthcare CDHP with HSA
$23
Kaiser HMO (CA)
$23
Dental
Plan
Cost
Core
$3
Enhanced
$7
Vision
Plan
Cost
Core
$1
Enhanced
$2
Employee and spouse/partner*
Medical
Plan
Cost
UnitedHealthcare $300 Deductible
$70
UnitedHealthcare CDHP with HSA
$70
Kaiser HMO (CA)
$70
Dental
Plan
Cost
Core
$6
Enhanced
$15
Vision
Plan
Cost
Core
$2
Enhanced
$5
*Imputed income: The IRS states that the fair market value for domestic partner coverage is taxable to the employee. This means the full cost of individual coverage (for your domestic partner) would be added to your taxable income (imputed income). You will see domestic partner imputed income added to your earnings (to incur the tax liability) and then deducted from your gross pay.
Employee and child(ren)
Medical
Plan
Cost
UnitedHealthcare $300 Deductible
$59
UnitedHealthcare CDHP with HSA
$59
Kaiser HMO (CA)
$59
Dental
Plan
Cost
Core
$8
Enhanced
$18
Vision
Plan
Cost
Core
$2
Enhanced
$5
Employee and family
Medical
Plan
Cost
UnitedHealthcare $300 Deductible
$99
UnitedHealthcare CDHP with HSA
$99
Kaiser HMO (CA)
$99
Dental
Plan
Cost
Core
$11
Enhanced
$24
Vision
Plan
Cost
Core
$3
Enhanced
$8
2021 employee per paycheck contributions: All other grades
Employee only
Medical
Plan
Cost
UnitedHealthcare $300 Deductible
$53
UnitedHealthcare CDHP with HSA
$41
Kaiser HMO (CA)
$39
Dental
Plan
Cost
Core
$3
Enhanced
$7
Vision
Plan
Cost
Core
$1
Enhanced
$2
Employee and spouse/partner*
Medical
Plan
Cost
UnitedHealthcare $300 Deductible
$182
UnitedHealthcare CDHP with HSA
$130
Kaiser HMO (CA)
$131
Dental
Plan
Cost
Core
$6
Enhanced
$15
Vision
Plan
Cost
Core
$2
Enhanced
$5
*Imputed income: The IRS states that the fair market value for domestic partner coverage is taxable to the employee. This means the full cost of individual coverage (for your domestic partner) would be added to your taxable income (imputed income). You will see domestic partner imputed income added to your earnings (to incur the tax liability) and then deducted from your gross pay.
