Plan Costs

Kaiser HMO Under $50K

Employee Only: $123.87

Employee and Spouse/DP: $417.57

Employee and Child(ren): $379.56

Employee and Family: $569.78

Kaiser HMO $50K to $74.9K

Employee Only: $139.68

Employee and Spouse/DP: $468.23

Employee and Child(ren): $425.61

Employee and Family: $638.86

Kaiser HMO $75K+

Employee Only: $150.70

Employee and Spouse/DP: $505.05

Employee and Child(ren): $459.09

Employee and Family: $689.09

Aetna AVN HMO Low Under $50K

Employee Only: $74.62

Employee and Spouse/DP: $277.11

Employee and Child(ren): $249.29

Employee and Family: $416.62

Aetna AVN HMO Low $50K to $74.9K

Employee Only: $92.53

Employee and Spouse/DP: $328.28

Employee and Child(ren): $295.34

Employee and Family: $493.37

Aetna AVN HMO Low $75+

Employee Only: $98.50

Employee and Spouse/DP: $345.34

Employee and Child(ren): $310.70

Employee and Family: $518.95

Aetna AVN HMO High Under $50K

Employee Only: $150.05

Employee and Spouse/DP: $456.36

Employee and Child(ren): $410.66

Employee and Family: $685.41

Aetna AVN HMO High $50K to $74.9K

Employee Only: $168.29

Employee and Spouse/DP: $511.60

Employee and Child(ren): $460.36

Employee and Family: $768.24

Aetna AVN HMO High $75K+

Employee Only: $174.38

Employee and Spouse/DP: $530.02

Employee and Child(ren): $476.91

Employee and Family: $795.85

Aetna OMAC POS Under $50K

Employee Only: $385.96

Employee and Spouse/DP: $891.22

Employee and Child(ren): $802.01

Employee and Family: $1,337.66

Aetna OMAC POS $50K to $74.9K

Employee Only: $432.50

Employee and Spouse/DP: $998.62

Employee and Child(ren): $898.68

Employee and Family: $1,498.78

Aetna OMAC POS $75K+

Employee Only: $448.02

Employee and Spouse/DP: $1,034.43

Employee and Child(ren): $930.90

Employee and Family: $1,552.48

Aetna HMO (NV Only) Under $50K

Employee Only: $109.79

Employee and Spouse/DP: $491.09

Employee and Child(ren): $441.91

Employee and Family: $737.47

Aetna HMO (NV Only) $50K to $74.9K

Employee Only: $173.08

Employee and Spouse/DP: $550.47

Employee and Child(ren): $495.35

Employee and Family: $826.55

Aetna HMO (NV Only) $75K+

Employee Only: $187.69

Employee and Spouse/DP: $570.28

Employee and Child(ren): $513.18

Employee and Family: $856.25

Aetna Dental HMO

Employee Only: $7.65

Employee and Spouse/DP: $13.29

Employee and Child(ren): $13.76

Employee and Family: $19.12

Aetna Dental PPO Base

Employee Only: $19.45

Employee and Spouse/DP: $44.38

Employee and Child(ren): $45.96

Employee and Family: $63.85

Aetna Dental PPO Buy-up

Employee Only: $22.87

Employee and Spouse/DP: $50.61

Employee and Child(ren): $52.42

Employee and Family: $72.81

Aetna Vision

Employee Only: $1.84

Employee and Spouse/DP: $3.49

Employee and Child(ren): $3.67

Employee and Family: $5.40

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 LMI if your domestic partner is your tax dependent.