Rates - 2025-2026 Plan Year
Insurance Premiums & Rates for 2025-2026
Act 93, Miscellaneous & PEA
| ACT 93/MISC | PEA 22 PAYS | PEA 26 PAYS | ||||
|---|---|---|---|---|---|---|
| Per Pay | Annually | Per Pay | Annually | Per Pay | Annually | |
| MED Single | $37.34 | $ 970.72 | $44.12 | $970.72 | $37.34 | $970.72 |
| MED EE/Child | $60.63 | $1,576.38 | $71.65 | $1,576.38 | $60.63 | $1,576.38 |
| MED EE/Children | $82.51 | $2,145.24 | $97.51 | $2,145.24 | $82.51 | $2,145.24 |
| MED EE/Spouse | $85.87 | $2,232.58 | $101.48 | $2,232.58 | $85.87 | $2,232.58 |
| MED Family | $110.23 | $2,865.88 | $130.27 | $2,865.88 | $110.23 | $2,865.88 |
| RX Single | $12.89 | $335.14 | $15.23 | $335.14 | $12.89 | $335.14 |
| RX Family | $25.71 | $668.34 | $30.38 | $668.34 | $25.71 | $668.34 |
| Vision Single | $0.18 | $4.75 | $0.22 | $4.75 | $0.18 | $4.75 |
| Vision Family | $0.51 | $13.29 | $0.60 | $13.29 | $0.51 | $13.29 |
| Dental Single | $2.40 | $62.29 | $2.83 | $62.29 | $2.40 | $62.29 |
| Dental Family | $6.55 | $170.35 | $7.74 | $170.35 | $6.55 | $170.35 |
Nutritional Services
|
CAFETERIA MGRS - 22 PAYS |
CAFETERIA MGRS - 26 PAYS |
NUTRITIONAL SVCS | ||||
| Per Pay | Annually | Per Pay | Annually | Per Pay | Annually | |
| MED Single | $30.43 | $669.46 | $25.75 | $669.46 | $33.47 | $669.46 |
| MED EE/Child | $49.42 | $1,087.16 | $41.81 | $1,087.16 | $242.32 | $4,846.45 |
| MED EE/Children | $67.25 | $1,479.48 | $56.90 | $1,479.48 | $438.48 | $8,769.60 |
| MED EE/Spouse | $69.99 | $1,539.71 | $59.22 | $1,539.71 | $468.60 | $9,371.96 |
| MED Family | $89.84 | $1,976.47 | $76.02 | $1,976.47 | $686.97 | $13,739.49 |
| RX Single | $10.51 | $231.13 | $8.89 | $231.13 | $11.56 | $231.13 |
| RX Family | $20.95 | $460.93 | $17.73 | $460.93 | $126.45 | $2,529.08 |
| Vision Single | $0.15 | $3.28 | $0.13 | $3.28 | $0.16 | $3.28 |
| Vision Family | $0.42 | $9.17 | $0.35 | $9.17 | $3.11 | $62.20 |
| Dental Single | $1.95 | $42.96 | $1.65 | $42.96 | $2.15 | $42.96 |
| Dental Family | $5.34 | $117.48 | $4.52 | $117.48 | $39.41 | $788.16 |
PESPA
| PESPA 26 Pay FT | PESPA TRANSPORTATION | PESPA 4 hr/day Rates | PESPA 100% Rates | |||||
| Per Pay | Annually | Per Pay | Annually | Per Pay | Annually | Per Pay | Annually | |
| MED Single | $32.19 | $836.83 | $79.73 | $1,594.63 | $71.05 | $1,847.32 | $334.73 | $6,694.63 |
| MED EE/Child | $52.27 | $1,358.95 | $198.58 | $3,971.62 | $151.38 | $3,935.81 | $543.58 | $10,871.62 |
| MED EE/Children | $71.13 | $1,849.35 | $394.74 | $7,894.77 | $226.82 | $5,897.39 | $739.74 | $14,794.77 |
| MED EE/Spouse | $74.02 | $1,924.64 | $424.86 | $8,497.13 | $238.41 | $6,198.57 | $769.86 | $15,397.13 |
| MED Family | $95.02 | $2,470.58 | $643.23 | $12,864.66 | $322.40 | $8,382.33 | $988.23 | $19,764.66 |
| RX Single | $11.11 | $288.91 | $115.57 | $2,311.32 | $44.45 | $1,155.66 | $115.57 | $2,311.32 |
| RX Family | $22.16 | $576.16 | $230.46 | $4,609.27 | $88.64 | $2,304.64 | $230.46 | $4,609.27 |
| Vision Single | $0.16 | $4.10 | $1.64 | $32.76 | $0.63 | $16.38 | $1.64 | $32.76 |
| Vision Family | $0.44 | $11.46 | $4.58 | $91.68 | $1.76 | $45.84 | $4.58 | $91.68 |
| Dental Single | $2.07 | $53.70 | $21.48 | $429.60 | $8.26 | $214.80 | $21.48 | $429.60 |
| Dental Family | $5.65 | $146.85 | $58.74 | $1,174.80 | $22.59 | $587.40 | $58.74 | $1,174.80 |
| PESPA 7 Hr Aid Rates | PESPA 7.25 Hr Aid Rates | |||
| Per Pay | Annually | Per Pay | Annually | |
| MED Single | $67.23 | $1,344.63 | $63.04 | $1,260.70 |
| MED EE/Child | $143.24 | $2,864.81 | $134.30 | $2,686.00 |
| MED EE/Children | $214.63 | $4,292.62 | $201.23 | $4,024.68 |
| MED EE/Spouse | $225.59 | $4,511.84 | $211.51 | $4,230.22 |
| MED Family | $305.07 | $6,101.37 | $286.03 | $5,720.54 |
| RX Single | $42.06 | $841.19 | $39.43 | $788.68 |
| RX Family | $83.88 | $1,677.51 | $78.64 | $1,572.80 |
| Vision Single | $0.60 | $11.92 | $0.56 | $11.18 |
| Vision Family | $1.67 | $33.37 | $1.56 | $31.28 |
| Dental Single | $7.82 | $156.35 | $7.33 | $146.59 |
| Dental Family | $21.38 | $427.56 | $20.04 | $400.87 |