| Total Monthly Premium | Monthly State Share | Monthly Employee Share | BW State Share | BW Employee Share | |||
|---|---|---|---|---|---|---|---|
| United HealthCare | Basic Dental Plan | Employee Only | $40.03 | $40.03 | $0.00 | $18.48 | $0.00 |
| Employee +1 | $122.09 | $97.47 | $24.62 | $44.99 | $11.36 | ||
| Family | $122.09 | $97.47 | $24.62 | $44.99 | $11.36 | ||
| FLES | $82.06 | $69.45 | $12.61 | $32.05 | $5.82 | ||
| Enhanced Dental Plan | Employee Only | $36.83 | $36.83 | $0.00 | $17.00 | $0.00 | |
| Employee +1 | $112.33 | $89.68 | $22.65 | $41.39 | $10.45 | ||
| Family | $112.33 | $89.68 | $22.65 | $41.39 | $10.45 | ||
| FLES | $75.50 | $63.90 | $11.60 | $29.49 | $5.35 | ||
| CIGNA | Dental HMO | Employee Only | $24.94 | $24.94 | $0.00 | $11.51 | $0.00 |
| Employee +1 | $54.87 | $45.89 | $8.98 | $21.18 | $4.14 | ||
| Family | $67.34 | $54.62 | $12.72 | $25.21 | $5.87 | ||
| FLES | $42.40 | $37.16 | $5.24 | $17.15 | $2.42 | ||
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