Henriksen Butler / Cost Summary

Premium Cost Summary
Regence - Costs Per Pay Period
PVC NETWORK
PPO $500
(National)
FP NETWORK
PPO $2,000
(Utah)
PVC NETWORK
PPO $2,000
(National)
FP NETWORK
HDHP $2,500
(Utah)
PVC NETWORK
HDHP $2,500
(National)
Employee Only
$149.73
$88.43
$111.86
$66.20
$82.43
Employee + Spouse or Domestic Partner
$321.41
$185.67
$237.95
$139.40
$179.66
Employee + Child(ren)
$311.26
$182.07
$231.34
$140.01
$178.46
Employee + Family
$457.17
$266.09
$338.80
$205.40
$262.48
Regence - Costs Per Month
PVC NETWORK
PPO $500
(National)
FP NETWORK
PPO $2,000
(Utah)
PVC NETWORK
PPO $2,000
(National)
FP NETWORK
HDHP $2,500
(Utah)
PVC NETWORK
HDHP $2,500
(National)
Employee Only
$299.46
$176.86
$223.73
$132.40
$164.85
Employee + Spouse or Domestic Partner
$642.92
$371.35
$475.90
$278.81
$359.32
Employee + Child(ren)
$622.51
$364.14
$462.67
$280.03
$356.93
Employee + Family
$914.34
$532.17
$677.59
$410.80
$523.96
Dental Select - Costs Per Pay Period
DENTAL WITH
MEDICAL COVERAGE
DENTAL WITHOUT
MEDICAL COVERAGE
Employee Only
$0.00
$13.57
Employee + Spouse or Domestic Partner
$0.00
$29.64
Employee + Child(ren)
$0.00
$32.14
Employee + Family
$0.00
$46.70
Dental Select - Costs Per Month
DENTAL WITH
MEDICAL COVERAGE
DENTAL WITHOUT
MEDICAL COVERAGE
Employee Only
$0.00
$27.13
Employee + Spouse or Domestic Partner
$0.00
$59.28
Employee + Child(ren)
$0.00
$64.27
Employee + Family
$0.00
$93.39
 
Henriksen Butler covers 100% of your dental premium if you are enrolled in medical coverage.
VSP - Costs Per Pay Period
EXAM ONLY INCLUDED
WITH MEDICAL PLAN
FULL COVERAGE
VISION PLAN
Employee Only
$0.00
$4.55
Employee + One Dependent
$0.00
$6.60
Employee + Family
$0.00
$11.84
VSP - Costs Per Month
EXAM ONLY INCLUDED
WITH MEDICAL PLAN
FULL COVERAGE
VISION PLAN
Employee Only
$0.00
$9.11
Employee + One Dependent
$0.00
$13.21
Employee + Family
$0.00
$23.69
 
Henriksen Butler covers 100% of your vision premium if you are enrolled in medical coverage.