Retirees

You under 65

$579

$450

You + Spouse under 65

$1,267

$987

You + Child(ren) under 65

$1,079

$851

You + Spouse + Child(ren) under 65

$1,904

$1,485

You over 65

$494

$504

You + Spouse over 65

$986

$1,009

You + Child(ren) over 65

$1,085

$1,168

You + Spouse + Child(ren) over 65

$1,579

$1,672

You over 65 + Spouse under 65

$1,127

$998

You under 65 + Spouse over 65

$1,127

$998

You over 65 + Spouse under 65 + Child(ren)

$1,819

$1,539

You under 65 + Spouse over 65 + Child(ren)

$1,819

$1,539

Dearborn National PPO

$46

$100

$113

$160

First Commonwealth

$16

$29

$30

$44

EyeMed

$7

$12

$13

$17