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2016 2017 <br /> Employee Employee Employee& <br /> AEmployee D Cost with Employee Cost with Spouse <br /> RA A Cost Wellness Cost Wellness Wellness Rate <br /> Employee Only $ 52.41 S 40.02 $ 54.51 $ 22.51 NA <br /> EE& Souse Only $ 126.00 $ 61.20 $ 131.04 S 99.04 $ 67.04 <br /> Employee& <br /> Child(ren)Only $ 73.60 $ 41.00 $76.54 $ 44.54 NA <br /> Employee& <br /> Family $ 132.97 S 68.17 $ 138.29 $ 106.29 S 74.29 <br /> Employee& <br /> Spouse Surcharge $ 156.00 $ 91.20 $ 166.04 $ 134.04 S 102.04 <br /> Employee& <br /> Family Surcharge 1 $ 162.97 S 98.17 $ 173.29 $ 141.29 1 $ 109.29 <br /> f- Iletiree Cost Share Per Month-Active Union Member <br /> 2016-PPO 2017-PPO 2016-HRA 2017-HRA <br /> Employee 5200.00 S210.00 S 12)5. S132.00 <br /> Employee& Spouse S600.00 S630.00 ,75.00 5394.00 <br /> Employee& Children S435.00 $457.00 �?.ti11.00 5294.00 <br /> Employee& Family 5835.00 $877.00 >•0.00 S557.00 <br /> Retiree Cost Share Per Month-Non Active Union Member <br /> 2016-PPO 2017-PPO 2016-IIRA 2016- HRA <br /> Employee $250.00 S260.00 S175.00 $182.00 <br /> Employee& Spouse S650.00 S680.00 5425.00 $444.00 <br /> Employee& Children 5485.00 S507.00 S325.00 S344.00 <br /> Employee& Family $885.00 S927.00 5580.00 $607.00 <br />