Overview of PEIA Premium Changes
Health Coverage Annual Premium Cost Changes
Follow these instructions to determine which plan you are enrolled in. You also may call PEIA at 1-888-680-7342.
If you have a spouse that is offered health coverage available through their employer but has chosen PEIA coverage instead, you moved from ‘Family’ coverage to ‘Family with Eligible Spouse’ for Plan Year 2024. Family with Eligible Spouse coverage is the ‘Family’ premium plus the Spousal Surcharge cost. The spousal surcharge is not included in the premium offset. When viewing the chart to determine your annual increase, for ‘Health Coverage Tier’, please use ‘Family.'
The premium offset salary adjustment is based on the plan you are currently enrolled in as of July 1, 2023. If you made plan changes during this recent open enrollment, you will not use your former plan’s premium that ended on June 30, 2023.
- PEIA - PPB Plan A
- PEIA - PPB Plan B
- PEIA - PPB Plan C
- PEIA - PPB Plan D
- The Health Plan - Plan A
- The Health Plan - Plan B
- The Health Plan - Plan C
|
PEIA – PPB Plan A |
||
|
Health Coverage Tier |
Salary Tier (July 1, 2023) |
Annual Premium Change (Cap at $1,000) |
|
Single |
$0 - $28,100 |
$108 |
|
Single |
$28,101 - $38,100 |
$144 |
|
Single |
$38,101 - $44,100 |
$156 |
|
Single |
$44,101 - $50,100 |
$168 |
|
Single |
$50,101 - $58,100 |
$192 |
|
Single |
$58,101 - $70,600 |
$240 |
|
Single |
$70,601 - $83,100 |
$264 |
|
Single |
$83,101 - $108,100 |
$312 |
|
Single |
$108,101 - $133,100 |
$396 |
|
Single |
$133,101 and Greater |
$456 |
|
Emp/Child |
$0 - $28,100 |
$252 |
|
Emp/Child |
$28,101 - $38,100 |
$300 |
|
Emp/Child |
$38,101 - $44,100 |
$324 |
|
Emp/Child |
$44,101 - $50,100 |
$336 |
|
Emp/Child |
$50,101 - $58,100 |
$408 |
|
Emp/Child |
$58,101 - $70,600 |
$504 |
|
Emp/Child |
$70,601 - $83,100 |
$552 |
|
Emp/Child |
$83,101 - $108,100 |
$684 |
|
Emp/Child |
$108,101 - $133,100 |
$804 |
|
Emp/Child |
$133,101 and Greater |
$924 |
|
Family |
$0 - $28,100 |
$312 |
|
Family |
$28,101 - $38,100 |
$408 |
|
Family |
$38,101 - $44,100 |
$456 |
|
Family |
$44,101 - $50,100 |
$504 |
|
Family |
$50,101 - $58,100 |
$588 |
|
Family |
$58,101 - $70,600 |
$708 |
|
Family |
$70,601 - $83,100 |
$768 |
|
Family |
$83,101 - $108,100 |
$912 |
|
Family |
$108,101 - $133,100 |
$1,000 |
|
Family |
$133,101 and Greater |
$1,000 |
|
Family w Emp Spouse |
$0 - $28,100 |
$264 |
|
Family w Emp Spouse |
$28,101 - $38,100 |
$324 |
|
Family w Emp Spouse |
$38,101 - $44,100 |
$360 |
|
Family w Emp Spouse |
$44,101 - $50,100 |
$396 |
|
Family w Emp Spouse |
$50,101 - $58,100 |
$480 |
|
Family w Emp Spouse |
$58,101 - $70,600 |
$564 |
|
Family w Emp Spouse |
$70,601 - $83,100 |
$636 |
|
Family w Emp Spouse |
$83,101 - $108,100 |
$804 |
|
Family w Emp Spouse |
$108,101 - $133,100 |
$1,000 |
|
Family w Emp Spouse |
$133,101 and Greater |
$1,000 |
|
PEIA – PPB Plan B |
||
|
Health Coverage Tier |
Salary Tier (July 1, 2023) |
Annual Premium Change (Cap at $1,000) |
|
Single |
$0 - $28,100 |
$72 |
|
Single |
$28,101 - $38,100 |
$84 |
|
Single |
$38,101 - $44,100 |
$84 |
|
Single |
$44,101 - $50,100 |
$96 |
|
Single |
$50,101 - $58,100 |
$96 |
|
Single |
$58,101 - $70,600 |
$120 |
|
Single |
$70,601 - $83,100 |
$132 |
|
Single |
$83,101 - $108,100 |
$144 |
|
Single |
$108,101 - $133,100 |
$204 |
|
Single |
$133,101 and Greater |
$252 |
|
Emp/Child |
$0 - $28,100 |
$132 |
|
Emp/Child |
$28,101 - $38,100 |
$144 |
|
Emp/Child |
$38,101 - $44,100 |
$156 |
|
Emp/Child |
$44,101 - $50,100 |
$168 |
|
Emp/Child |
$50,101 - $58,100 |
$204 |
|
Emp/Child |
$58,101 - $70,600 |
$264 |
|
Emp/Child |
$70,601 - $83,100 |
$300 |
|
Emp/Child |
$83,101 - $108,100 |
$372 |
|
Emp/Child |
$108,101 - $133,100 |
$468 |
|
Emp/Child |
$133,101 and Greater |
$540 |
|
Family |
$0 - $28,100 |
$192 |
|
Family |
$28,101 - $38,100 |
$228 |
|
Family |
$38,101 - $44,100 |
$252 |
|
Family |
$44,101 - $50,100 |
$276 |
|
Family |
$50,101 - $58,100 |
$324 |
|
Family |
$58,101 - $70,600 |
$396 |
|
Family |
$70,601 - $83,100 |
$432 |
|
Family |
$83,101 - $108,100 |
$540 |
|
Family |
$108,101 - $133,100 |
$684 |
|
Family |
$133,101 and Greater |
$792 |
|
Family w Emp Spouse |
$0 - $28,100 |
$144 |
|
Family w Emp Spouse |
$28,101 - $38,100 |
$168 |
|
Family w Emp Spouse |
$38,101 - $44,100 |
$192 |
|
Family w Emp Spouse |
$44,101 - $50,100 |
$216 |
|
Family w Emp Spouse |
$50,101 - $58,100 |
$252 |
|
Family w Emp Spouse |
$58,101 - $70,600 |
$300 |
|
Family w Emp Spouse |
$70,601 - $83,100 |
$348 |
|
Family w Emp Spouse |
$83,101 - $108,100 |
$468 |
|
Family w Emp Spouse |
$108,101 - $133,100 |
$612 |
|
Family w Emp Spouse |
$133,101 and Greater |
$720 |
|
PEIA – PPB Plan C |
||
|
Health Coverage Tier |
Salary Tier (July 1, 2023) |
Annual Premium Change Cap at $1,000) |
|
Single |
$0 - $28,100 |
$120 |
|
Single |
$28,101 - $38,100 |
$120 |
|
Single |
$38,101 - $44,100 |
$120 |
|
Single |
$44,101 - $50,100 |
$120 |
|
Single |
$50,101 - $58,100 |
$120 |
|
Single |
$58,101 - $70,600 |
$120 |
|
Single |
$70,601 - $83,100 |
$120 |
|
Single |
$83,101 - $108,100 |
$120 |
|
Single |
$108,101 - $133,100 |
$120 |
|
Single |
$133,101 and Greater |
$120 |
|
Emp/Child |
$0 - $28,100 |
$216 |
|
Emp/Child |
$28,101 - $38,100 |
$216 |
|
Emp/Child |
$38,101 - $44,100 |
$216 |
|
Emp/Child |
$44,101 - $50,100 |
$216 |
|
Emp/Child |
$50,101 - $58,100 |
$216 |
|
Emp/Child |
$58,101 - $70,600 |
$216 |
|
Emp/Child |
$70,601 - $83,100 |
$216 |
|
Emp/Child |
$83,101 - $108,100 |
$216 |
|
Emp/Child |
$108,101 - $133,100 |
$216 |
|
Emp/Child |
$133,101 and Greater |
$216 |
|
Family |
$0 - $28,100 |
$480 |
|
Family |
$28,101 - $38,100 |
$480 |
|
Family |
$38,101 - $44,100 |
$480 |
|
Family |
$44,101 - $50,100 |
$480 |
|
Family |
$50,101 - $58,100 |
$480 |
|
Family |
$58,101 - $70,600 |
$480 |
|
Family |
$70,601 - $83,100 |
$480 |
|
Family |
$83,101 - $108,100 |
$480 |
|
Family |
$108,101 - $133,100 |
$480 |
|
Family |
$133,101 and Greater |
$480 |
|
Family w Emp Spouse |
$0 - $28,100 |
$408 |
|
Family w Emp Spouse |
$28,101- $38,100 |
$408 |
|
Family w Emp Spouse |
$38,101 - $44,100 |
$408 |
|
Family w Emp Spouse |
$44,101 - $50,100 |
$408 |
|
Family w Emp Spouse |
$50,101 - $58,100 |
$408 |
|
Family w Emp Spouse |
$58,101 - $70,600 |
$408 |
|
Family w Emp Spouse |
$70,601- $83,100 |
$408 |
|
Family w Emp Spouse |
$83,101 - $108,100 |
$408 |
|
Family w Emp Spouse |
$108,101 - $133,100 |
$408 |
|
Family w Emp Spouse |
$133,101 and Greater |
$408 |
|
PEIA – PPB Plan D |
||
|
Health Coverage Tier |
Salary Tier (July 1, 2023) |
Annual Premium Change (Cap at $1,000) |
|
Single |
$0 - $28,100 |
$108 |
|
Single |
$28,101- $38,100 |
$132 |
|
Single |
$ 8,101- $44,100 |
$144 |
|
Single |
$44,101 - $50,100 |
$156 |
|
Single |
$50,101 - $58,100 |
$180 |
|
Single |
$58,101 - $70,600 |
$216 |
|
Single |
$70,601 - $83,100 |
$252 |
|
Single |
$83,101 - $108,100 |
$300 |
|
Single |
$108,101 - $133,100 |
$360 |
|
Single |
$133,101 and Greater |
$420 |
|
Emp/Child |
$0 - $28,100 |
$204 |
|
Emp/Child |
$28,101 - $38,100 |
$252 |
|
Emp/Child |
$38,101 - $44,100 |
$264 |
|
Emp/Child |
$44,101 - $50,100 |
$288 |
|
Emp/Child |
$50,101 - $58,100 |
$336 |
|
Emp/Child |
$58,101 - $70,600 |
$420 |
|
Emp/Child |
$70,601 - $83,100 |
$468 |
|
Emp/Child |
$83,101 - $108,100 |
$576 |
|
Emp/Child |
$108,101 - $133,100 |
$684 |
|
Emp/Child |
$133,101 and Greater |
$780 |
|
Family |
$0 - $28,100 |
$252 |
|
Family |
$28,101- $38,100 |
$324 |
|
Family |
$38,101 - $44,100 |
$360 |
|
Family |
$44,101- $50,100 |
$408 |
|
Family |
$50,101- $58,100 |
$468 |
|
Family |
$58,101 - $70,600 |
$576 |
|
Family |
$70,601 - $83,100 |
$624 |
|
Family |
$83,101 - $108,100 |
$744 |
|
Family |
$108,101 - $133,100 |
$912 |
|
Family |
$133,101 and Greater |
$1,000 |
|
Family w Emp Spouse |
$0 - 28,100 |
$204 |
|
Family w Emp Spouse |
$28,101 - $38,100 |
$252 |
|
Family w Emp Spouse |
$38,101 - $44,100 |
$276 |
|
Family w Emp Spouse |
$44,101 - $50,100 |
$312 |
|
Family w Emp Spouse |
$50,101 - $58,100 |
$372 |
|
Family w Emp Spouse |
$58,101 - $70,600 |
$456 |
|
Family w Emp Spouse |
$70,601 - $83,100 |
$504 |
|
Family w Emp Spouse |
$83,101 - $108,100 |
$648 |
|
Family w Emp Spouse |
$108,101 - $133,100 |
$816 |
|
Family w Emp Spouse |
$133,101 and Greater |
$948 |
|
The Health Plan – Plan A |
||
|
Health Coverage Tier |
Salary Tier (July 1, 2023) |
Annual Premium Change (Cap at $1,000) |
|
Single |
$0 - $28,100 |
$108 |
|
Single |
$28,101 - $38,100 |
$144 |
|
Single |
$38,101 - $44,100 |
$156 |
|
Single |
$44,101 - $50,100 |
$168 |
|
Single |
$50,101 - $58,100 |
$192 |
|
Single |
$58,101 - $70,600 |
$240 |
|
Single |
$70,601 - $83,100 |
$264 |
|
Single |
$83,101 - $108,100 |
$324 |
|
Single |
$108,101 - $133,100 |
$408 |
|
Single |
$133,101 and Greater |
$468 |
|
Emp/Child |
$0 - $28,100 |
$252 |
|
Emp/Child |
$28,101 - $38,100 |
$300 |
|
Emp/Child |
$38,101 - $44,100 |
$324 |
|
Emp/Child |
$44,101 - $50,100 |
$348 |
|
Emp/Child |
$50,101 - $58,100 |
$420 |
|
Emp/Child |
$58,101 - $70,600 |
$504 |
|
Emp/Child |
$70,601 - $83,100 |
$564 |
|
Emp/Child |
$83,101 - $108,100 |
$684 |
|
Emp/Child |
$108,101 - $133,100 |
$816 |
|
Emp/Child |
$133,101 and Greater |
$924 |
|
Family |
$0 - $28,100 |
$312 |
|
Family |
$28,101 - $38,100 |
$396 |
|
Family |
$38,101 - $44,100 |
$444 |
|
Family |
$44,101 - $50,100 |
$504 |
|
Family |
$50,101 - $58,100 |
$576 |
|
Family |
$58,101 - $70,600 |
$708 |
|
Family |
$70,601 - $83,100 |
$768 |
|
Family |
$83,101 - $108,100 |
$912 |
|
Family |
$108,101 - $133,100 |
$1,000 |
|
Family |
$133,101 and Greater |
$1,000 |
|
Family w Emp Spouse |
$0 - $28,100 |
$240 |
|
Family w Emp Spouse |
$28,101 - $38,100 |
$312 |
|
Family w Emp Spouse |
$38,101 - $44,100 |
$348 |
|
Family w Emp Spouse |
$44,101 - $50,100 |
$372 |
|
Family w Emp Spouse |
$50,101 - $58,100 |
$456 |
|
Family w Emp Spouse |
$58,101 - $70,600 |
$552 |
|
Family w Emp Spouse |
$70,601 - $83,100 |
$612 |
|
Family w Emp Spouse |
$83,101 - $108,100 |
$780 |
|
Family w Emp Spouse |
$108,101 - $133,100 |
$984 |
|
Family w Emp Spouse |
$133,101 and Greater |
$1,000 |
|
The Health Plan – Plan B |
||
|
Health Coverage Tier |
Salary Tier (July 1st, 2023) |
Annual Premium Change (Cap at $1,000) |
|
Single |
$0 - $28,100 |
$84 |
|
Single |
$28,101 - $38,100 |
$108 |
|
Single |
$38,101 - $44,100 |
$108 |
|
Single |
$44,101 - $50,100 |
$120 |
|
Single |
$50,101 - $58,100 |
$120 |
|
Single |
$58,101 - $70,600 |
$144 |
|
Single |
$70,601 - $83,100 |
$156 |
|
Single |
$83,101 - $108,100 |
$168 |
|
Single |
$108,101 - $133,100 |
$216 |
|
Single |
$133,101 and Greater |
$276 |
|
Emp/Child |
$0 - $28,100 |
$132 |
|
Emp/Child |
$28,101 - $38,100 |
$144 |
|
Emp/Child |
$38,101 - $44,100 |
$156 |
|
Emp/Child |
$44,101 - $50,100 |
$168 |
|
Emp/Child |
$50,101 - $58,100 |
$204 |
|
Emp/Child |
$58,101 - $70,600 |
$264 |
|
Emp/Child |
$70,601 - $83,100 |
$300 |
|
Emp/Child |
$83,101 - $108,100 |
$372 |
|
Emp/Child |
$108,101 - $133,100 |
$468 |
|
Emp/Child |
$133,101 and Greater |
$540 |
|
Family |
$0 - $28,100 |
$336 |
|
Family |
$28,101 - $38,100 |
$372 |
|
Family |
$38,101 - $44,100 |
$396 |
|
Family |
$44,101 - $50,100 |
$420 |
|
Family |
$50,101 - $58,100 |
$456 |
|
Family |
$58,101 - $70,600 |
$540 |
|
Family |
$70,601 - $83,100 |
$576 |
|
Family |
$83,101 - $108,100 |
$672 |
|
Family |
$108,101 - $133,100 |
$828 |
|
Family |
$133,101 and Greater |
$924 |
|
Family w Emp Spouse |
$0 - $28,100 |
$252 |
|
Family w Emp Spouse |
$28,101 - $38,100 |
$276 |
|
Family w Emp Spouse |
$38,101 - $44,100 |
$300 |
|
Family w Emp Spouse |
$44,101 - $50,100 |
$336 |
|
Family w Emp Spouse |
$50,101 - $58,100 |
$372 |
|
Family w Emp Spouse |
$58,101 - $70,600 |
$420 |
|
Family w Emp Spouse |
$70,601 - $83,100 |
$456 |
|
Family w Emp Spouse |
$83,101 - $108,100 |
$588 |
|
Family w Emp Spouse |
$108,101 - $133,100 |
$732 |
|
Family w Emp Spouse |
$133,101 and Greater |
$828 |
|
The Health Plan – Plan C |
||
|
Health Coverage Tier |
Salary Tier (July 1, 2023) |
Annual Premium Change Cap at $1,000) |
|
Single |
$0 - $28,100 |
$132 |
|
Single |
$28,101 - $38,100 |
$312 |
|
Single |
$38,101 - $44,100 |
$372 |
|
Single |
$44,101 - $50,100 |
$432 |
|
Single |
$50,101- $58,100 |
$564 |
|
Single |
$58,101 - $70,600 |
$768 |
|
Single |
$70,601 - $83,100 |
$876 |
|
Single |
$83,101 - $108,100 |
$1,000 |
|
Single |
$108,101 - $133,100 |
$1,000 |
|
Single |
$133,101 and Greater |
$1,000 |
|
Emp/Child |
$0 - $28,100 |
$228 |
|
Emp/Child |
$28,101 - $38,100 |
$444 |
|
Emp/Child |
$38,101 - $44,100 |
$540 |
|
Emp/Child |
$44,101 - $50,100 |
$672 |
|
Emp/Child |
$50,101 - $58,100 |
$888 |
|
Emp/Child |
$58,101 - $70,600 |
$1,000 |
|
Emp/Child |
$70,601 - $83,100 |
$1,000 |
|
Emp/Child |
$83,101 - $108,100 |
$1,000 |
|
Emp/Child |
$108,101 - $133,100 |
$1,000 |
|
Emp/Child |
$133,101 and Greater |
$1,000 |
|
Family |
$0 - $28,100 |
$348 |
|
Family |
$28,101 - $38,100 |
$708 |
|
Family |
$38,101 - $44,100 |
$912 |
|
Family |
$44,101 - $50,100 |
$1,000 |
|
Family |
$50,101 - $58,100 |
$1,000 |
|
Family |
$58,101 - $70,600 |
$1,000 |
|
Family |
$70,601 - $83,100 |
$1,000 |
|
Family |
$83,101 - $108,100 |
$1,000 |
|
Family |
$108,101 - $133,100 |
$1,000 |
|
Family |
$133,101 and Greater |
$1,000 |
|
Family w Emp Spouse |
$0 - $28,100 |
$348 |
|
Family w Emp Spouse |
$28,101 - $38,100 |
$660 |
|
Family w Emp Spouse |
$38,101 - $44,100 |
$792 |
|
Family w Emp Spouse |
$44,101 - $50,100 |
$948 |
|
Family w Emp Spouse |
$50,101 - $58,100 |
$1,000 |
|
Family w Emp Spouse |
$58,101 - $70,600 |
$1,000 |
|
Family w Emp Spouse |
$70,601 - $83,100 |
$1,000 |
|
Family w Emp Spouse |
$83,101 - $108,100 |
$1,000 |
|
Family w Emp Spouse |
$108,101 - $133,100 |
$1,000 |
|
Family w Emp Spouse |
$133,101 and Greater |
$1,000 |