Health Plan Premiums (Bi-weekly Team Member Contributions – 26 Contributions) HEALTH PLAN PREMIUMS (BI-WEEKLY TEAM MEMBER CONTRIBUTIONS – 26 CONTRIBUTIONS) TEAM MEMBER & TEAM MEMBER + TEAM MEMBER ONLY FAMILY SPOUSE CHILD(REN) EPO PLAN JUST PREMIUM $21.89 $95.40 $43.27 $118.85 STANDARD PREMIUM $50.52 $163.16 $100.17 $214.65 PART-TIME PREMIUM $50.56 $274.74 $184.36 $356.20 TEAM MEMBER & TEAM MEMBER + TEAM MEMBER ONLY FAMILY SPOUSE CHILD(REN) PPO PLAN JUST PREMIUM $48.23 $180.39 $90.93 $228.96 STANDARD PREMIUM $100.54 $257.67 $180.75 $337.88 PART-TIME PREMIUM $146.51 $365.53 $271.72 $490.74 TEAM MEMBER & TEAM MEMBER + TEAM MEMBER ONLY FAMILY SPOUSE CHILD(REN) HDHSA PLAN JUST PREMIUM N/A N/A N/A N/A STANDARD PREMIUM $82.00 $222.74 $191.00 $308.00 PART-TIME PREMIUM $119.50 $315.97 $287.12 $405.50 24