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Medical Plan <br />1st of the month <br />Total <br />Monthly <br />Premium <br />City's <br />Contribution <br />FTE <br />Employee <br />Monthly <br />Cost <br />Employee <br />Per Pay <br />Period <br />Cost* <br />Monthly <br />City HSA <br />Contribution <br />PEIP - High - Single 657.22$ 657.22$ -$ -$ <br />PEIP - High - Family 1,684.36$ 1,347.49$ 336.87$ 168.44$ <br />PEIP - H S A - Single 465.94$ 465.94$ -$ -$ 125.00$ <br />PEIP - H S A - Family 1,172.78$ 1,114.14$ 58.64$ 29.32$ 250.00$ <br />Health Partners Dental Plan Monthly <br />Premium <br />Single 40.26$ <br />Single + One 80.53$ <br />Family 120.78$ <br />BCBS Vision Plan Monthly <br />Premium <br />Single 6.41$ <br />Family 15.33$ <br />Health and Dental <br />I.U.O.E Union Coverage <br />30 days after hire <br />Monthly <br />Premium <br />City's <br />Contribution <br />Employee <br />Monthly <br />Cost <br />Family 1,475.00$ 1,256.50$ 218.50$ <br />Monthly <br />Premium <br />City's <br />Contribution <br />Life Insurance ($25,000) 4.75$ 100% -$ <br />AD&D ($25,000) 0.75$ 100% -$ <br />STD Insurance .415/$10 100% -$ <br />LTD Insurance .17/$100 100% -$ <br />PERA <br />Public Employee Retirement <br />Association <br />Coordinated <br />Fire Plan <br />*Insurance premiums are only deducted from the first 2 paychecks each month <br />2025 City of Lake Elmo Benefit Rates and Contributions <br />Employee <br />ContributionEmployer Contribution <br />17.7% 11.8% <br />7.5% 6.5% <br />Employee Per <br />Pay Period Cost <br />Employee Monthly <br />Cost <br />6.41$ <br />Employee <br />Monthly Cost <br />FTE <br />Employee <br />Monthly <br />Cost <br />-$ <br />-$ <br />-$ <br />City's <br />Contribution <br />100% <br />100% <br />100% <br />Employee Per Pay <br />Period Cost* <br />109.25$ <br />15.33$ <br />3.21$ <br />7.67$