|
Number of months coverage |
Member Only |
Addition of one dependent |
Member plus one dependent |
Addition of two or more dependents |
Member plus two or more dependents |
|
|
Base |
Tax |
Base |
Tax |
Base |
Tax |
Base |
Tax |
Base |
Tax |
|
1 |
$52.78 |
$4.22 |
$82.41 |
$6.59 |
$135.19 |
$10.81 |
$164.81 |
$13.19 |
$217.59 |
$17.41 |
|
2 |
$105.56 |
$8.44 |
$164.81 |
$13.19 |
$270.37 |
$21.63 |
$329.63 |
$26.37 |
$435.19 |
$34.81 |
|
3 |
$158.33 |
$12.67 |
$247.22 |
$19.78 |
$405.56 |
$32.44 |
$494.44 |
$39.56 |
$652.78 |
$52.22 |
|
4 |
$211.11 |
$16.89 |
$329.63 |
$26.37 |
$540.74 |
$43.26 |
$659.26 |
$52.74 |
$870.37 |
$69.63 |
|
5 |
$263.89 |
$21.11 |
$412.04 |
$32.96 |
$675.93 |
$54.07 |
$824.07 |
$65.93 |
$1,087.96 |
$87.04 |
|
6 |
$316.67 |
$25.33 |
$494.44 |
$39.56 |
$811.11 |
$64.89 |
$988.89 |
$79.11 |
$1,305.56 |
$104.44 |
|
7 |
$369.44 |
$29.56 |
$576.85 |
$46.15 |
$946.30 |
$75.70 |
$1,153.70 |
$92.30 |
$1,523.15 |
$121.85 |
|
8 |
$422.22 |
$33.78 |
$659.26 |
$52.74 |
$1,081.48 |
$86.52 |
$1,318.52 |
$105.48 |
$1,740.74 |
$139.26 |
|
9 |
$475.00 |
$38.00 |
$741.67 |
$59.33 |
$1,216.67 |
$97.33 |
$1,483.33 |
$118.67 |
$1,958.33 |
$156.67 |
|
10 |
$527.78 |
$42.22 |
$824.07 |
$65.93 |
$1,351.85 |
$108.15 |
$1,648.15 |
$131.85 |
$2,175.93 |
$174.07 |
|
11 |
$580.56 |
$46.44 |
$906.48 |
$72.52 |
$1,487.04 |
$118.96 |
$1,812.96 |
$145.04 |
$2,393.52 |
$191.48 |
|
12 |
$633.33 |
$50.67 |
$988.89 |
$79.11 |
$1,622.22 |
$129.78 |
$1,977.78 |
$158.22 |
$2,611.11 |
$208.89 |
|
|
A |
a |
B |
b |
C |
c |
D |
d |
E |
e |
|
|
|
|
|
|
A + B = C |
a + b = c |
|
|
A + D = E |
a + d = e |
|
|
|
