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Single +Spouse +Child(ren)Family <br />City Contribution 575.00 1,202.00 1,193.00 1,656.00 <br />HealthPartners through Sourcewell <br />$500 Deductible 591.74 1,291.76 1,281.88 1,870.11 <br />Monthly Employee Cost 16.74 89.76 88.88 214.11 <br />Annual Employee Cost 200.88 1,077.12 1,066.56 2,569.32 <br />HSA Open Access 512.62 1,121.65 1,113.23 1,614.73 <br />Monthly Employee Cost -62.38 -80.35 -79.77 -41.27 <br />Annual Employee Cost -748.56 -964.20 -957.24 -495.24 <br />HSA Achieve 485.17 1,062.64 1,054.72 1,526.14 <br />Monthly Employee Cost -89.83 -139.36 -138.28 -129.86 <br />Annual Employee Cost -1,077.96 -1,672.32 -1,659.36 -1,558.32 <br />Opt-Out of Medical 300.00 <br />DeltaDental 40.80 107.98 <br />Add'l Monthly HSA Contribution 130.00 130.00 130.00 130.00 <br />2022 Flexible Benefits Plan Renewal Rates