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Appendix

Appendix A - Wage Rates

FY24 (2%) - Effective July 1, 2023

Range A B C D E
1
$13.87 $14.69 $15.57 $16.49 $17.58
2
$15.03  $16.32  $17.71 $19:24 $20.87
3
$15.23 $16.56 $18.17 $19.75 $21.56
4
$19.75 $20.33 $20.91 $21.60 $22.28
5
$20.33  $20.91 $21.60 $22.25 $22.94
6
$21.01 $21.68 $22.34 $23.00 $23.70
7
$22.34  $23.00 $23.66 $24.44 $25.16
8
$23.66 $24.36 $25.09 $25.84 $26.64
9
$24.79 $25.55 $26.34 $27.16 $27.98
10
$27.18 $28.02 $28.86 $29.69 $30.58
11
$28.54  $29.42 $30.30 $31.18 $32.11

FY2S (2%) - Effective July 1, 2024

Range A B C D E
1
$14.15 $14.98 $15.88 $16.82 $17.94
2
$15.34 $16.65 $18.06 $19.62 $21.29
3
$15.53 $16.90 $18.53 $20.14 $21.99
4
$20.14 $20.74 $21.33 $22.04 $22.72
5
$20.74 $21.33 $22.04 $22.69 $23.40
6
$21.43 $22.11 $22.78 $23.46 $24.18
7
$22.78 $23.46 $24.14 $24.93 $25.67
8
$24.14 $24.84 $25.59 $26.35 $27.18
9
$25.28 $26.06 $26.86 $27.71 $28.54
10
$27.73 $28.58 $29.43 $30.29 $31.19
11
$29.11 $30.01 $30.90 $31.80 $32.75

FY26 (2%) - Effective July 1, 2025

Range A B C D E
1
$14.43 $15.28 $16.19 $17.16 $18.30
2
$15.64 $16.98 $18.42 $20.01 $21.71
3
$15.84 $17.23 $18.90 $20.54 $22.43
4
$20.54 $21.15 $21.75 $22.48 $23.18
5
$21.15 $21.75 $22.48 $23.14 $23.87
6
$21.86 $22.55 $23.24 $23.93 $24.66
7
$23.24 $23.93 $24.62 $25.43 $26.18
8
$24.62 $25.34 $26.11 $26.88 $27.72
9
$25.79 $26.58 $27.40 $28.26  $29.11
10
$28.28 $29.15 $30.02 $30.89 $31.82
11
$29.70 $30.61 $31.52 $32.44 $33.41

Appendix B - Summary of Insurance Benefits

Summary
First Year 7/1/2023
Second Year 7/1/2024
Third Year 7/1/2025
Employee Share of Premiums

Employee contribution will be equal to 15% of the Total Annual Premium, not to exceed the following:

  • $80 - Single
  • $160 - Single +1
  • $240 - Family

Employee contribution will be equal to 15% of the Total Annual Premium, not to exceed the following:

  • $85 - Single
  • $170 - Single +1
  • $250 - Family

Employee contribution will be equal to 15% of the Total Annual Premium, not to exceed the following:

  • $90 - Single
  • $180 - Single +1
  • $265 - Family
Drug Co-pays* Retail
  • $20.00-Generic
  • $30.00-Brand Formulary
  • $40.00-Non-Formulary
  • $20.00-Generic
  • $30.00-Brand Formulary
  • $40.00-Non-Formulary
  • $20.00-Generic
  • $30.00-Brand Formulary
  • $40.00-Non-Formulary
Drug Co-pays* Mail Order
  • $25.00-Generic
  • $40.00-Brand Formulary
  • $55.00-Non-Formulary
  • $25.00-Generic
  • $40.00-Brand Formulary
  • $55.00-Non-Formulary
  • $25.00-Generic
  • $40.00-Brand Formulary
  • $55.00-Non-Formulary
Benefits First Year 7/1/2023 Second Year 7/1/2024 Third Year 7/1/2025
Deductibles
$600 / $1200 $700 / $1400 $800 / $1600
Co-Insurance Maximum
$2,250 / $4,500 $2,500 / $5,000 $2,700 / $5.400
Out of Pocket Maximum
$2,800 / $5,600 $3,250 / $6,500 $3,500 / $7,000
Co-Insurance
80% 80% 80%
Office Visit Co-Pays
$25.00 $25.00 $25.00

*All employees will be enrolled in the PrudentRX Specialty Drug Copay Program offered through CVS Caremark. Employees under this program will have a $0 copay for their specialty drug prescriptions. CVS Specialty Pharmacy will distribute and update the Prudent RX specialty drug listing periodically. Any prescription not included in the Prudent RX specialty drug listing will be subject to the PPO design detailed herein.

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