Premium Contribution Table

Salary Bracket Salary Range Salary Base Total Monthly Premium Employee Share Employer Share
*Employee share represents half of the total monthly premium
while the other half is shouldered by the employer.
1 7,999.99 and below 7,000.00 175.00 87.50 87.50
2 8,000.00 - 8,999.99 8,000.00 200.00 100.00 100.00
3 9,000.00 - 9,999.99 9,000.00 225.00 112.50 112.50
4 10,000.00 - 10,999.99 10,000.00 250.00 125.00 125.00
5 11,000.00 - 11,999.99 11,000.00 275.00 137.50 137.50
6 12,000.00 - 12,999.99 12,000.00 300.00 150.00 150.00
7 13,000.00 - 13,999.99 13,000.00 325.00 162.50 162.50
8 14,000.00 - 14,999.99 14,000.00 350.00 175.00 175.00
9 15,000.00 - 15,999.99 15,000.00 375.00 187.50 187.50
10 16,000.00 - 16,999.99 16,000.00 400.00 200.00 200.00
11 17,000.00 - 17,999.99 17,000.00 425.00 212.50 212.50
12 18,000.00 - 18,999.99 18,000.00 450.00 225.00 225.00
13 19,000.00 - 19,999.99 19,000.00 475.00 237.50 237.50
14 20,000.00 - 20,999.99 20,000.00 500.00 250.00 250.00
15 21,000.00 - 21,999.99 21,000.00 525.00 262.50 262.50
16 22,000.00 - 22,999.99 22,000.00 550.00 275.00 275.00
17 23,000.00 - 23,999.99 23,000.00 575.00 287.50 287.50
18 24,000.00 - 24,999.99 24,000.00 600.00 300.00 300.00
19 25,000.00 - 25,999.99 25,000.00 625.00 312.50 312.50
20 26,000.00 - 26,999.99 26,000.00 650.00 325.00 325.00
21 27,000.00 - 27,999.99 27,000.00 675.00 337.50 337.50
22 28,000.00 - 28,999.99 28,000.00 700.00 350.00 350.00
23 29,000.00 - 29,999.99 29,000.00 725.00 362.50 362.50
24 30,000.00 - 30,999.99 30,000.00 750.00 375.00 375.00
25 31,000.00 - 31,999.99 31,000.00 775.00 387.50 387.50
26 32,000.00 - 32,999.99 32,000.00 800.00 400.00 400.00
27 33,000.00 - 33,999.99 33,000.00 825.00 412.50 412.50
28 34,000.00 - 34,999.99 34,000.00 850.00 425.00 425.00
29 35,000.00 and up 35,000.00 875.00 437.50 437.50