| 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 | 4,999.99 and below | 4,000.00 | 100.00 | 50.00 | 50.00 |
| 2 | 5,000.00 - 5,999.99 | 5,000.00 | 125.00 | 62.50 | 62.50 |
| 3 | 6,000.00 - 6,999.99 | 6,000.00 | 150.00 | 75.00 | 75.00 |
| 4 | 7,000.00 - 7,999.99 | 7,000.00 | 175.00 | 87.50 | 87.50 |
| 5 | 8,000.00 - 8,999.99 | 8,000.00 | 200.00 | 100.00 | 100.00 |
| 6 | 9,000.00 - 9,999.99 | 9,000.00 | 225.00 | 112.50 | 112.50 |
| 7 | 10,000.00 - 10,999.99 | 10,000.00 | 250.00 | 125.00 | 125.00 |
| 8 | 11,000.00 - 11,999.99 | 11,000.00 | 275.00 | 137.50 | 137.50 |
| 9 | 12,000.00 - 12,999.99 | 12,000.00 | 300.00 | 150.00 | 150.00 |
| 10 | 13,000.00 - 13,999.99 | 13,000.00 | 325.00 | 162.50 | 162.50 |
| 11 | 14,000.00 - 14,999.99 | 14,000.00 | 350.00 | 175.00 | 175.00 |
| 12 | 15,000.00 - 15,999.99 | 15,000.00 | 375.00 | 187.50 | 187.50 |
| 13 | 16,000.00 - 16,999.99 | 16,000.00 | 400.00 | 200.00 | 200.00 |
| 14 | 17,000.00 - 17,999.99 | 17,000.00 | 425.00 | 212.50 | 212.50 |
| 15 | 18,000.00 - 18,999.99 | 18,000.00 | 450.00 | 225.00 | 225.00 |
| 16 | 19,000.00 - 19,999.99 | 19,000.00 | 475.00 | 237.50 | 237.50 |
| 17 | 20,000.00 - 20,999.99 | 20,000.00 | 500.00 | 250.00 | 250.00 |
| 18 | 21,000.00 - 21,999.99 | 21,000.00 | 525.00 | 262.50 | 262.50 |
| 19 | 22,000.00 - 22,999.99 | 22,000.00 | 550.00 | 275.00 | 275.00 |
| 20 | 23,000.00 - 23,999.99 | 23,000.00 | 575.00 | 287.50 | 287.50 |
| 21 | 24,000.00 - 24,999.99 | 24,000.00 | 600.00 | 300.00 | 300.00 |
| 22 | 25,000.00 - 25,999.99 | 25,000.00 | 625.00 | 312.50 | 312.50 |
| 23 | 26,000.00 - 26,999.99 | 26,000.00 | 650.00 | 325.00 | 325.00 |
| 24 | 27,000.00 - 27,999.99 | 27,000.00 | 675.00 | 337.50 | 337.50 |
| 25 | 28,000.00 - 28,999.99 | 28,000.00 | 700.00 | 350.00 | 350.00 |
| 26 | 29,000.00 - 29,999.99 | 29,000.00 | 725.00 | 362.50 | 362.50 |
| 27 | 30,000.00 and up | 30,000.00 | 750.00 | 375.00 | 375.00 |