Enrollment Form (Required)
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Enrollment Form
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2026 Health Plan 1: Blue Elect Plus Bronze HSA/POS
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Plan 1 Details
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2026 Health Plan 2: Blue Elect Plus Silver HSA/POS
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Plan 2 Details
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2026 Health Plan 3: Blue Care Network Gold Option 2 HSA/HMO
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Plan 3 Details
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2026 Health Plan 4: Blue Elect Plus Gold Option 4 POS
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Plan 4 Details
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2026 Dental Plan: Kansas City Life Go2 Dental Option 3
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Dental ID Card
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Dental Plan Details
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Pediatric dental option: Blue Dental Pediatric 80/50/50 PPO is available only with Health Plan 4 (Blue Elect Plus Gold Option 4 POS), for children through age 18. See Plan 4 on the Health Plans tab for details and the Pricing tab for rates.
2026 Medical Weekly Rates
Rates are estimated weekly payroll deductions based on each covered person’s age. Add the rate for each person on the plan you select. The Plan 4 pediatric dental add-on is only available with Plan 4 and only for children through age 18; gray cells are not eligible. Actual payroll deductions may vary by coverage level, enrollment status, and payroll processing.
| Age | Plan 1 Bronze HSA/POS |
Plan 2 Silver HSA/POS |
Plan 3 Gold HSA/HMO |
Plan 4 Gold Option 4 POS |
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| Medical |
+ Pediatric Dental optional, ages 0 to 18 |
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| 0 to 14 | $44.33/Week | $49.63/Week | $57.75/Week | $64.41/Week | $4.87/Week |
| 15 | $48.27/Week | $54.04/Week | $62.88/Week | $70.14/Week | $4.87/Week |
| 16 | $49.78/Week | $55.73/Week | $64.85/Week | $72.33/Week | $4.87/Week |
| 17 | $51.29/Week | $57.41/Week | $66.81/Week | $74.52/Week | $4.87/Week |
| 18 | $52.91/Week | $59.23/Week | $68.92/Week | $76.88/Week | $4.87/Week |
| 19 | $54.53/Week | $61.05/Week | $71.04/Week | $79.23/Week | Not Eligible |
| 20 | $56.22/Week | $62.93/Week | $73.23/Week | $81.67/Week | Not Eligible |
| 21 to 24 | $57.95/Week | $64.87/Week | $75.49/Week | $84.20/Week | Not Eligible |
| 25 | $58.18/Week | $65.13/Week | $75.79/Week | $84.54/Week | Not Eligible |
| 26 | $59.34/Week | $66.43/Week | $77.30/Week | $86.22/Week | Not Eligible |
| 27 | $60.73/Week | $67.99/Week | $79.11/Week | $88.24/Week | Not Eligible |
| 28 | $63.00/Week | $70.52/Week | $82.06/Week | $91.53/Week | Not Eligible |
| 29 | $64.85/Week | $72.59/Week | $84.48/Week | $94.22/Week | Not Eligible |
| 30 | $65.78/Week | $73.63/Week | $85.68/Week | $95.57/Week | Not Eligible |
| 31 | $67.17/Week | $75.19/Week | $87.49/Week | $97.59/Week | Not Eligible |
| 32 | $68.56/Week | $76.74/Week | $89.31/Week | $99.61/Week | Not Eligible |
| 33 | $69.43/Week | $77.72/Week | $90.44/Week | $100.87/Week | Not Eligible |
| 34 | $70.35/Week | $78.76/Week | $91.65/Week | $102.22/Week | Not Eligible |
| 35 | $70.82/Week | $79.28/Week | $92.25/Week | $102.89/Week | Not Eligible |
| 36 | $71.28/Week | $79.80/Week | $92.85/Week | $103.57/Week | Not Eligible |
| 37 | $71.75/Week | $80.31/Week | $93.46/Week | $104.24/Week | Not Eligible |
| 38 | $72.21/Week | $80.83/Week | $94.06/Week | $104.91/Week | Not Eligible |
| 39 | $73.14/Week | $81.87/Week | $95.27/Week | $106.26/Week | Not Eligible |
| 40 | $74.06/Week | $82.91/Week | $96.48/Week | $107.61/Week | Not Eligible |
| 41 | $75.45/Week | $84.47/Week | $98.29/Week | $109.63/Week | Not Eligible |
| 42 | $76.79/Week | $85.96/Week | $100.03/Week | $111.57/Week | Not Eligible |
| 43 | $78.64/Week | $88.03/Week | $102.44/Week | $114.26/Week | Not Eligible |
| 44 | $80.96/Week | $90.63/Week | $105.46/Week | $117.63/Week | Not Eligible |
| 45 | $83.68/Week | $93.68/Week | $109.01/Week | $121.59/Week | Not Eligible |
| 46 | $86.93/Week | $97.31/Week | $113.24/Week | $126.30/Week | Not Eligible |
| 47 | $90.58/Week | $101.40/Week | $117.99/Week | $131.61/Week | Not Eligible |
| 48 | $94.75/Week | $106.07/Week | $123.43/Week | $137.67/Week | Not Eligible |
| 49 | $98.87/Week | $110.67/Week | $128.79/Week | $143.65/Week | Not Eligible |
| 50 | $103.50/Week | $115.86/Week | $134.83/Week | $150.38/Week | Not Eligible |
| 51 | $108.08/Week | $120.99/Week | $140.79/Week | $157.03/Week | Not Eligible |
| 52 | $113.13/Week | $126.63/Week | $147.36/Week | $164.36/Week | Not Eligible |
| 53 | $118.23/Week | $132.34/Week | $154.00/Week | $171.77/Week | Not Eligible |
| 54 | $123.73/Week | $138.51/Week | $161.17/Week | $179.77/Week | Not Eligible |
| 55 | $129.24/Week | $144.67/Week | $168.35/Week | $187.77/Week | Not Eligible |
| 56 | $135.21/Week | $151.35/Week | $176.12/Week | $196.44/Week | Not Eligible |
| 57 | $141.23/Week | $158.10/Week | $183.97/Week | $205.20/Week | Not Eligible |
| 58 | $147.66/Week | $165.30/Week | $192.35/Week | $214.54/Week | Not Eligible |
| 59 | $150.85/Week | $168.87/Week | $196.50/Week | $219.18/Week | Not Eligible |
| 60 | $157.29/Week | $176.07/Week | $204.88/Week | $228.52/Week | Not Eligible |
| 61 | $162.85/Week | $182.30/Week | $212.13/Week | $236.60/Week | Not Eligible |
| 62 | $166.50/Week | $186.38/Week | $216.89/Week | $241.91/Week | Not Eligible |
| 63 | $171.08/Week | $191.51/Week | $222.85/Week | $248.56/Week | Not Eligible |
| 64 to 65+ | $173.86/Week | $194.62/Week | $226.47/Week | $252.60/Week | Not Eligible |
2026 Dental Rates: Kansas City Life Go2 Dental Option 3
Dental rates are a flat amount by coverage level, not by age.
| Coverage Level | Weekly | Monthly |
| Employee Only | $8.82/Week | $38.21/Month |
| Employee + Spouse | $17.40/Week | $75.42/Month |
| Employee + Child(ren) | $18.84/Week | $81.65/Month |
| Family | $28.53/Week | $123.62/Month |
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