FSA/HSA Eligible
$6,999.00
$2,099.70
$7,999.00
$2,399.70
$7,299.00
$2,189.70
$1,500.00
$450.00
$4,899.00
$1,469.70
$5,299.00
$1,589.70
$15,498.00
$8,499.00
$14,698.00
$4,409.40
$11,998.00
$3,599.40
$8,399.00
$12,698.00
$3,809.40
