Nevada on Thursday became the first U.S. state to impose a surcharge on workers who have not gotten a COVID-19 vaccine, though the penalty doesn’t take effect until the middle of next year.

All but two members of the state’s Public Employees’ Benefit Program Board (PEBP) voted during a meeting to approve a surcharge of $55 a month on unvaccinated workers.

The approved proposal also stipulates a surcharge of $175 a month for workers’ spouses, partners, and dependents 18 and older. That could be adjusted down the road.

The surcharges will go into effect on July 1, 2022.