Your payroll contributions for Medical, Dental, Vision, Life, Short-Term Disability, Accident, Critical Illness, and Hospital Indemnity benefits are shown here. The premiums you pay are based on the plans you select.
| Medical Rates | ||||
|---|---|---|---|---|
|
Core Plan Monthly Rates |
Choice Plus Monthly Rates |
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|
Employee (to estimate the employee portion of the medical rate, enter your hourly pay) |
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| Spouse | $927.06* | $964.00* | ||
| Child(ren) | $479.30* | $498.40* | ||
| Spouse and Child(ren) | $1,507.28* | $1,567.33* | ||
| * When selecting medical coverage for Dependents, add the Employee Rate from the calculator to the Dependent Rate in the table to get your Total Monthly Rate. When you enroll for coverage in Employee Navigator, you will see your pay period amount. | ||||
| Dental Rates | ||||
|---|---|---|---|---|
|
Low Plan Monthly Rates |
High Plan Monthly Rates |
|||
| Employee Only | $40.40 | $49.45 | ||
| Employee and Spouse | $81.47 | $99.73 | ||
| Employee and Child(ren) | $76.13 | $93.18 | ||
| Family | $131.44 | $160.88 | ||
| Vision Rates | ||||
|---|---|---|---|---|
|
Low Plan Monthly Rates |
High Plan Monthly Rates |
|||
| Employee Only | $2.71 | $5.60 | ||
| Employee and Spouse | $5.41 | $11.20 | ||
| Employee and Child(ren) | $5.55 | $11.48 | ||
| Family | $8.26 | $17.08 | ||
| Accident Rates | ||||
|---|---|---|---|---|
|
Low Plan Monthly Rates |
High Plan Monthly Rates |
|||
| Employee Only | $7.50 | $9.99 | ||
| Employee and Spouse | $11.97 | $15.94 | ||
| Employee and Child(ren) | $14.80 | $20.11 | ||
| Family | $22.87 | $30.96 | ||
| Hospital Indemnity Rates | |
|---|---|
| Monthly Rates | |
| Employee Only | $11.15 |
| Employee and Spouse | $22.27 |
| Employee and Child(ren) | $21.42 |
| Family | $35.07 |
| Voluntary Life Rates | |
|---|---|
| Employee & Spouse | |
| Age Range | Per $1,000 |
| Under 25 | $0.063 |
| 25-29 | $0.056 |
| 30-34 | $0.070 |
| 35-39 | $0.096 |
| 40-44 | $0.150 |
| 45-49 | $0.230 |
| 50-54 | $0.360 |
| 55-59 | $0.565 |
| 60-64 | $0.820 |
| 65-69 | $1.370 |
| 70+ | $3.120 |
| Child(ren) - $1.80 for $10,000 | |
| Voluntary AD&D | |
| Employee - $0.60 for $20,000 | |
| Spouse - $0.075 for $2,500 | |
| Child(ren) - $0.10 for $2,500 | |
| Short-Term Disability Rates | |
|---|---|
| Age Range | Per $1,000 |
| Under 25 | $0.29 |
| 25-29 | $0.30 |
| 30-34 | $0.31 |
| 35-39 | $0.28 |
| 40-44 | $0.31 |
| 45-49 | $0.375 |
| 50-54 | $0.46 |
| 55-59 | $0.57 |
| 60-64 | $0.67 |
| 65+ | $0.81 |
| Critical Illness Rates | |||||
|---|---|---|---|---|---|
| Employee | Spouse | ||||
| Age Range | Non-Tobacco | Tobacco | Age Range | Non-Tobacco | Tobacco |
| Under 25 | $0.18 | $0.19 | Under 25 | $0.17 | $0.18 |
| 25-29 | $0.25 | $0.27 | 25-29 | $0.24 | $0.26 |
| 30-34 | $0.31 | $0.36 | 30-34 | $0.30 | $0.35 |
| 35-39 | $0.42 | $0.50 | 35-39 | $0.39 | $0.50 |
| 40-44 | $0.60 | $0.81 | 40-44 | $0.59 | $0.84 |
| 45-49 | $0.87 | $1.28 | 45-49 | $0.91 | $1.48 |
| 50-54 | $1.17 | $1.92 | 50-54 | $1.27 | $2.20 |
| 55-59 | $1.54 | $2.72 | 55-59 | $1.69 | $3.09 |
| 60-64 | $2.20 | $4.14 | 60-64 | $2.48 | $4.77 |
| 65-69 | $3.24 | $6.48 | 65-69 | $3.28 | $6.60 |
| 70-74 | $4.43 | $8.67 | 70-74 | $4.51 | $8.89 |
| 75+ | $6.11 | $11.07 | 75+ | $5.69 | $10.02 |
| Child(ren) - $0.60 for $5,000 or $1.20 for $10,000 | |||||
| Medical Rates | ||||
|---|---|---|---|---|
|
Choice Plus Monthly Rates |
Core Plan Monthly Rates |
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|
Employe (to calculate your medical rate, enter your hourly rate) |
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| Employee and Spouse | $1,619.79 | $1,557.72 | ||
| Employee and Child(ren) | $1,154.19 | $1,109.96 | ||
| Family | $2,223.12 | $2,137.94 | ||