2020-2021 Employee Premiums
| Medical | ||||||
|---|---|---|---|---|---|---|
| Medical Rates | ||||||
| Preferred Plan Biweekly Rates | POS Plan Biweekly Rates | HDHP with HSA Biweekly Rates | ||||
| Full-time | Part-time | Full-time | Part-time | Full-time | Part-time | |
| Employee Only | $46.03 | $176.48 | $140.00 | $256.21 | $46.03 | $152.46 |
| Employee / Spouse | $135.00 | $213.25 | $215.00 | $316.97 | $92.02 | $187.56 |
| Employee / Child(ren) | $115.00 | $192.49 | $190.00 | $282.58 | $68.42 | $166.32 |
| Family1 | $185.00 | $243.45 | $283.00 | $361.34 | $139.73 | $217.77 |
| Vitality Wellness Credit per paycheck: Bronze $15; Platinum $30 (or actual plan contribution if less) 1 If you are covering your domestic partner, please click here for domestic partner rates as they are different from what is listed above. |
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| Dental | ||||
|---|---|---|---|---|
| Metlife Copay Plan Biweekly Rates | MetLife PPO Plan Biweekly Rates | |||
| Full-time | Part-time | Full-time | Part-time | |
| Employee Only | $4.04 | $6.29 | $9.95 | $15.39 |
| Employee / Spouse | $8.20 | $12.96 | $22.12 | $34.33 |
| Employee / Child(ren) | $9.28 | $13.66 | $23.76 | $35.67 |
| Family1 | $14.41 | $23.99 | $30.57 | $46.97 |
| 1 If you are covering your domestic partner, please click here for domestic partner rates as they are different from what is listed above. | ||||
| Vision | ||
|---|---|---|
| UnitedHealthcare Vision Biweekly Rates | ||
| Full-time | Part-time | |
| Employee Only | $4.51 | $4.51 |
| Employee / Spouse | $8.48 | $8.48 |
| Employee / Child(ren) | $9.29 | $9.29 |
| Family1 | $11.95 | $11.95 |
| 1 If you are covering your domestic partner, please click here for domestic partner rates as they are different from what is listed above. | ||
| Employee Term Life/AD&D | |||
|---|---|---|---|
| Rate per Age Biweekly Rate | |||
$10,000 of Coverage |
|||
| <25 | $0.245 | 50-54 | $0.974 |
| 25-29 | $0.268 | 55-59 | $1.237 |
| 30-34 | $0.305 | 60-64 | $2.012 |
| 35-39 | $0.328 | 65-69 | $2.797 |
| 40-44 | $0.392 | 70+ | $5.063 |
| 45-49 | $0.595 | ||
| Employee Term Life / AD&D Calculator | |
|---|---|
Bi-weekly cost |
|
| Coverage Amount | $ |
| Divided by 10,000 | |
| Equals number of units | |
| Times Rate | |
| Equals Bi-weekly Cost | $ |
| Spouse Term Life/AD&D | |||||
|---|---|---|---|---|---|
| Age | Biweekly Rate per $5,000 of Coverage | Age | Biweekly Rate per $5,000 of Coverage | Age | Biweekly Rate per $5,000 of Coverage |
| <25 | $0.189 | 40-44 | $0.342 | 60-64 | $2.056 |
| 25-29 | $0.217 | 45-49 | $0.494 | 65-69 | $3.928 |
| 30-34 | $0.282 | 50-54 | $0.78 | 70+ | $4.800 |
| 35-39 | $0.314 | 55-59 | $1.352 | ||
| Spouse Term Life / AD&D Calculator | |
|---|---|
Bi-weekly cost |
|
| Coverage Amount | $ |
| Divided by 5,000 | |
| Times Rate | |
| Equals Bi-weekly Cost | $ |
| Child(ren) Term Life | |
|---|---|
| Coverage Biweekly Rate | |
| $1,000/child | $0.06 |
| $5,000/child | $0.30 |
| $10,000/child | $0.60 |
| Flat rate for Child policy covers all children regardless of number of children. This is not |
|
| Short-Term Disability | |||||||
|---|---|---|---|---|---|---|---|
| Monthly Rate | |||||||
| Age | Day 7 | Day 14 | Day 30 | Age | Day 7 | Day 14 | Day 30 |
| 18-24 | $1.51 | $1.21 | $0.78 | 45-49 | $1.02 | $0.80 | $0.61 |
| 25-29 | $1.58 | $1.34 | $0.93 | 50-54 | $1.17 | $0.94 | $0.79 |
| 30-34 | $1.38 | $1.11 | $0.76 | 55-59 | $1.62 | $1.27 | $0.98 |
| 35-39 | $1.05 | $0.87 | $0.60 | 60-64 | $2.17 | $1.64 | $1.18 |
| 40-44 | $1.03 | $0.79 | $0.58 | 65+ | $2.35 | $1.87 | $1.24 |
| Short-Term Disability Calculator | |
|---|---|
| Biweekly Rate | |
| Annual Base Pay | $ |
| Divide by 52 | |
| Weekly Base Pay | $ |
| Times 60% (.60) | |
| Times Rate | |
| And divide by 10 | |
| Equals Monthly Rate | $ |
| Multiply Monthly rate by 12 | |
| Divide by 26 | |
| Equals Biweekly Rate | $ |
| Critical Illness | ||
|---|---|---|
| Employee Only Biweekly Rate* | ||
| $40,000 of Coverage | ||
| Age | Tobacco | Non-Tobacco |
| 0-29 | $8.68 | $6.09 |
| 30-34 | $11.82 | $8.49 |
| 35-39 | $14.95 | $9.97 |
| 40-44 | $20.68 | $13.11 |
| 45-49 | $24.74 | $16.06 |
| 50-54 | $29.54 | $19.38 |
| 55-59 | $47.26 | $30.46 |
| 60-64 | $47.63 | $29.35 |
| 65-69 | $97.48 | $61.48 |
| 70-74 | $169.29 | $110.95 |
| 75-79 | $334.34 | $257.17 |
| 80-84 | $385.85 | $323.45 |
| 85+ | $525.78 | $489.78 |
| Spouse Biweekly Rate* | ||
| $20,000 of Coverage | ||
| Age | Tobacco | Non-Tobacco |
| 0-29 | $4.34 | $3.05 |
| 30-34 | $5.91 | $4.25 |
| 35-39 | $7.48 | $4.98 |
| 40-44 | $10.34 | $6.55 |
| 45-49 | $12.37 | $8.03 |
| 50-54 | $14.77 | $9.69 |
| 55-59 | $23.63 | $15.23 |
| 60-64 | $23.82 | $14.68 |
| 65-69 | $48.74 | $30.74 |
| 70-74 | $84.65 | $55.48 |
| 75-79 | $167.17 | $128.58 |
| 80-84 | $192.92 | $161.72 |
| 85+ | $262.89 | $244.89 |
| Child Premium Rates | ||
| Child automatically included with employee coverage. | ||
*Age-banded premium rates are based on the age at last birthday. They will change on the policy anniversary date coinciding with or next following the Insured’s last birthday. The Insured Dependent spouse age, for purposes of determining Premium, is equivalent to the Insured’s age.
| Accident | |
|---|---|
| Coverage Biweekly Rate | |
| Employee Only | $4.07 |
| Employee/Spouse | $6.23 |
| Employee/Child(ren) | $6.03 |
| Family | $8.19 |
| MetLaw | |
|---|---|
| Coverage Biweekly Rate | |
| Family | $7.62 |