2020-2021 Employee Premiums

Medical
Medical Rates
Preferred Plan Biweekly RatesPOS Plan Biweekly RatesHDHP with HSA Biweekly Rates
Full-timePart-timeFull-timePart-timeFull-timePart-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.
Dental
 Metlife Copay Plan Biweekly RatesMetLife PPO Plan Biweekly Rates
 Full-timePart-timeFull-timePart-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-timePart-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$0.24550-54$0.974
25-29$0.26855-59$1.237
30-34$0.30560-64$2.012
35-39$0.32865-69$2.797
40-44$0.39270+$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

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Spouse Term Life/AD&D
AgeBiweekly Rate per $5,000 of CoverageAgeBiweekly Rate per $5,000 of CoverageAgeBiweekly Rate per $5,000 of Coverage
<25$0.18940-44$0.34260-64$2.056
25-29$0.21745-49$0.49465-69$3.928
30-34$0.28250-54$0.7870+$4.800
35-39$0.31455-59$1.352
Spouse Term Life / AD&D Calculator

Bi-weekly cost

Coverage Amount

$

Divided by 5,000
Times Rate
Equals Bi-weekly Cost

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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 a per child or per policy deduction.
Short-Term Disability
Monthly Rate
AgeDay 7Day 14Day 30AgeDay 7Day 14Day 30
18-24$1.51$1.21$0.7845-49$1.02$0.80$0.61
25-29$1.58$1.34$0.9350-54$1.17$0.94$0.79
30-34$1.38$1.11$0.7655-59$1.62$1.27$0.98
35-39$1.05$0.87$0.6060-64$2.17$1.64$1.18
40-44$1.03$0.79$0.5865+$2.35$1.87$1.24
Short-Term Disability Calculator
Biweekly Rate
Annual Base Pay

$

Divide by 52
Weekly Base Pay

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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