Cost of Coverage
Medical Cost of Coverage
| Bronze | Silver (HSA) | Gold (HSA) | Platinum | |||||
|---|---|---|---|---|---|---|---|---|
| Bronze | Silver (HSA) | Gold (HSA) | Platinum | |||||
| Monthly Premiums | ||||||||
| Employee | $35.64 | $72.36 | $110.00 | $188.16 | ||||
| Employee + Child(ren) | $71.28 | $144.72 | $220.00 | $376.32 | ||||
| Employee + Spouse | $106.92 | $217.08 | $330.00 | $564.48 | ||||
| Family | $142.56 | $289.44 | $440.00 | $752.64 | ||||
Dental Cost of Coverage
| Dental Plan Highlights | Dental Low Plan | Dental High Plan | ||
|---|---|---|---|---|
| Dental Plan Highlights | Dental Low Plan | Dental High Plan | ||
| Monthly Premiums | ||||
| Employee | $24.14 | $45.60 | ||
| Employee + Child(ren) | $61.16 | $97.14 | ||
| Employee + Spouse | $48.76 | $82.72 | ||
| Family | $91.54 | $139.22 | ||
Vision Cost of Coverage
| Vision Plan Highlights | In-Network | |
|---|---|---|
| Monthly Premiums | ||
| Employee | $5.40 | |
| Employee + Child(ren) | $11.88 | |
| Employee + Spouse | $10.80 | |
| Family | $17.30 | |
Life Cost of Coverage
| Monthly Premium | |
|---|---|
| Monthly Premium | |
| Life & AD&D | $.03 per $1,000 of coverage |
Voluntary Life Cost of Coverage
| Monthly Premium* per $1,000 of coverage, based on age | Employee & Spouse | |
|---|---|---|
| Monthly Premium* per $1,000 of coverage, based on age |
Employee & Spouse | |
| <25 | $0.070 | |
| 25-29 | $0.070 | |
| 30-34 | $0.090 | |
| 35-39 | $0.130 | |
| 40-44 | $0.170 | |
| 45-49 | $0.250 | |
| 50-54 | $0.410 | |
| 55-59 | $0.70 | |
| 60-64 | $1.040 | |
| 65-69 | $1.680 | |
| 70-99 | $5.360 | |
| Child | ||
|
Child Life for $5,000 benefit (regardless of # of children) |
$0.40 | |
Disability Cost of Coverage
| Monthly Premiums | |
|---|---|
| Monthly Premiums | |
| Short-Term Disability | $.21 per $10 of weekly benefit |
| Long-Term Disability | $.12 per $100 of covered salary |
Voluntary Benefits Cost of Coverage – Accident
| Monthly Premiums | |
|---|---|
| Monthly Premiums | |
| Employee only | $9.52 |
| Employee + Child(ren) | $18.10 |
| Employee + Spouse | $15.44 |
| Family | $24.02 |
Voluntary Benefits Cost of Coverage – Hospital Indemnity
| Monthly Premiums | |
|---|---|
| Monthly Premiums | |
| Employee only | $20.42 |
| Employee + Child(ren) | $32.06 |
| Employee + Spouse | $41.96 |
| Family | $55.54 |
Voluntary Benefits Cost of Coverage – Critical Illness
| Monthly Premium* per $1,000 of coverage, based on employee’s age | Non-Tobacco User | Tobacco User | ||
|---|---|---|---|---|
| Monthly Premium* per $1,000 of coverage, based on employee’s age | Non-Tobacco User | Tobacco User | ||
| <25 | $.25 | $.25 | ||
| 25-29 | $.32 | $.36 | ||
| 30-34 | $.37 | $.48 | ||
| 35-39 | $.44 | $.62 | ||
| 40-44 | $.59 | $.90 | ||
| 45-49 | $.87 | $1.43 | ||
| 50-54 | $1.16 | $2.05 | ||
| 55-59 | $1.52 | $2.79 | ||
| 60-64 | $2.07 | $4.07 | ||
| 65-69 | $2.98 | $5.89 | ||
| 70-74 | $3.91 | $7.74 | ||
| 75+ | $4.95 | $9.82 | ||
| Child | ||||
|
Child Benefit per $1,000 (regardless of # of children) |
Included | |||