2021-2022 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: Gold $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$0.22650-54$0.886
25-29$0.24555-59$1.226
30-34$0.27760-64$1.832
35-39$0.30065-69$2.548
40-44$0.36070+$4.611
45-49$0.545
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
AgeBiweekly Rate per $5,000 of CoverageAgeBiweekly Rate per $5,000 of CoverageAgeBiweekly Rate per $5,000 of Coverage
<25$0.17840-44$0.33060-64$2.045
25-29$0.20545-49$0.48265-69$3.916
30-34$0.27050-54$0.72770+$4.788
35-39$0.30255-59$1.341
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 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

$

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
AgeTobaccoNon-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
AgeTobaccoNon-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