Medical Plans
Medical Plans
EPO Plus (Core)
| Coverage Tier | Employee Pays | Employer Pays |
|---|---|---|
| Employee Only | $0.00 | $668.00 |
| Employee and Spouse | $85.80 | $1,372.08 |
| Employee and Child(ren) | $53.39 | $1,180.75 |
| Employee and Family | $227.56 | $1,678.33 |
Open Access POS II (Buy-up)
| Coverage Tier | Employee Pays | Employer Pays |
|---|---|---|
| Employee Only | $39.60 | $668.00 |
| Employee and Spouse | $312.36 | $1,372.08 |
| Employee and Child(ren) | $241.97 | $1,180.75 |
| Employee and Family | $514.73 | $1,678.33 |
*To calculate your rate per paycheck:
- 12-month employees: Multiply the rates by 12 and divide by 26
- 9-month employees: Multiply the rates by 12 and divide by 18
Solstice Dental Insurance
| Plan | High DPPO | Low DDPO | S700B |
|---|---|---|---|
| Employee Only | $64.48 | $19.51 | $9.75 |
| Employee and Spouse | $135.59 | $39.71 | $16.51 |
| Employee and Child(ren) | $145.32 | $48.80 | $22.88 |
| Employee and Family | $160.79 | $74.40 | $27.01 |
*To calculate your rate per paycheck:
- 12-month employees: Multiply the rates by 12 and divide by 26
- 9-month employees: Multiply the rates by 12 and divide by 18
Basic and Supplemental Life Insurance
Supplemental Life Insurance—Employee Coverage
| Age | Rate |
|---|---|
| <25 | $0.031 |
| 25-29 | $0.033 |
| 30-34 | $0.043 |
| 35-39 | $0.056 |
| 40-44 | $0.078 |
| 45-49 | $0.117 |
| 50-54 | $0.180 |
| 55-59 | $0.311 |
| 60-64 | $0.387 |
| 65-69 | $0.536 |
| 70-74 | $0.744 |
*To determine pay period cost:
- Select the amount of coverage desired
- Divide by 1,000
- Multiply that number by the rate shown on the chart for your age
- Multiply rate times 12, then divide by 26 or 18 (depending on the number of pay periods)
Supplemental Term Life Insurance—Employee Coverage
| Coverage Amount | Coverage Increments |
|---|---|
| $10,000-$500,000 | $10,000 |
Supplemental Term Life Insurance—Child(ren) Coverage
| Coverage Amount | Cost |
|---|---|
| $5,000 | $1.67 |
| $10,000 | $3.34 |
| $15,000 | $5.01 |
| $20,000 | $6.68 |
| $25,000 | $8.35 |
Supplemental Term Life Insurance—Spouse/Domestic Partner Coverage
| Coverage Amount | Cost |
|---|---|
| $5,000 | $1.67 |
| $10,000 | $3.34 |
| $15,000 | $5.01 |
| $20,000 | $6.68 |
| $25,000 | $8.35 |
| $30,000 | $10.02 |
| $35,000 | $11.69 |
| $40,000 | $13.36 |
| $45,000 | $15.03 |
| $50,000 | $16.70 |
Basic and Supplemental Accidental Death and Dismemberment Insurance
| Coverage Only Amount | Employee Only Pays | Employee and Dependents Pay |
|---|---|---|
| $2,5000 | $0.53 | $0.63 |
| $50,000 | $1.05 | $1.25 |
| $100,000 | $2.10 | $2.50 |
| $150,000 | $3.15 | $3.75 |
| $200,000 | $4.20 | $5.00 |
| $250,000 | $5.25 | $6.25 |
| $300,000 | $6.30 | $7.50 |
| $350,000 | $7.35 | $8.75 |
| $400,000 | $8.40 | $10.00 |
| $450,000 | $9.45 | $11.25 |
| $500,000 | $10.50 | $12.50 |
*To calculate your rate per paycheck:
- 12-month employees: Multiply the rates by 12 and divide by 26
- 9-month employees: Multiply the rates by 12 and divide by 18
Disability
| Coverage Amount | Employee Only Pays |
|---|---|
| $250 | $1.13 |
| $400 | $1.80 |
| $550 | $2.48 |
| $700 | $3.15 |
| $850 | $3.83 |
| $1,000 | $4.50 |
| $1,150 | $5.18 |
| $1,300 | $5.85 |
| $1,450 | $6.53 |
| $1,600 | $7.20 |
| $1,750 | $7.88 |
| $1,900 | $8.55 |
| $2,050 | $9.23 |
| $2,200 | $9.90 |
| $2,350 | $10.58 |
| $2,500 | $11.25 |
| $2,650 | $11.93 |
| $2,800 | $12.60 |
| $2,950 | $13.28 |
| $3,100 | $13.95 |
| $3,250 | $14.63 |
| $3,400 | $15.30 |
| $3,550 | $15.98 |
| $3,700 | $16.65 |
| $3,850 | $17.33 |
| $4,000 | $18.00 |
*To calculate your rate per paycheck:
- 12-month employees: Multiply the rates by 12 and divide by 26
- 9-month employees: Multiply the rates by 12 and divide by 18