Cost of coverage
Medical – 2022 Monthly Rates
The rates shown here do not include a tobacco surcharge and/or working spouse surcharge. If you qualify for either surcharge, your rates will be higher than indicated in the table.
| Cigna | 900 Deductible Plan | 1850 Deductible Plan w/HSA | 2850 Deductible Plan w/HSA |
|---|---|---|---|
| Employee Only | $230.21 | $134.34 | $67.61 |
| Employee + Spouse | $551.46 | $352.79 | $212.65 |
| Employee + Child(ren) | $501.43 | $321.88 | $195.10 |
| Employee + Family | $776.92 | $492.23 | $292.03 |
| Kaiser | 900 Deductible Plan | 1850 Deductible Plan w/HSA | 2850 Deductible Plan w/HSA |
|---|---|---|---|
| Employee Only | $167.78 | $86.07 | $44.26 |
| Employee + Spouse | $401.94 | $225.86 | $139.11 |
| Employee + Child(ren) | $365.47 | $206.46 | $127.86 |
| Employee + Family | $566.25 | $313.38 | $189.98 |
Dental – 2022 Monthly Rates
| Enhanced | Basic Plus | DHMO | |
|---|---|---|---|
| Employee Only | $30.46 | $23.95 | $9.31 |
| Employee + Spouse | $60.91 | $47.91 | $18.23 |
| Employee + Child(ren) | $73.10 | $57.48 | $21.30 |
| Employee + Family | $103.55 | $81.44 | $33.11 |
| *Different rates apply for Hawaii. | |||
Vision – Monthly Rates
| Enhanced | Materials Only | |
|---|---|---|
| Employee Only | $12.68 | $6.00 |
| Employee + Spouse | $20.21 | $9.56 |
| Employee + Child(ren) | $20.36 | $9.62 |
| Employee + Family | $33.37 | $15.75 |
Voluntary Life – Monthly Rates
| Monthly Rate Per $1,000 of Coverage | ||
|---|---|---|
| Employee Age-Band | Employee | Spouse |
| <=24 | $0.040 | $0.050 |
| 25 - 29 | $0.048 | $0.060 |
| 30 - 34 | $0.056 | $0.080 |
| 35 - 39 | $0.072 | $0.090 |
| 40 - 44 | $0.080 | $0.100 |
| 45 - 49 | $0.120 | $0.150 |
| 50 - 54 | $0.184 | $0.230 |
| 55 - 59 | $0.344 | $0.430 |
| 60 - 64 | $0.520 | $0.660 |
| 65 - 69 | $0.776 | $1.270 |
| 70 - 74 | $0.968 | $2.060 |
| 75 - 79 | $1.623 | $2.060 |
| >= 80 | $1.623 | $2.060 |
| Child | $0.110 | |
Voluntary AD&D – Monthly Rates
| Monthly Rate Per $1,000 of coverage | ||
|---|---|---|
| Coverage Tier: | Employee Only | Employee Plus Family |
| Monthly Rate: | $0.022 | $0.034 |
Critical Illness – Monthly Rates
| Monthly Rate | Employee amount: $10,000 Spouse amount: $5,000 Child amount: $2,500 | Employee amount: $20,000 Spouse amount: $10,000 Child amount: $5,000 | ||||||
|---|---|---|---|---|---|---|---|---|
| EE | EE + SP | EE + Child | EE + Fam | EE | EE + SP | EE + Child | EE + Fam | |
| 0-24 | $3.77 | $6.66 | $4.10 | $6.99 | $5.77 | $9.78 | $$6.35 | $10.36 |
| 25-29 | $4.22 | $7.36 | $4.55 | $7.69 | $6.67 | $11.18 | $7.25 | $11.76 |
| 30-34 | $5.32 | $9.05 | $5.65 | $9.38 | $8.87 | $14.55 | $9.45 | $15.13 |
| 35-39 | $6.92 | $11.84 | $7.25 | $12.17 | $12.06 | $20.14 | $12.64 | $20.72 |
| 40-44 | $8.82 | $14.86 | $9.15 | $15.19 | $15.87 | $26.18 | $16.45 | $26.76 |
| 45-49 | $12.65 | $20.90 | $12.98 | $21.23 | $23.53 | $38.25 | $24.11 | $38.83 |
| 50-54 | $18.35 | $29.60 | $18.68 | $29.93 | $34.93 | $55.66 | $35.51 | $56.24 |
| 55-59 | $25.30 | $40.57 | $25.63 | $40.90 | $48.83 | $77.60 | $49.41 | $78.18 |
| 60-64 | $33.62 | $53.26 | $33.95 | $53.59 | $65.47 | $102.98 | $66.05 | $103.56 |
| 65-69 | $40.19 | $64.66 | $40.52 | $64.99 | $78.60 | $125.78 | $79.18 | $126.36 |
| 70-74 | $57.17 | $90.36 | $57.50 | $90.69 | $112.57 | $177.18 | $113.15 | $177.76 |
| 75-79 | $70.89 | $117.17 | $71.22 | $117.5 | $140.00 | $230.79 | $140.58 | $231.37 |
| 80-84 | $85.76 | $141.93 | $86.09 | $142.26 | $169.74 | $280.32 | $170.32 | $280.90 |
| 85+ | $120.78 | $199.02 | $121.12 | $199.35 | $239.80 | $394.50 | $240.38 | $395.08 |
Note that rates will be higher than what is shown if you are a tobacco user.
Accident – Monthly Rates
| Standard (Low) | Enhanced (High) | |
|---|---|---|
| Tier | Monthly Employee Rate | Monthly Employee Rate |
| Employee | $6.34 | $12.27 |
| Employee & Spouse | $10.81 | $20.94 |
| Employee & Child(ren) | $10.99 | $21.30 |
| Family | $14.82 | $28.75 |
Hospital Indemnity – Monthly Rates
| Standard | Enhanced | |
|---|---|---|
| Tier | Monthly Employee Rate | Monthly Employee Rate |
| Employee | $9.22 | $14.55 |
| Employee & Spouse | $19.83 | $31.57 |
| Employee & Child(ren) | $17.23 | $26.82 |
| Family | $27.83 | $43.84 |
Hyatt Legal – Monthly Rates
| Tier | Monthly Employee rate |
|---|---|
| Employee & Family | $18.00 |
Allstate Identity Protection – Monthly Rates
| Tier | Monthly Employee Rate |
|---|---|
| Employee | $9.95 |
| Employee & Family | $17.95 |