| Medical Rates | ||||
|---|---|---|---|---|
|
Core Plan Monthly Rates |
Choice Plus Monthly Rates |
|||
| Employee Only | $1,027.59 | $1,027.59 | ||
| Spouse | $1,027.59 | $1,069.28 | ||
| Child(ren) | $531.28 | $552.83 | ||
| Spouse and Child(ren) | $1,670.73 | $1,738.50 | ||
| Dental Rates | ||||
|---|---|---|---|---|
|
Low Plan Monthly Rates |
High Plan Monthly Rates |
|||
| Employee Only | $42.24 | $51.70 | ||
| Employee and Spouse | $85.18 | $104.27 | ||
| Employee and Child(ren) | $79.59 | $97.42 | ||
| Family | $137.43 | $168.20 | ||
| Vision Rates | ||||
|---|---|---|---|---|
|
Low Plan Monthly Rates |
High Plan Monthly Rates |
|||
| Employee Only | $3.58 | $7.39 | ||
| Employee and Spouse | $7.14 | $14.78 | ||
| Employee and Child(ren) | $7.32 | $15.15 | ||
| Family | $10.90 | $22.54 | ||
| Accident Rates | ||||
|---|---|---|---|---|
|
Low Plan Monthly Rates |
High Plan Monthly Rates |
|||
| Employee Only | $7.50 | $9.99 | ||
| Employee and Spouse | $11.97 | $15.94 | ||
| Employee and Child(ren) | $14.80 | $20.11 | ||
| Family | $22.87 | $30.96 | ||
| Hospital Indemnity Rates | |
|---|---|
| Monthly Rates | |
| Employee Only | $11.15 |
| Employee and Spouse | $22.27 |
| Employee and Child(ren) | $21.42 |
| Family | $35.07 |
| Voluntary Life and AD&D Rates | ||
|---|---|---|
| Age Range |
Employee Per $1,000 |
Spouse Per $1,000 |
| Under 25 | $0.093 | $0.093 |
| 25-29 | $0.086 | $0.086 |
| 30-34 | $0.100 | $0.100 |
| 35-39 | $0.126 | $0.126 |
| 40-44 | $0.180 | $0.180 |
| 45-49 | $0.260 | $0.260 |
| 50-54 | $0.390 | $0.390 |
| 55-59 | $0.595 | $0.595 |
| 60-64 | $0.850 | $0.850 |
| 65-69 | $1.400 | $1.400 |
| 70+ | $3.150 | $3.150 |
| Child(ren) - $2.20 for $10,000 | ||
| Short-Term Disability Rates | |
|---|---|
| Age Range | Per $1,000 |
| Under 25 | $0.29 |
| 25-29 | $0.30 |
| 30-34 | $0.31 |
| 35-39 | $0.28 |
| 40-44 | $0.31 |
| 45-49 | $0.375 |
| 50-54 | $0.46 |
| 55-59 | $0.57 |
| 60-64 | $0.67 |
| 65+ | $0.81 |
| Critical Illness Rates | |||||
|---|---|---|---|---|---|
| Employee | Spouse | ||||
| Age Range | Non-Tobacco | Tobacco | Age Range | Non-Tobacco | Tobacco |
| Under 25 | $0.18 | $0.19 | Under 25 | $0.17 | $0.18 |
| 25-29 | $0.25 | $0.27 | 25-29 | $0.24 | $0.26 |
| 30-34 | $0.31 | $0.36 | 30-34 | $0.30 | $0.35 |
| 35-39 | $0.42 | $0.50 | 35-39 | $0.39 | $0.50 |
| 40-44 | $0.60 | $0.81 | 40-44 | $0.59 | $0.84 |
| 45-49 | $0.87 | $1.28 | 45-49 | $0.91 | $1.48 |
| 50-54 | $1.17 | $1.92 | 50-54 | $1.27 | $2.20 |
| 55-59 | $1.54 | $2.72 | 55-59 | $1.69 | $3.09 |
| 60-64 | $2.20 | $4.14 | 60-64 | $2.48 | $4.77 |
| 65-69 | $3.24 | $6.48 | 65-69 | $3.28 | $6.60 |
| 70-74 | $4.43 | $8.67 | 70-74 | $4.51 | $8.89 |
| 75+ | $6.11 | $11.07 | 75+ | $5.69 | $10.02 |
| Child(ren) - $0.60 for $5,000 or $1.20 for $10,000 | |||||