Cost of Coverage
Per Paycheck Contributions
Medical
| Coverage | Associate Contribution | Employer Contribution |
|---|---|---|
| PPO | ||
| Associate | $77.50 | $240.00 |
| Associate + Spouse | $210.75 | $503.75 |
| Associate + Child(ren) | $201.00 | $450.25 |
| Family | $296.75 | $703.25 |
| CDHP | ||
| Associate | $46.25 | $226.00 |
| Associate + Spouse | $128.50 | $484.00 |
| Associate + Child(ren) | $117.00 | $441.25 |
| Family | $179.25 | $678.25 |
Dental
| Coverage | Associate Contribution | Employer Contribution |
|---|---|---|
| Associate | $11.25 | $4.63 |
| Associate + Spouse | $21.75 | $9.31 |
| Associate + Child(ren) | $26.00 | $11.22 |
| Family | $36.50 | $15.41 |
Vision
| Coverage | Associate Contribution | |
|---|---|---|
| Standard Plan | Enhanced Plan | |
| Associate | $4.34 | $8.51 |
| Associate + Spouse | $6.25 | $12.27 |
| Associate + Child(ren) | $7.39 | $14.50 |
| Family | $11.80 | $23.15 |
Voluntary Life/AD&D
| Age Band | Voluntary Employee & Spouse Life/AD&D Per $1,000 of Coverage |
|---|---|
| 00 – 24 | $0.0335 |
| 25 – 29 | $0.0385 |
| 30 – 34 | $0.0485 |
| 35 – 39 | $0.0560 |
| 40 – 44 | $0.0685 |
| 45 – 49 | $0.0985 |
| 50 – 54 | $0.1485 |
| 55 – 59 | $0.2685 |
| 60 – 64 | $0.4035 |
| 65 – 69 | $0.7685 |
| 70 + | $1.2435 |
| Child Life/AD&D | $0.0435 |
Identity Theft Protection
| Identity Theft Protection | |
|---|---|
| Associate | $4.98 |
| Family | $8.98 |
Legal Plan
| Legal Plan | |
|---|---|
| $8.25 |
Accident & Cancer
| Accident | Cancer | |
|---|---|---|
| Associate Only | $8.20 | $10.75 |
| Associate + Spouse | $14.18 | $16.60 |
| Associate + Child(ren) | $15.71 | $15.28 |
| Family | $20.82 | $21.12 |
Critical Illness
| Per Check for Non-tobacco | ||
|---|---|---|
| Age Band | Employee Only & Employee + Child(ren) | Employee + Spouse & Family |
| 18 - 29 | $1.32 | $2.30 |
| 30 - 39 | $2.23 | $3.66 |
| 40 - 49 | $4.14 | $6.53 |
| 50 - 59 | $7.45 | $11.49 |
| 60 - 64 | $10.44 | $15.97 |
| 65+ | $17.43 | $26.45 |
| PER CHECK FOR TOBACCO | ||
| Age Band | Employee Only & Employee + Child(ren) | Employee + Spouse & Family |
| 18 - 29 | $1.68 | $2.83 |
| 30 - 39 | $3.37 | $5.36 |
| 40 - 49 | $6.80 | $10.52 |
| 50 - 59 | $11.84 | $18.07 |
| 60 - 64 | $16.61 | $25.23 |
| 65+ | $27.97 | $42.27 |
Questions?
- For questions about your benefits, contact Health Advocate at 866-799-2728.
- For questions on the enrollment process, contact HRLink.