Semi-Monthly Rates
| Benefit plan options | Employee | Employee + Spouse/DP |
Employee + Child(ren) |
Family |
|---|---|---|---|---|
| Medical | ||||
| Cigna PPO 2000 | $60.00 | $245.00 | $220.00 | $340.00 |
| Cigna HDHP | $40.00 | $210.00 | $190.00 | $300.00 |
| Dental | ||||
| Cigna DPPO | $8.00 | $16.00 | $21.00 | $31.00 |
| Vision | ||||
| VSP Choice Network | $2.00 | $3.00 | $3.00 | $5.00 |
| Voluntary Life (rate per $1,000 based on employee’s age) | ||||
| 20-24 | 0.03 | 0.03 | ||
| 25-29 | 0.03 | 0.03 | ||
| 30-34 | 0.035 | 0.035 | ||
| 35-39 | 0.05 | 0.05 | ||
| 40-44 | 0.08 | 0.08 | ||
| 45-49 | 0.13 | 0.13 | ||
| 50-54 | 0.195 | 0.195 | ||
| 55-59 | 0.325 | 0.325 | ||
| 60-64 | 0.52 | 0.52 | ||
| 65-69 | 0.825 | 0.825 | ||
| 70-74 | 1.37 | – | ||
| 75-79 | 2.37 | – | ||
| 80-84 | 4.905 | – | ||
| 85-89 | 7.955 | – | ||
| 90-94 | 12.545 | – | ||
| 95-99 | 19.135 | – | ||
| Voluntary AD&D (rate per $1,000) | ||||
| $.015 for employees, spouses, and child(ren) | ||||
| Accident Insurance | ||||
| Plan 1: | $3.35 | $5.98 | $7.91 | $10.54 |
| Plan 2: | $5.38 | $9.78 | $12.80 | $17.21 |
| Hospital Care | ||||
| Plan 1: | $3.80 | $9.75 | $6.99 | $12.94 |
| Plan 2: | $7.49 | $19.40 | $13.87 | $25.77 |
| Critical Illness with $15,000 benefit: | ||||
| 0-24 | $2.64 | $5.57 | $4.70 | $7.62 |
| 25-29 | $2.80 | $5.95 | $4.86 | $8.01 |
| 30-34 | $3.27 | $6.92 | $5.33 | $8.97 |
| 35-39 | $4.24 | $9.15 | $6.30 | $11.19 |
| 40-44 | $5.55 | $11.60 | $7.60 | $13.65 |
| 45-49 | $7.35 | $15.92 | $9.40 | $17.97 |
| 50-54 | $9.78 | $21.25 | $11.83 | $23.31 |
| 55-59 | $13.84 | $29.58 | $15.89 | $31.64 |
| 60-64 | $17.16 | $37.58 | $19.20 | $39.63 |
| 65-69 | $24.91 | $49.95 | $26.97 | $52.01 |
| 70-74 | $31.20 | $66.78 | $33.26 | $68.84 |
| 75-79 | $41.55 | $88.71 | $43.59 | $90.76 |
| 80-84 | $49.47 | $106.04 | $51.52 | $108.09 |
| 85+ | $64.81 | $139.68 | $66.86 | $141.72 |
| Critical Illness with $30,000 benefit: | ||||
| 0-24 | $5.28 | $11.13 | $9.39 | $15.24 |
| 25-29 | $5.60 | $11.90 | $9.71 | $16.01 |
| 30-34 | $6.54 | $13.83 | $10.65 | $17.93 |
| 35-39 | $8.48 | $18.29 | $12.59 | $22.38 |
| 40-44 | $11.09 | $23.19 | $15.20 | $27.29 |
| 45-49 | $14.69 | $31.83 | $18.80 | $35.94 |
| 50-54 | $19.56 | $42.50 | $23.66 | $46.61 |
| 55-59 | $27.68 | $59.16 | $31.77 | $63.27 |
| 60-64 | $34.31 | $75.15 | $38.39 | $79.25 |
| 65-69 | $49.82 | $99.90 | $53.93 | $104.01 |
| 70-74 | $62.40 | $133.56 | $66.51 | $137.67 |
| 75-79 | $83.09 | $177.42 | $87.18 | $181.52 |
| 80-84 | $98.94 | $212.07 | $103.04 | $216.18 |
| 85+ | $129.62 | $279.35 | $133.71 | $283.44 |
