MERITAIN MEDICAL PLANS
Bi-weekly Payroll Contributions
|
HDHP Base Plan |
|
|
Employee Only |
$0.00 |
|
Employee + Child(ren) |
$65.94 |
|
Employee + Spouse |
$84.89 |
|
Family |
$114.73 |
|
HRA Low Plan |
|
|
Employee Only |
$50.77 |
|
Employee + Child(ren) |
$144.47 |
|
Employee + Spouse |
$195.01 |
|
Family |
$261.96 |
|
HRA High Plan |
|
|
Employee Only |
$92.31 |
|
Employee + Child(ren) |
$207.03 |
|
Employee + Spouse |
$278.92 |
|
Family |
$375.42 |
|
Buy Up Plan |
|
|
Employee Only |
$187.77 |
|
Employee + Child(ren) |
$346.02 |
|
Employee + Spouse |
$464.94 |
|
Family |
$626.31 |
KAISER MEDICAL PLANS
CA employees only
Bi-weekly Payroll Contributions
|
Kaiser HDHP Base Plan |
|
|
Employee Only |
$0.00 |
|
Employee + Child(ren) |
$76.34 |
|
Employee + Spouse |
$90.19 |
|
Family |
$109.11 |
|
Kaiser HMO Low Plan |
|
|
Employee Only |
$54.62 |
|
Employee + Child(ren) |
$120.96 |
|
Employee + Spouse |
$162.63 |
|
Family |
$219.74 |
|
Kaiser HMO High Plan |
|
|
Employee Only |
$106.57 |
|
Employee + Child(ren) |
$191.15 |
|
Employee + Spouse |
$257.00 |
|
Family |
$347.26 |
DELTA DENTAL PLANS
Bi-Weekly Payroll Contributions
|
|
DHMO Plan |
DPPO Plan |
|
Employee Only |
$0.00 |
$5.93 |
|
Employee + Child(ren) |
$5.90 |
$17.21 |
|
Employee + Spouse |
$2.01 |
$12.09 |
|
Family |
$10.15 |
$23.23 |
DELTA VISION PLAN
Bi-weekly Payroll Contributions
|
Essential Plan |
|
|
Employee Only |
$0.00 |
|
Employee + Child(ren) |
$2.72 |
|
Employee + Spouse |
$2.41 |
|
Family |
$5.11 |
|
Platinum Choice Plan |
|
|
Employee Only |
$2.64 |
|
Employee + Child(ren) |
$8.38 |
|
Employee + Spouse |
$7.69 |
|
Family |
$14.16 |
PRUDENTIAL WORKSITE BENEFITS
Bi-weekly Payroll Contributions
|
Accident |
|
|
Employee Only |
$5.63 |
|
Employee + Child(ren) |
$9.38 |
|
Employee + Spouse |
$8.84 |
|
Family |
$13.72 |
|
Hospital Indemnity Insurance |
|
|
Employee Only |
$4.01 |
|
Employee + Child(ren) |
$8.23 |
|
Employee + Spouse |
$7.43 |
|
Family |
$11.66 |
Critical Illness - Non Smokers & Monthly Rate per $1,000 of coverage
|
Age Bands |
Employee + Child(ren) |
Spouse |
|
Age <30 |
$0.214 |
$0.215 |
|
Age 30-39 |
$0.378 |
$0.313 |
|
Age 40-49 |
$0.595 |
$0.530 |
|
Age 50-59 |
$1.143 |
$1.155 |
|
Age 60-69 |
$1.968 |
$2.184 |
|
Age 70+ |
$3.332 |
$3.695 |
Critical Illness - Smokers & Monthly Rate per $1,000 of coverage
|
Age Bands |
Employee + Child(ren) |
Spouse |
|
Age <30 |
$0.239 |
$0.240 |
|
Age 30-39 |
$0.474 |
$0.406 |
|
Age 40-49 |
$0.896 |
$0.829 |
|
Age 50-59 |
$1.954 |
$2.022 |
|
Age 60-69 |
$3.458 |
$3.841 |
|
Age 70+ |
$5.580 |
$6.189 |
PRUDENTIAL VOLUNTARY LIFE
Monthly Payroll Rates
|
Age Bands |
Employee Rates per $1,000 of coverage: |
Spouse Rates per $1,000 of coverage based on spouse’s age: |
|
Age <30 |
$0.110 |
$0.110 |
|
Age 30-34 |
$0.150 |
$0.150 |
|
Age 35-39 |
$0.190 |
$0.190 |
|
Age 40-44 |
$0.260 |
$0.260 |
|
Age 45-49 |
$0.370 |
$0.370 |
|
Age 50-54 |
$0.570 |
$0.570 |
|
Age 55-59 |
$0.840 |
$0.840 |
|
Age 60-64 |
$1.170 |
$1.170 |
|
Age 65-69 |
$2.010 |
$2.010 |
|
Age 70-74 |
$3.460 |
$3.460 |
|
Age 75+ |
$12.670 |
$12.670 |
|
Child Rate: $.580 per $1,000 of coverage |
||