Rates


Medical Plan Contributions

Effective 7/1/2021

(Bi-Weekly)
With Wellness Discount
Coverage Level $2000 PPO $1500 PPO $1000 PPO
Associate Only $23.41 $89.95 $125.95
Associate + One $107.40 $250.20 $323.74
Associate + Family $158.23 $354.04 $454.89
Without Wellness Discount
Coverage Level $2000 PPO $1500 PPO $1000 PPO
Associate Only $52.26 $118.79 $154.80
Associate + One $136.24 $279.04 $352.58
Associate + Family $187.07 $382.88 $483.74
(Weekly)
With Wellness Discount
Coverage Level $2000 PPO $1500 PPO $1000 PPO
Associate Only $11.70 $44.97 $62.97
Associate + One $53.71 $125.10 $161.87
Associate + Family $79.11 $177.02 $227.45
Without Wellness Discount
Coverage Level $2000 PPO $1500 PPO $1000 PPO
Associate Only $26.12 $59.40 $77.40
Associate + One $68.13 $139.52 $176.29
Associate + Family $93.53 $191.44 $241.87

New plan enrollees will enter the plan without the wellness discount. You have 90 days from your medical plan enrollment date to complete the Live Healthy New Enrollee Program. If the Live Healthy New Enrollee Program is completed within the first 90 days of enrollment, you will be moved to the Wellness Discount rates as of the next payroll period after completion.


Dental Plan Contributions

Bi-Weekly
Coverage Level Low Plan High Plan
Associate Only $7.29 $9.96
Associate + One $13.53 $19.05
Associate + Family $22.05 $33.95
Weekly
Coverage Level Low Plan High Plan
Associate Only $3.64 $4.98
Associate + One $6.76 $9.52
Associate + Family $11.02 $16.98

Vision Plan Contributions

Bi-Weekly
Coverage Level Highmark Vision Plan
Associate Only $2.64
Associate + One $5.28
Associate + Family $7.93
Weekly
Coverage Level Highmark Vision Plan
Associate Only $1.32
Associate + One $2.64
Associate + Family $3.97

Life Insurance Contributions

Supplemental Term Life Insurance Contribution (Monthly)
Age Rate (per $,1000)
16-24 $0.11
25-29 $0.12
30-34 $0.15
35-39 $0.17
40-44 $0.20
45-49 $0.29
50-54 $0.43
55-59 $0.78
60-64 $1.18
65-69 $2.24
70+ $3.62
Spouse Term Life Insurance Contribution(Monthly)
Age Rate (per $1,000)
16-24 $0.13
25-29 $0.14
30-34 $0.17
35-29 $0.19
40-44 $0.22
45-49 $0.31
50-54 $0.45
55-59 $0.80
60-64 $1.20
65-69 $2.26
70+ $3.64


Child Term Life Insurance Contribution
$1.35 per month ($0.62 bi-weekly; $0.31 weekly)