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Benefit Rates

Benefit Rates

Medical

  $1,000 Deductible $3,000 Deductible HRA $4,000 Deductible HRA
Employee Only $156.78 $68.31 $54.53
Employee + Spouse* $360.55 $130.86 $102.68
Employee + Child(ren) $327.80 $113.12 $88.40
Family* $459.71 $180.81 $139.30

*Spousal surcharge of $60 per pay will apply for those covering spouses/domestic partners who have coverage available through their employer or Medicare.

Vision

  Rate
Employee Only Free
Employee + Spouse $3.23
Employee + Child(ren) $3.59
Family $6.97

Dental

  Rate
Employee Only Free
Employee + Spouse $14.35
Employee + Child(ren) $20.88
Family $40.26

Legal Insurance ARAG

  Per Pay Rate
Basic Coverage $9.58
Expanded Coverage $11.19

Voluntary Life and AD&D

per $1,000

 Age Life AD&D
Under 20 $0.025 $0.009
20-24 $0.025 $0.009
25-29 $0.025 $0.009
30-34 $0.033 $0.009
35-39 $0.050 $0.009
40-44 $0.075 $0.009
45-49 $0.145 $0.009
50-54 $0.245 $0.009
55-59 $0.399 $0.009
60-64 $0.594 $0.009
65-69 $0.910 $0.009
70-74 $1.333 $0.009
75-79 $2.438 $0.009
80-84 $2.438 $0.009
85-89 $2.438 $0.009
90-94 $2.438 $0.009
95-99 $2.438 $0.009
Dependent Child $0.078 $0.009


All costs are per pay bi-weekly