Full-time, biweekly rates (effective January 1, 2024)
To see other contribution sheets, visit MyBenefits, click on “My Plan Information” and then “Contributions, Guides & Overviews.”
Medical Coverage
| Provider | Colleague Only | Colleague + Spouse1 | Colleague + Children | Family1 |
|---|---|---|---|---|
UHC Basic HDHP
|
$23.88 $25.96 $28.73 |
$71.25 $77.45 $85.71 |
$61.98 $67.37 $74.55 |
$107.09 $116.41 $128.82 |
UHC Core HDHP
|
$42.76 $46.92 $50.95 |
$96.00 $105.33 $114.37 |
$76.36 $83.79 $90.98 |
$139.63 $153.21 $166.35 |
UHC PPO
|
$111.93 $115.13 $123.86 |
$251.28 $258.46 $278.05 |
$199.88 $205.60 $221.18 |
$336.94 $346.58 $372.84 |
|
Kaiser HMO — California |
$126.57 |
$269.16 |
$244.76 |
$368.29 |
|
Kaiser HMO — Northwest |
$85.40 |
$195.55 |
$172.50 |
$275.82 |
|
Quartz HMO |
$61.21 |
$185.89 |
$154.06 |
$267.37 |
|
Quartz POS |
$70.39 |
$220.90 |
$187.16 |
$320.84 |
|
UPMC EPO |
$114.44 |
$251.31 |
$204.94 |
$350.79 |
|
HMSA PPO — Hawaii |
$31.32 |
$74.58 |
$74.58 |
$111.45 |
|
Triple-S PPO — Puerto Rico |
$24.87 |
$51.64 |
$46.81 |
$74.20 |
1 Colleagues who choose to cover a spouse/domestic partner who has access to subsidized medical coverage through their employer will pay an additional $100 per month for coverage. Learn more about the Working Spouse Surcharge here.
2 Career Band is denoted as Management Level in the Workday HR system
Dental Coverage
| Provider | Colleague Only | Colleague + Spouse | Colleague + Children | Family |
|---|---|---|---|---|
|
Delta Dental of MA — Core |
$5.01 |
$11.13 |
$10.02 |
$16.69 |
|
Delta Dental of MA — Enhanced |
$11.68 |
$22.81 |
$20.59 |
$35.61 |
|
Delta Dental of Puerto Rico |
$1.56 |
$2.38 |
$2.33 |
$2.97 |
Vision Coverage
| Provider | Colleague Only | Colleague + Spouse | Colleague + Children | Family |
|---|---|---|---|---|
|
EyeMed Vision Plan |
$3.05 |
$5.80 |
$6.11 |
$8.98 |
Supplemental Health Coverage
| Benefit | Colleague Only | Colleague + Spouse | Colleague + Children | Family |
|---|---|---|---|---|
|
Voya Accident Insurance |
$3.82 |
$6.21 |
$7.38 |
$9.78 |
|
Voya Hospital Indemnity |
$4.45 |
$9.91 |
$7.42 |
$12.88 |
|
Voya Critical Illness |
For detailed rates, refer to our separate rate sheet |
|||
Voluntary Benefits
| Benefit | Colleague Only | Colleague + Spouse | Colleague + Children | Family |
|---|---|---|---|---|
|
MetLife Legal Plan |
$7.50 |
|||
|
Norton LifeLock Identity Theft |
$3.92 |
$7.38 |
$7.38 |
$7.38 |
Life Insurance and Disability3
Securian Colleague Optional Life Insurance4
| Non-Smoker5 | Smoker | |
|---|---|---|
|
Age <25 |
$0.024 |
$0.042 |
|
25-29 |
$0.029 |
$0.042 |
|
30-34 |
$0.036 |
$0.042 |
|
35-39 |
$0.040 |
$0.046 |
|
40-44 |
$0.047 |
$0.053 |
|
45-49 |
$0.067 |
$0.075 |
|
50-54 |
$0.108 |
$0.120 |
|
55-59 |
$0.180 |
$0.201 |
|
60-64 |
$0.316 |
$0.350 |
|
65-69 |
$0.441 |
$0.594 |
|
70-74 |
$0.664 |
$0.964 |
|
≥75 |
$0.989 |
$2.173 |
Securian Spouse/Domestic Partner Optional Life Insurance4
|
Age <25 |
$0.023 |
|
25-29 |
$0.028 |
|
30-34 |
$0.035 |
|
35-39 |
$0.039 |
|
40-44 |
$0.045 |
|
45-49 |
$0.065 |
|
50-54 |
$0.104 |
|
55-59 |
$0.173 |
|
60-64 |
$0.304 |
|
65-69 |
$0.424 |
|
70-74 |
$0.639 |
|
≥75 |
$0.951 |
Securian Child Life Insurance
|
$5,000 in coverage |
$0.16 |
|
$10,000 in coverage |
$0.32 |
|
$20,000 in coverage |
$0.65 |
Securian Optional Accidental Death and Dismemberment (AD&D)
|
Colleague |
$0.007 per pay per $1,000 of coverage |
|
Colleague and Family |
$0.012 per pay per $1,000 of coverage |
Lincoln Financial Long Term Disability (LTD) Buy-Up6
|
$0.051 per pay per $100 of coverage |
3 Rates may vary slightly due to rounding
4 Per pay cost per thousand dollars of coverage
5 To receive this rate, you must certify that you have not used any tobacco products for 12 months prior to making your election.
6 Not available to Career Bands 11-13
