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Employee Rates - Currently Updating


Medical

Total premium rates Employer contribution rates Employee contribution rates
  2012 2012   2012 2012   2012 2012
Active Buy Up Core Active Buy Up Core Active Buy Up Core
Employee Only $567 $499 Employee Only $434 $434 Employee Only $133 $65
Employee + Spouse $1,019 $900 Employee + Spouse $631 $631 Employee + Spouse $388 $269
Employee + Child(ren) $899 $793 Employee + Child(ren) $578 $578 Employee + Child(ren) $321 $215
Employee + Family $1,350 $1,193 Employee + Family $775 $775 Employee + Family $575 $418
  2012 2012   2012 2012   2012 2012
Retirees Buy Up Core Retirees Buy Up Core Retiress Buy Up Core
Non-Medicare     Non-Medicare     Non-Medicare    
Retiree Only $867 $769 Retiree Only $660 $660 Retiree Only $207 $109
Retiree + Spouse $1,537 $1,361 Retiree + Spouse $1,086 $1,086 Retiree + Spouse $451 $275
Retiree + Child(ren) $1,205 $1,070 Retiree + Child(ren) $812 $812 Retiree + Child(ren) $393 $258
Retiree + Family $1,871 $1,659 Retiree + Family $1,238 $1,238 Retiree + Family $633 $421
                 
Split Medicare     Split Medicare     Split Medicare    
Retiree + Spouse1 $1,131 $1,003 Retiree + Spouse1 $817 $817 Retiree + Spouse1 $314 $186
Retiree + Spouse2 $1,227 $1,088 Retiree + Spouse2 $889 $889 Retiree + Spouse2 $338 $199
Retiree + Family1 $1,470 $1,303 Retiree + Family1 $971 $971 Retiree + Family1 $499 $332
Retiree + Family2 $1,564 $1,386 Retiree + Family2 $1,041 $1,041 Retiree + Family2 $523 $345
                 
Medicare     Medicare     Medicare    
Retiree Only $463 $409 Retiree Only $390 $390 Retiree Only $73 $19
Retiree + Spouse $824 $730 Retiree + Spouse $620 $620 Retiree + Spouse $204 $110
Retiree + Child(ren) $800 $708 Retiree + Child(ren) $541 $541 Retiree + Child(ren) $259 $167
Retiree + Family $1,162 $1,030 Retiree + Family $773 $773 Retiree + Family $389 $257
                 
Return to Work with Medicare     Return to Work with Medicare     Return to Work with Medicare    
Retiree Only $567 $499 Retiree Only $434 $434 Retiree Only $133 $65
Retiree + Spouse $1,019 $900 Retiree + Spouse $631 $631 Retiree + Spouse $388 $269
Retiree + Child(ren) $899 $793 Retiree + Child(ren) $578 $578 Retiree + Child(ren) $321 $215
Retiree + Family $1,350 $1,193 Retiree + Family $775 $775 Retiree + Family $575 $418

1 Retiree has Medicare, spouse does not
2 Spouse has Medicare, retiree does not
All estimates are based upon the information available at a point in time and subject to unforeseen and random events; therefore, any projection must be interpreted as having a likely range of variability from the estimate


Dental & Vision

Gold Plan Dental Coverage Total Montly Premium
employee/only dental gold $24.20
employee/spouse dental gold $50.68
employee/children dental gold $55.40
employee/family dental gold $78.64
Silver Plan Dental Coverage Total Montly Premium
employee/only dental silver $14.08
employee/spouse dental silver $28.18
employee/children dental silver $32.84
employee/family dental silver $46.92
Vision Coverage Total Montly Premium
employee/only $7.86
employee/spouse $16.84
employee/children $12.70
employee/family $23.12

EMPLOYEES PAY 100% OF THESE PREMIUMS


Welfare Products

Coverage Rate Rate Basis Who Pays
Active Basic Life Insurance Rate $0.16 per $1,000 of benefit Employer
Active Basic AD&D Insurance $0.02 per $1,000 of benefit Employer
Retiree Basic Life Insurance $0.99 per $1,000 of benefit Employer
Retiree Basic AD&D Insurance $0.02 per $1,000 of benefit Employer
Active Voluntary Life Insurance
Age band      
Under 30 $0.07 per $1,000 of benefit Employee Pays All
30-34 $0.08 per $1,000 of benefit Employee Pays All
35-39 $0.09 per $1,000 of benefit Employee Pays All
40-44 $0.14 per $1,000 of benefit Employee Pays All
45-49 $0.24 per $1,000 of benefit Employee Pays All
50-54 $0.43 per $1,000 of benefit Employee Pays All
55-59 $0.64 per $1,000 of benefit Employee Pays All
60-64 $1.00 per $1,000 of benefit Employee Pays All
65-69 $1.78 per $1,000 of benefit Employee Pays All
70-74 $2.88 per $1,000 of benefit Employee Pays All
75-79 $4.54 per $1,000 of benefit Employee Pays All
80+ $7.07 per $1,000 of benefit Employee Pays All
Spouse Voluntary Life Insurance
Age band      
Under 30 $0.07 per $1,000 of benefit Employee Pays All
30-34 $0.08 per $1,000 of benefit Employee Pays All
35-39 $0.09 per $1,000 of benefit Employee Pays All
40-44 $0.14 per $1,000 of benefit Employee Pays All
45-49 $0.24 per $1,000 of benefit Employee Pays All
50-54 $0.43 per $1,000 of benefit Employee Pays All
55-59 $0.64 per $1,000 of benefit Employee Pays All
60-64 $1.00 per $1,000 of benefit Employee Pays All
65-69 $1.78 per $1,000 of benefit Employee Pays All
70-74 $2.88 per $1,000 of benefit Employee Pays All
75-79 $4.54 per $1,000 of benefit Employee Pays All
80+ $7.07 per $1,000 of benefit Employee Pays All
Child Voluntary Life Insurance
  $0.200 per $1,000 of benefit Employee Pays All
Active optional AD&D
Employee only rate $0.02 per $1,000 of benefit Employee Pays All
Family Rate $0.04 per $1,000 of benefit Employee Pays All
Long Term Disability
Age band Rate    
Under 25 $0.20 per $100 of monthly covered salary Employee Pays All
25-29 $0.20 per $100 of monthly covered salary Employee Pays All
30-34 $0.24 per $100 of monthly covered salary Employee Pays All
35-39 $0.30 per $100 of monthly covered salary Employee Pays All
40-44 $0.42 per $100 of monthly covered salary Employee Pays All
45-49 $0.63 per $100 of monthly covered salary Employee Pays All
50-54 $0.94 per $100 of monthly covered salary Employee Pays All
55-59 $1.17 per $100 of monthly covered salary Employee Pays All
60-64 $1.19 per $100 of monthly covered salary Employee Pays All
65-69 $1.27 per $100 of monthly covered salary Employee Pays All
70-74 $1.59 per $100 of monthly covered salary Employee Pays All
75-79 $2.27 per $100 of monthly covered salary Employee Pays All
Max Monthly covered salary is $16,666.67 Max Annual Salary is $200,000
Short Term Disability
All Age Bands $0.93 per $10 of covered weekly benefit Employee Pays All