Benefits Rate Charts

Medical Plans

Medical Plans (cost per month)

EPO Plus (Core)

Coverage Tier Employee Pays Employer Pays
Employee Only $12.81 $668.00
Employee and Spouse $126.40 $1,372.08
Employee and Child(ren) $75.46 $1,180.75
Employee and Family $348.18 $1,678.33

Open Access POS II (Buy-up)

Coverage Tier Employee Pays Employer Pays
Employee Only $57.52 $668.00
Employee and Spouse $461.69 $1,372.08
Employee and Child(ren) $354.60 $1,180.75
Employee and Family $772.81 $1,678.33

*To calculate your rate per paycheck:

  • 12-month employees: Multiply the rates by 12 and divide by 26
  • 9-month employees: Multiply the rates by 12 and divide by 18

Dental Plans (cost per month)

Coverage Tier High DPPO Low DDPO S700B
Employee Only $65.77 $19.90 $9.95
Employee and Spouse $138.30 $40.50 $16.84
Employee and Child(ren) $148.23 $49.78 $23.34
Employee and Family $164.01 $75.89 $27.55

*To calculate your rate per paycheck:

  • 12-month employees: Multiply the rates by 12 and divide by 26
  • 9-month employees: Multiply the rates by 12 and divide by 18

Vision Plans (cost per month)

Coverage Tier Core Plan Buy-Up Plan
Employee Only $7.14 $10.62
Employee and Spouse $16.13 $23.99
Employee and Child(ren) $17.26 $25.67
Employee and Family $27.59 $41.04

*To calculate your rate per paycheck:

  • 12-month employees: Multiply the rates by 12 and divide by 26
  • 9-month employees: Multiply the rates by 12 and divide by 18

Basic and Supplemental Life Insurance

Supplemental Life Insurance—Employee Coverage (cost per month)

Age Rate
<25 $0.031
25-29 $0.033
30-34 $0.043
35-39 $0.056
40-44 $0.078
45-49 $0.117
50-54 $0.180
55-59 $0.311
60-64 $0.387
65-69 $0.536
70-74 $0.744

*To determine pay period cost:

  1. Select the amount of coverage desired
  2. Divide by 1,000
  3. Multiply that number by the rate shown on the chart for your age
  4. Multiply rate times 12, then divide by 26 or 18 (depending on the number of pay periods)

Supplemental Term Life Insurance—Employee Coverage

Coverage Amount Coverage Increments
$10,000-$500,000 $10,000

Supplemental Term Life Insurance—Child(ren) Coverage (cost per month)

Coverage Amount Cost
$5,000 $1.67
$10,000 $3.34
$15,000 $5.01
$20,000 $6.68
$25,000 $8.35

Supplemental Term Life Insurance—Spouse/Domestic Partner Coverage (cost per month)

Coverage Amount Cost
$5,000 $1.67
$10,000 $3.34
$15,000 $5.01
$20,000 $6.68
$25,000 $8.35
$30,000 $10.02
$35,000 $11.69
$40,000 $13.36
$45,000 $15.03
$50,000 $16.70

Basic and Supplemental Accidental Death and Dismemberment Insurance (cost per month)

Coverage Only Amount Employee Only Pays Employee and Dependents Pay
$2,5000 $0.53 $0.63
$50,000 $1.05 $1.25
$100,000 $2.10 $2.50
$150,000 $3.15 $3.75
$200,000 $4.20 $5.00
$250,000 $5.25 $6.25
$300,000 $6.30 $7.50
$350,000 $7.35 $8.75
$400,000 $8.40 $10.00
$450,000 $9.45 $11.25
$500,000 $10.50 $12.50

*To calculate your rate per paycheck:

  • 12-month employees: Multiply the rates by 12 and divide by 26
  • 9-month employees: Multiply the rates by 12 and divide by 18

Voluntary Short Term Disability (cost per month)

Coverage Amount Employee Only Pays
$250 $1.13
$400 $1.80
$550 $2.48
$700 $3.15
$850 $3.83
$1,000 $4.50
$1,150 $5.18
$1,300 $5.85
$1,450 $6.53
$1,600 $7.20
$1,750 $7.88
$1,900 $8.55
$2,050 $9.23
$2,200 $9.90
$2,350 $10.58
$2,500 $11.25
$2,650 $11.93
$2,800 $12.60
$2,950 $13.28
$3,100 $13.95
$3,250 $14.63
$3,400 $15.30
$3,550 $15.98
$3,700 $16.65
$3,850 $17.33
$4,000 $18.00

*To calculate your rate per paycheck:

  • 12-month employees: Multiply the rates by 12 and divide by 26
  • 9-month employees: Multiply the rates by 12 and divide by 18

Supplemental Health Insurance Plans

Hospital Indemnity Insurance (cost per month)

Coverage Level Employee Pays
Employee Only $18.17
Employee and Spouse / Domestic Partner $35.88
Employee and Child(ren) $30.09
Employee and Family $47.80

Accident Insurance (cost per month)

Coverage Level Employee Pays
Employee Only $9.13
Employee and Spouse / Domestic Partner $17.99
Employee and Child(ren) $21.38
Employee and Family $25.37

Critical Illness Insurance (cost per month)

Monthly premium per $1,000 of coverage

Attained Age Employee Employee and Spouse
<25 $0.36 $0.69
25–29 $0.41 $0.78
30–34 $0.47 $0.92
35–39 $0.62 $1.20
40–44 $0.81 $1.57
45–49 $1.07 $2.10
50–54 $1.42 $2.85
55–59 $1.93 $3.92
60–64 $2.52 $5.18
65–69 $3.18 $6.55
70–74 $4.10 $8.44
75–79 $5.16 $10.57
80–84 $6.67 $13.60
85+ $8.10 $16.46

Plans to Keep You and Your Family Secure

Pet Insurance

Rates vary based on pet's species, breed, age, your location, and the plan's reimbursement rate and the coverage limits.

Option Monthly Cost
LegalGUARD $17.50 per month per enrolled employee
LegalGUARD + TurnSignl $20.47 per enrolled employee

Worksite Whole Life Insurance

Rates vary based on age, gender, health and coverage amount.