Your per-pay-period contributions are shown here.
| Benefit Plan | Team Member Only | Team Member + Spouse / Domestic Partner | Team Member + Child(ren) | Team Member + Family |
|---|---|---|---|---|
| Medical | ||||
| Cigna HSA | $36.00 | $144.00 | $70.00 | $180.00 |
| Cigna PPO | $74.00 | $201.00 | $138.00 | $258.00 |
| Cigna PPO High | $102.00 | $254.00 | $191.00 | $330.00 |
| Dental | ||||
| Delta Dental PPO Low | $5.00 | $12.00 | $14.00 | $21.00 |
| Delta Dental PPO High | $15.00 | $30.00 | $34.00 | $51.00 |
| Vision | ||||
| VSP Low | $2.76 | $5.50 | $5.89 | $9.40 |
| VSP High | $4.57 | $9.15 | $9.83 | $15.63 |
| Coverage Options | Per Pay Period Rate |
|---|---|
| LegalShield Only | $7.98 |
| Identity Theft Only | $6.48 |
| Identity Theft Only (TM + Family) | $6.98 |
| Combo: Legal & Identity Theft | $12.95 |
| Pet Discount Plan | Per Pay Period Rate |
|---|---|
| PETplus (Single Pet) | $3.50 |
| PETplus (Unlimited Pets) | $5.00 |
| Pet Assure (Single Pet) | $2.25 |
| Pet Assure (Unlimited Pets) | $4.25 |
| Long Term Disability (LTD) | ||
|---|---|---|
| Team Member Age | Rates per $100 of Covered Base Pay (50%) | Rates per $100 of Covered Base Pay (60%) |
| <25 | $0.039 | $0.045 |
| 25-29 | $0.065 | $0.075 |
| 30-34 | $0.111 | $0.127 |
| 35-39 | $0.202 | $0.232 |
| 40-44 | $0.364 | $0.419 |
| 45-49 | $0.494 | $0.568 |
| 50-54 | $0.631 | $0.725 |
| 55-59 | $0.715 | $0.823 |
| 60-64 | $0.696 | $0.800 |
| 65-69 | $0.689 | $0.793 |
| 70-74 | $0.462 | $0.531 |
| Voluntary Life and AD&D Rates based on Team Members age (FYI: this is inclusive of Spouse rates as well) |
|||
|---|---|---|---|
| Rates Per $1,000 of Covered Base Pay | |||
| Age | Team Member | Age | Spouse |
| <25 | $0.04 | <25 | $0.03 |
| 25-29 | $0.04 | 25-29 | $0.03 |
| 30-34 | $0.05 | 30-34 | $0.03 |
| 35-39 | $0.06 | 35-39 | $0.04 |
| 40-44 | $0.06 | 40-44 | $0.05 |
| 45-49 | $0.09 | 45-49 | $0.07 |
| 50-54 | $0.12 | 50-54 | $0.11 |
| 55-59 | $0.22 | 55-59 | $0.16 |
| 60-64 | $0.31 | 60-64 | $0.26 |
| 65-69 | $0.54 | 65-69 | $0.45 |
| 70-74 | $0.86 | 70-74 | $0.45 |
| 75+ | $0.86 | 75+ | $0.45 |
| Child Supplemental Life and AD&D | Rate Per $1,000 of Covered Pay |
|---|---|
| Covers all Children | $0.08 |
| Unum Accident Insurance | Per Pay Period Rate |
|---|---|
| Team Member Only | $4.79 |
| Team Member + Spouse | $8.40 |
| Team Member + Child(ren) | $8.02 |
| Family | $11.63 |
| Chubb Critical Illness Insurance | ||||
|---|---|---|---|---|
| Per Pay Period Rate for $10,000 Benefit | ||||
| Age | Team Member | Team Member + Spouse | Team Member + Child(ren) | Team Member + Family |
| 18-25 | $1.44 | $1.72 | $1.44 | $1.72 |
| 26-30 | $1.96 | $2.49 | $1.96 | $2.49 |
| 31-35 | $2.32 | $3.03 | $2.32 | $3.03 |
| 36-40 | $2.99 | $4.04 | $2.99 | $4.04 |
| 41-45 | $4.13 | $5.74 | $4.13 | $5.74 |
| 46-50 | $6.04 | $8.62 | $6.04 | $8.62 |
| 51-55 | $8.51 | $12.31 | $8.51 | $12.31 |
| 56-60 | $11.74 | $17.17 | $11.74 | $17.17 |
| 61-65 | $15.92 | $23.43 | $15.92 | $23.43 |
| 66-70 | $19.79 | $29.23 | $19.79 | $29.23 |
| 71-75 | $22.46 | $33.23 | $22.46 | $33.23 |
| 76-80 | $27.55 | $40.92 | $27.55 | $40.92 |
| 81+ | $42.01 | $62.61 | $42.01 | $62.61 |
| Chubb Critical Illness Insurance | ||||
| Per Pay Period Rate for $20,000 Benefit | ||||
| Age | Team Member | Team Member + Spouse | Team Member + Child(ren) | Team Member + Family |
| 18-25 | $2.09 | $2.65 | $2.09 | $2.65 |
| 26-30 | $3.12 | $4.18 | $3.12 | $4.18 |
| 31-35 | $3.84 | $5.27 | $3.84 | $5.27 |
| 36-40 | $5.19 | $7.29 | $5.19 | $7.29 |
| 41-45 | $7.46 | $10.68 | $7.46 | $10.68 |
| 46-50 | $11.29 | $16.44 | $11.29 | $16.44 |
| 51-55 | $16.22 | $23.83 | $16.22 | $23.83 |
| 56-60 | $22.69 | $33.54 | $22.69 | $33.54 |
| 61-65 | $31.05 | $46.07 | $31.05 | $46.07 |
| 66-70 | $38.78 | $57.67 | $38.78 | $57.67 |
| 71-75 | $44.12 | $65.67 | $44.12 | $65.67 |
| 76-80 | $54.33 | $81.05 | $54.30 | $81.05 |
| 81+ | $83.22 | $124.42 | $83.22 | $124.42 |
| Chubb Critical Illness Insurance | ||||
| Per Pay Period Rate for $30,000 Benefit | ||||
| Age | Team Member | Team Member + Spouse | Team Member + Child(ren) | Team Member + Family |
| 18-25 | $2.74 | $3.57 | $2.74 | $3.57 |
| 26-30 | $4.28 | $5.87 | $4.28 | $5.87 |
| 31-35 | $5.37 | $7.50 | $5.37 | $7.50 |
| 36-40 | $7.39 | $10.53 | $7.39 | $10.53 |
| 41-45 | $10.79 | $15.62 | $10.79 | $15.62 |
| 46-50 | $16.54 | $24.26 | $16.54 | $24.26 |
| 51-55 | $23.93 | $35.34 | $23.93 | $35.34 |
| 56-60 | $33.64 | $49.92 | $33.64 | $49.92 |
| 61-65 | $46.18 | $68.71 | $46.18 | $68.71 |
| 66-70 | $57.77 | $86.11 | $57.77 | $86.11 |
| 71-75 | $65.78 | $98.11 | $65.78 | $98.11 |
| 76-80 | $81.06 | $121.18 | $81.06 | $121.18 |
| 81+ | $124.43 | $186.23 | $124.43 | $186.23 |
