Your cost depends on the plan option and the coverage amount you choose. You pay nothing for the first month. Likewise, if you increase coverage, you don't pay the extra premium for the first partial month of increased coverage.
Monthly Employee Rates
Coverage for employees can range from $10,000 to $500,000.
| Coverage | Self (You) |
Family (You, spouse/partner & eligible children) |
Modified Family (You & eligible children) |
|---|---|---|---|
| $10,000 | $0.10 | $0.17 | $0.12 |
| $20,000 | $0.20 | $0.34 | $0.24 |
| $30,000 | $0.30 | $0.51 | $0.36 |
| $40,000 | $0.40 | $0.68 | $0.48 |
| $50,000 | $0.50 | $0.85 | $0.60 |
| $60,000 | $0.60 | $1.02 | $0.72 |
| $70,000 | $0.70 | $1.19 | $0.84 |
| $80,000 | $0.80 | $1.36 | $0.96 |
| $90,000 | $0.90 | $1.53 | $1.08 |
| $100,000 | $1.00 | $1.70 | $1.20 |
| $125,000 | $1.25 | $2.13 | $1.50 |
| $150,000 | $1.50 | $2.55 | $1.80 |
| $175,000 | $1.75 | $2.98 | $2.10 |
| $200,000 | $2.00 | $3.40 | $2.40 |
| $300,000 | $3.00 | $5.10 | $3.60 |
| $400,000 | $4.00 | $6.80 | $4.80 |
| $500,000 | $5.00 | $8.50 | $6.00 |
Annual Retiree Cost
All retirees, regardless of their level of coverage as an employee, may opt for coverage of up to $100,000. If your level of coverage as an active employee was $250,000 or more on the day prior to your date of retirement, you may enroll in any level of coverage up to a maximum of $250,000.
| Coverage | Individual | Individual & Spouse/Domestic Partner |
|---|---|---|
| $10,000 | $11.80 | $17.40 |
| $20,000 | $23.60 | $34.80 |
| $25,000 | $29.50 | $43.50 |
| $30,000 | $35.40 | $52.20 |
| $40,000 | $47.20 | $69.60 |
| $50,000 | $59.00 | $87.00 |
| $60,000 | $70.80 | $104.40 |
| $70,000 | $82.60 | $121.80 |
| $80,000 | $94.40 | $139.20 |
| $90,000 | $106.20 | $156.60 |
| $100,000 | $118.00 | $174.00 |
| $125,000* | $147.50 | $217.50 |
| $150,000* | $177.00 | $261.00 |
| $175,000* | $206.50 | $304.50 |
| $200,000* | $236.00 | $348.00 |
| $250,000* | $295.00 | $435.00 |
* Available only if coverage as employee (on the day prior to your retirement date) exceeded $250,000