Rates

The OPEH&W Health Plan’s Plan Year runs from July 1, 2019 through June 30, 2020.

Rates and Coverage details are per plan year unless stated otherwise and are valid July 1, 2019 through June 30, 2020.

Rates shown are for Active Employees.

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》	Health
》	Dental
》	Vision
》	Group Term Life
》	Additional Term Life

Health
》Health Coverage Details

		Diamond Preferred		Diamond Choice		Platinum		Gold		Silver		Bronze
Member		586.02		626.94		545.58		513.36		484.06		455.34
Child		285.58		305.50		265.88		250.18		235.90		221.90
Children		464.90		497.32		432.82		407.26		384.02		361.24
Spouse		698.88		747.66		650.66		612.22		577.28		543.04
Spouse & Child		984.46		1,053.16		916.54		862.40		813.16		764.94
Spouse & Children		1,163.78		1,244.98		1,083.48		1,019.48		961.28		904.26

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Dental
》Dental Coverage Details

Coverage Tier		Rate
Member		42.36
Child		22.82
Children		36.28
Spouse		53.36
Spouse & Child		76.18
Spouse & Children		89.64
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Vision
》Vision Coverage Details

Coverage Tier		Enhanced		Standard
Member		7.74		6.28
Child		7.22		5.82
Children		7.22		5.82
Spouse		6.80		5.50
Spouse & Child		18.44		14.92
Spouse & Children		18.44		14.92
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Group Term Life
》Group Term Life Coverage Details

Death Benefit		Rate
20,000		6.00
30,000		9.00
40,000		12.00
50,000		15.00

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Additional Term Life
》Additional Term Life Coverage Details

First $20,000 of Death Benefit Coverage
		18-34		35-39		40-44		45-49		50-54		55-59		60-64		65-69		70-74		75+
With AD&D Coverage		2.00		2.60		3.40		5.20		8.40		13.40		15.40		24.80		41.60		64.20
Without AD&D Coverage		1.40		2.00		2.80		4.60		7.80		12.80		14.80		24.00		41.00		63.60
Each additional $5,000 of Death Benefit Coverage
		18-34		35-39		40-44		45-49		50-54		55-59		60-64		65-69		70-74		75+
With AD&D Coverage		0.50		0.65		0.85		1.30		2.10		3.35		3.85		6.20		10.40		16.05
Without AD&D Coverage		0.35		0.50		0.70		1.15		1.95		3.20		3.70		6.05		10.25		15.90

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