2024/25 Plan Year Rates
for Current & Former Employees

Health
  Health Coverage Details  

		Diamond		Platinum		Gold		Silver		Bronze
Member		743.26		668.94		639.20		616.90		594.60
Child		355.08		319.58		305.36		294.72		284.06
Children		578.06		520.26		497.14		479.78		462.44
Spouse		869.02		782.12		747.36		721.28		695.22
Spouse & Child		1,224.10		1,101.70		1,052.72		1,016.00		979.28
Spouse & Children		1,447.08		1,302.38		1,224.50		1,201.06		1,180.82

Dental
  Dental Coverage Details  

		Enhanced		Standard
Member		47.62		42.86
Child		25.16		22.64
Children		40.00		36.02
Spouse		58.82		52.94
Spouse & Child		83.98		75.58
Spouse & Children		98.82		88.96

Vision
  Vision Coverage Details  

		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

Group Life
  Group Life Coverage Details  

Benefit		Rate
20,000		6.50
30,000		9.74
40,000		13.00
50,000		16.24

Additional Life
  Additional Life Coverage Details  
Per $5,000 of Coverage

		18-34		35-39		40-44		45-49		50-54		55-59		60-64		65-69		70-74		75+
With AD&D		0.50		0.65		0.85		1.30		2.10		3.35		3.85		6.20		10.40		16.05
Without AD&D		0.35		0.50		0.70		1.15		1.95		3.20		3.70		6.05		10.25		15.90