| Rates |
| 2022/23 Plan Year |
| Contents |
| 》All-in-One Rate Sheet PDF |
| 》Health |
| 》Dental |
| 》Vision |
| 》Group Life |
| 》Additional Life |
Health
》Health Coverage Details
| Diamond | Platinum | Gold | Silver | Bronze | ||||||
| Member | 674.16 | 633.72 | 600.00 | 573.04 | 539.32 | |||||
| Child | 322.08 | 302.76 | 286.66 | 273.76 | 257.66 | |||||
| Children | 524.32 | 492.86 | 466.64 | 445.68 | 419.46 | |||||
| Spouse | 788.22 | 740.92 | 701.52 | 669.98 | 630.58 | |||||
| Spouse & Child | 1,110.30 | 1,043.68 | 988.18 | 943.74 | 888.24 | |||||
| Spouse & Children | 1,312.54 | 1,233.78 | 1,168.16 | 1,115.66 | 1,050.04 |
Dental
》Dental Coverage Details
| Coverage Tier | Enhanced | Standard | ||
| Member | 43.20 | 38.88 | ||
| Child | 22.82 | 20.54 | ||
| Children | 36.28 | 32.66 | ||
| Spouse | 53.36 | 48.02 | ||
| Spouse & Child | 76.18 | 68.56 | ||
| Spouse & Children | 89.64 | 80.68 |
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 |
Group Life
》Group Life Coverage Details
| Death Benefit | Rate | |
| 20,000 | 6.00 | |
| 30,000 | 9.00 | |
| 40,000 | 12.00 | |
| 50,000 | 15.00 |
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 | ||||||||||