| Rates |
| Rates and Coverage details shown are for Current and Former Employees of the OPEH&W |
| Health Plan for the 2020/21 plan year which runs from 7/1/2020 through 6/30/2021. |
| Contents |
| 》All-in-One Rate Sheet PDF |
| 》Health |
| 》Dental |
| 》Vision |
| 》Group Life |
| 》Additional Life |
Health
》Health Coverage Details
| Diamond | Platinum | Gold | Silver | Bronze | ||||||
| Member | 603.60 | 561.94 | 528.76 | 498.58 | 469.00 | |||||
| Child | 294.14 | 273.86 | 257.68 | 242.98 | 228.56 | |||||
| Children | 478.84 | 445.80 | 419.48 | 395.54 | 372.08 | |||||
| Spouse | 719.84 | 670.18 | 630.58 | 594.60 | 559.34 | |||||
| Spouse & Child | 1,013.98 | 1,115.98 | 1,050.06 | 990.14 | 931.42 | |||||
| Spouse & Children | 1,198.68 | 1,138.30 | 1,071.06 | 1,009.96 | 950.04 |
Dental
》Dental Coverage Details
| Coverage Tier | Enhanced | Standard | ||
| Member | 42.36 | 38.12 | ||
| 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 |
| 》Top of Page |
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 | ||
| 》Top of Page | ||||
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 | ||||||||||