2022/23 Plan Year Rates
for Current & Former Employees


  Quick Links
  All-in-One Rate Sheet  
  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  

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  

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 6.00
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