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Contribution Rates

Contributions/Basic Rates Through December 31, 2016 (See below for 2017 rates)

This charts below show the costs for the various coverage options effective January 1, 2016 — December 31, 2016.

Contributions for Active Employees-2016

Medical/Vision PlanWith CIGNA DentalWith CareFirst Dental
Full-TimePart-TimeFull-TimePart-Time
Kaiser Permanente Medical and NVA Vision Single   Family $97.63
$258.22		 $220.56
$575.86		 $98.99
$261.30		 $223.13
$581.52
BlueChoice HMO Medical and Davis Vision* Single   Family $91.74
$241.02		 $205.05
$529.69		 $93.10
$244.10		 $207.62
$535.35
CareFirst PPO Medical and Davis Vision* Single   Family $175.22
$437.17		 $346.63
$855.71		 $176.58
$440.25		 $349.20
$861.37
Supplemental Orthodontic Single   Family n/a n/a $8.58
$27.44		 $8.58
$27.44

* CareFirst PPO medical coverage is only available to employees hired before March 1, 2011. (Employees hired on or after March 1, 2011 are eligible to elect CareFirst PPO medical coverage after completing 39 months of service from the date of hire.)

Retired Employees and Survivors of Retirees-2016

Medical/Vision Plan
Normal/DisabilityMedicareSurvivors of RetireesSurvivors of Retirees on Medicare
Kaiser Permanente Medical and NVA Vision Single
Family		 $90.81
$242.39		   $90.60
$242.18		  
 

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$48.91

$131.73


$101.32

  

$48.70

$131.52


$101.11
BlueChoice HMO Medical and Davis Vision* Single
Family		 $85.32
$225.59		   $85.11
$225.38		  
 

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$56.69

$176.63


$139.11

  

$56.48

$176.42


$138.90
CareFirst PPO Medical and Davis Vision* Single
Family		 $168.80
$421.81		   $168.59
$421.60		  
 

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$114.12

$330.44


$253.87

  

$113.91

$330.23


$253.66

MetLife Term Life Insurance Rates-2016

Age Band$10K$35K$50K$70K$100K$150K$200K$250K$300K$400K
Less Than 25 $0.50 $1.75 $2.50 $3.75 $5.00 $7.50 $10.00 $12.50 $15.00 $20.00
25-29 $0.60 $2.10 $3.00 $4.50 $6.00 $9.00 $12.00 $15.00 $18.00 $24.00
30-34 $0.80 $2.80 $4.00 $6.00 $8.00 $12.00 $16.00 $20.00 $24.00 $32.00
35-39 $0.90 $3.15 $4.50 $6.75 $9.00 $13.50 $18.00 $22.50 $27.00 $36.00
40-44 $1.00 $3.50 $5.00 $7.50 $10.00 $15.00 $20.00 $25.00 $30.00 $40.00
45-49 $1.60 $5.60 $8.00 $12.00 $16.00 $24.00 $32.00 $40.00 $48.00 $64.00
50-54 $2.60 $9.10 $13.00 $19.50 $26.00 $39.00 $52.00 $65.00 $78.00 $104.00
55-59 $4.60 $16.10 $23.00 $34.50 $46.00 $69.00 $92.00 $115.00 $138.00 $184.00
60-64 $6.80 $23.80 $34.00 $51.00 $68.00 $102.00 $136.00 $170.00 $204.00 $272.00
65-69 $12.70 $44.45 $63.50 $95.25 $127.00 $190.50 $254.00 $317.00 $381.00 $508.00
70+ $20.60 $72.10 $103.00 $154.50 $206.00 $309.00 $412.00 $515.00 $618.00 $824.00

Contributions for Survivors of Active Employees-2016

Medical/Vision PlanWith Cigna DentalWith CareFirst Dental
Kaiser Permanente Medical and NVA Vision Single
Family		 $96.06
$256.65		 $97.42
$259.73
BlueChoice HMO Medical and Davis Vision Single
Family		 $90.17
$239.45		 $91.53
$242.53
CareFirst PPO Medical and Davis Vision

Single
Family

 $173.65
$435.60		 $175.01
$438.68

Contributions for Retired Employees with an Early Pension-2016

Medical/Vision PlanAge 60-64 at RetirementAge 55-59 at RetirementAge 50-54 at Retirement
    Pre-Medicare Medicare Pre-Medicare Medicare Pre-Medicare Medicare
Kaiser Permanente Medical and NVA Vision Single
Family		 $135.27
$360.70

 

 $179.69
$478.98		   $201.91
$538.13		  

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$74.72

$214.45


$160.43

  

$100.53

$297.16


$219.54

  

$113.43

$338.52


$249.10
BlueChoice HMO Medical and Davis Vision Single
Family		 $125.95
$332.33		   $166.53
$439.03		   $186.83
$492.36		  

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$83.84

$262.64


$202.77

  

 $111.00

$348.66


$266.44

  

$124.57

$391.66


$298.27
CareFirst PPO Medical and Davis Vision Single
Family		 $232.65
$580.49		   $296.48
$739.12		   $317.82
$797.60		  

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$158.10

$455.80


$350.42

  

$74.72

$214.45


$160.43

  

$74.72

$214.45


$160.43

 

 

Contributions/Basic Rates Through December 31, 2017

This charts below show the costs for the various coverage options effective January 1, 2017 — December 31, 2017.

Contributions for Active Employees-2017

Medical/Vision PlanWith CIGNA DentalWith CareFirst Dental
Full-TimePart-TimeFull-TimePart-Time
Kaiser Permanente Medical and NVA Vision Single   Family $106.54
$284.19		 $236.14
$621.31		 $108.04
$287.82		 $238.95
$627.94
BlueChoice HMO Medical and Davis Vision* Single   Family $97.41
$256.55		 $214.97
$556.86		 $98.91
$260.18		 $217.78
$563.49
CareFirst PPO Medical and Davis Vision* Single   Family $175.39
$439.09		 $346.93
$859.05		 $176.89
$442.72		 $349.74
$865.68
Supplemental Orthodontic Single   Family n/a n/a $8.72
$27.15		 $8.72
$27.15

* CareFirst PPO medical coverage is only available to employees hired before March 1, 2011. (Employees hired on or after March 1, 2011 are eligible to elect CareFirst PPO medical coverage after completing 39 months of service from the date of hire.)

Retired Employees and Survivors of Retirees-2017

Medical/Vision Plan
Normal/DisabilityMedicareSurvivors of RetireesSurvivors of Retirees on Medicare
Kaiser Permanente Medical and NVA Vision Single
Family		 $102.63
$271.27		   $100.63
$269.27		  
 

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$53.53

$148.10


$109.29

  

$51.53

$146.10


$107.29
BlueChoice HMO Medical and Davis Vision* Single
Family		 $93.91
$244.02		   $91.91
$242.02		  
 

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$59.37

$181.73


$136.97

  

$57.37

$179.73


$134.97
CareFirst PPO Medical and Davis Vision* Single
Family		 $171.88
$426.64		   $169.88
$424.64		  
 

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$107.83

$305.36


$234.41

  

$105.83

$303.36


$232.41

MetLife Term Life Insurance Rates-2017

Age Band$10K$35K$50K$70K$100K$150K$200K$250K$300K$400K
Less Than 25 $0.50 $1.75 $2.50 $3.75 $5.00 $7.50 $10.00 $12.50 $15.00 $20.00
25-29 $0.60 $2.10 $3.00 $4.50 $6.00 $9.00 $12.00 $15.00 $18.00 $24.00
30-34 $0.80 $2.80 $4.00 $6.00 $8.00 $12.00 $16.00 $20.00 $24.00 $32.00
35-39 $0.90 $3.15 $4.50 $6.75 $9.00 $13.50 $18.00 $22.50 $27.00 $36.00
40-44 $1.00 $3.50 $5.00 $7.50 $10.00 $15.00 $20.00 $25.00 $30.00 $40.00
45-49 $1.60 $5.60 $8.00 $12.00 $16.00 $24.00 $32.00 $40.00 $48.00 $64.00
50-54 $2.60 $9.10 $13.00 $19.50 $26.00 $39.00 $52.00 $65.00 $78.00 $104.00
55-59 $4.60 $16.10 $23.00 $34.50 $46.00 $69.00 $92.00 $115.00 $138.00 $184.00
60-64 $6.80 $23.80 $34.00 $51.00 $68.00 $102.00 $136.00 $170.00 $204.00 $272.00
65-69 $12.70 $44.45 $63.50 $95.25 $127.00 $190.50 $254.00 $317.00 $381.00 $508.00
70+ $20.60 $72.10 $103.00 $154.50 $206.00 $309.00 $412.00 $515.00 $618.00 $824.00

Contributions for Survivors of Active Employees-2017

Medical/Vision PlanWith Cigna DentalWith CareFirst Dental
Kaiser Permanente Medical and NVA Vision Single
Family		 $106.09
$283.74		 $107.59
$287.37
BlueChoice HMO Medical and Davis Vision Single
Family		 $96.96
$256.10		 $98.46
$259.73
CareFirst PPO Medical and Davis Vision

Single
Family

 $174.94
$438.64		 $176.44
$438.64

Contributions for Retired Employees with an Early Pension-2017

Medical/Vision PlanAge 60-64 at RetirementAge 55-59 at RetirementAge 50-54 at Retirement
    Pre-Medicare Medicare Pre-Medicare Medicare Pre-Medicare Medicare
Kaiser Permanente Medical and NVA Vision Single
Family		 $150.61
$398.22

 

 $198.58
$525.17		   $222.57
$588.64		  

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$80.73

$235.73


$170.79

  

$107.92

$323.36


$232.30

  

$121.52

$367.17


$263.05
BlueChoice HMO Medical and Davis Vision Single
Family		 $137.07
$356.24		   $180.23
$468.47		   $201.81
$524.58		  

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$87.33

$269.27


$199.99

  

 $115.28

$356.80


$263.01

  

$129.26

$400.57


$294.53
CareFirst PPO Medical and Davis Vision Single
Family		 $236.63
$586.72		   $301.39
$746.79		   $333.76
$826.83		  

Single Medicare
Family 1 Medicare
Family 2 Medicare

  

$149.92

$423.19


$325.12

  

$192.01

$541.02


$415.82

  

$213.06

$599.94


$461.18

 

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FAQs

My girlfriend just had a baby. Can I add the child to our plan?

Yes, as long as the newborn child is your natural child, your legally adopted child, or you are the child’s legal guardian. If your girlfriend is covered under the Plan as your domestic partner, your child may also be added to the Plan. You’ll need to show documents of proof to the Health & Welfare Plan Office. For more information on dependent eligibility, see Eligibility for Your Spouse and Children.

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