Contribution Rates
Contributions/Basic Rates for the various coverage options effective January 1, 2021 through December 31, 2021
Contributions for Active Employees
| Medical/Vision Plan | With CIGNA Dental | With CareFirst Dental | |||
|---|---|---|---|---|---|
| Full-Time | Part-Time | Full-Time | Part-Time | ||
| Kaiser Permanente Medical and NVA Vision | Single Family | $127.54 $342.36 |
$255.45 $685.92 |
$128.35 $343.48 |
$257.05 $688.16 |
| BlueChoice HMO Medical and Davis Vision* | Single Family | $118.88 $313.09 |
$237.95 $626.86 |
$119.69 $314.21 |
$239.55 $629.10 |
| CareFirst POS Medical and Davis Vision* | Single Family | $159.10 $410.46 |
$323.15 $830.42 |
$115.90 $411.58 |
$324.74 $832.66 |
| Supplemental Orthodontic | Single Family |
n/a |
n/a | $3.72 $14.76 |
$3.72 $14.76 |
Contributions for Survivors of Active Employees
| Medical/Vision Plan | With CIGNA Dental | With CareFirst Dental | |||
|---|---|---|---|---|---|
| Kaiser Permanente Medical and NVA Vision | Single Family | $116.06 $311.14 |
$116.87 $312.26 |
||
| BlueChoice HMO Medical and Davis Vision* | Single Family | $110.26 $290.10 |
$111.07 $291.22 |
||
| CareFirst POS Medical and Davis Vision* | Single Family | $169.79 $437.89 |
$170.59 $439.01 |
||
| Supplemental Orthodontic | Single Family |
n/a |
$3.72 $14.76 |
||
Normal Retired Employees and Survivors of Retirees - 2021 Rates
Contributions for NORMAL Retired Employees and Survivors of Retired Employees (who retired BEFORE January 1, 2019)
| Medical/Vision Plan | |||||
|---|---|---|---|---|---|
| Normal/Disability | Medicare | Survivors of Retirees | |||
| Kaiser Permanente Medical and NVA Vision | Single Family |
$111.86 $296.82 |
$110.02 $294.88 |
||
|
Single Medicare |
$50.88 $173.63
|
||||
| BlueChoice HMO Medical and Davis Vision* | Single Family |
$106.46 $276.08 |
$104.52 $274.14 |
||
|
Single Medicare |
$67.82 $215.22
|
||||
| CareFirst BC Advantage Medical (POS) and Davis Vision* | Single Family |
$165.99 $423.94 |
$164.05 $422.00 |
||
|
Single Medicare |
$114.38 $343.84
|
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Contributions for NORMAL Retired Employees and Survivors of Retired Employees (who retired ON OR AFTER January 1, 2019)
| Medical/Vision Plan | |||||
|---|---|---|---|---|---|
| Normal/Disability | Medicare | Survivors of Retirees | |||
| Kaiser Permanente Medical and NVA Vision | Single Family |
$123.62 $328.27 |
$121.68 $326.33 |
||
|
Single Medicare |
$62.66 $224.98
|
||||
| BlueChoice HMO Medical and Davis Vision* | Single Family |
$114.82 $298.58 |
$112.88 $296.64 |
||
|
Single Medicare |
$74.23 $237.90
|
||||
| CareFirst BC Advantage Medical (POS) and Davis Vision* | Single Family |
$158.85 $403.00 |
$159.91 $401.06 |
||
|
Single Medicare |
$110.67 $327.20
|
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Early Retired Employees and Survivors of Retirees - 2021 Rates
Contributions for EARLY Retired Employees and Survivors of Retired Employees (who retired BEFORE January 1, 2019)
| Medical/Vision Plan | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Age 60-64 at Retirement | Age 55-59 at Retirement | Age 50-54 at Retirement | |||||||||
| Pre-Medicare | Medicare | Pre-Medicare | Medicare | Pre-Medicare | Medicare | ||||||
| Kaiser Permanente Medical and NVA Vision | Single Family |
$163.59 $432.28 |
$215.21 $567.74 |
$241.02 $635.47 |
|||||||
|
Single Medicare |
$78.13 $269.76
$168.90 |
$105.38 $365.90
$230.62 |
$119.01 $413.97
$261.48 |
||||||||
| BlueChoice HMO Medical and Davis Vision* | Single Family |
$154.23 $398.77 |
$202.01 $521.46 |
$225.89 $582.80 |
|||||||
|
Single Medicare |
$99.16 $313.65
$211.88 |
$130.50 $412.09
$278.30 |
$146.17 $461.31
$311.51 |
||||||||
| CareFirst BC Advantage Medical (POS) and Davis Vision* | Single Family |
$229.82 $584.06 |
$293.65 $744.18 |
$325.57 $824.23 |
|||||||
|
Single Medicare |
$159.29 $474.07
$344.58 |
$204.19 $604.30
$440.43 |
$226.64 $669.41
$488.36 |
||||||||
Contributions for EARLY Retired Employees and Survivors of Retired Employees (who retired ON OR AFTER January 1, 2019)
| Medical/Vision Plan | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Age 60-64 at Retirement | Age 55-59 at Retirement | Age 50-54 at Retirement | |||||||||
| Pre-Medicare | Medicare | Pre-Medicare | Medicare | Pre-Medicare | Medicare | ||||||
| Kaiser Permanente Medical and NVA Vision | Single Family |
$174.08 $460.58 |
$224.53 $592.90 |
$249.76 $659.05 |
|||||||
|
Single Medicare |
$88.73 $315.98
$201.01 |
$114.80 $406.98
$259.16 |
$127.83 $452.48
$288.24 |
||||||||
| BlueChoice HMO Medical and Davis Vision* | Single Family |
$161.76 $419.02 |
$208.70 $539.46 |
$232.17 $599.68 |
|||||||
|
Single Medicare |
$104.93 $334.06
$224.88 |
$135.62 $430.23
$289.85 |
$150.97 $478.31
$322.34 |
||||||||
| CareFirst BC Advantage Medical (POS) and Davis Vision* | Single Family |
$223.39 $565.22 |
$287.94 $727.43 |
$320.21 $808.53 |
|||||||
|
Single Medicare |
$155.94 $459.10
$336.22 |
$201.22 $590.99
$433.00 |
$223.86 $656.93
$481.39 |
||||||||
MetLife Term Life Insurance Rates - 2021
| Age Band | $10K | $35K | $50K | $75K | $100K | $150K | $200K | $250K | $300K | $400K | $500K |
|---|---|---|---|---|---|---|---|---|---|---|---|
| Less Than 25 | $0.45 | $1.58 | $2.25 | $3.38 | $4.50 | $6.75 | $9.00 | $11.25 | $13.50 | $18.00 | $22.50 |
| 25-29 | $0.54 | $1.89 | $2.70 | $4.05 | $5.40 | $8.10 | $10.80 | $13.50 | $16.20 | $21.60 | $27.00 |
| 30-34 | $0.72 | $2.52 | $3.60 | $5.40 | $7.20 | $10.80 | $14.40 | $18.00 | $21.60 | $28.80 | $36.00 |
| 35-39 | $0.81 | $2.84 | $4.05 | $6.08 | $8.10 | $12.15 | $16.20 | $20.25 | $24.30 | $32.40 | $40.50 |
| 40-44 | $0.90 | $3.15 | $4.50 | $6.75 | $9.00 | $13.50 | $18.00 | $22.50 | $27.00 | $36.00 | $45.00 |
| 45-49 | $1.44 | $5.04 | $7.20 | $10.80 | $14.40 | $21.60 | $28.80 | $36.00 | $43.20 | $57.60 | $72.00 |
| 50-54 | $2.30 | $8.05 | $11.50 | $17.25 | $23.00 | $34.50 | $46.00 | $57.50 | $69.00 | $92.00 | $115.00 |
| 55-59 | $3.74 | $13.09 | $18.70 | $28.05 | $37.40 | $56.10 | $74.80 | $93.50 | $112.20 | $149.60 | $187.00 |
| 60-64 | $5.56 | $19.46 | $27.80 | $41.70 | $55.60 | $83.40 | $111.20 | $139.00 | $166.80 | $222.40 | $278.00 |
