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
|
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
|
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 |
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.