2021 Premiums
Medical
Active Employees
If you enroll in coverage for yourself and your dependents, including a domestic partner who is your tax dependent, your medical premiums are deducted before taxes from the first and second paycheck of each month.
2021 Medical Monthly Premiums Deducted before-tax |
||
---|---|---|
Coverage Level | Consumer Choice Plan1 | Aetna International Medical Plan2 (Expat Only) |
Employee Only | $147.50 | $147.50 |
Employee + Spouse or Tax-Dependent Domestic Partner |
$340.50 | $340.50 |
Employee + Child(ren) | $281.00 | $281.00 |
Employee + Family | $428.50 | $428.50 |
- The Consumer Choice Plan is administered by Blue Cross Blue Shield in Illinois, and UnitedHealthcare in all other states.
- Enrollment in the Aetna International Medical Plan is a combined enrollment with the Aetna International Dental Plan.
Non-Tax Dependent Domestic Partner
If you enroll a non-tax dependent domestic partner, their premiums are deducted from your pay after taxes. The BMO-paid portion of your partner’s premium is considered imputed income, so you pay FICA and income taxes on that amount.
2021 Medical Monthly Premiums Deducted after-tax |
|||||
---|---|---|---|---|---|
Coverage Level | Before-Tax Premium | After-Tax |
Imputed Income Consumer Choice |
Imputed Income Aetna International | |
Employee + Non-Tax- |
$147.50 | + | $193.00 | $586.13 | $1,158.68 |
Employee + Family | $235.50 | + | $193.00 | $586.13 | $1,158.68 |
Dental
Active Employees
If you enroll in coverage for yourself and your dependents, including a domestic partner who is your tax dependent, your dental premiums are deducted before taxes from the first and second paycheck of each month.
2021 Dental Monthly Premiums Deducted before-tax | ||
---|---|---|
Coverage Level | Delta Dental | Aetna International Dental Plan (Expat Only) |
Employee Only | $20.00 | $20.00 |
Employee + Spouse or Tax-Dependent Domestic Partner | $43.00 | $43.00 |
Employee + Child(ren) | $45.00 | $45.00 |
Employee + Family | $59.00 | $59.00 |
Enrollment in the Aetna International Dental Plan is a combined enrollment with the Aetna International Medical Plan.
Non-Tax Dependent Domestic Partner
If you enroll a non-tax dependent domestic partner, their premiums are deducted from your pay after taxes. The BMO-paid portion of your partner’s premium is considered imputed income, so you pay FICA and income taxes on that amount.
2021 Dental Monthly Premiums Deducted after-tax | |||||
---|---|---|---|---|---|
Coverage Level | Before-Tax Premium | After-Tax
|
Imputed Income Delta Dental | Imputed Income Aetna International* | |
Employee + Non-Tax-
|
$20.00 | + | $23.00 | $24.04 | $41.05 |
Employee + Family | $36.00 | + | $23.00 | $24.04 | $41.05 |
Vision
Active Employees
If you enroll in coverage for yourself and your dependents, including a domestic partner who is your tax dependent, your vision premiums are deducted before taxes from the first and second paycheck of each month.
2021 Vision Monthly Premiums Deducted before-tax | |
---|---|
Coverage Level | VSP |
Employee Only | $7.46 |
Employee + Spouse or
Tax-Dependent Domestic Partner |
$14.88 |
Employee + Child(ren) | $15.90 |
Employee + Family | $25.44 |
Non-Tax Dependent Domestic Partner
If you enroll a non-tax dependent domestic partner, their premiums are deducted from your pay after taxes.
2021 Vision Monthly Premiums Deducted after-tax | ||||
---|---|---|---|---|
Coverage Level | Before-Tax Premium | After-Tax Premium | Imputed Income | |
Employee + Non-Tax-
|
$7.46 | + | $7.42 | N/A |
Employee + Family | $18.02 | + | $7.42 | N/A |
Supplemental Life Insurance
If you enroll in Supplemental Life or Family Life insurance, the premium is deducted from the first and second paycheck of each month.
Supplemental Life Insurance
2021 Supplemental Life Insurance Monthly Premiums
Deducted after-tax
|
||
---|---|---|
Age | Non-Smoker Rate per $1,000 of coverage |
Smoker Rate per $1,000 of coverage |
Under 25 | $0.039 | $0.050 |
25-29 | $0.039 | $0.060 |
30-34 | $0.049 | $0.080 |
35-39 | $0.068 | $0.107 |
40-44 | $0.088 | $0.155 |
45-49 | $0.127 | $0.213 |
50-54 | $0.205 | $0.398 |
55-59 | $0.381 | $0.679 |
60-64 | $0.576 | $1.067 |
65-69 | $1.103 | $2.008 |
70+ | $1.796 | $3.250 |
Family Life
2021 Family Life Insurance Monthly Premiums
Deducted after-tax
|
|||
---|---|---|---|
Coverage for Spouse | Premium | Coverage for Child(ren) | Premium |
$12,000 | $2.180 | $3,000 | $0.500 |
$24,000 | $4.380 | $6,000 | $1.020 |
$36,000 | $6.560 | $9,000 | $1.540 |
The total amount of Family Life insurance for all dependents cannot exceed 100% of your combined Basic and Supplemental Life insurance.
Long-Term Disability
If you enroll in Supplemental Long Term Disability (LTD) coverage, the premium is deducted from the first and second paycheck of each month.
2021 Supplemental Disability Monthly Premium Deducted before-tax |
|
---|---|
Coverage Level | Your Cost |
Additional 15% of base pay (75% total) | $0.084 (annual premium per $100 of annual base pay) |
Accident Insurance
If you enroll in voluntary Accident Insurance, the premium is deducted after-tax from the first and second paycheck of each month.
2021 Accident Insurance Monthly Premiums Deducted after-tax | ||
---|---|---|
Coverage Level | High Plan | Low Plan |
Employee Only | $5.88 | $2.98 |
Employee + Spouse | $11.60 | $5.48 |
Employee + Child(ren) | $12.10 | $6.22 |
Employee + Family | $17.82 | $8.72 |
Critical Illness Insurance
If you enroll in voluntary Critical Illness Insurance, the premium is deducted after-tax from the first and second paycheck of each month. The premium is based on your benefit amount and smoker/non-smoker status.
2021 Critical Illness Insurance Monthly Premiums $10,000 benefit amount Deducted after-tax | ||||
---|---|---|---|---|
Non-Smoker | ||||
Age |
Employee |
Employee + Spouse |
Employee + Children |
Employee + Family |
Under 25 |
$3.60 |
$7.80 |
$4.30 |
$8.50 |
25-29 |
$4.00 |
$8.40 |
$4.70 |
$9.10 |
30-34 |
$4.60 |
$10.00 |
$5.30 |
$10.70 |
35-39 |
$5.60 |
$12.00 |
$6.30 |
$12.70 |
40-44 |
$7.80 |
$17.40 |
$8.50 |
$18.10 |
45-49 |
$12.00 |
$26.80 |
$12.70 |
$27.50 |
50-54 |
$18.80 |
$38.60 |
$19.50 |
$39.30 |
55-59 |
$21.60 |
$46.00 |
$22.30 |
$46.70 |
60-64 |
$25.20 |
$57.40 |
$25.90 |
$58.10 |
65-69 |
$26.40 |
$64.20 |
$27.10 |
$64.90 |
70+ |
$35.80 |
$81.20 |
$36.50 |
$81.90 |
2021 Critical Illness Insurance Monthly Premiums $10,000 benefit amount Deducted after-tax | ||||
---|---|---|---|---|
Smoker | ||||
Age |
Employee |
Employee + Spouse |
Employee + Children |
Employee + Family |
Under 25 |
$5.80 |
$12.60 |
$6.50 |
$13.30 |
25-29 |
$6.20 |
$13.40 |
$6.90 |
$14.10 |
30-34 |
$7.00 |
$15.60 |
$7.70 |
$16.30 |
35-39 |
$8.40 |
$18.60 |
$9.10 |
$19.30 |
40-44 |
$15.40 |
$31.20 |
$16.10 |
$31.90 |
45-49 |
$27.20 |
$60.80 |
$27.90 |
$61.50 |
50-54 |
$31.60 |
$73.80 |
$32.30 |
$74.50 |
55-59 |
$36.80 |
$92.80 |
$37.50 |
$93.50 |
60-64 |
$40.20 |
$113.00 |
$40.90 |
$113.70 |
65-69 |
$45.20 |
$125.40 |
$45.90 |
$126.10 |
70+ |
$51.80 |
$139.00 |
$52.50 |
$139.70 |
2021 Critical Illness Insurance Monthly Premiums $20,000 benefit amount Deducted after-tax | ||||
---|---|---|---|---|
Non-Smoker | ||||
Age |
Employee |
Employee + Spouse |
Employee + Children |
Employee + Family |
Under 25 |
$7.20 |
$15.60 |
$8.60 |
$17.00 |
25-29 |
$8.00 |
$16.80 |
$9.40 |
$18.20 |
30-34 |
$9.20 |
$20.00 |
$10.60 |
$21.40 |
35-39 |
$11.20 |
$24.00 |
$12.60 |
$25.40 |
40-44 |
$15.60 |
$34.80 |
$17.00 |
$36.20 |
45-49 |
$24.00 |
$53.60 |
$25.40 |
$55.00 |
50-54 |
$37.60 |
$77.20 |
$39.00 |
$78.60 |
55-59 |
$43.20 |
$92.00 |
$44.60 |
$93.40 |
60-64 |
$50.40 |
$114.80 |
$51.80 |
$116.20 |
65-69 |
$52.80 |
$128.40 |
$54.20 |
$129.80 |
70+ |
$35.80 |
$81.20 |
$36.50 |
$81.90 |
2021 Critical Illness Insurance Monthly Premiums $20,000 benefit amount Deducted after-tax | ||||
---|---|---|---|---|
Smoker | ||||
Age |
Employee |
Employee + Spouse |
Employee + Children |
Employee + Family |
Under 25 |
$11.60 |
$25.20 |
$13.00 |
$26.60 |
25-29 |
$12.40 |
$26.80 |
$13.80 |
$28.20 |
30-34 |
$14.00 |
$31.20 |
$15.40 |
$32.60 |
35-39 |
$16.80 |
$37.20 |
$18.20 |
$38.60 |
40-44 |
$30.80 |
$62.40 |
$32.20 |
$63.80 |
45-49 |
$54.40 |
$121.60 |
$55.80 |
$123.00 |
50-54 |
$63.20 |
$147.60 |
$64.60 |
$149.00 |
55-59 |
$73.60 |
$185.60 |
$75.00 |
$187.00 |
60-64 |
$80.40 |
$226.00 |
$81.80 |
$227.40 |
65-69 |
$90.40 |
$250.80 |
$91.80 |
$252.20 |
70+ |
$103.60 |
$278.00 |
$105.00 |
$279.40 |
Hospital Indemnity Insurance
If you enroll in voluntary Hospital Indemnity Insurance, the premium is deducted after-tax from the first and second paycheck of each month.
2021 Hospital Indemnity Insurance Monthly Premiums Deducted after-tax | ||
---|---|---|
Coverage Level | High Plan | Low Plan |
Employee Only | $15.72 | $7.34 |
Employee + Spouse | $33.70 | $15.92 |
Employee + Child(ren) | $30.64 | $14.82 |
Employee + Family | $48.62 | $23.40 |
Legal Insurance
If you enroll in voluntary Legal Insurance, the premium is deducted after-tax from the first and second paycheck of each month.
2021 Legal Insurance Monthly Premium Deducted after-tax | |
---|---|
Option | Your Cost |
ARAG Group Legal | $20.04 |