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 |