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
  1. The Consumer Choice Plan is administered by Blue Cross Blue Shield in Illinois, and UnitedHealthcare in all other states.
  2. 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
Premium
Imputed Income
Consumer Choice
Imputed Income Aetna International
Employee + Non-Tax-
Dependent Domestic Partner
$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 Premium Imputed Income Delta Dental Imputed Income Aetna International*
Employee + Non-Tax- Dependent Domestic Partner $20.00 + $23.00 $24.04 $41.05
Employee + Family $36.00 + $23.00 $24.04 $41.05
* Enrollment in the Aetna International Dental Plan is a combined enrollment with the Aetna International Medical Plan.
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- Dependent Domestic Partner $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+

$71.60

$162.40

$73.00

$163.80

 

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