Medical (Monthly)

January 1, 2025 – December 31, 2025

For more information about Domestic Partner (DP) rates, view the Domestic Partner After Tax Contributions and Imputed Income resource.

		Total Cost	Employer Cost	Employee Cost
Cigna OAP 750 Rate
	Employee Only	$1,029.50	$874.50	$155.00
	Employee and Spouse	$2,264.92	$1,864.92	$400.00
	Employee and Child(ren)	$1,853.11	$1,523.11	$330.00
	Employee and Family	$3,191.47	$2,656.47	$535.00

		Total Cost	Employer Cost	Employee Cost
Cigna HDHP Rate
	Employee Only	$850.53	$762.53	$88.00
	Employee and Spouse	$1,871.16	$1,621.16	$250.00
	Employee and Child(ren)	$1,530.96	$1,345.96	$185.00
	Employee and Family	$2,636.65	$2,316.65	$320.00

		Total Cost	Employer Cost	Employee Cost
Kaiser Traditional HMO (CA) Rate
	Employee Only	$742.27	$657.27	$85.00
	Employee and Spouse	$1,633.00	$1,398.00	$235.00
	Employee and Child(ren)	$1,484.54	$1,304.54	$180.00
	Employee and Family	$2,226.81	$1,911.81	$315.00

		Total Cost	Employer Cost	Employee Cost
Kaiser Traditional HMO (CO) Rate
	Employee Only	$593.38	$513.38	$80.00
	Employee and Spouse	$1,305.44	$1,075.44	$230.00
	Employee and Child(ren)	$1,186.76	$1,011.76	$175.00
	Employee and Family	$1,780.14	$1,470.14	$310.00

Dental (Monthly)

		Total Cost	Employer Cost	Employee Cost
Cigna Dental PPO Base Plan Rate
	Employee Only	$40.65	$30.65	$10.00
	Employee and Spouse	$81.17	$61.17	$20.00
	Employee and Child(ren)	$96.56	$73.56	$23.00
	Employee and Family	$137.09	$104.09	$33.00

		Total Cost	Employer Cost	Employee Cost
Cigna Dental PPO Buy-Up Plan Rate
	Employee Only	$52.22	$36.22	$16.00
	Employee and Spouse	$104.04	$73.04	$31.00
	Employee and Child(ren)	$123.68	$86.68	$37.00
	Employee and Family	$175.53	$122.53	$53.00

Vision (Monthly)

		Total Cost	Employer Cost	Employee Cost
VSP Vision PPO Rate
	Employee Only	$8.40	$6.86	$1.54
	Employee and Spouse	$14.41	$11.77	$2.64
	Employee and Child(ren)	$14.72	$12.02	$2.70
	Employee and Family	$23.74	$19.38	$4.36

Critical Illness — Low Plan $10,000 Coverage (Monthly)

Age Band	EE only	EE + Spouse	EE + Child(ren)	EE + Family
0-24	$1.62	$4.23	$1.62	$4.23
25-29	$2.11	$5.21	$2.11	$5.21
30-34	$3.02	$7.02	$3.02	$7.02
35-39	$4.38	$9.74	$4.38	$9.74
40-44	$6.59	$14.17	$6.59	$14.17
45-49	$9.12	$19.23	$9.12	$19.23
50-54	$13.57	$28.19	$13.57	$28.19
55-59	$19.52	$40.11	$19.52	$40.11
60-64	$28.71	$58.55	$28.71	$58.55
65-69	$39.36	$79.89	$39.36	$79.89
70-74	$55.12	$111.45	$55.12	$111.45
75+	$55.12	$138.40	$55.12	$138.40

Critical Illness — High Plan $20,000 Coverage (Monthly)

Age Band	EE only	EE + Spouse	EE + Child(ren)	EE + Family
0-24	$3.24	$8.46	$3.24	$8.46
25-29	$4.22	$10.42	$4.22	$10.42
30-34	$6.04	$14.04	$6.04	$14.04
35-39	$8.76	$19.48	$8.76	$19.48
40-44	$13.18	$28.34	$13.18	$28.34
45-49	$18.24	$38.46	$18.24	$38.46
50-54	$27.14	$56.38	$27.14	$56.38
55-59	$39.04	$80.22	$39.04	$80.22
60-64	$57.42	$117.10	$57.42	$117.10
65-69	$78.72	$159.78	$78.72	$159.78
70-74	$110.24	$222.90	$110.24	$222.90
75+	$110.24	$276.80	$110.24	$276.80

Critical Illness — High Plan $30,000 Coverage (Monthly)

Critical Illness	High Plan ($30,000 Coverage)
Age Band	EE only	EE + Spouse	EE + Children	Family
0-24	$4.86	$12.69	$4.86	$12.69
25-29	$6.33	$15.63	$6.33	$15.63
30-34	$9.06	$21.06	$9.06	$21.06
35-39	$13.14	$29.22	$13.14	$29.22
40-44	$19.77	$42.51	$19.77	$42.51
45-49	$27.36	$57.69	$27.36	$57.69
50-54	$40.71	$84.57	$40.71	$84.57
55-59	$58.56	$120.33	$58.56	$120.33
60-64	$86.13	$175.65	$86.13	$175.65
65-69	$118.08	$239.67	$118.08	$239.67
70-74	$165.36	$334.35	$165.36	$334.35
75+	$165.36	$415.20	$165.36	$415.20

Accident Insurance (Monthly)

	Low Plan	High Plan
EE only	$3.99	$5.83
EE + Spouse	$7.98	$11.66
EE + Child(ren)	$8.38	$12.25
EE + Family	$12.36	$18.08

Hospital Indemnity Insurance (Monthly)

Hospital Indemnity	Monthly Cost
EE only	$13.86
EE + Spouse	$35.33
EE + Child(ren)	$26.93
EE + Family	$48.40

Supplemental Life Insurance (Monthly)

Employee and Spouse
Age Band	Rate per $1,000 of Coverage
0-24	$0.04
25-29	$0.04
30-34	$0.05
35-39	$0.07
40-44	$0.10
45-49	$0.15
50-54	$0.23
55-59	$0.41
60-64	$0.66
65-69	$1.10
70-74	$1.81
75+	$2.06

Dependent Child
$0.17 per $1,000 of Coverage

Supplemental AD&D Insurance (Monthly)

Employee and Spouse
Age Band	Rate per $1,000 of Coverage
0-24	$0.04
25-29	$0.04
30-34	$0.05
35-39	$0.07
40-44	$0.10
45-49	$0.15
50-54	$0.23
55-59	$0.41
60-64	$0.66
65-69	$1.10
70-74	$1.81
75+	$2.06

EE + Family
$0.04 per $1,000 of Coverage

* Total supplemental AD&D costs combined for employee, spouse, and/or child coverage as applicable.

Identity Theft (Monthly)

EE only	$6.50
EE + Family	$12.50