Cost of Coverage 2022/2023

This guide is intended to provide a brief summary of your benefits costs. If there is a discrepancy between this guide and the official plan documents, the plan documents will govern.

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Medical

Anthem Bronze Plan

Medical Plans Bi-Weekly
Associate Only $59.34
Associate + Spouse or Domestic Partner** $208.47
Associate + Child(ren) $180.86
Associate + Family $289.38

Anthem Consumer Choice Plan* (with HSA)

Medical Plans Bi-Weekly
Associate Only $78.20
Associate + Spouse or Domestic Partner** $253.54
Associate + Child(ren) $219.97
Associate + Family $351.96

Anthem Gold PPO

Medical Plans Bi-Weekly
Associate Only $154.10
Associate + Spouse or Domestic Partner** $584.39
Associate + Child(ren) $382.30
Associate + Family $811.21

Kaiser Permanente – California, Washington & Virginia ONLY

Medical Plans Bi-Weekly
Associate Only $132.39
Associate + Spouse or Domestic Partner** $356.82
Associate + Child(ren) $319.42
Associate + Family $509.45

 


*When you enroll in the Consumer Choice medical plan, the company will help boost your health savings account with a company contribution of $50 per month.

**Cost of coverage for a Domestic Partner and/or a Domestic Partner’s children is subject to federal and state taxes.

Dental

Dental HMO

Dental Plan Options Bi-Weekly
Associate Only $5.19
Associate + Spouse or Domestic Partner** $10.24
Associate + Child(ren) $8.66
Associate + Family $14.42

Dental PPO

Dental Plan Options Bi-Weekly
Associate Only $9.68
Associate + Spouse or Domestic Partner** $19.28
Associate + Child(ren) $25.62
Associate + Family $35.12

**Cost of coverage for a Domestic Partner and/or a Domestic Partner’s children is subject to federal and state taxes.

Vision

Vision Service Plan (VSP) Bi-Weekly
Associate Only $1.98
Associate + Spouse or Domestic Partner** $3.97
Associate + Child(ren) $4.25
Associate + Family $6.80

**Cost of coverage for a Domestic Partner and/or a Domestic Partner’s children is subject to federal and state taxes.

Voluntary Life & Accident Death & Dismemberment (AD&D)

Provides financial protection in the event that the policyholder dies.

Silverado provides Basic Life and AD&D insurance of 1X’s your annual salary. You may purchase additional life and AD&D insurance as indicated below. The cost for child life insurance coverage is $0.33 bi-weekly. This rate covers all eligible children. From birth – 6 months have a max benefit of $500. Children 6 months – 26 (w/student extension) have a max benefit of $5000. *Guarantee issue, age and maximums may apply.

Associate or Spouse Life Insurance Rate (rates per $1,000 of coverage)

Associate or Spouse Age Bi-Weekly
<29 $0.0470
30 to 34 $0.0620
35 to 39 $0.0700
40 to 44 $0.1000
45 to 49 $0.1500
50 to 54 $0.2300
55 to 59 $0.4290
60 to 64 $0.6550
65 to 69 $1.1000
*70 to 74 $1.7010
*75+ $2.0600

To calculate the cost of your voluntary life coverage:

  1. Find your age tier (or your spouse’s age)
  2. Determine your coverage amount
  3. Multiply your coverage amount by the age rate to get your per-pay-period deduction amount

Example of a 30 year old electing $150,000:

  1. Age 30 rate = $0.0620 (bi-weekly)
  2. $0.0620 x 150 = $9.30 bi-weekly

*Spouse life available until age 69.

Voluntary Long-Term Disability (LTD) Insurance

Silverado provides Long-Term Disability coverage of 40% of eligible salary. You can choose to purchase additional coverage up to 60% of salary up to a maximum of $5,000 per month. Buy up cost is $0.368 per $100 of covered salary per month.

Voluntary Short-Term Disability (LTD) Insurance

You may purchase Voluntary Short-Term Disability coverage for yourself.

Associate or Spouse Age Bi-Weekly
<25 $1.8100
25 to 29 $2.4500
30 to 34 $2.2500
35 to 39 $1.1300
40 to 44 $0.7500
45 to 49 $0.6300
50 to 54 $0.7200
55 to 59 $0.8300
60 to 64 $0.8500
65-69 $1.1800
70+ $1.1800

To calculate the cost of your voluntary life coverage:

  1. Find your age tier (or your spouse’s age)
  2. Determine your coverage amount
  3. Multiply your coverage amount by the age rate to get your per-pay-period deduction amount

Example of a 40 year old with a $25,000 annual income:
Weekly benefit $480.77, 50% benefit amount $240.38

  1. Age 40 rate = $0.6240 (bi-weekly)
  2. $0.624 x 24.038 = $14.99 bi-weekly

Critical Illness Insurance

Pays cash directly to you after diagnosis of a covered critical illness to use any way you choose.

Bi-weekly Premium for $10,000 of Coverage (non-tobacco)

Issue Age Associate Only Associate + Spouse Associate + Child(ren) Associate + Family
<25 $1.65 $2.95 $3.15 $4.50
25 – 29 $1.70 $3.15 $3.25 $4.70
30 – 34 $2.20 $4.00 $3.75 $5.50
35 – 39 $3.20 $5.55 $4.70 $7.10
40 – 44 $4.90 $8.15 $6.45 $9.70
45 – 49 $6.60 $11.20 $8.15 $12.75
50 – 54 $9.70 $16.20 $11.20 $17.70
55 – 59 $12.45 $21.50 $13.95 $23.05
60 – 64 $16.85 $29.85 $18.35 $31.40
65 – 69 $23.90 $42.95 $25.40 $44.45
70+ $36.25 $63.65 $37.75 $65.15

Bi-weekly Premium for $20,000 of Coverage (non-tobacco)

Issue Age Associate Only Associate + Spouse Associate + Child(ren) Associate + Family
<25 $3.30 $5.90 $6.30 $9.00
25 – 29 $3.40 $6.30 $6.50 $9.40
30 – 34 $4.40 $8.00 $7.50 $11.00
35 – 39 $6.40 $11.10 $9.40 $14.20
40 – 44 $9.80 $16.30 $12.90 $19.40
45 – 49 $13.20 $22.40 $16.30 $25.50
50 – 54 $19.40 $32.40 $22.40 $35.40
55 – 59 $24.90 $43.00 $27.90 $46.10
60 – 64 $33.70 $59.70 $36.70 $62.80
65 – 69 $47.80 $85.90 $50.80 $88.90
70+ $72.50 $127.30 $75.50 $130.30


Bi-Weekly Premium for $30,000 of Coverage (non-tobacco)

Issue Age Associate Only Associate + Spouse Associate + Child(ren) Associate + Family
<25 $4.95 $8.85 $9.45 $13.50
25 – 29 $5.10 $9.45 $9.75 $14.10
30 – 34 $6.60 $12.00 $11.25 $16.50
35 – 39 $9.60 $16.65 $14.40 $21.30
40 – 44 $14.70 $24.45 $19.35 $29.10
45 – 49 $19.80 $33.60 $24.45 $38.25
50 – 54 $29.10 $48.60 $33.60 $53.10
55 – 59 $37.35 $64.50 $41.85 $69.15
60 – 64 $50.55 $89.55 $55.05 $94.20
65 – 69 $71.70 $128.85 $76.20 $133.35
70+ $108.75 $190.95 $113.25 $195.45

▪Tobacco users are subject to higher premiums.

Accident Insurance

Pays cash directly to you after a covered accident occurs to use any way you choose.

Coverage Level Bi-Weekly
Associate Only $5.39
Associate + Spouse or Domestic Partner** $9.29
Associate + Child(ren) $9.52
Associate + Family $11.70

Hospital Indemnity Insurance

Pays cash directly to you after a covered accident occurs to use any way you choose.

Coverage Level Bi-Weekly
Associate Only $16.24
Associate + Spouse or Domestic Partner** $30.55
Associate + Child(ren) $25.21
Associate + Family $41.67

Legal Insurance

Coverage Level Bi-Weekly
Covers Associate, Spouse and Dependents $9.00