Monthly Costs for Coverage
Note: Rates listed are monthly amounts, but your premiums will be deducted either weekly or bi-weekly depending on your pay schedule.
| HSA Yellow | Enrollment Tier | Total Premium | Wilbur-Ellis Pays | You Pay |
| Employee Only | $794.73 | $638.73 | $156.00 | |
| Employee + Spouse | $1,740.48 | $1,399.48 | $341.00 | |
| Employee + Child(ren) | $1,430.54 | $1,149.54 | $281.00 | |
| Employee + Family | $2,463.68 | $1,980.68 | $483.00 | |
| HSA Black | Enrollment Tier | Total Premium | Wilbur-Ellis Pays | You Pay |
| Employee Only | $765.04 | $672.04 | $93.00 | |
| Employee + Spouse | $1,675.44 | $1,470.44 | $205.00 | |
| Employee + Child(ren) | $1,377.07 | $1,209.07 | $168.00 | |
| Employee + Family | $2,371.61 | $2,081.61 | $290.00 | |
| Traditional PPO | Enrollment Tier | Total Premium | Wilbur-Ellis Pays | You Pay |
| Employee Only | $894.08 | $574.08 | $320.00 | |
| Employee + Spouse | $1,958.03 | $1,237.03 | $721.00 | |
| Employee + Child(ren) | $1,609.35 | $1,017.35 | $592.00 | |
| Employee + Family | $2,771.65 | $1,752.65 | $1,019.00 |
| Dental | Enrollment Tier | Total Premium | Wilbur-Ellis Pays | You Pay |
| Employee Only | $49.24 | $34.47 | $14.77 | |
| Employee + Spouse | $97.91 | $68.53 | $29.38 | |
| Employee + Child(ren) | $79.88 | $55.91 | $23.97 | |
| Employee + Family | $135.85 | $95.10 | $40.75 | |
| Vision | Enrollment Tier | Total Premium | Wilbur-Ellis Pays | You Pay |
| Employee Only | $8.60 | $4.30 | $4.30 | |
| Employee + Spouse | $13.87 | $6.93 | $6.94 | |
| Employee + Child(ren) | $14.17 | $7.09 | $7.08 | |
| Employee + Family | $23.39 | $11.69 | $11.70 |
| Plan | Cost |
|---|---|
| Basic Life | Wilbur-Ellis pays 100% of the premium cost for Employee Only coverage. |
| Basic AD&D | |
| Short-Term Disability | |
| Long-Term Disability |
| Supplemental Life Premiums | ||||
|---|---|---|---|---|
| Employee | Spouse/Domestic Partner | Child(ren) | ||
| Age | Cost per $1,000 of coverage |
Age | Cost per $1,000 of coverage |
Cost per $1,000 of coverage |
| Under 30 | $0.072 | Under 30 | $0.050 | $0.20 |
| 30-34 | $0.072 | 30-34 | $0.060 | |
| 35-39 | $0.097 | 35-39 | $0.090 | |
| 40-44 | $0.108 | 40-44 | $0.100 | |
| 45-49 | $0.162 | 45-49 | $0.150 | |
| 50-54 | $0.248 | 50-54 | $0.230 | |
| 55-59 | $0.464 | 55-59 | $0.430 | |
| 60-64 | $0.711 | 60-64 | $0.660 | |
| 65-69 | $1.239 | 65-69 | $1.150 | |
| 70 and up | $2.219 | 70 and up | $2.060 | |
| Supplemental AD&D Premiums |
|---|
| Employee Only |
| $0.04 per $1,000 of coverage |
| Enrollment Tier | You Pay |
|---|---|
| Employee Only | $4.40 |
| Employee + Spouse | $8.22 |
| Employee + Child(ren) | $13.10 |
| Employee + Family | $16.92 |
| Age | $10,000 | $20,000 | $30,000 | |||
|---|---|---|---|---|---|---|
| Employee | Spouse | Employee | Spouse | Employee | Spouse | |
| You Pay | You Pay | You Pay | ||||
| Under 25 | $1.50 | $1.50 | $3.00 | $3.00 | $4.50 | $4.50 |
| 25-29 | $2.10 | $2.10 | $4.20 | $4.20 | $6.30 | $6.30 |
| 30-34 | $3.10 | $3.10 | $6.20 | $6.20 | $9.30 | $9.30 |
| 35-39 | $4.20 | $4.20 | $8.40 | $8.40 | $12.60 | $12.60 |
| 40-44 | $6.00 | $6.00 | $12.00 | $12.00 | $18.00 | $18.00 |
| 45-49 | $9.20 | $9.20 | $18.40 | $18.40 | $27.60 | $27.60 |
| 50-54 | $13.60 | $13.60 | $27.20 | $27.20 | $40.80 | $40.80 |
| 55-59 | $18.90 | $18.90 | $37.80 | $37.80 | $56.70 | $56.70 |
| 60-64 | $27.10 | $27.10 | $54.20 | $54.20 | $81.30 | $81.30 |
| 65-69 | $39.30 | $39.30 | $78.60 | $78.60 | $117.90 | $117.90 |
| 70-74 | $57.60 | $57.60 | $115.20 | $115.20 | $172.80 | $172.80 |
| 75+ | $77.70 | $77.70 | $155.40 | $155.40 | $233.10 | $233.10 |
| Enrollment Tier | You Pay |
|---|---|
| Employee Only | $12.56 |
| Employee + Spouse | $28.84 |
| Employee + Child(ren) | $20.64 |
| Employee + Family | $36.92 |