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Non-Medical Premium Rates

Non-Medical Premium Rates (dental, vision, life insurance and long-term disability), effective January 1, 2021.

Download the Non-Medical Premium Rate Sheet (PDF)

Bimonthly Payroll Deductions

If you earn $45,000 or more.
(EE 40% - APS 60% of Total Premium)
PlanSingleTwo-PartyEE + SpouseEE + Child(ren)Family
Davis Vision $1.30 $2.47 — — $3.63
Delta Comprehensive Dental $6.81 — $15.66 $17.03 $27.78
Delta Basic Dental $3.25 — $6.50 $6.84 $11.33
If you earn $39,500 to $44,999 or more.
(EE 30% - APS 70% of Total Premium)
PlanSingleTwo-PartyEE + SpouseEE + Child(ren)Family
Davis Vision $0.98 $1.85 — — $2.72
Delta Comprehensive Dental $5.11 — $11.75 $12.77 $20.84
Delta Basic Dental $2.44 — $4.88 $5.13 $8.50
If you earn less than $39,500.
(EE 20% - APS 80% of Total Premium)
PlanSingleTwo-PartyEE + SpouseEE + Child(ren)Family
Davis Vision $0.65 $1.24 — — $1.81
Delta Comprehensive Dental $3.40 — $7.83 $8.51 $13.89
Delta Basic Dental $1.62 — $3.25 $3.42 $5.66

The Standard Life and AD&D Insurance

Coverage is available in increments of $10,000 from $10,000 up to $400,000. Please see the Dependent Life Worksheet for Dependent Life Insurance Options.

Basic Life Coverage for $10,000 – 100% Employer Paid
Additional Life Coverage
Age Bands		Rates per
$1,000 Coverage
<30 $0.032
30-34 $0.043
35-39 $0.049
40-44 $0.054
45-49 $0.085
50-54 $0.114
55-59 $0.206
60-64 $0.315
65-69 $0.592
70+ $0.995

How to Calculate Rates

To calculate your Life bimonthly payroll deduction, follow these steps: 

  1. Enter the amount of coverage
  2. Divide by 1,000 (for the number of units of $1,000)
  3. Multiply by the rate for Employee's age group to get the Employee Life Insurance total bimonthly premium
  4. Multiply total premium by employee cost share of 50%

For example: $100,000 Coverage, Age 46

  1. Calculate the Units: $100,000 (Amount of Coverage) divided by $1,000 = 100 Units.
  2. Calculate the Premium: 100 Units x $0.085 (Rate for Age Band 45-49) = $8.50
  3. Calculate the Employee Cost Share: $8.50 x 50% = $4.25 bimonthly

The Standard Long-Term Disability

Long-Term Disability Coverage Rates
CoverageRates
60% $0.128

How to Calculate Rates

To calculate your Long-Term Disability bimonthly payroll deduction, follow these steps: 

  1. Enter Contracted Annual Salary but not more than $100,000
  2. Divide Salary by 12 to get Monthly Salary
  3. Divide Monthly Salary by 100
  4. Multiply by plan rate
  5. Multiply total premium by employee cost share percentage
    • 40% if you earn $45,000 or more
    • 30% if you earn $39,500 to $44,999
    • 20% if you earn less than $39,500

For example: $45,000 Yearly Salary, 60% Coverage

  1. Calculate Monthly Salary: $45,000 (Yearly) divided by 12 = $3,750 (Monthly)
  2. Calculate Units: $3,750 (Monthly) divided by 100 = $37.50 Units
  3. Calculate Plan Rate: $37.50 Units x $0.128 = $4.80 Plan Rate
  4. Calculate Employee Cost Share: $4.80 x 40% = $1.92 bimonthly