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Non-Medical Premium Rates (Food Services)

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

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 $1.73 $3.29 $4.84
Delta Comprehensive Dental $9.08 $20.88 $22.71 $37.04
Delta Basic Dental $4.33 $8.67 $9.12 $15.11
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 $1.31 $2.47 $3.63
Delta Comprehensive Dental $6.81 $15.67 $17.03 $27.79
Delta Basic Dental $3.25 $6.51 $6.84 $11.33
If you earn less than $39,500.
(EE 20% - APS 80% of Total Premium)
PlanSingleTwo-PartyEE + SpouseEE + Child(ren)Family
Davis Vision $0.87 $1.65 $2.41
Delta Comprehensive Dental $4.53 $10.44 $11.35 $18.52
Delta Basic Dental $2.16 $4.33 $4.56 $7.55

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 $0.042
30-34 $0.057
35-39 $0.065
40-44 $0.072
45-49 $0.113
50-54 $0.151
55-59 $0.275
60-64 $0.419
65-69 $0.789
70+ $1.273

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 $0.113 (Rate for Age Band 45-49) = $11.30
  3. Calculate the Employee Cost Share: $11.30 x 50% = $5.65 bimonthly

The Standard Long-Term Disability

Long Term Disability Coverage Rates
CoverageRates
60% $0.171

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 $0.171 = $6.40 Plan Rate
  4. Calculate Employee Cost Share: $6.40 x 40% = $2.56 bimonthly