EMPLOYEE COSTS – Per Pay Period (26) Medical/Rx/Vision With Wellness
Medical/Rx/Vision Without Wellness
Dental
Employee Only
$0.00
$42.00
$0.00
Employee & Spouse
$123.00
$204.00
$13.07
Employee & Child(ren)
$68.00
$102.00
$15.19
Family
$169.00
$277.00
$18.23
Employee Voluntary Term Life
Amount $10,000 $20,000 $30,000 $40,000 $50,000 $60,000 $70,000 $80,000 $90,000 $100,000 $110,000 $120,000 $130,000 $140,000 $150,000 $160,000 $170,000 $180,000 $190,000 $200,000 Amount $20,000 $25,000 $30,000 $40,000 $50,000
Under 30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75+ $0.28 $0.37 $0.51 $0.78 $1.34 $1.94 $3.60 $4.57 $7.80 $15.00 $20.77 $0.55 $0.74 $1.02 $1.57 $2.68 $3.88 $7.20 $9.14 $15.60 $30.00 $41.54 $0.83 $1.11 $1.52 $2.35 $4.02 $5.82 $10.80 $13.71 $23.40 $45.00 $62.31 $1.11 $1.48 $2.03 $3.14 $5.35 $7.75 $14.40 $18.28 $31.20 $60.00 $83.08 $1.38 $1.85 $2.54 $3.92 $6.69 $9.69 $18.00 $22.85 $39.00 $75.00 $103.85 $1.66 $2.22 $3.05 $4.71 $8.03 $11.63 $21.60 $27.42 $46.80 $90.00 $124.62 $1.94 $2.58 $3.55 $5.49 $9.37 $13.57 $25.20 $31.98 $54.60 $105.00 $145.38 $2.22 $2.95 $4.06 $6.28 $10.71 $15.51 $28.80 $36.55 $62.40 $120.00 $166.15 $2.49 $3.32 $4.57 $7.06 $12.05 $17.45 $32.40 $41.12 $70.20 $135.00 $186.92 $2.77 $3.69 $5.08 $7.85 $13.39 $19.39 $36.00 $45.69 $78.00 $150.00 $207.69 $3.05 $4.06 $5.58 $8.63 $14.72 $21.32 $39.60 $50.26 $85.80 $165.00 $228.46 $3.32 $4.43 $6.09 $9.42 $16.06 $23.26 $43.20 $54.83 $93.60 $180.00 $249.23 $3.60 $4.80 $6.60 $10.20 $17.40 $25.20 $46.80 $59.40 $101.40 $195.00 $270.00 $3.88 $5.17 $7.11 $10.98 $18.74 $27.14 $50.40 $63.97 $109.20 $210.00 $290.77 $4.15 $5.54 $7.62 $11.77 $20.08 $29.08 $54.00 $68.54 $117.00 $225.00 $311.54 $4.43 $5.91 $8.12 $12.55 $21.42 $31.02 $57.60 $73.11 $124.80 $240.00 $332.31 $4.71 $6.28 $8.63 $13.34 $22.75 $32.95 $61.20 $77.68 $132.60 $255.00 $353.08 $4.98 $6.65 $9.14 $14.12 $24.09 $34.89 $64.80 $82.25 $140.40 $270.00 $373.85 $5.26 $7.01 $9.65 $14.91 $25.43 $36.83 $68.40 $86.81 $148.20 $285.00 $394.61 $5.54 $7.38 $10.15 $15.69 $26.77 $38.77 $72.00 $91.38 $156.00 $300.00 $415.38 Spouse Voluntary Term Life
Under 30 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69
$0.55 $0.69 $0.83 $1.11 $1.38
$0.74 $1.02 $0.92 $1.27 $1.11 $1.52 $1.48 $2.03 $1.85 $2.54
$1.57 $1.96 $2.35 $3.14 $3.92
$2.68 $3.35 $4.02 $5.35 $6.69
$3.88 $4.85 $5.82 $7.75 $9.69
$7.20 $9.00
$9.14
$15.60
$11.42 $19.50
$10.80 $13.71 $23.40 $14.40 $18.28 $31.20 $18.00 $22.85 $39.00
Cancer Low
Cancer High
Accident
Child Voluntary Term Life
Employee Only
$8.09
$7.13
$13.78
Live Birth to 6-months 6-months to age 26
Employee & Spouse
$13.22
$12.25
$22.87
Employee & Child(ren)
$14.38
$12.25
$22.87
$1,000 Policy $0.92
$10,000 Policy $0.92
Family
$19.51
$12.25
$22.87
Hospital Confinement
Age
Employee Only Employee & Spouse Employee & Children Family
17-49 50-59 60-64
$9.40
$17.37 $25.09 $30.92 $36.50
$15.25 $18.77 $21.25 $23.74
$23.22 $30.94 $36.77 $42.35
$12.92 $15.40 $17.89
65+
CONMB Employee Benefit Guide 2025
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