Medical premiums are deducted pre-tax from your pay semi-monthly, except for premiums for domestic partners and their children, which are deducted after-tax.

The amount you save as a LifeForce participant will be credited to your pay and reflected as a medical credit in your pay.  

For COBRA rates, see the COBRA Benefits Guide.

$500 PPO plans

Aetna broad network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $116.08 $11.61 $23.21 $34.82 $46.43
$53,000 - $136,999 $136.57 $13.66 $27.31 $40.97 $54.63
>$137,000 $157.06 $15.71 $31.41 $47.12 $62.83
Teammate and spouse or domestic partner $0 - $52,999 $355.65 $35.57 $71.13 $106.69 $142.26
$53,000 - $136,999 $418.41 $41.84 $83.68 $125.52 $167.36
>$137,000 $481.17 $48.11 $96.23 $144.35 $192.46
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $298.78 $29.88 $59.76 $89.64 $119.51
$53,000 - $136,999 $351.50 $35.15 $70.30 $105.45 $140.60
>$137,000 $404.23 $40.43 $80.85 $121.27 $161.69
Family $0 - $52,999 $596.53 $59.65 $119.31 $178.96 $238.61
$53,000 - $136,999 $701.80 $70.18 $140.36 $210.54 $280.72
>$137,000 $807.07 $80.71 $161.41 $242.12 $322.83

Aetna narrow network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $101.24 $10.13 $20.25 $30.38 $40.50
$53,000 - $136,999 $119.10 $11.91 $23.82 $35.73 $47.64
>$137,000 $136.97 $13.70 $27.40 $41.09 $54.79
Teammate and spouse or domestic partner $0 - $52,999 $310.36 $31.03 $62.07 $93.11 $124.14
$53,000 - $136,999 $365.13 $36.51 $73.03 $109.54 $146.05
>$137,000 $419.90 $41.99 $83.98 $125.97 $167.96
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $269.88 $26.99 $53.98 $80.97 $107.95
$53,000 - $136,999 $317.50 $31.75 $63.50 $95.25 $127.00
>$137,000 $365.13 $36.52 $73.03 $109.54 $146.05
Family $0 - $52,999 $552.19 $55.22 $110.44 $165.66 $220.88
$53,000 - $136,999 $649.63 $64.96 $129.93 $194.89 $259.85
>$137,000 $747.07 $74.70 $149.41 $224.12 $298.82

$1,500 Upfront Advantage plans 

Aetna broad network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $103.13 $10.31 $20.63 $30.94 $41.25
$53,000 - $136,999 $121.33 $12.13 $24.27 $36.40 $48.53
>$137,000 $139.53 $13.95 $27.91 $41.86 $55.81
Teammate and spouse or domestic partner $0 - $52,999 $266.79 $26.68 $53.35 $80.04 $106.72
$53,000 - $136,999 $313.87 $31.39 $62.77 $94.16 $125.55
>$137,000 $360.95 $36.10 $72.18 $108.28 $144.38
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $208.35 $20.83 $41.66 $62.51 $83.34
$53,000 - $136,999 $245.12 $24.51 $49.02 $73.54 $98.05
>$137,000 $281.89 $28.19 $56.37 $84.57 $112.76
Family $0 - $52,999 $435.90 $43.59 $87.18 $130.78 $174.36
$53,000 - $136,999 $512.82 $51.28 $102.56 $153.85 $205.13
>$137,000 $589.74 $58.97 $117.94 $176.92 $235.90

Aetna narrow network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $90.22 $9.02 $18.05 $27.06 $36.09
$53,000 - $136,999 $106.14 $10.61 $21.23 $31.84 $42.46
>$137,000 $122.06 $12.20 $24.41 $36.61 $48.83
Teammate and spouse or domestic partner $0 - $52,999 $227.13 $22.71 $45.43 $68.14 $90.85
$53,000 - $136,999 $267.21 $26.72 $53.44 $80.16 $106.88
>$137,000 $307.29 $30.73 $61.45 $92.18 $122.91
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $177.38 $17.74 $35.48 $53.21 $70.95
$53,000 - $136,999 $208.68 $20.87 $41.74 $62.60 $83.47
>$137,000 $239.98 $24.00 $48.00 $71.99 $95.99
Family $0 - $52,999 $371.08 $37.11 $74.21 $111.32 $148.43
$53,000 - $136,999 $436.57 $43.66 $87.31 $130.97 $174.63
>$137,000 $502.06 $50.21 $100.41 $150.62 $200.83

$250 ACO plan

Aetna narrow network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $102.14 $10.22 $20.43 $30.65 $40.85
$53,000 - $136,999 $120.16 $12.02 $24.03 $36.05 $48.06
>$137,000 $138.18 $13.82 $27.63 $41.45 $55.26
Teammate and spouse or domestic partner $0 - $52,999 $290.90 $29.09 $58.19 $87.27 $116.36
$53,000 - $136,999 $342.23 $34.22 $68.45 $102.67 $136.89
>$137,000 $393.56 $39.35 $78.71 $118.07 $157.42
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $238.49 $23.85 $47.70 $71.54 $95.39
$53,000 - $136,999 $280.58 $28.06 $56.12 $84.17 $112.23
>$137,000 $322.67 $32.27 $64.54 $96.80 $129.07
Family $0 - $52,999 $497.71 $49.77 $99.54 $149.31 $199.09
$53,000 - $136,999 $585.54 $58.55 $117.11 $175.66 $234.22
>$137,000 $673.37 $67.33 $134.68 $202.01 $269.35

$2,500 HDHP plans

Aetna broad network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $67.97 $6.80 $13.59 $20.39 $27.19
$53,000 - $136,999 $79.97 $8.00 $15.99 $23.99 $31.99
>$137,000 $91.97 $9.20 $18.39 $27.59 $36.79
Teammate and spouse or domestic partner $0 - $52,999 $177.25 $17.72 $35.45 $53.18 $70.90
$53,000 - $136,999 $208.53 $20.85 $41.71 $62.56 $83.41
>$137,000 $239.81 $23.98 $47.97 $71.94 $95.92
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $143.96 $14.40 $28.79 $43.19 $57.58
$53,000 - $136,999 $169.36 $16.94 $33.87 $50.81 $67.74
>$137,000 $194.76 $19.48 $38.95 $58.43 $77.90
Family $0 - $52,999 $296.76 $29.67 $59.35 $89.03 $118.70
$53,000 - $136,999 $349.13 $34.91 $69.83 $104.74 $139.65
>$137,000 $401.50 $40.15 $80.30 $120.45 $160.60

Aetna narrow network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $57.48 $5.75 $11.49 $17.25 $23.00
$53,000 - $136,999 $67.62 $6.76 $13.52 $20.29 $27.05
>$137,000 $77.76 $7.77 $15.54 $23.33 $31.10
Teammate and spouse or domestic partner $0 - $52,999 $152.84 $15.28 $30.57 $45.85 $61.13
$53,000 - $136,999 $179.81 $17.98 $35.96 $53.94 $71.92
>$137,000 $206.78 $20.68 $41.35 $62.03 $82.71
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $122.85 $12.28 $24.57 $36.86 $49.14
$53,000 - $136,999 $144.53 $14.45 $28.91 $43.36 $57.81
>$137,000 $166.21 $16.62 $33.25 $49.86 $66.48
Family $0 - $52,999 $262.45 $26.24 $52.48 $78.73 $104.98
$53,000 - $136,999 $308.77 $30.88 $61.75 $92.63 $123.51
>$137,000 $355.09 $35.52 $71.02 $106.53 $142.04

Kaiser Permanente

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $66.73 $6.67 $13.34 $20.01 $26.69
$53,000 - $136,999 $78.51 $7.85 $15.70 $23.55 $31.40
>$137,000 $90.29 $9.03 $18.06 $27.09 $36.11
Teammate and spouse or domestic partner $0 - $52,999 $152.97 $15.30 $30.60 $45.90 $61.19
$53,000 - $136,999 $179.96 $18.00 $35.99 $53.99 $71.98
>$137,000 $206.95 $20.70 $41.38 $62.08 $82.77
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $110.47 $11.05 $22.09 $33.14 $44.19
$53,000 - $136,999 $129.97 $13.00 $25.99 $38.99 $51.99
>$137,000 $149.47 $14.95 $29.89 $44.84 $59.79
Family $0 - $52,999 $202.13 $20.21 $40.43 $60.64 $80.85
$53,000 - $136,999 $237.80 $23.78 $47.56 $71.34 $95.12
>$137,000 $273.47 $27.35 $54.69 $82.04 $109.39

$4,000 HDHP plans

Aetna broad network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only $0 - $52,999 $48.27 $4.83 $9.65 $14.48 $19.31
$53,000 - $136,999 $56.79 $5.68 $11.36 $17.04 $22.72
>$137,000 $65.31 $6.53 $13.07 $19.60 $26.13
Teammate and spouse or domestic partner $0 - $52,999 $141.60 $14.16 $28.32 $42.48 $56.64
$53,000 - $136,999 $166.59 $16.66 $33.32 $49.98 $66.64
>$137,000 $191.58 $19.16 $38.32 $57.48 $76.64
Teammate and child(ren) or domestic partner's child(ren) $0 - $52,999 $104.24 $10.42 $20.85 $31.27 $41.70
$53,000 - $136,999 $122.64 $12.26 $24.53 $36.79 $49.06
>$137,000 $141.04 $14.10 $28.21 $42.31 $56.42
Family $0 - $52,999 $185.16 $18.51 $37.03 $55.54 $74.06
$53,000 - $136,999 $217.84 $21.78 $43.57 $65.35 $87.14
>$137,000 $250.52 $25.05 $50.11 $75.16 $100.21

Aetna narrow network

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only 0 - 52,999 $41.19 $4.12 $8.24 $12.36 $16.47
53,000 - 136,999 $48.46 $4.85 $9.69 $14.54 $19.38
>=137,000 $55.73 $5.58 $11.14 $16.72 $22.29
Teammate and spouse or domestic partner 0 - 52,999 $124.00 $12.40 $24.80 $37.20 $49.60
53,000 - 136,999 $145.88 $14.59 $29.18 $43.76 $58.35
>=137,000 $167.76 $16.78 $33.55 $50.32 $67.10
Teammate and child(ren) or domestic partner's child(ren) 0 - 52,999 $89.77 $8.98 $17.95 $26.93 $35.91
53,000 - 136,999 $105.61 $10.56 $21.12 $31.68 $42.24
>=137,000 $121.45 $12.14 $24.29 $36.43 $48.57
Family 0 - 52,999 $159.15 $15.91 $31.83 $47.74 $63.66
53,000 - 136,999 $187.24 $18.72 $37.45 $56.17 $74.90
>=137,000 $215.33 $21.53 $43.07 $64.60 $86.14

Kaiser EPO plan

Coverage level Salary (BAR) band Semi-monthly premium LifeForce phase 2 credit LifeForce phase 3 credit LifeForce phase 4 credit LifeForce phase 5 credit
Teammate only 0 - 52,999 $101.12 $10.12 $20.23 $30.34 $40.45
53,000 - 136,999 $118.96 $11.90 $23.79 $35.69 $47.58
>=137,000 $136.80 $13.68 $27.35 $41.04 $54.71
Teammate and spouse or domestic partner 0 - 52,999 $316.71 $31.67 $63.34 $95.01 $126.68
53,000 - 136,999 $372.60 $37.26 $74.52 $111.78 $149.04
>=137,000 $428.49 $42.85 $85.70 $128.55 $171.40
Teammate and child(ren) or domestic partner's child(ren) 0 - 52,999 $245.05 $24.51 $49.01 $73.52 $98.03
53,000 - 136,999 $288.29 $28.83 $57.66 $86.49 $115.32
>=137,000 $331.53 $33.15 $66.31 $99.46 $132.61
Family 0 - 52,999 $511.93 $51.20 $102.38 $153.58 $204.77
53,000 - 136,999 $602.27 $60.23 $120.45 $180.68 $240.91
>=137,000 $692.61 $69.26 $138.52 $207.78 $277.05