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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce phase 5 credit
Teammate only0 - 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 partner0 - 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
Family0 - 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 levelSalary (BAR) bandSemi-monthly premiumLifeForce phase 2 creditLifeForce phase 3 creditLifeForce phase 4 creditLifeForce phase 5 credit
Teammate only0 - 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 partner0 - 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
Family0 - 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