2022 Associate Monthly Payroll Contributions 

MEDICAL

High Deductible
Health Plan (HDHP)

Traditional PPO

Buy-Up PPO

Tier 1 (Less Than $65,000)
Associate$72.10$92.70$149.35
Associate + Spouse$164.80$211.15$329.60
Associate + Child(ren)$144.20$185.40$293.55
Family$226.60$293.55$468.55
Tier 2 (More Than $65,000)
Associate$128.75$164.80$360.50
Associate + Spouse$288.40$370.80$793.10
Associate + Child(ren)$252.35$324.45$705.55
Family$396.55$515.00$1,133.00

DENTAL

Associate $15 
Associate + spouse $20 
Associate + child(ren) $25 
Family $30 

SUPPLEMENTAL LIFE

Age Associate and Spouse Rate per $1,000 
Under 20 $.105 
20–24 $.105 
25–29 $.105 
30–34 $.119 
35–39 $.154 
40–44 $.231 
45–49 $.356 
50–54 $.549 
55–59 $.699 
60–64 $.699 
65–69 $.699 
70+ $.699 
Child(ren) Rate per $10,000 $1.33 

ACCIDENT

 
Associate $14.86 
Associate + Spouse $24.28 
Associate + Child(ren) $28.20 
Family $37.62 

HOSPITAL INDEMNITY

Individual $22.09 
Associate + Spouse $50.78 
Associate + Child(ren) $36.93 
Family $65.62

VISION

VSP Choice Plan 
Associate $7.85 
Associate + spouse $13.21 
Associate + child(ren) $13.47 
Family$21.32 
David Designer Plan 
Associate $6.44 
Associate + spouse $10.85 
Associate + child(ren) $11.06 
Family $17.51 

CRITICAL ILLNESS

 
Attained Ages Associate Monthly Contributions ($10,000 Benefit Amount) 
Non-Tobacco Rates 
Under 30 $6.70 
30–39 $7.60 
40–49 $14.20 
50–59 $30.90 
60–64 $48.50 
65–69 $61.10 
70+ $66.30 
Tobacco Rates 
Under 30 $9.10 
30–39 $11.10 
40–49 $21.60 
50–59 $50.10 
60–64 $82.10 
65–69 $95.50 
70+ $100.30 

INFOARMOUR

Individual $9.95 
Individual + Family $17.95