2022 House Staff Rate Sheet
MonteCare PPO Bi-weekly Premiums (non-nicotine user rates)
MonteCare PPO Stipend Band Under $39,999
Full-time You Only
$74.77
Full-time You and Your Family
$209.43
Part-time You Only
$139.43
Part-time You and Your Family
$390.38
MonteCare PPO Stipend Band $40,000 – $64,999
Full-time You Only
$81.94
Full-time You and Your Family
$229.40
Part-time You Only
$144.68
Part-time You and Your Family
$405.09
MonteCare PPO Stipend Band $65,000 – $99,999
Full-time You Only
$105.22
Full-time You and Your Family
$294.59
Part-time You Only
$173.20
Part-time You and Your Family
$484.98
MonteCare PPO Stipend Band $100,000 – $149,999
Full-time You Only
$121.03
Full-time You and Your Family
$338.87
Part-time You Only
$184.81
Part-time You and Your Family
$517.45
MonteCare PPO Stipend Band $150,000 – $199,999
Full-time You Only
$127.94
Full-time You and Your Family
$358.20
Part-time You Only
$189.87
Part-time You and Your Family
$531.62
MonteCare PPO Stipend Band $200,000 – $249,999
Full-time You Only
$136.09
Full-time You and Your Family
$381.07
Part-time You Only
$195.86
Part-time You and Your Family
$548.40
MonteCare PPO Stipend Band $250,000 and over
Full-time You Only
$143.06
Full-time You and Your Family
$400.56
Part-time You Only
$200.96
Part-time You and Your Family
$562.68
UNITEDHEALTHCARE VISION PLAN - BI-WEEKLY PREMIUMS
LOW OPTION
You Only
$2.30
You and One Family Member
$4.10
You and Your Family
$6.95
HIGH OPTION
You Only
$3.54
You and One Family Member
$6.79
You and Your Family
$9.39
DENTAL BI-WEEKLY PREMIUMS
Cigna DHMO
Cigna DHMO – You Only
$0
Cigna DHMO – You and Your Family
$0
Preventive & Diagnostic Dental Care Only
Preventive & Diagnostic – You Only
$0
Preventive & Diagnostic – You and Your Family
$0
Cigna DPPO Dental Plan
Cigna DPPO – You Only
$8.52
Cigna DPPO – You and Your Family
$27.84
LIFE INSURANCE
Basic Life Insurance
Montefiore provides Basic Life Insurance – at no cost to you after you complete one year at Montefiore.
- Your Basic Life Insurance monthly premium is $0.08 for every $1,000 of your annual stipend.
- If you elect to opt down to $50,000, your monthly premium is $4.00 ($1.85 bi-weekly).
Supplemental Life Insurance
Under 25 Age Group
Non-nicotine user
$0.025 per $1,000
Nicotine user
$0.027 per $1,000
25-29 Age Group
Non-nicotine user
$0.027 per $1,000
Nicotine user
$0.029 per $1,000
30-34 Age Group
Non-nicotine user
$0.034 per $1,000
Nicotine user
$0.037 per $1,000
35-39 Age Group
Non-nicotine user
$0.043 per $1,000
Nicotine user
$0.045 per $1,000
40-44 Age Group
Non-nicotine user
$0.056 per $1,000
Nicotine user
$0.061 per $1,000
45-49 Age Group
Non-nicotine user
$0.089 per $1,000
Nicotine user
$0.098 per $1,000
50-54 Age Group
Non-nicotine user
$0.142 per $1,000
Nicotine user
$0.158 per $1,000
55-59 AGE GROUP
Non-nicotine user
$0.243 per $1,000
Nicotine user
$0.270 per $1,000
60-64 AGE GROUP
Non-nicotine user
$0.345 per $1,000
Nicotine user
$0.383 per $1,000
65-69 AGE GROUP
Non-nicotine user
$0.583 per $1,000
Nicotine user
$0.647 per $1,000
70+ Age Group
Non-nicotine user
$0.916 per $1,000
Nicotine user
$1.017 per $1,000
Supplemental Life Insurance Premium Calculator
DEPENDENT LIFE INSURANCE
If you elect Dependent Life Insurance, the bi-weekly cost is:
- $1.49 – $10,000 for your spouse; $5,000 for each child
- $2.97 – $20,000 for your spouse; $10,000 for each child.
AD&D INSURANCE
Basic AD&D
Montefiore provides Basic AD&D Insurance – at no cost to you after you complete one year at Montefiore. Your Basic AD&D Insurance monthly premium is $0.014 for every $1,000 of your annual stipend.
SUPPLEMENTAL AD&D
For every $1,000 of coverage you elect, your Supplemental AD&D monthly premium is based on:
- $0.018 for yourself
- $0.018 for your spouse
- $0.015 for each child.
GROUP LEGAL SERVICES
If you elect Group Legal Services, the bi-weekly cost is:
- $3.80 for yourself
- $5.19 for you and your family.