2020 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
$96.37
Full-time You and Your Family
$269.82
Part-time You Only
$158.64
Part-time You and Your Family
$444.20
MonteCare PPO Stipend Band $100,000 – $149,999
Full-time You Only
$110.85
Full-time You and Your Family
$310.38
Part-time You Only
$169.27
Part-time You and Your Family
$473.94
MonteCare PPO Stipend Band $150,000 – $199,999
Full-time You Only
$117.18
Full-time You and Your Family
$328.08
Part-time You Only
$173.91
Part-time You and Your Family
$486.92
MonteCare PPO Stipend Band $200,000 – $249,999
Full-time You Only
$124.65
Full-time You and Your Family
$349.03
Part-time You Only
$179.39
Part-time You and Your Family
$502.29/div>
MonteCare PPO Stipend Band $250,000 and over
Full-time You Only
$131.03
Full-time You and Your Family
$366.88
Part-time You Only
$184.06
Part-time You and Your Family
$515.37
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
$0.026 per $1,000
Nicotine user
$0.028 per $1,000
25-29 Age Group
Non-nicotine user
$0.028 per $1,000
Nicotine user
$0.030 per $1,000
30-34 Age Group
Non-nicotine user
$0.035 per $1,000
Nicotine user
$0.038 per $1,000
35-39 Age Group
Non-nicotine user
$0.044 per $1,000
Nicotine user
$0.046 per $1,000
40-44 Age Group
Non-nicotine user
$0.057 per $1,000
Nicotine user
$0.063 per $1,000
45-49 Age Group
Non-nicotine user
$0.091 per $1,000
Nicotine user
$0.101 per $1,000
50-54 Age Group
Non-nicotine user
$0.146 per $1,000
Nicotine user
$0.162 per $1,000
55-59 AGE GROUP
Non-nicotine user
$0.249 per $1,000
Nicotine user
$0.277 per $1,000
60-64 AGE GROUP
Non-nicotine user
$0.354 per $1,000
Nicotine user
$0.393 per $1,000
65-69 AGE GROUP
Non-nicotine user
$0.598 per $1,000
Nicotine user
$0.664 per $1,000
70+ Age Group
Non-nicotine user
$0.939 per $1,000
Nicotine user
$1.043 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.