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Monthly Critical Illness Premiums
You will make your elections for this beneit using the online Choicelinx enrollment platform and premiums
will be calculated for you based on your age and tobacco status as indicated by the tobacco status you enter in
Choicelinx.
Non-Tobacco Tobacco
$10,000 Employee/$5,000 Spouse/$2,500 Child(ren) $10,000 Employee/$5,000 Spouse/$2,500 Child(ren)
Attained Employee Employee Employee + Employee Attained Employee Employee Employee + Employee
age + spouse child(ren) + family age + spouse child(ren) + family
0–24 $4.72 $8.14 $5.00 $8.42 0–24 $5.72 $9.64 $6.00 $9.92
25– 29 $5.32 $9.14 $5.60 $9.42 25– 29 $6.92 $11.74 $7.30 $12.02
30– 34 $6.52 $11.44 $6.80 $11.72 30– 34 $9.52 $16.34 $9.80 $16.62
35– 39 $9.52 $15.84 $9.80 $16.12 35– 39 $16.12 $26.14 $16.40 $26.42
40– 44 $12.02 $20.14 $12.30 $20.42 40– 44 $21.72 $35.54 $22.00 $35.82
45– 49 $16.92 $28.64 $17.20 $28.92 45– 49 $33.02 $54.94 $33.30 $55.22
50– 54 $26.02 $41.64 $26.30 $41.92 50– 54 $49.92 $79.84 $50.20 $80.12
55– 59 $37.02 $58.14 $37.30 $58.42 55– 59 $69.92 $109.64 $70.20 $109.92
60– 64 $49.32 $76.74 $49.60 $77.02 60– 64 $89.22 $138.84 $89.50 $139.12
65– 69 $61.12 $94.34 $61.40 $94.62 65– 69 $101.32 $159.74 $101.60 $160.02
70– 74 $84.72 $142.04 $85.00 $142.42 70– 74 $134.12 $229.94 $134.50 $230.32
75– 79 $117.92 $189.64 $118.30 $189.92 75– 79 $165.52 $277.04 $165.90 $277.32
80– 84 $152.52 $217.94 $152.80 $218.22 80– 84 $203.62 $311.44 $203.90 $311.72
85+ $201.22 $323.44 $201.50 $323.82 85+ $240.92 $393.84 $241.20 $394.12
Non-Tobacco Tobacco
$20,000 Employee/$10,000 Spouse/$5,000 Child(ren) $20,000 Employee/$10,000 Spouse/$5,000 Child(ren)
Attained Employee Employee + Employee Attained Employee Employee + Employee
age Employee + spouse child(ren) + family age Employee + spouse child(ren) + family
0–24 $7.62 $12.64 $8.10 $13.12 0–24 $9.62 $15.64 $10.10 $16.12
25– 29 $8.82 $14.64 $9.30 $15.12 25– 29 $12.02 $19.84 $12.70 $20.32
30– 34 $11.22 $19.24 $11.70 $19.72 30– 34 $17.22 $29.04 $17.70 $29.52
35– 39 $17.22 $28.04 $17.70 $28.52 35– 39 $30.42 $48.64 $30.90 $49.12
40– 44 $22.22 $36.64 $22.70 $37.12 40– 44 $41.62 $67.44 $42.10 $67.92
45– 49 $32.02 $53.64 $32.50 $54.12 45– 49 $64.22 $106.24 $64.70 $106.72
50– 54 $50.22 $79.64 $50.70 $80.12 50– 54 $98.02 $156.04 $98.50 $156.52
55– 59 $72.22 $112.64 $72.70 $113.12 55– 59 $138.02 $215.64 $138.50 $216.12
60– 64 $96.82 $149.84 $97.30 $150.32 60– 64 $176.62 $274.04 $177.10 $274.52
65– 69 $120.42 $185.04 $120.90 $185.52 65– 69 $200.82 $315.84 $201.30 $316.32
70– 74 $167.62 $280.44 $168.10 $281.12 70– 74 $266.42 $456.24 $267.10 $456.92
75– 79 $234.02 $375.64 $234.70 $376.12 75– 79 $329.22 $550.44 $329.90 $550.92
80– 84 $303.22 $432.24 $303.70 $432.72 80– 84 $405.42 $619.24 $405.90 $619.72
85+ $400.62 $643.24 $401.10 $643.92 85+ $480.02 $784.04 $480.50 $784.52
2016 Open Enrollment
Monthly Critical Illness Premiums
You will make your elections for this beneit using the online Choicelinx enrollment platform and premiums
will be calculated for you based on your age and tobacco status as indicated by the tobacco status you enter in
Choicelinx.
Non-Tobacco Tobacco
$10,000 Employee/$5,000 Spouse/$2,500 Child(ren) $10,000 Employee/$5,000 Spouse/$2,500 Child(ren)
Attained Employee Employee Employee + Employee Attained Employee Employee Employee + Employee
age + spouse child(ren) + family age + spouse child(ren) + family
0–24 $4.72 $8.14 $5.00 $8.42 0–24 $5.72 $9.64 $6.00 $9.92
25– 29 $5.32 $9.14 $5.60 $9.42 25– 29 $6.92 $11.74 $7.30 $12.02
30– 34 $6.52 $11.44 $6.80 $11.72 30– 34 $9.52 $16.34 $9.80 $16.62
35– 39 $9.52 $15.84 $9.80 $16.12 35– 39 $16.12 $26.14 $16.40 $26.42
40– 44 $12.02 $20.14 $12.30 $20.42 40– 44 $21.72 $35.54 $22.00 $35.82
45– 49 $16.92 $28.64 $17.20 $28.92 45– 49 $33.02 $54.94 $33.30 $55.22
50– 54 $26.02 $41.64 $26.30 $41.92 50– 54 $49.92 $79.84 $50.20 $80.12
55– 59 $37.02 $58.14 $37.30 $58.42 55– 59 $69.92 $109.64 $70.20 $109.92
60– 64 $49.32 $76.74 $49.60 $77.02 60– 64 $89.22 $138.84 $89.50 $139.12
65– 69 $61.12 $94.34 $61.40 $94.62 65– 69 $101.32 $159.74 $101.60 $160.02
70– 74 $84.72 $142.04 $85.00 $142.42 70– 74 $134.12 $229.94 $134.50 $230.32
75– 79 $117.92 $189.64 $118.30 $189.92 75– 79 $165.52 $277.04 $165.90 $277.32
80– 84 $152.52 $217.94 $152.80 $218.22 80– 84 $203.62 $311.44 $203.90 $311.72
85+ $201.22 $323.44 $201.50 $323.82 85+ $240.92 $393.84 $241.20 $394.12
Non-Tobacco Tobacco
$20,000 Employee/$10,000 Spouse/$5,000 Child(ren) $20,000 Employee/$10,000 Spouse/$5,000 Child(ren)
Attained Employee Employee + Employee Attained Employee Employee + Employee
age Employee + spouse child(ren) + family age Employee + spouse child(ren) + family
0–24 $7.62 $12.64 $8.10 $13.12 0–24 $9.62 $15.64 $10.10 $16.12
25– 29 $8.82 $14.64 $9.30 $15.12 25– 29 $12.02 $19.84 $12.70 $20.32
30– 34 $11.22 $19.24 $11.70 $19.72 30– 34 $17.22 $29.04 $17.70 $29.52
35– 39 $17.22 $28.04 $17.70 $28.52 35– 39 $30.42 $48.64 $30.90 $49.12
40– 44 $22.22 $36.64 $22.70 $37.12 40– 44 $41.62 $67.44 $42.10 $67.92
45– 49 $32.02 $53.64 $32.50 $54.12 45– 49 $64.22 $106.24 $64.70 $106.72
50– 54 $50.22 $79.64 $50.70 $80.12 50– 54 $98.02 $156.04 $98.50 $156.52
55– 59 $72.22 $112.64 $72.70 $113.12 55– 59 $138.02 $215.64 $138.50 $216.12
60– 64 $96.82 $149.84 $97.30 $150.32 60– 64 $176.62 $274.04 $177.10 $274.52
65– 69 $120.42 $185.04 $120.90 $185.52 65– 69 $200.82 $315.84 $201.30 $316.32
70– 74 $167.62 $280.44 $168.10 $281.12 70– 74 $266.42 $456.24 $267.10 $456.92
75– 79 $234.02 $375.64 $234.70 $376.12 75– 79 $329.22 $550.44 $329.90 $550.92
80– 84 $303.22 $432.24 $303.70 $432.72 80– 84 $405.42 $619.24 $405.90 $619.72
85+ $400.62 $643.24 $401.10 $643.92 85+ $480.02 $784.04 $480.50 $784.52
2016 Open Enrollment
