Page 19 - Guide
P. 19
Monthly Critical Illness Premiums
You will make your elections for this beneit using the online Cigna Beneits Technology Solutions 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 Cigna Beneits Technology Solutions.
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 Attained Employee Employee + Employee
age Employee + spouse child(ren) + family age Employee + 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
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You will make your elections for this beneit using the online Cigna Beneits Technology Solutions 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 Cigna Beneits Technology Solutions.
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 Attained Employee Employee + Employee
age Employee + spouse child(ren) + family age Employee + 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
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