Your monthly premium contributions will depend on the benefit plans and coverage options you choose and who you cover. The costs outlined below do not include any surcharges that may apply to you and/or your spouse.
Keep in mind:
Keep in mind:
- Your contributions toward medical, dental, vision coverage are deducted from your paycheck on a pre-tax basis.
- If you elect other benefits, such as supplemental life and AD&D, accident insurance, or critical illness, your contributions will be deducted on a post-tax basis.
Hourly Employees
Salaried Employees
| Coverage Tier | Green Plan | Blue Plan | Monthly Premium for 2024 | Monthly Premium for 2024 |
| Employee Only | $70 | $129 |
| Employee + Spouse | $204 | $322 |
| Employee + Child(ren) | $190 | $296 |
| Employee + Family | $299 | $491 |
Salaried Employees
| Coverage Tier | Green Plan | Blue Plan | Monthly Premium for 2024 | Monthly Premium for 2024 |
| Employee Only | $95 | $167 |
| Employee + Spouse | $254 | $400 |
| Employee + Child(ren) | $234 | $372 |
| Employee + Family | $364 | $572 |
| Coverage Tier | Monthly Premium |
| Employee Only | $8.46 |
| Employee + Spouse | $12.27 |
| Employee + Child(ren) | $14.83 |
| Employee + Family | $22.31 |
| Coverage Tier | Monthly Premium |
| Employee Only | $26.50 |
| Employee + Spouse | $54.00 |
| Employee + Child(ren) | $55.50 |
| Employee + Family | $89.50 |
| Employee Age as of 1/1/2024 |
Monthly Premium Per $1,000 of Coverage |
| Under 30 | $0.085 |
| 30 – 34 | $0.105 |
| 35 – 39 | $0.115 |
| 40 – 44 | $0.145 |
| 45 – 49 | $0.215 |
| 50 – 54 | $0.325 |
| 55 – 59 | $0.595 |
| 60 – 64 | $0.915 |
| 65 – 69 | $1.755 |
| 70 – 74 | $2.805 |
| 75+ | $4.475 |
| Plan Option | Max Coverage Amount | Monthly Premium |
| High | Spouse – $20,000
Per Child – $10,000 |
$6.80 |
| Low | Spouse – $10,000 Per Child – $5,000 |
$3.40 |
Hourly Employees
Salaried Employees
| Plan Option | Monthly Premium Per $100 of Coverage |
| Long-Term Disability Rate | $0.610 |
Salaried Employees
| Plan Option | Monthly Premium Per $100 of Coverage |
| Long-Term Disability Rate | $0.515 |
| Coverage Tier | Monthly Premium |
| Employee Only | $5.14 |
| Employee + Spouse | $8.76 |
| Employee + Child(ren) | $10.30 |
| Employee + Family | $13.92 |
| Employee/Spouse Age as of 1/1/2024 |
Employee Monthly Premium Per $1,000 of Coverage |
Spouse Monthly Premium Per $1,000 of Coverage |
| Under 25 | $0.54 | $0.54 |
| 25 – 29 | $0.56 | $0.56 |
| 30 – 34 | $0.58 | $0.58 |
| 35 – 39 | $0.64 | $0.64 |
| 40 – 44 | $0.83 | $0.83 |
| 45 – 49 | $1.15 | $1.15 |
| 50 – 54 | $1.66 | $1.66 |
| 55 – 59 | $2.44 | $2.44 |
| 60 – 64 | $3.18 | $3.18 |
| 65 – 69 | $3.92 | $3.92 |
| 70+ | $5.02 | $5.02 |
| Child(ren) Coverage Amount (eligible up to age 26) |
Monthly Premium | |
| $2,500 | $1.63 | |
| $5,000 | $3.25 | |
| $10,000 | $6.50 | |
| $15,000 | $9.75 | |
| Plan Option | Monthly Premium |
| LegalShield | $14 |
If you enroll in the Lennox medical plan you can save even more money each year by taking the following steps:
- Confirm Tobacco Use: You will pay a monthly surcharge if you (or your covered spouse) uses tobacco and enrolls in a Lennox medical plan. If you are not a tobacco user, be sure to answer “No” on the Tobacco Use question in BenefitSource during enrollment.
- Certify Working Spouse Status: You will pay an additional monthly surcharge if you cover a spouse who is eligible for coverage under another employer’s medical plan. If this situation does not apply to you, be sure to answer the Working Spouse Status question accordingly in BenefitSource during enrollment.
- Complete an Annual Health Screening: Submit your results by the current plan year’s deadline to avoid the monthly Wellness surcharge the following plan year. If your spouse is enrolled in the medical plan, there is a separate additional Wellness surcharge.
| Monthly Surcharge | Employee | Covered Spouse |
| If You Fail to Complete an Annual Health Screening* | $75 | $75 |
| If Using Tobacco Products** | $150 | $150 |
| Working Spouse Status*** | N/A | $100 |
* If you and/or your spouse are unable to complete these requirements or meet the healthy target ranges due to a medical condition, your physician can fill and sign the Medical Waiver form located on LIIveWell. If you or your spouse are pregnant, you do NOT need to complete a health screening. Instead, you must submit the Pregnancy Waiver form. You can also inquire about alternative screening options by contacting LIIveWell at (844) 800-2454.
** If you or your covered spouse’s status changes during the year, you can submit an affidavit through BenefitSource.
** If you or your covered spouse’s status changes during the year, you can submit an affidavit through BenefitSource.