Cost Summary

Explanation of Benefits

Health Care Summary EOB
Beyond Health Care Summary EOB

Coverage Plan

Employee Contribution

City Contribution

Total Monthly Cost
Employee Only $26 $489 $515
Employee + Child $264 $561 $825
Employee + Children $379 $806 $1,185
Employee + Spouse $330 $701 $1,031
Family $544 $1,156 $1,700
Family (both employees)** $153 $1,547 $1,700

**This coverage tier is only available to eligible employees enrolled prior to January 1, 2016.
 

Vision Plan

City Contribution per month

Employee Contribution per month

Employee Only $4.08
$3.91 effective 1/1/2022
$0
Employee + Dependent
(spouse or one child)
$4.16 $4
$3.67 effective 1/1/2022
Family $4.24 $8
$7.50 effective 1/1/2022

 

Prescription Coverage

City Cost

Employee Cost

Administered by
Anthem Blue Cross
60% for 30-day supply 40% for 30-day supply

 

Dental Plan

City Contribution per month

Employee Contribution per month

Employee Only $28 $0
Employee + Dependent
(spouse or one child)
$28 $22
Family $28 $39

 

Retirement

City Contribution

Employee Contribution

Virginia Retirement System
(VRS)
The City pays employer portion (20.96%) of base pay towards the retirement and disability benefit Employees pay the 5% member portion of this benefit
457 Deferred Compensation Retirement Plan (MissionSquare, formerly ICMA) No match  Min. $5 per pay period
2022: Max. up to $20,500 annually or $27,000 if age 50+

 

Group Life Insurance

City Contribution

Group Life Insurance
2x annual pay - natural death
4x annual pay - accidental death
1.34% of pay

Optional Life Insurance Coverage

How to calculate monthly cost of optional life insurance:

1. Decide how much additional life insurance you want for yourself. Choose Option 1, 2, 3, or 4 and whether you want coverage on spouse and children.
2. Find cost per $1,000 of coverage next to your age in Employee + Spouse Rates table below.
3. Multiply cost times per $1,000 of life insurance coverage. For example, if one times your annual base pay is $20,000, and your age is 35, you would multiply 20 times .06 to find a monthly cost of $1.20.
4. Based on option chosen and corresponding spouse coverage, if any, repeat formula using cost based on spouse's age for spouse premium.
5. Children's premium is a flat rate based on the option you choose. See rates below.

Optional Life Coverage

Employee

Spouse

Children

Option Insurance Amount Insurance Amount Insurance Amount
1 1x Annual Base Pay .5 Employee Base Pay $10,000
2 2x Annual Base Pay 1x Employee Base Pay $10,000
3 3x Annual Base Pay 1.5x Employee Base Pay $20,000
4 4x Annual Base Pay 2x Employee Base Pay $30,000

 

Optional Life Rates

Employee + Spouse

Age Monthly Rates Per $1000
Under 30 $0.05
30 - 34 $0.05
35 - 39 $0.06
40 - 44 $0.08
45 - 49 $0.14
50 - 54 $0.20
55 - 59 $0.33
60 - 64 $0.59
65 - 69 $1.06
70 and over $2.06

 

Optional Life Rates

Children

 

Option Insurance Amount Flat Monthly Rate
1 $10,000 $0.80
2 $10,000 $0.80
3 $20,000 $1.60
4 $30,000 $2.40
 

Cost of Maintaining Coverage When Employment Ends

Medical Coverage

Monthly COBRA Rate

Individual Only $525
Individual + Spouse $1,052
Individual + Child $842
Individual + Children $1,209
Family $1,734
Family - Two Married City Employees $1,734

 

Dental Coverage

Monthly COBRA Rate

Individual Only $29
Individual + One $51
Family $68

 

Vision Coverage

Monthly COBRA Rate

Individual Only $4.16
$3.91 effective 1/1/2022
Individual + One $8.32
$7.83 effective 1/1/2022
Family $12.48
$11.74 effective 1/1/2022

You will receive information in the mail from HR about COBRA.