(Effective January 1, 2027)
Your premiums and cost contributions are determined by by your elected benefits and who you choose to cover.
- Medical, dental, and/or vision costs are deducted before taxes each pay period.
- Costs for voluntary benefits are deducted after-tax each pay period.
- Supplemental Life Insurance (Employee, Spouse, Child)
- Long-Term Disability (LTD)
- Accident Insurance
- Critical Illness Insurance
- Hospital Indemnity Insurance (Effective Jan. 1, 2027)
- Prepaid Legal Services
Unless otherwise indicated, the following plan year costs do not include any surcharges you and/or your covered spouse may incur (e.g. Working Spouse, Tobacco Use).
Per pay period medical premiums for Hourly and Salaried employees are as follows.
Hourly Employees
| Coverage Tier | Green Plan | Blue Plan |
| Per Pay Period Premium (Weekly) | Per Pay Period Premium (Weekly) | |
| Employee Only | $18.90 | $34.41 |
| Employee + Spouse | $54.52 | $86.02 |
| Employee + Child(ren) | $50.88 | $79.23 |
| Employee + Family | $79.96 | $131.33 |
Salaried Employees
| Coverage Tier | Green Plan | Blue Plan |
| Per Pay Period Premium (Semi-Monthly) | Per Pay Period Premium (Semi-Monthly) | |
| Employee Only | $55.13 | $96.60 |
| Employee + Spouse | $147.00 | $231.53 |
| Employee + Child(ren) | $135.45 | $215.78 |
| Employee + Family | $210.53 | $331.28 |
Per pay period dental premiums for Hourly and Salaried employees are as follows.
Hourly Employees
| Coverage Tier | Per Pay Period Premium (Weekly) |
| Employee Only | $6.87 |
| Employee + Spouse | $14.04 |
| Employee + Child(ren) | $14.40 |
| Employee + Family | $23.28 |
Salaried Employees
| Coverage Tier | Per Pay Period Premium (Semi-Monthly) |
| Employee Only | $14.89 |
| Employee + Spouse | $30.43 |
| Employee + Child(ren) | $31.20 |
| Employee + Family | $50.45 |
Per pay period vision premiums for Hourly and Salaried employees are as follows.
Hourly Employees
| Coverage Tier | Per Pay Period Premium (Weekly) |
| Employee Only | $1.95 |
| Employee + Spouse | $2.83 |
| Employee + Child(ren) | $3.42 |
| Employee + Family | $5.15 |
Salaried Employees
| Coverage Tier | Per Pay Period Premium (Semi-Monthly) |
| Employee Only | $4.23 |
| Employee + Spouse | $6.14 |
| Employee + Child(ren) | $7.42 |
| Employee + Family | $11.16 |
Monthly Supplemental Employee Life premiums for Hourly and Salaried employees are as follows.
To view pay period premiums, visit BenefitSource.
| Employee Age as of January 1, 2026 | 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 |
Per pay period Supplemental Spouse and/or Child Life premiums for Hourly and Salaried employees are as follows.
Hourly Employees
| Plan Option | Max Coverage Amount | Per Pay Period Premium(Weekly) |
| High | Spouse – $20,000 Per Child – $10,000 | $1.57 |
| Low | Spouse – $10,000 Per Child – $5,000 | $0.78 |
Salaried Employees
| Plan Option | Max Coverage Amount | Per Pay Period Premium(Semi-Monthly) |
| High | Spouse – $20,000 Per Child – $10,000 | $3.40 |
| Low | Spouse – $10,000 Per Child – $5,000 | $1.70 |
Monthly Long-Term Disability premiums for Hourly and Salaried employees are as follows.
To view pay period premiums, visit BenefitSource.
Hourly 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 |
Per pay period Accident Insurance premiums for Hourly and Salaried employees are as follows.
Hourly Employees
| Coverage Tier | Per Pay Period Premium (Weekly) |
| Employee Only | $1.16 |
| Employee + Spouse | $1.98 |
| Employee + Child(ren) | $2.33 |
| Employee + Family | $3.15 |
Salaried Employees
| Coverage Tier | Per Pay Period Premium (Semi-Monthly) |
| Employee Only | $2.52 |
| Employee + Spouse | $4.29 |
| Employee + Child(ren) | $5.05 |
| Employee + Family | $6.82 |
Monthly Critical Illness Insurance premiums for Hourly and Salaried employees are as follows.
To view pay period premiums, visit BenefitSource.
Employee and/or Spouse
| Employee/Spouse Age as of January 1, 2026 | Employee Monthly Premium Per $1,000 of Coverage | Spouse Monthly Premium Per $1,000 of Coverage |
| Under 25 | $0.53 | $0.53 |
| 25 – 29 | $0.55 | $0.55 |
| 30 – 34 | $0.57 | $0.57 |
| 35 – 39 | $0.63 | $0.63 |
| 40 – 44 | $0.81 | $0.81 |
| 45 – 49 | $1.13 | $1.13 |
| 50 – 54 | $1.63 | $1.63 |
| 55 – 59 | $2.39 | $2.39 |
| 60 – 64 | $3.12 | $3.12 |
| 65 – 69 | $3.84 | $3.84 |
| 70+ | $4.92 | $4.92 |
Child(ren) Coverage
| Child(ren) Coverage Amount (eligible up to age 26) | Monthly Premium | |
| $2,500 | $1.60 | |
| $5,000 | $3.20 | |
| $10,000 | $6.40 | |
| $15,000 | $9.60 | |
(Effective Jan. 1, 2027)
Per pay period Hospital Indemnity premiums for Hourly and Salaried employees are as follows.
Hourly Employees
| Coverage Tier | Per Pay Period Premium (Weekly) |
| Employee Only | $2.57 |
| Employee + Spouse | $6.52 |
| Employee + Child(ren) | $5.20 |
| Employee + Family | $9.79 |
Salaried Employees
| Coverage Tier | Per Pay Period Premium (Semi-Monthly) |
| Employee Only | $5.58 |
| Employee + Spouse | $14.13 |
| Employee + Child(ren) | $11.27 |
| Employee + Family | $21.21 |
Per pay period LegalShield premiums for Hourly and Salaried employees are as follows.
Hourly Employee
| Plan Option | Per Pay Period Premium
(Weekly) |
| LegalShield | $3.23 |
Salaried Employee
| Plan Option | Per Pay Period Premium
(Semi-Monthly) |
| LegalShield | $7.00 |
Whether you enroll in the Green Plan or Blue Plan, you MUST complete these steps each year to avoid extra monthly surcharges:
Certify Working Spouse Status
A $100 monthly Working Spouse surcharge will apply if you enroll a working spouse who is offered health coverage through their employer. If this does not apply and you wish to avoid the surcharge, answer “No” on the Working Spouse Status question in BenefitSource during Open Enrollment every year.
NOTE: If your spouse’s status changes, call (800) 284-4549 and submit a Working Spouse Affidavit.*
Confirm Tobacco Use
A $150 per person monthly Tobacco Use surcharge will apply if you and/or your covered spouse uses tobacco and enrolls in a Lennox medical plan. If this does not apply and you wish to avoid the surcharge, answer “No” on the Tobacco Use question in BenefitSource during Open Enrollment every year.
NOTE: If your/your spouse’s status changes, call (800) 284-4549 and submit a Tobacco Use affidavit.* Quantum Health has a dedicated program in place to help you and/or your spouse quit smoking.
Complete an Annual Health Screening
A $75 per person monthly Wellness surcharge will apply if you and/or your covered spouse enroll in a Lennox medical plan and 1) do not complete an annual health screening, and 2) do not meet or improve 3 out of 5 target health metrics by the next set deadline. To avoid this surcharge, visit the LIIveWell page.
NOTE: In the case of a medical condition or pregnancy, a screening waiver can be submitted.**
Monthly Surcharge Overview
In the event that you do not comply with one or more of the above actions, you and/or your covered spouse will be charged the extra monthly surcharges as outlined below:
| Monthly Surcharge | Employee | Covered Spouse |
| Working Spouse Status* | N/A | $100 |
| If Using Tobacco Products* | $150 | $150 |
| If You Fail to Complete an Annual Health Screening or Do Not Meet or Improve 3 of the 5 Measured Health Metrics** | $75 | $75 |
* If your or your covered spouse’s status changes during the year, you can submit an affidavit through BenefitSource.
** In the event you (or your covered spouse) are medically unable to meet the screening requirements (achieving at least 3 out of 5 health metrics or complete the full health screening), your physician may fill out and sign a Medical Waiver form on your behalf. If you or your spouse is pregnant, you must submit a Pregnancy Waiver form.