Benefits 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  

**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 $0
Employee + Dependent (spouse or one child) $4.08 $3.67 effective 1/1/2022
Family $4.08 $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  
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 (Mission Square, formerly ICMA) N/A 2024: Max. up to $23,000 annually or $30,500 if age 50+
2023: Max. up to $22,500 annually or $30,000 if age 50+
Roth IRA (Mission Square, formerly ICMA) N/A 2024: Max. up to $7,000 annually or $8,000 if age 50+
2023: Max. up to $6,500 annually or $7,500 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  
Optional Life Rates Employee + Spouse
Age Monthly Rates Per $1,000
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  
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  

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  
Dental Coverage Monthly COBRA Rate
Individual Only $29
Individual + One $51
Family  
Vision Coverage Monthly COBRA Rate
Individual Only $4.16
Individual + One $7.91
Family   
You will receive information in the mail from HR about COBRA.