The charts below list the amounts you will pay per pay period for coverage. It’s important to review your options and costs, and choose the coverage that’s right for you.

Medical Costs (Per Pay Period)

Coverage DISH Medical Plan (DMP)
Employee Only $65
Employee + One $130
Employee + Two $195
Each Additional Dependent $15 per dependent

Dental Costs (Per Pay Period)

Dental Plans Cigna DHMO MetLife Low Plan MetLife High Plan
Employee Only $6.08 $8.25 $16.48
Employee + One $10.87 $16.29 $31.52
Employee + Two $16.72 $23.23 $44.76
Employee + Family $19.75 $31.33 $49.07

Vision Costs (Per Pay Period)

Coverage Exam Plus Plan Enhanced Vision Plan
Employee Only $0.45 $3.08
Employee + One $0.72 $4.31
Employee + Family $1.30 $7.73

Buy-up Short-Term and Optional Long-Term Disability Costs (Per Pay Period)

Buy-up Short-Term Disability Optional Long-Term Disability
  Rate per $10 of Weekly Benefit Age on 1/1/23 Rate per $100 of Monthly Base Pay
All Employees $0.060 Under 30 $0.073
    30 – 34 $0.108
    35 – 39 $0.163
    40 – 44 $0.271
    45 – 49 $0.393
    50 – 54 $0.552
    55 – 59 $0.678
    60+ $0.801

Accident Insurance

Employee Only $2.94
Employee + Spouse $4.69
Employee + Child(ren) $6.24
Employee + Spouse and Child(ren) $9.50

Critical Illness Insurance (Per Pay Period)

Employee Only

Age on 1/1/23 Option 1 Option 2 Option 3
Under 25 $0.74 $1.48 $2.22
25 – 29 $1.02 $2.03 $3.05
30 – 34 $1.38 $2.77 $4.15
35 – 39 $1.98 $3.97 $5.95
40 – 44 $3.32 $6.65 $9.97
45 – 49 $5.54 $11.08 $16.62
50 – 54 $8.03 $16.06 $24.09
55 – 59 $11.12 $22.25 $33.37
60 – 64 $15.74 $31.48 $47.22
65 – 69 $21.51  $43.02 $64.52
70 – 74 $28.48 $56.95 $85.43
75+ $40.20 $80.40 $120.60

Employee + Spouse

Age on 1/1/23 Option 1 Option 2 Option 3
Under 25 $1.04 $2.08 $3.12
25 – 29 $1.48 $2.95 $4.43
30 – 34 $2.03 $4.06 $6.09
35 – 39 $2.93 $5.86 $8.79
40 – 44 $4.85 $9.69 $14.54
45 – 49 $7.94 $15.88 $23.82
50 – 54 $11.52 $23.03 $34.55
55 – 59 $15.74 $31.48 $47.22
60 – 64 $22.68 $45.37 $68.05
65 – 69 $31.20 $62.40 $93.60
70 – 74 $41.56 $83.12 $124.68
75+ $55.57 $111.14 $166.71

Employee + Child(ren)

Age on 1/1/23 Option 1 Option 2 Option 3
Under 25 $0.90 $1.80 $2.70
25 – 29 $1.18 $2.35 $3.53
30 – 34 $1.55 $3.09 $4.64
35 – 39 $2.15 $4.29 $6.44
40 – 44 $3.48 $6.97 $10.45
45 – 49 $5.70 $11.40 $17.10
50 – 54 $8.19 $16.38 $24.58
55 – 59 $11.28 $22.57 $33.85
60 – 64 $15.90 $31.80 $47.70
65 – 69 $21.67 $43.34 $65.01
70 – 74 $28.64 $57.28 $85.92
75+ $40.36 $80.72 $121.08

Employee + Family

Age on 1/1/23 Option 1 Option 2 Option 3
Under 25 $1.20 $2.40 $3.60
25 – 29 $1.64 $3.28 $4.92
30 – 34 $2.19 $4.38 $6.58
35 – 39 $3.09 $6.18 $9.28
40 – 44 $5.01 $10.02 $15.02
45 – 49 $8.10 $16.20 $24.30
50 – 54 $11.68 $23.35 $35.03
55 – 59 $15.90 $31.80 $47.70
60 – 64 $22.85 $45.69 $68.54
65 – 69 $31.36 $62.72 $94.08
70 – 74 $41.72 $83.45 $125.17
75+ $55.73 $111.46 $167.19

Hospital Indemnity Insurance

Employee Only $4.87
Employee + Spouse $13.26
Employee + Child(ren) $11.36
Employee + Spouse and Child(ren) $21.15

Your Costs for Employee, Spouse and Dependent Optional Term Life Insurance

The rates below are shown per pay period per $1,000 of coverage.

Age on 1/1/23 Employee Life:
Non-Tobacco User1
Employee Life:
Tobacco User1
Spouse Life 2 Dependent Child Life
Under 25 $0.012 $0.023 $0.017 $0.017
25 – 29 $0.017 $0.027 $0.021  
30 – 34 $0.021 $0.037 $0.024  
35 – 39 $0.024 $0.040 $0.028  
40 – 44 $0.037 $0.045 $0.041  
45 – 49 $0.057 $0.068 $0.062  
50 – 54 $0.090 $0.105 $0.094  
55 – 59 $0.168 $0.196 $0.176  
60 – 64 $0.242 $0.300 $0.254  
65 – 69 $0.381 $0.578 $0.520  
70 – 74 $0.626 $0.937 $0.709  
75+ $0.799 $0.937 $0.844  

1 You are considered a “tobacco user” if you have used any tobacco products in the last 12 months.

2 The rates for Employee Life and Spouse Life Insurance are based on the employee’s age and salary as of January 1, 2023. These rates will remain in effect for the entire calendar year.

Separate Rates for Tobacco and Non-Tobacco Users

If you are a non-tobacco user, your life insurance rates will be lower than if you use tobacco.