Your 2022 cost of coverage
Semi-monthly plan rates
Most benefit contributions are pre-tax, which lower your taxable income. Different contribution rates, as well as imputed income, apply when covering a Domestic Partner and their children. Please review the Domestic Partner information below to learn more.
| Plans | Employee Only | Employee + Spouse/ Domestic Partner | Employee + Children | Employee + Family |
|---|---|---|---|---|
| UHC HDHP w/HSA | $15.00 | $113.00 | $58.00 | $143.50 |
| UHC PPO | $41.50 | $191.50 | $119.50 | $239.00 |
| Kaiser HMO | $26.00 | $123.50 | $81.00 | $157.00 |
| Delta Dental | $2.50 | $8.00 | $13.50 | $19.00 |
| VSP Vision | $0.50 | $2.50 | $2.50 | $5.50 |
2022 COBRA Rates (Hawaii only)
Domestic Partner Information
Domestic partner contributions and imputed income
Domestic partner contributions are regulated by the IRS. Contributions you make for domestic partner coverage must be made on a post-tax basis. Similarly, ServiceNow’s contribution towards the cost of benefits for your domestic partner and his or her dependents is taxable income to you. If your domestic partnership is registered with the Secretary of the State of California, your imputed income will be exempt from California state tax. Contact your tax advisor for more detailed information on how the tax treatment may affect you.
Domestic Partner Affidavit
If you are enrolling a Domestic Partner, you may need to complete the attached affidavit and submit it through BenefitSolver during the online enrollment process. You are encouraged to carefully review the eligibility criteria for covering a domestic partner.
Voluntary Life Rates
Voluntary Life premiums: employees, interns, spouses/domestic partners
The premium listed is per $1,000 of voluntary life coverage and payable in post-tax deductions each pay period. Rates are based on the employee’s attained age as of December 31st and premiums are re-set each January 1.
Voluntary Life premiums: children
The premium is $0.081 per $1,000 of voluntary life coverage and is payable in post-tax deductions each pay period. Elections and premiums cover all eligible children (single rate for all children).
| Age | Rate | Age | Rate |
|---|---|---|---|
| <25 | $0.0250 | 50 - 54 | $0.1350 |
| 25 - 29 | $0.0300 | 55 - 59 | $0.2425 |
| 30 - 34 | $0.0430 | 60 - 64 | $0.3850 |
| 35 - 39 | $0.0550 | 65 - 69 | $0.7400 |
| 40 - 44 | $0.0600 | 70 - 74 | $1.2050 |
| 45 - 49 | $0.0900 | 75+ | $1.7245 |
| Voluntary AD&D | All ages | $0.0090 |