Your 2021 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.

PlansEmployee OnlyEmployee + Spouse/
Domestic Partner
Employee + ChildrenEmployee + 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

2021 COBRA Rates

2021 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.

2021 Domestic Partner Imputed Income Monthly Contributions

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.

Domestic Partner Affidavit

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).

AgeRateAgeRate
<25$0.025050 - 54$0.1350
25 - 29$0.030055 - 59$0.2425
30 - 34$0.043060 - 64$0.3850
35 - 39$0.055065 - 69$0.7400
40 - 44$0.060070 - 74$1.2050
45 - 49$0.090075+$1.7245
 
Voluntary AD&D
All ages$0.0090
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