BNY Mellon Benefits Guide
2019 Medical Premiums
The rates shown in the table below are 2019 semi-monthly health plan premium amounts. This is the amount that will be withheld from each paycheck for eligible full-time and part-time employees, based on annual base pay. Your base pay for the 2019 plan year is determined as of September 1, 2018, for existing employees or as of your date of hire, if later. To verify your contribution rate after enrollment, go to MyBenefit Solutions. At work: MySource > MyReward > Logon to MyReward > Proceed to My Personal Total Reward Data > MyBenefit Solutions. From home: mybenefits.bnymellon.com.
2019 SEMI-MONTHLY MEDICAL PLAN EMPLOYEE PREMIUMS
(The amount below will be withheld from each paycheck)
 
 
Lower Deductible HSA Plan
Higher Deductible HSA Plan
Kaiser Plan
Aetna International
 
 
Preferred Carrier Rate
Non-Preferred Carrier Rate
Preferred Carrier Rate
Non-Preferred Carrier Rate
Under $30,000
 
Employee Only
$19.00
$21.50
$9.50
$10.50
$33.50
$34.50
Employee + Child(ren)
$40.50
$46.00
$20.50
$22.50
$71.50
$73.50
Employee + Spouse/Qualified Domestic Partner
$49.50
$56.50
$25.00
$27.50
$87.50
$90.50
Employee + Family
$74.00
$83.50
$37.00
$41.00
$130.00
$134.00
$30,000 - $39,999
 
Employee Only
$40.50
$45.50
$16.50
$18.50
$56.00
$56.00
Employee + Child(ren)
$86.50
$97.00
$35.00
$39.50
$119.50
$119.50
Employee + Spouse/Qualified Domestic Partner
$106.00
$119.00
$43.00
$48.50
$146.50
$146.50
Employee + Family
$157.50
$176.50
$64.00
$72.00
$217.50
$217.50
$40,000 - $49,999
 
Employee Only
$47.00
$52.50
$19.50
$22.00
$69.00
$72.00
Employee + Child(ren)
$100.50
$112.00
$41.50
$47.00
$147.00
$153.50
Employee + Spouse/Qualified Domestic Partner
$123.00
$137.50
$51.00
$57.50
$180.50
$188.50
Employee + Family
$182.50
$204.00
$75.50
$85.50
$268.00
$279.50
$50,000 - $79,999
 
Employee Only
$51.00
$57.00
$22.00
$24.50
$85.50
$92.00
Employee + Child(ren)
$109.00
$121.50
$47.00
$52.50
$182.50
$196.50
Employee + Spouse/Qualified Domestic Partner
$133.50
$149.00
$57.50
$64.00
$223.50
$240.50
Employee + Family
$198.00
$221.50
$85.50
$95.00
$332.00
$357.50
$80,000 - $99,999
 
Employee Only
$60.00
$67.00
$28.00
$31.50
$104.50
$97.50
Employee + Child(ren)
$128.00
$143.00
$59.50
$67.00
$223.00
$208.00
Employee + Spouse/Qualified Domestic Partner
$157.00
$175.50
$73.50
$82.50
$273.50
$255.00
Employee + Family
$233.00
$260.00
$108.50
$122.50
$406.00
$378.50
$100,000 - $124,999
 
Employee Only
$76.50
$85.50
$35.50
$40.00
$112.00
$134.00
Employee + Child(ren)
$163.00
$182.50
$75.50
$85.50
$239.00
$286.00
Employee + Spouse/Qualified Domestic Partner
$200.00
$223.50
$93.00
$104.50
$293.00
$350.50
Employee + Family
$297.00
$332.00
$138.00
$155.50
$435.00
$520.50
$125,000 - $149,999
 
Employee Only
$90.00
$101.00
$42.50
$47.50
$141.00
$136.50
Employee + Child(ren)
$192.50
$216.00
$90.00
$100.50
$301.00
$291.00
Employee + Spouse/Qualified Domestic Partner
$236.00
$264.50
$110.50
$124.00
$369.00
$357.00
Employee + Family
$350.50
$393.50
$164.50
$183.50
$547.50
$530.00
$150,000 - $249,999
 
Employee Only
$110.00
$123.00
$51.50
$57.50
$146.50
$156.50
Employee + Child(ren)
$234.00
$262.00
$110.00
$123.00
$312.50
$334.00
Employee + Spouse/Qualified Domestic Partner
$287.50
$321.50
$135.00
$150.50
$383.50
$409.50
Employee + Family
$426.50
$477.50
$200.50
$224.00
$569.00
$607.50
$250,000 and Above
 
Employee Only
$128.50
$144.00
$60.50
$67.50
$168.00
$170.00
Employee + Child(ren)
$274.50
$307.50
$129.00
$144.00
$358.50
$362.50
Employee + Spouse/Qualified Domestic Partner
$336.50
$377.00
$158.00
$177.00
$439.50
$445.00
Employee + Family
$499.50
$559.50
$234.50
$262.50
$652.50
$660.00