Rates and fees

Monthly medical, dental and vision costs1

Employee only Employee + child(ren)/domestic partner child(ren) Employee + spouse/domestic partner Employee + family
Medical
Core CDHP + HSA $18.26 $75.07 $87.44 $128.18
Buy-up CDHP + HSA $63.89 $161.73 $183.23 $271.85
Core PPO $145.93 $317.55 $355.48 $530.36
Dental
Core $8.36 $20.66 $22.83 $34.25
Buy-up $14.96 $32.35 $36.58 $54.05
Vision
$6.97 $13.94 $13.24 $20.49

Employee only Employee + child(ren)/domestic partner child(ren) Employee + spouse/domestic partner Employee + family
Medical*
GeoBlue CDHP + HSA + Dental $78.85 $194.08 $219.81 $325.90
GeoBlue PPO + Dental $160.89 $349.90 $392.06 $584.41
Vision
$6.97 $13.94 $13.24 $20.49

Fees

Schneider Electric self-insures its medical plan options. This means after you pay your share of the cost for coverage and services, the Company pays the remaining cost of medical claims for you and your family. As a participant in our plans, you have a direct impact on the overall cost of medical expenses. In an effort to help contain these costs, the following fees may apply depending on your responses (or lack of response) during your benefit enrollment:2

  1. If you live in Puerto Rico, your medical and prescription drug coverage is administered by Triple S (Blue Cross and Blue Shield of Puerto Rico). If you live in Hawaii, your medical and prescription drug coverage is administered by UHA Health Insurance. You will receive a separate insert regarding coverage details and cost. If you’re a U.S. employee working abroad, your medical, prescription drug and dental coverage is administered by GeoBlue. See the 2024 Benefits Guide for U.S. employees working abroad.
  2. If you’re a current employee and you don’t change your response during Annual Enrollment, your responses will automatically carry forward to the next calendar year.

Life and AD&D monthly costs

Basic Life Insurance — imputed income

If your Basic Life Insurance coverage is more than $50,000, you will owe taxes on the value of your coverage over $50,000. This value is called imputed income. IRS regulations require the Company to report employee federal wages and deduct Social Security taxes (FICA) on imputed income from your paycheck and report it on your W-2 each year.

Under IRS regulations, imputed income is based on your age and the monthly cost per $1,000 of life insurance over $50,000. To determine your monthly amount of imputed income, multiply the rate in the following IRS table by the amount of your insurance coverage over $50,000 divided by $1,000.

IRS Table — Monthly cost of $1,000 of insurance
Employee’s age IRS rate
Under 25 $0.05
25 – 29 $0.06
30 – 34 $0.08
35 – 39 $0.09
40 – 44 $0.10
45 – 49 $0.15
50 – 54 $0.23
55 – 59 $0.43
60 – 64 $0.66
65 – 69 $1.27
70 and over $2.06

Imputed income example

Supplemental AD&D Insurance

The monthly rate for Supplemental AD&D Insurance is $0.019 for every $1,000 of coverage you elect.

Supplemental Life and Spouse Life Insurance

Monthly rate per $1,000 of coverage:

Employee/spouse age Employee rates Spouse rates
Non tobacco-user rate Tobacco-user rate Non tobacco-user rate Tobacco-user rate
Under 25 $0.026 $0.039 $0.023 $0.035
25 – 29 $0.031 $0.047 $0.031 $0.046
30 – 34 $0.042 $0.062 $0.039 $0.058
35 – 39 $0.046 $0.074 $0.045 $0.073
40 – 44 $0.049 $0.087 $0.058 $0.100
45 – 49 $0.081 $0.132 $0.095 $0.150
50 – 54 $0.123 $0.203 $0.141 $0.230
55 – 59 $0.217 $0.360 $0.224 $0.400
60 – 64 $0.360 $0.561 $0.383 $0.650
65 – 69 $0.662 $0.985 $0.659 $1.050
70 and over $1.206 $1.815 $1.566 $2.060

Child Life Insurance

Coverage level Weekly cost Semi-monthly cost
$5,000 $0.10 $0.20
$10,000 $0.21 $0.40

Disability monthly costs

Short-term disability

Your options STD coverage levels Cost per $100 of monthly base pay
Company-paid 100% of your base pay for 4 weeks, 60% of your base pay thereafter $0.00
Buy-up1,2 100% of your base pay for 4 weeks, 70% of your base pay thereafter $0.030

Long-term disability

Your options LTD coverage levels Cost per $100 of monthly base pay
Company-paid 50% of your base pay $0.00
Buy-up2 60% of your base pay $0.111

Legal services plan

The cost for coverage is $16.50 per month.

  1. Due to state law, employees who work in New Jersey will automatically receive the STD Buy-up coverage level Company-paid. If you work in New Jersey, your option will be reflected on se-benefitslink.com.
  2. Due to state law, employees who work in New York for less than 17.5 hours per week will receive Company-paid disability coverage.