Health Premiums for 9-Pay Faculty

Choose Your Appropriate Wellness $$ Level

Level Requirements Completed
Full Wellness Credit ($500 to $550/yr) Biometric Screening, Health Assessment, Non-Tobacco User (completed affidavit)
Partial Wellness Credit ($250 to $275/yr) Biometric Screening, Health Assessment, Tobacco Use (did not choose “reasonable alternative”)
No Wellness Credit Did Not Take Biometric Screening/Health Assessment
Plan A ($750 Deductible, $2,500 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $1,245.48 $1,033.19 $212.29
Employee & Spouse $2,600.28 $1,442.13 $1,158.15
Employee & Children $2,224.24 $1,386.40 $837.84
Family $3,385.73 $1,598.53 $1,787.20
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $968.79 $1,024.34 ($55.55)*
Employee & Spouse $2,022.63 $1,442.13 $580.49
Employee & Children $1,730.08 $1,386.40 $343.68
Family $2,633.60 $1,598.53 $1,035.07

* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).

Plan C (H.S.A.) ($3,000/$3,400 Deductible, $5,000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $877.19 $1,000.10 ($122.91)*
Employee & Spouse $1,831.37 $1,436.09 $395.28
Employee & Children $1,566.52 $1,373.13 $193.39
Family $2,384.59 $1,598.54 $786.05

* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).

H.S.A Participants – The University will contribute $111.11/month to an H.S.A. account for employee only. And $222.22/month to an H.S.A. for those enrolled in dependent tiers.

Plan A ($750 Deductible, $2,500 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $1,245.48 $1,000.99 $244.49
Employee & Spouse $2,600.28 $1,409.93 $1,190.35
Employee & Children $2,224.24 $1,354.20 $870.04
Family $3,385.73 $1,566.33 $1,819.40
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $968.79 $996.56 ($27.77)*
Employee & Spouse $2,022.63 $1,409.93 $612.69
Employee & Children $1,730.08 $1,354.20 $375.88
Family $2,633.60 $1,566.33 $1,067.27

* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).

Plan C (H.S.A.) ($3,000/$3,400 Deductible, $5,000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $877.19 $972.32 ($95.13)*
Employee & Spouse $1,831.37 $1,405.60 $425.77
Employee & Children $1,566.52 $1,342.64 $223.88
Family $2,384.59 $1,566.34 $818.25

* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).

H.S.A Participants – The University will contribute $111.11/month to an H.S.A. account for employee only. And $222.22/month to an H.S.A. for those enrolled in dependent tiers.

Plan A ($750 Deductible, $2,500 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $1,245.48 $968.79 $276.69
Employee & Spouse $2,600.28 $1,377.72 $1,222.56
Employee & Children $2,224.24 $1,322.00 $902.24
Family $3,385.73 $1,534.13 $1,851.60
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $968.79 $968.79 $0
Employee & Spouse $2,022.63 $1,377.72 $644.91
Employee & Children $1,730.08 $1,322.00 $408.08
Family $2,633.60 $1,534.13 $1,099.47

 

Plan C (H.S.A.) ($3,000/$3,400 Deductible, $5,000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $877.19 $944.55 ($67.36)*
Employee & Spouse $1,831.37 $1,375.09 $456.28
Employee & Children $1,566.52 $1,312.15 $254.37
Family $2,384.59 $1,534.14 $850.45

* Employee may use excess University Contributions for qualifying dental elections. If dental coverage
is also employee only, excess contributions will cover Plan B (high option).

H.S.A Participants – The University will contribute $111.11/month to an H.S.A. account for employee only. And $222.22/month to an H.S.A. for those enrolled in dependent tiers.