Health Premiums

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 $934.11 $774.89 $159.22
Employee & Spouse $1,950.21 $1,081.60 $868.61
Employee & Children $1,668.18 $1,039.80 $628.38
Family $2,539.30 $1,198.90 $1,340.40
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $726.59 $768.25 ($41.66)*
Employee & Spouse $1,516.97 $1,081.60 $435.37
Employee & Children $1,297.56 $1,039.80 $257.76
Family $1,975.20 $1,198.90 $776.30

* 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 $657.89 $750.07 ($92.18)*
Employee & Spouse $1,373.53 $1,077.07 $296.46
Employee & Children $1,174.89 $1,029.85 $145.04
Family $1,788.44 $1,198.90 $589.54

* 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 $83.33/month to an H.S.A. account for employee only. And $166.67/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 $934.11 $750.74 $183.37
Employee & Spouse $1,950.21 $1,057.45 $892.76
Employee & Children $1,668.18 $1,015.65 $652.53
Family $2,539.30 $1,174.75 $1,364.55
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $726.59 $747.42 ($20.83)*
Employee & Spouse $1,516.97 $1,057.45 $459.52
Employee & Children $1,297.56 $1,015.65 $281.91
Family $1,975.20 $1,174.75 $800.45

* 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).

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 $657.89 $729.24 ($71.35)*
Employee & Spouse $1,373.53 $1,054.20 $319.33
Employee & Children $1,174.89 $1,006.98 $167.91
Family $1,788.44 $1,174.75 $613.69

*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 $83.33/month to an H.S.A. account for employee only. And $166.67/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 $934.11 $726.59 $207.52
Employee & Spouse $1,950.21 $1,033.29 $916.92
Employee & Children $1,668.18 $991.50 $676.68
Family $2,539.30 $1,150.60 $1,388.70
Plan B ($1,500 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $726.59 $726.59 $0
Employee & Spouse $1,516.97 $1,033.29 $483.68
Employee & Children $1,297.56 $991.50 $306.06
Family $1,975.20 $1,150.60 $824.60

 

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 $657.89 $708.41 ($50.52)*
Employee & Spouse $1,373.53 $1,031.32 $342.21
Employee & Children $1,174.89 $984.11 $190.78
Family $1,788.44 $1,150.60 $637.84

*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 $83.33/month to an H.S.A. account for employee only. And $166.67/month to an H.S.A. for those enrolled in dependent tiers.