Health Premiums

Choose Your Appropriate Wellness $$ Level

Level Amount Requirements Completed
Full Wellness $$ Appox. $500/yr Biometric Screening, Health Assessment, Non-Tobacco User (completed affidavit)
Partial Wellness $$ Appox. $250/yr Biometric Screening, Health Assessment, Tobacco Use (did not choose “reasonable alternative”)
No Wellness $$ No $$ Credit Did Not Take Biometric Screening/Health Assessment
Plan A ($750 Deductible, $2500 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $871.37 $733.80 $137.57
Employee & Spouse $1,819.23 $1,024.24 $794.99
Employee & Children $1,556.14 $984.66 $571.48
Family $2,368.75 $1,135.32 $1,233.43
Plan B ($1,500 Deductible , $5000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $688.06 $729.72 ($41.66)*
Employee & Spouse $1,436.52 $1,024.24 $412.28
Employee & Children $1,228.75 $984.66 $244.09
Family $1,870.45 $1,135.32 $735.13

* 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.) ($3,300 Deductible, $5000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $632.59 $724.77 ($92.18)*
Employee & Spouse $1,320.70 $1,024.24 $296.46
Employee & Children $1,129.70 $984.66 $145.04
Family $1,719.65 $1,135.32 $584.33

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

Plan A ($750 Deductible, $2500 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $871.37 $710.93 $160.44
Employee & Spouse $1,819.23 $1,001.37 $817.86
Employee & Children $1,556.14 $961.79 $594.35
Family $2,368.75 $1,112.45 $1,256.30
Plan B ($1,500 Deductible , $5000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $688.06 $708.89 ($20.83)*
Employee & Spouse $1,436.52 $1,001.37 $435.15
Employee & Children $1,228.75 $961.79 $266.96
Family $1,870.45 $1,112.45 $758.00

* 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.) ($3,300 Deductible, $5000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $632.59 $703.94 ($71.35)*
Employee & Spouse $1,320.70 $1,001.37 $319.33
Employee & Children $1,129.70 $961.79 $167.91
Family $1,719.65 $1,112.45 $607.20

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

Plan A ($750 Deductible, $2500 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $871.37 $688.06 $183.31
Employee & Spouse $1,819.23 $978.49 $840.74
Employee & Children $1,556.14 $938.92 $617.22
Family $2,368.75 $1,089.58 $1,279.17
Plan B ($1,500 Deductible , $5000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $688.06 $688.06 $0
Employee & Spouse $1,436.52 $978.49 $458.03
Employee & Children $1,228.75 $938.92 $289.83
Family $1,870.45 $1,089.58 $780.87

 

Plan C (H.S.A.) ($3,300 Deductible, $5000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $632.59 $683.11 ($50.52)*
Employee & Spouse $1,320.70 $978.49 $342.21
Employee & Children $1,129.70 $938.92 $190.78
Family $1,719.65 $1,089.58 $630.07

*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).

H.S.A Participants – The University will contribute $83.33/month to an H.S.A. for employee only. And $166.67/month to an H.S.A. for those enrolled in dependent tiers.