Health Premiums for 9-Pay Faculty

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 $1,161.83 $978.40 $183.43
Employee & Spouse $2,425.64 $1,365.65 $1,059.99
Employee & Children $2,074.85 $1,312.88 $761.97
Family $3,158.33 $1,513.76 $1,644.57
Plan B ($1,500 Deductible , $5000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $917.41 $972.96 ($55.55)*
Employee & Spouse $1,915.36 $1,365.65 $549.71
Employee & Children $1,638.33 $1,312.88 $325.45
Family $2,493.93 $1,513.76 $980.17

* 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 $843.45 $966.36 ($122.91)*
Employee & Spouse $1,760.93 $1,365.65 $395.28
Employee & Children $1,506.27 $1,312.88 $193.39
Family $2,292.87 $1,513.76 $779.11

* 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. for employee only. And $222.22/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 $1,161.83 $947.91 $213.92
Employee & Spouse $2,425.64 $1,335.16 $1,090.48
Employee & Children $2,074.85 $1,282.39 $792.46
Family $3,158.33 $1,483.27 $1,675.06
Plan B ($1,500 Deductible , $5000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $917.41 $945.19 ($27.78)*
Employee & Spouse $1,915.36 $1,335.16 $580.20
Employee & Children $1,638.33 $1,282.39 $355.94
Family $2,493.93 $1,483.27 $1,010.66

* 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 $843.45 $938.59 ($95.14)*
Employee & Spouse $1,760.93 $1,335.16 $425.77
Employee & Children $1,506.27 $1,282.39 $223.88
Family $2,292.87 $1,483.27 $809.60

* 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. for employee only. And $222.22/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 $1,161.83 $917.41 $244.42
Employee & Spouse $2,425.64 $1,304.65 $1,120.99
Employee & Children $2,074.85 $1,251.89 $822.96
Family $3,158.33 $1,452.77 $1,705.56
Plan B ($1,500 Deductible , $5000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $917.41 $917.41 $0
Employee & Spouse $1,915.36 $1,304.65 $610.71
Employee & Children $1,638.33 $1,251.89 $386.44
Family $2,493.93 $1,452.77 $1,041.16

 

Plan C (H.S.A.) ($3,300 Deductible, $5000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $843.45 $910.81 ($67.36)*
Employee & Spouse $1,760.93 $1,304.65 $456.28
Employee & Children $1,506.27 $1,251.89 $254.38
Family $2,292.87 $1,452.77 $840.10

* 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. for employee only. And $222.22/month to an H.S.A. for those enrolled in dependent tiers.

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