Health Premiums

Choose Your Appropriate Wellness $$ Level

Level Amount Requirements Completed
Full Wellness $$ Appox. $550/yr Biometric Screening, Health Assessment, Non-Tobacco User (completed affidavit)
Partial Wellness $$ Appox. $275/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 ($1,000 Deductible, $3,000 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $1,093.19 $906.86 $186.33
Employee & Spouse $2,282.34 $1,265.80 $1,016.54
Employee & Children $1,952.28 $1,216.88 $735.40
Family $2,971.76 $1,403.08 $1,568.68
Plan B ($1,750 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $850.33 $891.99 ($41.66)*
Employee & Spouse $1,775.32 $1,265.80 $509.52
Employee & Children $1,518.54 $1,216.88 $301.66
Family $2,311.59 $1,403.08 $908.51

* 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/$3,500 Deductible, $5,000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $769.93 $862.11 ($92.18)*
Employee & Spouse $1,607.45 $1,260.50 $346.95
Employee & Children $1,374.98 $1,205.24 $169.74
Family $2,093.02 $1,403.08 $689.94

* 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 ($1,000 Deductible, $3,000 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $1,093.19 $883.94 $209.25
Employee & Spouse $2,282.34 $1,242.88 $1,039.46
Employee & Children $1,952.28 $1,193.96 $758.32
Family $2,971.76 $1,380.16 $1,591.60
Plan B ($1,750 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $850.33 $869.07 ($18.74)*
Employee & Spouse $1,775.32 $1,242.88 $532.44
Employee & Children $1,518.54 $1,193.96 $324.58
Family $2,311.59 $1,380.16 $931.43

* 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/$3,500 Deductible, $5,000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $769.93 $839.19 ($69.26)*
Employee & Spouse $1,607.45 $1,237.58 $369.87
Employee & Children $1,374.98 $1,182.32 $192.66
Family $2,093.02 $1,380.16 $712.86

*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 ($1,000 Deductible, $3,000 Out of Pocket Max ; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $1,093.19 $861.03 $232.16
Employee & Spouse $2,282.34 $1,219.97 $1,062.37
Employee & Children $1,952.28 $1,171.05 $781.23
Family $2,971.76 $1,357.25 $1,614.51
Plan B ($1,750 Deductible , $5,000 Out of Pocket Max; 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $850.33 $846.16 $4.17
Employee & Spouse $1,775.32 $1,219.97 $555.35
Employee & Children $1,518.54 $1,171.05 $347.49
Family $2,311.59 $1,357.25 $954.34

 

Plan C (H.S.A.) ($3,000/$3,500 Deductible, $5,000 Out of Pocket Max: 2x Family)
Coverage Total Premium University Contribution Employee Contribution
Employee Only $769.93 $816.28 ($46.35)*
Employee & Spouse $1,607.45 $1,214.67 $392.78
Employee & Children $1,374.98 $1,159.41 $215.57
Family $2,093.02 $1,357.25 $735.77

*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.