|Salary Band ***||Your PPO Plan||Your HSA-Eligible Plan|
|Full-Time Employees Earning < $62,100||$675.79||$566.66|
|Full-Time Employees Earning $62,100 – $132,500 and Part-Time Employees < $132,500 with more than 5 Years of University Service||$670.19||$560.48|
|Part-Time Employees Earning < $132,500 with less than 5 Years of University Service*||$670.19||$560.48|
|Employees Earning > $132,500||$670.19||$560.48|
Rates for certain adult children through age 29*
*This coverage is available for unmarried children through age 29 who are not otherwise eligible for coverage under his or her parent’s University Health Care Plan due to age who live, work, or reside in New York State, and who are not covered by Medicare, and not covered by or eligible for health insurance coverage through another employer’s group health plan (e.g. own employer’s plan or the plan of their other parent’s employer).
**Adult child must be enrolled in the same health plan his or her parent is enrolled (e.g. YOUR PPO Plan or YOUR HSA-Eligible Plan).
***The salary band is based on the employee’s salary, University service, and full-time/part-time status. Any changes to the employee’s salary or University service throughout the calendar year will not change the child’s premiums in 2021. If the employee’s work status changes between full-time and part-time during the calendar year, the child’s premiums will be adjusted as appropriate.
Premiums are billed directly by the Third-Party Administrator for the Health Care Plan.