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Health Care & Dental Rate Sheets

 

Monthly Premium Contributions (monthly paid)

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $50,000

YOUR PPO Plan

$87.78

$263.26

$193.06

$157.94

YOUR HSA-Eligible Plan

$8.96

$26.86

$19.70

$16.12

Full-Time Employees Earning $50,000 - $124,000 and Part-Time Employees < $124,000.

YOUR PPO Plan

$136.76

$410.24

$300.86

$246.14

YOUR HSA-Eligible Plan

$10.08

$30.20

$22.16

$18.14

Part-Time Employees Earning < $124,000 with less than 5 Years of Service*

YOUR PPO Plan

$177.92

$533.72

$391.40

$320.24

YOUR HSA-Eligible Plan

$54.60

$163.76

$120.08

$98.26

Employees Earning > $124,000

YOUR PPO Plan

$219.08

$657.26

$482.02

$394.34

YOUR HSA-Eligible Plan

$98.58

$295.72

$216.84

$177.42

 

Bi-weekly and Semi-monthly Premium Contributions (bi-weekly† /semi-monthly paid)


University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $50,000

YOUR PPO Plan

$43.89

$131.63

$96.53

$78.97

YOUR HSA-Eligible Plan

$4.48

$13.43

$9.85

$8.06

Full-Time Employees Earning $50,000 - $124,000 and Part-Time Employees < $124,000.

YOUR PPO Plan

$68.38

$205.12

$150.43

$123.07

YOUR HSA-Eligible Plan

$5.04

$15.10

$11.08

$9.07

Part-Time Employees Earning < $124,000 with less than 5 Years of Service*

YOUR PPO Plan

$88.96

$266.86

$195.70

$160.12

YOUR HSA-Eligible Plan

$27.30

$81.88

$60.04

$49.13

Employees Earning > $124,000

YOUR PPO Plan

$109.54

$328.63

$241.01

$197.17

YOUR HSA-Eligible Plan

$49.29

$147.86

$108.42

$88.71

 

Share of Dental Premiums


University Dental Plans

Monthly

Bi-Weekly/Semi-Monthly

 

Single

Family

Single

Family

Traditional Dental Plan

$4.38

$8.94

$2.19

$4.47

Medallion Dental Plan

$13.76

$28.22

$6.88

$14.11

 

Printer-Friendly Faculty & Staff Rate Sheets

†Faculty/staff members who are paid bi-weekly will have their Health Care and Dental Plan premium contributions deducted in the first two paydays of each month. In the month(s) that contain three paydays (June and November), Health Care Plan and Dental Plan deductions will not be taken from the third payday.

*Also includes Agency Nurses with Medical and Time-as-Reported employees who qualify as a full-time employee in accordance with the University's Measurement and Stability Periods Policy.

The rates represented in these charts reflect the amount that will be deducted each pay period from faculty/staff members' paychecks from January 1 - December 31, 2018 respectively. This is in addition to the amount contributed by the University. Faculty/Staff member premiums are based on salary, full-time/part-time status and University years of service as of January 1, 2018.

Any changes to either salary or University service throughout the calendar year will not change the faculty/staff member's premium amount in 2018. If your work status changes between full-time and part- time during the calendar year, your payroll deductions will be adjusted as appropriate.

For a salaried faculty or staff member, annual salary is 12 times the regular monthly salary or 24 times the regular semi-monthly salary. For faculty members under the School of Medicine and Dentistry Faculty Compensation plan, annual salary means the "Targeted Salary”.

 

Monthly Premium Contributions (monthly paid)


University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

YOUR PPO Plan

$87.78

$263.26

$193.06

$157.94

YOUR HSA-Eligible Plan

$8.96

$26.86

$19.70

$16.12

 

Bi-weekly and Semi-monthly Premium Contributions (bi-weekly/semi-monthly paid)


University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

YOUR PPO Plan

$43.89

$131.63

$96.53

$78.97

YOUR HSA-Eligible Plan

$4.48

$13.43

$9.85

$8.06

 

Share of Dental Premiums


University Dental Plans

Monthly

Bi-Weekly/Semi-Monthly

 

Single

Family

Single

Family

Traditional Dental Plan

$4.38

$8.94

$2.19

$4.47

Medallion Dental Plan

$13.76

$28.22

$6.88

$14.11

 

Printer-Friendly Resident & Fellow Rate Sheets

 

The rates represented on this page reflect the amount that will be deducted each pay period from Resident/Fellow's paychecks from January 1, 2018 - December 31, 2018 respectively. This is in addition to the amount contributed by the University. Residents/fellows member premiums are based on salary, full-time/part-time status, and University years of service as of January 1, 2018.

 

Monthly COBRA Continuation Premium Contributions (monthly paid)


University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $50,000

YOUR PPO Plan

$561.33

$1,683.90

$1,234.89

$1,010.35

YOUR HSA-Eligible Plan

$470.67

$1,412.01

$1,035.48

$847.21

Full-Time Employees Earning $50,000 - $124,000 and Part-Time Employees < $124,000.

YOUR PPO Plan

$556.68

$1,669.94

$1,224.67

$1,001.99

YOUR HSA-Eligible Plan

$465.53

$1,396.58

$1,024.20

$837.97

Part-Time Employees Earning < $124,000 with less than 5 Years of Service*

YOUR PPO Plan

$556.68

$1,669.94

$1,224.67

$1,001.99

YOUR HSA-Eligible Plan

$465.53

$1,396.58

$1,024.20

$837.97

Employees Earning > $124,000

YOUR PPO Plan

$556.68

$1,669.94

$1,224.67

$1,001.99

YOUR HSA-Eligible Plan

$465.53

$1,396.58

$1,024.20

$837.97

 

Dental Plan COBRA Rates


University Dental Plans

Single

Family

Traditional Dental Plan

$31.11

$63.74

Medallion Dental Plan

$40.69

$83.37

Printer-Friendly COBRA Continuation Rate Sheets

 

The Salary Band level is based on the faculty or staff member’s salary, University service and full-time/part-time status as of the date of the COBRA qualifying event. COBRA Premiums are billed directly by the Third Party Administrator for the Health Care Plan, Aetna or Excellus. Those eligible for the Employee Assistance Program (EAP) at the time their employment or benefit eligible status ends will automatically be enrolled, together with any eligible dependents, for EAP COBRA continuation coverage at no cost for the period of their COBRA eligibility period. 

 

Monthly Premium Contributions (monthly paid)


University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

YOUR PPO Plan

$177.92

$533.72

$391.40

$320.24

YOUR HSA-Eligible Plan

$54.60

$163.76

$120.08

$98.26

 

Bi-weekly and Semi-monthly Premium Contributions (bi-weekly† /semi-monthly paid)


University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

YOUR PPO Plan

$88.96

$266.86

$195.70

$160.12

YOUR HSA-Eligible Plan

$27.30

$81.88

$60.04

$49.13

Printer-Friendly Rate Sheets for employees eligible under ACA

† Faculty/staff members who are paid bi-weekly will have their Health Care premium contributions deducted in the first two paydays of each month. In the month(s) that contain three paydays (June and November), Health Care Plan deductions will not be taken from the third payday

The rates represented in these charts reflect the amount that will be deducted each pay period from faculty/staff members' paychecks from January 1 - December 31, 2018 respectively. This is in addition to the amount contributed by the University. Faculty/Staff member premiums are based on salary, full-time/part-time status and University years of service as of January 1, 2018. Any changes to either salary or University service throughout the calendar year will not change the faculty/staff member's premium amount in 2018. If your work status changes between TAR and part-time/full-time during the calendar year, your payroll deductions will be adjusted as appropriate.

*Under the Employer Shared Responsibility (ESR) Mandate of the Patient Protection and Affordable Care Act (PPACA), the University is required to offer health care coverage to substantially all full-time employees and their eligible dependents (see dependent eligibility in the Health Program Guide).

 

For Certain Adult Children through Age 29*

Employee’s Elected University Health Care Plan** Premiums


Salary Band ***

YOUR PPO Plan

YOUR HSA-Eligible Plan

Full-Time Employees Earning < $50,000

$550.32

$461.44

Full-Time Employees Earning $50,000 - $124,000 and Part-Time Employees < $124,000 with more than 5 Years of University Service

$545.76

$456.40

Part-Time Employees Earning < $124,000 with less than 5 Years of University Service*

$545.76

$456.40

Employees Earning > $124,000

$545.76

$456.40

 

Printer-Friendly Special Extended Health Care Coverage Rate Sheet

*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 2018. 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, either Aetna or Excellus.