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2020 Health Care & Dental Rate Sheets

 

2020 rates are updated as of 11/1/2019.

Monthly Premium Contributions (monthly paid)

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $60,000

YOUR PPO Plan

$105.32

$339.20

$248.76

$189.50

YOUR HSA-Eligible Plan

$10.76

$34.66

$25.42

$19.36

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $128,000.

YOUR PPO Plan

$164.08

$528.44

$387.54

$295.32

YOUR HSA-Eligible Plan

$12.12

$39.02

$28.62

$21.78

Part-Time Employees Earning < $128,000 with less than 5 Years of Service*

YOUR PPO Plan

$213.48

$687.54

$504.22

$384.26

YOUR HSA-Eligible Plan

$65.52

$211.02

$154.76

$117.90

Employees Earning > $128,000

YOUR PPO Plan

$262.86

$846.58

$620.84

$473.14

YOUR HSA-Eligible Plan

$118.28

$380.94

$279.36

$212.86

 

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 < $60,000

YOUR PPO Plan

$52.66

$169.60

$124.38

$94.75

YOUR HSA-Eligible Plan

$5.38

$17.33

$12.71

$9.68

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $128,000.

YOUR PPO Plan

$82.04

$264.22

$193.77

$147.66

YOUR HSA-Eligible Plan

$6.06

$19.51

$14.31

$10.89

Part-Time Employees Earning < $128,000 with less than 5 Years of Service*

YOUR PPO Plan

$106.74

$343.77

$252.11

$192.13

YOUR HSA-Eligible Plan

$32.76

$105.51

$77.38

$58.95

Employees Earning > $128,000

YOUR PPO Plan

$131.43

$423.29

$310.42

$236.57

YOUR HSA-Eligible Plan

$59.14

$190.47

$139.68

$106.43

 

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

 

VSP Vision Care Plans

VSP Vision Care Plans

Employee Monthly Contribution+

 

Single

Member + Spouse or Domestic Partner

Member + Child(ren)

Member + Family

UR Vision Basic

$4.07

$8.12

$8.70

$13.89

UR Vision Plus

$7.92

$15.82

$16.94

$27.06

+Rates are shown as monthly, therefore semi-monthly and bi-weekly employees will see a different deduction amount per paycheck

VSP Vision Care is a voluntary benefit, that is employee paid. For more details view the VSP Summary and to enroll go to YourBenefitsExtras.com.

 

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, 2020 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, 2020.

Any changes to either salary or University service throughout the calendar year will not change the faculty/staff member's premium amount in 2020. 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”.

 

2020 rates are updated as of 11/1/2019.

Monthly Premium Contributions (monthly paid)

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

YOUR PPO Plan

$105.32

$339.20

$248.76

$189.50

YOUR HSA-Eligible Plan

$10.76

$34.66

$25.42

$19.36

 

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

$52.66

$169.60

$124.38

$94.75

YOUR HSA-Eligible Plan

$5.38

$17.33

$12.71

$9.68

 

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

 

VSP Vision Care Plans

VSP Vision Care Plans

Employee Monthly Contribution+

 

Single

Member + Spouse or Domestic Partner

Member + Child(ren)

Member + Family

UR Vision Basic

$4.07

$8.12

$8.70

$13.89

UR Vision Plus

$7.92

$15.82

$16.94

$27.06

+Rates are shown as monthly, therefore semi-monthly and bi-weekly employees will see a different deduction amount per paycheck

VSP Vision Care is a voluntary benefit, that is employee paid. For more details view the VSP Summary and to enroll go to YourBenefitsExtras.com.

 

Printer-Friendly Resident & Fellow Rate Sheets

The rates represented in these charts reflect the amount that will be deducted each pay period from residents/fellows members’ paychecks from January 1–December 31, 2020, 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, 2020.

 

2020 rates are updated as of 11/1/2019.

Shares of Premiums for Faculty, Staff and SEIU Members on Long-Term Disability - both member and spouse/domestic partner are Medicare-eligible*

University Health Care Plans

Monthly Premium Contributions

Quarterly Premium Contributions

Single

Employee & Spouse/Domestic Partner

Single

Employee & Spouse/Domestic Partner

Full-Time Employees Earning < $60,000

YOUR PPO Plan

$0.00

$0.00

$0.00

$0.00

YOUR HSA-Eligible Plan

$0.00

$0.00

$0.00

$0.00

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $128,000 with more than 5 Years of Service

YOUR PPO Plan

$58.76

$117.52

$176.28

$352.56

YOUR HSA-Eligible Plan

$1.36

$2.72

$4.08

$8.16

Part-Time Employees Earning < $128,000 with less than 5 Years of Service

YOUR PPO Plan

$108.16

$216.32

$324.48

$648.96

YOUR HSA-Eligible Plan

$54.76

$109.52

$164.28

$328.56

Employees Earning > $128,000

YOUR PPO Plan

$157.54

$315.08

$472.62

$945.24

YOUR HSA-Eligible Plan

$107.52

$215.04

$322.56

$645.12


Share of Dental Premiums

University Dental Plans**

Monthly Premium Contributions

 

Single

Family

Traditional Dental Plan

$4.38

$8.94

Medallion Dental Plan

$13.76

$28.22

* The rates above apply only to Faculty/Staff/SEIU members on Long-Term Disability who are Medicare-eligible and whose spouse or domestic partner are also Medicare-eligible. Medicare is the primary payer for health care expenses and the above plans through the University are the secondary payer. Therefore, the above University Health Care Plans will not cover any expenses that would have been covered under Medicare Part A and Part B if you were enrolled (commonly known as "carve out" plans).

** Eligibilty rules apply

 

Share of Premiums for Faculty, Staff and SEIU Members on Long-Term Disability - both member and spouse/domestic partner are NON-Medicare-eligible*

Monthly Premium Contributions

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $60,000

YOUR PPO Plan

$105.32

$339.20

$248.76

$189.50

YOUR HSA-Eligible Plan

$10.76

$34.66

$25.42

$19.36

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $128,000 with more than 5 Years of Service

YOUR PPO Plan

$164.08

$528.44

$387.54

$295.32

YOUR HSA-Eligible Plan

$12.12

$39.02

$28.62

$21.78

Part-Time Employees Earning < $128,000 with less than 5 Years of Service*

YOUR PPO Plan

$213.48

$687.54

$504.22

$384.26

YOUR HSA-Eligible Plan

$65.52

$211.02

$154.76

$117.90

Employees Earning > $128,000

YOUR PPO Plan

$262.86

$846.58

$620.84

$473.14

YOUR HSA-Eligible Plan

$118.28

$380.94

$279.36

$212.86

 

Quarterly Premium Contributions

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $60,000

YOUR PPO Plan

$315.96

$1,017.60

$746.28

$568.50

YOUR HSA-Eligible Plan

$32.28

$103.98

$76.26

$58.08

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $128,000 with more than 5 Years of Service

YOUR PPO Plan

$492.24

$1,585.32

$1,162.62

$885.96

YOUR HSA-Eligible Plan

$36.36

$117.06

$85.86

$65.34

Part-Time Employees Earning < $128,000 with less than 5 Years of Service*

YOUR PPO Plan

$640.44

$2,062.62

$1,512.66

$1,152.78

YOUR HSA-Eligible Plan

$196.56

$633.06

$464.28

$353.70

Employees Earning > $128,000

YOUR PPO Plan

$788.58

$2,539.74

$1,862.52

$1,419.42

YOUR HSA-Eligible Plan

$354.84

$1,142.82

$838.08

$638.58

 

* The rates above apply to Faculty/Staff/SEIU members on Long-Term Disability who are not eligible for Medicare. The University Health Care Plan will be primary payer for health care expenses.


Shares of Premiums for Faculty, Staff and SEIU Members on Long-Term Disability - who are Medicare-eligible or are covering a Medicare-eligible dependent*

Monthly Premium Contributions

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $60,000

YOUR PPO Plan

$0.00

$189.58

$105.32

$84.18

YOUR HSA-Eligible Plan

$0.00

$19.36

$10.76

$8.60

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $128,000 with more than 5 Years of Service

YOUR PPO Plan

$58.76

$354.10

$222.84

$190.00

YOUR HSA-Eligible Plan

$1.36

$23.18

$13.48

$11.02

Part-Time Employees Earning < $128,000 with less than 5 Years of Service

YOUR PPO Plan

$108.16

$492.42

$321.64

$278.94

YOUR HSA-Eligible Plan

$54.76

$172.70

$120.28

$107.14

Employees Earning > $128,000

YOUR PPO Plan

$157.54

$630.68

$420.40

$367.82

YOUR HSA-Eligible Plan

$107.52

$320.42

$225.80

$202.10

 

Quarterly Premium Contributions

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $60,000

YOUR PPO Plan

$0.00

$568.74

$315.96

$252.54

YOUR HSA-Eligible Plan

$0.00

$58.08

$32.28

$25.80

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $128,000 with more than 5 Years of Service

YOUR PPO Plan

$176.28

$1,062.30

$668.52

$570.00

YOUR HSA-Eligible Plan

$4.08

$69.54

$40.44

$33.06

Part-Time Employees Earning < $128,000 with less than 5 Years of Service

YOUR PPO Plan

$324.48

$1,477.26

$964.92

$836.82

YOUR HSA-Eligible Plan

$164.28

$518.10

$360.84

$321.42

Employees Earning > $128,000

YOUR PPO Plan

$472.62

$1,892.04

$1,261.20

$1,103.46

YOUR HSA-Eligible Plan

$322.56

$961.26

$677.40

$606.30

 

*The rates above apply to Faculty/Staff/SEIU members on Long-Term Disability who are Medicare-eligible or whose dependents are Medicare-eligible. For the Medicare-eligible member only, Medicare is the primary payer for health care expenses and the University Health Care Plans are the secondary payer. Therefore, the University Health Care Plans will not cover any expenses that would have been covered under Medicare Part A and Part B if the Medicare-eligible member were enrolled (commonly known as "carve out" plans). The University Health Care Plans will continue to be primary payer for health care expenses for members not eligible for Medicare.

 

2020 rates are updated as of 11/1/2019.

Monthly COBRA Continuation Premium Contributions (monthly paid)

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

Full-Time Employees Earning < $60,000

YOUR PPO Plan

$662.35

$1,986.94

$1,457.13

$1,192.20

YOUR HSA-Eligible Plan

$555.39

$1,666.11

$1,221.84

$999.68

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $128,000.

YOUR PPO Plan

$656.86

$1,970.48

$1,445.07

$1,182.30

YOUR HSA-Eligible Plan

$549.33

$1,647.91

$1,208.54

$988.77

Part-Time Employees Earning < $128,000 with less than 5 Years of Service*

YOUR PPO Plan

$656.86

$1,970.48

$1,445.07

$1,182.30

YOUR HSA-Eligible Plan

$549.33

$1,647.91

$1,208.54

$988.77

Employees Earning > $128,000

YOUR PPO Plan

$656.86

$1,970.48

$1,445.07

$1,182.30

YOUR HSA-Eligible Plan

$549.33

$1,647.91

$1,208.54

$988.77

 

Dental Plan COBRA Rates

University Dental Plans

Single

Family

Traditional Dental Plan

$31.11

$63.74

Medallion Dental Plan

$40.69

$83.37

 

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. 

 

2020 rates are updated as of 11/1/2019.

Monthly Premium Contributions (monthly paid)

University Health Care Plans

Single

Family

Employee & Spouse/ Domestic Partner

Employee & Child(ren)

YOUR PPO Plan

$213.48

$687.54

$504.22

$384.26

YOUR HSA-Eligible Plan

$65.52

$211.02

$154.76

$117.90

 

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

$106.74

$343.77

$252.11

$192.13

YOUR HSA-Eligible Plan

$32.76

$105.51

$77.38

$58.95

† 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, 2020 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, 2020. Any changes to either salary or University service throughout the calendar year will not change the faculty/staff member's premium amount in 2020. 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).

 

2020 rates are updated as of 11/1/2019.

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 < $60,000

$649.36

$544.50

Full-Time Employees Earning $60,000 - $128,000 and Part-Time Employees < $124,000 with more than 5 Years of University Service

$643.98

$538.56

Part-Time Employees Earning < $128,000 with less than 5 Years of University Service*

$643.98

$538.56

Employees Earning > $128,000

$643.98

$538.56

 

*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 2020. 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.