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Home > Benefits > Medical Care Plans > 2013 PPO $400

2013 PPO $400 Deductible Medical Care Plan

On this page: General Info | Medical Services | Prescription Drugs

 

Coverage
Monthly Employee Contribution
Employee’s Annual Base Salary*
Below $30,000
$30,000 -
$49,999
$50,000 -
$99,999
$100,000 -
$149,999
$150,000 -
$199,999
$200,000 -
$249,999
$250,000
and Above
Employee only
$102.42
$125.15
$153.57
$182.00
$210.42
$238.84
$267.26
Employee and Child(ren)
$202.88
$247.92
$304.20
$360.50
$416.80
$473.09
$529.39
Employee and Spouse
$248.49
$303.64
$372.59
$441.55
$510.50
$579.45
$648.39
Family
$282.14
$344.77
$423.06
$501.35
$579.64
$657.93
$736.23

* The employee’s salary band is determined by the annual base salary at the time payroll runs each month.

General Information

Things you can do…

Medical Services (includes Mental Health)

Things you can do…

Prescription Drugs (Rx)

Things you can do now…

 


For all plans, to access information on background and licensing of individual doctors, nurses, chiropractors and pharmacists, search and verify licensing online or call (toll free) 888-333-7515.

 

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Page updated: 24 December 2013
UNIVERSITY HUMAN RESOURCES
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