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Home > Benefits > Medical Care Plans > 2014 PPO $500

2014 PPO $500 Deductible Medical Care Plan

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

 

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
$125.86
$150.25
$180.74
$211.25
$241.74
$272.24
$302.73
Employee and Child(ren)
$249.31
$297.64
$358.03
$418.44
$478.85
$539.25
$599.66
Employee and Spouse
$305.36
$364.54
$438.52
$512.51
$586.50
$660.48
$734.45
Family
$346.71
$413.91
$497.92
$581.92
$665.93
$749.93
$833.95

* The employee’s salary band is determined by the annual base salary at the time payroll runs each month. For School of Medicine full-time faculty, annual base salary includes IU base salary and IU Health and/or VA salary, as determined by IUSM.

General Information

Things you can do…

Medical Services (includes Mental Health)

Things you can do…

Prescription Drugs (Rx)

Things you can do…

Vision

Things you can do…

 


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: 11 July 2014
UNIVERSITY HUMAN RESOURCES
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