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Home > Benefits > Medical Care Plans > 2012 Monthly Employee Contributions for IU-Sponsored Medical and Dental Plans

2012 Monthly Employee Contributions for IU-Sponsored Medical and Dental Plans

Medical Plans

Employee contributions are deducted before taxes.
Subtract $25 per month for an employee or spouse ($50 for both) who do not use tobacco.

Monthly Employee Contribution
Employee’s Annual Base Salary
Total
Monthly
Premium
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 coverage
HDHP PPO & HSA
$25.51
$35.71
$48.46
$61.21
$73.96
$86.72
$99.47
$255.05
IU Health Quality Partners*
$48.01
$67.21
$91.21
$115.21
$139.22
$163.22
$187.22
$480.06
PPO $900 Deductible
$49.00
$68.60
$93.10
$117.60
$142.10
$166.60
$191.10
$489.99
PPO $400 Deductible
$53.62
$75.07
$101.88
$128.70
$155.51
$182.32
$209.13
$536.23
Employee and Child(ren) coverage
HDHP PPO & HSA
$50.87
$71.22
$96.66
$122.10
$147.53
$172.97
$198.41
$508.74
IU Health Quality Partners*
$95.76
$134.06
$181.94
$229.82
$277.70
$325.57
$373.45
$957.57
PPO $900 Deductible
$97.74
$136.83
$185.70
$234.57
$283.44
$332.31
$381.18
$977.38
PPO $400 Deductible
$106.22
$148.71
$201.81
$254.92
$308.03
$361.14
$414.25
$1,062.18
Employee and Spouse coverage
HDHP PPO & HSA
$62.19
$87.07
$118.17
$149.26
$180.36
$211.46
$242.55
$621.93
IU Health Quality Partners*
$117.06
$163.89
$222.42
$280.95
$339.48
$398.01
$456.55
$1,170.63
PPO $900 Deductible
$119.48
$167.28
$227.02
$286.76
$346.50
$406.25
$465.99
$1,194.84
PPO $400 Deductible
$130.10
$182.13
$247.18
$312.23
$377.28
$442.33
$507.37
$1,300.96
Family coverage
HDHP PPO & HSA
$70.63
$98.88
$134.20
$169.51
$204.83
$240.14
$275.46
$706.30
IU Health Quality Partners*
$132.94
$186.12
$252.59
$319.06
$385.53
$452.01
$518.48
$1,329.43
PPO $900 Deductible
$135.69
$189.97
$257.81
$325.66
$393.51
$461.35
$529.20
$1,356.92
PPO $400 Deductible
$147.72
$206.80
$280.66
$354.52
$428.38
$502.24
$576.10
$1,477.17

* Eligibility is limited to employees residing in certain counties.

 

Dental Plan

Employee contributions are deducted before taxes.

Monthly Employee Contribution
Employee’s Annual Base Salary

Total
Monthly Premium
Below $30,000
$30,000 -
$49,999
$50,000
and Above
PPO Dental Plan
Employee
$5.25
$6.73
$8.08
$26.92
Employee/Child(ren)
$9.45
$12.12
$14.54
$48.47
Employee/Spouse
$12.33
$15.81
$18.97
$63.23
Family
$17.98
$23.06
$27.67
$92.22

 

 

 

 

Page updated: 7 February 2012
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