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Home > Benefits > Medical Care Plans > 2013 Monthly Employee Contributions for Health Plans

2013 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
$28.93
$39.74
$53.25
$66.77
$80.28
$93.81
$107.33
$272.24
PPO $900 Deductible
$65.66
$86.44
$112.41
$138.38
$164.35
$190.32
$216.29
$533.11
IU Health Quality Partners**
$76.81
$97.17
$122.61
$148.05
$173.50
$198.94
$224.38
$534.79
PPO $400 Deductible
$102.42
$125.15
$153.57
$182.00
$210.42
$238.84
$267.26
$613.98
Employee and Child(ren) coverage
HDHP PPO & HSA
$57.69
$79.26
$106.22
$133.19
$160.15
$187.11
$214.08
$543.03
PPO $900 Deductible
$130.97
$172.41
$224.21
$276.01
$327.81
$379.62
$431.42
$1,063.39
IU Health Quality Partners**
$153.21
$193.81
$244.57
$295.32
$346.07
$396.81
$447.57
$1,066.73
PPO $400 Deductible
$202.88
$247.92
$304.20
$360.50
$416.80
$473.09
$529.39
$1,216.20
Employee and Spouse coverage
HDHP PPO & HSA
$70.52
$96.90
$129.86
$162.82
$195.78
$228.75
$261.71
$663.85
PPO $900 Deductible
$160.10
$210.77
$274.10
$337.42
$400.75
$464.08
$527.40
$1,299.99
IU Health Quality Partners**
$187.30
$236.94
$298.98
$361.02
$423.06
$485.10
$547.16
$1,304.08
PPO $400 Deductible
$248.49
$303.64
$372.59
$441.55
$510.50
$579.45
$648.39
$1,489.60
Family coverage
HDHP PPO & HSA
$80.09
$110.04
$147.48
$184.91
$222.35
$259.78
$297.21
$753.90
PPO $900 Deductible
$181.83
$239.36
$311.27
$383.19
$455.11
$527.02
$598.95
$1,476.33
IU Health Quality Partners**
$212.71
$269.08
$339.53
$409.99
$480.45
$550.92
$621.38
$1,480.99
PPO $400 Deductible
$282.14
$344.77
$423.06
$501.35
$579.64
$657.93
$736.23
$1,691.36

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

** 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
$5.97
$7.54
$8.97
$28.94
Employee/Child(ren)
$10.74
$13.57
$16.14
$52.11
Employee/Spouse
$14.02
$17.71
$21.06
$67.97
Family
$20.44
$25.83
$30.71
$99.14

 

 

 

 

Page updated: 19 September 2012
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