2021 Cost Sheet for Eligible Full-Time Regular Employees
AFUM ONLY
(Effective 01/01/2021 – 12/31/2021)
Rates are subject to Collective Bargaining. Refer to the costs below before making your elections for 2021
Total Medical Premium
| Enrollment Status | Choice Monthly | Copay Monthly |
|---|---|---|
| Employee Only | $702.68 | $929.94 |
| Employee Plus One | $1,545.89 | $2,045.82 |
| Family | $1,967.49 | $2,603.77 |
Quality Incentive Medical Coverage: Wellness Participants
Employee Share of Premium | Choice Monthly | Copay Monthly |
|---|---|---|
| Employee Only | $73.37 | $111.50 |
| Employee Plus One | $177.17 | $265.36 |
| Family | $229.06 | $342.28 |
Quality Incentive Medical Coverage: Wellness Non-Participants
Employee Share of Premium | Choice Monthly | Copay Monthly |
|---|---|---|
| Employee Only | $143.64 | $204.49 |
| Employee Plus One | $331.75 | $469.94 |
| Family | $425.81 | $602.66 |
Dental Coverage
| Traditional Dental (Default Plan) | Enhanced Dental | Preventative Dental | |
|---|---|---|---|
| Enrollment Status | Monthly Premium | Monthly Premium | Monthly Premium |
| Employee Only | $0.00 | $6.94 | $0.00 |
| Employee Plus One | $35.56 | $48.24 | $9.63 |
| Family | $91.01 | $112.68 | $46.75 |
# UMS pays 100% of the single coverage premium (traditional plan) for full-time regular employees.
Vision Coverage
| Enrollment Status | Monthly Premium |
|---|---|
| Employee Only | $9.23 |
| Employee Plus One | $17.68 |
| Family | $28.68 |
Important Note
Domestic Partner Enrollment: In accordance with IRS regulations, premiums for Domestic Partner health coverage (medical, dental, and vision) will be withheld on an after-tax basis. Also, the value of benefits provided by the University (health) will be taxable. Contact the UMS Employee Benefits Center for more information.
Supplemental (Optional) Life Insurance
| Benefit | Monthly Cost |
|---|---|
Employee Coverage: | Under age 35 $0.04 |
Spousal/Domestic Partner Coverage: | Under age 35 $0.09 |
Child(ren) Coverage: | $0.28 for $5,000 |
Supplemental (Optional) AD&D Insurance
| Benefit | Monthly Cost per $10,000 of Coverage |
|---|---|
| Employee Only Coverage | $0.15 |
| Family Coverage | $0.26 |
Short Term Disability (STD)
| Benefit | $100 of Per-Pay Period Base Salary |
|---|---|
| All Eligible Groups Other Than Full-Time Faculty Coverage | $1.043 |
Flexible Spending Account
| Benefit | Monthly Contribution |
|---|---|
Health Care Account Minimum annual pledge of $200 | $16.67 Employee Minimum |
Dependent Day Care Account Minimum annual pledge of $200 | $16.67 Employee Minimum |
*Maximum estimated amounts are based on 12 (monthly) pay periods.
Health Savings Account**
| Benefit | Monthly Contribution |
|---|---|
Individual Coverage in Choice Plan | $83.33 University* |
Family Coverage in Choice Plan | $166.66 University* |
*Additional $1,000 Catch-Up if over 55
