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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 DentalPreventative 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 StatusMonthly 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

BenefitMonthly Cost

Employee Coverage:
Increments of salary (1x to 5x) to a maximum of $1,000,000 (combined with Basic Life)

Under age 35      $0.04
35 to 39              $0.07
40 to 44              $0.09
45 to 49              $0.15
50 to 54              $0.23
55 to 59              $0.43
60 to 64              $0.66
65 to 69              $1.27
70+                    Not Available

Spousal/Domestic Partner Coverage:
Increments of $10,000 to a maximum of $50,000

Under age 35      $0.09
35 to 39              $0.11
40 to 44              $0.12
45 to 49              $0.18
50 to 54              $0.29
55 to 59              $0.56
60 to 64              $0.74
65 to 69              $1.40
70+                    Not Available

Child(ren) Coverage:
$5,000 or $10,000 benefit per child

$0.28 for $5,000
$0.55 for $10,000

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

BenefitMonthly Contribution

Health Care Account

Minimum annual pledge of $200
Maximum annual pledge of $2,700


$16.67 Employee Minimum
$229.17 Employee Maximum*

Dependent Day Care Account

Minimum annual pledge of $200
Maximum annual pledge of $5,000


$16.67 Employee Minimum
$416.67 Employee Maximum*

*Maximum estimated amounts are based on 12 (monthly) pay periods.

Health Savings Account**

BenefitMonthly Contribution

Individual Coverage in Choice Plan
Maximum Combined Max of $3,600*

$83.33 University*
$0.00 - $216.66 Employee*

Family Coverage in Choice Plan
Maximum Combined Max of $7,200*

$166.66 University*
$0.00 - $433.33 Employee*

*Additional $1,000 Catch-Up if over 55

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