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Premiums: Effective July 01, 2016

Medical

HIGH MEDICAL PLAN Full-Time Monthly Faculty & StaffFull-Time Biweekly Faculty & StaffPart-Time Monthly Faculty & StaffPart-Time Biweekly Faculty & StaffCOBRA
Employee Only$165.00$76.00$552.08$254.81$563.12
Employee and Spouse$442.00$204.00$1,269.79$586.06$1,295.19
Employee and Child$288.00$133.00$828.13$382.21$844.69
Employee and Children$385.00$178.00$1,104.17$509.62$1,126.25
Family$558.00$258.00$1,601.04$738.94$1,633.06
LOW MEDICAL PLANFull-Time Monthly Faculty & StaffFull-Time Biweekly Faculty & StaffPart-Time Monthly Faculty & StaffPart-Time Biweekly Faculty & StaffCOBRA
Employee Only$89.00$41.00$471.87$217.79$481.31
Employee and Spouse$258.00$119.00$1,085.29$500.90$1,107.00
Employee and Child$169.00$78.00$707.80$326.68$721.96
Employee and Children$225.00$104.00$943.73$435.57$962.60
Family$326.00$150.00$1,368.41$631.58$1,395.78

Dental

HIGH OPTION DENTAL PLANFull-Time Monthly Faculty & StaffFull-Time Biweekly Faculty & StaffPart-Time Monthly Faculty & StaffPart-Time Biweekly Faculty & StaffCOBRA
Employee Only$29.00$13.00$44.40$20.49$45.29
Employee and Spouse$60.00$28.00$92.43$42.66$94.28
Employee and Child$48.00$22.00$73.79$34.06$75.27
Employee and Children$62.00$29.00$95.69$44.17$97.61
Family$92.00$42.00$141.68$65.39$144.52
LOW OPTION DENTAL PLANFull-Time Monthly Faculty & StaffFull-Time Biweekly Faculty & StaffPart-Time Monthly Faculty & StaffPart-Time Biweekly Faculty & StaffCOBRA
Employee Only$16.00$7.00$24.19$11.16$24.68
Employee and Spouse$33.00$15.00$51.05$23.56$52.07
Employee and Child$27.00$12.00$41.12$18.98$41.95
Employee and Children$36.00$17.00$54.91$25.34$56.01
Family$51.00$24.00$78.62$36.29$80.19

Vision

VISION PLANFull & Part-Time
Monthly Faculty &
Staff
Full & Part-Time
Biweekly Faculty &
Staff
COBRA
Employee Only$6.18$2.85$6.30
Employee and 1 Dependent $11.96$5.52$12.20
Family$17.58$8.12$17.93

FSA

FLEXIBLE SPENDING ACCOUNTS - ANNUAL LIMITS
Health Care FSA (per employee limit)$2,550/ maximum per year
Dependent Care FSA (per household limit)$5,000/ maximum per year

Legal

Ultimate Advisor PlusUltimate Advisor
Full & Part-Time Monthly Faculty & Staff $23.00 $17.50
Full & Part-Time Biweekly Faculty & Staff $10.62 $8.08

Life Insurance

VOLUNTARY LIFE INSURANCE PLAN
AgeMonthly Biweekly
Rate per $1,000Rate per $1,000
Less than 25$0.06 $0.03
25 - 29$0.07 $0.03
30 - 34$0.09 $0.04
35 - 39$0.10 $0.05
40 - 44$0.11 $0.05
45 – 49$0.17 $0.08
50 - 54$0.25 $0.12
55 - 59$0.47 $0.22
60 - 64$0.73 $0.34
65 – 69$1.40 $0.65
70 – 74$2.27 $1.05
75 and over$3.40 $1.57
VOLUNTARY LIFE INSURANCE PLANBenefitMonthly PremiumBiweekly Premium
Option 1 - Spouse and Children$25,000/$10,000$5.25 $2.42
Option 2 - Spouse and Children$10,000/$5,000$2.25 $1.04
Option 3 - Spouse$25,000 $4.05 $1.87
Option 4 - Children$10,000 $1.20 $0.55
Option 5 - Spouse$10,000 $1.65 $0.76
Option 6 - Children$5,000 $0.60 $0.28

AFLAC

AFLAC - ACCIDENT PLANFull & Part-Time
Monthly Faculty & Staff
Full & Part-Time
Biweekly Faculty & Staff
Employee
Age 18-75
$17.29$7.98
Employee and Spouse
Age 18-75
$24.57$11.34
One-Parent Family
Age 18-75
$29.25$13.50
Two-Parent Family
Age 18-75
$38.22$17.64
AFLAC - SPECIFIED EVENT PLANFull & Part-Time
Monthly Faculty & Staff
Full & Part-Time Biweekly Faculty & Staff
Employee
Age 18-35
$11.70$5.40
Employee
Age 36-45
$18.86$8.70
Employee
Age 46-55
$25.35$11.70
Employee
Age 56-64
$32.89$15.18
One-Parent Family
Age 18-35
$12.87$5.94
One-Parent Family
Age 36-45
$19.63$9.06
One-Parent Family
Age 46-55
$26.13$12.06
One-Parent Family
Age 56-64
$33.80$15.60
Two-Parent Family
Age 18-35
$20.28$9.36
Two-Parent Family
Age 36-45
$33.54$15.48
Two-Parent Family
Age 46-55
$46.67$21.54
Two-Parent Family
Age 56-64
$63.96$29.52
Employee and Spouse
Age 18-35
$18.07$8.34
Employee and Spouse
Age 36-45
$30.94$14.28
Employee and Spouse
Age 46-55
$43.68$20.16
Employee and Spouse
Age 56-64
$60.32$27.84
AFLAC - CANCER PLANFull & Part-Time
Monthly Faculty & Staff
Full & Part-Time Biweekly Faculty & Staff
Employee
Age 18-75
$38.48$17.76
Employee and Spouse
Age 18-75
$68.64$31.68
One-Parent Family
Age 18-75
$38.48$17.76
Two-Parent Family
Age 18-75
$68.64$31.68

Retiree Information

Retiree on BCBS Medical (under age 65) Monthly Premiums
Retiree Only - High Plan$465.08
Spouse Only - High Plan$552.08
Retiree and Spouse - High Plan$1,182.79
Retiree Only - Low Plan$384.87
Spouse Only - Low Plan$471.87
Retiree and Spouse - Low Plan$1,085.29
Retiree on BCBS and 1X
1X Retiree, BCBS High Spouse$552.08
1X Retiree, BCBS Low Spouse$471.87
1X Retiree, BCBS High Spouse and Child$828.13
1X Retiree, BCBS Low Spouse and Child$707.80
BCBS High Retiree, 1X Spouse$465.08
BCBS Low Retiree, 1X Spouse$384.87
Retiree on 1X Medical (age 65 and over) Monthly Premiums
Retiree or Spouse Only Monthly Rates Vary
Retiree and Spouse Monthly Rates Vary
Retiree on AARP Medical (age 65 and over) Monthly Premiums
Outside of NCMonthly Rates Vary
Retiree Dental High Option Plan Monthly Premiums
Retiree or Spouse Only$44.40
Retiree and Spouse$92.43
Retiree Dental Low Option Plan Monthly Premiums
Retiree or Spouse Only$24.19
Retiree and Spouse$51.05
Retiree Vision Plan Monthly Premiums
Retiree or Spouse Only$6.18
Retiree and Spouse$11.96
Family$17.58