Employee Costs for Insurance Benefits
Medical Plan ....................................................................... 2 Blue Choice – PPO (Blue Cross/Blue Shield of Texas ……..... 2 3 3 3 3
Dental Plans ....................................................................... DR Dental ...................................................................... QCD Red ....................................................................... QCD White .......................................................................
Other Insurances ............................................................... 4 Accidental Death & Dismemberment (AD&D) ............ 4 AFLAC Policies .............................................................. 5 AIG Cancer +30 ............................................................. 6 Long Term Care ............................................................. 6 Supplemental Term Life ................................................ 7-8
Insurance premiums for bi-weekly paid employees are deducted once a month from the #2 pay period. Disclaimer: Every attempt has been made to have the chart and information above accurately reflect the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description prevails .
1
Medical Plan – Blue Choice
2008 Monthly Medical Premium Schedule Faculty/Staff Contributions per *Annualized Salary Range
Coverage Elections 2008 Faculty/Staff Monthly Premiums per Annualized Salary Range $28,215 $28,215- $38,666- $49,116- $59,566- $70,016 or less $38,665 $49,115 $59,565 $70,015 & over $38 $75 $83 $166 $100 $197 $120 $239 $139 $275 $145 $289
Employee only Employee + Spouse Employee + Children Employee + Family
$65
$144
$173
$212
$241
$253
$82
$175
$227
$280
$314
$325
*Annualized Salary for faculty/lecturers: The medical premiums for Faculty/Lecturers are calculated on annualized salary (1/10th of contracted salary X 12). Supplemental pay for teaching during the summer is not added to the benefit base. Explanation of How Medical Premiums are Determined
Insurance premiums for bi-weekly paid employees are deducted once a month from the #2 pay period. Disclaimer: Every attempt has been made to have the chart and information above accurately reflect the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description prevails .
2
Dental Plans
DR Dental
Plan – DR Dental Your Cost Monthly
Employee only Employee + One Employee + Family (more than one)
0.00 $39.00 $51.00
QCD Red
Plan – QCD Red Your Cost Monthly
Employee only Employee + One Employee + Family (more than one)
0.00 $0.00 $0.00
QCD White
Plan – QCD White Your Cost Monthly
Employee only Employee + One Employee + Family (more than one)
0.00 $26.00 $50.00
Insurance premiums for bi-weekly paid employees are deducted once a month from the #2 pay period. Disclaimer: Every attempt has been made to have the chart and information above accurately reflect the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description prevails .
3
Insurances Accidental Death & Dismemberment (AD&D)
Plans Employee only 100% Employee (100%) and Spouse (50%) Employee (100%) and Spouse (100%) Employee (100%) and Child (10%) Employee (100%), Spouse (50%), and Child (10%) Employee (100%), Spouse (100%), and Child (10%) Plans Employee only 100% Employee (100%) and Spouse (50%) Employee (100%) and Spouse (100%) Employee (100%) and Child (10%) Employee (100%), Spouse (50%), and Child (10%) Employee (100%), Spouse (100%), and Child (10%) Plan Plan Plan Plan A B C D $25,000 $50,000 $75,000 $100,000 $125,000 $ 0.88 $ 1.75 $ 2.63 $ 3.50 $ 4.38 $ 1.28 $ 2.55 $ 3.83 $ 5.10 $ 6.38 $ 1.68 $ 3.35 $ 5.03 $ 6.70 $ 8.38 $ 1.03 $ 2.05 $ 3.08 $ 4.10 $ 5.13 $ 1.43 $ 1.83 $ 2.85 $ 3.65 $ 4.28 $. 5.48 $ 5.70 $ 7.30 $ 7.13 $ 9.13 $150,000 $ 5.25 $ 7.65 $10.05 $ 6.15 $ 8.55 $10.95 $300,000 $10.50 $15.30 $20.10 $12.30 $17.10 $21.90
Plan E Plan D
Plan Plan Plan Plan
A B C D
$175,000 $200,000 $225,000 $250,000 $275,000 $ 6.13 $ 7.00 $ 7.88 $ 8.75 $ 9.63 $ 8.93 $10.20 $11.48 $12.75 $14.03 $11.73 $13.4 $15.08 $16.75 $18.43 $ 7.1 $ 8.20 $ 9.23 $10.25 $11.28 $ 9.98 $12.78 $11.40 $14.60 $12.83 $16.43 $14.25 $18.25 $15.68 $20.08
Plan E Plan D
Insurance premiums for bi-weekly paid employees are deducted once a month from the #2 pay period. Disclaimer: Every attempt has been made to have the chart and information above accurately reflect the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description prevails .
4
AFLAC
Prepared for BAYLOR UNIVERSITY by MILES KECHTER - FC975 with version 342,1 on 112312008
American Family Life Assurance Company of ColumbUS (AFLAC) TEXAS 342.5 A-RATES - MONTHLY
PERSONAL ACCIDENT INDEMNITY LEVEL 2 - Series A34200 Age 18-64 Age 18-64 Age 18-64 Age 18-64 MAXIMUM DIFFERENCE – NEW CANCER POLICY Series A76000 18-35 36-45 46-55 56-70 18-35 36-45 46-55 56-70 HOSPITAL INTENSIVE CARE PROTECTION - Series A18400 • Plan 1 Age 18-35 36-45 46-55 56-70 HOSPITAL INTENSIVE CARE PROTECTION - Series Al840H Plan 2 Age 18-35 36-45 46-55 56-70 SPECIFIED HEALTH EVENT PROTECTION –Series A71100 Plan 1 Age 18-35 36-45 46-55 56-70 SPECIFIED HEALTH EVENT PROTECTION –Series A71200 Plan 2 Age 18-35 36-45 46-55 56-70 Premium
Employee One-Parent Family Employee & Spouse Two-Parent Family
19.40 3210 27.50 40.70
Individual & one-parent family
Insured/spouse & two-parent family
30.94 44.07 58.89 72.54 59.28 80.86 110,63 139.88
Individual Premium 10.40 11.31 13,65 15.47
One parent family premium 20.41 20.41 22.36 28.86
Insured/spouse premium 20.80 20.80 25.35 30.94
Two parent family premium 24.57 24.57 27.43 34.06
Individual Premium 10.14 10.92 13,26 14.95
One parent family premium 19.76 19.76 21.71 27.95
Insured/spouse premium 20.15 20.15 24.27 30.03
Two parent family premium 23.79 23.79 26.65 33.02
Individual Premium 11.44 18.46 24.70 32.11
One parent family premium 12.61 19.24 25.48 33.02
Insured/spouse premium 17.68 30.29 42.64 58.89
Two parent family premium 19.89 32.76 45.63 62.40
Individual Premium 18.72 27.69 36.92 46.67
One parent family premium 30.55 37.57 47.71 61.75
Insured/spouse premium 36.27 49.66 65.39 88.14
Two parent family premium 40.69 54.34 71.11 95.03
Insurance premiums for bi-weekly paid employees are deducted once a month from the #2 pay period. Disclaimer: Every attempt has been made to have the chart and information above accurately reflect the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description prevails .
5
AIG Cancer and Specified Disease
AIG Cancer and Specified Disease Your Cost Monthly
Employee only Family
$32.48 $69.93
Long Term Care
Plans 1 - 4 Your Cost Based on plan, facility monthly benefit, facility benefit duration and age. Approved through underwriting. Contact Compensation & Benefits, 254.710.2218, to receive a Long Term Care packet.
Insurance premiums for bi-weekly paid employees are deducted once a month from the #2 pay period. Disclaimer: Every attempt has been made to have the chart and information above accurately reflect the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description prevails .
6
Supplemental Term Life Insurance
Premium Calculation Table
What am I eligible for: round your *basic annual salary to the nearest $25,000. Select a Plan: 1 times; 2 times; 3 times; 4 times; 5 times. Multiple your rounded salary by the plan selected. Spouse Spouse (50% of (50% of 25,000) Employee 50,000) $13,000 $25,000 $25,000 0.72 0.85 0.98 1.17 1.43 1.69 2.73 4.81 6.89 11.05 18.59 32.11 57.07 106.21 1.38 1.63 1.88 2.25 2.75 3.25 5.25 9.25 13.25 21.25 35.75 61.75 109.75 204.25 1.38 1.63 1.88 2.25 2.75 3.25 5.25 9.25 13.25 21.25 35.75 61.75 109.75 204.25 Spouse (50% of Employee 75,000) $50,000 $38,000 2.75 3.25 3.75 4.50 5.50 6.50 10.50 18.50 26.50 42.50 71.50 123.50 219.50 408.50 2.09 2.47 2.85 3.42 4.18 4.94 7.98 14.06 20.14 32.30 54.34 93.86 166.82 310.46 Spouse (50% of Employee $100,000) $75,000 $50,000 4.13 4.88 5.63 6.75 8.25 9.75 15.75 27.75 39.75 63.75 107.25 185.25 329.25 612.75 2.75 3.25 3.75 4.50 5.50 6.50 10.50 18.50 26.50 42.50 71.50 123.50 219.50 408.50
Your Age Under age 20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84
Employee $100,000 5.50 6.50 7.50 9.00 11.00 13.00 21.00 37.00 53.00 85.00 143.00 247.00 439.00 817.00
Your Age Under age 20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 85-89
Spouse Spouse (50% of (50% of 125,000) Employee 150,000) $63,000 $125,000 $75,000 3.47 4.10 4.73 5.67 6.93 8.19 13.23 23.31 33.39 53.55 90.09 155.61 276.57 514.71 658.35 135.85 6.88 8.13 9.38 11.25 13.75 16.25 26.25 46.25 66.25 106.25 178.75 308.75 548.75 1021.25 1306.25 261.25 4.13 4.88 5.63 6.75 8.25 9.75 15.75 27.75 39.75 63.75 107.25 185.25 329.25 612.75 783.75 261.25
Spouse (50% of Employee 175,000) $150,000 $88,000 8.25 9.75 11.25 13.50 16.50 19.50 31.50 55.50 79.50 127.50 214.50 370.50 658.50 1225.50 1567.50 522.50 4.84 5.72 6.60 7.92 9.68 11.44 18.48 32.56 46.64 74.80 125.84 217.36 386.32 718.96 919.60 397.10
Spouse Max. (50% of Employee $200,000) $175,000 $100,000 9.63 11.38 13.13 15.75 19.25 22.75 36.75 64.75 92.75 148.75 250.25 432.25 768.25 1429.75 1828.75 783.75 5.50 6.50 7.50 9.00 11.00 13.00 21.00 37.00 53.00 85.00 143.00 247.00 439.00 817.00 1045.00 522.50
Employee $200,000 11.00 13.00 15.00 18.00 22.00 26.00 42.00 74.00 106.00 170.00 286.00 494.00 878.00 1634.00 2090.00 1045.00
Insurance premiums for bi-weekly paid employees are deducted once a month from the #2 pay period. Disclaimer: Every attempt has been made to have the chart and information above accurately reflect the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description prevails .
7
Your Age Under age 20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89
Employee $225,000 12.38 14.63 16.88 20.25 24.75 29.25 47.25 83.25 119.25 181.25 321.75 555.75 987.75 1838.25 2351.25 Employee $375,000 20.63 24.38 28.13 33.75 41.25 48.75 78.75 138.75 188.75 318.75 536.25 926.25 1646.25 3063.75 3918.75
Employee $250,000 13.75 16.25 18.75 22.50 27.50 32.50 52.50 92.50 132.50 212.50 357.50 617.50 1097.50 2042.50 2612.50 Employee $400,000 22.00 26.00 30.00 36.00 44.00 52.00 84.00 148.00 212.00 340.00 572.00 988.00 1756.00 3268.00 4180.00
Employee $275,000 15.13 17.88 20.63 24.75 30.25 35.75 57.75 101.75 145.75 233.75 393.25 679.25 1207.25 2246.75 2873.75 Employee $425,000 23.38 27.63 31.88 38.25 46.75 55.25 89.25 157.25 225.25 361.25 607.75 1049.75 1865.75 3472.25 4441.25
Employee $300,000 16.50 19.50 22.50 27.00 33.00 39.00 63.00 111.00 159.00 255.00 429.00 741.00 1317.00 2451.00 3135.00 Employee $450,000 24.75 29.25 33.75 40.50 49.50 58.50 94.50 166.50 238.50 382.50 643.50 1111.50 1975.50 3676.50 4702.50
Employee $325,000 17.88 21.13 24.38 29.25 35.75 42.25 68.25 120.25 172.25 276.25 464.75 802.75 1426.75 2655.25 3396.25 Employee $475,000 26.13 30.88 35.63 42.75 52.25 61.75 99.75 175.75 251.75 403.75 679.25 1173.25 2085.25 3880.75 4963.75
Employee $350,000 19.25 22.75 26.25 31.50 38.50 45.50 73.50 129.50 185.50 297.50 500.50 864.50 1536.50 2859.50 3657.50 Employee $500,000 27.50 32.50 37.50 45.00 55.00 65.00 105.00 185.00 265.00 425.00 715.00 1235.00 2195.00 4085.00 5225.00
Your Age Under age 20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74 75-79 80-84 85-89
*Annualized Salary for faculty/lecturers: The premiums for Faculty/Lecturers are calculated on annualized salary (1/10th of contracted salary X 12). Supplemental pay for teaching during the summer is not added to the benefit base.
Insurance premiums for bi-weekly paid employees are deducted once a month from the #2 pay period. Disclaimer: Every attempt has been made to have the chart and information above accurately reflect the details of the plan. Should there be any errors, the terms and conditions of the Summary Plan Description prevails .
8