Medical Insurance (Base Plan)

Pay

12 Pay

10 Pay

Employee

$0.00*

$0.00*

Spouse

$383.04

$459.65

Children

$240.67

$288.80

Family

$552.52

$663.02

*75% to 100% FTE employee premium 100% funded by University; 50% to 74% FTE employees employee premium 70% funded by University
Note: Base Plan costs listed above are net of University-provided subsidies listed below.

Medical Insurance (Accelerated Plan)

Pay

12 Pay

10 Pay

Employee

$22-$90**

$26.40-$108**

Spouse

$648.43***

$778.12***

Children

$530.52***

$636.62***

Family

$1120.00***

$1344.00***

**See below for employee contribution schedule. Employee between 50% and 74%, University will fund 70% of premium
***Employee to pay dependent premium listed plus employee monthly contribution will apply ($22.00 - $90.00 for 12 pay; $26.40-$108 for 10 pay)

Monthly Dependent Medical Premium Supplement for Base Plan

Coverage

12 Pay

10 Pay

Employee + Spouse

$125.00

$150.00

Employee + Child(ren)

$175.00

$210.00

*Family

$325.00

$390.00

 

Monthly Employee Contribution Schedule for Accelerated Plan

2015 W-2 Medicare wages

12 Pay

10 Pay

< $27,000

$22.00

$26.40

$27,000 - $44,999

$45.00

$54.00

$45,000 - $69,999

$67.00

$80.40

$70,000 +

$90.00

$108.00

Note:  Employee contribution to employee premium based on Medicare wages, reported in Box 5 of the 2015 W-2 (Part time employees 75% and greater will have an annualized Medicare wage)

Contact

573.651.2206
Fax: 573.651.2108
humanresources@semo.edu
Academic Hall Room 012
Office of Human Resources
One University Plaza, MS 3150
Cape Girardeau, Missouri 63701