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Domestic Partner Health Care Plan Rate Chart
(Monthly Rates for 2009)
UnitedHealthcare Options Preferred Provider Organization (PPO)
Aetna PPO
Aetna Choice POS II Point of Service Plan (POS)
UnitedHealthcare Select Plus Point of Service (POS)
Aetna HMO
J-1 Visa Plan
Vision Care Plan
Dental Care Plans
UnitedHealthcare
Options Preferred Provider Organization (PPO)
If your current type of coverage is |
and you would like to add |
Your Total Monthly Cost |
Pre-tax Total (EE) |
Post-tax Total (Partner) |
EE Pre-Tax Contribution + University Contribution |
Partner Post-Tax
Contribution
+ University
Contribution |
TOTAL EE+Partner +University Contribution |
Monthly Imputed Income |
Annual Imputed Income |
EE only |
your domestic partner |
232.00 |
63.00 |
169.00 |
503.23 |
603.88 |
1107.11 |
434.88 |
5218.56 |
EE only |
your domestic partner's children |
177.00 |
63.00 |
114.00 |
503.23 |
407.62 |
910.85 |
293.62 |
3523.44 |
EE only |
both |
355.00 |
63.00 |
292.00 |
503.23 |
1041.69 |
1544.92 |
749.69 |
8996.28 |
EE + your children |
your domestic partner |
355.00 |
177.00 |
178.00 |
910.85 |
634.07 |
1544.92 |
456.07 |
5472.84 |
EE + your children |
your domestic partner's children |
177.00 |
177.00 |
- |
910.85 |
- |
910.85 |
-
|
-
|
EE + your children |
both |
355.00 |
177.00 |
178.00 |
910.85 |
634.07 |
1544.92 |
456.07 |
5472.84 |
|
* Monthly Imputed income is the portion of the accrual rate
attributed to the partner less the monthly post-tax contribution
paid for the partner's coverage. |
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Aetna Preferred Provider Organization (PPO)
If
your current type of coverage is |
and
you would like to add |
Your
Total Monthly Cost |
Pre-tax
Total (EE) |
Post-tax
Total (Partner) |
EE
Pre-Tax Contribution + University Contribution |
Partner
Post-Tax
Contribution
+ University
Contribution |
TOTAL
EE+Partner +University Contribution |
Monthly
Imputed Income |
Annual
Imputed Income |
EE
only |
your
domestic partner |
232.00 |
63.00 |
169.00 |
503.23 |
603.88 |
1107.11 |
434.88 |
5218.56 |
EE
only |
your
domestic partner's children |
177.00 |
63.00 |
114.00 |
503.23 |
407.62 |
910.85 |
293.62 |
3523.44 |
EE
only |
both |
355.00 |
63.00 |
292.00 |
503.23 |
1041.69 |
1041.69 |
1544.92 |
8996.28 |
EE
+ your children |
your
domestic partner |
355.00 |
177.00 |
178.00 |
910.85 |
634.07 |
1544.92 |
456.07 |
5472.84 |
EE
+ your children |
your
domestic partner's children |
177.00 |
177.00 |
-
|
910.85 |
-
|
910.85 |
-
|
-
|
EE
+ your children |
both |
355.00 |
177.00 |
178.00 |
910.85 |
634.07 |
1544.92 |
456.07 |
5472.84 |
| *
Monthly Imputed income is the portion of the accrual rate attributed
to the partner less the monthly post-tax contribution paid for the
partner's coverage. |
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Aetna Choice POS II Point of Service (POS)
If your current type of coverage is |
and you would like to add |
Your Total Monthly Cost |
Pre-tax Total (EE) |
Post-tax Total (Partner) |
EE Pre-Tax Contribution + University Contribution |
Partner Post-Tax
Contribution
+ University
Contribution |
TOTAL EE+Partner +University Contribution |
Monthly Imputed Income |
Annual Imputed Income |
EE only |
your domestic partner |
216.00 |
58.00 |
158.00 |
425.04 |
510.05 |
935.09 |
352.05 |
4224.60 |
EE only |
your domestic partner's children |
165.00 |
58.00 |
107.00 |
425.04 |
344.28 |
769.32 |
237.28 |
2847.36 |
EE only |
both |
331.00 |
58.00 |
273.00 |
425.04 |
879.83 |
1304.84 |
606.83 |
7281.96 |
EE + your children |
your domestic partner |
331.00 |
165.00 |
166.00 |
769.32 |
535.55 |
1304.87 |
369.55 |
4434.60 |
EE + your children |
your domestic partner's children |
165.00 |
165.00 |
- |
769.32 |
- |
769.32 |
- |
- |
EE + your children |
both |
331.00 |
165.00 |
166.00 |
769.32 |
535.55 |
1304.84 |
369.55 |
4434.60 |
| * Monthly Imputed income is the portion of the accrual rate attributed to the partner less the monthly post-tax contribution paid for the partner's coverage. |
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UnitedHealthCare
Select Plus Point of Service Plan (POS)
If your current type of coverage is |
and you would like to add |
Your Total Monthly Cost |
Pre-tax Total (EE) |
Post-tax Total (Partner) |
EE Pre-Tax Contribution + University Contribution |
Partner Post-Tax
Contribution
+ University
Contribution |
TOTAL EE+Partner +University Contribution |
Monthly Imputed Income |
Annual Imputed Income |
EE only |
your domestic partner |
216.00 |
58.00 |
158.00 |
425.04 |
510.05 |
935.09 |
352.05 |
4224.60 |
EE only |
your domestic partner's children |
165.00 |
58.00 |
107.00 |
425.04 |
344.28 |
769.32 |
237.28 |
2847.36 |
EE only |
both |
331.00 |
58.00 |
273.00 |
425.04 |
879.83 |
1304.87 |
606.83 |
7281.96 |
EE + your children |
your domestic partner |
331.00 |
165.00 |
166.00 |
769.32 |
535.55 |
1304.87 |
396.55 |
4434.60 |
EE + your children |
your domestic partner's children |
165.00 |
165.00 |
- |
769.32 |
- |
769.32 |
- |
- |
EE + your children |
both |
331.00 |
165.00 |
166.00 |
769.32 |
535.55 |
1304.87 |
369.55 |
4434.60 |
| * Monthly Imputed income is the portion of the accrual rate attributed to the partner less the monthly post-tax contribution paid for the partner's coverage. |
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Aetna HMO
If your current type of coverage is |
and you would like to add |
Your Total Monthly Cost |
Pre-tax Total (EE) |
Post-tax Total (Partner) |
EE Pre-Tax Contribution + University Contribution |
Partner Post-Tax
Contribution
+ University
Contribution |
TOTAL EE+Partner +University Contribution |
Monthly Imputed Income |
Annual Imputed Income |
EE only |
your domestic partner |
200.00 |
51.00 |
149.00 |
437.02 |
524.42 |
961.44 |
375.42 |
4505.04 |
EE only |
your domestic partner's children |
152.00 |
51.00 |
101.00 |
437.02 |
353.98 |
791.00 |
252.98 |
3035.76 |
EE only |
both |
308.00 |
51.00 |
257.00 |
437.02 |
904.62 |
1341.64 |
647.62 |
7771.44 |
EE + your children |
your domestic partner |
308.00 |
152.00 |
156.00 |
791.00 |
550.64 |
1341.64 |
394.64 |
4735.68 |
EE + your children |
your domestic partner's children |
152.00 |
152.00 |
- |
791.00 |
- |
791.00 |
- |
- |
EE + your children |
both |
308.00 |
152.00 |
156.00 |
791.00 |
550.64 |
1341.64 |
394.64 |
4735.68 |
| * Monthly Imputed income is the portion of the accrual rate attributed to the partner less the monthly post-tax contribution paid for the partner's coverage. |
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J-1
Visa Plan
If
your current type of coverage is |
and
you would like to add |
Your
Total Monthly Cost |
Pre-tax
Total (EE) |
Post-tax
Total (Partner) |
EE
Pre-Tax Contribution + University Contribution |
Partner
Post-Tax
Contribution
+ University
Contribution |
TOTAL
EE+Partner +University Contribution |
Monthly
Imputed Income |
Annual
Imputed Income |
EE
only |
your
domestic partner |
169.00 |
- |
169.00 |
503.23 |
603.88 |
1107.11 |
434.88 |
5218.56 |
EE
only |
your
domestic partner's children |
114.00 |
- |
114.00 |
503.23 |
407.62 |
910.85 |
293.62 |
3523.44 |
EE
only |
both |
292.00 |
- |
292.00 |
503.23 |
1041.69 |
1544.92 |
749.69 |
8996.28 |
EE
+ your children |
your
domestic partner |
292.00 |
114.00 |
178.00 |
910.85 |
634.07 |
1544.92 |
456.07 |
5472.84 |
EE
+ your children |
your
domestic partner's children |
114.00 |
114.00 |
-
|
910.85 |
-
|
910.85 |
-
|
-
|
EE
+ your children |
both |
292.00 |
114.00 |
178.00 |
910.85 |
634.07 |
1544.92 |
456.07 |
5472.84 |
| *
Monthly Imputed income is the portion of the accrual rate attributed
to the partner less the monthly post-tax contribution paid for the
partner's coverage. |
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Vision
Care Plan (Vision
Service Plan)
If
your current type of coverage is |
and
you would like to add |
Your
Total Monthly Cost |
Pre-tax
Total (EE) |
Post-tax
Total (Partner) |
EE
only |
your
domestic partner |
19.88 |
12.36 |
7.52 |
EE
only |
your
domestic partner's children |
20.26 |
12.36 |
7.90 |
EE
only |
both |
32.66 |
12.36 |
20.30 |
EE
+ your children |
your
domestic partner |
32.66 |
20.26 |
12.40 |
EE
+ your children |
your
domestic partner's children |
20.26 |
20.26 |
- |
EE
+ your children |
both |
32.66 |
20.26 |
12.40 |
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Dental
Care Plan
MetLife Basic Option PPO Dental Plan |
If
your current type of coverage is |
and
you would like to add |
Your
Total Monthly Cost |
Pre-tax
Total (EE) |
Post-tax
Total (Partner) |
EE
only |
your
domestic partner |
35.98 |
16.85 |
19.13 |
EE
only |
your
domestic partner's children |
39.21 |
16.85 |
22.36 |
EE
only |
both |
59.13 |
16.85 |
42.28 |
EE
+ your children |
your
domestic partner |
59.13 |
39.21 |
19.92 |
EE
+ your children |
your
domestic partner's children |
39.21 |
39.21 |
- |
EE
+ your children |
both |
59.13 |
39.21 |
19.92 |
Aetna DMO |
If
your current type of coverage is |
and
you would like to add |
Your
Total Monthly Cost |
Pre-tax
Total (EE) |
Post-tax
Total (Partner) |
EE
only |
your
domestic partner |
50.44 |
25.01 |
25.43 |
EE
only |
your
domestic partner's children |
48.78 |
25.01 |
23.77 |
EE
only |
both |
69.71 |
25.01 |
44.70 |
EE
+ your children |
your
domestic partner |
69.71 |
48.78 |
20.93 |
EE
+ your children |
your
domestic partner's children |
48.78 |
48.78 |
- |
EE
+ your children |
both |
69.71 |
48.78 |
20.93 |
Aetna MetLife High Option PPO Dental Plan |
If
your current type of coverage is |
and
you would like to add |
Your
Total Monthly Cost |
Pre-tax
Total (EE) |
Post-tax
Total (Partner) |
EE
only |
your
domestic partner |
114.30 |
56.64 |
57.66 |
EE
only |
your
domestic partner's children |
110.98 |
56.64 |
54.34 |
EE
only |
both |
157.88 |
56.64 |
101.24 |
EE
+ your children |
your
domestic partner |
157.88 |
110.98 |
46.90 |
EE
+ your children |
your
domestic partner's children |
110.98 |
110.98 |
- |
EE
+ your children |
both |
157.88 |
110.98 |
46.90 |
Return to topLast Updated:
06/19/09
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