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Sept. 18, 2009

2010 employee premiums for medical and dental coverage

UPMC will continue to offer employees and their dependents access to world-class providers and facilities through affordable medical coverage. Your participation in MyHealth has helped keep our annual medical cost increases lower than those of many employers. As a result, UPMC staff pay less of their total medical premiums than those in many other organizations, realizing a higher overall compensation for our workforce.

Although premiums under each plan differ depending on the level of coverage selected (such as individual or family), UPMC will continue to pay the majority of the medical costs for employees in 2010. For example, UPMC’s average annual cost under these plans amounts to more than $7,750 per employee. Employees are asked to pay, on average, slightly more than $1,100 per year.

Employees can choose between the Advantage HMO, Advantage PPO, and Open Access PPO plans. An Out-of-Area PPO plan will also be offered to employees who live outside UPMC’s Advantage network service area. The rates to the right show biweekly payroll deductions for medical and dental options. Please keep in mind that these benefits and associated costs may not be applicable to all staff, including some costs that are covered by collective bargaining agreements.

Plan designs have changed and now have a core deductible, including — for the first time — the Advantage HMO and Out-of-Area PPO. While this means additional out-of-pocket expenses when using services such as inpatient or outpatient hospital care and diagnostic labwork, this can help offset some premium increases for those who enroll in our health care plans. Be sure to read “Which option works for you?” in this issue to learn how some employees determined which plan was right for them.

Don’t forget that out-of-pocket expenses for medical care, including copays, can be funded through a pretax health care flexible spending account (FSA). 2010 may be the year to begin participating, or to increase your FSA contributions, which not only help to pay for eligible expenses, but also lower your taxable income. Take a moment to read the FSA article and learn more about the advantages of this account.

Dental options have been enhanced through a Preventive Incentive program. Preventive and diagnostic services, such as annual routine cleaning and x-rays, will not count toward the annual calendar year maximums. This means that cleanings and preventive and diagnostic services are always covered, even if you have already reached the plan’s annual maximum. Coverage for white composite fillings has also been expanded to include all teeth, based on the provisions of the dental benefit. These additional items have been added to the dental plan for a minimal increase in cost.

2010 Employee Premiums

2010 Biweekly Employee Medical Contribution Rates*
(Full-time & Flex Full-time)

 
Advantage HMO
Advantage PPO
Open Access PPO
Out-of-Area PPO
Individual

$34.15

$9.69
$95.08
$41.08
Employee & Child(ren)
$65.08
$18.46
$181.38
$78.46
Employee & Spouse
$80.31
$23.08
$223.85
$96.92
Family
$84.92
$24.46
$237.23
$102.46
*These biweekly rates include the standard vision plan and are deducted from 26 pays per year. An enhanced vision plan is available for an additional cost.

2010 Biweekly Employee Medical Contribution Rates*
(Part-time & Job-Share)

 
Advantage HMO
Advantage PPO
Open Access PPO
Out-of-Area PPO
Individual
$94.62
$59.08
$117.23
$109.38
Employee & Child(ren)
$180.46
$113.08
$224.31
$209.54
Employee & Spouse
$222.92
$139.38
$277.38
$258.46
Family
$235.85
$147.69
$293.54
$274.15
*These biweekly rates include the standard vision plan and are deducted from 26 pays per year. An enhanced vision plan is available for an additional cost.

2010 Biweekly Employee Dental Contribution Rates

 
Full-time,
Flex Full-time
Part-time, Job-Share
Dental Plans
Standard Dental PPO
Premier Dental PPO
Standard Dental PPO
Premier Dental PPO
Individual
$2.31
$6.00
$4.62
$8.31
Family
$12.46
$23.54
$14.31
$27.69

To calculate the corresponding monthly employee rates,
multiply the biweekly premium by 26 and divide by 12.