Premier PPO
The Premier PPO plan enables you to choose care from any licensed physician though benefits are higher if care is provided by a Blue Cross network provider. This plan has an annual deductible of $250 for an individual and $750 for a family. Once the deductible is met, you pay 10% of eligible charges for hospital and physician care and the plan pays 90%. The plan pays 100% of the cost of prescription drugs after you pay specified co-payments.
Full Time |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$121 |
$265 |
$225 |
$398 |
$42,000.01-$75,000 |
$143 |
$313 |
$266 |
$471 |
$75,000.01-$128,000 |
$172 |
$376 |
$320 |
$566 |
$128,000.01-$182-000 |
$209 |
$457 |
$389 |
$688 |
$182,000.01 and above |
$264 |
$578 |
$492 |
$869 |
Part Time |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$291 |
$637 |
$542 |
$958 |
$42,000.01-$75,000 |
$302 |
$661 |
$562.50 |
$994.50 |
$75,000.01-$128,000 |
$316.50 |
$692.50 |
$589.50 |
$1,042 |
$128,000.01-$182-000 |
$335 |
$733 |
$624 |
$1,103 |
$182,000.01 and above |
$362.50 |
$793.50 |
$675.50 |
$1,193.50 |
| NOTE:
- Full Time status is defined as employees scheduled to work
at least 35 hours per week or an 100% appointment.
- Part Time status is defined as employees scheduled to work
at least 17.5 hours per week or at least a 50% appointment
but less than 100%.
- For Academic Full-Time Faculty [e.g., Medical School Faculty]
Contributions are based on an individual's total professional
salary.
- Union employees should consult the current contract for
premium rates. |
Select PPO
The Select PPO plan enables you to choose care from any licensed physician though benefits are higher if care is provided by a Blue Cross network provider. This plan has an annual deductible of $500 for an individual and $1,500 for a family. Once the deductible is met, you pay 20% of eligible charges for hospital and physician care and the plan pays 80%. The plan pays 100% of the cost of prescription drugs after you pay specified co-payments.
Full Time |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$25 |
$55 |
$46 |
$82 |
$42,000.01-$75,000 |
$45 |
$98 |
$84 |
$148 |
$75,000.01-$128,000 |
$72 |
$157 |
$134 |
$236 |
$128,000.01-$182-000 |
$105 |
$229 |
$195 |
$345 |
$182,000.01 and above |
$156 |
$341 |
$290 |
$512 |
Part Time |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$180 |
$393.50 |
$334.50 |
$591 |
$42,000.01-$75,000 |
$190 |
$415 |
$353.50 |
$624 |
$75,000.01-$128,000 |
$203.50 |
$444.50 |
$378.50 |
$668 |
$128,000.01-$182-000 |
$220 |
$480.50 |
$409 |
$722.50 |
$182,000.01 and above |
$245.50 |
$536.50 |
$456.50 |
$806 |
| NOTE:
- Full Time status is defined as employees scheduled to work
at least 35 hours per week or an 100% appointment.
- Part Time status is defined as employees scheduled to work
at least 17.5 hours per week or at least a 50% appointment
but less than 100%.
- For Academic Full-Time Faculty [e.g., Medical School Faculty]
Contributions are based on an individual's total professional
salary.
- Union employees should consult the current contract for
premium rates. |
Value PPO
The
Value PPO plan is an innovative plan that offers the lowest monthly premium, but higher out of pocket expenses. This plan enables you to choose care from any licensed physician though benefits are higher if care is provided by a Blue Cross network provider. There is an annual deductible of $1,400 for an individual and $2,800 for a family. Once the deductible is met, you pay 20% of eligible charges for hospital, physician and prescription drugs and the plan pays 80%. As it qualifies as a high deductible health plan, it also offers a health savings account (HSA) and tax savings ways to help you pay for health related expenses. Wellness services are covered at 100%.
Full Time |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$10 |
$22 |
$20 |
$33 |
$42,000.01-$75,000 |
$20 |
$44 |
$37 |
$66 |
$75,000.01-$128,000 |
$45 |
$99 |
$84 |
$148 |
$128,000.01-$182-000 |
$71 |
$155 |
$132 |
$234 |
$182,000.01 and above |
$108 |
$237 |
$201 |
$355 |
Part Time |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$152.50 |
$334 |
$284.50 |
$502 |
$42,000.01-$75,000 |
$157.50 |
$345 |
$293 |
$518.50 |
$75,000.01-$128,000 |
$170 |
$372.50 |
$316.50 |
$559.50 |
$128,000.01-$182-000 |
$183 |
$400.50 |
$340.50 |
$602.50 |
$182,000.01 and above |
$201.50 |
$441.50 |
$375 |
$663 |
| NOTE:
- Full Time status is defined as employees scheduled to work
at least 35 hours per week or an 100% appointment.
- Part Time status is defined as employees scheduled to work
at least 17.5 hours per week or at least a 50% appointment
but less than 100%.
- For Academic Full-Time Faculty [e.g., Medical School Faculty]
Contributions are based on an individual's total professional
salary.
- Union employees should consult the current contract for
premium rates. |
HMOs
HMO Illinois provides care from a network of physicians (including NorthShore University HealthSystem) and pays 100% after specified co-payments and deductibles are paid. Members must select a primary care physician who will coordinate your care with other network providers. The inpatient hospital deductible is $500 and the outpatient surgery deductible is $250.
UniCare provides care from a network of physicians (including NMFF) and pays 100% after specified co-payments and deductibles are paid. Members must select a primary care physician who will coordinate your care with other network providers. The inpatient hospital deductible is $300 and the outpatient surgery deductible is $250.
HMO Illinois |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Full Time |
$94 |
$220 |
$192 |
$275 |
Part Time |
$228.50 |
$533.50 |
$465 |
$665.50 |
Unicare |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Full Time |
$104 |
$242 |
$215 |
$307 |
Part Time |
$238.50 |
$555.50 |
$488 |
$697.50 |
| NOTE:
- Full Time status is defined as employees scheduled to work
at least 35 hours per week or an 100% appointment.
- Part Time status is defined as employees scheduled to work
at least 17.5 hours per week or at least a 50% appointment
but less than 100%.
- Union employees should consult the current contract for
premium rates. |
Leave of Absence
|
You |
You+Spouse |
You+Child(ren) |
You+Spouse+Child(ren) |
Premier PPO |
$461 |
$1,009 |
$859 |
$1,518 |
Select PPO |
$335 |
$732 |
$623 |
$1,100 |
Value PPO |
$295 |
$646 |
$549 |
$971 |
HMO Illinois |
$363 |
$847 |
$738 |
$1,056 |
Unicare |
$373 |
$869 |
$761 |
$1,088 |
COBRA
|
You |
You+Spouse |
You+Child(ren) |
You+Spouse+Child(ren) |
Premier PPO |
$470.22 |
$1,029.18 |
$876.18 |
$1,548.36 |
Select PPO |
$341.70 |
$746.64 |
$635.46 |
$1,122.00 |
Value PPO |
$300.90 |
$658.92 |
$559.98 |
$990.42 |
HMO Illinois |
$370.26 |
$863.94 |
$752.76 |
$1,077.12 |
Unicare |
$380.46 |
$886.38 |
$776.22 |
$1,109.76 |
Retirees
|
Premier PPO |
HMO Illinois |
Unicare |
You under 65 |
$461 |
$366 |
$373 |
You + Spouse under 65 |
$1,009 |
$854 |
$869 |
You + Child(ren) under 65 |
$859 |
$744 |
$761 |
You + Spouse + Child(ren) under 65 |
$1,518 |
$1,066 |
$1,088 |
You over 65 |
$331 |
$346 |
|
You + Spouse over 65 |
$662 |
$702 |
You + Child(ren) over 65 |
$729 |
$744 |
You + Spouse + Child(ren) over 65 |
$1,060 |
$1,072 |
You over 65 + Spouse under 65 |
$792 |
$722 |
You under 65 + Spouse over 65 |
$792 |
$722 |
You over 65 + Spouse under 65 + Child(ren) |
$1,388 |
$1,072 |
You under 65 + Spouse over 65 + Child(ren) |
$1,388 |
$1,072 |
|
|
|
|
|
NRSA Post Doctoral Fellows
Since NSRA recipients are not considered by the Internal Revenue Service (IRS) to be employees, employee related benefits are not generally available. However, the University has made its health, dental and vision insurance plans accessible to NRSA recipients. Single coverage has the monthly insurance premium paid by a combination of funds from the NRSA grant and from University funds. No premium amount is charged to the recipient. Family coverage has the monthly premium paid by a combination of funds from the NRSA grant, from University funds and from the NRSA recipient by payroll deduction. The deduction is on an after tax basis. The amount is the increment between the single and family related contributions normally made by University faculty and staff.
Premier PPO |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$0 |
$144 |
$104 |
$277 |
$42,000.01-$75,000 |
$0 |
$170 |
$123 |
$328 |
$75,000.01-$128,000 |
$0 |
$204 |
$148 |
$394 |
$128,000.01-$182-000 |
$0 |
$248 |
$180 |
$479 |
$182,000.01 and above |
$0 |
$314 |
$228 |
$605 |
Select PPO |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$0 |
$30 |
$21 |
$57 |
$42,000.01-$75,000 |
$0 |
$53 |
$39 |
$103 |
$75,000.01-$128,000 |
$0 |
$85 |
$62 |
$164 |
$128,000.01-$182-000 |
$0 |
$124 |
$90 |
$240 |
$182,000.01 and above |
$0 |
$185 |
$134 |
$356 |
Value PPO |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
Under $42,000 |
$0 |
$12 |
$10 |
$23 |
$42,000.01-$75,000 |
$0 |
$24 |
$17 |
$46 |
$75,000.01-$128,000 |
$0 |
$54 |
$39 |
$103 |
$128,000.01-$182-000 |
$0 |
$84 |
$61 |
$163 |
$182,000.01 and above |
$0 |
$129 |
$93 |
$247 |
HMO Illinois |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
|
$0 |
$126 |
$98 |
$181 |
Unicare HMO |
You |
You + spouse |
You + child(ren) |
You + spouse + child(ren) |
|
$0 |
$138 |
$111 |
$203 |
|
| Holiday Schedule | Human Resources Staff.
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