Rev. 6/1/2018 Page 1 of 5
UNIVERSITY OF ILLINOIS
State Health and Dental Rate Tables
Effective July 1, 2018
This document contains background information and examples to help State benefits-eligible employees understand
and calculate the cost of health (including vision) and dental insurance. Calculation examples for full-time and part-
time employees begin on page 4.
NOTES ON STATE HEALTH INSURANCE RATE INFORMATION
The State health rates apply to these types of enrollees:
1. Benefits-eligible employees active on payroll, including eligible dependents
2. Benefits-eligible employees on leave of absence, etc., including eligible dependents
3. Veteran Adult Children of benefits-eligible employees
4. Civil Union Partners (same-sex or opposite-sex partners) of benefits-eligible employees, including eligible
dependents of the Civil Union Partner
5. Grandfathered same-sex domestic partners of benefits-eligible employees if enrolled prior to 6/1/2011 may
continue coverage as long as they remain eligible and premiums are paid
Definitions for these dependent categories are available on the CMS website
. The amount an employee pays for
health insurance depends upon the plan selected and the type of enrollee.
For part-time employees, the State contribution (employer cost) is based on the percentage of time worked.
o New and newly benefits eligible faculty members with a 100% job for less than 9 months, may also be
considered part-time for insurance purposes.
For employees on leave, the State contribution is based on the type of leave.
o Employees on personal leave without pay, the State has no contribution and employee pays employee
and State contribution (employer cost).
o Employees on partial personal leave are defined as part-time employees.
o State contributions are not affected by leave status for full- and part-time employees on the following
leaves:
FMLA
Educational
University Academic Break
Medical
Sabbatical
Suspension- 30 day limit
Disability
Workers Compensation
This rate information may assist individuals in estimating the cost of COBRA benefits continuation; however, you
should contact MyBenefits Service Center at 844-251-1777 or TDD/TTY 844-251-1778 or University Payroll and
Benefits for specific COBRA information. COBRA participants pay the entire premium cost (State premium plus
employee premium) plus a 2% administrative fee.
Contact University Payroll and Benefits with any questions:
Urbana
Henry Administration Building
506 S. Wright St., Room 177
Urbana, IL 61801
Phone: 217-265-6363
Fax: 217-244-3135
Email: benef[email protected]du
Chicago
809 S. Marshfield Ave., 1
st
Floor
Chicago, IL 60612
Phone: 312-996-7200
Fax: 217-244-3135
Email: benef[email protected]du
Springfield
Business Services Building (BSB) 85
One University Plaza
Springfield, IL 62703-5407
Phone: 217-206-7144
Fax: 217-244-3135
Email: benef[email protected]du
Rev. 6/1/2018 Page 2 of 5
State Health Insurance
EMPLOYEE SALARY-BASED MONTHLY CONTRIBUTIONS
While the State covers a portion of the cost of employee health insurance, employees also make monthly
contributions for their health care coverage. Employee contribution amounts are based on the employee’s salary,
i.e., the higher the employee’s salary, the higher the employee’s contribution will be.
Employees who enroll in a Managed Care Plan (an HMO or OAP) will pay a lower monthly contribution than will
employees who enroll in the Quality Care Health Plan (comprehensive benefit plan with enhanced benefits when
network providers are utilized).
Employee Annual Salary
Monthly Cost to Employee
Managed Care
Quality Care
A. $30,200 or Less
$68
$93
B. $30,201 - $45,600
$86
$111
C. $45,601 - $60,700
$103
$127
D. $60,701 - $75,900
$119
$144
E. $75,901 - $100,000
$137
$162
F. $100,001 and Over
$186
$211
STATE MONTHLY CONTRIBUTIONS FOR EMPLOYEE ONLY (by Health Plan and Employee Salary Range)
This is the amount the State of Illinois pays to insure a full-time employee. Part-time employees must pay a
percentage of this amount. See page 5 for an explanation.
Health Plan
Monthly State
Contribution for
Employee Only
Health Plan
Monthly State
Contribution for
Employee Only
Quality Care Health Plan
A. $945.04
Health Alliance HMO
A. $850.02
B. $927.04
B. $832.02
C. $911.04
C. $815.02
D. $894.04
D. $799.02
E. $876.04
E. $781.02
F. $827.04
F. $732.02
HMO Illinois
A. $692.36
BlueAdvantage HMO
A. $659.58
B. $674.36
B. $641.58
C. $657.36
C. $624.58
D. $641.36
D. $608.58
E. $623.36
E. $590.58
F. $574.36
F. $541.58
Aetna HMO
A. $841.58
Aetna OAP
A. $564.68
B. $823.58
B. $546.68
C. $806.58
C. $529.68
D. $790.58
D. $513.68
E. $772.58
E. $495.68
F. $723.58
F. $446.68
HealthLink OAP
A. $955.30
B. $937.30
C. $920.30
D. $904.30
E. $886.30
F. $837.30
COBRA participants pay the “state” contribution amount in addition to the “employee” cost above, any dependent
premiums, and a 2% administrative fee. See the CMS website for the COBRA rates
.
Rev. 6/1/2018 Page 3 of 5
MONTHLY HEALTH INSURANCE COST FOR DEPENDENT COVERAGE
Part-time employees also pay a percentage of the State of Illinois contribution for coverage of dependents.
Pre-tax payroll deduction applies to the following dependents. The amount charged is the same as for any other
dependent:
IRS-Qualified Civil Union Partner, including eligible children of the Civil Union Partner
Grandfathered IRS-Qualified Domestic Partner, if enrolled prior to 6/1/2011, may continue coverage as
long as they remain eligible and premiums are paid
IRS Veteran Adult Children
Post-tax payroll deduction applies to the following dependents:
Non-IRS Civil Union Partner, including eligible children of the Civil Union Partner
Grandfathered Non-IRS Domestic Partner, if enrolled prior to 6/1/2011, may continue coverage as long as
they remain eligible and premiums are paid
Non-IRS Veteran Adult Children
Special Notes
IRS Veteran Adult Children - Premiums are shown in the “1 Dependent” or “2+ Dependents” categories
below and are pre-tax when deducted through payroll. Part-time employees will pay a portion of the
employer cost as explained on page 5.
Non-IRS Veteran Adult Children - Premiums are post-tax and both full- and part-time employees pay the
same amount for coverage because the State does not contribute a portion of the cost. The cost can be
calculated by adding the employee’s monthly cost and the monthly State contribution. For example, the
monthly cost for one Non-IRS Veteran Adult Child in the Health Alliance HMO plan would be $113.00 +
$661.32 = $774.32. See the CMS website for the Non-IRS Adult Veteran Child Rates
.
Grandfathered Non-IRS Domestic Partners - The premium charged is the “1 Dependent” rate,
regardless of the number of dependents on the employee’s coverage, but it is a post-tax deduction. The
portion of the cost paid by the State will be added to the employee’s annual gross income that is subject to
federal income tax withholding and employment taxes and will be reported on a W-2 form at the end of
each calendar year. The IRS refers to this as imputed income. See the CMS website for the
Non-IRS
Domestic Partner Rates. Part-time employees should contact the CMS Analysis and Resolution Unit at 217-
558-4671 for the cost of a Non-IRS qualified domestic partner.
The amounts listed below are for Non-Medicare dependents. To obtain the cost of Medicare dependents, please
contact University Payroll and Benefits
.
DEPENDENT HEALTH COVERAGE
Monthly
Employee
Contribution
Monthly
State
Contribution
Monthly
Employee
Contribution
Monthly
State
Contribution
Quality Care Health Plan
Health Alliance HMO
1 Dependent
$249.00
$896.58
1 Dependent
$113.00
$661.32
2+ Dependents
$287.00
$1,237.32
2+ Dependents
$159.00
$1,203.36
HMO Illinois
BlueAdvantage HMO
1 Dependent
$100.00
$541.90
1 Dependent
$96.00
$518.36
2+ Dependents
$139.00
$996.32
2+ Dependents
$132.00
$956.12
Aetna HMO
Aetna OAP
1 Dependent
$111.00
$656.24
1 Dependent
$111.00
$421.36
2+ Dependents
$156.00
$1,194.20
2+ Dependents
$156.00
$773.24
HealthLink OAP
1 Dependent
$126.00
$734.58
2+ Dependents
$179.00
$1,314.12
COBRA participants pay the “state” contribution amount in addition to the “employee” cost above, any dependent
premiums, and a 2% administrative fee. See the CMS website for the COBRA rates
.
Rev. 6/1/2018 Page 4 of 5
Dental Insurance
MONTHLY DENTAL INSURANCE COST
See the table below for the full-time employee rate. A part-time employee pays a percentage of the State of Illinois
contribution for dental insurance. The guidelines in the dependent health insurance coverage section on page 3 also
apply to dental insurance coverage.
Monthly Cost
To Employee
Monthly State
Contribution
Employee Only
$11.00
$25.30
Employee Plus One Dependent
$17.00
$50.24
Employee Plus Two or More Dependents
$19.50
$92.88
Employee Plus One IRS Civil Union Dependent
Same rate as for any other
dependent
Same rate as for any
other dependent
Employee Plus Two or More IRS Civil Union
Dependents
Same rate as for any other
dependent
Same rate as for any
other dependent
Non-IRS One Veteran Adult Child
$28.16
$0.00
Non-IRS Civil Union One Dependent
$28.16
($6 plus $22.16 imputed income)
$24.94
Non-IRS Civil Union Two or More Dependents
$74.76
($8.50 plus $66.26 imputed
income)
$67.58
COBRA participants pay the “state” contribution amount in addition to the “employee” cost above, any dependent
premiums, and a 2% administrative fee. See the CMS website for the COBRA rates
.
Calculation Examples for Cost of Insurance
FULL-TIME EMPLOYEES: CALCULATING MONTHLY COST OF INSURANCE
To calculate the total monthly cost of health (including vision) and dental insurance premiums for full-time
employees, add the monthly cost of each plan, plus any dependent coverage.
Example #1: Monthly cost of health and dental insurance for a full-time employee who has a salary of
$45,000/year and is enrolled in the Quality Care Health Plan.
Health
Employee contribution for self
$111.00
Dental
Employee contribution for self
$11.00
Total Monthly Cost to Employee
$122.00
Example #2: Monthly cost of health and dental insurance for a full-time employee who has a salary of
$45,000/year, insures two dependents, and is enrolled in HealthLink OAP Managed Care Plan.
Health
Employee contribution for self
$86.00
Employee contribution for 2 dependents
$179.00
Dental
Employee contribution for self plus 2 dependents
$19.50
Total Monthly Cost to Employee
$284.50
Rev. 6/1/2018 Page 5 of 5
PART-TIME EMPLOYEES: CALCULATING MONTHLY COST OF INSURANCE
To calculate the monthly health (including vision) or dental insurance premiums for part-time employees, follow
these steps:
1. Subtract the employee’s percentage of time worked from 100%
2. Multiply the result by the State contribution for the employee
3. Add that amount to the full-time employee’s salary-based monthly cost
4. The total equals the monthly premium cost for a part-time employee
To calculate the cost of dependent coverage for part-time employees, follow the above steps using the Dependent
State Contribution information.
Example #1: Monthly cost of health and dental insurance for a part-time employee, who works 65% time,
has a salary of $30,000/year and is enrolled in the Quality Care Health Plan.
Health
35% of full-time State contribution - employee only
$945.04
x 35% =
$330.76
Employee contribution - self
$93.00
=
$93.00
Dental
35% of full-time State contribution - employee only
$25.30
x 35% =
$8.86
Employee contribution - self
$11.00
=
$11.00
Total Monthly Cost to Employee $443.62
Example #2: Monthly cost of health and dental insurance for a part-time employee, who works 65% time,
has a salary of $30,000/year, insures two dependents, and is enrolled in HealthLink OAP Managed Care
Plan.
Health
35% of full-time State contribution - employee
$955.30
x 35% =
$334.36
Employee contribution - self
$68.00
=
$68.00
35% of full-time State contribution - 2 dependents
$1,314.12
x 35% =
$459.94
Employee contribution - 2 dependents
$179.00
=
$179.00
Dental
35% of full-time State contrib. - employee plus 2
$92.88
x 35% =
$32.51
Employee contribution for self plus 2 dependents
$19.50
=
$19.50
Total Monthly Cost to Employee
$1,093.31
Example #3: Monthly cost of health and dental insurance for a faculty member, who works 100% for 4.5
months and is considered to be working part-time 50% for insurance purposes, has a salary of
$60,000/year and is enrolled in the Quality Care Health Plan.
Health
50% of full-time State contribution for employee only
$911.04
x 50% =
$455.52
Employee contribution for self
$127.00
=
$127.00
Dental
50% of full-time State contribution for employee only
$25.30
x 50% =
$12.65
Employee contribution for self
$11.00
=
$11.00
Total Monthly Cost to Employee
$606.17
