2003 MEDICAL, DENTAL, AND LIFE INSURANCE PREMIUMS


Medical Plan Premiums

MEDICAL PLANS EMPLOYEE DEDUCTION – Per Pay Period UNIVERSITY CONTRIBUTION – Per Pay Period
Individual Employee + 1 Family Individual Employee + 1 Family
HealthNet Charter Point of Service $0.00 $169.30 $211.62 $268.72 $314.40 $393.01
Aetna -New York $0.00 $105.11 $159.23 $159.45 $195.19 $295.7
Blue Cross/Blue Shield Prestige* $0.00 $102.46 $152.37 $148.95 $190.29 $282.98
HealthNet – HMO $0.00 $122.28 $178.62 $173.05 $227.09 $331.73
HIP Health Plan of New York $0.00 $85.04 $135.37 $133.06 $157.92 $251.41
Oxford Health Plan $0.00 $106.34 $154.54 $146.85 $197.50 $287.01

*Premiums based upon New York City, Westchester and Rockland Counties. Please contact Human Resources/Benefits to obtain rates in other counties

Dental Plan Premiums

EMPLOYEE DEDUCTION– Per Pay Period UNIVERSITY CONTRIBUTION – Per Pay Period
Dental Plan Individual Employee+1 Family All Coverages
DeltaCare NY $4.39 $10.10 $10.10 $4.39
DeltaCare NJ $3.62 $10.09 $10.09 $3.62

DeltaCare Preferred POS

$8.26 $27.19 $27.19 $8.26


Supplemental Life & AD&D Insurance

Supplemental Life Insurance rates are in effect from July 1, 2003 to June 30, 2005.

Age
Monthly Cost Per $1000 of Coverage
Under 30
$0 .10
30 to 34
$0.11
35 to 39
$0.12
40 to 44
$0.17
45 to 49
$0.29
50 to 54
$0.48
55 to 59
$0.73
60 to 64
$0.83
65 to 69
$1.45
70 to 74
$2.43
75 to 79
$4.10
80 to 84
$6.28
85 to 99
$9.92