Common use of High Deductible Health Plan Clause in Contracts

High Deductible Health Plan. (HDHP). The University shall offer a High Deductible Health Plan and Health Savings Account. The HDHP plan provides 100% of preventive care in-network and 70% after deductible for out-of-network preventive care. The annual deductibles are $1,500 for individual coverage in-network/$3,000 out-of-network and $3,000 for other coverage levels in- network/$6,000 out-of-network. The annual co- insurance maximum is $3,000 for individual coverage in-network/$6,000 out-of-network and $6,000 for other coverage levels in-network/$12,000 out-of-network. The plan pays as follows: In-Network Out-of-Network Physician/Specialist 90% after deductible 70% after deductible Urgent Care 90% after deductible 70% after deductible Emergency Room 90% after deductible 70% after deductible Outpatient 90% after deductible 70% after deductible Inpatient 90% after deductible 70% after deductible Prescription Drugs 90% after deductible 70% after deductible Faculty Members shall contribute the following amounts, monthly pre-tax, for the HDHP: HDHP CONTRIBUTIONS MONTHLY EMPLOYEE CONTRIBUTION, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only Employee and Child(ren) Employee and Spouse/Domestic Partner Family Less than $60,000 49.10 103.20 106.50 147.40 $60,000- $79,999.99 51.56 108.36 111.71 154.77 $80,000- $99,999.99 54.01 113.52 116.82 162.14 $100,000 or more 58.92 123.84 127.06 176.88 The University shall contribute the following amounts to Faculty Members’ Health Savings Accounts for the HDHP in each year in which the Faculty Member enrolls in the HDHP. Such contributions are spread over the calendar year in monthly payments. UNIVERSITY CONTRIBUTION TO EMPLOYEE HSA, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only All Others Less than $60,000 800 1,600 $60,000-$79,999.99 550 1,100 $80,000-$99,999.99 450 900 $100,000 or more 350 700

High Deductible Health Plan. (HDHP). The University shall offer a High Deductible Health Plan and Health Savings Account. The HDHP plan provides 100% of preventive care in-network and 70% after deductible for out-of-network preventive care. The annual deductibles are $1,500 1500 for individual coverage in-network/$3,000 out-network/$3000 out- of-network and $3,000 3000 for other coverage levels in- network/$6,000 in-network/$6000 out-of-network. The annual co- co-insurance maximum is $3,000 3000 for individual coverage in-network/$6,000 network/$6000 out-of-network and $6,000 6000 for other coverage levels in-network/$12,000 out-of-network. The plan pays as follows: In-Network Out-of-Network Physician/Specialist Urgent Care 90% after deductible 90% after deductible 70% after deductible Urgent Care 90% after deductible 70% after deductible Emergency Room Outpatient 90% after deductible 90% after deductible 70% after deductible Outpatient 90% after deductible 70% after deductible Inpatient 90% after deductible 70% after deductible Prescription Drugs 90% after deductible 70% after deductible Faculty Members shall contribute the following amounts, monthly pre-tax, for the HDHP: HDHP CONTRIBUTIONS MONTHLY EMPLOYEE CONTRIBUTION, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only Employee and Child(ren) Employee and Spouse/Domestic Partner Family Less than $60,000 49.10 103.20 106.50 147.40 $60,000- $79,999.99 51.56 108.36 111.71 154.77 $80,000- $99,999.99 54.01 113.52 116.82 162.14 $100,000 or more 58.92 123.84 127.06 176.88 The University shall contribute the following amounts to Faculty Members’ Health Savings Accounts for the HDHP in each year in which the Faculty Member enrolls in the HDHP. Such contributions are spread over the calendar year in monthly payments. UNIVERSITY CONTRIBUTION TO EMPLOYEE HSA, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only All Others Less than $60,000 800 1,600 $60,000-$79,999.99 550 1,100 $80,000-$99,999.99 450 900 $100,000 or more 350 700

High Deductible Health Plan. (HDHP). The University shall offer a High Deductible Health Plan and Health Savings Account. The HDHP plan provides 100% of preventive care in-network and 70% after deductible for out-of-network preventive care. The annual deductibles are $1,500 for individual coverage in-in- network/$3,000 out-of-network and $3,000 for other coverage levels in- in-network/$6,000 out-of-network. The annual co- co-insurance maximum is $3,000 for individual coverage in-network/$6,000 out-of-network and $6,000 for other coverage levels in-in- network/$12,000 out-of-network. The plan pays as follows: In-Network Out-of-Network Physician/Specialist 90% after deductible 70% after deductible Urgent Care 90% after deductible 70% after deductible Emergency Room 90% after deductible 70% after deductible Outpatient 90% after deductible 70% after deductible Inpatient 90% after deductible 70% after deductible Prescription Drugs 90% after deductible 70% after deductible Faculty Members shall contribute the following amounts, monthly pre-tax, for the HDHP: HDHP CONTRIBUTIONS MONTHLY EMPLOYEE CONTRIBUTION, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only Employee and Child(ren) Employee and Spouse/Domestic Partner Family Less than $60,000 49.10 103.20 106.50 147.40 $60,000- $79,999.99 51.56 108.36 111.71 154.77 $80,000- $99,999.99 54.01 113.52 116.82 162.14 $100,000 or more 58.92 123.84 127.06 176.88 The University shall contribute the following amounts to Faculty Members’ Health Savings Accounts for the HDHP in each year in which the Faculty Member enrolls in the HDHP. Such contributions are spread over the calendar year in monthly payments. UNIVERSITY CONTRIBUTION TO EMPLOYEE HSA, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only All Others Less than $60,000 800 1,600 $60,000-$79,999.99 60,000- 550 1,100 $80,000-$99,999.99 450 900 80,000- 000 000 $100,000 or more 350 700

High Deductible Health Plan. (HDHP). The University shall offer a High Deductible Health Plan and Health Savings Account. The HDHP plan provides 100% of preventive care in-network and 70% after deductible for out-of-network preventive care. The annual deductibles are $1,500 1500 for individual coverage in-network/$3,000 out-network/$3000 out- of-network and $3,000 3000 for other coverage levels in- network/$6,000 in-network/$6000 out-of-network. The annual co- co-insurance maximum is $3,000 3000 for individual coverage in-network/$6,000 network/$6000 out-of-network and $6,000 6000 for other coverage levels in-network/$12,000 out-of-network. The plan pays as follows: Physician/Specialist In-Network 90% after deductible Out-of-Network Physician/Specialist 90% after deductible 70% after deductible Urgent Care 90% after deductible 70% after deductible Emergency Room 90% after deductible 70% after deductible Outpatient 90% after deductible 70% after deductible Inpatient 90% after deductible 70% after deductible Prescription Drugs 90% after deductible 70% after deductible Faculty Members shall contribute the following amounts, monthly pre-tax, for the HDHP: HDHP CONTRIBUTIONS MONTHLY EMPLOYEE CONTRIBUTION, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only Employee and Child(ren) Employee and Spouse/Domestic Partner Family Less than $60,000 49.10 103.20 106.50 147.40 $60,000- $79,999.99 51.56 108.36 111.71 154.77 $80,000- $99,999.99 54.01 113.52 116.82 162.14 $100,000 or more 58.92 123.84 127.06 176.88 The University shall contribute the following amounts to Faculty Members’ Health Savings Accounts for the HDHP in each year in which the Faculty Member enrolls in the HDHP. Such contributions are spread over the calendar year in monthly payments. UNIVERSITY CONTRIBUTION TO EMPLOYEE HSA, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only All Others Less than $60,000 800 1,600 $60,000-$79,999.99 550 1,100 $80,000-$99,999.99 450 900 $100,000 or more 350 700

High Deductible Health Plan. (HDHP). The University shall offer a High Deductible Health Plan and Health Savings Account. The HDHP plan provides 100% of preventive care in-network and 70% after deductible for out-of-network preventive care. The annual deductibles are $1,500 1500 for individual coverage in-network/$3,000 out-network/$3000 out- of-network and $3,000 3000 for other coverage levels in- network/$6,000 in-network/$6000 out-of-network. The annual co- co-insurance maximum is $3,000 3000 for individual coverage in-network/$6,000 network/$6000 out-of-network and $6,000 6000 for other coverage levels in-network/$12,000 out-of-network. The plan pays as follows: In-Network Out-of-Network Physician/Specialist 90% after deductible 70% after deductible Urgent Care 90% after deductible 70% after deductible Emergency Room 90% after deductible 70% after deductible Outpatient 90% after deductible 70% after deductible Inpatient 90% after deductible 70% after deductible Prescription Drugs 90% after deductible 70% after deductible Faculty Members shall contribute the following amounts, monthly pre-tax, for the HDHP: HDHP CONTRIBUTIONS MONTHLY EMPLOYEE CONTRIBUTION, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only Employee and Child(ren) Employee and Spouse/Domestic Partner Family Less than $60,000 49.10 103.20 106.50 147.40 $60,000- $79,999.99 51.56 108.36 111.71 154.77 $80,000- $99,999.99 54.01 113.52 116.82 162.14 $100,000 or more 58.92 123.84 127.06 176.88 The University shall contribute the following amounts to Faculty Members’ Health Savings Accounts for the HDHP in each year in which the Faculty Member enrolls in the HDHP. Such contributions are spread over the calendar year in monthly payments. UNIVERSITY CONTRIBUTION TO EMPLOYEE HSA, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only All Others Less than $60,000 800 1,600 $60,000-$79,999.99 550 1,100 $80,000-$99,999.99 450 900 $100,000 or more 350 700

High Deductible Health Plan. (HDHP). The University shall offer a High Deductible Health Plan and Health Savings Account. The HDHP plan provides 100% of preventive care in-network and 70% after deductible for out-of-network preventive care. The annual deductibles are $1,500 for individual coverage in-network/$3,000 out-of-network and $3,000 for other coverage levels in- in-network/$6,000 out-of-of- network. The annual co- co-insurance maximum is $3,000 for individual coverage in-network/$6,000 out-of-network and $6,000 for other coverage levels in-network/$12,000 out-of-of- network. The plan pays as follows: In-Network Out-of-Network Physician/Specialist 90% after deductible 70% after deductible Urgent Care 90% after deductible 70% after deductible Emergency Room 90% after deductible 70% after deductible Outpatient 90% after deductible 70% after deductible Inpatient 90% after deductible 70% after deductible Prescription Drugs 90% after deductible 70% after deductible Faculty Members shall contribute the following amounts, monthly pre-tax, for the HDHP: HDHP CONTRIBUTIONS MONTHLY EMPLOYEE CONTRIBUTION, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only Employee and Child(ren) Employee and Spouse/Domestic Partner Family Less than $60,000 49.10 103.20 106.50 147.40 $60,000- $79,999.99 51.56 108.36 111.71 154.77 $80,000- $99,999.99 54.01 113.52 116.82 162.14 $100,000 or more 58.92 123.84 127.06 176.88 The University shall contribute the following amounts to Faculty Members’ Health Savings Accounts for the HDHP in each year in which the Faculty Member enrolls in the HDHP. Such contributions are spread over the calendar year in monthly payments. UNIVERSITY CONTRIBUTION TO EMPLOYEE HSA, BY PLAN TYPE AND SALARY RANGE Salary Range Employee Only All Others Less than $60,000 800 1,600 $60,000-$79,999.99 550 1,100 $80,000-$99,999.99 450 900 $100,000 or more 350 700