Common use of Premium Conversion Clause in Contracts

Premium Conversion. To help minimize your employee contribution for your medical plan, WPS will continue tooffer an IRC (Internal Revenue Code) Section 125 Premium Conversion Plan. This allows you to pay for your employee contribution for the medical coverage on a pre-tax (before tax) basis. As a result, your net take home pay will be higher than if contributions were deducted on a post-tax (after tax) basis. Contributions taken on a pre-tax basis are not subject to federal or state income taxes or FICA taxes. The amount of savings depends onyour individual contribution and tax bracket. Single CB PPO 100/80% with $150/$300 deductible $168.29 2 Person CB PPO 100/80% with $150/$300 deductible $585.10 Family CB PPO 100/80% with $150/$300 deductible $664.95 Single CB PPO 100/80% with $1,000/$2,000 deductible $85.93 2 Person CB PPO 100/80% with $1,000/$2,000 deductible $387.42 Family CB PPO 100/80% with $1,000/$2,000 deductible $417.86 Single Simply Blue PPO HSA $1,400/$2,800 Plan $0.00 2 Person Simply Blue PPO HSA $1,400/$2,800 Plan $0.00 Family Simply Blue PPO HSA $1,400/$2,800 Plan $0.00 The following chart provides employees with the contributions forthe plans offered this year. Figures listed are subject to change if there isa change to the cost of insurance. Amounts paid by WPS are limited by PA 152; employees are responsible for any amounts above limits set by PA 152. Employee contribution rates effective January 1 , 2021 are: Employees who opt out of medical may be eligible for a cash in lieu benefit. Please refer to your collective bargaining agreement for details. Please note, there is no change to your life and disability benefits provided by the District. For additional information on these benefits, please contact ▇▇▇▇▇ ▇▇▇▇▇▇, Benefits Coordinator, at ▇▇▇▇▇▇▇@▇▇.▇▇▇.▇▇.▇▇ or at ▇▇▇-▇▇▇-▇▇▇▇. BCBSM Online Access • Personal snapshot of your plan: Check out easy-to-understand graphics that provide a quick snapshot of your deductibles, coinsurance and claims. • Single user ID forlife: Onceregistered,your personalID stays with you, even if you switch plans, change jobs or retire.