General Information
Cost of Coverage
How Much Do I Have To Pay?
The amount you pay towards your employee-only coverage depends on your annual earnings and is as follows:
Category 1
Full-time and part-time employees working 130 hours or more per month whose annual salaries are at or below the Federal Health and Human Services Poverty Threshold (currently $31,200 for a family of four), will be exempt from making a monthly premium contribution for employee-only coverage. Whitman College will pay 100% of the employee portion of the monthly premium.
Category 2
Full-time and part-time employees working 130 or more regularly scheduled hours per month whose annual salary is above $31,200 will pay a monthly premium contribution equal to 0.65% of their pay. If you receive an increase in pay during the year, your employee-only monthly premium will be re-calculated based on the new salary. Whitman College pays 95% of the overall premium cost of health insurance for all employees, and employees pay 5%.
Example: If you are currently making $35,000 or $60,000 per year, then you would use the following calculation to determine your employee-only monthly premium cost:
- Employee Salary $60,000 x .0065 = $390/12 months = $32.50 per month
- Employee Salary $35,000 x .0065 = $227.5/12 months = $18.95 per month
Category 3
The monthly premiums for part-time employees working less than 130 hours per month but at least 910 hours per year will continue to be prorated based on the full-time equivalent percentage. For example, a part-time employee working 24 hours per week (0.6 FTE) will pay 40% of the monthly premium.
Family Coverage
Family coverage will be based on your salary, you will pay between 45%–55% of the premium cost to cover your eligible family members for medical, vision, and prescription drug coverage. You will continue to pay 100% of the premium cost to cover your eligible family members for dental coverage. Please refer to the Summary of Benefits for your contribution level.
View the Family Coverage Excel Sheet
** Includes coverage for domestic partners. Due to IRS regulations, contributions for domestic partners are made on a post-tax basis. In addition, any premiums paid by Whitman on behalf of a domestic partner will be considered taxable income to the employee. Please note that your contributions will be taken out of your paycheck on a pre-tax basis, as allowed by Section 125 of the Internal Revenue Code. IRS rules state that once you make your enrollment election for the year, you will not be allowed to change that election until the next Open Enrollment period, unless you have a change in family status, such as marriage, divorce, birth of a child, or change in employment status. This means you may not drop coverage for a dependent during the year unless there is a qualified change in family status.
Summary & Notices
- Premera Medical Plan 2024
- Premera Dental Plan 2024
- C.H.I.P. (Children's Health Insurance Program) Notice
- Affordable Care Act Notice
- Notice about your Prescription Drug Coverage and Medicare
- Summary of Benefits and Coverage (Coverage Period: 01/01/2024-12/31/2024)
- Summary of Benefits and Coverage (Coverage Period: 01/01/2025-12/31/2025)
- Beneficios Para Empleados (Periodo de cobertura: 01/01/2024-12/31/2024)
Public Access Requirement
On October 29, 2020, the Department of Health and Human Services, the Department of Labor, and the Department of the Treasury jointly released the Transparency in Coverage final rule. One of the requirements of the rule that group health plans and issuers must meet is to make certain price information accessible to plan participants and other stakeholders. This is known as the Public Access Requirement. There are three files that must be updated monthly and include the following detailed pricing information:
- In network: Negotiated rates for all covered items and services between the plan or issuer and in-network providers.
- Out of network: Historical payments to, and billed charges from, out-of-network providers. Files are not required if there are fewer than 20 claims for a service for a provider.
- Prescription drugs: In-network negotiated rates and historical net prices for all covered prescription drugs at the pharmacy location level (this requirement is delayed pending further rulemaking).
Premera has created a link that will take Whitman employees to our monthly updated data. The URL to the file site is https://premera.sapphiremrfhub.com, which will be live beginning July 1, 2022.