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This document provides employees with the 2024 Individual Choice Rates for benefits coverage.
Do you have questions about benefits?
Reach out to a member of the Benefits team at Benefits@Ithaca.Edu.
Contents
Plan Option
|
Employee's Annual Contribution
|
College's Contribution to HSA*
|
High Deductible Health Plan/Health Savings Account
|
| Employee Only |
$ 1,248.00 |
$ 1,000.00 |
| Employee & Spouse/GFQDP* |
$ 3,480.00 |
$ 1,500.00 |
| Employee & Children |
$ 3,354.00 |
$ 1,500.00 |
| Employee & Family |
$ 5,509.00 |
$ 1,500.00 |
Open Access Point of Service II Plan
|
| Employee Only |
$ 2,925.00 |
N/A |
| Employee & Spouse/GFQDP* |
$ 6,341.00 |
N/A |
| Employee & Children |
$ 6,178.00 |
N/A |
| Employee & Family |
$ 8,069.00 |
N/A |
*Only tax-dependent grandfathered qualified domestic partners are eligible for the employer's contribution to the HSA. Please see plan rules for eligibility.
Plan Option
|
Employee's Annual Contribution
|
Dental - Legacy Prime
|
| Employee Only |
$ 192.00 |
| Employee & Spouse/GFQDP* |
$ 516.00 |
| Employee & Children |
$ 624.00 |
| Employee & Family |
$ 972.00 |
Dental - Ortho Advantage
|
| Employee Only |
$ 192.00 |
| Employee & Spouse/GFQDP* |
$ 516.00 |
| Employee & Children |
$ 624.00 |
| Employee & Family |
$ 972.00 |
Plan Option
|
Employee's Annual Contribution
|
| Employee Only |
$ 36.00 |
| Employee & Spouse/GFQDP* |
$ 90.00 |
| Employee & Children |
$ 84.00 |
| Employee & Family |
$ 132.00 |
Amount of coverage
|
Employee's Annual Contribution
|
| $50,000** |
$ 0.00 |
Age
|
Employee's Annual Premium Rate Per $20,000** Unit
|
| < 25 |
$ 8.40 |
| 25-29 |
$ 8.40 |
| 30-34 |
$ 9.60 |
| 34-39 |
$ 14.40 |
| 40-44 |
$ 21.60 |
| 45-49 |
$ 36.00 |
| 50-54 |
$ 55.20 |
| 55-59 |
$ 93.60 |
| 60-64 |
$ 124.80 |
| 65-69 |
$ 196.80 |
| 70-74 |
$ 344.40 |
| 75+ |
$ 494.40 |
**Coverage amounts are reduced by 35% at age 65; 60% at age 70; and 75% at age 75. Maximum amount of coverage is $500,000. Evidence of Insurability may apply.
Plan Options
|
Employee's Annual Contribution
|
| Option 1 - (Spouse/GFQDP* = $5,000; Children - $2,500) |
$23.52 |
| Option 2 - (Spouse/GFQDP* = $10,000; Children - $4,000) |
$44.52
|
Basic
|
Employee's Annual Contribution
|
| $50,000** |
$ 0.00 |
Voluntary**
|
Employee's Annual Contribution
|
| Employee Only |
$ 9.36 |
| Employee & Dependents |
$ 13.68 |
**Coverage amounts are reduced by 35% at age 65; 60% at age 70; and 75% at age 75. Maximum amount of coverage is $300,000.
|
Employee's Annual Contribution
|
| 60% Benefit with Pension |
$0.00 |
| 60% Benefit without Pension |
$0.00 |
Health Savings Account
|
Health Care Flexible Spending Account
|
Dependent Care Flexible Spending Account
|
$4,150 - Individual Coverage
$8,30 - Family Coverage
$1,000 -- Catch-up (age 55+) |
$3,050 |
$5000 ($2,500 if you are married and you and your spouse file separate tax returns) |
*GFQDP refers to Grandfathered Qualified Domestic Partners. No new enrollments in QDP benefits allowed after January 1, 2015.