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The University of Oklahoma Human Resources Website

Medical Plan Rates

Part-time .5-.59 FTE, 9-month Appointed Active Employees

This is the amount that you will pay from each paycheck.

TIER 1
($15,000 and Below)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $286.36 $694.44 $902.81 $1,130.81
Aetna HMO $230.53 $564.93 $739.22 $929.73
Aetna HealthFund $268.68 $637.41 $830.78 $1,042.28
TIER 2
($15,001 to $21,000)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $301.37 $704.94 $929.06 $1,175.81
Aetna HMO $233.21 $575.43 $765.47 $974.73
Aetna HealthFund $271.36 $647.91 $857.03 $1,087.28
TIER 3
($21,001 to $30,000)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $308.73 $729.69 $963.56 $1,220.81
Aetna HMO $240.57 $600.18 $799.97 $1,019.73
Aetna HealthFund $278.72 $672.66 $891.53 $1,132.28
TIER 4
($30,001 to $50,000)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $316.23 $737.94 $998.06 $1,265.81
Aetna HMO $248.07 $608.43 $834.47 $1,064.73
Aetna HealthFund $286.22 $680.91 $926.03 $1,177.28
TIER 5
($50,001 to $92,500)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $330.48 $745.44 $1,034.81 $1,310.81
Aetna HMO $262.32 $615.93 $871.22 $1,109.73
Aetna HealthFund $300.47 $688.41 $962.78 $1,222.28
TIER 6
($92,501 and Above)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $345.48 $751.44 $1,071.56 $1,348.31
Aetna HMO $277.32 $621.93 $907.97 $1,147.23
Aetna HealthFund $315.47 $694.41 $999.53 $1,259.78