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The University of Oklahoma Human Resources Website

Medical Plan Rates

Part-time .6-.75 FTE, 9-month Appointed Active Employees

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

TIER 1
($22,500 and Below)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $143.18 $497.56 $666.93 $851.43
Aetna HMO $93.52 $368.05 $503.34 $650.35
Aetna HealthFund $131.67 $440.53 $594.90 $762.90
TIER 2
($22,501 to $31,500)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $165.69 $513.31 $706.31 $918.93
Aetna HMO $97.53 $383.80 $542.72 $717.85
Aetna HealthFund $135.68 $456.28 $634.28 $830.40
TIER 3
($31,501 to $45,000)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $176.73 $550.44 $758.06 $986.43
Aetna HMO $108.57 $420.93 $594.47 $785.35
Aetna HealthFund $146.72 $493.41 $686.03 $897.90
TIER 4
($45,001 to $75,000)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $187.98 $562.81 $809.81 $1,053.93
Aetna HMO $119.82 $433.30 $646.22 $852.85
Aetna HealthFund $157.97 $505.78 $737.78 $965.40
TIER 5
($75,001 to $138,750)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $209.35 $574.06 $864.93 $1,221.43
Aetna HMO $141.19 $444.55 $701.34 $920.35
Aetna HealthFund $179.34 $517.03 $792.90 $1,032.90
TIER 6
($138,751 and Above)		 EMPLOYEE ONLY EMPLOYEE AND CHILD(REN) EMPLOYEE AND SPOUSE EMPLOYEE AND FAMILY
Aetna PPO $231.85 $583.06 $920.06 $1,177.68
Aetna HMO $163.69 $453.55 $756.47 $976.60
Aetna HealthFund $201.84 $526.03 $848.03 $1,089.15