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Medical Rates

Coverage Dates for 2016-2017

Annual - 08/10/16- 08/09/17  |   Fall - 08/10/2016 - 01/09/2017  |   Spring - 01/10/17 - 08/09/17


Student Rates for 2016-2017
Annual Fall Spring
Total: $ 3,296.00 100% $1,380.00 100% $1,916.00 100%
PSU: $2,636.80 80% $1,104.00 80% $1,532.80 80%
Student: $659.20 20% $276.00 divided by 4 = $69.00 20% $383.20 divided by 5 = $76.64 20%

Student & Spouse Rates for 2016-2017
Annual Fall Spring
Total: $6,592.00 100% $2,760.00 100% $3,832.00 100%
PSU: $5,108.80 80%/75% $2,139.00 80%/75% $2,969.80 80%/75%
Student: $1483.20 20%/25% $621.00 divided by 4 = $155.25 20%/25% $862.20 divided by 5 = $172.44 20%/25%

Student & 1 Child Rates for 2016-2017
Annual Fall Spring
Total: $6,592.00 100% $2,760.00 100% $3,832.00 100%
PSU: $5108.80 80%/75% $2,139.00 80%/75% $2,969.80 80%/75%
Student: $1,483.20 20%/25% $621.00 divided by 4 = $155.25 20%/25% $862.20 divided by 5 = $172.44 20%/25%

 

Student & 2 or More Children Rates for 2016-2017
Annual Fall Spring
Total: $9,888.00 100% $4140.00 100% $5,748.00 100%
PSU: $7,646.00 80%/76% $3,201.60 80%/76% $4,445.20 80%/76%
Student: $2,241.20 20%/24% $938.40 divided by 4 = $234.60 20%/24% $1,302.80 divided by 5 = $260.56 20%/24%

 

 

Student & Spouse &1 Child for 2016-2017
Annual Fall Spring
Total: $9,888.00 100% $4,140.00 100% $5.748.00 100%
PSU: $7,646.80 80%/76% $3,201.60 80%/76% $4,445.20 80%/76%
Student: $2,241.20 20%/24% $938.40 divided by 4 = $234.60 20%/24% $1,302.80 divided by 5 = $260.56 20%/24%


Student & Spouse & 2 or More Children for 2016-2017
Annual Fall Spring
Total: $13,184.00 100% $5,520.00 100%

$7,664.00

100%
PSU: $10,151.80 80%/76% $4,250.40 80%/76% $5,901.40 80%/76%
Student: $3,032.20 20%/24% $1,269.60 divided by 4 = $317.40 20%/24% $1,762.60 divided by 5 = $352.52 20%/24%

Payroll Deductions will appear on paycheck as follows:
Fall (Sept through Dec) Spring (Jan through May)
Single Student $69.00 $76.64
Student and Spouse/
Domestic Partner
$155.25 $172.44
Student & Child $155.25 $172.44
Student & Children $234.60 $260.56
Family (Child) $234.60 $260.56
Family (Children) $317.40 $352.52

Student Health Center | 814.865.6556 | Contact University Health Services