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Indiana State Personnel Department

SPD > Benefits > 2013 Plan Rates 2013 Plan Rates

Plan Coverage Bi-Weekly Employee Rate Bi-Weekly Employer Rate Bi-Weekly Total Rate Annual Employee Rate Annual Employer Rate
CDHP 1 Single
Family
$42.74
$59.78
$167.82
$502.98
$210.56
$562.76
$1,111.24
$1,554.28
$4,363.32
$13,077.48
CDHP 1 w/ Non-Tobacco Use Single
Family
$7.74
$24.78
$167.82
$502.98
$175.56
$527.76
$201.24
$644.28
$4,363.322
$13,077.48
CDHP 2 Single
Family
$81.68
$169.52
$185.10
$537.66
$266.78
$707.18
$2,123.68
$4,407.52
$4,812.60
$13,979.16
CDHP 2 w/ Non-Tobacco Use Single
Family
$46.68
$134.52
$185.10
$537.66
$231.78
$672.18
$1,213.68
$3,497.52
$4,812.60
$13,979.16
Trad PPO Single
Family
$197.24
$494.30
$211.02
$589.50
$408.26
$1,083.80
$5,128.24
$12,851.80
$5,486.52
$15,327.00
Trad PPO w/ Non-Tobacco Use Single
Family
$162.24
$459.30
$211.02
$589.50
$373.26
$1,048.80
$4,218.24
$11,941.80
$5,486.52
$15,327.00
Dental Single
Family
$1.20
$3.16
$10.02
$26.36
$11.22
$29.52
$31.20
$82.16
$260.52
$685.36
Vision Single
Family
$0.17
$2.52
$1.47
$1.64
$1.64
$4.16
$4.42
$65.52
$38.22
$42.64
Flexible Spending Accounts Medical Limited Purpose
Medical (HSA Holders) and/or
Dependent Care Admin Fee
$2.00 $0.00 $2.00 $52.00 $0.00

To view rates for early retirees, COBRA and the annual total rates: View entire rate chart

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Health Savings Accounts

HSA Account Coverage Initial Contribution* Bi-Weekly Contribution Monthly Contribution Maximum Annual ER Contribution
HSA 1 w/CDHP 1 Single
Family
$561.60
$1,124.76
$21.60
$43.26
$46.80
$93.73
$1,123.20
$2,249.52
HSA 2 w/CDHP 2 Single
Family
$336.96
$673.92
$12.96
$25.92
$28.08
$56.16
$673.92
$1,347.84

*Initial contribution as listed above apply to employees with a CDHP effective between 1/1/13 thru 6/1/13 and with an open HSA. CDHPs effective after 6/1/13 but before 12/1/13 and with an open HSA, will receive 1/2 of the initial contribution.

Employees participating in CDHP plans are reminded that they must open an HSA in order to receive the state's HSA contribution.

HSA and FSA contributions will be spread over the first 26 pay dates om 2013. For A-payroll, no HSA contributions or FSA contributions will be made on the 27th pay date (12/31/13).