UA offers premium assistance to benefit-eligible employees by giving a medical premium discount based on (1) family size and (2) total combined household income set at 1.5x the Federal Poverty Level. To apply for this discount, benefit-eligible employees must submit the Premium Assistance Application and furnish acceptable proof of total annual household income based on their most recently filed Federal Income Tax Transcript, W-2s and 1099s.
Application Deadlines:
- Current Employees – Submit documentation annually during Open Enrollment.
- Newly Eligible Employees – Submit documentation within 30 days from date of hire.
The amount of the discount provided is equal to the lowest cost single plan employee premium offered. The amount is $57 per month (up to $684 per year) and will increase to $62 for 2025. The discount is available for employees covered by either health plan option, the PPO or HDHP. Once an application is approved, the premium discount will be effective based on the medical plan effective date and will be reflected in the first available paycheck.
InfoAnnual Renewal Required
If approved, the premium assistance discount only applies to medical plan enrollment and is for the current plan year only. Employees must reapply each plan year during Open Enrollment (Oct. 15 – 31 each year).
Estimate your eligibility for the discount using the federal poverty level table below:
2025 Premium Assistance (1.5 x 2024 Federal Poverty Level)
| Family Size | Total Annual Household Income |
|---|---|
| 1 | $22,590 |
| 2 | $30,660 |
| 3 | $38,730 |
| 4 | $46,800 |
| 5 | $54,870 |
| 6 | $62,940 |
| 7 | $71,010 |
| 8 | $79,080 |
2024 Premium Assistance (1.5 x 2023 Federal Poverty Level)
| Family Size | Total Annual Household Income |
|---|---|
| 1 | $21,870 |
| 2 | $29,580 |
| 3 | $37,290 |
| 4 | $45,000 |
| 5 | $52,710 |
| 6 | $60,420 |
| 7 | $68,130 |
| 8 | $75,840 |
Premium Assistance Application Process
Complete Application
Complete the required Application Form and submit the form to the HR Service Center by email hr@ua.edu or fax to 205-348-8755, or deliver to the drop box outside of the Human Resources Administration Building located at 1670 Ruby Tyler Parkway.
Submit Required Documents
Submit all required documentation (Federal Income Tax Transcript, W-2s and 1099s) online in the BenefitFocus portal OR deliver to the drop box outside of the Human Resources Administration Building located at 1670 Ruby Tyler Parkway. Please blacken out any Social Security Numbers.
Review for Approval
Your application will be reviewed by the Assistant Director of Benefits, then you will be notified of your approval or denial via your official UA email address.