Office of Human Resources

Dental Insurance Rates: Weekly

Non-Exempt Staff

DPPO High Plan

(Group No. 004623-9901)

48 weekly payroll deductions will be taken during the calendar year.

Rate Type Employee Only Employee + Spouse Employee + Child(ren) Family
Employee Contribution Weekly / Monthly $3.12 / $12.48 $6.00 / $24.00 $6.38 / $25.52 $10.61 / $42.44
University Contribution Monthly $37.37 $72.01 $76.52 $127.24
Total Monthly Premium $49.85 $96.01 $102.04 $169.68
Employee / University Monthly Percentage 25% / 75% 25% / 75% 25% / 75% 25% / 75%

* Dependent coverage through end of month of 26th birthday.

DPPO Low Plan

(Group No. 004623-9902)

48 weekly payroll deductions will be taken during the calendar year.

Rate Type Employee Only Employee + Spouse Employee + Child(ren)* Family*
Employee Contribution Weekly / Monthly $2.40 / $9.60 $4.62 / $18.48 $4.91 / $19.64 $8.16 / $32.64
University Contribution Monthly $28.75 $55.39 $58.87 $97.92
Total Monthly Premium $38.35 $73.87 $78.51 $130.56
Employee / University Monthly Percentage 25% / 75% 25% / 75% 25% / 75% 25% / 75%

* Dependent coverage through end of month of 26th birthday.