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Premiums/Rates — Dental
Delta Dental PPO — Indemnity Plan
|
Plan Level |
Eligible Employee
Category |
Party Designation |
Monthly Premium* |
| Basic |
Public Safety (R08), Excluded (E99, except class 1237),
Retired Annuitants |
Single |
$31.74 |
| Double |
$59.96 |
| Multiple |
$120.40 |
| Enhanced Level I |
Excluded (E99, class 1237 only), Operating Engineers (R10), Teaching Associates Only (R11),
Head Start Employees (SFSU) (R12) |
Single |
$38.63 |
| Double |
$73.07 |
| Multiple |
$150.63 |
| Enhanced Level II |
Physicians (R01),
Faculty (R03),
CSUEU (R02, 05, 07, 09),
Academic Support (R04), Skilled
Crafts (R06), Confidential (C99),
Management (M80), Executives (M98),
FERP Annuitants |
Single |
$47.81 |
| Double |
$90.20 |
| Multiple |
$176.22 |
*Rates are effective January 1, 2011, through December 31, 2011, and are paid by the CSU.
DeltaCare USA — Prepaid Plan
|
Plan Level |
Eligible Employee
Category |
Party Designation |
Monthly Premium* |
| Basic |
Public Safety
(R08), Operating Engineers (R10),
Teaching Associates Only (R11),Head Start Employees (SFSU) (R12),
Excluded (E99),
Retired Annuitants |
Single |
$19.73
|
| Double |
$32.54 |
| Multiple |
$48.11 |
| Enhanced |
Physicians (R01),
Faculty(R03),
CSUEU (R02, 05, 07, 09),
Academic Support (R04), Skilled Crafts (R06),
Confidential (C99),
Management (M80),
Executives (M98),
FERP Annuitants |
Single |
$26.20 |
| Double |
$43.26 |
| Multiple |
$63.97 |
*Rates are effective January 1, 2011, through December 31, 2011, and are paid by the CSU.
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