 |
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 |
$26.95
|
| Double |
$50.91
|
| Multiple |
$102.24
|
| Enhanced Level I |
Excluded (E99, class 1237 only), Operating Engineers (R10), Teaching Associates Only (R11),
Head Start Employees (SFSU) (R12) |
Single |
$32.80
|
| Double |
$62.05
|
| Multiple |
$127.89
|
| 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 |
Single |
$40.59
|
| Double |
$76.58
|
| Multiple |
$149.62
|
*Rates are effective through December 31, 2008, 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 |
$17.53
|
| Double |
$28.92
|
| Multiple |
$42.75
|
| Enhanced |
Physicians (R01),
Faculty(R03),
CSUEU (R02, 05, 07, 09),
Academic Support (R04), Skilled Crafts (R06),
Confidential (C99),
Management (M80),
Executives (M98) |
Single |
$23.29
|
| Double |
$38.45
|
| Multiple |
$56.85
|
*Rates are effective through December 31, 2008, and are paid by the CSU.
|
