|
Delta Dental PPO — Indemnity Plan
COBRA Rates
|
Plan Level |
Eligible Employee
Category |
Party Designation |
Monthly COBRA Premium
(102%)* |
| Basic |
Public Safety (R08), Excluded (E99, except Teaching
Associates),
Retired Annuitants |
Single Person |
$ 29.66 |
| Two People |
$ 56.03 |
| Three or More |
$112.52 |
| Enhanced Level I |
Teaching Associates (R11),
CMA Operating Engineers (R10) |
Single Person |
$ 36.10 |
| Two People |
$ 68.29 |
| Three or More |
$140.76 |
| Enhanced Level II |
Physicians (R01), Faculty (R03),
CSUEU (R02,05,07,09),
Academic Support (R04),
Skilled Crafts (R06),
Confidential (C99), Management Personnel Plan (M80),
Executives (M98), FERP |
Single Person |
$ 44.68 |
| Two People |
$ 84.29 |
| Three or More |
$164.67 |
*Rates are effective January 1, 2009, through December 31, 2009. COBRA
premium rates are paid for by the participant. The CSU does not
pay any portion of the COBRA premium.
Back to Top
DeltaCare USA — Prepaid Plan
COBRA Rates
|
Plan Level |
Eligible Employee
Category |
Party Designation |
Monthly COBRA Premium
(102%)* |
| Basic |
Public Safety
(R08), CMA Operating Engineers (R10),
Excluded (E99), Teaching Associates
(R11), Retired Annuitants |
Single Person |
$ 19.01 |
| Two People |
$ 31.37 |
| Three or More |
$ 46.37 |
| Enhanced |
Faculty
(R03),
CSUEU (R02,05,07,09), Academic Support (R04),
Skilled Crafts (R06),
Confidential (C99),
Management
(M80),
Executives (M98),
FERP |
Single Person |
$ 25.26 |
| Two People |
$ 41.70 |
| Three or More |
$ 61.66 |
*Rates are effective January 1, 2009, through December 31, 2009. COBRA
premium rates are paid for by the participant. The CSU does not
pay any portion of the COBRA premium.
Back
to Top
|
