Attachment to AD NOAT 05-28
The California State University, Chancellor's Office
 
PFA 049157
           
             
DELTA DENTAL PLAN EXCESS PREMIUM REFUND   
REFER TO CODED MEMO B04-05 (Revised) Dated December 15, 2004  
             
Coded Memo B04-05 is revised to adjust the refund distribution to correlate with   
1999/2000 since the premiums accumulated were through December 31, 1999.  
             
    Long  Life   Tax
AGENCY   REFUND      
# CAMPUS TO CAMPUS     TOTAL
           
6650 BAKERSFIELD 95,147     95,147
6850 CHANNEL ISLANDS       0
6680 CHICO 227,190     227,190
6690 DOMINGUEZ HILLS 112,566     112,566
6700 FRESNO 245,552     245,552
6710 FULLERTON  270,134     270,134
6720 EAST BAY (Formerly Hayward) 185,758     185,758
6730 HUMBOLDT 154,465     154,465
6740 LONG BEACH 290,014     290,014
6750 LOS ANGELES 207,709     207,709
6752 MARITIME ACAD 24,286     24,286
6756 MONTEREY BAY 55,852     55,852
6760 NORTHRIDGE 291,610     291,610
6770 POMONA 256,866     256,866
6780 SACRAMENTO 280,289     280,289
6660 SAN BERNARDINO 150,990     150,990
6790 SAN DIEGO 358,932     358,932
6800 SAN FRANCISCO 306,549     306,549
6810 SAN JOSE 314,992     314,992
6820 SAN LUIS OBISPO 279,227     279,227
6840 SAN MARCOS   82,267     82,267
6830 SONOMA 134,380     134,380
6670 STANISLAUS 98,299     98,299
  CAMPUS TOTAL 4,423,074     4,423,074
6620 CHANC. OFFICE 67,790     67,790
  TOTAL 4,490,864     4,490,864
CAMPUS ENTRIES REQUIRED  FY04 (USING FIRMS 603003 DENTAL INSURANCE EXPENSE)        
           
EXPENDITURES   603003     CR
           
FUND BALANCE CLEARING  305022     DR
           
CHANCELLOR'S OFFICE CONTACT: Chris Canfield   562-951-4558    ccanfield@calstate.edu