| HROG Section: | Work/Life Benefits |
| Document Title: | COBRA Health Premium Rates and COBRA Disability Health Rates
|
| Initial Date Posted: | Sept.1, 2008 |
| Last Date Revised: | Sept. 1, 2009 |
| Applies To: | Full-Time Employees |
| Source: | District Human Resources |
COBRA Health Premium Rates (HealthSelect of Texas) including dental rates
Note: These premiums are monthly and includes a 2% administrative fee.
| Plan Name |
Members pay |
| Members Only |
$390.82 |
| Member & Spouse |
$840.28 |
| Members & Child(ren) |
$691.76 |
| Member & Family |
$1,141.22 |
COBRA Dental Premium Rates
Note: These premiums are monthly and include a 2% administrative fee.
| Coverage Category |
Members Pay |
| State of Texas Dental Choice Plan |
|
| Members Only |
$22.91 |
| Member & Spouse |
$45.82 |
| Members & Child(ren) |
$54.98 |
| Member & Family |
$77.89 |
|
|
| HumanaDental DHMO |
|
| Member Only |
$8.69 |
| Member and Spouse |
$17.39 |
| Member and Children |
$20.86 |
| Member and Family |
$29.56 |
COBRA Disability Health Rates (HealthSelect of Texas) including dental rates
| Plan Name |
Members pay |
| Members Only |
$574.74 |
| Member & Spouse |
$1,235.70 |
| Members & Child(ren) |
$1,017.30 |
| Member & Family |
$1,678.26 |
COBRA Disability Dental Rates
Note: These premiums are monthly and include a 50% administrative fee.
| Coverage Category |
Members Pay |
| State of Texas Dental Choice Plan |
|
| Members Only |
$33.69 |
| Member & Spouse |
$67.38 |
| Members & Child(ren) |
$80.85 |
| Member & Family |
$114.54 |
|
|
| HumanaDental DHMO |
|
| Member Only |
$12.78 |
| Member and Spouse |
$25.58 |
| Member and Children |
$30.68 |
| Member and Family |
$43.47 |
|