Retiree OUt-of-Pocket Premium Rates for 2014-2015

  Single Person Icon
Retiree
 
Couple Icon
Retiree &
Spouse
Parent Child Icon
Retiree &
Child(ren)
Family Icon
Retiree &
Family
UT SELECT
Medical*
$0 $227.07
$12.85 increase
$237.49
$13.44 increase
$447.17
$25.31 increase
UT SELECT
Dental
$32.40
$1.54 increase
$61.51
$2.93 increase
$67.80
$3.23 increase
$96.40
$4.59 increase
UT SELECT
Dental Plus
$55.85
$2.66 increase
$106.06
$5.05 increase
$117.03
$5.57 increase
$166.74
$7.94 increase
UT SELECT
Dental HMO
$8.89
$0.34 increase
$16.90
$0.65 increase
$18.68
$0.72 increase
$26.67
$1.02 increase
Vision $7.00
$0.20 increase
$11.00
$0.24 increase
$11.24
$0.28 increase
$17.84
$0.44 increase
Vision Plus $11.00
$0.20 increase
$17.18
$0.42 increase
$18.40
$0.44 increase
$26.00
$0.60 increase
*Tobacco Premium Program $0 to $90 per month based upon tobacco user status

Basic coverage package includes medical, prescription, and $6K Basic Life for retirees.

Premium Rates for Voluntary Group Term Life and Long Term Care insurance are not changing for the 2014-2015 plan year.