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2018 Dental and Vision COBRA Premiums

State-Sponsored Dental Plans

Delta Dental


Plan Type

Covered Persons   

1-Party   

2-Party   

3-Party   
​Basic Rank and File Employees ​$52.67​$92.24​$133.48
​Enhanced​Excluded employees and their eligible dependents ​$54.80$​108.22​$152.16
​PPO​Excluded and Rank and File employees and their eligible dependents ​$48.10​$93.86​$141.42
​Basic Dependents​Eligible dependents of Rank and File employees ​$45.18​$67.71$88.54

 

DeltaCare USA

Plan Type    Covered Persons    1-Party    2-Party3-Party
StandardExcluded and Rank and File employees and their eligible dependents $19.25    $31.59 $43.70

 

Premier Access

Plan Type    Covered Persons    1-Party2-Party    3-Party   
Standard    Excluded and Rank and File employees and their eligible dependents     $16.12    $26.10 $36.56

 

SafeGuard

Plan Type    Covered Persons    1-Party    2-Party    3-Party
​Standard​Rank and File employees and their eligible dependents ​$16.05​$26.01​$36.42
​​EnhancedExcluded employees and their eligible dependents $16.38​$27.7234.15

 

Western Dental

Plan Type    Covered Persons    1-Party    2-Party    3-Party   
Standard    Excluded and Rank and File employees and their eligible dependents $15.46 $25.52     $36.20    

​State-Sponsored Vision Plans

Vision Service Plan (VSP)

Plan Type    Covered Persons    1-Party2-Party    3-Party   
Basic     Excluded and Rank and File employees and their eligible dependents*     $8.81    $8.81$8.81   
​Premier ​Excluded and Rank and File employees and their eligible dependents* ​17.83 26.85​37.84

*Vision benefits for BU6 employees are provided through the CCPOA Health Benefits Trust.

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