Health Insurance Rates

The following health insurances rates are Effective September 1, 2019 – August 31, 2020

Full-Time Employees, Retirees, and Academic Graduate Student Employees

UT Select

Total Monthly Premium Monthly Premium Sharing Monthly Out-of Pocket Cost

Subscriber Only

$628.05 $628.05 0.00

Subscriber and Spouse

$1,227.68 $957.27 $270.41

Subscriber and Child(ren)

$1,121.51 $838.70 $282.81

Subscriber and Family

$1,702.40 $1,169.89 $532.51

 

 UT CONNECT 

(DFW area only)

Total Monthly Premium Monthly Premium Sharing Monthly Out-of Pocket Cost

Subscriber Only

$628.05 $628.05 0.00

Subscriber and Spouse

$1,200.64 $957.27 $243.37

Subscriber and Child(ren)

$1,093.23 $838.70 $254.53

Subscriber and Family

$1,649.15 $1,169.89 $479.26

Part-Time Employees

UT Select

Total Monthly Premium Monthly Premium Sharing Monthly Out-of Pocket Cost

Subscriber Only

$628.05 $314.03 $314.02

Subscriber and Spouse

$1,227.68 $478.64 $749.04

Subscriber and Child(ren)

$1,121.51 $419.35 $702.16

Subscriber and Family

$1,702.40 $584.95 $1,117.45

 

UT CONNECT 

(DFW area only) 

Total Monthly Premium Monthly Premium Sharing Monthly Out-of Pocket Cost

Subscriber Only

$628.05 $314.03 $314.02

Subscriber and Spouse

$1,227.68 $478.03 $749.65

Subscriber and Child(ren)

$1,121.51 $419.35 $702.16

Subscriber and Family

$1,702.40 $584.95 $1,117.45

Graduate Student Fellows & Research Affiliate Postdoctoral Fellows

UT Select

Total Monthly Premium

Subscriber Only

$628.05

Subscriber and Spouse

$1,227.68

Subscriber and Child)ren

$1,121.51

Subscriber and Family

$1,702.40

Dental and Vision

(FT/PT Employees, Retirees, Academic Graduate Student Employees, Graduate Student Fellows & Research Affiliate Postdoctoral Fellows)

Level

UT Select Dental (Delta) UT Select Dental Plus (Delta) DeltaCare USA Superior Vision Superior Vision Plus

Subscriber Only

$28.51 $61.39 $8.80 $5.90 $9.00

Subscriber and Spouse

$54.13 $116.59 $16.73 $9.30 $14.08

Subscriber and Child(ren)

$59.66 $128.65 $18.49 $9.52 $15.08

Subscriber and Family

$84.83 $183.29 $26.40 $15.10 $21.30

Surviving Dependents

Coverage Type

UT Select Medical (BCBS) UT Connect (DFW Area Only) UT Select Dental (Delta) UT Select Dental Plus (Delta) DeltaCare USA Superior Vision Superior Vision Plus

Spouse Only

$599.63 $572.59 $25.62 $55.20 $7.93 $5.90 $9.00

Child Only

$493.46 $465.18 $31.15 $67.26 $9.69 $5.90 $9.00

Family

$1,074.35 $1,021.10 $56.32 $121.90 $17.60 $9.52 $15.08

 

COBRA Premiums

Plan

Subscriber Only Subscriber & Spouse Subscriber & Child(ren) Subscriber & Family

UT Select PPO (BCBS)

$636.47 $1,248.09 $1,139.80 $1,732.31

UT CONNECT Medical

 (DFW area only)

$636.47 $1220.51 $1,110.95 $1677.99

UT Select Dental (Delta)

$29.08 $55.21 $60.85 $86.53

UT Select Dental Plus (Delta)

$62.62 $118.92 $131.22 $186.96

DeltaCare DHMO

$8.98 $17.06 $18.86 $26.93

Superior Vision

$6.02 $9.49 $9.71 $15.40

Superior Vision Plus

$9.18 $14.36 $15.38 $21.73