The following health insurances rates are Effective September 1, 2016 – August 31, 2017
Full-Time Employees, Retiree, and Academic Graduate Student Employees
| UT Select | Total Monthly Premium | Monthly Premium Sharing | Monthly Out-of Pocket Cost |
|---|---|---|---|
| Subscriber Only | $598.14 | $598.14 | 0.00 |
| Subscriber and Spouse | $1,169.22 | $911.69 | $257.53 |
| Subscriber and Child(ren) | $1,068.10 | $798.76 | $269.34 |
| Subscriber and Family | $1,621.33 | $1,114.18 | $507.15 |
Part-Time Employees
| UT Select | Total Monthly Premium | Monthly Premium Sharing | Monthly Out-of Pocket Cost |
|---|---|---|---|
| Subscriber Only | $598.14 | $299.07 | $299.07 |
| Subscriber and Spouse | $1,169.22 | $455.85 | $713.37 |
| Subscriber and Child(ren) | $1,068.10 | $399.38 | $668.72 |
| Subscriber and Family | $1,621.33 | $557.09 | $1,064.24 |
COBRA Premiums
| Plan | Subscriber Only | Subscriber & Spouse | Subscriber & Child(ren) | Subscriber & Family |
|---|---|---|---|---|
| UT Select PPO (BCBS) | $605.96 | $1,188.46 | $1,085.32 | $1,649.62 |
| UT Select Dental (Delta) | $33.05 | $62.74 | $69.16 | $98.33 |
| UT Select Dental Plus (Delta) | $60.21 | $114.35 | $126.17 | $179.76 |
| DeltaCare DHMO | $9.07 | $17.24 | $19.05 | $27.20 |
| Superior Vision | $6.02 | $9.49 | $9.71 | $15.40 |
| Superior Vision Plus | $9.18 | $14.36 | $15.38 | $21.73 |
Graduate Student Fellows & Research Affiliate Postdoctoral Fellows
| Coverage Type | UT Select Medical (BCBS) | UT Select Dental (Delta) | UT Select Dental Plus (Delta) | DeltaCare USA | Superior Vision | Superior Vision Plus |
|---|---|---|---|---|---|---|
| Subscriber Only | $598.14 | $32.40 | $59.03 | $8.89 | $5.90 | $9.00 |
| Subscriber and Spouse | $1,169.22 | $61.51 | $112.11 | $16.90 | $9.30 | $14.08 |
| Subscriber and Child(ren) | $1,068.10 | $67.80 | $123.70 | $18.68 | $9.52 | $15.08 |
| Subscriber and Family | $1,621.33 | $96.40 | $176.24 | $26.67 | $15.10 | $21.30 |
Surviving Dependents
| Medical Insurance | Spouse Only | Children Only | Family Only |
|---|---|---|---|
| UT Select PPO (BCBS) | $571.08 | $469.96 | $1,023.19 |
| Dental Insurance | Spouse Only | Children Only | Family Only |
|---|---|---|---|
| UT Select Delta Dental | $29.11 | $35.40 | $64.00 |
| UT Select Delta Dental Plus | $53.08 | $64.67 | $117.21 |
| DeltaCare USA | $8.01 | $9.79 | $17.78 |
| Vision Insurance | Spouse Only | Children Only | Family Only |
|---|---|---|---|
| Superior Vision | $5.90 | $5.90 | $9.52 |
| Superior Vision Plus | $9.00 | $9.00 | $15.08 |