About Us | Contact Us | Search HR
Human Resources

Medical Coverage Rates > Insurance > Current Employees > HR Home

Medical Coverage Rates Effective September 1, 2014 – August 31, 2015

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

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

Subscriber Only

$527.40

$527.40

0.00

Subscriber and Spouse

$1030.95

$803.88

$227.07

Subscriber and Child(ren)

$941.79

$704.30

$237.49

Subscriber and Family

$1429.59

$982.42

$447.17


Part-Time Employees

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

Subscriber Only

$527.40

$263.70

$263.70

Subscriber and Spouse

$1030.95

$401.94

$629.01

Subscriber and Child(ren)

$941.79

$352.15

$589.64

Subscriber and Family

$1429.59

$491.21

$938.38

COBRA Premiums

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

UT Select PPO (BCBS)

$534.84

$1,048.46

$957.51

$1,455.07

UT Select Dental (Delta)

$33.05

$62.74

$69.16

$98.33

UT Select Dental Plus (Delta)

$56.97

$108.18

$119.37

$170.07

DeltaCare DHMO

$9.07

$17.24

$19.05

$27.20
Superior Vision $7.14 $11.22 $11.46 $18.20
Superior Vision Plus $11.22 $17.52 $18.77 $26.52

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

$527.40

$32.40

$55.85

$8.89 $7.00 $11.00

Subscriber and Spouse

$1030.95

$61.51

$106.06

$16.90 $11.00 $17.18

Subscriber and Child(ren)

$941.79

$67.80

$117.03

$18.68 $11.24 $18.40

Subscriber and Family

$1429.59

$96.40

$166.74

$26.67 $17.84 $26.00

Surviving Dependents

Medical Insurance Spouse Only Children Only Family Only

UT Select PPO (BCBS)

$503.55

$414.39

$902.19

Dental Insurance Spouse Only Children Only Family Only

UT Select Delta Dental

$29.11

$35.40

$64.00

UT Select Delta Dental Plus $50.21 $61.18 $110.89
DeltaCare USA $8.01 $9.79 $17.78
Vision Insurance Spouse Only Children Only Family Only

Superior Vision

$7.00

$7.00

$11.24

Superior Vision Plus $11.00 $11.00 $18.40