Benefits Plans - Dental Plan: Dental Plan rates

Rates are effective January 1, 2013

Click the following links for monthly Dental Plan rates.

Effective January 1, 2013

Your 2013 Monthly Dental Plan Rates

Dental Plan Option

Your 2013 Monthly Deduction

University 2013 Monthly Contribution

Faculty and Staff members, GEO members, GSRAs, and Benefit-Eligible Fellowship Holders

Option 1

You Only

$ 0

$ 22.00

You + 1 Child

$ 0

$ 44.00

You + 1 Adult

$ 0

$ 44.00

You + 1 Adult + Children

$ 0

$ 70.18

You + 2 or More Children

$ 0

$ 70.18

Option 2

You Only

$ 16.92

$ 22.00

You + 1 Child

$ 33.84

$ 44.00

You + 1 Adult

$ 33.84

$ 44.00

You + 1 Adult + Children

$ 50.88

$ 70.18

You + 2 or More Children

$ 50.88

$ 70.18

Option 3

You Only

$ 26.52

$ 22.00

You + 1 Child

$ 53.04

$ 44.00

You + 1 Adult

$ 53.04

$ 44.00

You + 1 Adult + Children

$ 80.72

$ 70.18

You + 2 or More Children

$ 80.72

$ 70.18

Medical School Students

Option 1

Your 2013 Monthly Deduction

University 2013 Monthly Contribution

You Only

$ 22.00

$ 0

You + 1 Child

$ 44.00

$ 0

You + 1 Adult

$ 44.00

$ 0

You + 1 Adult + Children

$ 70.18

$ 0

You + 2 or More Children

$ 70.18

$ 0

Option 2

 

 

You Only

$ 38.92

$ 0

You + 1 Child

$ 77.84

$ 0

You + 1 Adult

$ 77.84

$ 0

You + 1 Adult + Children

$ 121.06

$ 0

You + 2 or More Children

$ 121.06

$ 0

Option 3

 

 

You Only

$ 48.52

$ 0

You + 1 Child

$ 97.04

$ 0

You + 1 Adult

$ 97.04

$ 0

You + 1 Adult + Children

$ 150.90

$ 0

You + 2 or More Children

$ 150.90

$ 0

 

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cRetiree 2013 Monthly Dental Plan Rates

Click a link below to view retiree Dental Plan rates. Click here to view retiree Health Plan rates.

  • Chart A (PDF)
    Use this chart if you retired before January 1, 1987.

  • Chart B (PDF)
    Use this chart if you were hired on or after July 1, 1988 and are retired and under age 62.

  • Chart C (PDF)
    Use this chart if you retired on or after January 1, 1987, and

    (a) Were hired before July 1, 1988, and are any age,
    — OR —
    (b) Were hired on or after July 1, 1988, and are age 62 or older.

Chart A

Dental Plan Option

Your 2013 Monthly Contribution

University 2013 Monthly Contribution

Option 1

You Only

$ 0

$ 22.00

You + Child

$ 0

$ 44.00

You + Adult

$ 0

$ 44.00

You + Adult + Children

$ 0

$ 70.18

You + Children

$ 0

$ 70.18

Option 2

You Only

$ 16.92

$ 22.00

You + Child

$ 33.84

$ 44.00

You + Adult

$ 33.84

$ 44.00

You + Adult + Children

$ 50.88

$ 70.18

You + Children

$ 50.88

$ 70.18

Option 3

You Only

$ 26.52

$ 22.00

You + Child

$ 53.04

$ 44.00

You + Adult

$ 53.04

$ 44.00

You + Adult + Children

$ 80.72

$ 70.18

You + Children

$ 80.72

$ 70.18

 

Chart B

Dental Plan Option

Your 2013 Monthly Contribution

University 2013 Monthly Contribution

Option 1

You Only

$ 22.00

$ 0

You + Child

$ 44.00

$ 0

You + Adult

$ 44.00

$ 0

You + Adult + Children

$ 70.18

$ 0

You + Children

$ 70.18

$ 0

Option 2

You Only

$ 38.92

$ 0

You + Child

$ 77.84

$ 0

You + Adult

$ 77.84

$ 0

You + Adult + Children

$ 121.06

$ 0

You + Children

$ 121.06

$ 0

Option 3

You Only

$ 48.52

$ 0

You + Child

$ 97.04

$ 0

You + Adult

$ 97.04

$ 0

You + Adult + Children

$ 150.90

$ 0

You + Children

$ 150.90

$ 0

 

Chart C

Dental Plan Option

Your 2013 Monthly Contribution

University 2013 Monthly Contribution

Option 1

You Only

$ 0

$ 22.00

You + Child

$ 0

$ 44.00

You + Adult

$ 0

$ 44.00

You + Adult + Children

$ 0

$ 70.18

You + Children

$ 0

$ 70.18

Option 2

You Only

$ 16.92

$ 22.00

You + Child

$ 33.84

$ 44.00

You + Adult

$ 33.84

$ 44.00

You + Adult + Children

$ 50.88

$ 70.18

You + Children

$ 50.88

$ 70.18

Option 3

You Only

$ 26.52

$ 22.00

You + Child

$ 53.04

$ 44.00

You + Adult

$ 53.04

$ 44.00

You + Adult + Children

$ 80.72

$ 70.18

You + Children

$ 80.72

$ 70.18

 

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Leave of Absence/RIF 2013 Dental Plan Rates

 

 DENTAL PLAN

2013 LOA / RIF Monthly Premium

Option 1

You Only

$ 22.00

You + Child

$ 44.00

You + Adult

$ 44.00

You + Adult + Children

$ 70.18

You + 2 or More Children

$ 70.18

Option 2

You Only

$ 38.93

You + Child

$ 77.84

You + Adult

$ 77.84

You + Adult + Children

$ 121.06

You + 2 or More Children

$ 121.06

Option 3

You Only

$ 48.52

You + Child

$ 97.04

You + Adult

$ 97.04

You + Adult + Children

$ 150.90

You + 2 or More Children

$ 150.90

 

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COBRA 2013 Dental Plan Rates

 

Dental Plan Option

2013 Total COBRA Premium

Option 1

You Only

$ 22.44

You + Adult

$ 44.88

You + Adult + Children

$ 71.58

You + Child

$ 44.88

You + Children

$ 71.58

Option 2

You Only

$ 39.70

You + Adult

$ 79.40

You + Adult + Children

$ 123.48

You + Child

$ 79.40

You + Children

$ 123.48

Option 3

You Only

$ 49.49

You + Adult

$ 98.98

You +  Adult + Children

$ 153.92

You +  Child

$ 98.98

You + Children

$ 153.92

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Limitations
The University of Michigan in its sole discretion may modify, amend, or terminate the benefits provided with respect to any individual receiving benefits, including active employees, retirees, and their dependents. Although the university has elected to provide these benefits this year, no individual has a vested right to any of the benefits provided. Nothing in these materials gives any individual the right to continued benefits beyond the time the university modifies, amends, or terminates the benefit. Anyone seeking or accepting any of the benefits provided will be deemed to have accepted the terms of the benefits programs and the university's right to modify, amend or terminate them.