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Self-Pay Insurance
for Faculty, Staff & Librarians — 2009 Self-Pay Rates

These rates are for employees in a leave-without-pay (LWOP) or reduction-in-force (RIF) situation. Medicare rates are not available to these subscribers.

Medical rates

2009 Medical Plans Subscriber Only Subscriber
& Spouse/QDP*
Subscriber
& Child(ren)
Full Family
Aetna Public Employees Plan $513.44 $1,020.79 $893.95 $1,401.30
Group Health Classic 508.50 1,010.91 885.31 1,387.72
Group Health Value 426.16 846.23 741.21 1,161.28
Kaiser Permanente Classic 476.60 947.11 829.48 1,299.99
Kaiser Permanente Value 433.88 861.67 754.72 1,182.51
Uniform Medical Plan 427.25 848.41 743.12 1,164.28

Dental rates (with medical)

2009 Dental Plans Subscriber Only Subscriber
& Spouse/QDP*
Subscriber
& Child(ren)
Full Family
DeltaCare, administered by Washington Dental Service $37.19 $74.38 $74.38 $ 111.57
Willamette Dental of Washington 37.03 74.06 74.06 111.09
Uniform Dental Plan 41.69 83.38 83.38 125.07

Dental rates (without medical)

2009 Dental Plans Subscriber Only Subscriber
& Spouse/QDP*
Subscriber
& Child(ren)
Full Family
DeltaCare, administered by Washington Dental Service $43.28 $80.47 $80.47 $117.66
Willamette Dental of Washington 43.12 80.15 80.15 117.18
Uniform Dental Plan 47.78 89.47 89.47 131.16

*QDP = Qualified Domestic Partner

Leave/Layoff
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