Skip navigation - Jump to main content

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

Monthly Premium Rates

The following 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 Premium Surcharges in the form of a tobacco use surcharge or a spousal coverage surcharge may apply, in which case it will be added to the base medical premium rates shown below.

Base Medical Premium Rates
Effective January 1, 2014

Uniform Medical Plan Classic Uniform Medical Plan CDHP w/HSA Group Health Classic Group Health Value Group Health CDHP w/HSA Kaiser Permanente Classic Kaiser Permanente CDHP w/HSA
Subscriber Only
$551.03
$504.56
$589.19
$537.04
$500.69
$588.43
$503.93
Subscriber & Spouse/QDP*
1,095.84
999.94
1,172.16
1,067.86
992.20
1,170.64
998.18
Subscriber & Child(ren)
959.64
890.68
1,026.42
935.16
883.91
1,025.09
889.20
Full Family
1,504.45
1,327.73
1,609.39
1,465.98
1,317.09
1,607.30
1,325.12

Dental Premium Rates (with medical)

  Uniform Dental Plan, administered by WDS DeltaCare,
administered by WDS
Willamette Dental
Subscriber Only
$44.72
$39.53
$43.23
Subscriber & Spouse/QDP*
89.44
79.06
86.46
Subscriber & Child(ren)
89.44
79.06
86.46
Full Family
134.16
118.59
129.69

Dental Premium Rates (without medical)

  Uniform Dental Plan, administered by WDS DeltaCare,
administered by WDS
Willamette Dental
Subscriber Only
$50.94
$45.75
$49.45
Subscriber & Spouse/QDP*
95.66
85.28
92.68
Subscriber & Child(ren)
95.66
85.28
92.68
Full Family
140.38
124.81
135.91

Base Medical Premium Rates
Effective January 1, 2015

Uniform Medical Plan Classic Uniform Medical Plan CDHP w/HSA Group Health Classic Group Health Value Group Health CDHP w/HSA Kaiser Permanente Classic Kaiser Permanente CDHP w/HSA
Subscriber Only
$578.51
$535.82
$600.80
$569.38
$530.10
$619.65
$540.35
Subscriber & Spouse/QDP*
1,150.77
1,056.18
1,195.35
1,132.51
1,044.74
1,233.05
1,064.74
Subscriber & Child(ren)
1,007.71
940.67
1,046.71
991.73
930.66
1,079.70
948.23
Full Family
1,579.97
1,402.70
1,641.26
1,554.86
1,386.97
1,693.10
1,414.29

Dental Premium Rates (with medical)

  Uniform Dental Plan, administered by WDS DeltaCare,
administered by WDS
Willamette Dental
Subscriber Only
$45.22
$39.53
$42.37
Subscriber & Spouse/QDP*
90.44
79.06
86.74
Subscriber & Child(ren)
90.44
79.06
86.74
Full Family
135.66
118.59
127.11

Dental Premium Rates (without medical)

  Uniform Dental Plan, administered by WDS DeltaCare,
administered by WDS
Willamette Dental
Subscriber Only
$51.47
$45.78
$48.62
Subscriber & Spouse/QDP*
96.69
85.31
90.99
Subscriber & Child(ren)
96.69
85.31
90.99
Full Family
141.91
124.84
133.36

*QDP = Qualified Domestic Partner

All rates are subject to change.


Disclaimer: The information on this page does not substitute for official plan documents. If there is a conflict between the information on this site and an official plan document, the official plan document will govern. Refer to the Benefits Forms & Publications page.

Plan availability and eligibility may change depending on your employment status and/or actions of the Washington State Health Care Authority (HCA), the agency that purchases and coordinates health insurance benefits for public employees, including employees of the University of Washington, through the Public Employees Benefits Board (PEBB) program.

Leave/Layoff
Insurance Topics