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Self-Pay Insurance
for Faculty, Staff & Librarians — Self-Pay Rates for 2015

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

Base Monthly Medical Premiums**
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 Premiums (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 Premiums (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

**Note: These are base rates. If a tobacco use surcharge or a spousal coverage surcharge applies to you, it will be added to the base medical premium rates shown above. For more information, see Medical Premium Surcharges.

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.

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