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

2014 Rates: Effective January 1, 2014

Medical rates

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 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 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

*QDP = Qualified Domestic Partner

** Rates are subject to change.

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