| The University of Texas System Employee Group Insurance Program | ||||||||
| COBRA Insurance Premium Rates | ||||||||
| Effective September 1, 2007 through August 31, 2008 | ||||||||
| FY2007 Insurance Premium Rates COBRA | FY2007 Insurance Premium Rates COBRA | |||||||
| REGULAR | DISABILITY | |||||||
| Medical Insurance Plan | SUB | SSP | SCH | SFM | SUB | SSP | SCH | SFM |
| UT Select PPO | 374.30 | 733.62 | 670.00 | 1018.09 | 550.44 | 1078.86 | 985.29 | 1497.20 |
| Dental Insurance Plan | ||||||||
| Delta Dental | 28.83 | 54.72 | 60.32 | 85.77 | 42.39 | 80.48 | 88.71 | 126.14 |
| Assurant Dental | 10.25 | 19.48 | 21.53 | 30.75 | 15.08 | 28.65 | 31.67 | 45.23 |
| Vision Insurance Plan | ||||||||
| Superior Vision | 7.51 | 11.71 | 11.97 | 19.28 | 11.04 | 17.22 | 17.61 | 28.35 |
| LEGEND FOR LEVEL OF COVERAGE: | ||||||||
| SUB = Subscriber Only | ||||||||
| SSP = Subscriber & Spouse | ||||||||
| SCH = Subscriber & Child(ren) | ||||||||
| SFM = Subscriber & Family | ||||||||