Bargaining Units 1, 3, 4, 5, 6, 9, 10, 11, 12, 13, 14, 15, 20, and 21

Dental Plan

2004 Premiums (monthly)

2005 Premiums (monthly)

Dollar Change

State share

Employee share

Total premium

State share

Employee share

Total premium

State

Employee

DeltaPremier (Basic)*

1-party

2-party

3-party

 

$34.09

$59.98

$86.99

 

$11.36

$20.00

$29.00

 

$45.45

$79.98

$115.99

 

$34.09

$59.98

$86.99

 

$11.36

$20.00

$29.00

 

$45.45

$79.98

$115.99

 

$0

$0

$0

 

$0

$0

$0

DeltaPreferred Option**

1-party

2-party

3-party

 

$30.70

$58.63

$88.45

 

$9.19

$19.54

$29.49

 

$39.89

$78.17

$117.94

 

$30.70

$58.63

$88.45

 

$9.19

$19.54

$29.49

 

$39.89

$78.17

$117.94

 

$0

$0

$0

 

$0

$0

$0

PMI

1-party

2-party

3-party

 

$16.21

$26.60

$36.80

 

$0

$0

$0

 

$16.21

$26.60

$36.80

 

$16.70

$27.40

$37.90

 

$0

$0

$0

 

$16.70

$27.40

$37.90

 

+ $0.49

+ $0.80

+ $1.10

 

$0

$0

$0

SafeGuard Dental (Standard)

1-party

2-party

3-party

 

$13.29

$21.49

$29.57

 

$0

$0

$0

 

$13.29

$21.49

$29.57

 

$14.31

$23.18

$32.48

 

$0

$0

$0

 

$14.31

$23.18

$32.48

 

+ $1.02

+ $1.69

+ $2.91

 

$0

$0

$0

SafeGuard Dental (Enhanced)

1-party

2-party

3-party

 

NA

NA

NA

 

NA

NA

NA

 

NA

NA

NA

 

$14.00

$23.70

$29.19

 

$0

$0

$0

 

$14.00

$23.70

$29.19

 

NA

NA

NA

 

$0

$0

$0

CAHP Dental Plan***

1-party

2-party

3-party

 

$29.09

$50.98

$74.99

 

$8.00

$14.00

$21.00

 

$42.09

$73.98

$107.99

 

$29.09

$50.98

$74.99

 

$8.00

$14.00

$21.00

 

$42.09

$73.98

$107.99

 

$0

$0

$0

 

$0

$0

$0

CCPOA Dental Plan

1-party

2-party

3-party

 

$44.33

$44.33

$44.33

 

$25.00

$25.00

$25.00

 

$69.33

$69.33

$69.33

 

$44.33

$44.33

$44.33

 

$30.00

$30.00

$30.00

 

$74.33

$74.33

$74.33

 

$0

$0

$0

 

+ $5

+ $5

+ $5

*           Unit 5 employee share (2005): $16.36, $29.00, $41.00

**         Unit 5 employee share (2005): $10.80, $27.19, $42.95

***        CAHP subsidizes member premiums, which results in the employee costs shown above.