Cobra Benefits Dental
Delta Dental PPO Indemnity Plan - Cobra Benefits Dental Rates
1. Basic
Public Safety (R08),
Excluded (E99, except Teaching Associates),
Retired Annuitants
Single Person - $ 29.66
Two People - $ 56.03
Three or More - $112.52
2. Enhanced Level
Teaching Associates (R11),
CMA Operating Engineers (R10)
Single Person - $ 36.10
Two People - $ 68.29
Three or More - $140.76
3. Enhanced Level II
Physicians (R01),
Faculty (R03),
CSUEU (R02,05,07,09),
Academic Support (R04),
Skilled Crafts (R06),
Confidential (C99),
Management Personnel Plan (M80),
Executives (M98), FERP
Single Person - $ 44.68
Two People - $ 84.29
Three or More - $164.67
Delta Care USA - Prepaid Plan - Cobra Benefits Dental Rates
1. Basic
Public Safety (R08),
CMA Operating Engineers (R10),
Excluded (E99),
Teaching Associates (R11),
Retired Annuitants
Single Person - $ 19.01
Two People - $ 31.37
Three or More - $ 46.37
2. Enhanced
Faculty (R03),
CSUEU (R02,05,07,09),
Academic Support (R04),
Skilled Crafts (R06),
Confidential (C99),
Management (M80),
Executives (M98),
FERP
Single Person - $ 25.26
Two People - $ 41.70
Three or More - $ 61.66
