2012-2013 AE Benefits Overview
The 2012-2013 Annual Enrollment Benefits Overview table allows you to quickly view your insurance plan options and to easily see if there are changes to the premium rates and what is new within each of the plans. Additional information is included in the last column to highlight details such as evidence of insurability requirements, a brief description of the tobacco premium program, and reminders to enroll in UT FLEX.
Insurance Plan / Premium Rates / Plan Changes / Additional InformationUT SELECT Medical and Prescription Drug Plan / Emp Only $ 0
Emp/Sp $207.98
Emp/Child $217.52
Emp/Fam $409.57 / Expanded benefits for preventive services / No EOI required
UT SELECT Medical Tobacco Premium Program / New! / New premium surcharge for tobacco user(s) / New premium surcharges based on three categories:
· Member $30 per month;
· Spouse $30 per month, and
· Child(ren) $30 per month.
Maximum of $90 per family for three or more tobacco users.
UT SELECT Dental / Emp Only $30.86
Emp/Sp $58.58
Emp/Child $64.57
Emp/Fam $91.81 / Additional benefits
UT SELECT Dental Plus
New! /
Emp Only $53.19
Emp/Sp $101.01
Emp/Child $111.46
Emp/Fam $158.80 / Higher annual benefit maximum
DeltaCare DHMO USA
New! / Emp Only $ 8.55
Emp/Sp $16.25
Emp/Child $17.96
Emp/Fam $26.65 / New vendor -- Expanded coverage area, new provider network, simplified fee schedule
Superior Vision / Emp Only $6.80
Emp/Sp $10.76
Emp/Child $10.96
Emp/Fam $17.40 / No changes
Superior Vision Plus
New! / Emp Only $10.80
Emp/Sp $16.76
Emp/Child $17.96
Emp/Fam $25.40 / Expanded benefits
Short Term Disability / Slight premium increase
$0.302 per $100 / No changes / EOI required
Long Term Disability / No changes
$0.397 per $100 / No changes / EOI required
Long Term Care / No changes / No changes / EOI required, must be submitted directly through CNA
Voluntary Group Term Life / No changes / No changes / EOI required
Accidental Death and Dismemberment / No changes / No changes
UT FLEX Health Care Reimbursement Account / No changes to admin fee(s) / IRS Update: Maximum election to remain $5,000 / Must make election even if currently enrolled
UT FLEX Dependent Day Care Reimbursement Account / No changes / No changes / Must make election even if currently enrolled