The University of Texas System 11/1/2011
Employee Group Insurance Program 8:14 PM
FY2002 Medical Insurance Premium Rates Page 1 of 2
FY2002 Total Premium Rates FY2002 Employee Out-of-Pocket FY2002 State Premium Sharing
Health Plan
SUB SSP SPO SCH CHD SFM FAM SUB SSP SPO SCH CHD SFM FAM SUB SSP SPO SCH CHD SFM FAM
MEDICAL
Austin Area
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
Humana HMO 235.45 460.51 225.06 420.66 185.21 638.69 403.24 0.00 90.47 225.06 94.69 185.21 179.56 403.24 235.45 370.04 0.00 325.97 0.00 459.13 0.00
Dallas/Ft Worth Area
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
HMO Blue 248.74 486.58 237.84 444.46 195.72 674.86 426.12 0.00 95.69 237.84 100.15 195.72 189.83 426.12 248.74 390.89 0.00 344.31 0.00 485.03 0.00
El Paso Area
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
HMO Blue 248.74 486.58 237.84 444.46 195.72 674.86 426.12 0.00 95.69 237.84 100.15 195.72 189.83 426.12 248.74 390.89 0.00 344.31 0.00 485.03 0.00
Houston/Galveston Area
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
Humana HMO - Except Galveston 234.77 459.20 224.43 419.45 184.68 636.86 402.09 0.00 90.21 224.43 94.41 184.68 179.04 402.09 234.77 368.99 0.00 325.04 0.00 457.82 0.00
Humana HMO - Galveston 276.85 541.67 264.82 494.78 217.93 751.32 474.47 0.00 106.70 264.82 111.67 217.93 211.53 474.47 276.85 434.97 0.00 383.11 0.00 539.79 0.00
Permian Basin
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
HMO Blue 248.74 486.58 237.84 444.46 195.72 674.86 426.12 0.00 95.69 237.84 100.15 195.72 189.83 426.12 248.74 390.89 0.00 344.31 0.00 485.03 0.00
San Antonio Area
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
Humana HMO 224.91 439.87 214.96 401.81 176.90 610.05 385.14 0.00 86.34 214.96 90.38 176.90 171.44 385.14 224.91 353.53 0.00 311.43 0.00 438.61 0.00
TUHP HMO 201.59 394.15 192.56 360.05 158.46 546.60 345.01 0.00 77.20 192.56 80.81 158.46 153.42 345.01 201.59 316.95 0.00 279.24 0.00 393.18 0.00
Tyler Area
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
HMO Blue 248.74 486.58 237.84 444.46 195.72 674.86 426.12 0.00 95.69 237.84 100.15 195.72 189.83 426.12 248.74 390.89 0.00 344.31 0.00 485.03 0.00
Rio Grande Valley Area
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
Corpus Christi Area
UT Select 283.65 554.99 271.34 506.94 223.29 769.80 486.15 0.00 109.37 271.34 114.46 223.29 216.78 486.15 283.65 445.62 0.00 392.48 0.00 553.02 0.00
Humana HMO 226.46 442.90 216.44 404.58 178.12 614.26 387.80 0.00 86.95 216.44 91.01 178.12 172.63 387.80 226.46 355.95 0.00 313.57 0.00 441.63 0.00
DENTAL
f:\users\egi\finance\premiums\prem2001-02\388e559b-10f0-43f0-92e0-d1b4dcaaeb7d.xls:Military
The University of Texas System 11/1/2011
Employee Group Insurance Program 8:14 PM
FY2002 Medical Insurance Premium Rates Page 2 of 2
FY2002 Total Premium Rates FY2002 Employee Out-of-Pocket FY2002 State Premium Sharing
Health Plan
SUB SSP SPO SCH CHD SFM FAM SUB SSP SPO SCH CHD SFM FAM SUB SSP SPO SCH CHD SFM FAM
All areas:
Delta Dental 26.41 50.14 23.73 55.27 28.86 78.59 52.18 26.41 50.14 23.73 55.27 28.86 78.59 52.18 - - - - - - -
United Dental 10.73 19.94 9.21 26.20 15.47 31.50 20.77 10.73 19.94 9.21 26.20 15.47 31.50 20.77 - - - - - - -
VISION
All areas:
Superior Vision 7.22 11.20 7.22 11.46 7.22 18.48 11.20 7.22 11.20 7.22 11.46 7.22 18.48 11.20 - - - - - - -
f:\users\egi\finance\premiums\prem2001-02\388e559b-10f0-43f0-92e0-d1b4dcaaeb7d.xls:Military