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Dental Health Services (DPO) Information
Dental Health Services (DPO) Premiums
| Coverage Type | Annual | Monthly | Semi-monthly (24 pay periods)* |
||
|---|---|---|---|---|---|
| Post-tax | Pre-tax | ||||
| Employee only | $487.20 | $40.60 | $0.00 | $20.30 | |
| Employee & Spouse/Domestic Partner | $944.88 | $78.74 | $0.00 | $39.37 | |
| Employee & Domestic Partner (post-tax)** | $944.88 | $78.74 | $19.07 | $20.30 | |
| Employee & 1 Child | $944.88 | $78.74 | $0.00 | $39.37 | |
| Employee & Children | $1,767.60 | $147.30 | $0.00 | $73.65 | |
| Family |
$1,767.60 |
$147.30 | $0.00 | $73.65 | |
| Family (Domestic Partner post-tax)** | $1,767.60 | $147.30 | $34.28 | $39.37 | |
* Variances Due to Rounding
**Domestic partners can only be enrolled on a pre-tax basis if they qualify as a tax dependent under IRS guidelines. To enroll your Domestic Partner on a pre-tax basis, submit a Tax Dependent Certification form which can be found on the Flexible Benefits website.