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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 $40.60 $0.00 $20.30
Employee & Spouse/Domestic Partner $945 $78.74 $0.00 $39.37
Employee & Domestic Partner (post-tax)** $945 $78.74 $19.07 $20.30
Employee & 1 Child $945 $78.74 $0.00 $39.37
Employee & Children $1,768 $147.30 $0.00 $73.65
Family $1,768 $147.30 $0.00 $73.65
Family (Domestic Partner post-tax)** $1,768 $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.