The University of Iowa
MONTHLY PREMIUM FOR HEALTH/DENTAL
CONTINUATION COVERAGE *(COBRA)
EFFECTIVE JANUARY 1, 2012
Faculty/P&S/Merit Exempt Options:
| Plan Name | Single | Employee/Spouse | Employee/Children | Employee/Family |
CHIP II |
593.00 |
1,326.00 |
613.00 |
$1,448.00 |
UICHOICE |
476.00 |
1106.00 |
910.00 |
1,163.00 |
Dental I |
30.00 |
60.00 |
75.00 |
93.00 |
Dental II |
49.00 |
95.00 |
100.00 |
129.00 |
Merit System Options:
| Plan Name | Single | Employee/Spouse | Employee/Children | Employee/Family |
*Blue Advantage |
463.41 |
N/A |
N/A |
1,084.40 |
*Blue Access |
481.29 |
N/A |
N/A |
1,126.19 |
Program III Plus |
771.58 |
N/A |
N/A |
1,805.53 |
Iowa Select |
769.19 |
N/A |
N/A |
1,799.90 |
State Dental |
28.39 |
N/A |
N/A |
76.33 |
Effective September 1, 2011
Student and Graduate Student Options:
| Plan Name | Single | Employee/Spouse | Employee/Children | Employee/Family |
| Student | 120.00 |
440.00 |
909.00 |
707.00 |
| *UIGRADCare | 211.00 |
551.00 |
888.00 |
957.00 |
| Student Dental | 25.00 |
47.00 |
50.00 |
75.00 |
Effective September 1, 2012
Student and Graduate Student Options:
| Plan Name | Single | Employee/Spouse | Employee/Children | Employee/Family |
| Student | 125.00 |
540.00 |
640.00 |
920.00 |
| *UIGRADCare | 228.00 |
451.00 |
1110.00 |
871.00 |
| Student Dental | 25.00 |
47.00 |
46.00 |
67.00 |
*Only EMERGENCY care is covered outside the provider network.
The plan in which you are currently enrolled in is listed on the enrollment form. You may be eligible to change plans within your category. Please call the University Benefits Office (319-335-2676) for more information.