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Self-Pay Early Retiree Rates 2024-25

COBRA benefits are administered by Benefit Help Solutions (BHS).
Phone: 1-800-556-3137

Self-Pay Early Retiree (SPER) Monthly Insurance Rates  10/01/2024 through 09/30/2025

Self-Pay Early Retirees are eligible to continue medical, dental, vision and optional life (if enrolled in these prior to retirement).

SPER Medical Insurance

Medical Plan Options Retiree Only Retiree & Spouse or Domestic Partner Retiree & Child(ren) Retiree & Spouse or Domestic Partner & Child(ren)
Moda Medical Plan 1

$793.33

$1745.32 $1,507.36 $2,459.39
Moda Medical Plan 2 $735.94 $1,619.06 $1,398.31 $2,281.45
Moda Medical Plan 3 $690.43 $1,518.96 $1,311.87 $2,140.41
Moda Medical Plan 4 $651.94 $1,434.27 $1,238.70 $2,021.05
Moda Medical Plan 5 $602.23 $1,324.91 $1,144.26 $1,866.96
Moda Medical Plan 6  $614.29 $1351.45 $1,167.19 $1,904.35
Moda Medical Plan 7  $573.32 $1261.30 $1,089.34 $1,777.33
Kaiser Medical Plan 1 $721.66 $1587.65 $1,371.16 $2,237.15
Kaiser Medical Plan 2A $595.37 $1310.65 $1,131.15 $1,846.54
Kaiser Medical Plan 2B $576.47 $1269.05 $1,095.24 $1,787.92
Kaiser Med Plan 3 (HSA eligible) $439.75 $968.02 $835.18 $1,363.49

SPER Dental Insurance

Dental Plan Options Employee Only Employee & Spouse or Domestic Partner Employee & Child(ren) Employe & Spouse or Domestic Partner & Child(ren)
Moda Delta Dental Plan 1 $67.54 $133.80 $148.78 $220.33
Moda Delta Dental Plan 5 $59.66 $118.17 $131.41 $194.60
Moda Delta Dental Plan 6 (no ortho) $45.54 $90.16 $91.51 $139.81
Moda Exclusive PPO INCENTIVE Delta Dental $58.55 $115.98 $128.97 $190.99
Moda Exclusive PPO Delta dental $39.46 $78.15 $86.91 $128.72
Kaiser Dental $73.48 $161.68 $139.63 $227.81
Willamette Dental $46.99 $93.99 $100.11 $150.18

SPER Vision Insurance

Vision Plan Options Employee Only Employee & Spouse or Domestic Partner Employee & Child(ren) Employe & Spouse or Domestic Partner & Child(ren)
Moda Vision Opal $21.83 $47.99 $41.40 $67.60
Moda Vision Pearl $17.81 $39.24 $33.87 $55.26
Moda Vision Quartz $12.58 $27.71 $23.91 $38.99
VSP Choice Plus Plan $14.15 $31.14 $26.90 $43.87
VSP Choice Plan $6.89 $15.14 $13.08 $21.33
Kaiser Vision (Only available with Kaiser Medical) $8.49 $18.67 $16.12 $26.31