Step 2: Use your rate code to find your 2022 premium
High premium biweekly - employed
Rate code 1 *
Rate code 2 *
Rate code 3 *
Rate code 4 *
Rate code 5 *
$17.28
$19.43
$21.24
$23.73
$25.72
Self Only
$34.56
$38.85
$42.48
$47.46
$51.45
Self Plus One
$51.85
$58.28
$63.72
$71.19
$77.17
Self and Family
High premium monthly - retired
Rate code 1 *
Rate code 2 *
Rate code 3 *
Rate code 4 *
Rate code 5 *
$37.44
$42.10
$46.02
$51.42
$55.73
Self Only
$74.88
$84.18
$92.04
$102.83
$111.48
Self Plus One
$112.34
$126.27
$138.06
$154.25
$167.20
Self and Family
Standard premium biweekly - employed
Rate code 1 *
Rate code 2 *
Rate code 3 *
Rate code 4 *
Rate code 5 *
$9.56
$10.72
$11.74
$13.10
$14.18
Self Only
$19.13
$21.43
$23.43
$26.16
$28.36
Self Plus One
$28.68
$32.15
$35.15
$39.25
$42.53
Self and Family
Standard premium monthly - retired
Rate code 1 *
Rate code 2 *
Rate code 3 *
Rate code 4 *
Rate code 5 *
$20.71
$23.23
$25.44
$28.38
$30.72
Self Only
$41.45
$46.43
$50.77
$56.68
$61.45
Self Plus One
$62.14
$69.66
$76.16
$85.04
$92.15
Self and Family
* Rate based on member’s primary state of residence.
2022 GEHA DENTAL PLANS
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