8-D8 - City of Burleson 906435 - ODSCR-08B - Dental Membership by Tier Product - Membership CurMo thru 2025-12.pdf

This is a dental membership report for the City of Burleson, Texas, documenting enrollment data under dental insurance plans administered through UHC ASO Custom Plans. The report captures membership information effective as of January 1, 2016, with data current through December 2025 for Group Policy Number 0906435 (Group ID 1019974). The City of Burleson maintains two dental product offerings: Plan D0033459UHC ASO Custom Plan 42P97 and Plan D0036125UHC ASO Custom Plan 58P83. As of December 2025, the combined membership across both plans totals 909 members, comprising 486 subscribers and 409 dependents distributed across various tier categories including subscriber only, spouse, child, and family coverage levels.

The enrollment data reflects active participation in the dental benefit programs, with Plan 42P97 accounting for 604 total members (342 subscribers and 280 dependents) and Plan 58P83 accounting for 305 total members (144 subscribers and 129 dependents). Membership is categorized by relationship tier, with the largest enrollment segment in the family coverage tier across both plans. This enrollment report serves as a baseline metric for the City of Burleson's dental benefits offering to eligible full-time employees, retirees, and their dependents as referenced in the related RFP 2026-015 for Dental and Vision Insurance Benefits.