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Monthly Employee Contribution: Administrative

2010-2011 Plan Year

Effective 10/1/2010 - 9/30/2011

With Dental

Administrative Insurance:
Medical, Rx, Vision and Dental Coverage

.5 - .749 FTE

.75 - .874 FTE

.875 – 1.0 FTE

Medical Plan 5
$200 deductible

$678.13

$460.13

$296.63

Medical Plan 6
$300 deductible

$555.93

$337.93

$174.43

Medical Plan 7**
$500 deductible

$434.58

$216.58

$53.08

Medical Plan 8
$1000 deductible

$365.81

$147.81

$0

Monthly payroll deductions are shown in the table above (with dental) and the table below (without dental). To determine your monthly payroll deduction, find your enrollment status (FTE) on the top and follow the column down to the different plan choices. These are composite rates, meaning the rate is the same regardless of how many dependents you cover on your plan. You can cover just yourself or your entire family for the same price.

Without Dental
All Administrative Employees may choose to waive dental coverage* 

Administrative Insurance:
Medical, Rx and Vision coverage

.5 - .749 FTE

.75 - .874 FTE

.875 – 1.0 FTE

Medical Plan 5
$200 deductible

$554.87

$336.87

$173.37

Medical Plan 6
$300 deductible

$432.67

$214.67

$51.17

Medical Plan 7
$500 deductible

$311.32

$93.32

$0

Medical Plan 8
$1000 deductible

$242.55

$24.55

$0

You have the option to waive dental coverage and thereby reduce your out-of-pocket insurance cost. Keep in mind, you may only waive dental coverage during annual enrollment (or upon initial eligibility) and you will not be able to re-enroll in dental coverage for the remainder of the plan year (the only exception to this is if you lose eligibility for other group dental coverage and provide proof of the loss within 31 days).

* Members who do not enroll in the dental plan when originally eligible and elect to enroll during a future Open Enrollment will be subject to "waiting period" restrictions, meaning for the first 12 months, the dental coverage will only allow preventive services and no orthodontia.  The 12-month waiting period does not apply for members who enroll in OEBB dental coverage due to loss of eligibility for other group coverage. 

**Plan 7 rates include a contribution from insurance reserves of $30 as agreed to by District and 4JA.