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NAVIGATION
Introduction
Health
Insurance
Dental
Insurance
Vision
Insurance
Sick
Leave
Life
and Accidental
Spending
Accounts
Employee
Assistance
Retirement
Shelters
and Savings
Closing
Site
Contents
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DPS Medical,
Dental and Vision Plans
Premiums Effective July 1, 2001 through June 30,
2002
KAISER 415
(Group
#415)
|
Total Monthly Premium
|
Monthly District
Contribution
|
Monthly Employee Payroll
Deduction
|
|
Employee Only
|
$195.00
|
$195.00
|
$0
|
|
Employee and Spouse
|
$390.00
|
$195.00
|
$195.00
|
|
Employee and Child(ren)
|
$386.10
|
$195.00
|
$191.10
|
|
Employee and Spouse and
Child(ren)
|
$565.52
|
$195.00
|
$370.52
|
PACIFICARE HMO
(Group
#20231)
|
Total Monthly Premium
|
Monthly District
Contribution
|
Monthly Employee Payroll
Deduction
|
|
Employee Only
|
$200.00
|
$200.00
|
$0
|
|
Employee and Spouse
|
$420.00
|
$200.00
|
$220.00
|
|
Employee and Child(ren)
|
$360.00
|
$200.00
|
$160.00
|
|
Employee and Spouse and
Child(ren)
|
$570.00
|
$200.00
|
$370.00
|
PACIFICARE PLUS
(Group
#20202)
|
Total Monthly Premium
|
Monthly District
Contribution
|
Monthly Employee Payroll
Deduction
|
|
Employee Only
|
$233.30
|
$233.30 *
|
$0
|
|
Employee and Spouse
|
$496.93
|
$233.30
|
$263.63
|
|
Employee and Child(ren)
|
$477.94
|
$233.30
|
$244.64
|
|
Employee and Spouse and
Child(ren)
|
$704.57
|
$233.30
|
$471.27
|
Dental and
Vision Insurance Premiums
DELTA DENTAL
(Group
#1015)
|
Total Monthly Premium
|
Monthly District
Contribution
|
Monthly Employee Payroll
Deduction
|
|
Employee Only
|
$26.07
|
$26.07
|
$0
|
|
Employee and Spouse
|
$50.07
|
$26.07
|
$24.00
|
|
Employee and Child(ren)
|
$70.98
|
$26.07
|
$44.91
|
|
Employee and Spouse and
Child(ren)
|
$95.02
|
$26.07
|
$68.95
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DELTA EPO PLAN
(Group
#6694)
|
Total Monthly Premium
|
Monthly District
Contribution
|
Monthly Employee Payroll
Deduction
|
|
Employee Only
|
$16.15
|
$16.15
|
$0
|
|
Employee and Spouse
|
$32.60
|
$16.15
|
$16.45
|
|
Employee and Child(ren)
|
$39.91
|
$16.15
|
$23.76
|
|
Employee and Spouse and
Child(ren)
|
$56.35
|
$16.15
|
$40.20
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VISION SERVICE PLAN
(Group
#12058969)
|
Total Monthly Premium
|
Monthly District
Contribution
|
Monthly Employee Payroll
Deduction
|
|
Employee Only
|
$6.21
|
$6.21
|
$0
|
|
Employee and Spouse
|
$13.82
|
$6.21
|
$7.61
|
|
Employee and Child(ren)
|
$14.24
|
$6.21
|
$8.03
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|
Employee and Spouse and
Child(ren)
|
$20.46
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$6.21
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$14.25
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* This is the monthly DPS contribution for teachers!
Classified employees receive a maximum monthly DPS
contribution of $200.00.
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