Below is a quick reference of the current insurance plans and their costs (before the District's fringe contribution).

SISC Blue Cross rates effective October 1st - September 30th

Classified/Management Blue Cross, Dental & Vision rates effective January 1st - December 31st

Faculty Medical 

Single Rate

Double Rate

Family Rate
 SISC Blue Cross (PPO) Group #40303A
  • $300 Individual/$600 Family Deductible
  • $20 Office Visits / 20% Co-insurance
  • Rx $7 Generic /$25 Brand
  $635/month  $1232/month  $1721/month
 SISC Blue Cross (PPO) Group #40303B
  • $500 Individual/$1,000 Family Deductible
  • $30 Office Visits / 20% Co-insurance
  • Rx $10 Generic/$35 Brand
  $560/month  $1091/month  $1530/month
 SISC Blue Cross (PPO) Group #40303C
  • $2,000 Individual/$4,000 Family Deductible
  • $30 Office Visits / 20% Co-insurance
  • Rx $10 Generic /$35 Brand
  $496/month  $965/month  $1349/month
 SISC Blue Cross (PPO) Group #40303D
  • $3,000 Individual/$6,000 Family Deductible
  • $40 Office Visits / 20% Co-insurance
  • Rx $9 Generic /$35 Brand
  $466/month  $898/month  $1250/month
 SISC Blue Cross (PPO) Group #40303E
  • $5,000 Individual/$10,000 Family Deductible
  • Health Savings Account compatible
    Office Visits 10%
  • Rx $7 generic/ $25 brand (subject to deductible)
  $443/month  $887/month  $1263/month
 SISC Blue Cross (PPO) Group #70303B
  •  $5,000 Individual/$10,000 Family Deductible
  • $60 Office Visits* / 30% Co-insurance 
  • Rx subject to medical deductible

Spouse/Domestic Partners not allowed on this plan

  $398/month  $788/month  $788/month

Classified / Management Medical

(2019)

Single

Rate

Double

Rate

Family

Rate
Blue Cross (PPO) Group# 1302M-B - Plan A
  • $400 Individual / $800 Family Deductible
  • $20 Office Visit / 10% Co-insurance
  • Rx $7 Generic /$20 Formulary/$35 Brand
 $799.00/month $1592.00/month $2069.00/month

Blue Cross (PPO) Group # 1302Q-A - Plan B

  • $650 Individual / $1,300 Family Deductible
  • $25 Office Visits / 20% Co-insurance
  • Rx $7 Generic /$20 Formulary/$35 Brand
 $721.00/month $1440.00/month $1871.00month

Blue Cross (PPO) Group #1854Q-A - Plan C

  • $1,000 Individual/$2,000 Family Deductible
  • $30 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
 $684.00/month $1367.00/month $1777.00/month

Blue Cross (PPO) Group #1854Q-L - Plan D

  • $1,200 Individual/$2,400 Family Deductible
  • $35 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
 $666.00/month $1331.00/month $1730.00/month

Blue Cross (PPO) Group #1854Q-W - Plan E

  • $1,500 Individual/$3,000 Family Deductible
  • $40 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
  $648.00/month $1296.00/month $1684.00/month

 Blue Cross (PPO) Group #1854R-G - Plan F

  • $2,500 Individual/$5,000 Family Deductible
  • $50 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
  $608.00/month $1215.00/month $1581.00/month

 Blue Cross (PPO) Group #1854R-S - Plan G

  • Deductible $5000  - Deductible must be met before any coverage
  • $60 Office Visits / 30% Co-insurance
  • Rx $25
 $546.00/month $1091.00/month $1418.00/month

 All Employees

Single Rate  

Double Rate 

Family Rate

 Delta Dental - Group #6736-0001 Plan A

  • $50 Individual/$150 Family Deductible
  • Annual Maximum Allowance $1,400 (PPO)
  • $500 Orthodontics Annual Max(Adult/Child)
  • Two-Year Commitment Required
  $55.62/month  $98.90/month  $142.85/month

 Delta Dental - Group #6736-0003 Plan B

  • $50 Individual/ $150 Family Deductible
    Annual Maximum Allowance $2,000 (PPO)
  • $1,000 Orthodontics Annual Max (Child Only)
  • Two-Year Commitment Required
  $62.14/month  $110.48/month  $159.64/month

Delta Dental - Group #6736-01001 Plan C

  • $50 Individual/$150 Family Deductible
    Annual Maximum Allowance $2,400 (PPO)
  • $500 Orthodontics Annual Max(Adult/Child)
  • This plan has implant coverage
  • Two-Year Commitment Required
  $70.63/month  $125.61/month  $180.85/month

Delta Dental - Group #6736-01003 Plan D

  • $50 Individual/$150 Family Deductible
    Annual Maximum Allowance $3,000 (PPO)
  • $1,000 Orthodontics Annual Max (Child Only)
  • This plan has implant coverage
  • Two-Year Commitment Required
  $78.92/month  $140.31/month  $202.70/month

Vision Service Plan (VSP) - Group #30071230

  • One eye exam every 12 months
  • Zero co-pay/ Zero deductible
  • $200 Annual Maximum for Lens/Frames every 12 months
  $11.01/month  $17.89/month  $28.36/month