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

 $728/month

10/1/22:
$771/month

 $1414/month

10/1/22:
$1,500/month

 $1976/month

10/1/22:
$2,102/month
 SISC Blue Cross (PPO) Group #40303B
  • $500 Individual/$1,000 Family Deductible
  • $30 Office Visits / 20% Co-insurance
  • Rx $10 Generic/$35 Brand

 $647/month

10/1/22:
$685/month

 $1261/month

10/1/22:
$1,339/month

 $1767/month

10/1/22:
$1,881/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

 $574/month

10/1/22:
$606/month

 $1115/month

10/1/22:
$1,180/month

 $1559/month

10/1/22:
$1,656/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

 $535/month

10/1/22:
$562/month

 $1032/month

10/1/22:
$1,088/month

 $1437/month

10/1/22:
$1,519/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)

 $508/month

10/1/22:
$542/month

 $1017/month

10/1/22:
$1,083/month

 $11449/month

10/1/22:
$1,544/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

 $457/month

10/1/22:
$486/month

 $904/month

10/1/22:
$963/month

 $904/month

10/1/22:
$963/month
Classified/Management Medical (2021) Single Rate Double Rate Family Rate

Blue Shield (PPO) Plan A

  • $650 Individual / $1,300 Family Deductible
  • $25 Office Visits / 20% Co-insurance
  • Rx $7 Generic /$20 Formulary/$35 Brand
 $1003.00/month $2003.00/month $2603.00month

Blue Shield (PPO) Plan B

  • $1,000 Individual/$2,000 Family Deductible
  • $30 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
 $836.00/month $1671.00/month $2172.00/month

Blue Shield (PPO) Plan C

  • $1,500 Individual/$3,000 Family Deductible
  • $40 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
  $841.00/month $1681.00/month $2185.00/month

 Blue Shield (PPO) Plan D

  • $2,500 Individual/$5,000 Family Deductible
  • $50 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
  $743.00/month $1485.00/month $1933.00/month

 Blue Shield (PPO)  Plan E

  • Deductible $5000  - Deductible must be met before any coverage
  • $60 Office Visits / 30% Co-insurance
  • Rx $25
 $677.00/month $1353.00/month $1758.00/month
Blue Shield (EPO) Plan F  
  • $1,000 Individual/$2,000 Family Deductible 
  • $25 Office Visits / 20% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
  • No out of network coverage
  • New plan start date 6/1/2019
  $707.00/month  $1408.00/month $1829.00/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

 $58.00/month

1/1/23:
$53.83/month

 $103.13/month

1/1/23:
$95.72/month

 $148.95/month

1/1/23:
$138.25/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

 $64.80/month

1/1/23:
$60.15/month

 $115.20/month

1/1/23:
$106.93/month

 $166.46/month

1/1/23:
$154.50/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

 $73.65/month

1/1/23:
$68.36/month

 $130.98/month

1/1/23:
$121.57/month

 $188.58/month

1/1/23:
$175.03/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

 $82.29/month

1/1/23:
$76.38/month

 $146.31/month

1/1/23:
$135.80/month

 $211.36/month

1/1/23:
$196.18/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

 $11.37/month

 

  $18.48/month  $29.30/month