CERTIFICATED
HEALTH & WELFARE BENEFIT COSTS
EFFECTIVE 11/1/07-10/31/08

Type of Plan	Single	+One	Family
Health Net HMO $20 OV/ $10/20/35 RX	$435.63	$936.60	$1,285.08
Health Net Low $25 OV/$500 per day Hospital $15/30/50 RX	$360.67	$775.41	$1,063.94
Kaiser (Vision included) $20 OV/ $10/$25 RX	$491.76	$983.52	$1,391.68
Kaiser Low $20 OV/ $500 Deductible/20% Hospital $10/$30 RX	$396.38	$792.76	$1,121.76
Delta Dental $2,000.00 per year	$96.00	$96.00	$96.00
Vision Service Plan (VSP)	$29.65	$29.65	$29.65
Blue Shield Life Insurance ($10,000)	$3.60

Negotiated Monthly Benefit Cap New Cap Amount $387.00 Effective 7/1/04
Certificated Bargaining Unit Hired after 1/18/82
Half Time or more:	$387.00
90%	$348.30
80%	$309.60
70%	$270.90
60%	$232.20
50%	$193.50
Less than 50%	Ineligible

 

Your Cap ___________

Your Cost __________

 

Total the costs of your choice of benefits and subtract your negotiated cap. The result is your monthly cost for your health and welfare selections.