9 / 27
9
Odessa R-VII School District 2017
The Medical Plan chart above is for illustrative purposes only and does not include all benefits, plan limitations,
and/or exclusions. This represents in-network benefits only. Please refer to the Humana summary for greater
detail. In the event there is a discrepancy in benefits, the carrier benefit summary/SPD will always govern.
Medical Plan Cost
Below are the costs for each plan per month.
QHDHP
BASE PPO
BUY-UP PPO
Retiree Only
$497.21
$588.71
$643.74
Retiree + Spouse
$994.41
$1,177.42
$1,287.49
Retiree + Child(ren)
$1,019.27
$1,206.86
$1,319.68
Family
$1,402.12
$1,660.17
$1,815.36