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14

Rates for 2017 - 2018

The amount you play for your coverage is outlined below and depends on the plan that you select and

whether you cover dependents on your plan. Please note that there are two set of rates; Classified (Blue) and

Certificated (Green). All premium amounts are tenthly.

CLASSIFIED RATES / TENTHLY

Anthem Blue Cross

Employee Pays (Tenthly)

District Contribution Amount

80 - E : PPO 1

Employee Only

$499.78

$327.02

Employee + 1 Dependent

$918.57

$701.43

Employee + 2 or More Dependents

$1,191.25

$1,086.35

80 - G : PPO 2

Employee Only

$443.38

$327.02

Employee + 1 Dependent

$806.97

$701.43

Employee + 2 or More Dependents

$1,032.85

$1,086.35

80 - M : PPO 3

Employee Only

$135.00

$475.80

Employee + 1 Dependent

$486.57

$701.43

Employee + 2 or More Dependents

$575.65

$1,086.35

High Deductible Health Plan :

HDHP - HSA

Employee Only

$288.58

$327.02

Employee + 1 Dependent

$528.57

$701.43

Employee + 2 or More Dependents

$666.85

$1,086.35

Kaiser Permanente

Employee Pays (Tenthly)

District Contribution Amount

HMO

Employee Only

$340.18

$327.02

Employee + 1 Dependent

$613.77

$701.43

Employee + 2 or More Dependents

$746.05

$1,086.35