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Vision Service Plan - VSP
Employee Pays (Tenthly)
District Contribution Amount
Vision
Employee Only
$0
$11.04
Employee + 1 Dependent
$8.18
$13.90
Employee + 2 or More Dependents
$19.22
$13.90
Delta Dental Premier
Employee Pays (Tenthly)
District Contribution Amount
PPO Dental
Employee Only
$21.95
$40.45
Employee + 1 Dependent
$89.03
$40.45
Employee + 2 or More Dependents
$147.95
$40.45
CERTIFICATED 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
$283.78
$327.02
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