What It All Costs
Medical, Dental & Vision
Your contributions toward the cost of medical, dental and vision coverage are automatically deducted from your paycheck before taxes.
Employee Costs – Medical
| MEDICAL TIER | TOTAL COST PER MONTH | FHCSD COST PER PAY PERIOD | YOUR COST PER PAY PERIOD* |
|---|---|---|---|
| SIMNSA HMO | |||
| Employee Only | $222.95 | $70.48 | $41.00 |
| Employee + Spouse | $401.71 | $157.86 | $43.00 |
| Employee + Child(ren) | $557.41 | $232.71 | $46.00 |
| Employee + Family | $699.59 | $301.30 | $48.50 |
| KAISER PERMANENTE DEDUCTIBLE HMO | |||
| Employee Only | $724.75 | $264.88 | $97.50 |
| Employee + Spouse | $1,637.94 | $598.97 | $220.00 |
| Employee + Child(ren) | $1,420.52 | $519.26 | $191.00 |
| Employee + Family | $2,268.47 | $829.74 | $304.50 |
| CIGNA SCRIPPS SELECT HMO | |||
| Employee Only | $711.69 | $298.35 | $57.50 |
| Employee + Spouse | $1,558.43 | $644.72 | $134.50 |
| Employee + Child(ren) | $1,352.34 | $559.67 | $116.50 |
| Employee + Family | $2,163.73 | $891.87 | $190.00 |
| CIGNA FULL HMO | |||
| Employee Only | $953.49 | $395.25 | $81.50 |
| Employee + Spouse | $2,085.40 | $859.20 | $183.50 |
| Employee + Child(ren) | $1,809.53 | $745.77 | $159.00 |
| Employee + Family | $2,895.25 | $1,189.63 | $258.00 |
| CIGNA OAP PPO | |||
| Employee Only | $1,123.02 | $473.01 | $88.50 |
| Employee + Spouse | $2,459.26 | $1,019.63 | $210.00 |
| Employee + Child(ren) | $2,133.91 | $886.96 | $180.00 |
| Employee + Family | $3,414.24 | $1,411.12 | $296.00 |
Employee Costs per Pay Period – Dental and Vision
| DENTAL/VISION TIER | CIGNA DHMO | CIGNA DPPO | SIMNSA DHMO | VSP VISION PLAN |
|---|---|---|---|---|
| Employee Only | $8.90 | $26.24 | $8.66 | $3.89 |
| Employee + Spouse | $18.23 | $52.22 | $15.75 | $6.66 |
| Employee + Child(ren) | $19.56 | $55.37 | $10.82 | $6.80 |
| Employee + Family | $27.11 | $79.32 | $27.05 | $10.96 |
Voluntary Life/AD&D
Employee Costs – Life Insurance
Deductions for voluntary life/AD&D are taken from your paycheck after taxes. Rates are available during enrollment.
| VOLUNTARY LIFE RATES | ||
| EMPLOYEE | SPOUSE | |
| per $1,000 | per $1,000 | |
| less than 25 | $0.04 | $0.04 |
| 25-29 | $0.04 | $0.04 |
| 30-34 | $0.05 | $0.05 |
| 35-39 | $0.06 | $0.06 |
| 40-44 | $0.09 | $0.09 |
| 45-49 | $0.14 | $0.14 |
| 50-54 | $0.22 | $0.22 |
| 55-59 | $0.30 | $0.30 |
| 60-64 | $0.45 | $0.45 |
| 65-69 | $0.76 | $0.76 |
| 70-74 | $2.06 | $2.06 |
| CHILD(REN) | Birth through age 25 | |
| Regardless of # of eligible children covered: Birth to Age 26 (if full-time student) | per $2,000 | $0.79 |
