Below is a quick reference of the current insurance plans and their costs (before the District's fringe contribution).

SISC Blue Cross rates effective October 1st - September 30th

Blue Shield, Dental & Vision rates effective January 1st - December 31st

Faculty Medical 

Single Rate

Double Rate

Family Rate

 SISC Blue Cross (PPO) Group #40303A
  • $300 Individual/$600 Family Deductible
  • $20 Office Visits / 20% Co-insurance
  • Rx $7 Generic /$25 Brand
 $589/month  $1141/month  $1593/month
 SISC Blue Cross (PPO) Group #40303B
  • $500 Individual/$1,000 Family Deductible
  • $30 Office Visits / 20% Co-insurance
  • Rx $10 Generic/$35 Brand
 $517/month  $1007/month  $1411/month
 SISC Blue Cross (PPO) Group #40303C
  • $2,000 Individual/$4,000 Family Deductible
  • $30 Office Visits / 20% Co-insurance
  • Rx $10 Generic /$35 Brand
 $459/month  $891/month  $1245/month
 SISC Blue Cross (PPO) Group #40303D
  • $3,000 Individual/$6,000 Family Deductible
  • $40 Office Visits / 20% Co-insurance
  • Rx $9 Generic /$35 Brand
 $432/month  $832/month  $1157/month
 SISC Blue Cross (PPO) Group #40303E
  • $5,000 Individual/$10,000 Family Deductible
  • Health Savings Account compatible
    Office Visits 10%
  • Rx $7 generic/ $25 brand (subject to deductible)
 $406/month  $812/month  $1157/month
 SISC Blue Cross (PPO) Group #70303B
  •  $5,000 Individual/$10,000 Family Deductible
  • $60 Office Visits* / 30% Co-insurance 
  • Rx subject to medical deductible

Spouse/Domestic Partners not allowed on this plan

 $365/month  $722/month  $722/month

Classified / Management Medical

(2017)

Single

Rate

Double

Rate

Family

Rate

Blue Cross (PPO) Group# 1302M-B - Plan A
  • $400 Individual / $80 Family Deductible
  • $20 Office Visit / 10% Co-insurance
  • Rx $7 Generic /$20 Formulary/$35 Brand
$696.23/month $1,392.45/month $1,810.19/month

Blue Cross (PPO) Group # 1302Q-A - Plan B

  • $650 Individual / $1,300 Family Deductible
  • $25 Office Visits / 20% Co-insurance
  • Rx $7 Generic /$20 Formulary/$35 Brand
$632.93/month $1,265.87/month $1,645.63month

Blue Cross (PPO) Group #1854Q-A - Plan C

  • $1,000 Individual/$2,000 Family Deductible
  • $30 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
$601.29/month $1,202.58/month $1,563.36/month

Blue Cross (PPO) Group #1854Q-L - Plan D

  • $1,200 Individual/$2,400 Family Deductible
  • $35 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
$585.47/month $1,170.93/month $1,522.21/month

Blue Cross (PPO) Group #1854Q-W - Plan E

  • $1,500 Individual/$3,000 Family Deductible
  • $40 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
 $569.64/month $1,139.28/month $1,481.07/month

 Blue Cross (PPO) Group #1854R-G - Plan F

  • $2,500 Individual/$5,000 Family Deductible
  • $50 Office Visits / 30% Co-insurance
  • Rx $10 Generic /$25 Formulary/$40 Brand
 $534.53/month $1,069.06/month $1,389.77/month

 Blue Cross (PPO) Group #1854R-S - Plan G

  • Deductible $5000  - Deductible must be met before any coverage
  • $60 Office Visits / 30% Co-insurance
  • Rx $25
$479.77/month $959.54/month $1,247.40/month

 All Employees

Single Rate  

Double Rate 

Family Rate

 Delta Dental - Group #6736-0001 Plan A

  • $50 Individual/$150 Family Deductible
  • Annual Maximum Allowance $1,400 (PPO)
  • $500 Orthodontics Annual Max(Adult/Child)
  • Two-Year Commitment Required
 $50.45/month  $89.70/month  $129.57/month

 Delta Dental - Group #6736-0003 Plan B

  • $50 Individual/ $150 Family Deductible
    Annual Maximum Allowance $2,000 (PPO)
  • $1,000 Orthodontics Annual Max (Child Only)
  • Two-Year Commitment Required
 $56.36/month  $100.21/month  $144.80/month

Delta Dental - Group #6736-01001 Plan C

  • $50 Individual/$150 Family Deductible
    Annual Maximum Allowance $2,400 (PPO)
  • $500 Orthodontics Annual Max(Adult/Child)
  • This plan has implant coverage
  • Two-Year Commitment Required
 $64.07/month  $113.93/month  $164.64/month

Delta Dental - Group #6736-01003 Plan D

  • $50 Individual/$150 Family Deductible
    Annual Maximum Allowance $3,000 (PPO)
  • $1,000 Orthodontics Annual Max (Child Only)
  • This plan has implant coverage
  • Two-Year Commitment Required
 $71.58/month  $127.27/month  $183.86/month

Vision Service Plan (VSP) - Group #30071230

  • One eye exam every 12 months
  • Zero co-pay/ Zero deductible
  • $200 Annual Maximum for Lens/Frames every 12 months
 $10.69/month  $17.37/month  $27.53/month