Statewide MODA: Evergreen ($1,600 H.S.A. compliant) RX applied to medical deductible PacificSource Dental/Vision
Complete Package: Medical/ Dental/Vision
496 366 275 236 171 106 67 -
661 531 440 401 336 271 232 141 11
Statewide MODA: Birch
Statewide MODA: Cedar
Statewide MODA: Dogwood
($800 ded)
($1,200 ded)
($1,600 ded)
Willamette Dental/PacSource Vision
Willamette Dental/PacSource Vision
Willamette Dental/PacSource Vision
If you work at Medical Only** least FTE
+ 0.50 0.60 0.67 0.70 0.75 0.80 0.83 0.90 1.00
809 679 588 549 484 419 380 289 159
Complete Package: Medical/ Dental/Vision
930 800 709 670 605 540 501 410 280
If you work at Medical Only** least FTE
0.50 0.60 0.67 0.70 0.75 0.80 0.83 0.90 1.00
665 535 444 405 340 275 236 145 15
Complete Package: Medical/ Dental/Vision
If you work at Medical Only** least FTE
786 656 565 526 461 396 357 266 136
0.50 0.60 0.67 0.70 0.75 0.80 0.83 0.90 1.00
496 366 275 236 171 106 67 -
If you work at Medical Only** least FTE
0.50 0.60 0.67 0.70 0.75 0.80 0.83 0.90 1.00
Health Savings Account Employer contributions:
Complete Package: Medical/ Dental/Vision
363 233 142 103 38 -
Employee Only Complete Package
528 398 307 268 203 138 99 8 -
122
2-party + Complete Package
122
Employee 2-party + Only Medical Medical Only Only
-
-
27 66 157 279
27 66 157 287
Statewide MODA: Evergreen
Complete Package: Medical/ Dental/Vision
617 487 396 357 292 227 188 97 -
($1,600 H.S.A. compliant) RX applied to medical deductible Willamette Dental/PacSource Vision
If you work at Medical Only** least FTE
0.50 0.60 0.67 0.70 0.75 0.80 0.83 0.90 1.00
363 233 142 103 38 -
Health Savings Account Employer contributions:
Complete Package: Medical/ Dental/Vision
Employee Only Complete Package
484 354 263 224 159 94 55 -
2-party + Complete Package
-
-
36 166
36 166
Employee 2-party + Only Medical Medical Only Only
-
-
27 66 157 279
27 66 157 287
PLAN NOTES: Rates are composite. (This means you pay the same cost regardless of # of people covered on your plan) * Dental/Vision option (medical declined): $0 cost to insurance eligible employees (.5 - 1 FTE)
***
Employees are responsible for not exceeding IRS limits District contribution reduced due to IRS limits.
**The Medical only option applies the District Employer Contribution towards the medical plan cost, pro-rated by your fte. Life insurance is provided to all insurance eligible employees.
Employer contribution is applied to the plan costs and reflected in rates above: full-time employees: $1,300 part-time employees: pro-rated based on fte * $1,300
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