2020-21 Rates
Key: EE – Employee Only | DS – Dual Spouse (both spouses are full-time employees with WJCC Schools)
Full-Time Employee Rates
KA 250 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $780 | $653 | $127 |
| EE+Child | $1,444 | $1,096 | $348 |
| EE+Spouse | $1,444 | $1,046 | $398 |
| EE+Children | $2,106 | $1,620 | $486 |
| Family | $2,106 | $1,570 | $536 |
| DS EE+1 | $1,444 | $1,203 | $241 |
| DS Family | $2,106 | $1,700 | $406 |
KA 250 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $763 | $653 | $110 |
| EE+Child | $1,412 | $1,096 | $316 |
| EE+Spouse | $1,412 | $1,046 | $366 |
| EE+Children | $2,060 | $1,620 | $440 |
| Family | $2,060 | $1,570 | $490 |
| DS EE+1 | $1,412 | $1,203 | $209 |
| DS Family | $2,060 | $1,700 | $360 |
KA 500 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $697 | $653 | $44 |
| EE+Child | $1,289 | $1,096 | $193 |
| EE+Spouse | $1,289 | $1,046 | $243 |
| EE+Children | $1,881 | $1,620 | $261 |
| Family | $1,881 | $1,570 | $311 |
| DS EE+1 | $1,289 | $1,203 | $86 |
| DS Family | $1,881 | $1,700 | $181 |
KA 500 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $680 | $653 | $27 |
| EE+Child | $1,258 | $1,096 | $162 |
| EE+Spouse | $1,258 | $1,046 | $212 |
| EE+Children | $1,836 | $1,620 | $216 |
| Family | $1,836 | $1,570 | $266 |
| DS EE+1 | $1,258 | $1,203 | $55 |
| DS Family | $1,836 | $1,700 | $136 |
HDHP w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $570 | $537 | $33 |
| EE+1 | $1,054 | $965 | $89 |
| Family | $1,538 | $1,381 | $157 |
| DS EE+1 | $1,054 | $992 | $62 |
| DS Family | $1,538 | $1,434 | $104 |
HDHP w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | HSA Employer Contribution (for either HDHP) | |
|---|---|---|---|---|
| EE | $553 | $532 | $21 | $116 |
| EE+1 | $1,023 | $959 | $64 | $131 |
| Family | $1,493 | $1,371 | $122 | $189 |
| DS EE+1 | $1,023 | $984 | $39 | $211 |
| DS Family | $1,493 | $1,421 | $72 | $266 |
Part-Time Employee Rates
KA 250 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $780 | $653 | $127 |
| EE+1 | $1,444 | $808 | $636 |
| Family | $2,106 | $1,081 | $1,025 |
KA 250 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $763 | $653 | $110 |
| EE+1 | $1,412 | $808 | $604 |
| Family | $2,060 | $1,081 | $979 |
KA 500 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $697 | $653 | $44 |
| EE+1 | $1,289 | $808 | $481 |
| Family | $1,881 | $1,081 | $800 |
KA 500 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $680 | $653 | $27 |
| EE+1 | $1,258 | $808 | $450 |
| Family | $1,836 | $1,081 | $755 |
HDHP w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $570 | $537 | $33 |
| EE+1 | $1,054 | $589 | $465 |
| Family | $1,538 | $781 | $757 |
HDHP w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | HSA Employer Contribution (for either HDHP) | |
|---|---|---|---|---|
| EE | $553 | $532 | $21 | $116 |
| EE+1 | $1,023 | $583 | $440 | $131 |
| Family | $1,493 | $773 | $720 | $189 |
Delta Dental (Stand-Alone) Rates
Full-Time Employees
| Total Monthly Premium | School Division Monthly Cost | Full-time Employee Monthly Cost | |
|---|---|---|---|
| EE | $35.85 | $29.54 | $6.31 |
| EE+Spouse | $76.81 | $44.57 | $32.24 |
| EE+Child(ren) | $79.29 | $50.02 | $29.27 |
| Family | $137.98 | $68.28 | $69.70 |
Part-Time Employees
| Total Monthly Premium | School Division Monthly Cost | Part-time Employee Monthly Cost | |
|---|---|---|---|
| EE | $35.85 | $29.54 | $6.31 |
| EE+Spouse | $76.81 | $36.89 | $39.92 |
| EE+Child(ren) | $79.29 | $43.79 | $35.50 |
| Family | $137.98 | $51.97 | $86.01 |
