2021-22 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 | $827 | $660 | $167 |
| EE+Child | $1,530 | $1,110 | $420 |
| EE+Spouse | $1,530 | $1,035 | $495 |
| EE+Children | $2,233 | $1,640 | $593 |
| Family | $2,233 | $1,565 | $668 |
| DS EE+1 | $1,530 | $1,217 | $313 |
| DS Family | $2,233 | $1,720 | $513 |
KA 250 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $810 | $660 | $150 |
| EE+Child | $1,499 | $1,110 | $389 |
| EE+Spouse | $1,499 | $1,035 | $464 |
| EE+Children | $2,187 | $1,640 | $547 |
| Family | $2,187 | $1,565 | $622 |
| DS EE+1 | $1,499 | $1,217 | $282 |
| DS Family | $2,187 | $1,720 | $467 |
KA 500 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $739 | $660 | $79 |
| EE+Child | $1,367 | $1,110 | $257 |
| EE+Spouse | $1,367 | $1,035 | $332 |
| EE+Children | $1,995 | $1,640 | $355 |
| Family | $1,995 | $1,565 | $430 |
| DS EE+1 | $1,367 | $1,217 | $150 |
| DS Family | $1,995 | $1,720 | $275 |
KA 500 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $722 | $660 | $62 |
| EE+Child | $1,336 | $1,110 | $226 |
| EE+Spouse | $1,336 | $1,035 | $301 |
| EE+Children | $1,949 | $1,640 | $309 |
| Family | $1,949 | $1,565 | $384 |
| DS EE+1 | $1,336 | $1,217 | $119 |
| DS Family | $1,949 | $1,720 | $229 |
HDHP w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $605 | $544 | $61 |
| EE+1 | $1,119 | $979 | $140 |
| Family | $1,634 | $1,451 | $183 |
| DS EE+1 | $1,119 | $1,006 | $113 |
| DS Family | $1,634 | $1,454 | $180 |
HDHP w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | HSA Employer Contribution (for either HDHP) | |
|---|---|---|---|---|
| EE | $588 | $544 | $44 | $116 |
| EE+1 | $1,088 | $979 | $109 | $131 |
| Family | $1,588 | $1,451 | $137 | $189 |
| DS EE+1 | $1,088 | $1,006 | $82 | $211 |
| DS Family | $1,588 | $1,454 | $134 | $266 |
Part-Time Employee Rates
KA 250 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $827 | $660 | $167 |
| EE+1 | $1,530 | $822 | $708 |
| Family | $2,233 | $1,100 | $1,133 |
KA 250 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $810 | $660 | $150 |
| EE+1 | $1,499 | $822 | $677 |
| Family | $2,187 | $1,100 | $1,087 |
KA 500 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $739 | $660 | $79 |
| EE+1 | $1,367 | $822 | $545 |
| Family | $1,995 | $1,100 | $895 |
KA 500 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $722 | $660 | $62 |
| EE+1 | $1,336 | $822 | $514 |
| Family | $1,949 | $1,100 | $849 |
HDHP w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $605 | $544 | $61 |
| EE+1 | $1,119 | $601 | $518 |
| Family | $1,634 | $800 | $834 |
HDHP w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | HSA Employer Contribution (for either HDHP) | |
|---|---|---|---|---|
| EE | $588 | $544 | $41 | $116 |
| EE+1 | $1,088 | $601 | $487 | $131 |
| Family | $1,588 | $800 | $788 | $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 | $5.91 |
| EE+Spouse | $76.45 | $44.57 | $31.88 |
| EE+Child(ren) | $76.95 | $50.02 | $26.93 |
| Family | $138.19 | $68.28 | $69.91 |
Part-Time Employees
| Total Monthly Premium | School Division Monthly Cost | Part-time Employee Monthly Cost | |
|---|---|---|---|
| EE | $35.45 | $29.54 | $5.91 |
| EE+Spouse | $76.45 | $36.89 | $39.56 |
| EE+Child(ren) | $76.95 | $43.79 | $33.16 |
| Family | $138.19 | $51.97 | $86.22 |
