2019-20 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 | $756 | $653 | $103 | |
| EE+Child | $1,399 | $1,096 | $303 | |
| EE+Spouse | $1,399 | $1,046 | $353 | |
| EE+Children | $2,041 | $1,620 | $421 | |
| Family | $2,041 | $1,570 | $471 | |
| DS EE+1 | $1,399 | $1,203 | $196 | |
| DS Family | $2,041 | $1,700 | $341 |
KA 250 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $740 | $653 | $87 |
| EE+Child | $1,369 | $1,096 | $273 |
| EE+Spouse | $1,369 | $1,046 | $323 |
| EE+Children | $1,998 | $1,620 | $378 |
| Family | $1,998 | $1,570 | $428 |
| DS EE+1 | $1,369 | $1,203 | $166 |
| DS Family | $1,998 | $1,700 | $298 |
KA 500 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $675 | $653 | $22 |
| EE+Child | $1,249 | $1,096 | $153 |
| EE+Spouse | $1,249 | $1,046 | $203 |
| EE+Children | $1,823 | $1,620 | $203 |
| Family | $1,823 | $1,570 | $253 |
| DS EE+1 | $1,249 | $1,203 | $46 |
| DS Family | $1,823 | $1,700 | $123 |
KA 500 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $659 | $653 | $6 |
| EE+Child | $1,219 | $1,096 | $123 |
| EE+Spouse | $1,219 | $1,046 | $173 |
| EE+Children | $1,779 | $1,620 | $159 |
| Family | $1,779 | $1,570 | $209 |
| DS EE+1 | $1,219 | $1,203 | $16 |
| DS Family | $1,779 | $1,700 | $79 |
HDHP w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $552 | $537 | $15 |
| EE+1 | $1,021 | $965 | $56 |
| Family | $1,490 | $1,381 | $109 |
| DS EE+1 | $1,021 | $992 | $29 |
| DS Family | $1,490 | $1,434 | $56 |
HDHP w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | HSA Employer Contribution (for either HDHP) | |
|---|---|---|---|---|
| EE | $536 | $532 | $4 | $116 |
| EE+1 | $992 | $959 | $33 | $131 |
| Family | $1,447 | $1,371 | $76 | $189 |
| DS EE+1 | $992 | $984 | $8 | $211 |
| DS Family | $1,447 | $1,421 | $26 | $266 |
Part-Time Employee Rates
KA 250 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $756 | $653 | $103 |
| EE+1 | $1,399 | $808 | $591 |
| Family | $2,041 | $1,081 | $960 |
KA 250 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $740 | $653 | $87 |
| EE+1 | $1,369 | $808 | $561 |
| Family | $1,998 | $1,081 | $917 |
KA 500 w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $675 | $653 | $22 |
| EE+1 | $1,249 | $808 | $441 |
| Family | $1,823 | $1,081 | $742 |
KA 500 w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $659 | $653 | $6 |
| EE+1 | $1,219 | $808 | $411 |
| Family | $1,779 | $1,081 | $698 |
HDHP w/ Comprehensive Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | |
|---|---|---|---|
| EE | $552 | $537 | $15 |
| EE+1 | $1,021 | $589 | $432 |
| Family | $1,490 | $781 | $709 |
HDHP w/ Preventative Dental
| Total Premium | School Division Monthly Cost | Employee Monthly Cost | HSA Employer Contribution (for either HDHP) | |
|---|---|---|---|---|
| EE | $536 | $532 | $4 | $116 |
| EE+1 | $992 | $583 | $409 | $131 |
| Family | $1,447 | $773 | $674 | $189 |
Delta Dental (Stand-Alone) Rates
Full-Time Employees
| Total Monthly Premium | School Division Monthly Cost | Full-time Employee Monthly Cost | |
|---|---|---|---|
| EE | $35.15 | $29.54 | $5.61 |
| EE+Spouse | $75.30 | $44.57 | $30.73 |
| EE+Child(ren) | $77.74 | $50.02 | $27.72 |
| Family | $135.27 | $68.28 | $66.99 |
Part-Time Employees
| Total Monthly Premium | School Division Monthly Cost | Part-time Employee Monthly Cost | |
|---|---|---|---|
| EE | $35.15 | $29.54 | $5.61 |
| EE+Spouse | $75.30 | $36.89 | $38.41 |
| EE+Child(ren) | $77.74 | $43.79 | $33.95 |
| Family | $135.27 | $51.97 | $83.30 |
