• Rate, Eligibility, and Verification Documentation

  • Benefits Eligibility Chart

    Benefit eligibility is based on employment classifications and the FTE or work hours per day.   

    Required Verification Documentation

    Premium Chart 2021-2022

    Kaiser Permanente, Blue Shield (except for Anchor Bronze), Delta Dental and Vision Service Plan are based on composite rate pricing. Composite Rate Pricing means that the monthly premium is the same for every employee regardless of the number of family members covered by the plan.  

    Blue Shield Anchor Bronze is based on tiered rate pricing. Tiered Rate Pricing means that the monthly premium is based on the specific number of family members covered by the plan (single, double, or family).

    The rate chart is based on the District-paid contribution for a full-time employee that is 100% benefit eligible. Part-time employees receive a pro-rated amount of all District-paid contributions for medical, dental and vision. To determine the over cap amount for a part-time employee, deducted the pro-rated cap amount from the cost per month as listed on the chart below.