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Below is a quick reference of the current insurance plans and their costs (before the District's fringe contribution).

SISC Blue Cross rates effective October 1st - September 30th

Blue Shield, Dental & Vision rates effective January 1st - December 31st

Faculty

Composite Rate

2012-2013

2013-2014

 SISC PPO-A,   Group #40303A

  $300 individual/$600 family Deductible

$983

$1,051

  $20 Office Visits / 20% Co-insurance
  Medco Rx $7 Generic /$25 Brand
 SISC PPO-B,   Group #40303B

  $500 individual/$1000 family Deductible

$872

$921

  $30 Office Visits / 20% Co-insurance
 Rx $200/$500 Brand Name  Deductible

Medco Rx $10 Generic /$35 Brand

 SISC PPO-C,   Group #40303C

  $2,000 individual/$4000 family Deductible

  $30 Office Visits / 20% Co-insurance

$769

$814

  Rx $200/$500 Brand Name  Deductible
  Medco Rx $10 Generic /$35 Brand
 SISC PPO-D,     Group #40403D

  $3,500 individual/$7,000 family Deductible

  $40 Office Visits/ 20% Co- insurance

$721

$768

  Medco Rx $9 Generic/ $35 Brand
       
       
 SISC PPO-E,     Group #40403E

  $500 individual/$1000 family Deductible

  $30 Office Visits / 20% Co-insurance

$913

$955

  Medco Rx $9 Generic/ $35 Brand
       
       

Classified / Management

Single Double Family
 Blue Shield PPO A        Group #943189 
  $250 individual / $500 family Deductible
  $10 Office Visit / 10% Co-insurance $736.69 $1,370.26 $2,136.42
 Rx $15 Generic /$30 Formulary/$45 Brand
 
 Blue Shield PPO B        Group #943190
  $500 individual / $1000 family Deductible
  $35 Office Visits / 20% Co-insurance $570.75 $1,061.60 $1,655.18
  Rx $15 Generic /$30 Formulary/$45 Brand
 
 
 Blue Shield PPO C        Group #944485  
  $2,600individual/$5,200 family Deductible $401.69 $747.13 $1,164.88
  Office Visits 20% after deductible   
  Rx subject to deductible, then 20% copay

All Staff

Single Double Family
 Delta Dental             Group #6736-0001
  $50 Deductible per person/$150 Family $61.00 $108.46 $156.70
  Maximum annual benefit $1,200 or $1,400
 *Two year commitment requirement*
 Medical Eye Services - MES Vision $11.19 $18.18 $28.82
 MES Group # 03573  /  Policy # F21306
 
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