Group Insurance Rates

Blue Cross of Idaho

Effective Rates - September 1, 2009

Blue N2 Plan (HMO)

Medical/Vision

Employee

Employee/
Spouse

Emp/Spouse 1+Children

Employee/
1 Child

Employee/ 2+Children

District Cost 412.97 722.06 816.80 553.16 622.31
Employee Cost 21.73 227.79 290.95 115.19 161.29
Total Medical/Vision 434.70 949.85 1107.75 668.35 783.60
Plan Summary (Adobe Acrobat)


Preferred Provider Organization (PPO)

District Cost 412.97 722.16 816.80 553.16 622.31
Employee Cost 41.98 273.34 343.10 146.84 195.79
Total Medical/Vision 454.95 995.40 1159.90 700.00 818.10
Plan Summary (Adobe Acrobat)

Dental Plans

Effective Rates - September 1, 2009

Delta Dental Plan of Idaho

District Cost 33.72 59.13 80.49 59.13 80.49
Employee Cost 1.78 18.72 32.96 18.72 32.96
Total Dental 35.50 77.85 113.45 77.85 113.45

Willamette Dental of Idaho

District Cost 33.68 54.5 72.14 54.5 72.14
Employee Cost 1.77 15.65 27.41 15.65 27.41
Total Dental 35.45 70.15 99.55 70.15 99.55

United Heritage Life Insurance Company

Employee
Cost

District
Cost

Total
Cost

Effective Rates 9/1/09      
Coverage - $50,000 with AD& D 0.40 7.60 8.00
Life insurance is available for spouse and dependents at $5,000 each for $1.67 per month.

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