DVISD Health Plan Mo Rates 201718.pdf - Google Drive

Del Valle ISD Monthly Rates TRS ActiveCare

Effective 09/01/2017 - 08/31/2018

TRS ACTIVECARE HEALTH PLAN MONTHLY RATES ACTIVECARE 1-HD (High Deductible Plan /Health Savings Account)

Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

Premium $351.00 $991.00 $671.00 $1,316.00

DVISD Contribution $351.00 $351.00 $351.00 $351.00

Employee Monthly Contribution $0.00 $640.00 $320.00 $965.00

Health Savings Account (HSA) District Monthly Contribution $149 * You must have an active HSA through A+FCU to start receiving deposits, contact the Benefits Coordinator to open your HSA*

ACTIVECARE 1-HD (High Deductible Plan) Employee + Spouse Employee + Child(ren) Employee + Family

$991.00 $671.00 $1,316.00

$500.00 $500.00 $500.00

$491.00 $171.00 $816.00

*The ActiveCare 1-HD dependent plans are HSA eligible but receive no District HSA contribution*

ACTIVECARE SELECT

Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

Premium $514.00 $1,264.00 $834.00 $1,589.00

DVISD Contribution $500.00 $500.00 $500.00 $500.00

Employee Monthly Contribution $14.00 $764.00 $334.00 $1,089.00

Premium $714.00 $1,694.00 $1,062.00 $2,004.00

DVISD Contribution $500.00 $500.00 $500.00 $500.00

Employee Monthly Contribution $214.00 $1,194.00 $562.00 $1,504.00

DVISD Contribution $500.00 $500.00 $500.00 $500.00

Employee Monthly Contribution $61.04 $763.08 $388.42 $900.98

ACTIVECARE 2 Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

SCOTT & WHITE HEALTH PLAN (HM0)

Employee Only Employee + Spouse Employee + Child(ren) Employee + Family

Premium $561.04 $1,263.08 $888.42 $1,400.98