Health Information & Contacts
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Insurance Rates - 2018/19
Rate sheet (PDF) or click on the headings below to expand the category information
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Dental - Delta Dental
Delta Dental
Delta Dental
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Retiree 65 & Over
Employee
37.00
0.00
37.00
47.80
Employee/Spouse
82.20
45.20
37.00
95.70
Ee/Child
71.25
34.25
37.00
92.25
Ee/Children
106.00
69.00
37.00
137.10
Family w/spouse
141.85
104.85
37.00
183.55
DBL CPL
141.85
67.85
74.00
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Dental - Willamette Dental
Willamette Dental (managed by Blue Cross)
Willamette Dental Rates
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Retiree 65 & Over
Employee
40.80
0.00
40.80
40.80
Employee/Spouse
88.27
47.47
40.80
88.27
Ee/Child
78.42
37.62
40.80
Ee/Children
116.74
75.94
40.80
Family w/spouse
156.35
115.55
40.80
DBL CPL
156.35
74.75
81.60
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Medical - PacificSource HSA Plan
HSA Plan
If you have PacificSource HSA Plan and also have Delta Dental, the premium for your Medical plan is:
Pacific Source – HSA Plan w/Delta Dental
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Employee *
493.53
0.00
493.53
Employee/Spouse
1084.77
549.69
535.08
Ee/Child
759.55
224.47
535.08
Ee/Children
882.58
347.50
535.08
Family w/spouse
1257.15
722.07
535.08
DBL CPL
1257.15
186.99
1070.16
* If you have the HSA plan as an “employee only”, the district will put $40.00 into your HSA account (if you have one open)
If you have PacificSource HSA Plan and also have Willamette Dental, the premium for your Medical plan is:
Pacific Source – HSA Plan w/Willamette Dental
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Employee *
493.53
0.00
493.53
Employee/Spouse
1084.77
553.49
531.28
Ee/Child
759.55
228.27
531.28
Ee/Children
882.58
351.30
531.28
Family w/spouse
1257.15
725.87
531.28
DBL CPL
1257.15
194.59
1062.56
* If you have the HSA plan as an “employee only”, the district will put $40.00 into your HSA account (if you have one open)
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Medical - PacificSource Signature Plan (PPO)
PPO Plan
If you have Pacific Source Signature Plan (PPO) and also have Delta Dental, the premium for your Medical Plan is:
Pacific Source – Signature Plan (PPO) w/Delta Dental
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Employee
584.23
49.15
535.08
Employee/Spouse
1284.18
749.10
535.08
Ee/Child
899.19
364.11
535.08
Ee/Children
1044.95
509.87
535.08
Family w/spouse
1488.32
953.24
535.08
DBL CPL
1488.32
418.16
1070.16
If you have Pacific Source Signature Plan (PPO) and also have Willamette Dental, the premium for your Medical Plan is:
Pacific Source – Signature Plan (PPO) w/Willamette Dental
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Employee
584.23
52.95
531.28
Employee/Spouse
1284.18
752.90
531.28
Ee/Child
899.19
367.91
531.28
Ee/Children
1044.95
513.67
531.28
Family w/spouse
1488.32
957.04
531.28
DBL CPL
1488.32
425.76
1062.56
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Vision - LifeMap/VSP
LifeMap – Vision Rates
LifeMap – Vision Rates
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Retiree 65 & Over
Employee
7.83
0.00
7.83
Same
Employee/Spouse
15.69
7.86
7.83
Same
Ee/Child(ren)
16.78
8.95
7.83
Family w/spouse
26.81
18.98
7.83
DBL CPL
26.81
11.15
15.66
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Benefits
These are benefits the district provides at no cost to full time employees
LifeMap – Life BenefitLifeMap – Life Benefit
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Benefit
Employee
9.45
0.00
9.45
50,000.00
Employee Assistance Program Benefit
Employee Assistance Program Benefit
Enrolled Members
Health Premium/Mo
Employee Cost
District Pays
Employee
0.64
0.00
0.64
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PacificSource Health Insurance
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Employee Assistance Program (EAP) - LifeMap
Call (866)750-1327 and let them know you have LifeMap coverage or go to MyRBH.com and enter "LifeMap" as your Group Code.
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Delta Dental
Register on the Delta Dental site and access your claims or find a doctor. Go to www.deltadentalid.com
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VSP/Vision
Register on the vision care site at www.vsp.com. Manage your coverage and claims, search for a doctor, etc. -
Willamette Dental
Schedule an appointment with Willamette Dental at 1-855-433-6825. Currently, Willamette has 2 local offices - Meridian and Boise.
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Due to IRS regulations, you cannot change your elections outside of the annual Open Enrollment period (July 1 - Aug 1st), unless you have a Qualifying Event during the year. Following are examples of the most common Qualifying Events:
- Marriage or divorce
- Birth or adoption of a child
- Child reaching age 26
- Death of a spouse, or child
- Change in child custody
- Change in coverage election made by spouse during their employer's Open Enrollment period
- Loss of coverage under spouse's plan.
