Benefits Calculator
Choose one in each category.
October 1, 2025 thru September 30, 2026
Medical
Empl. Only
+Spouse
+Child(ren)
Family
Choice
Cost/Month
Please Select one of the Health options.
$
Dental Opt Out
$
Vision Opt Out
$
TOTAL/MONTH
$0
X 12(TOTAL COST)
$0
CAP AMOUNT
$
OVER CAP (TOTAL COST-CAP)
$0
PAYROLL DEDUCTION
MTHLY FOR 9 PAYMENTS
$0
Cap Amount
Based on medical coverage level
Empl. Only = $13248.24
+Spouce = $19772.64
+Child(ern) = $13433.4
Family = $23788.44
KAISER
$1084
$2049
$1449
$2521
Blue Shield TRIO
$962
$1817
$1285
$2236
Blue Shield HMO LAP
$1015
$1918
$1356
$2360
Blue Shield HMO
$1090
$2061
$1457
$2536
Standard Blue Shield PPO 80J
$1121
$2121
$1499
$2610
Optional Blue Shield PPO 90G
$1275
$2413
$1705
$2970
Optional Blue Shield HSA
$1021
$1929
$1363
$2373
Anthem Proactive Care Platinum PPO
$1184
$2239
$1583
$2756
Medical Opt Out
$710
Dental
Empl. Only
+Spouse
+Child(ren)
Family
Delta Dental PPO
$41.2
$82.5
$94.8
$156.7
Delta Dental DHMO
$23.63
$40.87
$40.85
$61.62
Dental Opt Out
$0
Vision
Empl. Only
+Spouse
+Child(ren)
Family
VSP High Plan
$10.2
$20.39
$16.68
-->
$35.43
VSP Low Plan
$6.69
$13.28
$10.92
$23.17
Vision Opt Out
$0