Benefits Calculator
Choose one in each category.

October 1, 2026 thru September 30, 2027
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Medical
Empl. Only
+Spouse
+Child(ren)
Family
ChoiceCost/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 = $14065.68
+Spouse = $20992.68
+Child(ren) = $14262.24
Family = $25256.28
KAISER $1150 $2175 $1537 $2676
 
Blue Shield TRIO $1054 $1993 $1409 $2451
 
Blue Shield HMO LAP $1112 $2103 $1486 $2587
 
Blue Shield HMO $1194 $2259 $1596 $2779
 
Standard Blue Shield PPO 80J $1228 $2323 $1642 $2859
 
Optional Blue Shield PPO 90G $1396 $2643 $1867 $3252
 
Optional Blue Shield HSA $1118 $2114 $1494 $2601
 
Anthem Proactive Care Platinum PPO $1295 $2450 $1731 $3015
 
Medical Opt Out $779     
     
Dental
Empl. Only
+Spouse
+Child(ren)
Family
Delta Dental PPO $42.4  $85  $97.6  $161.4 
 
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 $10.52  $21.03  $17.2 $36.54 
 
VSP Low Plan $6.9  $13.7  $11.26  $23.9 
 
Vision Opt Out $0