Health Benefits and HSA Information
Annual OPEN ENROLLMENT for medical, dental, vision insurance coverage and flexible spending accounts is conducted each May with an effective date of July 1. The Open Enrollment period is an opportunity to change medical carriers, plans and/or change dependent coverage.
OPEN ENROLLMENT FOR CURRENT EMPLOYEES
Thursday, May 1 until Wednesday, May 21, 2025
ALL employees complete BENEFITSOLVER online submission
(even if retaining the same health plan and coverage)
Note: Our "Company Key" is SIG (case sensitive)
Benefitsolver Flyer
RJUHSD Benefit Guide, including 2025-26 Annual Notices
Health Benefit Rate Sheets 2025-26 (Rates effective 7-1-25 2025-26 Settlement Rates):
- $1,125/cap/month -- RSEA Group (Teachers)
- $950/cap/month -- CSEA Group (Classified Staff) SETTLEMENT NOT ACCOMPLISHED YET
- $900/cap/month -- Administrators and Cabinet Members
- $900/cap/month -- Classified Managers
- $900/cap/month -- Confidential Staff
- $900/cap/month -- Support Services Staff
Medical Plans 2025-26
New: Understanding the difference between HMO and High Deductible (HD) Plans
Items below are summarized. Please view and compare each plan carefully for full details.
KAISER (4 plans offered):
Kaiser HMO plus Optical and Chiro
$25 CoPay Primary Dr.,
$50 CoPay Specialist Dr.
| Plan coverage: | Deductible (Prescriptions only) | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $100 | $1,500 |
| Individual within the family | $100 per member | $1,500 |
| Family | $100 per member | $3,000 |
Kaiser DHMO plus Optical and Chiro (not HSA-eligible plan)
$20 CoPay Primary Dr.
$20 CoPay Specialist Dr.
Note: Hospital, emergency room and/or outpatient surgery services are subject to a 20% coinsurance after deductible.
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $1,000 | $3,000 |
| Individual within the family | $1,000 | $3,000 |
| Family | $2,000 | $6,000 |
Kaiser Mid High Deductible HMO (HSA eligible)
Primary and Specialist Office Visits: $30 CoPay after deductible
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $2,000 | $3,300 |
| Individual within the family | $3,300 | $3,300 |
| Family | $4,000 | $6,200 |
Kaiser High Deductible HMO (HSA eligible)
Primary / Specialist Office Visits: $30 / $50 CoPay after deductible
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $3,000 | $5,350 |
| Individual within the family | $3,300 | $5,350 |
| Family | $6,000 | $10,700 |
SUTTER HEALTH (4 plans offered):
Sutter HMO
$25 CoPay Primary Dr.
$50 CoPay Specialist Dr.
| Plan coverage: | Deductible (prescriptions only) | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $100 | $1,500 |
| Individual within the family | $100 | $1,500 |
| Family | $200 | $3,000 |
Sutter DHMO ML86 Plan (not HSA eligible)
$20 CoPay Primary Dr.
$20 CoPay Specialist Dr.
Note: Hospital, emergency room and/or outpatient surgery services are subject to a 20% coinsurance after deductible.
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $1,000 | $3,000 |
| Individual within the family | $1,000 | $3.000 |
| Family | $2,000 | $6,000 |
Sutter Mid High Deductible HMO (HSA eligible)
Primary and Specialist Office Visits: No charge after deductible
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $1,650 | $3,300 |
| Individual within the family | $3,300 | $3.300 |
| Family | $3,300 | $6,600 |
Sutter High Deductible HMO (HSA eligible)
Primary and Specialist Office Visits: 20% CoPay after deductible
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $2,500 | $4,000 |
| Individual within the family | $3,300 | $4.000 |
| Family | $5,000 | $8,000 |
WESTERN HEALTH ADVANTAGE (4 plans offered):
WHA HMO
$25 CoPay Primary Dr.
$50 CoPay Specialist Dr.
| Plan coverage: | Deductible (prescriptions only) | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $100 | $1,500 |
| Individual within the family | $100 per member | $1,500 |
| Family | $100 per member | $3,000 |
WHA DHMO 1000-20-20 % Plan (not HSA-eligible plan)
$20 CoPay Primary Dr.
$20 CoPay Specialist Dr.
Note: Hospital, emergency room and/or outpatient surgery services are subject to a 20% coinsurance after deductible.
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $1,000 | $5,000 |
| Individual within the family | $1,000 | $5,000 |
| Family | $2,000 | $10,000 |
WHA Mid High Deductible HMO (HSA eligible)
Primary and Specialist Office Visits: No charge after deductible
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $1,800 | $3,600 |
| Individual within the family | $3,300 | $3,600 |
| Family | $3,600 | $7,200 |
WHA High Deductible HMO (HSA eligible)
Primary and Specialist Office Visits: $40 CoPay after deductible
| Plan coverage: | Deductible | Annual Out of Pocket Maximum |
|---|---|---|
| Individual (self-only plan) | $2,800 | $6,500 |
| Individual within the family | $3,300 | $6,500 |
| Family | $5,600 | $13,000 |
Full Plan Summaries of Benefits & Coverage (SBC's) for Kaiser, Sutter Health and Western Health plans
Delta Dental Premium Insurance
The dental coverage plan for the family is paid 100% by the district and is only available with the employee's participation in medical coverage.
Delta Dental PPO Plan
Support for Chronic Conditions
Delta Dental PPO Plan
Support for Chronic Conditions
VSP Vision Care
Voluntary participation of Kaiser HD, Sutter Health Plus and Western Health Advantage subscribers. Employee only coverage.
VSP Plan
VSP Plan
Health Savings Account (HSA) with High Deductible Plans
Employees who choose a High Deductible Health Plan qualify to open a Health Savings Account (HSA). An HSA allows pre-tax dollars to be set aside for health-related expenses. The tax year individual plan maximum limits are listed on the Salary Reduction Form linked below. Additional catch-up contributions are allowed for subscribers over the age of 55. The District’s pre-tax HSA payroll deduction is administered through Optum Bank.* Please note: Unused HSA funds are non-refundable. HSA funds continue to earn interest and are carried forward to subsequent years for health-related expenses. The funds can be used in retirement years for qualified medical expenses.
Optum HSA Salary Reduction Form Monthly HSA contribution amount may be changed at any time throughout the year.
Optum Bank HSA Enrollment Form Optum Bank's monthly fee waived when enrolled in High Deductible Health Plan.
* Individual HSA's may be available through an employee's bank, however, the contribution will not be an automatic district payroll deduction. If interested in a non-Optum Bank HSA, please inquire with your banking institution.
Forms to Complete:
(ONLY for new hires OR if an employee declines/waives coverage)
SIG Enrollment Form plus your chosen Provider's enrollment form:
OR, if applicable, SIG Waiver of Coverage Form
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2024-25 INFORMATION FOR REFERENCE:
RJUHSD Benefit Guide, including 2024-25 Annual Notices
Health Benefit Rate Sheets 2024-25:
- $1,075/cap/month -- RSEA Group (Teachers)
- $950/cap/month -- CSEA Group (Classified Staff)
- $875/cap/month -- Administrators and Cabinet Members
- $875/cap/month -- Classified Managers
- $900/cap/month -- Confidential Staff
- $875/cap/month -- Support Services Staff