Page 12 - Inglewood USD Benefits Guide 2019 - ACTIVES_FINAL

EARLY RETIREE CONTRIBUTIONS

CLASSIFIED & CONFIDENTIAL

This chart compares the monthly premiums for our Employee Benefit plans. Your cost for coverage will vary depending on the
option and level of coverage you choose. Early retirees should make payments to Inglewood Unified School District for any
premium amounts exceeding the District Contribution by the first of each month. Hours listed below are based off of hours/day at
time of Retirement.

Medical Plans – 2019 Monthly Premiums
¹

Kaiser HMO $10 Employees working 7-8 Employees working less Employees working less Employees working less
hours per day than 7 hours/More than 6 than 6 Hours/More than 5 than 5 hours/More than 4
hours per day hours per day hours per day
Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays
Retiree Only $152.27 $537.01 $152.27 $537.01 $353.65 $335.63 $420.78 $268.51
Retiree + 1 $238.12 $1,124.44 $519.23 $843.33 $659.79 $702.78 $800.34 $562.22
Retiree + Family $316.32 $1,605.05 $717.58 $1,203.79 $918.21 $1,003.16 $1,118.85 $802.53

Kaiser HMO $20 Employees working 7-8 Employees working less Employees working less Employees working less
hours per day than 7 hours/More than 6 than 6 Hours/More than 5 than 5 hours/More than 4
hours per day hours per day hours per day

Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays
Retiree Only $126.00 $537.01 $126.00 $537.01 $327.38 $335.63 $394.51 $268.51
Retiree + 1 $185.58 $1,124.44 $466.69 $843.33 $607.25 $702.78 $747.80 $562.22
Retiree + Family $241.98 $1,605.05 $643.24 $1,203.79 $843.87 $1,003.16 $1,044.51 $802.53

Anthem Blue Cross Employees working 7-8 Employees working less Employees working less Employees working less
Vivity HMO hours per day than 7 hours/More than 6 than 6 Hours/More than 5 than 5 hours/More than 4
10/100% hours per day hours per day hours per day
Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays

Retiree Only $425.84 $537.01 $425.84 $537.01 $627.22 $335.63 $694.35 $268.51
Retiree + 1 $894.25 $1,124.44 $1,175.36 $843.33 $1,315.92 $702.78 $1,456.47 $562.22
Retiree + Family $1,277.50 $1,605.05 $1,678.76 $1,203.79 $1,879.39 $1,003.16 $2,080.03 $802.53

Anthem Blue Cross Employees working 7-8 Employees working less Employees working less Employees working less
Select HMO hours per day than 7 hours/More than 6 than 6 Hours/More than 5 than 5 hours/More than 4
15/30/250 hours per day hours per day hours per day
Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays

Retiree Only $396.04 $537.01 $396.04 $537.01 $597.42 $335.63 $664.55 $268.51
Retiree + 1 $831.67 $1,124.44 $1,112.78 $843.33 $1,253.34 $702.78 $1,393.89 $562.22
Retiree + Family $1,188.10 $1,605.05 $1,589.36 $1,203.79 $1,789.99 $1,003.16 $1,990.63 $802.53

Anthem Blue Cross Employees working 7-8 Employees working less Employees working less Employees working less
Vivity HMO hours per day than 7 hours/More than 6 than 6 Hours/More than 5 than 5 hours/More than 4
30/40/500 hours per day hours per day hours per day
Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays Retiree Pays IUSD Pays
Retiree Only $337.46 $537.01 $337.46 $537.01 $538.84 $335.63 $605.97 $268.51
Retiree + 1 $708.65 $1,124.44 $989.76 $843.33 $1,130.32 $702.78 $1,270.87 $562.22
Retiree + Family $1,012.36 $1,605.05 $1,413.62 $1,203.79 $1,614.25 $1,003.16 $1,814.89 $802.53

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