Medical Coverage Premiums Monthly Rates

Collectively Bargained

School District of Philadelphia (SDP) Contributions

PLAN NAME SINGLE PARENT/ CHILD PARENT/ CHILDREN COUPLE FAMILY
Personal Choice
20/30/70 w/Modifications
SDP
Contribution
$679.92 $951.90 $1223.87 $1359.86 $2039.77
Keystone SDP
Contribution
$575.90 $806.26 $1036.31 $1151.80 $1727.70

*Additional 2% charge added to COBRA rates

Benefit Personal Choice Plan Keystone HMO
Deductible Individual/Family In-Network $0/$0 Out of Network $2,000 Individual/$6,000 Family N/A
After deductible, Plan pays: N/A 50% N/A
Tier Level Keystone 20 PFT 1.5% Salary Personal Choice 25/35/50% 0% PFT + 1.5% Salary Personal Choice 25/35/50% 3% + 1.5% Salary* Personal Choice 25/35/50% 5% PFT + 1.5% Salary*
PHMO PPO PPO3 PPO5
Single $0.00 $0.00 $8.58 $14.30
Employee & Child $0.00 $0.00 $12.01 $20.02
Employee & Children $0.00 $0.00 $15.44 $25.74
Employee & Spouse or Life Partner $0.00 $0.00 $17.16 $28.60
Family $0.00 $0.00 $25.74 $42.90
Employee & Spouse or Life Partner with Surcharge $34.62 $34.62 $51.78 $63.21
Family with Spouse or Life Partner with Surcharge $34.62 $34.62 $60.36 $77.51

*Those hired before 9/1/10 and are switching to Personal Choice will pay 3% of premium + 1.50% of salary. Those hired on or after 9/1/10 will pay 5% + 1.50% of salary.”  Effective 2019-2020 school year all members will pay 1.50% of salary for Personal Choice and Keystone

 

 

Employees covering a spouse or domestic partner will be subject to a $75.00 monthly surcharge (spread over 27 paychecks) if the spouse/domestic partner is eligible for employee group coverage from his/her own job and continues to be enrolled in District Medical Coverage.  Those whose spouse or domestic partner is a District employee are not subject to the charge.