Employee Cost Monthly Premiums Monthly Premiums Medical Monthly Premiums DENTAL VISION PPO #1 PPO #2 Employee + Family Employee + Family Employee Only $36.56 Teachers $189.04 $539.25 $178.10 $508.06 Employee Only $5.20 Employee + Spouse $66.16 Administrators $75.61 $215.70 $71.24 $203.23 Employee + Spouse $10.41 Employee + Child(ren) $80.25 12mo. Classified $75.61 $215.70 $71.24 $203.23 Employee + Child(ren) $11.14 Family $128.24 9/10mo. Classified $75.61 $1,466.76 $71.24 $1,381.93 Family $17.80 Pre-65 Retirees $756.14 $2,157.00 $712.38 $2,032.25 SEE THIS PLAN SEE THIS PLAN SEE THIS PLAN