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{"sheet":"Individual Calculation ","index":0,"n_rows":45,"n_cols":11,"rows_kept":45,"cut":false,"hidden":false,"merged":[[2,3,2,10],[7,3,7,10],[13,3,13,8],[5,3,5,10],[28,5,28,6],[24,5,24,6],[19,3,19,8],[3,3,3,10],[14,5,14,8],[23,9,23,10],[27,9,27,10],[24,9,24,10],[11,9,13,9],[9,3,9,5],[21,7,21,8],[28,9,28,10],[32,9,33,10],[21,9,21,10],[43,7,43,9],[44,7,44,9],[42,7,42,9],[31,9,31,10],[44,10,44,11],[37,10,37,11],[38,10,38,11],[39,10,39,11],[40,10,40,11],[41,10,41,11],[42,10,42,11],[43,10,43,11],[9,6,9,8],[42,3,42,4],[11,3,11,5],[11,6,11,8],[38,3,38,5],[40,3,40,5],[37,6,38,6],[32,5,32,6],[33,5,33,6]]}
[]
[]
[null,null,null,"ROSEBURG PUBLIC SCHOOLS  2024/2025 INSURANCE OPTIONS "]
[null,null,null,"Plan Year Effective 10/01/2024"]
[]
[null,null,null,"Open Enrollment is MANDATORY for the 2024/2025 Plan Year. You are required to login and re-enroll for benefits for you and your dependent(s) (if applicable). This is an opportunity to review your benefits and make pre-tax benefit  changes for the new plan year. Open Enrollment begins August 15th and ends September 15, 2024."]
[]
[null,null,null,"Review member resources and complete the steps below to give you your monyhly out-of-pocket cost.   "]
[]
[null,null,null,"Open Enrollment Portal",null,null,"Open Enrollment Handbook",null,null,"Plan  Comparison Tool","What is a Dependent Care Account?"]
[]
[null,null,null,"2024 OEBB Presentation Videos & Insurance Updates",null,null,"Employee Assistance Plan (EAP)",null,null,"What is a Flexible Spending Account (FSA)? ","What is a Health Spending Account (HSA)?"]
[]
[null,null,null,"Step 1: Select your classification."]
[null,null,null,null,null,"Confidential",null,null,null,null,"CLICK TO RESET OPTIONS"]
[]
[null,null,null,"Step 2: Select your Regular Hours Worked. "]
[null,null,null,null,null,"6.5 and Above","  (Temporary or lunch hours not included.)"]
[]
[null,null,null,"Step 3: Make you plan selections below for cost estimates."]
[]
[null,null,null,null,null,null,null,"Full Plan Cost:",null,"Quick Plan Comparisons:"]
[null,null,null,"Moda Medical Plan Options"]
[null,null,null,null,null,null,null,null,null,"Medical Plans"]
[null,null,null,null,null,"Moda Medical Plan 7 (Deductible Ind. $2000 / Fam. $4,200)",null,null,{"$f":"IFERROR(_xlfn.XLOOKUP($F$25,'Reference Data'!$A:$A,'Reference Data'!$C:$C),\"0\")","v":1364.49},{"$f":"IFERROR(_xlfn.XLOOKUP(F25,'Reference Data'!A:A,'Reference Data'!B:B),\"Optional\")","v":"HSA Eligible. Individual deductible does not apply if enrolling dependents."}]
[]
[null,null,null,"Moda Vision and VSP Vision Options"]
[null,null,null,null,null,null,null,null,null,"Vision Plans"]
[null,null,null,null,null,"VSP Choice Plan (Copay Plan)",null,null,{"$f":"IFERROR(_xlfn.XLOOKUP($F$29,'Reference Data'!$A:$A,'Reference Data'!$C:$C),\"0\")","v":16.510000000000002},{"$f":"IFERROR(_xlfn.XLOOKUP(F29,'Reference Data'!A:A,'Reference Data'!B:B),\"Optional\")","v":"VSP Network only. May use frame allowance ($150) for non-prescription sunglasses or blue light filtering glasses. Limited out-of network  benefit."}]
[]
[null,null,null,"Delta Dental Plan & Willamette Dental Options"]
[null,null,null,null,null,null,null,null,null,"Dental Plans"]
[null,null,null,null,null," Willamette Dental Plan w/Ortho - Composite",null,null,{"$f":"IFERROR(_xlfn.XLOOKUP($F$33,'Reference Data'!$A:$A,'Reference Data'!$C:$C),\"0\")","v":120.55},{"$f":"IFERROR(_xlfn.XLOOKUP(F33,'Reference Data'!A:A,'Reference Data'!B:B),\"Optional\")","v":"No annual maximum or deductibles (implants excluded). No local providers; must travel out of town. No out-of network benefit for non-emergencies."}]
[]
[]
[null,null,null,"Benefits Summary Costs"]
[]
[null,null,null,"Basic Life (Employer Paid):",null,null,{"$f":"IFERROR(_xlfn.XLOOKUP(D39,'Reference Data'!G1:G5,'Reference Data'!H1:H5),\"TBD\")","v":7},null,null,"Medical:",{"$f":"I25","v":1364.49}]
[null,null,null,{"$f":"IFERROR(_xlfn.XLOOKUP($F$15,'Reference Data'!$F:$F,'Reference Data'!$G:$G),\"TBD\")","v":"Plan 10 Basic Life,  AD&D, EAP-$50K"},null,null,null,null,null,"Vision:",{"$f":"I29","v":16.510000000000002}]
[null,null,null,"Long Term Disability",null,null,null,null,null,"Dental",{"$f":"I33","v":120.55}]
[null,null,null,{"$f":"IFERROR(_xlfn.XLOOKUP($F$15,'Reference Data'!$F:$F,'Reference Data'!$I:$I),\"TBD\")","v":"Plan 12 LTD Employer Paid"},null,null,{"$f":"_xlfn.XLOOKUP(F15,Table4[[#All],[Classification]],'Reference Data'!K1:K5)","v":15.9},null,null,"Pre-Cap Total:",{"$f":"SUM(K38:K40)","v":1501.55}]
[]
[null,null,null,"* Total Cost:",null,{"$f":"G38+G41","v":22.9},null,"Total Cost of Benefits:",null,null,{"$f":"F43+K41","v":1524.45}]
[null,null,null,null,null,null,null,"District CAP Amount:",null,null,{"$f":"IFERROR(_xlfn.XLOOKUP($F$18,'Reference Data'!F:F,'Reference Data'!G:G),\"0\")","v":1550}]
[null,null,null,"*Estimate only.",null,null,null,"*Monthly Employee Portion:",null,null,{"$f":"IFERROR(K43-K44,\"0\")","v":-25.549999999999955}]

{"sheet":"Reference Data","index":1,"n_rows":36,"n_cols":11,"rows_kept":36,"cut":false,"hidden":false,"merged":[]}
["Heath Plan","Notes","No Selection Made",null,null,"Classification","Basic Life & AD&D","Cost","LTD","Cost","Estimated"]
["Moda Medical Plan 1 (Deductible Ind. $400/ Fam. $1,500 Coordinated)","FSA Eligible. $20 co-pays for PCP 360 Primary Care Visits. $40 co-pay for Specialist / Urgent Care.",1888.12,null,null,"Admin, Coord, Manager","Plan 10 Basic Life, AD&D, EAP-$50K",7,"Plan 12 LTD Employer Paid",3.1800000000000001E-3,29.150000000000002]
["Moda Medical Plan 2 (Deductible Ind. $800/ Fam. $2,700 Coordinated)","FSA Eligible. $20 co-pays for PCP 360 Primary Care Visits. $40 co-pay for Specialist / Urgent Care.",1751.51,null,null,"Classified","Plan 5 Basic Life, AD&D, EAP -$20K",4.0599999999999996,"Plan 12 LTD Employer Paid",3.1800000000000001E-3,7.4200000000000008]
["Moda Medical Plan 3 (Deductible Ind. $1,200/ Fam. $3,900 Coordinated)","FSA Eligible. $25 co-pays for PCP 360 Primary Care Visits. $50 co-pay for Specialist / Urgent Care.",1643.24,null,null,"Confidential","Plan 10 Basic Life,  AD&D, EAP-$50K",7,"Plan 12 LTD Employer Paid",3.1800000000000001E-3,15.9]
["Moda Medical Plan 4  (Deductible Indi. $1,600/ Fam. $5,100 Coordinated)","FSA Eligible. $25 co-pays for PCP 360 Primary Care Visits. $50 co-pay for Specialist / Urgent Care.",1551.61,null,null,"Licensed","Plan 5 Basic Life, AD&D, EAP -$20K",4.0599999999999996,"Plan 18 LTD Employee Paid",3.3500000000000001E-3,17.587500000000002]
["Moda Medical Plan 5 (Deductible Ind. $2,000/ Fam. $6,300)","FSA Eligible. $30 co-pays for PCP 360 Primary Care Visits. $50 co-pay for Specialist / Urgent Care.",1433.28]
["Moda Medical Plan 6  (Deductible Ind.  $1600/ Fam. $3,400)","HSA Eligible. Individual deductible does not apply if enrolling dependents.",1462.01]
["Moda Medical Plan 7 (Deductible Ind. $2000 / Fam. $4,200)","HSA Eligible. Individual deductible does not apply if enrolling dependents.",1364.49]
["Waive","See CBA for Opt-Out Stipend Information.",0]
[null,null,null,null,null,"Work Hours","Cap Amount"]
[null,null,null,null,null,"6.5 and Above",1550]
[null,null,null,null,null,6.25,1210.9375]
[null,null,null,null,null,"5.75-6.00",1162.5]
["Dental Plan",null,null,null,null,"5.25-5.50",1065.625]
[" Premier Plan 1 - Delta Dental Premier Network","Largest dental network. Plan benefits increase each year member visits dentist.",164.26,null,null,"4.75-5.00",968.75]
[" Premier Plan 5 - Delta Dental Premier Network","Largest dental network. Plan benefits increase each year member visits dentist.",145.08000000000001,null,null,"4.25-4.50",871.875]
[" Premier Plan 6 - Delta Dental Premier Network                                          ","Largest dental network. Plan provides no orthodontia coverage.",104.7]
[" Exclusive PPO Plan** - Delta Dental PPO Network","More limited network but lower contracted rates. No out-of network benefit for non-emergencies.",95.96]
[" Willamette Dental Plan w/Ortho - Composite","No annual maximum or deductibles (implants excluded). No local providers; must travel out of town. No out-of network benefit for non-emergencies.",120.55]
["Waive","See CBA for Opt-Out Stipend Information.",0]
[null,null,null,null,null,"Life Insurance & EAP (24-25 rates)",4.0600000000000005,"EAP $2.1"]
[null,null,null,null,null,"LTD District Pd Classified (23-24 rate + 8%)",8.3484000000000016]
[]
["VISION PLANS OFFERED"]
["Moda Opal (Plan year Max $600)","May use any licensed provider.",49.8,null,null,null,null,"LTD formula based on salary"]
["Moda Pearl (Plan year Max $400)","May use any licensed provider.",40.71,null,null,null,null,"Plan 12 EE Monthly Wage x 0.00318"]
["Moda Quartz (Plan year Max $250)","May use any licensed provider.",28.74,null,null,null,null,"Plan 18 x Monthly Wage 0.00335"]
["VSP Choice Plus Plan (Copay Plan)","VSP Network only. May use frame allowance ($300) for non-prescription sunglasses or blue light filtering glasses. Limited out-of network  benefit.",33.97,null,null,null,null,"Plan 10 Basic 50K .088*50K =$4.40","AD&D .010*50 =$0.50"]
["VSP Choice Plan (Copay Plan)","VSP Network only. May use frame allowance ($150) for non-prescription sunglasses or blue light filtering glasses. Limited out-of network  benefit.",16.510000000000002,null,null,null,null,"Plan 5 Basic .088*20K = $1.76","AD&D .010*20 =$0.20"]
["Waive","See CBA for Opt-Out Stipend Information.",0]
[]
[null,null,null,null,null,"Basic Life & AD&D","Cost","LTD","Cost"]
[null,null,null,null,null,"Plan 10 Basic Life, AD&D, EAP-$50K",7,"Plan 12 LTD Employer Paid",32.130000000000003]
[null,null,null,null,null,"Plan 5 Basic Life, AD&D, EAP -$20K",4.0599999999999996,"Plan 12 LTD Employer Paid",10.86]
[null,null,null,null,null,"Plan 10 Basic Life,  AD&D, EAP-$50K",7,"Plan 12 LTD Employer Paid",32.130000000000003]
[null,null,null,null,null,"Plan 5 Basic Life, AD&D, EAP -$20K",4.0599999999999996,"Plan 18 LTD Employee Paid",2.86]