Killeen ISD 2020 BENEFITS
Med i ca l Bene f i t s , con t ’ d…
Plan 1 – BSW Preferred HMO Network $500 Deductible $500 Individual Deductible / 20% Coinsurance / $35 Primary Care Copay / $50 Specialist Copay Urgent Care $75 Copay/ ER $300/$7,350 Individual Out of Pocket Maximum/RX $10-$45-$90
Monthly Cost (Total)
KISD Monthly Contribution
State Monthly Contribution
Monthly Cost
TIER Election
Employee Only
$641.88
$325.00 $325.00 $325.00 $325.00
$75.00 $75.00 $75.00 $75.00
$241.88
Employee & Spouse
$1,668.89 $1,181.06 $2,015.51
$1,268.89
Employee & Child(ren)
$781.06
Employee & Family
$1,615.51
*Plan 2 – BSW Preferred HMO Network $2,700 deductible (HSA Qualified Plan) $2,700 Individual Deductible* / 20% Coinsurance after Deductible $6,650 Individual Out Of Pocket Maximum**
** All claims, including prescriptions ( Not Including claims coded as Preventive Care ) are subject to the deductible. ***Once the Out of Pocket Maximum is met, covered benefits are received at 100% for the remainder of the calendar year.
Monthly Cost (Total)
KISD Monthly Contribution
State Monthly Contribution
Monthly Cost
TIER Election
Employee Only
$520.78
$325.00 $325.00 $325.00 $325.00
$75.00 $75.00 $75.00 $75.00
$120.78 $954.04 $558.24
Employee & Spouse
$1,354.04
Employee & Child(ren)
$958.24
Employee & Family
$1,635.26
$1,235.26
Plan 4 – SWHP HMO Network $1,000 Deductible $1,000 Individual Deductible / 0% Coinsurance / $35 Primary Care Copay / $80 Specialist Copay Urgent Care $75 Copay/ ER $500/$7,350 Individual Out of Pocket Maximum/RX $10-$45-$90
Monthly Cost (Total)
KISD Monthly Contribution
State Monthly Contribution
Monthly Cost
TIER Election
Employee Only
$665.86
$325.00 $325.00 $325.00 $325.00
$75.00 $75.00 $75.00 $75.00
$265.86
Employee & Spouse
$1,731.22 $1,225.17 $2,090.78
$1,331.22
Employee & Child(ren)
$825.17
Employee & Family
$1,690.78
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