• We offer two medical plan options, a PPO (Preferred Provider Organization) or a HDHP (High Deductible Health Plan). Please remember WCSD pays for employees' premium in full regardless of which plan you choose. 

    Below is a high-level overview of the differences between the two plans. Choosing between these two plans depends on your healthcare needs, financial situation, and if you would prefer to pay more in premiums or when you access care. 

    PPO HDHP

    Higher monthly premium

    		 Lower monthly premium

    Lower deductible

    		 Higher deductible

    Lower out-of-pocket maximum

    		 Higher out-of-pocket maximum

    Access to the GAP plan

    		 Access to a Health Savings Account (HSA)
     

     

    Key Terms: PPO Example: HDHP Example:
    Co-Pay: Your co-pay is the predetermined amount you will pay when seeing a provider that is in-network. Your co-pay does not count towards your deductible. When you go to visit an in-network Primary Care Physician you pay a $35 at your appointment. When you go to visit your Primary Care Physician you pay for your appointment in full. You could use your HSA funds or pay out of pocket.
    Deductible: Your deductible is the amount you must pay before your insurance starts to pay. Examples of payments that count towards your deductible include,

    In-Network:

    Individual: $500 

    Family: $1,000

    In-Network:

    Individual: $3,300 

    Family: $5,000
    Co-Insurance: Once your deductible is met, the co-insurance is the percentage you pay.

    In-Network:

    Member Portion: 20%

    WCSD Portion: 80%

    In-Network:

    Member Portion: 20%

    WCSD Portion: 80%
    Out-of-Pocket Maximum: Your out-of-pocket maximum is the amount you will pay before your health insurance will pay 100%.

    Individual: $4,000

    Family: $8,000

    Individual: $6,550

    Family: $13,100

    *Please note if you access care that is out of network, your deductible, co-insurance and out-pocket maximum will increase. You can still access care, but you will be responsible for a larger out of pocket portion.