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Health Plan Rates

HEALTH PLAN RATES

 

Understanding your healthcare investment is key to making the best choice for you and your family. In this section, you will find the current Rate Sheets and Summary of Benefits and Coverage (SBC) for all our medical, dental, and vision plans. We have organized these resources to help you easily compare monthly premiums, deductibles, and provider networks. Additionally, you can access information on our integrated wellness programs, including our Employee Assistance Program (EAP).

Beyond your medical, dental, and vision coverage, ACUSD/ACOE offers additional benefit options to help you plan and prepare for your financial future. Learn more at our Financial Security page.

Frequently Asked Questions

  •  Yes, these are separate deductible amounts.

  • Two or more people count as a family in relation to the family deductible. On page 32 of the PERS Gold Evidence of Coverage Document, it states: “If your plan has Family coverage, there is an individual Deductible within the Family Deductible. This means an individual Family Member can meet the individual Deductible before the entire Family meets the Family Deductible.”

  • September 16 - October 11, 2025, with changes taking effect January 1, 2026.

    1. PERS Gold: Mark Twain Medical Center in San Andreas, Marshall Medical Center in Placerville, and Mercy Hospital of Folsom
    2. PERS Platinum: Mark Twain Medical Center in San Andreas, Sutter Amador Hospital in Jackson, Marshall Medical Center in Placerville, and Mercy Hospital of Folsom.

  • These do not apply to us as they are for PORAC, which is for Safety Members.

  • That is correct, Sutter Amador Hospital is out-of-network for PPO Gold. You can still use their services, but you would pay the out of network Co-pay and Co-insurance rates.

  • With all of CalPERS plans, if you have an emergency you can seek care. And the plans can be used.

  • That is correct, you can still go to the hospital, but will pay the out-of network cost.

  • Mark Twain Hospital in San Andreas

  • It is all based on Zip Code, but in Amador County for Active Employees there is only one option.

  • Yes, CalPERS has no minimum participation requirement (No Opt-Out Cap)

  • To opt-out/waive coverage, you must decline coverage in American Fidelity & provide signed Attestation Form to Payroll.  This is required annually to opt-out.

  • Depending upon each employee's full-time/part-time status and bargaining unit agreement, cash-in-lieu may or may not be available.  Cash-in-lieu is also dependent upon meeting eligibility requirements with attestation and compliance with the Affordable Care Act.

  • Yes, you may opt-out if you have enrolled in a minimum essential coverage (MEC) health insurance plan, which could be Covered California or a marketplace plan.  

  • No, Covered California and marketplace plans are federally and state-subsidized plans targeted toward individuals who may not have access to insurance. The Affordable Care Act (ACA) does not allow employers to provide a financial benefit to employees to encourage the purchase of a subsidized plan. Because of this, ACUSD & ACOE are unable to provide cash-in-lieu to employees enrolled in marketplace plans. This is a part of the attestation form verification.

  • No, CalPERS confirmed that they do not accept P.O. Boxes as an address to be used for plan eligibility.  If a P.O. Box is on file with the District as your address, it will revert to the school’s address for plan eligibility.  To request a change in address, you can do so through the Employee Portal or by reaching out to HumanResources@acusd.org

  • If an employee has a qualifying life event, they need to alert Payroll (payroll@acusd.org) and make an insurance change within 30 days from the event.
    For a full list of events, view the CalPERS Health Benefits Guide available on the Health Insurance Change Information Hub.

  • Yes, because of the No Surprise Act, the out-of-network facility would need to inform you prior to services that you are out of network and will have a bill. 
    With the No Surprise Act:

    • Emergency Care at Out-of-Network Facilities
    • If you're on a CalPERS Gold plan and have an emergency, you can’t be balance billed even if you go to an out-of-network hospital. You’ll only pay your normal in-network cost-sharing, and the provider must negotiate payment with the insurer.
    • Non-Emergency Care at In-Network Hospitals (but Out-of-Network Providers)
    • If you go to an in-network hospital but are unknowingly treated by an out-of-network anesthesiologist or radiologist, you cannot be balance billed. Again, you’ll just pay in-network rates.

Benefits Contact Information:

Rachael Miller – Certificated employee payroll questions and all retirement-related questions
209-257-5425 | rachael.miller@acusd.org

Daisy Soto – Classified employee payroll questions and all health insurance-related questions
209-257-5352 | daisy.soto@acusd.org

Do you have a question, but you’re not sure who to ask? Send it to the general payroll inbox at payroll@acusd.org!