Insurance Distribution Worksheet.xlsx
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ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJAKALAMAN
1
ACCOUNTEMPLOYEECo Pay
MEMBER
IN LIEU Employee H.S.A. MESSA MESSA MESSA MESSA MESSA TOTAL MESSAMESSAMESSA MESSA TAX MESSANISMIEHIPMESSASET SET SETAFLACAFLACAFLACFRINGE
2
NUMBER%NAMEPOSITION%PLAN OF PR Deducts Annual PAK Tier
OPTS-EMP
EMPLOYEE
EMP
PAK B-EE
TIER-BDOPTS-BDLTD
HEALTH
HEALTH
ADM LIFE
DENTALVISION
MED REIM
DAY CARE
SELF PDTOTALS
3
18 Pays 18 Pays 1/1/2013 & 7/1/13 Health Dental Vision LIFE Options
INS COSTS
PR DEDUCTS
Per Mo
Bd Portion
BD PAID Per MoPer MoPer MoPer MoPer MoPer MoPer Mo18 Pays18 PaysPer Mo
4
SEPTSEPTSEPTSEPTSEPTPremPrem
Board Paid Premiums
5
11-1-111-2130-1011.00ES Teacher0.0%Full Fam 1,315.49 1,315.49 1,315.49 19.71 1,335.20
6
11-1-111-2130-1011.00ES Teacher0.0%Single 470.78 470.78 470.78 7.73 478.51
7
11-1-111-2130-1011.00ES Teacher0.0%Full Fam 1,315.49 1,315.49 1,315.49 19.71 1,335.20
8
11-1-111-2130-1011.00ES Teacher0.0%Single 1,057.40 1,057.40 1,057.40 7.73 1,065.13
9
11-1-111-2130-1011.00ES Teacher0.0%Full Fam 1,315.49 1,315.49 1,315.49 19.71 1,335.20
10
11-1-111-2130-1011.00ES Teacher0.0%Full Fam 1,315.49 1,315.49 1,315.49 19.71 1,335.20
11
11-1-111-2130-1011.00ES Teacher4.0%2 Person 1,057.40 1,057.40 1,057.40 15.79 1,073.19
12
11-1-111-2130-1011.00ES Teacher4.0%Full Fam 1,315.49 1,315.49 1,315.49 19.71 1,335.20
13
11-1-111-2130-1011.00ES Teacher16.0%Opt Out - - - -
14
11-1-111-2130-1011.00ES Teacher13.0%2 Person 1,057.40 1,057.40 1,057.40 15.79 1,073.19
15
11-1-111-2130-1011.00ES Teacher1.5%Full Fam 1,315.49 1,315.49 1,315.49 21.71 1,337.20
16
11-1-111-2130-1011.00ES Teacher1.0%Full Fam 1,057.40 1,057.40 1,057.40 15.79 1,073.19
17
11-1-111-2130-1011.00ES Teacher1.5%Full Fam 1,315.49 1,315.49 1,315.49 21.16 1,336.65
18
11-1-111-2130-1011.00ES Teacher2.0%Opt Out 561.76 - - -
19
11-1-111-2130-1011.00ES Teacher0.0%2 person 1,057.40 1,057.40 1,057.40 15.79 1,073.19
20
11-1-111-2130-1011.00ES Teacher0.0%2 Person 1,057.40 1,057.40 1,057.40 15.79 1,073.19
21
11-1-111-2130-1011.00ES Teacher3.0%Single 470.78 470.78 470.78 7.73 478.51
22
11-1-111-2130-1010.20JH Teacher16.0%Full Fam 263.10 263.10 263.10 21.71 284.81
23
11-1-111-2130-1011.00ES Teacher0.0%2 Person 1,057.40 1,057.40 1,057.40 15.79 1,073.19
24
11-1-111-2130-1011.00ES Teacher10.0%Opt Out 244.71 - - -
25
- - -
26
11-1-111-2130-101 Total
HEALTH CARE 806.47 - - 17,814.89 - - - - 17,814.89 - - 17,814.89 281.06 - - - - - - - - - - 18,095.95
27
-
28
11-1-111-2140-1011.00 54.42 54.42 54.42 54.42
29
11-1-111-2140-1011.00 17.42 17.42 17.42 17.42
30
11-1-111-2140-1011.00 54.42 54.42 54.42 54.42
31
11-1-111-2140-1011.00 32.47 32.47 32.47 32.47
32
11-1-111-2140-1011.00 54.42 54.42 54.42 54.42
33
11-1-111-2140-1011.00 54.42 54.42 54.42 54.42
34
11-1-111-2140-1011.00 32.47 32.47 32.47 32.47
35
11-1-111-2140-1011.00 54.42 54.42 54.42 54.42
36
11-1-111-2140-1011.00 59.31 59.31 59.31 59.31
37
11-1-111-2140-1011.00 32.47 32.47 32.47 32.47
38
11-1-111-2140-1011.00 54.42 54.42 54.42 54.42
39
11-1-111-2140-1011.00 32.47 32.47 32.47 32.47
40
11-1-111-2140-1011.00 54.42 54.42 54.42 54.42
41
11-1-111-2140-1011.00 36.23 36.23 36.23 36.23
42
11-1-111-2140-1011.00 32.47 32.47 32.47 32.47
43
11-1-111-2140-1011.00 32.47 32.47 32.47 32.47
44
11-1-111-2140-1011.00 17.42 17.42 17.42 17.42
45
11-1-111-2140-1010.20 10.88 10.88 10.88 10.88
46
11-1-111-2140-1011.00 32.47 32.47 32.47 32.47
47
11-1-111-2140-1011.00 59.31 59.31 59.31 59.31
48
- -
49
11-1-111-2140-101 Total
DENTAL - - - - 808.80 - - - 808.80 - - 808.80 - - - - - - - - - - - 808.80
50
-
51
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
52
11-1-111-2150-1011.00 7.17 7.17 7.17 7.17
53
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
54
11-1-111-2150-1011.00 15.42 15.42 15.42 15.42
55
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
56
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
57
11-1-111-2150-1011.00 15.42 15.42 15.42 15.42
58
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
59
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
60
11-1-111-2150-1011.00 15.42 15.42 15.42 15.42
61
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
62
11-1-111-2150-1011.00 15.42 15.42 15.42 15.42
63
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
64
11-1-111-2150-1011.00 15.42 15.42 15.42 15.42
65
11-1-111-2150-1011.00 15.42 15.42 15.42 15.42
66
11-1-111-2150-1011.00 15.42 15.42 15.42 15.42
67
11-1-111-2150-1011.00 7.17 7.17 7.17 7.17
68
11-1-111-2150-1010.20 4.64 4.64 4.64 4.64
69
11-1-111-2150-1011.00 15.42 15.42 15.42 15.42
70
11-1-111-2150-1011.00 23.19 23.19 23.19 23.19
71
- -
72
11-1-111-2150-101 Total
VISION - - - - - 351.05 - - 351.05 - - 351.05 - - - - - - - - - - - 351.05
73
-
74
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
75
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
76
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
77
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
78
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
79
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
80
11-1-111-2190-1011.00 28.73 18.90 47.63 47.63 47.63
81
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
82
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
83
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
84
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
85
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
86
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
87
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
88
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
89
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
90
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
91
11-1-111-2190-1010.20 5.75 5.75 5.75 5.75
92
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
93
11-1-111-2190-1011.00 28.73 28.73 28.73 28.73
94
- -
95
11-1-111-2190-101 Total
LIFE - - - - - - 551.62 18.90 570.52 - - 570.52 - - - - - - - - - - - 570.52
96
97
11-1-112-2130-2410.20
JH Spec Ed Teacher
0.0%Full Fam 263.10 263.10 - 263.10 21.71 284.81
98
11-1-112-2130-2411.00JH Teacher4.0%Full Fam 1,315.49 1,315.49 1,315.49 19.71 1,335.20
99
11-1-112-2130-2411.00JH Teacher16.0%Full Fam 1,315.49 1,315.49 1,315.49 19.71 1,335.20
100
11-1-112-2130-2411.00JH Teacher0.0%Full Fam 1,315.49 1,315.49 1,315.49 19.71 1,335.20
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SEPT 2014
JULY DEDUCT 2014
JUNE 2014
JUNE DEDUCT 2014
MAY DECDUCT 2014
MAY 2014
APRIL DECDUCT 2014
APRIL 2014
MARCH DECDUCT 2014
MARCH 2014
FEBRUARY DECDUCT 2014
FEBRUARY 2014
JANUARY 2014
JANUARY DEDUCT 2014
DEC 2013
DEC DEDUCT 2013
NOV 2013
Nov Deducts 2013
OCT 2013
Oct Deducts 2013
SEPT 2013
AUGUST 2013
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Jul Deducts 2013