HomeMy WebLinkAbout2026 Medical, Dental and Vision Rates**Please note there are 26 pay periods in 2026
Bi-Weekly Rates Employee
Share
Employer
Share Total Rate Employee
Share
Employer
Share Total Rate Employee
Share
Employer
Share Total Rate Employee
Share
Employer
Share Total Rate
Employee Only $0.00 $625.13 $625.13 $0.00 $674.10 $674.10 $0.00 $695.96 $695.96 $0.00 $567.13 $567.13
Employee + 1 $74.39 $1,170.64 $1,245.03 $80.95 $1,267.72 $1,348.67 $82.77 $1,302.98 $1,385.75 $66.17 $1,052.41 $1,118.58
Employee + 2 or more $118.88 $1,496.95 $1,615.83 $128.98 $1,619.96 $1,748.94 $132.52 $1,667.76 $1,800.28 $105.93 $1,343.99 $1,449.92
Bi-Weekly Rates Employee
Share
Employer
Share Total Rate
Employee Only $0.00 $2.62 $2.62
Employee + 1 $2.36 $2.62 $4.98
Employee + 2 or more $4.70 $2.62 $7.32
Annual Deductible:
Exam
Lenses:
Single
Bifocal
Trifocal
Prosthodontics-
Bridges, dentures and
implants
**Deductible is waived for Preventive and Diagnostic Services
Eye Exam
Lenses
Frames
$50
$70
*In lieu of frames
Frequency of Services:
12 months
12 months
24 months
12 months
12 months
24 months
12 monthsContact Lenses* 12 months
Otay Water District's vision provider is EyeMed.
In-Network
$25
Frames $130 allowance +
20% discount applied
to balance over $130
allowance
$91
Contact
Lenses
$130 allowance +
15% discount applied
to balance over $130
allowance
$91
Copay:Plan reimburses up to:
$30
$10 $40
Out-of-Network
$25
$25
Annual Plan Maximum (calendar year)
Employee Share
$0.00
$1.93
$4.40
$42.94$41.01 Employee + 1
Employee + 2 or more
$26.88
DENTAL BENEFITS
$63.57
Bi-Weekly Rates
2026 RATES AND BENEFITS-AT-A-GLANCE
Employee Only
Orthdontia Services (no age limit)
Out-of-Network
$2,000 per person
50% up to a $500
lifetime max benefit
Major treatment such as crown, inlays, onlays,
cast restorations, bridges, and dentures
50% up to a $500
lifetime max benefit
90%
60%50%
80%
$150
100%
Individual** (calendar year)
Family** (calendar year)
Basic treatment such as simple fillings and
simple tooth extractions
Preventive and diagnostic care such as routine
exams, cleanings, X-rays, and sealants
60%50%
MEDICAL BENEFITS
Kaiser HMO 15Blue Shield (Gold) PPO Blue Shield Access+ HMO 15 Blue Shield EPO
Otay Water District's dental provider is Delta Dental PPO.
$26.88
VISION BENEFITS
Employer Share Total Rate
In-Network
$50
$59.17
100%
This Benefits At-A-Glance is intended to provide highlights of the benefit plan. Actual plan benefits and provisions are governed by the formal Plan Document.