Monthly Plan Costs

Blue Shield/DHS EPO

Blue Shield/DHS EPO – Musician 

Employee Only:  $22.00 

Employee +1:  $65.00 

Employee +2 or more:  $87.00 

 

Blue Shield/DHS EPO – Symphony 

Employee Only:  $1,233.56 

Employee +1:  $2,456.50 

Employee +2 or more:  $3,355.73 

Blue Shield/DHS PPO

Blue Shield/DHS PPO – Musician 

Employee Only:  $74.00 

Employee +1:  $126.00 

Employee +2 or more:  $152.00 

 

Blue Shield/DHS PPO – Symphony 

Employee Only:  $2,094.44 

Employee +1:  $3,752.95 

Employee +2 or more:  $5,227.26 

Blue Shield/DHS HDHP

Blue Shield/DHS HDHP – Musician 

Employee Only:  $22.00 

Employee +1:  $65.00 

Employee +2 or more:  $87.00 

 

Blue Shield/DHS HDHP – Symphony 

Employee Only:  $1,434.26 

Employee +1:  $3,011.53 

Employee +2 or more:  $3,900.54 

Kaiser HMO

Kaiser HMO – Musician 

Employee Only:  $22.00 

Employee +1:  $65.00 

Employee +2 or more:  $87.00 

Kaiser HMO – Symphony 

Employee Only:  $1,288.68 

Employee +1:  $2,556.38 

Employee +2 or more:  $3,622.24 

Dental Plan

Dental Plan – Musician 

Employee Only:  $0.00 

Employee +1:  $0.00 

Employee +2:  $0.00 

 

Dental Plan – Symphony 

Employee Only:  $75.88 

Employee +1:  $136.91 

Employee +2:  $211.38 

Vision Plan

Vision Plan – Musician 

Employee Only:  $0.00 

Employee +1:  $0.00 

Employee +2:  $0.00 

 

Vision Plan – Symphony 

Employee Only:  $18.91 

Employee +1:  $29.37 

Employee +2:  $46.59 

Domestic Partner Coverage

Please note that unless your domestic partner is your tax dependent as defined by the IRS, contributions for domestic partner coverage must be made after-tax. Similarly, the company contribution toward coverage for your domestic partner and his/her dependents will be reported as taxable income on your W-2. Contact your tax advisor for more details on how this tax treatment applies to you. Notify the San Francisco Symphony if your domestic partner is your tax dependent.