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GRANITE MOUNTAIN CHARTER SCHOOL
10535 Foothill Blvd #100, Rancho Cucamonga, CA 91730
Phone (626) 317-0112 * Fax (626) 932-1804
Regular Scheduled Board Meeting
Granite Mountain Charter School
May 30, 2020 – 11:30 am
10535 Foothill Blvd. #100
Rancho Cucamonga, CA 91730
Through Teleconference
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Meeting ID: 961 4904 4939
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Meeting ID: 961 4904 4939
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AGENDA 1. Call to Order
2. Approval of the Agenda
3. Public Comments
4. Closed Session - Conference with Legal Counsel - Anticipated Litigation - 54956.9
5. Principal’s Report
a. Authorizer annual visit
b. Enrollment Updates
6. Approval of Minutes – May 21, 2020
7. Discussion and Potential Action on the 2020-2021 Vendor Contract
8. Discussion and Potential Action on the 2020-2021 Enrollment Capacity
9. Discussion and Potential Action on the Administrative office lease
10. Discussion and Potential Action on the School Organizational Chart
11. Discussion and Potential Action on the 2020-2021 Employee Benefits Package
12. Discussion and Potential Action on the Employee Supplemental Retirement Package
13. Discussion and Potential Action on the Summer Ordering Opportunity for Current Staff
14. Discussion and Potential Action on the COVID 19 Letter
15. Discussion and Potential Action on the ICS Invoices
16. Board of Directors’ Requests
17. Announcement of Next Regularly Scheduled Board Meeting
18. Adjournment
Public comment rules: Members of the public may address the Board on agenda or non-agenda items through the teleconference platform, Zoom. Zoom does not require the members of the public to have an account or login. Please either utilize the chat option to communicate with the administrative team your desire to address the board or simply communicate orally your desire to address the board when the board asks for public comments. Speakers may be called in the order that requests are received. We ask that comments are limited to 2 minutes each, with no more than 15 minutes per single topic so that as many people as possible may be heard. By law, the Board is allowed to take action only on items on the agenda. The Board may, at its discretion, refer a matter to district staff or calendar the issue for future discussion.
Note: Granite Mountain Charter School Governing Board encourages those with disabilities to participate fully in the public meeting process. If you need a disability-related modification or accommodation, including auxiliary aids or services, to participate in the public meeting, please contact the Governing Board Office at 951-290-3013 at least 48 hours before the scheduled board meeting so that we may make every reasonable effort to accommodate you. (Government Code § 54954.2; Americans with Disabilities Act of 1990, § 202 (42 U.S.C. § 12132)).
GRANITE MOUNTAIN CHARTER SCHOOL
10535 Foothill Blvd #100, Rancho Cucamonga, CA 91730
Phone (626) 317-0112 * Fax (626) 932-1804
Regular Scheduled Board Meeting- Granite Mountain Charter School
May 21, 2020 – 12:00 pm
10535 Foothill Blvd. #100, Rancho Cucamonga, CA 91730
Attendance: Mandy Osburn, Luke Kibler, Wendy Maldonado, Valarie Campa, Huda Haddad –
Teleconference
Absent: None
Also Present: Brook MacMillan, Carly Saieg, Lisa Reyes – Teleconference
Call to Order:
Mandy Osburn called the meeting to order at 12:07 pm.
Approval of the Agenda:
Huda Haddad motioned to approve agenda. Valarie Campa seconded.
-Unanimous
Public Comments:
Carly Saieg, who is a parent, shared her concern of the transition for next year and if curriculum
will be ordered on time.
Lisa Reyes, also a parent, wanted clarification on next school year’s curriculum program.
Both concerns were answered and explained by Brook Macmillan.
Valarie Campa motioned to close public comments. Huda Haddad seconded.
-Unanimous.
Executive Director’s Report and Updates:
The Executive Director provided a report on the following:
a. COVID-19
b. Contractor Updates
c. Enrollment Interest Updates
Approval of Minutes - April 25, 2020:
Huda Haddad motioned to approve the April 25, 20202 minutes. Valarie Campa seconded.
-Unanimous
Discussion and Potential Action on the April Financials:
Luke Kibler motioned to approve April financials. Valarie Campa seconded.
-Unanimous
Discussion and Potential Action on the School Organizational Chart:
Wendy Maldonado motioned to approve School Organizational Chart. Valarie Campa
seconded.
-Unanimous
Discussion and Potential Action on the Ad Hoc Committee Report and Recommendations:
-The board was presented the Ad Hoc Committee Report and Recommendations. No action was
taken.
Discussion and Potential Action on the Suicide Prevention Policy:
Huda Haddad motioned to approve the Suicide Prevention Policy. Valarie Campa seconded.
-Unanimous
Discussion and Potential Action on the Suspension and Expulsion Policy:
Luke Kibler motioned to approve the Suspension and Expulsion Policy. Huda Haddad
seconded.
-Unanimous
Discussion and Potential Action on the Contract Signature Authority Resolution:
Luke Kibler motioned to approve the Contract Signature Authority Resolution. Valarie Campa
seconded.
-Unanimous
Discussion and Potential Action on the Legal Counsel Engagement Letter:
Valarie Campa motioned to approve the Legal Counsel Engagement Letter. Luke Kibler
seconded.
-Unanimous
Discussion and Potential Action on the Selection of the Employee Benefits Broker:
Luke Kibler motioned to approve the Selection of Keenan as the Employee Benefits Broker.
Valarie Campa seconded.
-Unanimous
Discussion and Potential Action on the ICS Invoices:
Valarie Campa motioned to table this item for the next board meeting. Huda Haddad seconded.
-Unanimous
Board of Director’s Requests:
- A way to highlight employees, to connect them to Granite mountain’s families
- Presentation at different meeting to get a deeper understanding of what the school offers.
- Quotes on branding gear and adding an online store.
- Send surveys to parents about the vendors.
Announcement of Next Regular Meeting:
Next board meeting will be on May 30, 2020 at 11:30AM
Adjournment:
Valarie Campa motioned to adjourn the meeting at 2:21PM. Luke Kibler seconded.
-Unanimous
Prepared by:
Bryanna Brossman
Noted by:
Board Secretary
Granite Mountain Charter School Vendor Contract 2020 - 2021
This Vendor Agreement (“Agreement”) is made between Granite Mountain Charter School (“School”), a California nonprofit public corporation and ____________________________ (“Vendor”).
RECITALS
WHEREAS, School fosters successful student achievement through a quality, personalized, and standards-based education program featuring unique and hands-on experiential learning experiences;
WHEREAS, Vendor is engaged in the businesses of providing experienced and qualified educational services as set forth in Exhibit A; and
WHEREAS, School desires to retain Vendor for the purpose of providing the services described herein for the benefit of the School, families, and students.
NOW, THEREFORE, in consideration of the foregoing recitals, the promises and the mutual covenants contained herein, and for other good, valuable and sufficient consideration, the parties agree as follows:
SECTION 1. TERM and TERMINATION.
a. Term: This Agreement shall be effective as of July 1, 2020 until June 30, 2021 (the “Initial Term”).
b. Termination: Vendor may terminate this Agreement for cause after providing sixty (60) days advance written notice to School. School may terminate this Agreement at any time, with or without cause in its sole discretion with same- day written notice. Upon termination, School shall pay Vendor for all necessary and approved Services rendered pursuant to this Agreement and relevant “Service Certificate(s)” (defined below) up to the effective date of termination. School has no obligation to pay Vendor for any Services provided after the effective date of termination. The termination of this Agreement constitutes a termination of any active invoices and Service
Certificates.
c. Automatic Termination: This Agreement will automatically terminate if the California Legislature passes any legislation that renders this Agreement out of compliance with California law.
SECTION 2. SERVICES.
a. Scope of Services: Vendor is hereby engaged by School to perform the student services specified in Exhibit A, incorporated herein by reference (“Services”), subject to the terms and conditions contained herein. Vendor assumes full responsibility for the performance of the Services provided under the terms of this Agreement. School does not guarantee any minimum amount of work by this Agreement.
b. No Authority to Bind School: Vendor understands and agrees that Vendor lacks the authority to bind School contractually, conduct business on School’s behalf, or incur any obligations on behalf of School. Specifically, Vendor agrees not to represent himself/herself or any Vendor employees, agents, or contractors as an employee of School in any capacity, including, but not limited to, when interacting with School students, parents, vendors, or employees.
c. Responsibility for Performance: Vendor assumes full responsibility for the performance of Vendor’s duties under the terms of this Agreement and warrants that Vendor and its employees, contractors, and other agents are fully qualified in Vendor’s specialized skill or expertise to perform such duties. Vendor will not enter into any contract or engagement that conflicts or interferes with Vendor’s duties under this Agreement.
d. Compliance with Charter Petition and Law: Except when otherwise expressly required by applicable law, School shall not be responsible for monitoring Vendor’s compliance with the law, charter petition, and Agreement. Vendor acknowledges that School must comply with Education Code § 220’s prohibitions against discrimination, obligations to provide a free appropriate education to students with exceptional needs pursuant to the Individuals with Disabilities Education Act (“IDEA”) and Section 504 of the Rehabilitation Act, and be non- sectarian in its programs. Vendor must be non-sectarian in any Services provided to School students. Vendor shall ensure its performance of its Services complies with these legal and charter petition requirements. If Vendor performs any Services in a manner that is contrary to law, Vendor shall bear all claims, costs, losses and damages (including, but not limited to, reasonable attorneys’ fees and costs) arising therefrom.
e. Service Limitations: Vendor shall not serve a School student for more than twelve (12) core academic hours including math, language arts, social studies, science and world language during the school week under this Agreement or any other arrangement (e.g., Student participation in a Vendor program outside of School activities); excepting visual and performing arts, CTE pathways, robotics, and physical activities including dance, gymnastics, karate, and
other similar activities, as approved by the supervising teacher. Vendor understands that no School funds may be used for any of the following: Food & Transportation, recital, competition or registration fees, uniforms or clothing, therapy related services, and non-secular services. This is a non-comprehensive list of services for which School funds may not be used. Other services may be denied for payment with School funds as determined in the School’s discretion.
f. No Private School Affiliation: Vendor
certifies that it is not, nor is it affiliated with, a private school that submitted an affidavit to register with the California Department of Education and is listed on the state’s Private School Directory (“Private School”). Vendor affirms the Services shall not be provided at a Private School. Vendor affirms that it will not confer any compensation received for performing Services under this Agreement to a Private School.
g. Prohibited Conflicts: Vendor is prohibited from providing Services under this Agreement to a relative (e.g., child, grandchild, niece/nephew, sibling, etc.) of the Vendor (or its employees). School shall not be responsible for paying Vendor for the prohibited services described herein. h. Compliance with State and Local Health Department Orders: Vendor acknowledges and warrants that it will comply with all applicable State and Local Health Department Orders in place to ensure the health and safety of all students. This affirmation applies to COVID-19 orders and any other health orders relating to any other health emergency.
SECTION 3. PAYMENT.
a. Service Certificate: School requests Services from Vendor through a Service Certificate. School is not responsible for the costs of Services without issuance of a Service Certificate. The Service Certificate will detail requested Services, dates of Services, fees for Services, and other relevant information. Vendors must first receive a Service Certificate before providing Services to students. School does not pay for Services in advance. If a Service Certificate expires, Vendor must cease providing Services until it receives another Service Certificate.
b. Vendor Invoice: School shall pay Vendor for Services performed through invoices. Invoices may only be issued to the School after services are rendered by the Vendor. Vendor may submit invoices on a monthly, or less frequent, basis. The School will not pay for services in advance. Vendors should submit invoices to [email protected] School will endeavor to pay undisputed invoice amounts within thirty (30) days of receipt. In the event of unforeseen changes to the state budget due to the COVID-19 Pandemic or other circumstances, the School reserves the right to delay payment.
c. Termination of Service Certificate: School may terminate an Service Certificate at any time, with or without cause in its sole discretion with same-day written notice. School shall pay Vendor the undisputed amounts for Services already performed under the Service Certificate.
d. Incurred Costs: Any damages or costs incurred by School, including replacement costs, as a result of Vendor’s failure to competently perform under this Agreement may be deducted by School from any amounts owed to Vendor.
e. Use of School’s Name: Vendor shall not use the name, insignia, mark, or any facsimile of the School for any purpose, including but not limited to advertising, client lists, or references, without the advance written authorization of the School.
f. Student Withdrawal from Vendor Program: If a student withdrawals from a Vendor’s program, the School’s Service Certificate shall terminate automatically upon that withdrawal. The School shall not pay any amounts invoiced beyond the student’s withdrawal date. The School shall not be responsible for any cancellation fees imposed by the Vendor. The School will only pay Vendor for services actually provided to the School’s students. g. Virtual Services: If Vendor’s services are performed through a virtual model, the approved services shall be identified in Exhibit A. The School shall not pay for services that have not been provided; the School shall pay for services provided in an approved virtual delivery model.
SECTION 4. GENERAL CONDITIONS FOR VENDOR PERFORMANCE.
a. Vendor Qualifications: Vendor represents it has the qualifications, skills and, if applicable, the certification and licenses necessary to perform the Services in a competent, and professional manner, without the advice or direction of School. Upon School’s request, Vendor shall provide copies of certification or licensure. Subject to the terms of this Agreement, Vendor shall render all Services hereunder in accordance with this Agreement and Exhibit A, Vendor’s independent and professional judgment and in compliance with all applicable laws and with the generally accepted practices and principles of Vendor’s trade. Vendor is customarily engaged in the independently established trade, occupation, or business of the same nature as the Services performed.
b. Relationship: The School is not an employer of Vendor or its employees, contractors, or agents and shall not supervise individuals as such in carrying out the Services to be performed by Vendor under the terms of this Agreement. It is expressly understood between the parties that Vendor and its employees, contractors, and agents are not employee(s) of School.
c. Licenses: Vendor warrants that Vendor is engaged in an independent and bona fide business operation, markets him/her/itself as such, is in possession of a valid business license/insurance when required, and is providing or capable of providing similar services as set forth in Exhibit A to others.
d. No Training or Instruction: Although School may at times provide information concerning its business and students to Vendor, School will not provide any training or instruction to Vendor concerning the manner and means of providing the Services that are subject to this Agreement because Vendor warrants that Vendor is highly skilled in its industry.
SECTION 5. TAXES. Because Vendor is not an employee of School, all compensation called for under this Agreement shall be paid without deductions or withholdings, and will be accompanied by an IRS Form 1099, as applicable, at year end. Vendor is responsible for the reporting and payment of any state and/or federal income tax or other withholdings on the compensation provided under this Agreement or any related assessments. In addition, Vendor shall fill out and execute a Form W-9. In the event that the Internal Revenue Service or the State of California should determine that Vendor or its employee(s) is/are an employee of School subject to withholding and social security contributions, Vendor acknowledges consistent with this Agreement that all payments due to Vendor under this Agreement are gross payments, and the Vendor is solely responsible for all income taxes, social security payments, or other applicable deductions thereon.
SECTION 6. BENEFITS. Vendor and its employees, contractors, and agents are not entitled to the rights or benefits that may be afforded to School employees including, but not limited to, disability, workers’ compensation, unemployment benefits, sick leave, vacation leave, medical insurance and retirement benefits. Vendor is solely responsible for providing at Vendor’s own expense, disability, unemployment, workers’ compensation and other insurance for Vendor and any of its employees, contractors, and agents. Vendor shall further maintain at its own expense any permits, credentials, certifications and/or licenses necessary to provide the Services and shall provide any training necessary for its employees, contractors, and agents to perform all Services under this Agreement.
SECTION 7. MATERIALS. Vendor will furnish at its own expense all materials, equipment and supplies used to provide the Services. SECTION 8. BACKGROUND CHECK AND SAFETY REQUIREMENTS.
a. Background Check: Vendor shall ensure its employees, agents, and contractors working directly with School students complete a criminal background check through the Department of Justice (“DOJ”) in accordance with Education Code section 45125.1. Vendor certifies to School that no one working on behalf of Vendor (e.g., Vendor employees, agents, or contractors)
working with School students have been convicted or have pending charges of a violent or serious felony as defined in Penal Code sections 667.5(c) and 1192.7(c). The cost of the background check is the Vendor’s responsibility.
b. First Aid & CPR Certification: Upon School’s request, Vendor shall ensure its employees, agents, or contractors obtain First-Aid and CPR Certification.
c. Supervision: Vendor is responsible for supervising and ensuring students have a safe environment from the time they are dropped off to receive Services and until the responsible party picks them up. Students may not be left unattended during Vendor’s provision of Services. Vendor may not transport students without School’s express written permission.
d. Student Discipline: Vendor acknowledges that School is responsible for managing and overseeing the education program, which incorporates the Vendor’s services. Vendor must notify School when students act inappropriately and may require discipline. School is responsible for issuing discipline to students. If Vendor learns a student may pose a health or safety threat to himself/herself or to other individuals, Vendor must immediately notify the School. If Vendor wishes to remove a participant from their Services, the Vendor shall notify School and the parties will discuss appropriate measures.
e. Student Complaints: Vendor agrees to report to School any complaints made by a School student/parent/guardian/education rights holder within three days of the complaint being made relating to any services provided and paid for with School funding. Said report shall be made to [email protected].
f. Vendor Visitations: The School reserves the right to visit Vendor in person or virtually throughout the term of this Agreement and as often as the School deems necessary during the term of this Agreement.. The School may schedule these visits in advance, or may make unscheduled visits as it deems in its sole discretion. Vendor agrees to cooperate with scheduling and accommodate the School’s visits.
SECTION 9. INDEMNIFICATION AND INSURANCE.
a. Indemnification: To the maximum extent allowable by law, Vendor will indemnify, defend, and hold harmless School, its officers, directors, employees, agents and volunteers from and against all claims, demands, losses, costs, expenses, obligations, liabilities, damages, recoveries, and deficiencies, including interest, penalties, attorneys’ fees, and costs that such entities or persons may incur that arise out of or relate to this Agreement or the alleged negligence, recklessness or willful misconduct of Vendor, including of Vendor’s officers, directors, employees, subcontractors, agents, representatives, volunteers, successors, assigns or anyone for whom Vendor is legally responsible. Vendor’s indemnity, defense and hold harmless obligations shall survive the termination of this Agreement. To the maximum
extent allowable by law, Vendor also agrees to hold harmless, indemnify, and defend School from any and all liability, damages, or losses (including reasonable attorneys’ fees, costs, penalties, and fines) School suffers as a result of (a) Vendor’s failure to meet its obligations under Sections 4-6, or (b) a third party’s designation of Vendor or Vendor’s employees, agents, or contractors as an employee of School regardless of any actual or alleged negligence by School.
b. General Liability Insurance Limits: Vendor agrees to maintain general liability insurance coverage, including both bodily injury and property damage, with at least the following coverage limits:
i. $1,000,000 per occurrence
ii. $2,000,000 general aggregate
iii. $500,000 personal & adv. injury
c. Additional Insurance Requirements: Vendor’s insurance shall constitute primary coverage for any loss or liability arising from or relating to this Agreement and any insurance held by School shall constitute secondary, excess coverage. School may require additional insurance coverage depending on the Services and shall communicate these insurance requirements to the Vendor in conjunction with the provision of a Service Certificate. Vendor’s insurance policies required under this Agreement shall name School as additionally insured. Vendor shall provide School with a copy of the insurance certificate showing the School as additionally insured within 10 days of execution of this Agreement.
SECTION 10. CONFIDENTIALITY.
a. Confidential Information: Vendor acknowledges that during the course of performing Services, Vendor may become privy to confidential, privileged and/or proprietary information important to the School. Vendor further acknowledges its obligations under the Family Educational Rights and Privacy Act (“FERPA”) and California Uniform Trade Secrets Act. Vendor shall ensure that all of its employees, agents and contractors agree to the requirements of this section prior to receiving any Confidential Information (defined below). Vendor shall not use or disclose during or after the term of this Agreement, without the prior written consent of School, any information relating to School’s employees, directors, agents, students or families, or any information regarding the affairs or operations of School, including School’s confidential/proprietary information and trade secrets (“Confidential Information”). Confidential Information, whether prepared by or for the School, includes, without limitation, all of the following: education records, student rosters, medical records, personnel records, information technology systems, financial and accounting information, business or marketing plans or strategies, methods of doing business, curriculum, lists, email addresses and other information concerning actual and potential students or vendors
and/or any other information Vendor reasonably should know is treated as confidential by the School. The only allowed disclosures of Confidential Information are (i) with prior written consent of School; (ii) after the information is generally available to the public other than by reason of a breach by Vendor of this agreement to maintain confidentiality; (iii) after the information has been acquired by Vendor through independent means and without a breach of Vendor’s duties to School under this Agreement or otherwise; or (iv) pursuant to the order of a court or other tribunal with jurisdiction if Vendor has given School adequate notice so that School may contest any such process. Personally identifiable student information may only be used as necessary to meet Vendor’s obligations under this Agreement. Vendor must take all necessary and appropriate steps to protect and safeguard all of School’s Confidential Information and proprietary information from unauthorized disclosure.
b. Disclosure of Records: School will provide Vendor with those records requested by Vendor that are reasonably necessary to allow Vendor to perform the Services. Vendor shall use any such records only for the purpose provided and not for the benefit of any other person or entity. Upon termination of this Agreement or School’s request, Vendor will immediately surrender to School or destroy all Confidential Information and other materials provided to Vendor by School, including all physical copies, drafts, digital or computer versions.
SECTION 11. ENTIRE AGREEMENT. This Agreement and its incorporated exhibits constitute the entire agreement between the parties with respect to the subject matter contained herein and supersede all agreements, representations and understandings of the parties with respect to such subject matter made or entered into prior to the date of this Agreement.
SECTION 12. DISPUTE RESOLUTION.
a. Informal Dispute Resolution: If there is any dispute or controversy between the parties arising out of or relating to this Agreement, the parties shall first meet and confer informally in an attempt to resolve the issue.
b. Mediation: If reasonable efforts at informal resolution are unsuccessful, the parties shall participate in a mediation with a mutually-agreed upon mediator. Any costs and fees, other than attorneys’ fees, associated with the mediation shall be shared equally by the parties.
c. Arbitration: If School has paid more than $25,000 to Vendor for Services since the start of the previous fiscal year, and efforts to resolve the dispute at mediation are unsuccessful, the parties agree that such dispute will be submitted to private and confidential arbitration by a single neutral arbitrator through Judicial Arbitration and Mediation Services, Inc. (“JAMS”) at the nearest JAMS location, or other service agreed upon by both parties, and that such arbitration will be the exclusive final dispute resolution method under this Agreement. The JAMS Streamlined Arbitration Rules & Procedures in
effect at the time the claim or dispute is arbitrated will govern the procedure for the arbitration proceedings between the parties. The arbitrator shall not have the power to modify any of the provisions of this Agreement. The decision of the arbitrator shall be final, conclusive and binding upon the parties hereto, and shall be enforceable in any court of competent jurisdiction. The party initiating the arbitration shall advance the arbitrator’s initial fee. Otherwise and thereafter, each party shall bear their own costs of the arbitration proceeding or litigation to enforce this Agreement, including attorneys’ fees and costs. Except where clearly prevented by the area in dispute, both parties agree to continue performing their respective obligations under this Agreement until the dispute is resolved, subject to the right to terminate this Agreement. Nothing in this Agreement is intended to prevent either party from obtaining injunctive or equitable relief in court to prevent irreparable harm pending the conclusion of any such arbitration.
SECTION 13. MODIFYING THE AGREEMENT. No supplement, modification, or amendment of this Agreement shall be binding unless in writing and executed by both parties.
SECTION 14. NO WAIVER. No waiver of any provision of this Agreement shall constitute, or be deemed to constitute, a waiver of any other provision, nor shall any waiver constitute a continuing waiver. No waiver shall be binding unless executed in writing by the party making the waiver.
SECTION 15. NO ASSIGNMENT. No party shall assign this Agreement, any interest in this Agreement, or its rights or obligations under this Agreement without the express prior written consent of the other party. This Agreement shall be binding on, and shall inure to the benefit of, the parties and their respective permitted successors and assigns.
SECTION 16. SEVERABILITY. If any provision of this Agreement is invalid or contravenes applicable law, such provision shall be deemed not to be a part of this Agreement and shall not affect the validity or enforceability of its remaining provisions, unless such invalidity or unenforceability would defeat an essential business purpose of this Agreement.
SECTION 17. GOVERNING LAW. This Agreement shall be governed by and interpreted under the laws of the State of California.
SECTION 18. AUTHORITY TO CONTRACT. Each party warrants to the other that it has the authority to enter into this Agreement, that it is a binding and enforceable obligation of said party, and that the undersigned has been duly authorized to execute this Agreement.
SECTION 19. NOTICES. All notices and other communications in connection with this Agreement shall be in writing and shall be considered given as follows:
(a) When delivered personally to the recipient’s address as stated on this Agreement; (b) three
days after being deposited in the United States mail, with postage prepaid to the recipient's address as stated on this Agreement; (c) via email address as stated on this Agreement.
Notice is effective upon receipt provided that a duplicate copy of the notice is promptly given by first class mail, or the recipient delivers a written confirmation of receipt. If to Vendor: If to School: (Please fill in with your information) Business: ____________________________________________________________________ Name/Title: ___________________________________________________________________ Address: _____________________________________________________________________ _____________________________________________________________________________ Email: ____________________________________ Phone: _____________________________ SECTION 20. COUNTERPARTS. This Agreement may be executed in two or more counterparts, each of which shall be deemed an original and all of which together shall constitute one instrument. A faxed or emailed .pdf or other electronic copy of the fully executed original version of this Agreement shall have the same legal effect as an executed original for all purposes. IN WITNESS WHEREOF, the parties have executed this Agreement as of the Effective Date above. Granite Mountain Charter School Vendor
Name Name
Title Title
Date Date
Name of Owner/Vendor Name ___________________________________________________ Signature: ______________________________________ Date:________________________ GMCS Chief Business Officer __________________________________________________ Signature: _____________________________________ Date:_________________________
Student Withdrawal Service Vendor Cancellation Policy
When the school is notified of a student withdrawal, the vendor department will send a written notification of the student’s withdrawal to the vendor. The vendor can invoice for services rendered up to the date of the written notification of student withdrawal.
I. Adoption of Granite Mountain Charter School Approving the Authority of the Executive Director to Add to the Number of Enrollment Spots Available During Open Enrollment WHEREAS, the World Health Organization has declared COVID-19 is a global pandemic; and WHEREAS, on March 4, 2020, the Governor of the State of California declared a State of Emergency due to the outbreak and spread of a novel coronavirus (COVID-19); and WHEREAS, as of March 18, 2020, there were 1,063 confirmed cases of COVID-19 and 21 cases reported resulting in death in California; and WHEREAS, the Governor of the State of California has issued Executive Order N-33-20 requiring all California residents to “shelter in place” and all but essential functions have been halted or restricted; and WHEREAS, the Governor of the State of California has indicated that schools may be closed for an undetermined duration; and WHEREAS, approval of this resolution would allow the Executive Director to immediately respond to rapidly changing demand for distance learning by increasing the enrollment capacity of the School for the 2020 – 2021 school year.
NOW THEREFORE BE IT RESOLVED, the School hereby delegates to the Executive Director the authority to increase the number of enrollment spots available for the 2020-2021 school year and extend the board approved open enrollment period, (currently, April 1, 2020 – April 31, 2020), in her discretion, based on her determination that the capacity of the School can be increased to accommodate additional students during the coming school year. Any such increase in School capacity or extension of the open enrollment period shall be promptly announced on the School’s website. The Board shall be promptly notified.
Administrative Office Lease - Executive Summary
Rationale: As Granite Mountain Charter School is taking on its own classified staff team, there is a need to house student records and administrative team members in an office space beyond the capacity provided at our space in Lucerne Valley. The space in Lucerne Valley will be used for technology shipping, mail sorting/distribution and storage of returned curriculum materials. The administrative office space will be used for general day to day administrative operations. Fiscal impact: Reassignment of a lease is available, commencing month 15 Lease amount is as follows: Months 14-24: 9,155 per month Month 25 - abated Months 26-36: 9,430 per month Month 37 - abated Months 38-48: 9,713 per month Months 49-60: 10,004 per month Months 61-72: 10,305 per month Months 73-84: 10,614 per month Months 85-90: 10,932 per month 3 months up front security deposit is also requested.
Granite Mountain Charter School Organization Chart
Executive Director
Chief Business Officer
Director of Vendor
Relations
Vendor Specialists
ADs Instructional
Materials and Services
Ordering Specialists
Library Specialists
Accounts Payable
Specialist
Chief of Staff
AD of Human
Resources
AD of Communicatio
ns, Policy & Marketing
Staff Development Administrator
Director of School
Operations
Records/Mail Clerk
ADs of Family
Relations and
Community Life
Family Support
Specialists
Chief Academic
Officer
AD of Experiential
Learning
Director of Student
Achievement
Achievement Administrators
Director of Curriculum
and Instruction
High School Success
Coordinator
Curriculum Administrators
AD of Student Support Services
SST/504 Coordinators
Intervention Coordinators
School Counselor
Regional Directors
Regional Coordinators
Homeschool Teachers
Director of SpED
AD of SPED
SpEd Program
Coordinators
Case Managers
Assessment Team
GMCS School Board
Job Description French Teacher
Job Title: French Teacher
Direct Report: Director of Student Achievement
Position Summary: The French Teacher reports to the Director of Student Achievement and will organize and implement a subject specific instructional program that results in student academic success.
Essential Functions:
• Serve as subject matter expert • Monitor student progress for subject on school adopted online curriculum • Host weekly office hours • Be available for student questions regarding assignments and content area • Provide progress updates to students in regards to course deadlines and assignment
completion • Assist teachers with subject-specific questions • Provide subject-specific field trip opportunities, both virtual and in-person • Provide feedback on teacher-graded assignments as needed • Provide individual student support as needed • Collaborate with other departments • Assist in the development of subject specific assessments, curriculum guides, and A-G
approved courses • Other related duties as assigned
Qualifications:
• Bachelor’s Degree • Valid California Teaching Credential in specific subject • Experience working in an independent study setting preferred
Job Description Life Science Teacher
Job Title: Life Science Teacher
Direct Report: Director of Student Achievement
Position Summary: The Life Science Teacher reports to the Director of Student Achievement and will organize and implement a subject specific instructional program that results in student academic success.
Essential Functions:
• Serve as subject matter expert • Host weekly virtual class sessions • Collaborate in development of lesson video library • Participate in the assessment and evaluation of subject specific work • Monitor student progress for subject on school adopted online curriculum • Host weekly office hours • Be available for student questions regarding assignments and content area • Provide progress updates to students in regards to course deadlines and assignment
completion • Assist teachers with subject-specific questions • Provide subject-specific field trip opportunities, both virtual and in-person • Provide feedback on teacher-graded assignments as needed • Provide individual student support as needed • Collaborate with other departments • Assist in the development of subject specific assessments, curriculum guides, and A-G
approved courses • Other related duties as assigned
Qualifications:
• Bachelor’s Degree • Valid California Teaching Credential in specific subject • Experience working in an independent study setting preferred
Job Description Physical Science Teacher
Job Title: Physical Science Teacher
Direct Report: Director of Student Achievement
Position Summary: The Physical Science Teacher reports to the Director of Student Achievement and will organize and implement a subject specific instructional program that results in student academic success.
Essential Functions:
• Serve as subject matter expert • Host weekly virtual class sessions • Collaborate in development of lesson video library • Participate in the assessment and evaluation of subject specific work • Monitor student progress for subject on school adopted online curriculum • Host weekly office hours • Be available for student questions regarding assignments and content area • Provide progress updates to students in regards to course deadlines and assignment
completion • Assist teachers with subject-specific questions • Provide subject-specific field trip opportunities, both virtual and in-person • Provide feedback on teacher-graded assignments as needed • Provide individual student support as needed • Collaborate with other departments • Assist in the development of subject specific assessments, curriculum guides, and A-G
approved courses • Other related duties as assigned
Qualifications:
• Bachelor’s Degree • Valid California Teaching Credential in specific subject • Experience working in an independent study setting preferred
Job Description Spanish Teacher
Job Title: Spanish Teacher
Direct Report: Director of Student Achievement
Position Summary: The Spanish Teacher reports to the Director of Student Achievement and will organize and implement a subject specific instructional program that results in student academic success.
Essential Functions:
• Serve as subject matter expert • Monitor student progress for subject on school adopted online curriculum • Host weekly office hours • Be available for student questions regarding assignments and content area • Provide progress updates to students in regards to course deadlines and assignment
completion • Assist teachers with subject-specific questions • Provide subject-specific field trip opportunities, both virtual and in-person • Provide feedback on teacher-graded assignments as needed • Provide individual student support as needed • Collaborate with other departments • Assist in the development of subject specific assessments, curriculum guides, and A-G
approved courses • Other related duties as assigned
Qualifications:
• Bachelor’s Degree • Valid California Teaching Credential in specific subject • Experience working in an independent study setting preferred
Current Kaiser HMO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 10 $519.31 $519.31 $0.00 100.00% 0.00%Employee + Spouse 4 $1,142.47 $1,017.89 $124.58 89.10% 10.90%Employee + Child(ren) 7 $934.75 $851.69 $83.06 91.11% 8.89%Employee + Family 25 $1,609.84 $1,391.82 $218.02 86.46% 13.54%
Total Monthly Cost $50,021.99 $6,530.24 Total Annual Cost $600,263.88 $78,362.88
Proposed Kaiser HMO Contributions Option 1Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 10 $527.21 $527.21 $0.00 100.00% 0.00%Employee + Spouse 4 $1,159.86 $1,035.28 $124.58 89.26% 10.74%Employee + Child(ren) 7 $948.98 $865.92 $83.06 91.25% 8.75%Employee + Family 25 $1,634.35 $1,416.33 $218.02 86.66% 13.34%
Total Monthly Cost $50,882.91 $6,530.24 Total Annual Cost $610,594.92 $78,362.88
Proposed Kaiser HMO Contributions Option 2Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 10 $527.21 $527.21 $0.00 100.00% 0.00%Employee + Spouse 4 $1,159.86 $1,009.86 $150.00 87.07% 12.93%Employee + Child(ren) 7 $948.98 $848.98 $100.00 89.46% 10.54%Employee + Family 25 $1,634.35 $1,384.35 $250.00 84.70% 15.30%
Total Monthly Cost $49,863.15 $7,550.00 Total Annual Cost $598,357.80 $90,600.00
Proposed Kaiser HMO Contributions Option 3Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 10 $527.21 $512.21 $15.00 97.15% 2.85%Employee + Spouse 4 $1,159.86 $1,009.86 $150.00 87.07% 12.93%Employee + Child(ren) 7 $948.98 $848.98 $100.00 89.46% 10.54%Employee + Family 25 $1,634.35 $1,384.35 $250.00 84.70% 15.30%
Total Monthly Cost $49,713.15 $7,700.00 Total Annual Cost $596,557.80 $92,400.00
$56,552.23 $678,626.76
$57,413.15 $688,957.80
$688,957.80
$57,413.15 $688,957.80
$57,413.15
Current Blue Shield Access+ HMO Contributions Proposed Cigna Full HMO Contributions Option 2Rating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Rating Structure Current Subscribers
Current Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 1 $688.00 $524.14 $163.86 76.18% 23.82% Employee Only 1 $611.49 $524.14 $87.35 85.72% 14.28%Employee + Spouse 0 $1,582.39 $1,069.25 $513.14 67.57% 32.43% Employee + Spouse 0 $1,406.43 $1,069.25 $337.18 76.03% 23.97%Employee + Child(ren) 1 $1,169.60 $817.66 $351.94 69.91% 30.09% Employee + Child(ren) 1 $1,039.53 $817.66 $221.87 78.66% 21.34%Employee + Family 1 $1,995.19 $1,320.84 $674.35 66.20% 33.80% Employee + Family 1 $1,773.32 $1,320.84 $452.48 74.48% 25.52%
Total Monthly Cost $2,662.64 $1,190.15 Total Monthly Cost $2,662.64 $761.70 Total Annual Cost $31,951.68 $14,281.80 Total Annual Cost $31,951.68 $9,140.40
Proposed Blue Shield SaveNet HMO Contributions Proposed Cigna Value HMO Contributions Option 2Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Rating Structure Current Subscribers
Current Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $524.14 $524.14 $0.00 100.00% 0.00% Employee Only 5 $557.67 $524.14 $33.53 93.99% 6.01%Employee + Spouse 3 $1,205.52 $1,069.25 $136.27 88.70% 11.30% Employee + Spouse 3 $1,282.65 $1,069.25 $213.40 83.36% 16.64%Employee + Child(ren) 4 $891.04 $817.66 $73.38 91.76% 8.24% Employee + Child(ren) 4 $948.04 $817.66 $130.38 86.25% 13.75%Employee + Family 6 $1,520.01 $1,320.84 $199.17 86.90% 13.10% Employee + Family 6 $1,617.26 $1,320.84 $296.42 81.67% 18.33%
Total Monthly Cost $17,024.13 $1,897.35 Total Monthly Cost $17,024.13 $3,107.89 Total Annual Cost $204,289.56 $22,768.20 Total Annual Cost $204,289.56 $37,294.68
Proposed Cigna Full HMO Contributions Option 1 Proposed Health Net Full HMO Contributions Option 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Rating Structure Current Subscribers
Proposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 1 $611.49 $557.67 $53.82 91.20% 8.80% Employee Only 1 $547.80 $506.77 $41.03 92.51% 7.49%Employee + Spouse 0 $1,406.43 $1,132.65 $273.78 80.53% 19.47% Employee + Spouse 0 $1,314.54 $1,132.65 $181.89 86.16% 13.84%Employee + Child(ren) 1 $1,039.53 $873.04 $166.49 83.98% 16.02% Employee + Child(ren) 1 $958.52 $873.04 $85.48 91.08% 8.92%Employee + Family 1 $1,773.32 $1,417.26 $356.06 79.92% 20.08% Employee + Family 1 $1,670.57 $1,417.26 $253.31 84.84% 15.16%
Total Monthly Cost $2,847.97 $576.37 Total Monthly Cost $2,797.07 $379.82
Total Annual Cost $34,175.64 $6,916.44 Total Annual Cost $33,564.84 $4,557.84
Proposed Cigna Value HMO Contributions Option 1 Proposed Health Net SmartCare HMO Contributions Option 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Rating Structure Current Subscribers
Proposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $557.67 $557.67 $0.00 100.00% 0.00% Employee Only 5 $506.77 $506.77 $0.00 100.00% 0.00%Employee + Spouse 3 $1,282.65 $1,157.65 $125.00 90.25% 9.75% Employee + Spouse 3 $1,216.20 $1,091.20 $125.00 89.72% 10.28%Employee + Child(ren) 4 $948.04 $873.04 $75.00 92.09% 7.91% Employee + Child(ren) 4 $886.81 $811.81 $75.00 91.54% 8.46%Employee + Family 6 $1,617.26 $1,417.26 $200.00 87.63% 12.37% Employee + Family 6 $1,545.59 $1,345.59 $200.00 87.06% 12.94%
Total Monthly Cost $18,257.02 $1,875.00 Total Monthly Cost $17,128.23 $1,875.00
Total Annual Cost $219,084.24 $22,500.00 Total Annual Cost $205,538.76 $22,500.00
$20,132.02
$241,584.24
$3,852.79 $46,233.48
$18,921.48 $227,057.76
$3,424.34
$41,092.08
$3,176.89
$38,122.68
$19,003.23
$228,038.76
$3,424.34 $41,092.08
$20,132.02 $241,584.24
Current Blue Shield Traditional PPO Contributions Proposed Cigna Traditional PPO Contributions Option 2Rating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Rating Structure Current Subscribers
Proposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 1 $675.21 $524.14 $151.07 77.63% 22.37% Employee Only 1 $824.24 $524.14 $300.10 63.59% 36.41%Employee + Spouse 3 $1,552.97 $1,069.25 $483.72 68.85% 31.15% Employee + Spouse 3 $1,895.64 $1,069.25 $826.39 56.41% 43.59%Employee + Child(ren) 2 $1,147.84 $817.66 $330.18 71.23% 28.77% Employee + Child(ren) 2 $1,401.13 $817.66 $583.47 58.36% 41.64%Employee + Family 6 $1,958.10 $1,320.84 $637.26 67.46% 32.54% Employee + Family 6 $2,390.16 $1,320.84 $1,069.32 55.26% 44.74%
Total Monthly Cost $13,292.25 $6,086.15 Total Monthly Cost $13,292.25 $10,362.13 Total Annual Cost $159,507.00 $73,033.80 Total Annual Cost $159,507.00 $124,345.56
Current Blue Shield HSA PPO Contributions Proposed Cigna HSA PPO Contributions Option 2Rating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Rating Structure Current Subscribers
Proposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 0 $489.50 $489.50 $0.00 100.00% 0.00% Employee Only 0 $405.24 $489.50 $0.00 100.00% -20.79%Employee + Spouse 1 $1,125.82 $900.66 $225.16 80.00% 20.00% Employee + Spouse 1 $937.91 $900.66 $37.25 96.03% 3.97%Employee + Child(ren) 0 $832.14 $655.71 $176.43 78.80% 21.20% Employee + Child(ren) 0 $692.06 $655.71 $36.35 94.75% 5.25%Employee + Family 2 $1,419.52 $1,135.62 $283.90 80.00% 20.00% Employee + Family 2 $1,183.76 $1,135.62 $48.14 95.93% 4.07%
Total Monthly Cost $3,171.90 $792.96 Total Monthly Cost $3,171.90 $133.53 Total Annual Cost $38,062.80 $9,515.52 Total Annual Cost $38,062.80 $1,602.36
Proposed Cigna Traditional PPO Contributions Option 1 Proposed Health Net HDHP HSA PPO Contributions Option 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Rating Structure Current Subscribers
Proposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 1 $824.24 $557.67 $266.57 67.66% 32.34% Employee Only 1 $724.04 $506.77 $217.27 69.99% 30.01%Employee + Spouse 3 $1,895.64 $1,132.65 $762.99 59.75% 40.25% Employee + Spouse 3 $1,737.69 $1,091.20 $646.49 62.80% 37.20%Employee + Child(ren) 2 $1,401.13 $873.04 $528.09 62.31% 37.69% Employee + Child(ren) 2 $1,267.07 $811.81 $455.26 64.07% 35.93%Employee + Family 6 $2,390.16 $1,417.26 $972.90 59.30% 40.70% Employee + Family 6 $2,208.32 $1,345.59 $862.73 60.93% 39.07%
Total Monthly Cost $14,205.26 $9,449.12 Total Monthly Cost $13,477.53 $8,243.64 Total Annual Cost $170,463.12 $113,389.44 Total Annual Cost $161,730.36 $98,923.68
Proposed Cigna HSA PPO Contributions Option 1 Proposed Health Net HDHP HSA PPO Contributions Option 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Rating Structure Current Subscribers
Proposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 0 $405.24 $405.24 $0.00 100.00% 0.00% Employee Only 0 $724.04 $506.77 $217.27 69.99% 30.01%Employee + Spouse 1 $937.91 $937.91 $0.00 100.00% 0.00% Employee + Spouse 1 $1,737.69 $1,091.20 $646.49 62.80% 37.20%Employee + Child(ren) 0 $692.06 $692.06 $0.00 100.00% 0.00% Employee + Child(ren) 0 $1,267.07 $811.81 $455.26 64.07% 35.93%Employee + Family 2 $1,183.76 $1,183.76 $0.00 100.00% 0.00% Employee + Family 2 $2,208.32 $1,345.59 $862.73 60.93% 39.07%
Total Monthly Cost $3,305.43 $0.00 Total Monthly Cost $3,782.38 $2,371.95 Total Annual Cost $39,665.16 $0.00 Total Annual Cost $45,388.56 $28,463.40
$3,305.43 $39,665.16
$19,378.40 $232,540.80
$3,964.86 $47,578.32
$23,654.38 $283,852.56
$21,721.17 $260,654.04
$6,154.33 $73,851.96
$23,654.38 $283,852.56
$3,305.43 $39,665.16
Current Blue Shield Traditional PPO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 1 $675.21 $524.14 $151.07 77.63% 22.37%Employee + Spouse 3 $1,552.97 $1,069.25 $483.72 68.85% 31.15%Employee + Child(ren) 2 $1,147.84 $817.66 $330.18 71.23% 28.77%Employee + Family 6 $1,958.10 $1,320.84 $637.26 67.46% 32.54%
Total Monthly Cost $13,292.25 $6,086.15 Total Annual Cost $159,507.00 $73,033.80
Current Blue Shield HSA PPO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 0 $489.50 $489.50 $0.00 100.00% 0.00%Employee + Spouse 1 $1,125.82 $900.66 $225.16 80.00% 20.00%Employee + Child(ren) 0 $832.14 $655.71 $176.43 78.80% 21.20%Employee + Family 2 $1,419.52 $1,135.62 $283.90 80.00% 20.00%
Total Monthly Cost $3,171.90 $792.96 Total Annual Cost $38,062.80 $9,515.52
Proposed Cigna Traditional PPO Contributions Option 3 Proposed Health Net HDHP HSA PPO Contributions Option 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Rating Structure Current Subscribers
Proposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 1 $824.24 $557.67 $266.57 67.66% 32.34% Employee Only 1 $724.04 $524.14 $199.90 72.39% 27.61%Employee + Spouse 3 $1,895.64 $1,132.65 $762.99 59.75% 40.25% Employee + Spouse 3 $1,737.69 $1,069.25 $668.44 61.53% 38.47%Employee + Child(ren) 2 $1,401.13 $873.04 $528.09 62.31% 37.69% Employee + Child(ren) 2 $1,267.07 $817.66 $449.41 64.53% 35.47%Employee + Family 6 $2,390.16 $1,417.26 $972.90 59.30% 40.70% Employee + Family 6 $2,208.32 $1,320.84 $887.48 59.81% 40.19%
Total Monthly Cost $14,205.26 $9,449.12 Total Monthly Cost $13,292.25 $8,428.92 Total Annual Cost $170,463.12 $113,389.44 Total Annual Cost $159,507.00 $101,147.04
Proposed Cigna HSA PPO Contributions Option 3 Proposed Health Net HDHP HSA PPO Contributions Option 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Rating Structure Current Subscribers
Current Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 0 $405.24 $405.24 $0.00 100.00% 0.00% Employee Only 0 $724.04 $524.14 $199.90 72.39% 27.61%Employee + Spouse 1 $937.91 $887.91 $50.00 94.67% 5.33% Employee + Spouse 1 $1,737.69 $1,069.25 $668.44 61.53% 38.47%Employee + Child(ren) 0 $692.06 $667.06 $25.00 96.39% 3.61% Employee + Child(ren) 0 $1,267.07 $817.66 $449.41 64.53% 35.47%Employee + Family 2 $1,183.76 $1,108.76 $75.00 93.66% 6.34% Employee + Family 2 $2,208.32 $1,320.84 $887.48 59.81% 40.19%
Total Monthly Cost $3,105.43 $200.00 Total Monthly Cost $3,710.93 $2,443.40 Total Annual Cost $37,265.16 $2,400.00 Total Annual Cost $44,531.16 $29,320.80
$19,378.40 $232,540.80
$3,964.86 $47,578.32
$23,654.38 $21,721.17 $260,654.04
$6,154.33 $73,851.96
$3,305.43 $39,665.16
$283,852.56
Current Cigna Dental HMO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 7 $15.44 $10.44 $5.00 100.00% 0.00%Employee + Spouse 2 $26.57 $10.44 $16.13 39.29% 60.71%Employee + Child(ren) 7 $30.29 $10.44 $19.85 34.47% 65.53%Employee + Family 17 $38.54 $10.44 $28.10 27.09% 72.91%
Total Monthly Cost $344.52 $683.91 Total Annual Cost $4,134.24 $8,206.92
Proposed Cigna Dental HMO Contributions 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 7 $13.36 $10.44 $2.92 100.00% 0.00%Employee + Spouse 2 $24.23 $10.44 $13.79 43.09% 56.91%Employee + Child(ren) 7 $30.59 $10.44 $20.15 34.13% 65.87%Employee + Family 17 $44.45 $10.44 $34.01 23.49% 76.51%
Total Monthly Cost $344.52 $767.24 Total Annual Cost $4,134.24 $9,206.88
Proposed Cigna Dental HMO Contributions 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 7 $13.36 $8.36 $5.00 100.00% 0.00%Employee + Spouse 2 $24.23 $8.10 $16.13 33.43% 66.57%Employee + Child(ren) 7 $30.59 $10.74 $19.85 35.11% 64.89%Employee + Family 17 $44.45 $16.35 $28.10 36.78% 63.22%
Total Monthly Cost $427.85 $683.91 Total Annual Cost $5,134.20 $8,206.92
Proposed Cigna HMO Contributions Option 3Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 7 $13.36 $13.36 $0.00 100.00% 0.00%Employee + Spouse 2 $24.23 $9.23 $15.00 38.09% 61.91%Employee + Child(ren) 7 $30.59 $10.59 $20.00 34.62% 65.38%Employee + Family 17 $44.45 $14.45 $30.00 32.51% 67.49%
Total Monthly Cost $431.76 $680.00 Total Annual Cost $5,181.12 $8,160.00
$1,028.43 $12,341.16
$1,111.76 $13,341.12
$13,341.12
$1,111.76 $13,341.12
$1,111.76
Current Cigna Dental HMO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 7 $15.44 $10.44 $5.00 100.00% 0.00%Employee + Spouse 2 $26.57 $10.44 $16.13 39.29% 60.71%Employee + Child(ren) 7 $30.29 $10.44 $19.85 34.47% 65.53%Employee + Family 17 $38.54 $10.44 $28.10 27.09% 72.91%
Total Monthly Cost $344.52 $683.91 Total Annual Cost $4,134.24 $8,206.92
Proposed Principal Dental EPO Contributions 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 7 $18.63 $10.44 $8.19 100.00% 0.00%Employee + Spouse 2 $34.54 $10.44 $24.10 30.23% 69.77%Employee + Child(ren) 7 $46.04 $10.44 $35.60 22.68% 77.32%Employee + Family 17 $65.23 $10.44 $54.79 16.00% 84.00%
Total Monthly Cost $344.52 $1,286.16 Total Annual Cost $4,134.24 $15,433.92
Proposed Principal Dental EPO Contributions 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 7 $18.63 $13.63 $5.00 100.00% 0.00%Employee + Spouse 2 $34.54 $18.41 $16.13 53.30% 46.70%Employee + Child(ren) 7 $46.04 $26.19 $19.85 56.89% 43.11%Employee + Family 17 $65.23 $37.13 $28.10 56.92% 43.08%
Total Monthly Cost $946.77 $683.91 Total Annual Cost $11,361.24 $8,206.92
Proposed Principal EPO Contributions Option 3Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 7 $18.63 $18.63 $0.00 100.00% 0.00%Employee + Spouse 2 $34.54 $19.54 $15.00 56.57% 43.43%Employee + Child(ren) 7 $46.04 $26.04 $20.00 56.56% 43.44%Employee + Family 17 $65.23 $35.23 $30.00 54.01% 45.99%
Total Monthly Cost $950.68 $680.00 Total Annual Cost $11,408.16 $8,160.00
$1,630.68 $19,568.16
$1,028.43 $12,341.16
$1,630.68 $19,568.16
$1,630.68 $19,568.16
Current Cigna Dental Base PPO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 5 $28.57 $13.57 $15.00 100.00% 0.00%Employee + Spouse 4 $63.70 $13.57 $50.13 21.30% 78.70%Employee + Child(ren) 2 $70.05 $13.57 $56.48 19.37% 80.63%Employee + Family 12 $101.90 $13.57 $88.33 13.32% 86.68%
Total Monthly Cost $312.11 $1,448.44 Total Annual Cost $3,745.32 $17,381.28
Proposed Cigna Dental Base PPO Contributions 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $34.18 $13.57 $20.61 100.00% 0.00%Employee + Spouse 4 $76.21 $13.57 $62.64 17.81% 82.19%Employee + Child(ren) 2 $83.81 $13.57 $70.24 16.19% 83.81%Employee + Family 12 $121.91 $13.57 $108.34 11.13% 88.87%
Total Monthly Cost $312.11 $1,794.17 Total Annual Cost $3,745.32 $21,530.04
Proposed Cigna Dental Base PPO Contributions 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $34.18 $19.18 $15.00 100.00% 0.00%Employee + Spouse 4 $76.21 $26.08 $50.13 34.22% 65.78%Employee + Child(ren) 2 $83.81 $27.33 $56.48 32.61% 67.39%Employee + Family 12 $121.91 $33.58 $88.33 27.54% 72.46%
Total Monthly Cost $657.84 $1,448.44 Total Annual Cost $7,894.08 $17,381.28
Proposed Cigna Dental Base PPO Contributions 3Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $34.18 $19.18 $15.00 56.11% 43.89%Employee + Spouse 4 $76.21 $26.21 $50.00 34.39% 65.61%Employee + Child(ren) 2 $83.81 $28.81 $55.00 34.38% 65.62%Employee + Family 12 $121.91 $33.91 $88.00 27.82% 72.18%
Total Monthly Cost $665.28 $1,441.00 Total Annual Cost $7,983.36 $17,292.00
$2,106.28 $25,275.36
$1,760.55 $21,126.60
$2,106.28 $25,275.36
$2,106.28 $25,275.36
Current Cigna Dental Base PPO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 5 $28.57 $13.57 $15.00 100.00% 0.00%Employee + Spouse 4 $63.70 $13.57 $50.13 21.30% 78.70%Employee + Child(ren) 2 $70.05 $13.57 $56.48 19.37% 80.63%Employee + Family 12 $101.90 $13.57 $88.33 13.32% 86.68%
Total Monthly Cost $312.11 $1,448.44 Total Annual Cost $3,745.32 $17,381.28
Proposed Principal Dental EPO Contributions 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $18.63 $13.57 $5.06 100.00% 0.00%Employee + Spouse 4 $34.54 $13.57 $20.97 39.29% 60.71%Employee + Child(ren) 2 $46.04 $13.57 $32.47 29.47% 70.53%Employee + Family 12 $65.23 $13.57 $51.66 20.80% 79.20%
Total Monthly Cost $312.11 $794.04 Total Annual Cost $3,745.32 $9,528.48
Proposed Principal Dental EPO Contributions 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $18.63 $13.63 $5.00 100.00% 0.00%Employee + Spouse 4 $34.54 $18.41 $16.13 53.30% 46.70%Employee + Child(ren) 2 $46.04 $26.19 $19.85 56.89% 43.11%Employee + Family 12 $65.23 $37.13 $28.10 56.92% 43.08%
Total Monthly Cost $639.73 $466.42 Total Annual Cost $7,676.76 $5,597.04
Proposed Principal EPO Contributions Option 3Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $18.63 $18.63 $0.00 100.00% 0.00%Employee + Spouse 4 $34.54 $19.54 $15.00 56.57% 43.43%Employee + Child(ren) 2 $46.04 $26.04 $20.00 56.56% 43.44%Employee + Family 12 $65.23 $35.23 $30.00 54.01% 45.99%
Total Monthly Cost $646.15 $460.00 Total Annual Cost $7,753.80 $5,520.00
$1,106.15 $13,273.80
$1,760.55 $21,126.60
$1,106.15 $13,273.80
$1,106.15 $13,273.80
Current Cigna Dental Buy Up PPO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 5 $38.23 $13.57 $24.66 100.00% 0.00%Employee + Spouse 4 $76.44 $13.57 $62.87 17.75% 82.25%Employee + Child(ren) 4 $85.49 $13.57 $71.92 15.87% 84.13%Employee + Family 16 $123.40 $13.57 $109.83 11.00% 89.00%
Total Monthly Cost $393.53 $2,419.74 Total Annual Cost $4,722.36 $29,036.88
Proposed Cigna Buy Up PPO Contributions 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $45.74 $13.57 $32.17 100.00% 0.00%Employee + Spouse 4 $91.45 $13.57 $77.88 14.84% 85.16%Employee + Child(ren) 4 $102.28 $13.57 $88.71 13.27% 86.73%Employee + Family 16 $147.64 $13.57 $134.07 9.19% 90.81%
Total Monthly Cost $393.53 $2,972.33 Total Annual Cost $4,722.36 $35,667.96
Proposed Cigna Buy Up PPO Contributions 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $45.74 $20.74 $25.00 100.00% 0.00%Employee + Spouse 4 $91.45 $31.45 $60.00 34.39% 65.61%Employee + Child(ren) 4 $102.28 $32.28 $70.00 31.56% 68.44%Employee + Family 16 $147.64 $37.64 $110.00 25.49% 74.51%
Total Monthly Cost $960.86 $2,405.00 Total Annual Cost $11,530.32 $28,860.00
Proposed Cigna Buy Up PPO Contributions 3Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $45.74 $13.74 $32.00 30.04% 69.96%Employee + Spouse 4 $91.45 $13.45 $78.00 14.71% 85.29%Employee + Child(ren) 4 $102.28 $14.28 $88.00 13.96% 86.04%Employee + Family 16 $147.64 $12.64 $135.00 8.56% 91.44%
Total Monthly Cost $381.86 $2,984.00 Total Annual Cost $4,582.32 $35,808.00
$3,365.86 $40,390.32
$2,813.27 $33,759.24
$3,365.86 $40,390.32
$3,365.86 $40,390.32
Current Cigna Dental Buy Up PPO ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 5 $38.23 $13.57 $24.66 100.00% 0.00%Employee + Spouse 4 $76.44 $13.57 $62.87 17.75% 82.25%Employee + Child(ren) 4 $85.49 $13.57 $71.92 15.87% 84.13%Employee + Family 16 $123.40 $13.57 $109.83 11.00% 89.00%
Total Monthly Cost $393.53 $2,419.74 Total Annual Cost $4,722.36 $29,036.88
Proposed Principal Buy Up PPO Contributions 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $43.86 $13.57 $30.29 100.00% 0.00%Employee + Spouse 4 $78.41 $13.57 $64.84 17.31% 82.69%Employee + Child(ren) 4 $104.79 $13.57 $91.22 12.95% 87.05%Employee + Family 16 $146.63 $13.57 $133.06 9.25% 90.75%
Total Monthly Cost $393.53 $2,904.65 Total Annual Cost $4,722.36 $34,855.80
Proposed Principal Buy Up PPO Contributions 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $43.86 $18.86 $25.00 100.00% 0.00%Employee + Spouse 4 $78.41 $18.41 $60.00 23.48% 76.52%Employee + Child(ren) 4 $104.79 $34.79 $70.00 33.20% 66.80%Employee + Family 16 $146.63 $36.63 $110.00 24.98% 75.02%
Total Monthly Cost $893.18 $2,405.00 Total Annual Cost $10,718.16 $28,860.00
Proposed Principal Buy Up PPO Contributions 3Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 5 $43.86 $11.86 $32.00 27.04% 72.96%Employee + Spouse 4 $78.41 $0.41 $78.00 0.52% 99.48%Employee + Child(ren) 4 $104.79 $16.79 $88.00 16.02% 83.98%Employee + Family 16 $146.63 $11.63 $135.00 7.93% 92.07%
Total Monthly Cost $314.18 $2,984.00 Total Annual Cost $3,770.16 $35,808.00
$3,298.18 $39,578.16
$2,813.27 $33,759.24
$3,298.18 $39,578.16
$3,298.18 $39,578.16
Current EyeMed Vision ContributionsRating Structure Current
SubscribersCurrent Monthly
Rate
Current ER Contribution
Current EE Contribution
Current ER Contribution %
Current EE Contribution %
Employee Only 19 $5.64 $3.64 $2.00 100.00% 0.00%Employee + Spouse 12 $10.72 $3.64 $7.08 33.96% 66.04%Employee + Child(ren) 10 $11.28 $3.64 $7.64 32.27% 67.73%Employee + Family 43 $16.58 $3.64 $12.94 21.95% 78.05%
Total Monthly Cost $305.76 $755.78 Total Annual Cost $3,669.12 $9,069.36
Proposed EyeMed Vision Contributions 1Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 19 $5.64 $3.64 $2.00 100.00% 0.00%Employee + Spouse 12 $10.72 $3.64 $7.08 33.96% 66.04%Employee + Child(ren) 10 $11.28 $3.64 $7.64 32.27% 67.73%Employee + Family 43 $16.58 $3.64 $12.94 21.95% 78.05%
Total Monthly Cost $305.76 $755.78 Total Annual Cost $3,669.12 $9,069.36
Proposed EyeMed Vision Contributions 2Rating Structure Current
SubscribersProposed Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 19 $5.64 $5.64 $0.00 100.00% 0.00%Employee + Spouse 12 $10.72 $2.72 $8.00 25.37% 74.63%Employee + Child(ren) 10 $11.28 $2.28 $9.00 20.21% 79.79%Employee + Family 43 $16.58 $3.58 $13.00 21.59% 78.41%
Total Monthly Cost $316.54 $745.00 Total Annual Cost $3,798.48 $8,940.00
Proposed EyeMed Vision Contributions 3Rating Structure Current
SubscribersCurrent Monthly
Rate
Proposed ER Contribution
Proposed EE Contribution
Proposed ER Contribution %
Proposed EE Contribution %
Employee Only 19 $5.64 $5.64 $0.00 100.00% 0.00%Employee + Spouse 12 $10.72 $3.64 $7.08 33.96% 66.04%Employee + Child(ren) 10 $11.28 $3.64 $7.64 32.27% 67.73%Employee + Family 43 $16.58 $3.64 $12.94 21.95% 78.05%
Total Monthly Cost $343.76 $717.78 Total Annual Cost $4,125.12 $8,613.36
$1,061.54 $12,738.48
$1,061.54 $12,738.48
$1,061.54 $12,738.48
$1,061.54 $12,738.48
Proposed Proposed Proposed
Carrier MetLife Principal Guardian
Effective Date 07/01/2020 07/01/2020 07/01/2020
Rate Guarantee 3 years 3 years 2 years
Basic Life/ AD&D Benefits
Benefits (All Eligible Employees) Flat $50,000 Flat $50,000 Flat $50,000
Benefit Reduction
Reduced to 70% of benefit
at age 70 &
to 40% of benefit at age 75
Reduced to 65% of benefit at age
70 &
to 45% of benefit at age 75
Reduced to 70% of benefit at
age 70 &
to 40% of benefit at age 75
Basic Life/ AD&D - Rates
Rates/ $1,000 $0.08 $0.086 $0.09
Basic Life/ AD&D Total Premium Summary
Grand Total MONTHLY Premium (125 enrollees) $500.00 $537.50 $587.50
Grand Total ANNUAL Premium $6,000.00 $6,450.00 $7,050.00
% Change over Current Monthly Premium 0.00% 7.50% 17.50%
$ Change over Current Annual Premium $0.00 $450.00 $1,050.00
Voluntary Life/ AD&D Benefits
Employee Benefits Increments of
$10,000 up to lesser of 5x
salary or $500,000
Increments of
$10,000 up to $500,000
Increments of
$10,000 up to $500,000
Spouse Benefits
Increments of
$5,000 up to $100,000
(not to exceed 50% of
Employee elected amount)
Increments of
$5,000 up to $100,000(not to exceed 50% of Employee elected
amount)
Increments of
$5,000 up to $100,000
(not to exceed 50% of Employee
elected amount)
Child Benefits
Flat $1,000, $2,000, $4,000,
$5,000 or $10,000
(for 6 months old - age 26)
Flat $1,000
(15 days - 6 months old)
Flat $100
(Birth - 15 days old)
Flat $5,000, $10,000, $20,000 or
$25,000
(for 14 days old - age 26)
Flat $1,000
(Birth - 14 days old)
Child benefits cannot exceed 50% of
elected Employe coverage
Flat $10,000
(14 days old - Age 26)
Flat $500
(Birth - 14 days old)
Guarantee Issue AmountEmployee: $100,000
Spouse: $25,000
Children: All amounts
Employee: $150,000
($10,000 age 70 & over)
Spouse: $30,000
($10,000 age 70 & over)
Children: All amounts
Employee: $200,000
($10,000 age 65 & over)
Spouse: $30,000
Children: $10,000
Granite Mountain Charter School
Basic & Voluntary Life/ AD&D Marketing - Effective July 1, 2020
-$225.00
Increments of
$10,000 up to lesser of 5x salary
or $500,000
Increments of
$5,000 up to $100,000(not to exceed 50% of Employee
elected amount)
Flat $10,000
(Live Birth - Age 26)
Employee:
Lesser of 3x earnings or
$200,000
Spouse: $30,000
Children: All amounts
$0.077
$481.25
$5,775.00
-3.75%
Proposed
Hartford
07/01/2020
2 years
Flat $50,000
Reduced to 70% of benefit at
age 70 &
to 40% of benefit at age 75
$750.00
Increments of
$10,000 up to lesser of 3x salary
or $500,000Increments of
$5,000 up to lesser of 50% of
employee elected coverage or
$100,000
Terminates at age 70
Flat $10,000
(6 months - Age 26)
Flat $1,000
(15 days - 6 months)
Flat $500
(Birth - 14 days)
Employee: $150,000
Spouse: $30,000
Children: All amounts
$0.09
$562.50
$6,750.00
12.50%
Proposed
Cigna
07/01/2020
2 years(Rates are packaged with Cigna
Medical & Dental)
Flat $50,000
Reduced to 70% of benefit at
age 70 &
to 40% of benefit at age 75
Increments of
$10,000 up to lesser of 3x salary
or $500,000
Increments of
$5,000 up to lesser of 50% of
employee elected coverage or
$100,000
Flat $10,000
(15 days old - age 26)
Employee: $200,000
Spouse: $30,000
($5,000 age 65 & over)
Children: Age 15 days - 26:
$10,000
$500.00
$6,000.00
---
---
$0.08
Current(Through Inspire Charter)
Hartford
07/01/2019
1 year
Flat $50,000
Reduced to 70% of benefit at
age 70 &
to 40% of benefit at age 75
Keenan & Associates
CA License #0451271
Page 1 of 2
April 28, 2020
Proposed Proposed Proposed
Carrier MetLife Principal Guardian
Effective Date 07/01/2020 07/01/2020 07/01/2020
Rate Guarantee 3 years 3 years 2 years
Granite Mountain Charter School
Basic & Voluntary Life/ AD&D Marketing - Effective July 1, 2020
Proposed
Hartford
07/01/2020
2 years
Proposed
Cigna
07/01/2020
2 years(Rates are packaged with Cigna
Medical & Dental)
Current(Through Inspire Charter)
Hartford
07/01/2019
1 year
Voluntary Life/ AD&D Rates
Employee
Rate/ $1,000Vol Life & AD&D
combined
Spouse
Rate/ $1,000Vol Life & AD&D
combined
Employee
Rate/ $1,000Vol Life only
Spouse
Rate/ $1,000Vol Life only
Employee
Rate/ $1,000Vol Life only
Spouse
Rate/ $1,000Vol Life only
Rate/ $1,000
(Same rates for EE or
Spouse)
Rate/ $1,000
(Same rates for EE or Spouse)
Rate/ $1,000
(Same rates for EE or
Spouse)
under 25 $0.049 $0.067 $0.049 $0.096 $0.029 $0.047 $0.029 $0.052 $0.044
25 - 29 $0.047 $0.064 $0.047 $0.092 $0.027 $0.044 $0.029 $0.052 $0.044
30 - 34 $0.051 $0.071 $0.051 $0.102 $0.031 $0.051 $0.043 $0.060 $0.049
35 - 39 $0.067 $0.095 $0.067 $0.136 $0.047 $0.075 $0.066 $0.096 $0.073
40 - 44 $0.090 $0.133 $0.090 $0.190 $0.070 $0.113 $0.090 $0.145 $0.106
45 - 49 $0.137 $0.209 $0.137 $0.299 $0.117 $0.189 $0.135 $0.219 $0.168
50 - 54 $0.207 $0.322 $0.207 $0.461 $0.187 $0.302 $0.207 $0.361 $0.286
55 - 59 $0.291 $0.458 $0.291 $0.656 $0.271 $0.438 $0.329 $0.583 $0.460
60 - 64 $0.366 $0.579 $0.366 $0.829 $0.346 $0.559 $0.419 $0.889 $0.748
65 - 69 $0.524 $0.834 $0.524 $1.194 $0.504 $0.814 $0.675 $1.518 $1.654
70 - 74 $0.922 $1.479 $0.922 N/A $0.902 $1.459 $1.147 $2.749 $2.977
75+ $2.727 $4.397 $2.727 N/A $2.707 $4.377 $1.147 $2.749 $2.977
Voluntary Life - Child $0.24/ $1,000
Flat $5,000: $1.00/ family unit
Flat $10,000: $2.00/ family unit
Flat $20,000: $4.00/ family unit
Flat $25,000: $5.00/ family unit
$0.20/ $1,000
Voluntary AD&D - Employee or Spouse $0.016/ $1,000 $0.019/ $1,000 $0.03/ $1,000
Voluntary AD&D - Child $0.048/ $1,000Voluntary Child AD&D is not
available with Principal Financial$0.03/ $1,000
$0.02/ $1,000
$0.02/ $1,000$0.029
$0.188/ $1,000 $0.036/ $1,000
Employee: $0.02/ $1,000
Spouse: $0.033/ $1,000Included with Vol. Life rate
$0.56/ $10,000 benefit
Included with Vol. Life rate
Keenan & Associates
CA License #0451271
Page 2 of 2
April 28, 2020
Contact a Building Blocks representative to schedule your enrollment session today!
Call: 775-382-1287Email: [email protected]
A Building Blocks Benefit Advisor will assist you with your enrollment via a Telephone or Screen Share
Enrollment Session (requires access to a computer and internet),
whichever you prefer.
The Following Colonial Life Benefits are NowAvailable in Benefit Bridge!
After completing your enrollment session with a Building Blocks Benefit
Advisor, you will receive your membership login information to the
WellCard Savings Program!
You and your family will have access to receive discounts on Medical,
Pharmacy, Vision & Dental Care, Health & Wellness, PetDiscounts,
and more!
Accident
For a covered accident, policyholders receive cash benefits for use as they see fit.
Cancer
The cancer plan is designed to pay cash benefits that can be used to help offset cancer-related expenses.
Critical Illness
Helps with medical expenses related to a covered serious health event.
Short-Term Disability
In the case of an illness or injury, it helps you maintain your standard of living and helps you pay your bills.
Medical Bridge/Hospital Confinement
Pays cash amounts to help with the non-covered expenses of a hospital stay.
Term and Whole Life Insurance
Helps you get the peace of mind knowing your family is taken care of.
All benefits with this symbol have Guaranteed Issue availablefor New Enrollees!
Receive membership to the WellCard Savings Program!
COLONIAL 2020 Benefit GuideBenefits Booklet
WellCard Savings
Program!You are now
eligible for your complimentary discount savings
card!
3Your elections are recorded during the enrollment
session. That’s it!
2One of our Benefit Advisors will give you a call at your scheduled time to review the benefits offering withyou.
1You will receivea
call from our scheduling team to scheduleyour benefits review
session.
FAQs:Q: What is a “Non-Discriminatory Enrollment”?
A: A non-discriminatory enrollment means that all employees complete their enrollment session, regardless of their election choices, to ensure that all employees have received the same benefit offering and enrollment experience to make an educated decision on their benefits.
Q: Do I have to complete an enrollment call with a Benefit Advisor?
A: Yes! All benefit eligible employees complete the enrollment session to ensure non-discrimination. Once everyone has completed their call, everyone is eligible to receive access to the WellCard Savings Program.
Q: Do I have to purchase an Colonial Life policy to get my WellCardSavings?
A: No! During the non-discriminatory enrollment process, all employees that complete their enrollment session, regardless of their election choices, will receive access to the WellCard Savings Program.
Q: How long is the enrollment call?
A: Enrollment calls typically take anywhere from 10 – 25 minutes, depending on how many questions you have. We block out 30 minutes for each enrollment call to ensure we have enough time to answer all your inquiries.
Q: How does Building Blocks get my information?
A: Your employer provides some of the employment specific information in regards to collecting census, which is used to configure the enrollment software. All other information is collected from you securely during the session; this makes it possible to customize your enrollment call with only the options that make the most sense for you and your lifestyle. It also ensures that your enrollment call is quick and easy, allowing you to get back to work as soon as possible!
Q: How is my informationhandled?
A: All information is transmitted and stored in a secure format. We take privacy very seriously! We never share your information with third parties and will only contact you regarding your enrollment session or any service matters related to your policies.
Q: When can I have my enrollmentcall?
A: The benefit of working in a virtual environment means more flexibility in scheduling. You may schedule your call at work, at home, or even your off days if availability permits. Our team of caring professionals are here to accommodate you any way wecan.
Q: What is a virtual enrollment?
A: Our Benefit Advisors can complete your enrollment over the phone, and if you have a computer, they can even share their screen with you! Our virtual enrollments are an interactive session where we will review the benefit offerings and be able to answer any questions youmay have.
Q: How is my electioncollected?
A: Your election is collected electronically by a digital signature, either over a recorded phone line or an electronic signature through the screen share.
Q: Why am I getting a call from a Nevada area code (702 or775)?
A: Building Blocks’ corporate office is located in Nevada, which is why you will receive calls from aNevada area code.
Building Blocks Easy Virtual Enrollment Process
Base Policy Benefits Basic Preferred Premier
Accident Emergency TreatmentFor treatment in a doctor’s office, urgent care facility or emergency room within the first 72 hours of the accident. If initiallytreated after 72 hours, please see Accident Follow-up Doctor’s Visit
$75 $125 $125
Accident Follow-Up Doctor Visit $50/visit up to 2 visitsper accident
$50/visit up to 3 visits per accident
$50/visit up to 4 visitsper accident
Accidental Death $20,000 Employee$20,000 Spouse
$4,000 Child(ren)
$25,000 Employee$25,000 Spouse
$5,000 Child(ren)
$50,000 Employee$50,000 Spouse
$10,000 Child(ren)
Accidental Death: Common Carrier $80,000 Employee$80,000 Spouse
$16,000 Child(ren)
$100,000 Employee$100,000 Spouse
$20,000 Child(ren)
$200,000 Employee$200,000 Spouse
$40,000 Child(ren)
Accidental Dismemberment:(Loss of Finger/Toe/Hand/Foot or Sight)
$600- $12,000 $750- $15,000 $1,200-$24,000
Ambulance - Air $1,200 $2,000 $2,000
Ambulance - Ground $120 $200 $200
Appliances(such as wheelchair, crutches)
$75 $100 $100
Blood/Plasma/Platelets $300 $300 $300
Burns(based on size and degree)
$1,000- $12,000 $1,000- $12,000 $1,000- $12,000
Burns - Skin Graft 50% of burn benefit 50% of burn benefit 50% of burn benefit
Catastrophic Accident –prior to 65(For severe injuries that result in the total and irrevocable: loss of one hand and one foot; loss of both hands or both feet; loss of sight in both eyes; loss of hearing of both ears; loss of the ability to speak.)365 day elimination periodAmounts reduced for covered persons over age 65
$10,000 EE/SP$5,000 CH
$25,000 EE/SP$12,500 CH
$25,000 EE/SP$12,500 CH
Coma (duration of at least 7 days) $7,500 $10,000 $12,500
Concussion $60 $60 $60
Dislocation (Based on joint and if repaired byopen or closed reduction)
$90-$3,600 $110 - $4,400 $120 - $4,800
Emergency Dental Work $200 (crown, implant or denture) or $50 (extract)
$300 (crown, implant or denture) or $75 (extract)
$400 (crown, implantor denture)or $100 (extract)
Eye Injury $200 $300 $300
Fractures (Based on bone and if repaired by openor closed reduction)
$90 - $4,500 $110 - $5,500 $120 - $6,000
Hospital Admission* $750/accident $1,000/accident $1,250/accident
Hospital Confinement (Per day up to 365 days)
$175 $225 $250
Hospital ICU Admission* $1,500/accident $2,000/accident $2,500/accident
Hospital ICU Confinement (Up to 15 days per accident)
$350 $450 $500
Accident 1.0Colonial Life’s voluntary accident insurance policy is a medical indemnity plan that provides employees and their families with hospital,doctor, accidental death and catastrophic accident benefits in the event of a covered accident. Sample CA Rates shown at the bottomrepresentOn/Offjobcoverage with Health Screening. Accident coverage is pre-taxeligible.
10
Knee Cartilage - Torn $500 $500 $750
Laceration(based on size and repair)
$30-$500 $30-$500 $30-$500
Lodging (Companion) $100 per day up to 30 days
$125 per day up to 30 days
$150 per day up to 30 days
Medical Imaging Study Limit one accident per year
$100 per accident $150 per accident $200 per accident
Prosthetic Device/Artificial Limb $500 (1);$1,000 (2 or more)
$500 (1);$1,000 (2 or more)
$750 (1);$1,500 (2 or more
Rehabilitation Unit ConfinementUp to 15 days per confinement per covered accident.Maximum of 30 days per calendaryear.
$100/day $100/day $150/day
Ruptured Disc $500 $500 $750
Surgery-Cranial, Open Abdominal,Thoracic $1,000: $1,500 $1,500
Surgery- Hernia $100 $150 $150
Surgery – Exploratory or Arthroscopic
$150 $200 $200
Tendon/Ligament/Rotator Cuff $500 (1);$1,000 (2 or more)
$500 (1);$1,000 (2 or more)
$750 (1);$1,500 (2 or more)
Therapy - Occupational and Physical TherapyBenefit $25 per day (10 visits/accident)
$25 per day (10 visits/accident)
$35 per day (10 visits/accident)
Transportationup to 3 trips per accident
$400 per trip $500 per trip $600 per trip
X-Ray Benefit $20 $30 $40
Health Screening BenefitPer covered person per calendar year
$50 $50 $50
Mammography Benefit $200 $200 $200
* We will pay either the Hospital Admission or Hospital ICU Admission benefit, but not both.
MONTHLY RATES (12 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Basic 17-64 $21.11 $29.87 $29.73 $38.50
Preferred 17-64 $25.67 $35.91 $37.19 $47.42
Premier 17-64 $31.03 $43.26 $44.22 $56.44
11THLY RATES (11 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Basic 17-64 $23.03 $32.59 $32.43 $42.00
Preferred 17-64 $28.00 $39.17 $40.57 $51.73
Premier 17-64 $33.85 $47.19 $48.24 $61.57
10THLY RATES (10 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Basic 17-64 $25.33 $35.84 $35.68 $46.20
Preferred 17-64 $30.80 $43.09 $44.63 $56.90
Premier 17-64 $37.24 $51.91 $53.06 $67.73
SEMI-MONTHLY RATES (24 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Basic 17-64 $10.56 $14.94 $14.87 $19.25
Preferred 17-64 $12.84 $17.96 $18.60 $23.71
Premier 17-64 $15.52 $21.63 $22.11 $28.22
BI-WEEKLY (26 PAYPERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Basic 17-64 $9.74 $13.79 $13.72 $17.77
Preferred 17-64 $11.85 $16.57 $17.16 $21.89
Premier 17-64 $14.32 $19.97 $20.41 $26.05
11
Cancer AssistColonial Life’s individual cancer insurance product helps to provide valuable financial protection for America’s workers and their families in times of need, when medical bills and other expenses related to cancer diagnosis and treatment may limit their ability to focus on what's most important - getting well. Sample CA Rates shown at the bottom includes $100 Health Screening. Cancer coverage is pre-tax eligible.
Benefits Level 1 Level 2 Level 3 Level 4Air Ambulance, per trip $2,000 $2,000 $2,000 $2,000
Maximum trips per confinement 2 2 2 2Ambulance, per trip $250 $250 $250 $250
Maximum trips per confinement 2 2 2 2
Anesthesia, General 25% of Surgical Procedures Benefit
Anesthesia, Local, per procedure $25 $30 $40 $50Anti-Nausea Medication, per day $25 $40 $50 $60
Maximum per month $100 $160 $200 $240
Blood/Plasma/Platelets/Immunoglobulins, per day $150 $150 $175 $250
Maximum per calendar year $10,000 $10,000 $10,000 $10,000
Bone Marrow or Peripheral Stem Cell Donation, per donation, maximum one per lifetime
$500 $500 $750 $1,000
Bone Marrow Stem Cell Transplant, per transplant $3,500 $4,000 $7,000 $10,000
Peripheral Stem Cell Transplant, per transplant $3,500 $4,000 $7,000 $10,000
Maximum transplants per lifetime 2 2 2 2Companion Transportation, per mile $0.50 $0.50 $0.50 $0.50
Maximum per round trip $1,000 $1,000 $1,200 $1,500
Egg (s) Extraction or Harvesting or Sperm Collection,one per lifetime
$500 $700 $1,000 $1,500
Egg (s) or Sperm Storage, one per lifetime $175 $200 $350 $500Experimental Treatment, per day $200 $250 $300 $300
Maximum per lifetime $10,000 $12,500 $15,000 $15,000
Family Care, per day $30 $40 $50 $60Maximum per calendar year $1,500 $2,000 $2,500 $3,000
Hair/External Breast/Voice Box Prosthesis, per calendar year
$200 $200 $350 $500
Home Health Care Services, per day $50 $75 $100 $150
Maximum per calendar yearExamples include: physical therapy, occupational therapy, speech therapy, and audiology, prosthesis and orthopedic appliances and rental or purchase of medical equipment.
30 days or twice the days confined
Hospice, Initial $1,000 $1,000 $1,000 $1,000Hospice, Daily $50 $50 $50 $50
Maximum combined Initial and Daily per lifetime $15,000 $15,000 $15,000 $15,000
Hospital Confinement, 30 days or less, per day $100 $150 $250 $350
Hospital Confinement, 31 days or more, per day $200 $300 $500 $700
Lodging, per day $50 $50 $75 $80Maximum days per calendar year 70 70 70 70
Medical Imaging Studies, per study $75 $125 $175 $225Maximum per calendar year $150 $250 $350 $450
Outpatient Surgical Center, per day $100 $200 $300 $400Maximum per calendar year $300 $600 $900 $1,200
Private Full-time Nursing Services, per day $50 $75 $125 $150
Prosthetic Device/Artificial Limb, per device or limb $1,000 $1,500 $2,000 $3,000
Maximum per lifetime $2,000 $3,000 $4,000 $6,000
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Radiation/Chemotherapy
Injected chemotherapy by medical personnel, one per week $250 $500 $750 $1,000
Radiation delivered by medical personnel, one per week $250 $500 $750 $1,000
Self-Injected Chemotherapy, one per month $150 $200 $300 $400
Pump Chemotherapy, one per month $150 $200 $300 $400
Topical Chemotherapy, one per month $150 $200 $300 $400
Oral Hormonal Chemotherapy (1-24 months), one permonth $150 $200 $300 $400
Oral Hormonal Chemotherapy (25+ months), one permonth $75 $100 $150 $200
Oral Non-Hormonal Chemotherapy, one per month $150 $200 $300 $400
Reconstructive Surgery, per surgical unit $40 $40 $60 $60
Maximum per procedure, including 25% for generalanesthesia $2,500 $2,500 $3,000 $3,000
Second Medical Opinion, one per lifetime $150 $200 $300 $300
Skilled Nursing Care Facility, Per day up to the number of days for hospital confinement
$75 $100 $100 $150
Skin Cancer Initial Diagnosis one per lifetime $300 $300 $400 $600
Supportive/Protective Care Drugs/Colony Stimulating Factors, per day $50 $100 $150 $200
Maximum per calendar year $400 $800 $1,200 $1,600
Surgical Procedures, per unit $40 $50 $60 $70
Maximum per procedure $2,500 $3,000 $5,000 $6,000
Transportation, per mile $0.50 $0.50 $0.50 $0.50
Maximum per round trip $1,000 $1,000 $1,200 $1,500
Additional Benefits Level 1 Level 2 Level 3 Level 4
Bone Marrow Donor ScreeningMaximum of one per lifetime
$50 $50 $50 $50
Cancer Vaccine BenefitMaximum of one per lifetime
$50 $50 $50 $50
Waiver of Premium Yes Yes Yes Yes
Health Screening BenefitPer covered person per calendar year
$100 $100 $100 $100
MONTHLY RATES (12 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Level 1 17-75 $18.65 $29.45 $18.80 $29.60Level 2 17-75 $22.30 $34.85 $22.60 $35.15Level 3 17-75 $27.45 $45.70 $27.90 $46.15Level 4 17-75 $36.65 $61.15 $37.25 $61.7511THLY RATES (11 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Level 1 17-75 $20.35 $32.13 $20.51 $32.29Level 2 17-75 $24.33 $38.02 $24.65 $38.35Level 3 17-75 $29.95 $49.85 $30.44 $50.35Level 4 17-75 $39.98 $66.71 $40.64 $67.3610THLY RATES (10 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Level 1 17-75 $22.38 $35.34 $22.56 $35.52Level 2 17-75 $26.76 $41.82 $27.12 $42.18Level 3 17-75 $32.94 $54.84 $33.48 $55.38Level 4 17-75 $43.98 $73.38 $44.70 $74.10SEMI-MONTHLY RATES (24 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Level 1 17-75 $9.33 $14.73 $9.40 $14.80Level 2 17-75 $11.15 $17.43 $11.30 $17.58Level 3 17-75 $13.73 $22.85 $13.95 $23.08Level 4 17-75 $18.33 $30.58 $18.63 $30.88BI-WEEKLY (26 PAYPERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Level 1 17-75 $8.61 $13.59 $8.68 $13.66Level 2 17-75 $10.29 $16.08 $10.43 $16.22Level 3 17-75 $12.67 $21.09 $12.88 $21.30Level 4 17-75 $16.92 $28.22 $17.19 $28.50
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Critical Illness 1.0Colonial Life's individual Specified Critical Illness 1.0 insurance helps you and your family maintain financial security during the lengthy, expensive recovery period of a critical illness. It provides a lump sum benefit to help with the out-of-pocket medical and non-medicalexpenses of employees who suffer a critical illness. Sample CA Rates shown at the bottom includes Subsequent Diagnosis & Health Screening Benefits. Rates are based off non-tobacco. Critical Illness coverage is post-tax.
Benefits: Description:Face Amount: Can choose anywhere from $5,000 face amount up to $30,000. Spouse receives 50%
of employee’s face amount. Children receive 25% of the employee’s face amount.
For the diagnosis of this covered critical illness condition: This percentage of the face amount is payable:
Heart attack (myocardial infarction) 100%
Stroke 100%
End-stage renal (kidney) failure 100%
Major organ failure 100%
Permanent paralysis due to a covered accident 100%
Coma 100%
Blindness 100%
Coronary artery bypass graft surgery/disease 25%
Additional Benefits: Description:Subsequent Diagnosis Of A Critical Illness If you receive a benefit for a specified critical illness, and later you are diagnosed
with a different specified critical illness, the original percentage of the face amount is payable for that particular specified critical illness. If you receive a benefit for a specified critical illness, and later you are diagnosed with the same specified critical illness, 25% of the original face amount is payable
Maximum Benefit Amount 3x the face amount for the named insured for all covered persons combined. The policy will terminate when the maximum benefit amount for specified critical illness has been paid.
Health Screening Benefit Per covered person per calendar year $50
Mammography Benefit $200
Cervical Cancer Screening Test Benefit $70
MONTHLY RATES (12 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
$15,000 25-29 $9.30 $14.30 $9.30 $14.30
30-34 $10.50 $16.25 $10.50 $16.25
35-39 $14.10 $21.65 $14.10 $21.65
40-44 $16.50 $25.25 $16.50 $25.25
45-49 $21.00 $32.15 $21.00 $32.15
50-54 $26.40 $40.55 $26.40 $40.55
11THLY RATES (11 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
$15,000 25-29 $10.15 $15.60 $10.15 $15.60
30-34 $11.45 $17.73 $11.45 $17.73
35-39 $15.38 $23.62 $15.38 $23.62
40-44 $18.00 $27.55 $18.00 $27.55
45-49 $22.91 $35.07 $22.91 $35.07
50-54 $28.80 $44.24 $28.80 $44.24
10THLY RATES (10 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
$15,000 25-29 $11.16 $17.16 $11.16 $17.16
30-34 $12.60 $19.50 $12.60 $19.50
35-39 $16.92 $25.98 $16.92 $25.98
40-44 $19.80 $30.30 $19.80 $30.30
45-49 $25.20 $38.58 $25.20 $38.58
50-54 $31.68 $48.66 $31.68 $48.66
SEMI-MONTHLY RATES (24 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
$15,000 25-29 $4.65 $7.15 $4.65 $7.15
30-34 $5.25 $8.13 $5.25 $8.13
35-39 $7.05 $10.83 $7.05 $10.83
40-44 $8.25 $12.63 $8.25 $12.63
45-49 $10.50 $16.08 $10.50 $16.08
50-54 $13.20 $20.28 $13.20 $20.28
BI-WEEKLY (26 PAYPERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
$15,000 25-29 $4.29 $6.60 $4.29 $6.60
30-34 $4.85 $7.50 $4.85 $7.50
35-39 $6.51 $9.99 $6.51 $9.99
40-44 $7.62 $11.65 $7.62 $11.65
45-49 $9.69 $14.84 $9.69 $14.84
50-54 $12.18 $18.72 $12.18 $18.72
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Individual Short-Term Disability 3000Colonial Life’s voluntary short-term disability insurance policy is an individual plan that is sold via payroll deduction at the workplace. It insures your employee’s paycheck by replacing a portion of your employee’s income if he becomes disabled because of a covered accidental injury or covered sickness. Sample CA Rates shown at the bottom represents Off-Job Injury & Sickness/Maternity with Health Screening & 1st Day Hospital. Rates are based off AA Risk Classification & 6 month benefit period.
Benefits: Description:
Monthly Benefit AmountAmounts vary based on income, offered in $100 increments
Available up to $4,000 in monthly benefits for up to 40% of income
Benefit PeriodsRefers to the maximum length of time benefits may be payable for a covereddisability
6 months and 12 months are available
Elimination PeriodsElimination periods vary by benefit period selected, the first number represents accident elimination period, the second number represents sickness elimination period
0/7, 7/7, 7/14, 0/14, 14/14, 0/30, 30/30 60/60,90/90, and 180/180
Total Disability and Partial Disability BenefitsPartial disability pays 50% of the total disability benefit and for up to 3 months
Included
Pregnancy BenefitsThe usual recovery period is six weeks (vaginal delivery) or eight weeks (cesarean delivery), subject to elimination periods, subject to Giving BirthLimitation
Included
Additional Benefits: Description:
Additional Disability Benefits RidersProvides policyholders the ability to purchase additional disability coverage on a
guarantee issue basis after their initial enrollment, Policyholders can purchase amaximum of two riders, at two separate intervals
$100 or $200 monthly
Health Screening Rider Per calendar year $50
MONTHLY RATES (12 PAY PERIODS) ISSUE AGE $500/mo $1,000/mo $1,500/mo $2,000/mo $2,500/mo
Elimination 0 days Injury / 7 days Sickness 17-49 $29.25 $55.60 $81.95 $108.30 $134.6550-64 $39.90 $76.90 $113.90 $150.90 $187.9065-74 $47.70 $92.50 $137.30 $182.10 $226.90
Elimination 0 days Injury / 14 days Sickness 17-49 $23.65 $44.40 $65.15 $85.90 $106.6550-64 $31.00 $59.10 $87.20 $115.30 $143.4065-74 $36.90 $70.90 $104.90 $138.90 $172.90
11THLY RATES (11 PAY PERIODS) ISSUE AGE $500/mo $1,000/mo $1,500/mo $2,000/mo $2,500/mo
Elimination 0 days Injury / 7 days Sickness 17-49 $31.91 $60.65 $89.40 $118.15 $146.8950-64 $43.53 $83.89 $124.25 $164.62 $204.9865-74 $52.04 $100.91 $149.78 $198.65 $247.53
Elimination 0 days Injury / 14 days Sickness 17-49 $25.80 $48.44 $71.07 $93.71 $116.3550-64 $33.82 $64.47 $95.13 $125.78 $156.4465-74 $40.25 $77.35 $114.44 $151.53 $188.62
10THLY RATES (10 PAY PERIODS) ISSUE AGE $500/mo $1,000/mo $1,500/mo $2,000/mo $2,500/mo
Elimination 0 days Injury / 7 days Sickness 17-49 $35.10 $66.72 $98.34 $129.96 $161.5850-64 $47.88 $92.28 $136.68 $181.08 $225.4865-74 $57.24 $111.00 $164.76 $218.52 $272.28
Elimination 0 days Injury / 14 days Sickness 17-49 $28.38 $53.28 $78.18 $103.08 $127.9850-64 $37.20 $70.92 $104.64 $138.36 $172.0865-74 $44.28 $85.08 $125.88 $166.68 $207.48
SEMI-MONTHLY RATES (24 PAY PERIODS) ISSUE AGE $500/mo $1,000/mo $1,500/mo $2,000/mo $2,500/mo
Elimination 0 days Injury / 7 days Sickness 17-49 $14.63 $27.80 $40.98 $54.15 $67.3350-64 $19.95 $38.45 $56.95 $75.45 $93.9565-74 $23.85 $46.25 $68.65 $91.05 $113.45
Elimination 0 days Injury / 14 days Sickness 17-49 $11.83 $22.20 $32.58 $42.95 $53.3350-64 $15.50 $29.55 $43.60 $57.65 $71.7065-74 $18.45 $35.45 $52.45 $69.45 $86.45
BI-WEEKLY (26 PAY PERIODS) ISSUE AGE $500/mo $1,000/mo $1,500/mo $2,000/mo $2,500/mo
Elimination 0 days Injury / 7 days Sickness 17-49 $13.50 $25.66 $37.82 $49.98 $62.1550-64 $18.42 $35.49 $52.57 $69.65 $86.7265-74 $22.02 $42.69 $63.37 $84.05 $104.72
Elimination 0 days Injury / 14 days Sickness 17-49 $10.92 $20.49 $30.07 $39.65 $49.2250-64 $14.31 $27.28 $40.25 $53.22 $66.1865-74 $17.03 $32.72 $48.42 $64.11 $79.80
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Group Medical Bridge 7000Colonial Life’s Medical Bridge insurance can help with medical costs that your health insurance may not cover. These benefits are available for you, your spouse and eligible dependentchildren.
Benefits: Description:
Hospital ConfinementMaximum of one benefit per covered person per calendaryear
Can choose Plan 1: $1000, $1500 Plan 2 $500 or $3,000
Emergency Room VisitMaximum of two visits per covered person per calendaryear
$100 per visit
Medical Treatment PackageAir Ambulance, Ambulance , Appliance, Dr. Office Visit x3 per CY, X-Ray x 2 per CY
$1,000, $100, $100, $25, $100, $25
Diagnostic BenefitThe Diagnostic Procedure benefit is payable once per day with a maximum of one day per covered person per calendar year for the specified diagnostic procedures.
$250
Outpatient Surgery - Tier 1 (Plan 2 only)Examples: Colonoscopy, Hemorrhoidectomy, Laparoscopic hernia repair, Tonsillectomy, Pacemaker insertion, Foot surgery (bunionectomy, exostectomy, arthroplasty, hammertoe repair), Removal of tendonlesion
$500
Outpatient Surgery - Tier 2 (Plan 2 Only)Examples: Breast reconstruction, Breast reduction, Angioplasty, Cardiac catherization, Exploratory laparoscopy, Ethmoidectomy, Cataract surgery, Glaucoma surgery, Hysterectomy, Myomectomy, Arthroscopic knee surgery with meniscectomy (knee cartilage repair), Dislocations & Fractures (open reduction with internal fixation), Tendon/ligamentrepair
$1,000
Maximum Outpatient Surgery BenefitPer covered person per calendar year for all covered
$1,500
Health Screening Benefit $100
MONTHLY RATES (12 PAY PERIODS) ISSUE AGE NAMED INSURED EMPLOYEE & SPOUSE ONE-PARENT FAMILY TWO-PARENT FAMILY
Plan 1, Level 2: $1,000 17-99 $16.91 $33.58 $23.47 $40.15Plan 1, Level 3: $1,500 17-99 $21.33 $43.06 $29.51 $51.25Plan 2, Level 1: $500 17-99 $28.09 $58.37 $42.75 $73.04
Plan 2, Level 6: $3,000 17-99 $55.48 $117.15 $80.18 $141.87
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Whole Life 1000Colonial Life’s Whole Life 1000 is an individually owned, whole life insurance plan with guaranteed level premiums, guaranteed cash values and a guaranteed death benefit. Coverage is permanent and is guaranteed for the life of the policy (to age 100), provided premiums are paid when due.
Benefits: Description:
Death BenefitAmounts available vary by age
$5,000 to $150,000
Two Plan OptionsThe policy is paid-up at the original face amount when the insured reaches the specified age, with no additional premiums due
Paid-Up at Age 65 & Paid-Up at Age 95
Guaranteed Cash ValueIn addition to death benefit coverage, it also provides a guaranteed cash value accumulation that grows tax deferred.
4.5%
Accelerated Death Benefit ProvisionAutomatically included in the base policy at no additional premium, up to a maximum of $150,000 (in most states)
Can request up to 75% of death benefit if diagnosed with a terminal illness and has a life expectancy of 12 months or less
Guaranteed Purchase OptionProvides the policyowner the right to buy additional insurance on the life of theinsured without providing evidence of insurability if the policy is purchasedbefore age 55.
Available on the second, fifth, and eight anniversary dates.
Additional Benefits: Description:
Juvenile Whole Life PlanEmployees can purchase this for children or grandchildren without purchasing coverage of themselves
A juvenile whole life plan is available for eligible dependents.
Spouse Term RiderSpouse signature not required, may convert to a cash value policy
Face amounts range from $5,000 to $50,000, 10 and 20-year term options available
Dependent Children Term RiderCovers all dependent children for one level premium, may convert to a cash value policy
Face amounts range from $1,000 to $10,000
Waiver of Premium Benefit RiderTotal disability is considered permanent when the total disability continues with no interruptions for at least six consecutive months.
Waives all premiums due on the base policy & attached riders during the total andpermanent disability of the primary insured before age65
Long-Term Care Benefit RiderReduces the Whole Life policy death benefit to provide monthly indemnity payments to help pay for the insured’s long-term care services needed as aresult of a chronic illness, serious accident, sudden illness, or cognitive impairment.
Provides a monthly indemnity benefit toassist with the cost of long-term care services.
17
Non-Tobacco Rates Paid up at Age 65
MONTHLY RATES (12 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
40 $47.46 $91.91 $127.81 $169.41
45 $64.71 $126.41 $177.43 $235.57
11THLY RATES (11 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $31.47 $59.68 $78.61 $103.72
40 $51.77 $100.27 $139.43 $184.81
45 $70.59 $137.90 $193.56 $256.99
10THLY RATES (10 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $34.62 $65.65 $86.47 $114.10
40 $56.95 $110.29 $153.37 $203.29
45 $77.65 $151.69 $212.92 $282.68
SEMI-MONTHLY RATES (24 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $14.43 $27.36 $36.03 $47.54
40 $23.73 $45.96 $63.91 $84.71
45 $32.36 $63.21 $88.72 $117.79
BI-WEEKLY (26 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $13.32 $25.25 $33.26 $43.88
40 $21.90 $42.42 $58.99 $78.19
45 $29.87 $58.34 $81.89 $108.72
Non-Tobacco Rates Paid up at Age 95
MONTHLY RATES (12 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $25.17 $47.33 $62.00 $81.66
40 $37.17 $71.33 $96.93 $128.24
45 $46.08 $89.16 $121.62 $161.16
11THLY RATES (11 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $27.46 $51.63 $67.64 $89.08
40 $40.55 $77.81 $105.74 $139.90
45 $50.27 $97.27 $132.68 $175.81
10THLY RATES (10 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $30.20 $56.80 $74.40 $97.99
40 $44.60 $85.60 $116.32 $153.89
45 $55.30 $106.99 $145.94 $193.39
SEMI-MONTHLY RATES (24 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $12.59 $23.67 $31.00 $40.83
40 $18.59 $35.67 $48.47 $64.12
45 $23.04 $44.58 $60.81 $80.58
BI-WEEKLY (26 PAY PERIODS) ISSUE AGE $25,000.00 $50,000.00 $75,000.00 $100,000.00
30 $11.62 $21.84 $28.62 $37.69
40 $17.16 $32.92 $44.74 $59.19
45 $21.27 $41.15 $56.13 $74.38
Whole Life 1000Sample CA Rates shown below are based off non-tobacco. Both Paid up at age 65 and Paid up at age 95 are represented.
18
AVAILABLE FOR FREE – ONLY WHEN YOU’VE COMPLETED AN AGENT- ASSITED VIRTUAL ENROLLMENT WITH BUILDING BLOCKS
Gain access to value-added programs that can save
you money every time you use pharmacies, vision
care providers, hearing care specialists, prepaid lab
tests, prepaid imaging tests, patient advocacy
services and more.
As an employee of a REEP Member District you are
eligible to receive a FREE membership to the
WellCard Savings Program! After completing your
personal enrollment session with a Building Blocks
Benefit Advisor, you will receive an email with
instructions on how to gain access to the WellCard
Savings Discount Program.
WellCard discounts include:
Prescription Discounts
Pet Discounts
Dental Care
Vision Care
Fitness
Family & Entertainment
Question Answer
Q: What are Voluntary/Supplemental Benefits?
A: Voluntary plans are 100% paid by the employee (though employers are able to contribute, too). Employees can choose which voluntary plans are best for their own situation. Some voluntary plans pay cash benefits directly to employees to cover living expenses, lost wages, copayments and deductibles.
Q: How do the Voluntary Plan work with my Health Insurance?
A: Our Programs are Indemnity Products which do not coordinate with your major medical carrier. Products have flat benefits payable directly to the employee for covered events and services. VB plans do not typically pay the Doctors or Hospitals, payments are sent directly to the policyholder.
Q: Can I keep the plans if I move or retire? A: Yes! Most of the plans offered through BBforB are portable! This means if you move, retire, or change employment you can take the benefits with you at bill it at home, usually with no rate increase. We call this “Porting” your coverage. You can contact our service team at [email protected] for assistance in porting your coverage. The GROUP Plans may not be portable such as Group Medical Bridge, depending on the plan your employer elected to offer.
Q: Can I cover my family? A: Some products like Accident Plans offer Child Only coverage, however, most plans the employee must be covered in order to cover additional family members.
Q: How long are my kids covered? A: If family coverage is elected, children are covered to age 26.Q: Does the rate change as I age? A: Not on most plans. Plans like Term Life can change based on your age when the term up. Q: Do Voluntary Benefits qualify for ACA qualified coverage?
A: No. Voluntary plans are not qualified health plans and do not pay doctors or hospitals for services rendered.
Q: Why should I participate in Voluntary benefits?
A: Voluntary plans offered valuable financial protection where your major medical may not. When you or a family member suffers an accidental injury, catastrophic illness, or lost time from work. Various Voluntary plans can help keep money coming into your household to help pay rent, food, childcare and medical bills.
Q: Can I pay for these Voluntary plans pre-tax?
A: Many Voluntary Plans are pre-tax eligible like FSA, Accident, Cancer & Hospital Confinement. Life Insurance plans typically cannot be pre-taxed.
Q: How are FSA’s different from the other VB Plans my employer offers?
A: Flexible Spending Accounts (FSAs) are specifically designed to save you money on eligible medical, dependent care and commuter expenses. Other VB Plans can include Short Term Disability Insurance, Accident, Cancer, Hospital Confinement, Critical Illness and Life Insurance
Q: Are the Voluntary plans a package or are they A la carte?
A: They are Al la carte. You can elect one or stack multiple plans to enhance financial protection for certain circumstances.
Q: Will I be rated as a smoker? A: You can be rated as a smoker for Life Insurance, however Cancer and Disability products do NOT rate you as a smoker.
Q: Can I participate in Voluntary Plans if I am not eligible or not participating in the Health Plan?
A: Yes! As long as you work at least 20 hours per week.
Q: What are the most common VB plans people participate in?
A: Short Term Disability & Life Insurance are the most commonly participated in plans, however, due to the affordability of Accident and Cancer plans, more and more employees are adding these to their portfolio.
Q: How do I file a claim? A: At BBforB we service all claims out of our office. Simply email [email protected] and we will walk you through it.
Q: How do I enroll or make changes?A: Your employer will establish a defined enrollment period (the timeframe) you can enroll. You will be instructed to contact the BBforB Enrollment Center to schedule a Remote enrollment with a live agent to assist you in your enrollment and answer all of your questions.
Q: What if I have a question outside of open enrollment?
A: We are here for you year-round! Simply email [email protected] whenever you have a question. You can view your policies by registering at Coloniallife.com and downloading the My Colonial Life mobile app.
Q: Do I still have coverage if I am traveling outside of the country?
A: Most policies DO provide global coverage! Some have time limits that you have to return to the USA to continue coverage. Your certificate of coverage will disclose any stipulations.
Q: How much of my income should I budget to VB coverages?
A: You can find what fits for your budget. The average employee spends about an hour of their wage per week on Voluntary Benefits.
Q: Do pre-existing conditions disqualify me?A: It depends on the plans your employer offers. In most cases Guarantee Issue policies are available, this means you may participate but there could be waiting periods on your specific pre-existing condition.
Q: What is the waiting period before I can file a claim?
A: It depends on the plan. Most plans have either no waiting period or a 30-day waiting period before you file a claim. Essentially your payroll deduction need to be established.
Q: What if I need to make a change outside of open enrollment?
A: Pre-taxed plans require a qualifying event in order to make changes. Please do not change your plans directly with Colonial Life! BBforB will assist you with your questions. Simply email [email protected]
Frequently Asked Questions by Employees : Voluntary Supplemental Benefits
Got a pet? Save at the vet!
Pacific Charter Institute is pleased to offer our employees the opportunity to save on your veterinary
care. One low price includes preventative, accident and sick care.
Employees receive INSTANT savings of 20-50% off every veterinary visit! United Pet Care features
NO claim forms, NO deductibles, NO waiting period, NO age exclusions and
NO exclusions due to pre-existing or breed-specific conditions.
ALL PETS ARE ELIGIBLE!
United Pet Care Programs:
Preferred Program
Select Program
Partner Program
Procedures Covered: Employee Payment ($) / Employee Savings (%)
Office Visits 50% $40 25%
Annual Examinations 50% 20% 25%
Vaccinations 50% 20% 25%
All Surgeries/Hospitalization 25% 20% 25%
Dental Cleaning/Extractions 25% 20% 25%
Diagnostic Testing/Lab Work 25% 20% 25%
Allergies/Infections 25% 20% 25%
Radiology 25% 20% 25%
Medications 25% 20% In house only - 25%
Spay/Neuter 25% 20% 25%
Puppy/Kitty Vaccines
(under age of 1 year, series of
vaccines including rabies)
25% 20% 25%
Special Per Pay Period Payroll Deduct Rates for Pacific Charter Institute Employees!
One Pet: $6.25 $5.38 $6.25
Two Pets: $12.10 $10.30 $12.10
Three Pets: $17.80 $15.15 $17.80
Each Additional Pet: $5.65 $4.85 $5.65
To enroll in United Pet Care, go to http://www.unitedpetcare.com/PCI
United Pet Care contact information: 949-916-7374 or 888-781-6622
Re: Lincoln Financial
To Whom It May Concern:
Granite Mountain Charter School would like to establish its own retirement plan due to the fact that Granite Mountain is its own entity and will no longer be contracting with Inspire Charter Services as of July 1st, 2020.
Respectfully,
Brook MacMillan Executive Director Granite Mountain Charter School
Granite Mountain Charter School 8560 Aliento Road, Lucerne Valley, CA 92356
Phone (909) 906-3593 I Fax (909) 324-2720
Inspire District Office
1151 W. 5th StreetAzusa, CA 91702 [email protected]
INVOICEBILL TO
Granite Mountain Charter School8560 Aliento RoadLucerne Valley, CA 92356-8133USA
INVOICE # 1294DATE 03/19/2020
DUE DATE 04/18/2020TERMS Net 30
DATE ACTIVITY DESCRIPTION QTY RATE AMOUNT
Medical Benefits Medical Benefits - March 2020 96,954.08
Vision Benefits Vision Benefits March 2020 1,007.02
Dental Benefits Dental Benefits - March 2020 5,362.41
Life Insurance LIFEADD -Life Insurance March 2020
502.67
HSA HSA - March 2020 437.33 437.33
BALANCE DUE $104,263.51
Inspire District Office
1151 W. 5th StreetAzusa, CA 91702 [email protected]
INVOICEBILL TO
Granite Mountain Charter School8560 Aliento RoadLucerne Valley, CA 92356-8133USA
INVOICE # 1290DATE 03/18/2020
DUE DATE 04/17/2020TERMS Net 30
DATE ACTIVITY DESCRIPTION QTY RATE AMOUNT
Medical Benefits Medical Benefits - April 2020 98,563.92
Vision Benefits Vision Benefits - April 2020 1,017.94
Dental Benefits Dental Benefits - April 2020 5,435.74
Life Insurance Life Insurance- April 2020 502.67
HSA HSA - April 2020 437.33
BALANCE DUE $105,957.60
Inspire District Office
1151 W. 5th StreetAzusa, CA 91702 [email protected]
INVOICEBILL TO
Granite Mountain Charter School8560 Aliento RoadLucerne Valley, CA 92356-8133USA
INVOICE # 1881DATE 04/20/2020
DUE DATE 05/20/2020TERMS Net 30
DATE ACTIVITY DESCRIPTION QTY RATE AMOUNT
Medical Benefits Medical Benefits - May 2020 104,557.22
Vision Benefits Vision Benefits -May 2020 1,095.34
Dental Benefits Dental Benefits - May 2020 5,843.95
Life Insurance Life Insurance - May 2020 538.67
HSA HSA - May 2020 437.33
BALANCE DUE $112,472.51
Inspire District Office
1151 W. 5th StreetAzusa, CA 91702 [email protected]
INVOICEBILL TO
Granite Mountain Charter School8560 Aliento RoadLucerne Valley, CA 92356-8133USA
INVOICE # 1909DATE 04/30/2020
DUE DATE 05/30/2020TERMS Net 30
DATE ACTIVITY DESCRIPTION QTY RATE AMOUNT
Medical Benefits Medical Benefits - June 2020 104,819.29
Vision Benefits Vision Benefits - June 2020 1,081.58
Dental Benefits Dental Benefits - June 2020 5,827.94
Life Insurance Life Insurance - June 2020 534.67
HSA HSA - June 2020 437.33
BALANCE DUE $112,700.81
Inspire District Office
1740 E. Huntington Drive #205 DATE: May 1, 2020Duarte, CA 91010 INVOICE # INSPGM-111
Phone (626)317-0112 Fax (626)470-9713 FOR: Monthly Operational & Instructional Fee
Bill To:
Granite Mountain Charter School 1740 E. Huntington Drive #205Duarte, CA 91010
DESCRIPTION AMOUNT
Instructional Fee - 05/2020 246,287.00$
Operational Fee - 05/2020 37,448.00$
TOTAL 283,735.00$
INVOICE
Make all checks payable to Inspire District OfficeIf you have any questions concerning this invoice, please contact Accounts Payable at
THANK YOU FOR YOUR BUSINESS!
Inspire District Office
1740 E. Huntington Drive #205 DATE: June 1, 2020Duarte, CA 91010 INVOICE # INSPGM-112
Phone (626)317-0112 Fax (626)470-9713 FOR: Monthly Operational & Instructional Fee
Bill To:
Granite Mountain Charter School 1740 E. Huntington Drive #205Duarte, CA 91010
DESCRIPTION AMOUNT
Instructional Fee - 06/2020 246,287.00$
Operational Fee - 06/2020 37,448.00$
TOTAL 283,735.00$
INVOICE
Make all checks payable to Inspire District OfficeIf you have any questions concerning this invoice, please contact Accounts Payable at
THANK YOU FOR YOUR BUSINESS!