April 2025 CIS invoice.pdf
PDF 1 MB Posted
- Attached to
- RFP Insurance Agent Services
- Solicitation number
- S-C00040-00013116
- Issued by
- Benton County, Oregon
About this file
This document is a monthly benefits invoice from CIS Trust for Clatsop County, covering April 2025 and representing a final invoice for employee health and vision insurance. The invoice details individual employee premium costs across multiple departments including Courthouse & Roads, District Attorney (DA), Management, Non-Union, Nurses, Parole/Probation, and Sheriffs Union, with different coverage tiers such as Employee Only, Employee + Spouse, Employee + Children, and Employee + Family. The total active premium is $308,027.17, with medical premiums totaling $303,954.14 and vision premiums totaling $4,073.03, and includes a slight adjustment of -$2,239.61.
The invoice includes specific premium breakdowns for each employee, showing their selected health plan (either CIS Copay H Rx9 or CIS HDHP-4 W/HSA) and vision plan (CIS Vision-A), along with their coverage tier and corresponding monthly premium. Payments are to be remitted to CIS Trust in Portland, Oregon, with a late payment fee of 0.5% or $25.00 (whichever is greater) for payments received after 04/10/2025. The previous total due was $313,906.21, with total payments received matching that amount, resulting in an unpaid balance of $0.00 and a current amount due of $308,027.17.
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Monthly Benefits Invoice
Location Prepared Billing Period
Clatsop County 03/15/2025 April 2025 Final Invoice
Remit Payment to: Active Coverage Totals CIS Trust
PO Box 6836 Portland, OR 97228-6836
Payments received after 04/10/2025 will be assessed a late fee of one-half percent (.5%) of the invoice balance, or $25.00, whichever is greater.
Premium Adjustment Total
Medical: $306,163.32 -$2,209.18 $303,954.14
Vision: $4,103.46 -$30.43 $4,073.03
Total Active Premium: $308,027.17
Active Courthouse & Roads
Plan Tier Coverage Premium Adjustment Agalzoff, Lori CIS Copay H Rx9 CIS Copay Alt Care EMP + Spouse $1,559.47 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,575.31 $0.00 Net Totals $1,575.31
Bake, Dakota CIS Copay H Rx9 CIS Copay Alt Care EMP + Children $1,817.62 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,842.31 $0.00 Net Totals $1,842.31
Bell, Robert CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Bergeson, Dawn CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Bergeson, Matthew CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Brodigan, Annette CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $0.00 -$1,473.14 CIS Vision-A EMP + Spouse $0.00 -$15.84
Totals $0.00 -$1,488.98 Net Totals -$1,488.98
Brown, Ben CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Brown, Kai CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Active Courthouse & Roads
Plan Tier Coverage Premium Adjustment Byrne, Laura CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Carlson, Steven CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Carriere, Oscar CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Chapman, Heather CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Clark, Katelyn CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Cook, David CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Cope, Brendan CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Cordas, Rachel CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Corsetti, Raymond CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Criss, Krysta CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Culver, Kelly CIS Copay H Rx9 CIS Copay Alt Care EMP + Spouse $1,559.47 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,575.31 $0.00 Net Totals $1,575.31
Plan Tier Coverage Premium Adjustment Davis, Stephanie CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Davis, Andrew CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Denny, Amy CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Dunn, Daniel CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Eckert, Jami CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Ferguson, Lisa CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Fredrickson, Sydney CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Germond, Brian CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Gibson, Steven CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Gilbertson, Bradley CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Gonzalez, Erika CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Plan Tier Coverage Premium Adjustment Graham, Douglas CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Gramelt, William CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Granger, Chelsea CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Guerrero-Lara, Carolina CIS Copay H Rx9 CIS Copay Alt Care EMP + Child $1,364.41 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,378.29 $0.00 Net Totals $1,378.29
Harper, William CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Harrington, Chad CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Hord, Denice CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Houser, Jennifer CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Hubbard, Hannah CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Huddleston, Scott CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Hutmacher, Amy CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Plan Tier Coverage Premium Adjustment Irvin, Cynthia CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Johnson, Kelly CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Karna, Christopher CIS Copay H Rx9 CIS Copay Alt Care EMP + Spouse $1,559.47 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,575.31 $0.00 Net Totals $1,575.31
Kennet, Andrea CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Kerr, Jacqueline CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Kinney, Kaelee CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Klein, Kristen CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Kuhnly, Daniel CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Landwehr, Jonathan CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Larson, Colleen CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Layton, John CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Plan Tier Coverage Premium Adjustment Ledgerwood, Robert CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Lee, Mollie CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Lindgren, Kent CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Lindstrom, Matt CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Maher, Sara CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Manning, Philip CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Mcfadden, Karla CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
McLean, Jessica CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
McNaughton, Darby CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
McSwain, Adrian CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Mendoza, Nancy CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Plan Tier Coverage Premium Adjustment Mestrich, Tara CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Meyer, Christopher CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Moore, Don CIS Copay H Rx9 CIS Copay Alt Care EMP + Spouse $1,559.47 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,575.31 $0.00 Net Totals $1,575.31
Moore, Lisa CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Morrow, Michael CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Myers, Julia CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Nelson, Gretchen CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Niles, Adam CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Olson, Jennifer CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Owens, Charles CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Peden, Jennifer CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Plan Tier Coverage Premium Adjustment Poe, James CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Pollack, Jason CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Pugh, Kayla CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Quan, Genghis CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Reeder, Tracy CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Reilly, Marilyn CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Riley, Matthew CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Schulz, Christina CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Shade, Anita CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Small, Benjamin CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Sprague, Alicia CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Plan Tier Coverage Premium Adjustment Sprengeler, Rebecca CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Strupeni, Aimee CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Tucker, Mary CIS Copay H Rx9 CIS Copay Alt Care EMP + Spouse $1,559.47 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,575.31 $0.00 Net Totals $1,575.31
Turigliatto, Alicia CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Webb, Kristin CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Courthouse & Roads Totals: $119,481.36 -$1,488.98
Courthouse & Roads Net Totals: $117,992.38
Active
DA
Plan Tier Coverage Premium Adjustment Bounous, Kathleen CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Mccracken, Scott CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Shepherd, Sarah CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Snyder, Marissa CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
DA
Plan Tier Coverage Premium Adjustment Thomas, Alexander CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
DA Totals: $4,145.67 $0.00 DA Net Totals: $4,145.67
Active Management
Plan Tier Coverage Premium Adjustment Armstrong, Matthew CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Baldwin, Nathen CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Berg, Steven CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Bohn, Donald CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Braaten, Kelly CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Buzzard, Dawn CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Cameron, Rebecca CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Dersham, Justin CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Management
Plan Tier Coverage Premium Adjustment DeVisser, Elizabeth CIS Copay H Rx9 CIS Copay Alt Care EMP + Spouse $1,559.47 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,575.31 $0.00 Net Totals $1,575.31
Dotson, Eric CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Gardner, Leornal CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Gertler, Elissa CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Gibbs, Justin CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Gingerich, Julian CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Hanthorn, Kristen CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Hendryx, Terry CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Henrikson, Gail CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Houseknecht, Krysta CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Johnson, Lori CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Plan Tier Coverage Premium Adjustment Johnson, Corey CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Keranen, Dean CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Krevanko, Tracie CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Leader, Christopher CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Marshall, Lucas CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Martin, Christopher CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Miner, Lisa CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Phillips, Matthew CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Phillips, Thomas CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Pitts, Alycia CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Pope, Anthony CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Plan Tier Coverage Premium Adjustment Quackenbush, Jill CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Schuyler, Lisa CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Shackles, Jason CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Sharpsteen, Kyle CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Steele, Monica CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Sullivan, Andrew CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Swenson, Vance CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Tandy, Heidi CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Teague, Thomas CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Thompson, Rodney CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Williams, Paul CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Plan Tier Coverage Premium Adjustment Management Totals: $71,976.25 $0.00
Management Net Totals: $71,976.25
Active Non-Union
Plan Tier Coverage Premium Adjustment Bedford, Jennifer CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Benoit, Jennifer CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Blake, Jay CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Brenden, Brett CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Hecox Jr, Thomas CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Hoover, Jason CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Hubler, Traci CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Maras, Barbara CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Munson, Jennifer CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Non-Union
Plan Tier Coverage Premium Adjustment Neelon, Michael CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Rapinchuk, Amanda CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Renwick, Andrew CIS Copay H Rx9 CIS Copay Alt Care EMP + Spouse $1,559.47 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,575.31 $0.00 Net Totals $1,575.31
Runyon, Martin CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Scott, Bruce CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Steed, Shurisa CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Stevens, Douglas CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Williams, Jocelyn CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Wright, Eldon CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Non-Union Totals: $27,189.51 $0.00 Non-Union Net
Totals: $27,189.51
Nurses
Plan Tier Coverage Premium Adjustment Bisson, Jonathan CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Campbell-Davis, Nadine CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 -$736.04 CIS Vision-A EMP + Child $13.88 -$14.59
Totals $1,302.72 -$750.63 Net Totals $552.09
Irwin, James CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Johnson, April CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Mattison, Mandy CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Maurer, Tracy CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Mazzarella-Tisch, Nancy CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $1,473.14 CIS Vision-A EMP + Spouse $15.84 $15.84
Totals $1,488.98 $1,488.98 Net Totals $2,977.96
Nurses Totals: $10,461.57 $738.35 Nurses Net Totals: $11,199.92
Active Parole/Prob.
Plan Tier Coverage Premium Adjustment Davis, Melanie CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Devereaux, Jasper CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Parole/Prob.
Plan Tier Coverage Premium Adjustment Hazel, Barry CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Johnson, Julie CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Senquiz, Heather CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Stone, Edward CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Parole/Prob. Totals: $11,755.73 $0.00 Parole/Prob. Net
Totals: $11,755.73
Active Sheriffs Union
Plan Tier Coverage Premium Adjustment Anderson, Erik CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Boyle, Madison CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Brown, Alex CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Bush, Kyle CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Corbin, Sean CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Sheriffs Union
Plan Tier Coverage Premium Adjustment Crouter, Kelsea CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Davee, Graysin CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Decker, Jeffery CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Delie, Michael CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Fox, Joseph CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Garber, Daniel CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $0.00 -$688.67 CIS Vision-A EMP Only $0.00 -$11.24
Totals $0.00 -$699.91 Net Totals -$699.91
Hansen, Nickolas CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Hanthorn, Stephanie CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Hillard, David CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Humphrey, Jeremy CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Humphries, Wesley CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Plan Tier Coverage Premium Adjustment Irwin, Joshua CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Child $1,288.84 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,302.72 $0.00 Net Totals $1,302.72
Jacober, Stephen CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Korhonen, Teresa CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Landwehr, Brendan CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Lerma, Alexander CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Libertad, Jodi CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Maki, Brenton CIS Copay H Rx9 CIS Copay Alt Care EMP + Spouse $1,559.47 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,575.31 $0.00 Net Totals $1,575.31
Massier, Jennie CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
McNabb, Ian CIS Copay H Rx9 CIS Copay Alt Care EMP Only $731.98 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $743.22 $0.00 Net Totals $743.22
Moore, Chance CIS Copay H Rx9 CIS Copay Alt Care EMP + Child $1,364.41 $0.00 CIS Vision-A EMP + Child $13.88 $0.00
Totals $1,378.29 $0.00 Net Totals $1,378.29
Navarro, Nichole CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Plan Tier Coverage Premium Adjustment Osborn, Marissa CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Padilla, Herlet CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Children $1,755.55 $0.00 CIS Vision-A EMP + Children $24.69 $0.00
Totals $1,780.24 $0.00 Net Totals $1,780.24
Rico, Nathan CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Riley, Nicole CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $1,473.14 $0.00 CIS Vision-A EMP + Spouse $15.84 $0.00
Totals $1,488.98 $0.00 Net Totals $1,488.98
Robinson, Jason CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Russell, Tyler CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $688.67 CIS Vision-A EMP Only $11.24 $11.24
Totals $699.91 $699.91 Net Totals $1,399.82
Schultz, Tami CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Shaw, Lynnette CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Spouse $0.00 -$1,473.14 CIS Vision-A EMP + Spouse $0.00 -$15.84
Totals $0.00 -$1,488.98 Net Totals -$1,488.98
Shepherd, Lance CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Shimer, Grant CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Sisley, Ryan CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Plan Tier Coverage Premium Adjustment Thompson, Daniel CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Townsend, Robert CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Turigliatto, Corey CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Watson, Robert CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Wheatley, Joshua CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Williams, Andrew CIS Copay H Rx9 CIS Copay Alt Care EMP + Family $2,096.44 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,124.91 $0.00 Net Totals $2,124.91
Wood, Devinn CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP Only $688.67 $0.00 CIS Vision-A EMP Only $11.24 $0.00
Totals $699.91 $0.00 Net Totals $699.91
Yelton, David CIS HDHP-4 W/HSA CIS HDHP Alt Care EMP + Family $2,024.88 $0.00 CIS Vision-A EMP + Family $28.47 $0.00
Totals $2,053.35 $0.00 Net Totals $2,053.35
Sheriffs Union Totals: $65,256.69 -$1,488.98
Sheriffs Union Net Totals: $63,767.71
Active Active Totals: $310,266.78 -$2,239.61
Active Net Totals: $308,027.17
Remit Payment to: Statement Totals:
CIS Trust
PO Box 6836 Portland, OR 97228-6836
Payments received after 04/10/2025 will be assessed a late fee of one-half percent (.5%)
Previous Total Due $313,906.21 Total Payments Received $313,906.21 Unpaid Balance $0.00 Total Charges $310,266.78 Adjustments -$2,239.61
Remit Payment to: Statement Totals:
of the invoice balance, or $25.00, whichever is greater.
NSF/Late Fees $0.00 Location Adjustments $0.00 Amount Due $308,027.17
File details come from the government source that posted it. Updated .