|
Medical Plan Costs - $48,000
or Less
Plan |
Self |
Self + Child(ren) |
Self + Adult |
Self + Adult + Child(ren) |
Anthem Blue Cross PLUS |
Employee Cost |
$75.24
|
$135.43
|
$204.63
|
$264.83
|
| UC Contribution |
539.99 |
971.98 |
1,087.35 |
1,519.34 |
Anthem Blue Cross PPO |
Employee Cost |
$52.57
|
$94.63
|
$157.02
|
$199.09
|
| UC Contribution |
539.99 |
971.98 |
1,087.35 |
1,519.34 |
| Anthem Lumenos PPO with HRA |
Employee Cost |
$8.07
|
$14.53
|
$16.95
|
$23.40
|
| UC Contribution |
513.02 |
923.43 |
1,077.34 |
1,487.76 |
Core |
Employee Cost |
$0.00
|
$0.00
|
$0.00
|
$0.00
|
| UC Contribution |
98.05 |
176.49 |
205.91 |
284.35 |
| Health Net Blue & Gold |
Employee Cost |
$23.08 |
$41.55 |
$95.10 |
$113.56 |
| UC Contribution |
539.99 |
971.98 |
1,087.35 |
1,519.34 |
Health Net HMO |
Employee Cost |
$79.27
|
$142.69
|
$213.10
|
$276.52
|
| UC Contribution |
539.99 |
971.98 |
1,087.35 |
1,519.34 |
Kaiser Permanente--California |
Employee Cost |
$8.07
|
$14.53
|
$16.95
|
$23.40
|
| UC Contribution |
496.32 |
893.37 |
1,042.27 |
1,439.33 |
Kaiser Permanente--Umbrella |
Employee Cost |
$95.92
|
$172.66
|
$248.06
|
$324.80
|
| UC Contribution |
539.99 |
971.98 |
1,087.35 |
1,519.34 |
Western Health Advantage |
Employee Cost |
$8.07
|
$14.53
|
$16.95
|
$23.40
|
| UC Contribution |
505.32 |
909.57 |
1,061.17 |
1,465.43 |
Rates for union-represented employees are subject to ongoing collective bargaining as appropriate.
Medical Plan Costs - $48,001
to $96,000
Plan |
Self |
Self + Child(ren) |
Self + Adult |
Self + Adult + Child(ren) |
Anthem Blue Cross PLUS |
Employee Cost |
$111.29 |
$200.32 |
$286.93 |
$375.97 |
| UC Contribution |
503.94 |
907.09 |
1,005.05 |
1,408.20 |
Anthem Blue Cross PPO |
Employee Cost |
$88.62 |
$159.52 |
$239.32 |
$310.23 |
| UC Contribution |
503.94 |
907.09 |
1,005.05 |
1,408.20 |
| Anthem Lumenos PPO with HRA |
Employee Cost |
$44.12 |
$79.42 |
$99.25 |
$134.54 |
| UC Contribution |
476.97 |
858.54 |
995.04 |
1,376.62 |
Core |
Employee Cost |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
| UC Contribution |
98.05 |
176.49 |
205.91 |
284.35 |
| Health Net Blue & Gold |
Employee Cost |
$59.13 |
$106.44 |
$177.40 |
$224.70 |
| UC Contribution |
503.94 |
907.09 |
1,005.05 |
1,408.20 |
Health Net HMO |
Employee Cost |
$115.32 |
$207.58 |
$295.40 |
$387.66 |
| UC Contribution |
503.94 |
907.09 |
1,005.05 |
1,408.20 |
Kaiser Permanente--California |
Employee Cost |
$44.12 |
$79.42 |
$99.25 |
$134.54 |
| UC Contribution |
460.27 |
828.48 |
959.97 |
1,328.19 |
Kaiser Permanente--Umbrella |
Employee Cost |
$131.97 |
$237.55 |
$330.36 |
$435.94 |
| UC Contribution |
503.94 |
907.09 |
1,005.05 |
1,408.20 |
Western Health Advantage |
Employee Cost |
$44.12 |
$79.42 |
$99.25 |
$134.54 |
| UC Contribution |
469.27 |
844.68 |
978.87 |
1,354.29 |
Rates for union-represented employees are subject to ongoing collective bargaining as appropriate.
Medical Plan Costs - $96,001
to $144,000
Plan |
Self |
Self + Child(ren) |
Self + Adult |
Self + Adult + Child(ren) |
Anthem Blue Cross PLUS |
Employee Cost |
$148.29 |
$266.92 |
$360.69 |
$479.33 |
| UC Contribution |
466.94 |
840.49 |
931.29 |
1,304.84 |
Anthem Blue Cross PPO |
Employee Cost |
$125.62 |
$226.12 |
$313.08 |
$413.59 |
| UC Contribution |
466.94 |
840.49 |
931.29 |
1,304.84 |
| Anthem Lumenos PPO with HRA |
Employee Cost |
$81.12 |
$146.02 |
$173.01 |
$237.90 |
| UC Contribution |
439.97 |
791.94 |
921.28 |
1,273.26 |
Core |
Employee Cost |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
| UC Contribution |
98.05 |
176.49 |
205.91 |
284.35 |
| Health Net Blue & Gold |
Employee Cost |
$96.13 |
$173.04 |
$251.16 |
$328.06 |
| UC Contribution |
466.94 |
840.49 |
931.29 |
1,304.84 |
| Health Net HMO |
Employee Cost |
$152.32 |
$274.18 |
$369.16 |
$491.02 |
| UC Contribution |
466.94 |
840.49 |
931.29 |
1,304.84 |
Kaiser Permanente--California |
Employee Cost |
$81.12 |
$146.02 |
$173.01 |
$237.90 |
| UC Contribution |
423.27 |
761.88 |
886.21 |
1,224.83 |
Kaiser Permanente--Umbrella |
Employee Cost |
$168.97 |
$304.15 |
$404.12 |
$539.30 |
| UC Contribution |
466.94 |
840.49 |
931.29 |
1,304.84 |
Western Health Advantage |
Employee Cost |
$81.12 |
$146.02 |
$173.01 |
$237.90 |
| UC Contribution |
432.27 |
778.08 |
905.11 |
1,250.93 |
Rates for union-represented employees are subject to ongoing collective bargaining as appropriate.
Medical Plan Costs - $144,001
or More
Plan |
Self |
Self + Child(ren) |
Self + Adult |
Self + Adult + Child(ren) |
Anthem Blue Cross PLUS |
Employee Cost |
$186.60 |
$335.88 |
$437.11 |
$586.40 |
| UC Contribution |
428.63 |
771.53 |
854.87 |
1,197.77 |
Anthem Blue Cross PPO |
Employee Cost |
$163.93 |
$295.08 |
$389.50 |
$520.66 |
| UC Contribution |
428.63 |
771.53 |
854.87 |
1,197.77 |
| Anthem Lumenos PPO with HRA |
Employee Cost |
$119.43 |
$214.98 |
$249.43 |
$344.97 |
| UC Contribution |
401.66 |
722.98 |
844.86 |
1,166.19 |
Core |
Employee Cost |
$0.00 |
$0.00 |
$0.00 |
$0.00 |
| UC Contribution |
98.05 |
176.49 |
205.91 |
284.35 |
| Health Net Blue & Gold |
Employee Cost |
$134.44 |
$242.00 |
$327.58 |
$435.13 |
| UC Contribution |
428.63 |
771.53 |
854.87 |
1,197.77 |
Health Net HMO |
Employee Cost |
$190.63 |
$343.14 |
$445.58 |
$598.09 |
| UC Contribution |
428.63 |
771.53 |
854.87 |
1,197.77 |
Kaiser Permanente--California |
Employee Cost |
$119.43 |
$214.98 |
$249.43 |
$344.97 |
| UC Contribution |
384.96 |
692.92 |
809.79 |
1,117.76 |
Kaiser Permanente--Umbrella |
Employee Cost |
$207.28 |
$373.11 |
$480.54 |
$646.37 |
| UC Contribution |
428.63 |
771.53 |
854.87 |
1,197.77 |
Western Health Advantage |
Employee Cost |
$119.43 |
$214.98 |
$249.43 |
$344.97 |
| UC Contribution |
393.96 |
709.12 |
828.69 |
1,143.86 |
Rates for union-represented employees are subject to ongoing collective bargaining as appropriate.
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