Teammate Open Enrollment 2021

CalPERS Region 1 Health Plan Rates Available for 2021 - POA

Delta Dental PPO

2021 City Contribution

Total Premium

Employee Pays per month

Medical

Medical in-lieu

$610.00

Anthem Blue Cross Select HMO Employee

$

925.60

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

60.89

$

986.49

$ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $ $

865.00

$ $ $

121.49 222.57 401.57

Employee +1

1,851.20 $ 2,406.56 $

101.37 160.01

1,952.57 $ 2,566.57 $

1,730.00 2,165.00

Family

Anthem Blue Cross Traditional HMO Employee

1,307.86 $ 2,615.72 $ 3,400.44 $ 1,120.21 $ 2,240.42 $ 2,912.55 $

60.89

1,368.75 $ 2,717.09 $ 3,560.45 $ 1,181.10 $ 2,341.79 $ 3,072.56 $

865.00

$ $ $

503.75 987.09

Employee +1

101.37 160.01

1,730.00 2,165.00 2,165.00

Family

1,395.45

HealthNet SmartCare

Employee

60.89

865.00

$ $ $

316.10 611.79 907.56

Employee +1

101.37 160.01

1,730.00 2,165.00

Family

Kaiser Permanente

Employee

$

813.64

60.89

$

874.53

865.00

$

9.53

Employee +1

1,627.28 $ 2,115.46 $

101.37 160.01

1,728.65 $ 2,275.47 $

1,730.00 2,165.00

-

Family

$

110.47

Western Health Advantage Employee

$

757.02

60.89

$

817.91

865.00

- - -

Employee +1

1,514.04 $ 1,968.25 $

101.37 160.01

1,615.41 $ 2,128.26 $

1,730.00 2,165.00

Family

PERS Care PPO

Employee

1,294.69 $ 2,589.38 $ 3,366.19 $

60.89

1,355.58 $ 2,690.75 $ 3,526.20 $

865.00

$ $ $

490.58 960.75

Employee +1

101.37 160.01

1,730.00 2,165.00

Family

1,361.20

PERS Choice PPO

Employee

$

935.84

60.89

$

996.73

865.00

$ $ $

131.73 243.05 428.19

Employee +1

1,871.68 $ 2,433.18 $

101.37 160.01

1,973.05 $ 2,593.19 $

1,730.00 2,165.00

Family

PORAC

Employee

$

799.00

$ $ $

60.89

$

859.89

$ $ $

865.00

-

Employee +1

1,725.00 $ 2,199.00 $

101.37 160.01

1,826.37 $ 2,359.01 $

1,730.00 2,165.00

$ $

96.37

Family

194.01

PERS Select PPO

Employee

$

566.67

$ $ $

60.89

$

627.56

$ $ $

865.00

- - -

Employee +1

1,133.34 $ 1,473.34 $

101.37 160.01

1,234.71 $ 1,633.35 $

1,730.00 2,165.00

Family

*Health Plans and Rates listed are for Region 1 Pricing. Employees not living in Region 1 will have different rates* Delta Dental Employee 60.89 $ EyeMed Employee

$ $ $

10.92 20.76 30.45

Employee +1

$ $

101.37 160.01

Employee +1

Family

Family