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California State University, Long BeachCalifornia State University, Long Beach

Health Premium Rates 2016

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Anthem Blue Cross trademarked logo Blue Cross Select HMO California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 181 $695.77 $0.00 $0.00 $139.15
Employee + 1 181 $1,391.54 $48.54 $38.54 $278.31
Employee + 2 or more 181 $1,809.00 $82.00 $62.00 $361.80

Anthem Blue Cross trademarked logo Traditional HMO California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 180 $752.48 $47.48 $42.48 $150.50
Employee + 1 180 $1,504.96 $161.96 $151.96 $300.99
Employee + 2 or more 180 $1,956.45 $229.45 $209.45 $391.29

Anthem Blue Cross trademarked logo Blue Cross EPO California (restricted to Monterey & Del Norte Counties)

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 127 $715.70 $10.70 $5.70 $143.14
Employee + 1 127 $1,431.40 $88.40 $78.40 $286.28
Employee + 2 or more 127 $1,860.82 $133.82 $113.82 $372.16

Blue Shield trademarked logoBlue Shield Access+ California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 141 $767.45 $62.45 $57.45 $153.49
Employee + 1 141 $1,534.90 $191.90 $181.90 $306.98
Employee + 2 or more 141 $1,995.37 $268.37 $248.37 $399.07

Blue Shield trademarked logo Blue Shield Access+ EPO (restricted to Colusa, Mendocino & Sierra Counties)

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 191 $767.45 $62.45 $57.45 $153.49
Employee + 1 191 $1,534.90 $191.90 $181.90 $306.98
Employee + 2 or more 191 $1,995.37 $268.37 $248.37 $399.07

Blue Shield trademarked logo Blue Shield NetValue California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 042 $761.20 $56.20 $51.20 $152.24
Employee + 1 042 $1,552.40 $179.40 $169.40 $304.48
Employee + 2 or more 042 $1,979.12 $252.12 $232.12 $395.82

Health Net Salud Y Mas California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 184 $552.39 $0.00 $0.00 $110.48
Employee + 1 184 $1,104.48 $0.00 $0.00 $220.96
Employee + 2 or more 184 $1,436.21 $0.00 $0.00 $287.24

Health Net Smartcare California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 184 $651.23 $0.00 $0.00 $130.25
Employee + 1 184 $1,302.46 $0.00 $0.00 $260.49
Employee + 2 or more 184 $1,693.20 $0.00 $0.00 $338.64

Kaiser Permanente trademarked logo Kaiser Permanente California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 056 $661.76 $0.00 $0.00 $132.35
Employee + 1 056 $1,353.52 $0.00 $0.00 $264.70
Employee + 2 or more 056 $1,702.58 $0.00 $0.00 $344.12

Kaiser Permanente trademarked logo Kaiser Permanente - Out of State

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only Varies $930.29 $225.29 $220.29 $186.06
Employee + 1 Varies $1,860.58 $517.58 $507.58 $372.12
Employee + 2 or more Varies $2,418.75 $691.75 $671.75 $483.75

PERSCare

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 278 $801.58 $96.58 $91.58 $160.32
Employee + 1 2782 $1,603.16 $260.16 $250.16 $320.63
Employee + 2 or more 2783 $2,084.11 $357.11 $337.11 $416.82

PERS Choice

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 222 $715.70 $10.70 $5.70 $143.14
Employee + 1 222 $1,431.40 $88.40 $78.40 $286.28
Employee + 2 or more 222 $1,860.82 $133.82 $113.82 $372.16

PERS Select California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 045 $649.76 $0.00 $0.00 $129.95
Employee + 1 045 $1,299.52 $0.00 $0.00 $259.90
Employee + 2 or more 045 $1,689.38 $0.00 $0.00 $337.88

PORAC (PPO)

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 207 $699.00 $0.00 N/A N/A
Employee + 1 207 $1,399.00 $56.00 N/A N/A
Employee + 2 or more 207 $1789.00 $62.00 N/A N/A

Sharp Performance Plus California (restricted to San Diego County)

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 189 $574.73 $0.00 $0.00 $114.95
Employee + 1 189 $1,149.46 $0.00 $0.00 $229.89
Employee + 2 or more 189 $1,494.30 $0.00 $0.00 $298.86

United Healthcare Alliance HMO California

Enrolled Employee & Eligible Dependents Plan 2016
Total Mo. Premium
2016
Employee Mo. Ded.
2016
Unit 6 Mo. Ded.
2016
Unit 13 Mo. Ded.
Employee Only 187 $62.78 $0.00 $0.00 $125.16
Employee + 1 187 $1,251.56 $0.00 $0.00 $250.32
Employee + 2 or more 187 $1,627.03 $0.00 $0.00 $325.41

CSU CSU Contributions

Enrolled Employee & Eligible Dependents 2016
All Employees (except Unit 6 & 13)
2016
Unit 6 Only
2016
Unit 13 Only
Employee Only $705.00 $710.00 Varies
Employee +1 $1,343.00 $1,353.00 Varies
Employee +2 or more $1,727.00 $1,747.00 Varies

This plan is restricted to employees in Unit 8, State University Police Association (SUPA) and requires membership.

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