Health Premium Rates 2008-2009
Blue Shield NetValue
| Enrolled Employee & Eligible Dependents | Code | 2008 Total Mo. Premium |
2008 Employee Mo. Ded. |
2008 Unit 6 Mo. Ded. |
2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 0421 | $430.25 | $0.00 | $0.00 | $446.40 | $0.00 | $0.00 |
| Employee + 1 Dependent | 0422 | $860.50 | $0.00 | $0.00 | $892.80 | $0.00 | $0.00 |
| Employee + 2 or more | 0423 | $1,118.65 | $0.00 | $0.00 | $1,160.64 | $0.00 | $0.00 |
Blue Shield HMO
| Enrolled Employee & Eligible Dependents | Code | 2008 Total Mo. Premium |
2008 Employee Mo. Ded. |
2008
Unit 6 Mo. Ded. |
2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 2051 | $479.47 | $8.47 | $3.47 | $505.02 | $27.02 | $22.02 |
| Employee + 1 Dependent | 2052 | $958.94 | $72.94 | $62.94 | $1,010.04 | $101.04 | $91.04 |
| Employee + 2 or more | 2053 | $1,246.62 | $117.62 | $97.62 | $1,313.05 | $146.05 | $126.05 |
Kaiser Permanente
| Enrolled Employee & Eligible Dependents | Code | 2008 Total Mo. Premium |
2008 Employee Mo. Ded. |
2008
Unit 6 Mo. Ded. |
2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 561 | $436.25 | $0.00 | $0.00 | $471.87 | $0.00 | $0.00 |
| Employee + 1 Dependent | 562 | $872.50 | $0.00 | $0.00 | $943.74 | $34.74 | $24.74 |
| Employee + 2 or more | 563 | $1,134.25 | $5.25 | $0.00 | $1,226.86 | $59.86 | $39.86 |
PERS-Care
| Enrolled Employee & Eligible Dependents | Code | 2008 Total Mo. Premium |
2008 Employee Mo. Ded. |
2008
Unit 6 Mo. Ded. |
2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 2781 | $742.41 | $271.41 | $266.41 | $742.41 | $264.41 | $259.41 |
| Employee + 1 Dependent | 2782 | $1,484.82 | $598.82 | $588.82 | $1,484.82 | $575.82 | $565.82 |
| Employee + 2 or more | 2783 | $1,930.27 | $801.27 | $781.27 | $1,930.27 | $763.27 | $743.27 |
PERS Choice
| Enrolled Employee & Eligible Dependents | Code | 2008 Total Mo. Premium |
2008 Employee Mo. Ded. |
2008
Unit 6 Mo. Ded. |
2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 2221 | $477.70 | $6.70 | $1.70 | $477.70 | $0.00 | $0.00 |
| Employee + 1 Dependent | 2222 | $955.40 | $69.40 | $59.40 | $955.40 | $46.40 | $36.40 |
| Employee + 2 or more | 2223 | $1,242.02 | $113.02 | $93.02 | $1,242.02 | $75.02 | $55.02 |
PERS Select
| Enrolled Employee & Eligible Dependents | Code | 2008 Total Mo. Premium |
2008 Employee Mo. Ded. |
2008
Unit 6 Mo. Ded. |
2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 0451 | $462.55 | $0.00 | $0.00 | $448.67 | $0.00 | $0.00 |
| Employee + 1 Dependent | 0452 | $925.10 | $39.10 | $29.10 | $897.34 | $0.00 | $0.00 |
| Employee + 2 or more | 0453 | $1,076.00 | $73.63 | $53.63 | $1,166.54 | $0.00 | $0.00 |
PORAC †
| Enrolled Employee & Eligible Dependents | Code | 2008 Total Mo. Premium |
2008 Employee Mo. Ded. |
2008
Unit 6 Mo. Ded. |
2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 2071 | $452.00 | $0.00 | N/A | $484.00 | $6.00 | N/A |
| Employee + 1 Dependent | 2071 | $847.00 | $0.00 | N/A | $906.00 | $0.00 | N/A |
| Employee + 2 or more | 2071 | $1,076.00 | $0.00 | N/A | $1,151.00 | $0.00 | N/A |
Kaiser (Out-Of-State)
| Enrolled Employee & Eligible Dependents | Code | 2008 Total Mo. Premium |
2008 Employee Mo. Ded. |
2008
Unit 6 Mo. Ded. |
2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | N/A | $625.52 | $154.52 | $149.52 | $660.32 | $182.32 | $177.32 |
| Employee + 1 Dependent | N/A | $1,251.04 | $365.04 | $355.04 | $1,320.64 | $411.64 | $401.64 |
| Employee + 2 or more | N/A | $1,626.35 | $497.35 | $477.35 | $1,716.83 | $549.83 | $529.83 |
CSU Contributions
| Enrolled Employee & Eligible Dependents | 2008 Gov't Code |
2008 Unit 6 |
2009 Gov't Code |
2009 Unit 6 |
|---|---|---|---|---|
| Employee Only | $471.00 | $476.00 | $478 | $483 |
| Employee +1 Dependent | $886.00 | $896.00 | $909 | $919 |
| Employee +2 or more | $1,129.00 | $1,149.00 | $1,167 | $1,187 |
†This plan is restricted to employees in Unit 8, State University Police Association (SUPA) and requires membership.