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California State University, Long BeachCalifornia State University, Long Beach

Health Premium Rates 2011-2012

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Blue Shield trademarked logo Blue Shield Access+ (HMO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 2051 $601.68 $59.68 $54.68 $622.90 3.53% $56.90 $51.90
Employee + 1 Dependent 2052 $1,203.36 $173.36 $163.36 $1,245.80 3.53% $171.80 $161.80
Employee + 2 or more 2053 $1,564.37 $238.37 $218.37 $1,619.54 3.53% $237.54 $217.54

Blue Shield trademarked logo Blue Shield Access+ Advantage (HMO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 1411 $601.68 $59.68 $54.68 $622.90 3.53% $56.90 $51.90
Employee + 1 Dependent 1412 $1,203.36 $173.36 $163.36 $1,245.80 3.53% $171.80 $161.80
Employee + 2 or more 1413 $1,564.37 $238.37 $218.37 $1,619.54 3.53% $237.54 $217.54

Blue Shield trademarked logo Blue Shield NetValue (HMO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 0421 $517.72 $0.00 $0.00 $535.73 3.48% $0.00 $0.00
Employee + 1 Dependent 0422 $1,035.44 $5.44 0.00 $1,071.46 3.48% $0.00 $0.00
Employee + 2 or more 0423 $1,346.07 $20.07 $0.07 $1,392.90 3.48% $10.90 $0.00

Blue Shield trademarked logo Blue Shield NetValue Advantage (HMO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 1461 $517.72 $0.00 $0.00 $535.73 3.48% $0.00 $0.00
Employee + 1 Dependent 1462 $1,035.44 $5.44 $0.00 $1,071.46 3.48% $0.00 $0.00
Employee + 2 or more 1463 $1,346.07 $20.07 $0.07 $1,392.90 3.48% $10.90 $0.00

Kaiser Permanente trademarked logo Kaiser Permanente (HMO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 561 $522.58 $0.00 $0.00 $559.11 6.99% $0.00 $0.00
Employee + 1 Dependent 562 $1,045.16 $15.16 $5.16 $1,118.22 6.99% $44.22 $34.22
Employee + 2 or more 563 $1,358.71 $32.71 $12.71 $1,453.69 6.99% $71.69 $51.69

Anthem Blue Cross trademarked logo PERS-Care (PPO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 2781 $849.60 $307.60 $302.60 $977.98 15.11% $411.98 $406.98
Employee + 1 Dependent 2782 $1,699.20 $669.20 $659.20 $1,955.96 15.11% $881.96 $871.96
Employee + 2 or more 2783 $2,208.96 $882.96 $862.96 $2,542.75 15.11% $1,160.75 $1,140.75

Anthem Blue Cross trademarked logo PERS Choice (PPO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 2221 $535.45 $0.00 $0.00 $545.56 1.89% $0.00 $0.00
Employee + 1 Dependent 2222 $1,070.90 $40.90 $30.90 $1,091.12 1.89% $17.12 $7.12
Employee + 2 or more 2223 $1,392.17 $66.17 $46.17 $1,418.46 1.89% $36.46 $16.46

Anthem Blue Cross trademarked logo PERS Select (PPO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 0451 $468.24 $0.00 $0.00 $463.12 -1.09% $0.00 $0.00
Employee + 1 Dependent 0452 $936.48 $0.00 $0.00 $926.24 -1.09% $0.00 $0.00
Employee + 2 or more 0453 $1,217.42 $0.00 $0.00 $1,204.11 -1.09% $0.00 $0.00

PORAC (PPO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only 2071 $527.00 $0.00 N/A $556.00 5.50% $0.00 N/A
Employee + 1 Dependent 2072 $987.00 $0.00 N/A $1,041.00 5.47% $0.00 N/A
Employee + 2 or more 2073 $1,254.00 $0.00 N/A $1,323.00 5.50% $0.00 N/A

Kaiser Permanente trademarked logo Kaiser - Out of State (HMO)

Enrolled Employee & Eligible Dependents Plan 2011
Total Mo. Premium
2011
Employee Mo. Ded.
2011
Unit 6 Mo. Ded.
2012
Total Mo. Premium
2012
Total Mo. Premium Increase
2012
Employee Mo. Ded.
2012
Unit 6 Mo. Ded.
Employee Only Codes vary by region $785.28 $243.28 $238.28 $816.47 3.97% $250.47 $245.47
Employee + 1 Dependent Codes vary by region $1,570.56 $540.56 $530.56 $1,632.94 3.97% $558.94 $548.94
Employee + 2 or more Codes vary by region $2,041.73 $715.73 $695.73 $2,122.82 3.97% $740.82 $720.82

CSU CSU Contributions

Enrolled Employee & Eligible Dependents 2011
Gov't Code
Section 22871
2011
Unit 6
2012
Gov't Code
2012
Unit 6
Employee Only $542 $547 $566 $571
Employee +1 Dependent $1,030 $1,040 $1,074 $1,084
Employee +2 or more $1,326 $1,346 $1,382 $1,402

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

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