Health Premium Rates 2009-2010
Blue Shield NetValue
| Enrolled Employee & Eligible Dependents | Code | 2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
2010 Total Mo. Premium |
2010 Employee Mo. Ded. |
2010 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 0421 | $446.40 | $0.00 | $0.00 | $447.82 | $0.00 | $0.00 |
| Employee + 1 Dependent | 0422 | $892.80 | $0.00 | $0.00 | $895.64 | $0.00 | $0.00 |
| Employee + 2 or more | 0423 | $1,160.64 | $0.00 | $0.00 | $1,164.33 | $0.00 | $0.00 |
Blue Shield
| Enrolled Employee & Eligible Dependents | Code | 2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
2010 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 2051 | $505.02 | $27.02 | $22.02 | $517.09 | $24.09 | $19.09 |
| Employee + 1 Dependent | 2052 | $1,010.04 | $101.04 | $91.04 | $1,034.18 | $98.18 | $88.18 |
| Employee + 2 or more | 2053 | $1,313.05 | $146.05 | $126.05 | $1,344.43 | $142.43 | $122.43 |
Kaiser Permanente
| Enrolled Employee & Eligible Dependents | Code | 2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
2010 Total Mo. Premium |
2010 Employee Mo. Ded. |
2010 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 561 | $471.87 | $0.00 | $0.00 | $494.99 | $1.99 | $0.00 |
| Employee + 1 Dependent | 562 | $943.74 | $34.74 | $24.74 | $989.98 | $53.98 | $43.98 |
| Employee + 2 or more | 563 | $1,226.86 | $59.86 | $39.86 | $1,286.97 | $84.97 | $64.97 |
PERS-Care
| Enrolled Employee & Eligible Dependents | Code | 2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009
Unit 6 Mo. Ded. |
2010 Total Mo. Premium |
2010 Employee Mo. Ded. |
2010 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 2781 | $742.41 | $264.41 | $259.41 | $831.50 | $338.50 | $333.50 |
| Employee + 1 Dependent | 2782 | $1,484.82 | $575.82 | $565.82 | $1,663.00 | $727.00 | $717.00 |
| Employee + 2 or more | 2783 | $1,930.27 | $763.27 | $743.27 | $2,161.90 | $959.90 | $939.90 |
PERS Choice
| Enrolled Employee & Eligible Dependents | Code | 2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
2010 Total Mo. Premium |
2010 Employee Mo. Ded. |
2010 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 2221 | $477.70 | $0.00 | $0.00 | $487.25 | $0.00 | $0.00 |
| Employee + 1 Dependent | 2222 | $955.40 | $46.40 | $36.40 | $974.50 | $38.50 | $28.50 |
| Employee + 2 or more | 2223 | $1,242.02 | $75.02 | $55.02 | $1,266.85 | $64.85 | $44.85 |
PERS Select
| Enrolled Employee & Eligible Dependents | Code | 2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
2010 Total Mo. Premium |
2010 Employee Mo. Ded. |
2010 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 0451 | $448.67 | $0.00 | $0.00 | $454.87 | $0.00 | $0.00 |
| Employee + 1 Dependent | 0452 | $897.34 | $0.00 | $0.00 | $909.74 | $0.00 | $0.00 |
| Employee + 2 or more | 0453 | $1,166.54 | $0.00 | $0.00 | $1,182.66 | $0.00 | $0.00 |
PORAC †
| Enrolled Employee & Eligible Dependents | Code | 2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009 Unit 6 Mo. Ded. |
2010 Total Mo. Premium |
2010 Employee Mo. Ded. |
2010 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | 2071 | $484.00 | $6.00 | N/A | $484.00 | $0.00 | N/A |
| Employee + 1 Dependent | 2072 | $906.00 | $0.00 | N/A | $906.00 | $0.00 | N/A |
| Employee + 2 or more | 2073 | $1,151.00 | $0.00 | N/A | $1,151.00 | $0.00 | N/A |
Kaiser (Out-Of-State)
| Enrolled Employee & Eligible Dependents | Code | 2009 Total Mo. Premium |
2009 Employee Mo. Ded. |
2009
Unit 6 Mo. Ded. |
2010 Total Mo. Premium |
2010 Employee Mo. Ded. |
2010 Unit 6 Mo. Ded. |
|---|---|---|---|---|---|---|---|
| Employee Only | N/A | $660.32 | $182.32 | $177.32 | $724.69 | $231.69 | $226.69 |
| Employee + 1 Dependent | N/A | $1,320.64 | $411.64 | $401.64 | $1,449.38 | $513.38 | $503.38 |
| Employee + 2 or more | N/A | $1,716.83 | $549.83 | $529.83 | $1,884.19 | $682.19 | $662.19 |
CSU Contributions
| Enrolled Employee & Eligible Dependents | 2009 Gov't Code Section 22871 |
2009 Unit 6 |
2010 Gov't Code |
2010 Unit 6 |
|---|---|---|---|---|
| Employee Only | $478 | $483 | $493 | $498 |
| Employee +1 Dependent | $909 | $919 | $936 | $946 |
| Employee +2 or more | $1,167 | $1,187 | $1,202 | $1,222 |
†This plan is restricted to employees in Unit 8, State University Police Association (SUPA) and requires membership.