2017 Plan Information for California
Choose a Location, Employee Type, & Payment Period
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Location Specific Rates
Contract | Enrollment Code | Enrollment Type | Option/Enrollment Type | Payment Period | Employee Payment |
---|---|---|---|---|---|
Aetna Direct | 224 | Non-Postal | HDHP Self | Monthly | 138.7 |
Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 305.95 |
Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 299.95 |
Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 120.05 |
Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 302.77 |
Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 263.29 |
Aetna HealthFund CDHP and Aetna Value Plan | JS1 | Non-Postal | CDHP Self | Monthly | 485.2 |
Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 1106.22 |
Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 1148.2 |
Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Value Self | Monthly | 218.24 |
Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Value Self & Family | Monthly | 500.05 |
Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Value Self Plus One | Monthly | 548.01 |
Aetna Open Access | 2X1 | Non-Postal | High Self | Monthly | 198.9 |
Aetna Open Access | 2X2 | Non-Postal | High Self & Family | Monthly | 499.81 |
Aetna Open Access | 2X3 | Non-Postal | High Self Plus One | Monthly | 532.33 |
Anthem Blue Cross Select HMO | B31 | Non-Postal | High Self | Monthly | 275.66 |
Anthem Blue Cross Select HMO | B32 | Non-Postal | High Self & Family | Monthly | 541.97 |
Anthem Blue Cross Select HMO | B33 | Non-Postal | High Self Plus One | Monthly | 503.68 |
Blue Shield of California Access+ HMO | SI1 | Non-Postal | High Self | Monthly | 261.88 |
Blue Shield of California Access+ HMO | SI2 | Non-Postal | High Self & Family | Monthly | 612.39 |
Blue Shield of California Access+ HMO | SI3 | Non-Postal | High Self Plus One | Monthly | 601.92 |
Health Net of California | LB1 | Non-Postal | High Self | Monthly | 877.43 |
Health Net of California | LB2 | Non-Postal | High Self & Family | Monthly | 2163.85 |
Health Net of California | LB3 | Non-Postal | High Self Plus One | Monthly | 1956.09 |
Health Net of California | LB4 | Non-Postal | Standard Self | Monthly | 809.14 |
Health Net of California | LB5 | Non-Postal | Standard Self & Family | Monthly | 1999.97 |
Health Net of California | LB6 | Non-Postal | Standard Self Plus One | Monthly | 1805.87 |
Health Net of California | LP1 | Non-Postal | High Self | Monthly | 343.07 |
Health Net of California | LP2 | Non-Postal | High Self & Family | Monthly | 881.38 |
Health Net of California | LP3 | Non-Postal | High Self Plus One | Monthly | 780.45 |
Health Net of California | LP4 | Non-Postal | Standard Self | Monthly | 303.42 |
Health Net of California | LP5 | Non-Postal | Standard Self & Family | Monthly | 786.27 |
Health Net of California | LP6 | Non-Postal | Standard Self Plus One | Monthly | 693.29 |
Health Net of California | P61 | Non-Postal | Basic Self | Monthly | 76.58 |
Health Net of California | P62 | Non-Postal | Basic Self & Family | Monthly | 183.79 |
Health Net of California | P63 | Non-Postal | Basic Self Plus One | Monthly | 168.47 |
Kaiser Permanente - Fresno California | NZ1 | Non-Postal | High Self | Monthly | 195.86 |
Kaiser Permanente - Fresno California | NZ2 | Non-Postal | High Self & Family | Monthly | 468.09 |
Kaiser Permanente - Fresno California | NZ3 | Non-Postal | High Self Plus One | Monthly | 531.85 |
Kaiser Permanente - Fresno California | NZ4 | Non-Postal | Standard Self | Monthly | 117.45 |
Kaiser Permanente - Fresno California | NZ5 | Non-Postal | Standard Self & Family | Monthly | 271.45 |
Kaiser Permanente - Fresno California | NZ6 | Non-Postal | Standard Self Plus One | Monthly | 271.45 |
Kaiser Permanente - Northern California | 591 | Non-Postal | High Self | Monthly | 378.69 |
Kaiser Permanente - Northern California | 592 | Non-Postal | High Self & Family | Monthly | 955.81 |
Kaiser Permanente - Northern California | 593 | Non-Postal | High Self Plus One | Monthly | 1019.57 |
Kaiser Permanente - Northern California | 594 | Non-Postal | Standard Self | Monthly | 238.55 |
Kaiser Permanente - Northern California | 595 | Non-Postal | Standard Self & Family | Monthly | 587.47 |
Kaiser Permanente - Northern California | 596 | Non-Postal | Standard Self Plus One | Monthly | 651.23 |
Kaiser Permanente - Northern California | KC1 | Non-Postal | Basic Self | Monthly | 160.46 |
Kaiser Permanente - Northern California | KC2 | Non-Postal | Basic Self & Family | Monthly | 404.72 |
Kaiser Permanente - Northern California | KC3 | Non-Postal | Basic Self Plus One | Monthly | 468.48 |
Kaiser Permanente - Southern California | 621 | Non-Postal | High Self | Monthly | 157.81 |
Kaiser Permanente - Southern California | 622 | Non-Postal | High Self & Family | Monthly | 364.75 |
Kaiser Permanente - Southern California | 623 | Non-Postal | High Self Plus One | Monthly | 428.11 |
Kaiser Permanente - Southern California | 624 | Non-Postal | Standard Self | Monthly | 101.49 |
Kaiser Permanente - Southern California | 625 | Non-Postal | Standard Self & Family | Monthly | 234.56 |
Kaiser Permanente - Southern California | 626 | Non-Postal | Standard Self Plus One | Monthly | 234.56 |
UnitedHealthcare of California | CY1 | Non-Postal | High Self | Monthly | 177.77 |
UnitedHealthcare of California | CY2 | Non-Postal | High Self & Family | Monthly | 750.47 |
UnitedHealthcare of California | CY3 | Non-Postal | High Self Plus One | Monthly | 321.28 |
UnitedHealthcare of California | CY4 | Non-Postal | Standard Self | Monthly | 153.27 |
UnitedHealthcare of California | CY5 | Non-Postal | Standard Self & Family | Monthly | 624.48 |
UnitedHealthcare of California | CY6 | Non-Postal | Standard Self Plus One | Monthly | 299.35 |