2021 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 | 262.6 |
Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 515.62 |
Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 578.72 |
Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 153.96 |
Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 388.27 |
Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 337.64 |
Aetna Direct | Z24 | Non-Postal | Advantage Self | Monthly | 125 |
Aetna Direct | Z25 | Non-Postal | Advantage Self & Family | Monthly | 331.25 |
Aetna Direct | Z26 | Non-Postal | Advantage Self Plus One | Monthly | 275 |
Aetna HealthFund CDHP and Aetna Value Plan | JS1 | Non-Postal | CDHP Self | Monthly | 486.51 |
Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 1083.94 |
Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 1158.17 |
Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Value Self | Monthly | 571.16 |
Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Value Self & Family | Monthly | 1280.59 |
Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Value Self Plus One | Monthly | 1352.91 |
Aetna Open Access | 2X1 | Non-Postal | High Self | Monthly | 413.25 |
Aetna Open Access | 2X2 | Non-Postal | High Self & Family | Monthly | 980.81 |
Aetna Open Access | 2X3 | Non-Postal | High Self Plus One | Monthly | 1034.74 |
Anthem Blue Cross Select HMO | B31 | Non-Postal | High Self | Monthly | 250.71 |
Anthem Blue Cross Select HMO | B32 | Non-Postal | High Self & Family | Monthly | 550.7 |
Anthem Blue Cross Select HMO | B33 | Non-Postal | High Self Plus One | Monthly | 520 |
Blue Shield of California Access+ HMO | SI1 | Non-Postal | Access + HMO Self | Monthly | 335.45 |
Blue Shield of California Access+ HMO | SI2 | Non-Postal | Access + HMO Self & Family | Monthly | 757.18 |
Blue Shield of California Access+ HMO | SI3 | Non-Postal | Access + HMO Self Plus One | Monthly | 768.33 |
Health Net of California | LB1 | Non-Postal | High Self | Monthly | 1027.22 |
Health Net of California | LB2 | Non-Postal | High Self & Family | Monthly | 2503.28 |
Health Net of California | LB3 | Non-Postal | High Self Plus One | Monthly | 2290.19 |
Health Net of California | LB4 | Non-Postal | Standard Self | Monthly | 942.72 |
Health Net of California | LB5 | Non-Postal | Standard Self & Family | Monthly | 2300.5 |
Health Net of California | LB6 | Non-Postal | Standard Self Plus One | Monthly | 2104.34 |
Health Net of California | LP1 | Non-Postal | High Self | Monthly | 489.56 |
Health Net of California | LP2 | Non-Postal | High Self & Family | Monthly | 1212.96 |
Health Net of California | LP3 | Non-Postal | High Self Plus One | Monthly | 1107.41 |
Health Net of California | P61 | Non-Postal | Basic Self | Monthly | 91.01 |
Health Net of California | P62 | Non-Postal | Basic Self & Family | Monthly | 218.43 |
Health Net of California | P63 | Non-Postal | Basic Self Plus One | Monthly | 200.23 |
Health Net of California | T41 | Non-Postal | Basic Self | Monthly | 370.76 |
Health Net of California | T42 | Non-Postal | Basic Self & Family | Monthly | 927.83 |
Health Net of California | T43 | Non-Postal | Basic Self Plus One | Monthly | 846.04 |
Kaiser Permanente - Fresno California | NZ1 | Non-Postal | High Self | Monthly | 279.57 |
Kaiser Permanente - Fresno California | NZ2 | Non-Postal | High Self & Family | Monthly | 637.65 |
Kaiser Permanente - Fresno California | NZ3 | Non-Postal | High Self Plus One | Monthly | 734.7 |
Kaiser Permanente - Fresno California | NZ4 | Non-Postal | Standard Self | Monthly | 147.53 |
Kaiser Permanente - Fresno California | NZ5 | Non-Postal | Standard Self & Family | Monthly | 340.97 |
Kaiser Permanente - Fresno California | NZ6 | Non-Postal | Standard Self Plus One | Monthly | 340.97 |
Kaiser Permanente - Northern California | 591 | Non-Postal | High Self | Monthly | 491.12 |
Kaiser Permanente - Northern California | 592 | Non-Postal | High Self & Family | Monthly | 1203.65 |
Kaiser Permanente - Northern California | 593 | Non-Postal | High Self Plus One | Monthly | 1300.7 |
Kaiser Permanente - Northern California | 594 | Non-Postal | Standard Self | Monthly | 299.26 |
Kaiser Permanente - Northern California | 595 | Non-Postal | Standard Self & Family | Monthly | 706.9 |
Kaiser Permanente - Northern California | 596 | Non-Postal | Standard Self Plus One | Monthly | 803.95 |
Kaiser Permanente - Northern California | KC1 | Non-Postal | Basic Self | Monthly | 163.02 |
Kaiser Permanente - Northern California | KC2 | Non-Postal | Basic Self & Family | Monthly | 381.46 |
Kaiser Permanente - Northern California | KC3 | Non-Postal | Basic Self Plus One | Monthly | 404.69 |
Kaiser Permanente - Southern California | 621 | Non-Postal | High Self | Monthly | 226.77 |
Kaiser Permanente - Southern California | 622 | Non-Postal | High Self & Family | Monthly | 515.62 |
Kaiser Permanente - Southern California | 623 | Non-Postal | High Self Plus One | Monthly | 612.67 |
Kaiser Permanente - Southern California | 624 | Non-Postal | Standard Self | Monthly | 118.36 |
Kaiser Permanente - Southern California | 625 | Non-Postal | Standard Self & Family | Monthly | 273.55 |
Kaiser Permanente - Southern California | 626 | Non-Postal | Standard Self Plus One | Monthly | 273.55 |
UnitedHealthcare Advantage Plan | Y51 | Non-Postal | High Self | Monthly | 102.93 |
UnitedHealthcare Advantage Plan | Y52 | Non-Postal | High Self & Family | Monthly | 272.77 |
UnitedHealthcare Advantage Plan | Y53 | Non-Postal | High Self Plus One | Monthly | 226.45 |