2022 Plan Information for California
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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 | 293.78 |
| Aetna Direct | 225 | Non-Postal | HDHP Self & Family | Monthly | 574.3 |
| Aetna Direct | 226 | Non-Postal | HDHP Self Plus One | Monthly | 645.93 |
| Aetna Direct | N61 | Non-Postal | CDHP Self | Monthly | 157.07 |
| Aetna Direct | N62 | Non-Postal | CDHP Self & Family | Monthly | 396.12 |
| Aetna Direct | N63 | Non-Postal | CDHP Self Plus One | Monthly | 344.47 |
| 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 | 506.81 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS2 | Non-Postal | CDHP Self & Family | Monthly | 1120.71 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS3 | Non-Postal | CDHP Self Plus One | Monthly | 1204.54 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS4 | Non-Postal | Value Self | Monthly | 563.98 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS5 | Non-Postal | Value Self & Family | Monthly | 1254.69 |
| Aetna HealthFund CDHP and Aetna Value Plan | JS6 | Non-Postal | Value Self Plus One | Monthly | 1337.24 |
| Aetna Open Access | 2X1 | Non-Postal | High Self | Monthly | 508.8 |
| Aetna Open Access | 2X2 | Non-Postal | High Self & Family | Monthly | 1196.09 |
| Aetna Open Access | 2X3 | Non-Postal | High Self Plus One | Monthly | 1255.52 |
| Anthem Blue Cross Select HMO | B31 | Non-Postal | High Self | Monthly | 246.7 |
| Anthem Blue Cross Select HMO | B32 | Non-Postal | High Self & Family | Monthly | 539.11 |
| Anthem Blue Cross Select HMO | B33 | Non-Postal | High Self Plus One | Monthly | 509.38 |
| Blue Shield of California Access+ HMO | SI1 | Non-Postal | Access + HMO Self | Monthly | 354.08 |
| Blue Shield of California Access+ HMO | SI2 | Non-Postal | Access + HMO Self & Family | Monthly | 790.7 |
| Blue Shield of California Access+ HMO | SI3 | Non-Postal | Access + HMO Self Plus One | Monthly | 809.49 |
| Health Net of California | LB1 | Non-Postal | High Self | Monthly | 1088.17 |
| Health Net of California | LB2 | Non-Postal | High Self & Family | Monthly | 2640.91 |
| Health Net of California | LB3 | Non-Postal | High Self Plus One | Monthly | 2424.43 |
| Health Net of California | LP1 | Non-Postal | High Self | Monthly | 546.8 |
| Health Net of California | LP2 | Non-Postal | High Self & Family | Monthly | 1341.71 |
| Health Net of California | LP3 | Non-Postal | High Self Plus One | Monthly | 1233.48 |
| Health Net of California | P61 | Non-Postal | Basic Self | Monthly | 101.42 |
| Health Net of California | P62 | Non-Postal | Basic Self & Family | Monthly | 243.43 |
| Health Net of California | P63 | Non-Postal | Basic Self Plus One | Monthly | 223.14 |
| Health Net of California | T41 | Non-Postal | Basic Self | Monthly | 422.63 |
| Health Net of California | T42 | Non-Postal | Basic Self & Family | Monthly | 1043.66 |
| Health Net of California | T43 | Non-Postal | Basic Self Plus One | Monthly | 960.24 |
| Kaiser Permanente - Fresno California | NZ1 | Non-Postal | High Self | Monthly | 282.92 |
| Kaiser Permanente - Fresno California | NZ2 | Non-Postal | High Self & Family | Monthly | 636.11 |
| Kaiser Permanente - Fresno California | NZ3 | Non-Postal | High Self Plus One | Monthly | 743.36 |
| 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 | 471.77 |
| Kaiser Permanente - Northern California | 592 | Non-Postal | High Self & Family | Monthly | 1148.64 |
| Kaiser Permanente - Northern California | 593 | Non-Postal | High Self Plus One | Monthly | 1255.89 |
| Kaiser Permanente - Northern California | 594 | Non-Postal | Standard Self | Monthly | 284.35 |
| Kaiser Permanente - Northern California | 595 | Non-Postal | Standard Self & Family | Monthly | 662.85 |
| Kaiser Permanente - Northern California | 596 | Non-Postal | Standard Self Plus One | Monthly | 770.1 |
| Kaiser Permanente - Northern California | KC1 | Non-Postal | Prosper Self | Monthly | 164.64 |
| Kaiser Permanente - Northern California | KC2 | Non-Postal | Prosper Self & Family | Monthly | 385.25 |
| Kaiser Permanente - Northern California | KC3 | Non-Postal | Prosper Self Plus One | Monthly | 404.32 |
| Kaiser Permanente - Southern California | 621 | Non-Postal | High Self | Monthly | 230.1 |
| Kaiser Permanente - Southern California | 622 | Non-Postal | High Self & Family | Monthly | 514.02 |
| Kaiser Permanente - Southern California | 623 | Non-Postal | High Self Plus One | Monthly | 621.27 |
| Kaiser Permanente - Southern California | 624 | Non-Postal | Standard Self | Monthly | 122.09 |
| Kaiser Permanente - Southern California | 625 | Non-Postal | Standard Self & Family | Monthly | 282.15 |
| Kaiser Permanente - Southern California | 626 | Non-Postal | Standard Self Plus One | Monthly | 282.15 |
| Kaiser Permanente - Southern California | FL1 | Non-Postal | Prosper Self | Monthly | 91.41 |
| Kaiser Permanente - Southern California | FL2 | Non-Postal | Prosper Self & Family | Monthly | 255.94 |
| Kaiser Permanente - Southern California | FL3 | Non-Postal | Prosper Self Plus One | Monthly | 210.24 |