K9 Unit – APP. I: Health Benefits Rate

APPENDIX I

HEALTH BENEFITS RATES 

2015 medical plan costs — $51,000 and under

Plan

Self

Self +

Self +

Family

Child(ren)

Adult

Blue Shield Health Savings Plan

Employee Cost$15.78$28.40$34.56$47.17

UC Contribution

$609.00$1,096.19$1,277.46

$1,764.68

Health Net Blue & Gold

Employee Cost$33.84$60.91$126.05$153.11
UC Contribution$636.75$1,146.15$1,282.19

$1,791.59

Kaiser Permanente

Employee Cost$15.78$28.40$34.56$47.17
UC Contribution$571.08$1,027.94$1,197.85

$1,654.72

UC Care

Employee Cost$114.92$206.86$296.33$388.26
UC Contribution$636.75$1,146.15$1,282.19

$1,791.59

Western Health Advantage

Employee Cost$15.78$28.40$34.56$47.17
UC Contribution$562.03$1,011.66$1,178.85

$1,628.48

Core

Employee Cost$0.00$0.00$0.00$0.00
UC Contribution$235.87$424.57$495.33

$684.02

Rates for union-represented employees are subject to ongoing collective bargaining as appropriate.

2015 medical plan costs — $51,001–$102,000

Plan

SelfSelf +Self +Family
Child(ren)

Adult

Blue Shield Health Savings Plan

Employee Cost$51.83$93.29$116.86$158.31
UC Contribution$572.95$1,031.30$1,195.16

$1,653.54

Health Net Blue & Gold

Employee Cost$69.89$125.80$208.35$264.25
UC Contribution$600.70$1,081.26$1,199.89

$1,680.45

Kaiser Permanente

Employee Cost$51.83$93.29$116.86$158.31
UC Contribution$535.03$963.05$1,115.55

$1,543.58

UC Care

Employee Cost$150.97$271.75$378.63$499.40
UC Contribution$600.70$1,081.26$1,199.89

$1,680.45

Western Health Advantage

Employee Cost$51.83$93.29$116.86$158.31
UC Contribution$525.98$946.77$1,096.55

$1,517.34

Core

Employee Cost$0.00$0.00$0.00$0.00
UC Contribution$235.87$424.57$495.33

$684.02

Rates for union-represented employees are subject to ongoing collective bargaining as appropriate.

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