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    Healthcare Plan Information

    2018 Plan Information for California

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    State Specific Rates
    Contract Enrollment Code Employee Type Option/Enrollment Type Payment Period Employee Payment
    Health Net of California T41 Non-Postal Basic Self Monthly $290.46
    Health Net of California T42 Non-Postal Basic Self & Family Monthly $759.14
    Health Net of California T43 Non-Postal Basic Self Plus One Monthly $667.94
    Aetna Direct N61 Non-Postal CDHP Self Monthly $131.92
    Aetna Direct N62 Non-Postal CDHP Self & Family Monthly $332.67
    Aetna Direct N63 Non-Postal CDHP Self Plus One Monthly $289.29
    Aetna HealthFund CDHP and Aetna Value Plan JS1 Non-Postal CDHP Self Monthly $546.24
    Aetna HealthFund CDHP and Aetna Value Plan JS2 Non-Postal CDHP Self & Family Monthly $1247.37
    Aetna HealthFund CDHP and Aetna Value Plan JS3 Non-Postal CDHP Self Plus One Monthly $1290.12
    Aetna HealthFund CDHP and Aetna Value Plan JS4 Non-Postal Value Self Monthly $267.63
    Aetna HealthFund CDHP and Aetna Value Plan JS5 Non-Postal Value Self & Family Monthly $614.79
    Aetna HealthFund CDHP and Aetna Value Plan JS6 Non-Postal Value Self Plus One Monthly $663.78
    Aetna HealthFund HDHP 224 Non-Postal HDHP Self Monthly $151.86
    Aetna HealthFund HDHP 225 Non-Postal HDHP Self & Family Monthly $334.98
    Aetna HealthFund HDHP 226 Non-Postal HDHP Self Plus One Monthly $328.41
    Aetna Open Access 2X1 Non-Postal High Self Monthly $254.69
    Aetna Open Access 2X2 Non-Postal High Self & Family Monthly $633.90
    Aetna Open Access 2X3 Non-Postal High Self Plus One Monthly $665.58
    Anthem Blue Cross Select HMO of CA B31 Non-Postal High Self Monthly $281.67
    Anthem Blue Cross Select HMO of CA B32 Non-Postal High Self & Family Monthly $574.54
    Anthem Blue Cross Select HMO of CA B33 Non-Postal High Self Plus One Monthly $531.83
    Blue Shield of CA Access+HMO SI1 Non-Postal High Self Monthly $245.46
    Blue Shield of CA Access+HMO SI2 Non-Postal High Self & Family Monthly $576.94
    Blue Shield of CA Access+HMO SI3 Non-Postal High Self Plus One Monthly $568.97
    Health Net of California LB1 Non-Postal High Self Monthly $886.86
    Health Net of California LB2 Non-Postal High Self & Family Monthly $2190.46
    Health Net of California LB3 Non-Postal High Self Plus One Monthly $1980.03
    Health Net of California LB4 Non-Postal Standard Self Monthly $809.70
    Health Net of California LB5 Non-Postal Standard Self & Family Monthly $2005.32
    Health Net of California LB6 Non-Postal Standard Self Plus One Monthly $1810.30
    Health Net of California LP1 Non-Postal High Self Monthly $416.84
    Health Net of California LP2 Non-Postal High Self & Family Monthly $1062.40
    Health Net of California LP3 Non-Postal High Self Plus One Monthly $945.97
    Health Net of California LP4 Non-Postal Standard Self Monthly $378.84
    Health Net of California LP5 Non-Postal Standard Self & Family Monthly $971.27
    Health Net of California LP6 Non-Postal Standard Self Plus One Monthly $862.40
    Health Net of California P61 Non-Postal Basic Self Monthly $76.60
    Health Net of California P62 Non-Postal Basic Self & Family Monthly $183.85
    Health Net of California P63 Non-Postal Basic Self Plus One Monthly $168.53
    Kaiser Foundation Health Plan of California 591 Non-Postal High Self Monthly $423.78
    Kaiser Foundation Health Plan of California 592 Non-Postal High Self & Family Monthly $1067.24
    Kaiser Foundation Health Plan of California 593 Non-Postal High Self Plus One Monthly $1133.50
    Kaiser Foundation Health Plan of California 594 Non-Postal Standard Self Monthly $262.60
    Kaiser Foundation Health Plan of California 595 Non-Postal Standard Self & Family Monthly $646.71
    Kaiser Foundation Health Plan of California 596 Non-Postal Standard Self Plus One Monthly $712.97
    Kaiser Foundation Health Plan of California 621 Non-Postal High Self Monthly $164.54
    Kaiser Foundation Health Plan of California 622 Non-Postal High Self & Family Monthly $391.06
    Kaiser Foundation Health Plan of California 623 Non-Postal High Self Plus One Monthly $457.32
    Kaiser Foundation Health Plan of California 624 Non-Postal Standard Self Monthly $103.94
    Kaiser Foundation Health Plan of California 625 Non-Postal Standard Self & Family Monthly $240.26
    Kaiser Foundation Health Plan of California 626 Non-Postal Standard Self Plus One Monthly $240.26
    Kaiser Foundation Health Plan of California KC1 Non-Postal Basic Self Monthly $161.35
    Kaiser Foundation Health Plan of California KC2 Non-Postal Basic Self & Family Monthly $380.12
    Kaiser Foundation Health Plan of California KC3 Non-Postal Basic Self Plus One Monthly $446.38
    Kaiser Foundation Health Plan of California NZ1 Non-Postal High Self Monthly $217.10
    Kaiser Foundation Health Plan of California NZ2 Non-Postal High Self & Family Monthly $519.70
    Kaiser Foundation Health Plan of California NZ3 Non-Postal High Self Plus One Monthly $585.96
    Kaiser Foundation Health Plan of California NZ4 Non-Postal Standard Self Monthly $127.91
    Kaiser Foundation Health Plan of California NZ5 Non-Postal Standard Self & Family Monthly $295.62
    Kaiser Foundation Health Plan of California NZ6 Non-Postal Standard Self Plus One Monthly $295.62
    UnitedHealthcare of California CY1 Non-Postal High Self Monthly $217.42
    UnitedHealthcare of California CY2 Non-Postal High Self & Family Monthly $872.24
    UnitedHealthcare of California CY3 Non-Postal High Self Plus One Monthly $348.65
    UnitedHealthcare of California CY4 Non-Postal Standard Self Monthly $167.31
    UnitedHealthcare of California CY5 Non-Postal Standard Self & Family Monthly $731.81
    UnitedHealthcare of California CY6 Non-Postal Standard Self Plus One Monthly $324.20
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