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    Healthcare Plan Information

    2019 Plan Information for California

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    State Specific Rates
    Contract Enrollment Code Employee Type Option/Enrollment Type Payment Period Employee Payment
    Aetna Direct N61 Non-Postal CDHP Self Monthly $139.33
    Aetna Direct N62 Non-Postal CDHP Self & Family Monthly $351.38
    Aetna Direct N63 Non-Postal CDHP Self Plus One Monthly $305.56
    Aetna HealthFund CDHP and Aetna Value Plan JS1 Non-Postal CDHP Self Monthly $550.32
    Aetna HealthFund CDHP and Aetna Value Plan JS2 Non-Postal CDHP Self & Family Monthly $1253.16
    Aetna HealthFund CDHP and Aetna Value Plan JS3 Non-Postal CDHP Self Plus One Monthly $1301.10
    Aetna HealthFund CDHP and Aetna Value Plan JS4 Non-Postal Value Self Monthly $305.27
    Aetna HealthFund CDHP and Aetna Value Plan JS5 Non-Postal Value Self & Family Monthly $697.22
    Aetna HealthFund CDHP and Aetna Value Plan JS6 Non-Postal Value Self Plus One Monthly $750.66
    Aetna HealthFund HDHP 224 Non-Postal HDHP Self Monthly $164.93
    Aetna HealthFund HDHP 225 Non-Postal HDHP Self & Family Monthly $363.80
    Aetna HealthFund HDHP 226 Non-Postal HDHP Self Plus One Monthly $360.10
    Aetna Open Access 2X1 Non-Postal High Self Monthly $265.20
    Aetna Open Access 2X2 Non-Postal High Self & Family Monthly $655.25
    Aetna Open Access 2X3 Non-Postal High Self Plus One Monthly $691.68
    Anthem Blue Cross Select HMO B31 Non-Postal High Self Monthly $271.57
    Anthem Blue Cross Select HMO B32 Non-Postal High Self & Family Monthly $594.99
    Anthem Blue Cross Select HMO B33 Non-Postal High Self Plus One Monthly $543.35
    Blue Shield of California Access+ HMO and TRIO HMO SI1 Non-Postal High Self Monthly $280.57
    Blue Shield of California Access+ HMO and TRIO HMO SI2 Non-Postal High Self & Family Monthly $654.21
    Blue Shield of California Access+ HMO and TRIO HMO SI3 Non-Postal High Self Plus One Monthly $647.85
    Blue Shield of California Access+ HMO and TRIO HMO SI4 Non-Postal Standard Self Monthly $206.36
    Blue Shield of California Access+ HMO and TRIO HMO SI5 Non-Postal Standard Self & Family Monthly $483.50
    Blue Shield of California Access+ HMO and TRIO HMO SI6 Non-Postal Standard Self Plus One Monthly $484.59
    Health Net of California LB1 Non-Postal High Self Monthly $862.68
    Health Net of California LB2 Non-Postal High Self & Family Monthly $2129.19
    Health Net of California LB3 Non-Postal High Self Plus One Monthly $1928.50
    Health Net of California LB4 Non-Postal Standard Self Monthly $790.69
    Health Net of California LB5 Non-Postal Standard Self & Family Monthly $1956.40
    Health Net of California LB6 Non-Postal Standard Self Plus One Monthly $1770.12
    Health Net of California LP1 Non-Postal High Self Monthly $494.33
    Health Net of California LP2 Non-Postal High Self & Family Monthly $1245.14
    Health Net of California LP3 Non-Postal High Self Plus One Monthly $1118.13
    Health Net of California LP4 Non-Postal Standard Self Monthly $446.92
    Health Net of California LP5 Non-Postal Standard Self & Family Monthly $1131.35
    Health Net of California LP6 Non-Postal Standard Self Plus One Monthly $1013.82
    Health Net of California P61 Non-Postal Basic Self Monthly $83.09
    Health Net of California P62 Non-Postal Basic Self & Family Monthly $199.42
    Health Net of California P63 Non-Postal Basic Self Plus One Monthly $182.81
    Health Net of California T41 Non-Postal Basic Self Monthly $291.57
    Health Net of California T42 Non-Postal Basic Self & Family Monthly $758.51
    Health Net of California T43 Non-Postal Basic Self Plus One Monthly $672.03
    Kaiser Foundation Health Plan of California 591 Non-Postal High Self Monthly $493.77
    Kaiser Foundation Health Plan of California 592 Non-Postal High Self & Family Monthly $1230.95
    Kaiser Foundation Health Plan of California 593 Non-Postal High Self Plus One Monthly $1302.55
    Kaiser Foundation Health Plan of California 594 Non-Postal Standard Self Monthly $298.85
    Kaiser Foundation Health Plan of California 595 Non-Postal Standard Self & Family Monthly $728.09
    Kaiser Foundation Health Plan of California 596 Non-Postal Standard Self Plus One Monthly $799.69
    Kaiser Foundation Health Plan of California 621 Non-Postal High Self Monthly $188.48
    Kaiser Foundation Health Plan of California 622 Non-Postal High Self & Family Monthly $450.06
    Kaiser Foundation Health Plan of California 623 Non-Postal High Self Plus One Monthly $521.66
    Kaiser Foundation Health Plan of California 624 Non-Postal Standard Self Monthly $107.84
    Kaiser Foundation Health Plan of California 625 Non-Postal Standard Self & Family Monthly $249.23
    Kaiser Foundation Health Plan of California 626 Non-Postal Standard Self Plus One Monthly $249.23
    Kaiser Foundation Health Plan of California KC1 Non-Postal Basic Self Monthly $160.20
    Kaiser Foundation Health Plan of California KC2 Non-Postal Basic Self & Family Monthly $374.86
    Kaiser Foundation Health Plan of California KC3 Non-Postal Basic Self Plus One Monthly $432.85
    Kaiser Foundation Health Plan of California NZ1 Non-Postal High Self Monthly $232.31
    Kaiser Foundation Health Plan of California NZ2 Non-Postal High Self & Family Monthly $551.36
    Kaiser Foundation Health Plan of California NZ3 Non-Postal High Self Plus One Monthly $622.96
    Kaiser Foundation Health Plan of California NZ4 Non-Postal Standard Self Monthly $133.67
    Kaiser Foundation Health Plan of California NZ5 Non-Postal Standard Self & Family Monthly $308.93
    Kaiser Foundation Health Plan of California NZ6 Non-Postal Standard Self Plus One Monthly $308.93
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