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Page 2 of 3 <br />Ca1PERS 2016 Health Premiums - Regional <br />Contracting Agencies - HMOs Only <br />June PHBC Final Proposed Premiums - Alternative 1 <br />a/ New health plan option for 2016 <br />b/ Medicare healthplan is not available for 2016 under the Single Carrier Proposal <br />25A -15 <br />2015 <br />® " Single I 2 -Party Family <br />Alameda, Amador, Contra Costa, Marm, Napa, Nevada, San Francisco, San <br />Sonoma Sutter, and Yuba <br />2016 1 Percent <br />I Single I 2 -Party I Family I change( +l -) <br />Joaquin, San Mateo, Santa Clara, Santa Cruz, Solano, <br />Anthem HMO Select <br />$662.41 <br />$1,324.82 <br />$1,722.27 <br />$721.79 <br />$1,44158 <br />$1,876.65 <br />8.96% <br />Anthem HMO Traditional <br />827.57 <br />1,655.14 <br />2,151.68 <br />855.42 <br />1,710.84 <br />2,224.09 <br />3.37% <br />Blue Shield Access+ <br />928.87 <br />1,857.74 <br />2,415.06 <br />1,016.18 <br />2,032.36 <br />2,642.07 <br />9.40% <br />Blue Shield NetValue <br />870.60 <br />1,741.20 <br />2,263.56 <br />1,033.86 <br />2,067.72 <br />2,688.04 <br />18.757/6 <br />Health Net SmartCare°i <br />808.44 <br />11616.88 <br />2,101.94 <br />Kaiser CA <br />714.45 <br />1,428.90 <br />1,857.57 <br />746.47 <br />1,492.94 <br />1,940.82 <br />4.48% <br />UnitedHealthcare <br />850.67 <br />1,701.34 <br />2,211.74 <br />955.44 <br />11910.88 <br />2,484.14 <br />12,32% <br />El Dorado, <br />Placer, Sacramento <br />° <br />and Yolo <br />Anthem HMO Select <br />$811.14 <br />$1,622.28 <br />$2,108.96 <br />$902.07 <br />$1,804.14 <br />$2,345.38 <br />li.m <br />Anthem HMO Traditional <br />940.16 <br />1,880.32 <br />2,444.42 <br />1,112.54 <br />2,225.08 <br />2,892.60 <br />18.34% <br />Blue Shield Access+ <br />809.22 <br />1,618.44 <br />2,103.97 <br />885.33 <br />1,770.66 <br />2,301.86 <br />9.41% <br />Blue Shield NetValue <br />758.45 <br />1,516.90 <br />1,971.97 <br />900.73 <br />1,801.46 <br />2,341.90 <br />18.76% <br />Health Net SmartCare °l <br />747.55 <br />1,495.10 <br />1,943.63 <br />Kaiser CA <br />660.96 <br />1,321.92 <br />1,718.50 <br />695.11 <br />1,390.22 <br />1,807.29 <br />6.17% <br />UnitedHealthcare 623.45 1,246.90 1,620.97 68636 1,372.72 1,784.54 10.09% <br />o OFAMENNINNEEM <br />. Los Angeles, San Bernardino, and Ventura <br />Anthem HMO Select <br />$493.40 <br />$986.80 <br />$1,282.84 <br />$543.47 <br />$1,086.94 <br />$1,413.02 <br />10.15% <br />Anthem HMO Traditional <br />631.62 <br />1,263.24 <br />1,642.21 <br />610.64 <br />1,221.28 <br />1,587.66 <br />- 3.32% <br />Blue Shield Access+ <br />517.87 <br />1,035.74 <br />1,346.46 <br />566.53 <br />1,133.06 <br />1,472.98 <br />9.40% <br />Blue Shield NetValue <br />485.41 <br />970.82 <br />1,262.07 <br />576.46 <br />1,152.92 <br />1,498.80 <br />18.76% <br />Health Net Salud y Mas <br />430,71 <br />861.42 <br />1,119.85 <br />466.11 <br />932.22 <br />1,211.89 <br />8.22% <br />Health Net SmartCare <br />568.47 <br />1,136.94 <br />1,478.02 <br />585.39 <br />1,170.78 <br />1,522.01 <br />2.98% <br />Kaiser CA <br />52118 <br />1,042.36 <br />1,355.07 <br />543.83 <br />1,087.66 <br />1,41196 <br />4.35% <br />United Healthcare 458.74 917.48 1,192.72 492.24 984,481 1,279.82 7.30% <br />e a <br />Fresno, Imperial, Inyo, Kern, Kings, Madera, Riverside, Orange. San Diego, San Luis Obispo, Santa Barbara, and Tulare <br />Anthem HMO Select <br />$653.97 <br />$1,307.94 <br />$1,700.32 <br />$634.75 <br />$1,269.50 <br />$1,650.35 <br />-2.94% <br />Anthem HMO Traditional <br />743.12 <br />1,486.24 <br />1,932.11 <br />710.79 <br />1,421.58 <br />1,848.05 <br />-4.35% <br />Blue Shield Access+ <br />596.66 <br />1,197.32 <br />1,556.52 <br />654.87 <br />1,309.74 <br />1,702.66 <br />9.39% <br />Blue Shield NetValue <br />561.09 <br />1,122.18 <br />1,458.83 <br />666.35 <br />1,332.70 <br />1,732,51 <br />18.76% <br />Health Net Salud y M6s <br />520.59 <br />1,041.18 <br />1,353.53 <br />535.98 <br />1,071.96 <br />1,393.55 <br />2.96% <br />Health Net SmartCare <br />579.88 <br />1,159.76 <br />1,507.69 <br />596.98 <br />1,193.96 <br />1,552.15 <br />2.95% <br />Kaiser CA <br />579.80 <br />1,159.60 <br />1,507.48 <br />605.05 <br />1,210.10 <br />1,573.13 <br />4.35% <br />Sharp <br />564.57 <br />1,129.14 <br />1,467,88 <br />561.34 <br />1,122.68 <br />1,459.48 <br />United Healthcare <br />449.10 <br />896.20 <br />1,167.66 <br />493.99 <br />987.98 <br />1,284.37 <br />10.00% <br />a/ New health plan option for 2016 <br />b/ Medicare healthplan is not available for 2016 under the Single Carrier Proposal <br />25A -15 <br />