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2011 Bay Area- Rates Benefit & Level City Employee Benefit & Level City Employee 13lue Shield Access +l 5544.16 513135 PERSselect 1 5131.35 528.87 Blue Shield Access+ 2 51,088.32 5262.70 PERSselect 2 $262.70 $57.75 Blue Shield Access+ 3+ 51,386.82 5369.51 PERSselect 3+ $369.51 5103.07 Blue Shield Net Value 1 5513,25 567.99 PERScare I 5581.90 5312.05 Blue Shield Net Value 2 51,026.49 5135.99 PERScare 2 51,163.80 5624.10 Blue Shield Net Value 3+ 51,306.44 5204.78 PERScare 3+ 51,484.94 583933 Kaiser CA 1 5530.78 538.21 PERSchoice 1 $ 504.26 $ 59.14 Kaiser CA 2 51,061.55 576.43 PERSchoice 2 5 1,008.52 $ 118.28 Kaiser CA 3+ 51,352.02 $127.35 PERSchoice 3+ $ 1,283.07 $ 181.77 PORAC 1 $ 485.50 $ 41.50 PORAC 2 $ 906.50 $ 80.50 PORAC 3 $ 1,122.50 $ 131.50 2011 Other Northern CA Rates Benefit & Level City Employee Benefit & City Employee Level Blue Shield 1 5545.57 5140.10 PERSselect 1 5434.78 545.12 Blue Shield 2 51,091.15 5280.19 PERSselect 2 5869.57 590.23 Blue Shield 3+ 51,390.49 5392.25 PERSselect 3+ 51,102.43 514531 PERSchoice I $469.67 579.11 PERScare 1 5526.67 5344.09 PERSchoice 2 $939.35 5158.2I PERScare 2 $1,053.35 $688.17 PERSchoice 3+ $1,193.16 $233.67 PERScare 3 51,341.35 5922.63 Kaiser I 5526.43 547.89 PORAC 1 $443.09 541.50 Kaiser 2 51,052.87 $95.77 PORAC 2 5886.17 $80.50 Kaiser3+ 51,340.73 5152.50 PORAC 3 51,152.02 $131.50 2011 Sacramento -Rates Benefit & Level City Employee Benefit & Level City Employee Blue Shield Access +l $532.79 576.35 PERSchoice 1 5491.38 533.02 Blue Shield Access+ 2 51,066.57 5151.71 PERSchoice 2 5982.40 565.68 Blue Shield Access+ 3+ 51,358.44 522532 PERSchoice 3+ $1,277.12 $85.38 Blue Shield Net Value 1 $507.46 533.97 PERScare 1 $512.66 5318.84 Blue Shield Net Value 2 $1,014.91 567.95 PERScare 2 51,026.31 5636.69 Blue Shield Net Value 3+ 51,319.39 58833 PERScare 3+ 51,306.11 5855.79 Kaiser CA 1 $498.98 525.53 PERSselect 1 5443.09 $15.18 Kaiser CA 2 $998.95 550.07 PERSselect 2 5886.17 $30.37 Kaiser CA 3+ 51,270.54 593.19 PERSselect 3+ 51,152.02 539.48 PORAC 1 $443.09 541.50 PORAC 2 $886.17 $80.50 PORAC 3 51,152.02 $131.50 2011 Los Angeles -Rates Benefit & Level City Employee Benefit & Level City Employee Blue Shield Access +l 5532.79 576.35 PERSchoice 1 5491.38 533.02 Blue Shield Access+ 2 $1,066.57 5151.71 PERSchoice 2 5982.40 565.68 Blue Shield Access+ 3+ 51,358.44 522532 PERSchoice 3+ 51,277.12 $85.38 Blue Shield Net Value 1 5507.46 533.97 PERScare 1 5512.66 5318.84 Blue Shield Net Value 2 $1,014.91 567.95 PERScare 2 51.026.31 5636.69 Blue Shield Net Value 3+ $1,319.39 588.33 PERSeare 3+ 5 1,306.11 5855.79 Kaiser CA 1 5498.98 525.53 PERSselect 1 5443.09 $15.18 Kaiser CA 2 $998.95 550.07 PERSselect 2 $886.17 530.37 Kaiser CA 3+ $ 1,270.54 593.19 PERSselect 3+ 51,152.02 539.48 PORAC 1 $443.09 541.50 PORAC 2 5886.17 $80.50 PORAC 3 51,152.02 5131.50 18 SLPOA 11 -12 final