Agmt 2011 SLPOA - Laserfiche WebLink

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2011 Bay Area- Rates Benefit & Level City Employee Benefit & Level City Employee Blue Shield Access +l $544.16 S131.35 PERSselect I $131.35 $28.87 Blue Shield Access+ 2 $1,088.32 $262.70 PERSselect 2 $262.70 $57.75 Blue Shield Access+ 3+ $1,386.82 $369.51 PERSselect 3+ $369.51 $103.07 Blue Shield Net Value I $513.25 $67.99 PERScare I $581.90 S3I2.05 Blue Shield Net Value 2 51.026.49 $135.99 .PERScare 2 $1,163.80 S624.10 Blue Shield Net Value 3+ $1306.44 $204.78 PERScare 3+ $1,484.94 $83933 Kaiser CA I $530.78 $38.21 PERSchoice I $ 504.26 $ 59.14 Kaiser CA 2 51.061.55 $76.43 PERSchoice 2 $ 1,008.52 $ 118.28 Kaiser CA 3+ $1352.02 SI 27.35 PERSchoice 3+ $ 1.283.07 $ 181.77 PORAC I $ 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 I $545.57 $140.10 PERSselect 1 $434.78 $45.12 Blue Shield 2 $1.091.15 $280.19 PERSselect 2 $869.57 $90.23 Blue Shield 3+ $1,390.49 $392.25 PERSselect 3+ $1,102.43 $145.31 PERSchoice I $469.67 $79.11 PERScare I $526.67 $344.09 PERSchoice 2 $939.35 $158.21 PERScare 2 $1.053.35 $688.17 PERSchoice 3+ $1.193.16 S233.67 PERScare 3 $1.341.35 $922.63 Kaiser I $526.43 $47.89 PORAC I $443.09 $41.50 Kaiser 2 $1.052.87 595.77 PORAC 2 $886.17 $80.50 Kaiser3+ $1.340.73 $152.50 I PORAC 3 $1,152.02 $131.50 2011 Sacramento -Rates Benefit & Level City Employee Benefit & Level City Employee Blue Shield Access +l $532.79 S76.35 PERSchoice I $491.38 ' $33.02 Blue Shield Access+ 2 $1.066.57 $151.71 PERSchoice 2 $982.40 $65.68 Blue Shield Access+ 3+ $1.358.44 5225.32 PERSchoice 3+ . $1.277.12 $85.38 Blue Shield Net Value I $507.46 $33.97 PERScare 1 $512.66 $318.84 Blue Shield Net Value 2 $1.014.91 $67.95 PERScare 2 $1,026.31 $636.69 Blue Shield Net Value 3+ $1,319.39 S88.33 PERScare 3+ $1,306.11 $855.79 Kaiser CA 1 $498.98 525.53 PERSselect I $443.09 515.18 Kaiser CA 2 $998.95 $50.07 PERSselect 2 $886.17 $30.37 Kaiser CA 3+ $1,270.54 $93.19 PERSselect 3+ $1.152.02 $39.48 PORAC I $443.09 $41.50 PORAC 2 $886.17 $80.50 PORAC3 41,152.02 $131.50 2011 Los Angeles -Rates Benefit & Level City Employee Benefit & Level City Employee Blue Shield Access +I $532.79 $76.35 PERSchoice I $491.38 $33.02 Blue Shield Access+ 2 $1.066.57 $151.71 PERSchoice 2 $982.40 $65.68 Blue Shield Access+ 3+ $1,358.44 $225.32 PERSchoice 3+ $1,277.12 $85.38 Blue Shield Net Value I $507.46 $33.97 PERScare I $512.66 $318.84 Blue Shield Net Value 2 $1.014.91 $67.95 PERScare 2 $1,026.31 $636.69 Blue Shield Net Value 3+ $1.319.39 588.33 PERScare 3+ $1,306.11 $855.79 Kaiser CA I $498.98 $25.53 PERSselect I $443.09 $15.18 Kaiser CA 2 S998.95 $50.07 PERSselect 2 $886.17 $30.37 Kaiser CA 3+ $1170.54 $93.19 PERSselect 3+ $1.152.02 $39.48 PORAC I 4443.09 $41.50 PORAC 2 $886.17 $80.50 I'ORAC 3 $1,152.02 $131.50 I8 SLPOA I1 -12 final