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<br /> <br />Blue Shield NetValue* Employee only $670.21 $610.44 $59.77 <br />HMO Employee + 1 $1,340.42 $1,220.88 $119.54 <br /> Employee + 2 or more $1,742.55 $1,587.14 $155.41 <br />Kaiser (CA) HMO Employee only $668.63 $610.44 $58.19 <br /> Employee + 1 $1,337.26 $1,220.88 $116.38 <br /> Employee + 2 or more $1,738.44 $1,587.14 $151.30 <br />PERS Choice - PPO Employee only $667.03 $610.44 $56.59 <br /> Employee + 1 $1,334.06 $1,220.88 $113.18 <br /> Employee + 2 or more $1,734.28 $1,587.14 $147.14 <br />PERSCare - PPO Employee only $1,083.11 $610.44 $472.67 <br /> Employee + 1 $2,166.22 $1,220.88 $945.34 <br /> Employee + 2 or more $2,816.09 $1,587.14 $1,228.95 <br />PERS Select – PPO** Employee only $487.20 $487.20 $0.00 <br /> Employee + 1 $974.40 $974.40 $0.00 <br /> Employee + 2 or more $1,266.72 $1,266.72 $0.00 <br />PORAC - PPO Employee only $581.00 $581.00 $0.00 <br />For members of the Police Employee + 1 $1,088.00 $1,088.00 $0.00 <br />Officers’ Research Association Employee + 2 or more $1,382.00 $1,382.00 $0.00 <br /> <br />MetLife Dental Coverage Level <br />Monthly <br />Premium City Pays <br />Employee <br />Pays <br />Basic Plan Employee only $52.96 $52.96 $0 <br /> Employee + 1 $102.14 $102.14 $0 <br /> Employee + 2 or more $160.61 $160.61 $0 <br />Buy-up Plan (Option <br />1) Employee only $27.38 $0.00 $27.38 <br /> Employee + 1 $55.23 $0.00 $55.23 <br /> Employee + 2 or more $101.63 $0.00 $101.63 <br />Buy-up Plan (Option <br />2) Employee only $23.61 $0.00 $23.61 <br /> Employee + 1 $48.55 $0.00 $48.55 <br /> Employee + 2 or more $90.50 $0.00 $90.50 <br /> <br />In January 2014 and 2015, employees and City will each pay 50% of the increase or <br />decrease in medical and dental premiums based on Kaiser and the Basic dental plan <br />(i.e. 2014 premiums minus 2013 premiums, divided by two). Rates for subsequent <br />years, determined in accordance with this agreement, will be distributed to employees <br />during each Open Enrollment period and are hereby incorporated into this Agreement <br />by reference as though fully set forth herein. <br /> <br />Employees who wish to waive enrollment in the medical and dental plans and who <br />demonstrate to the satisfaction of the City their enrollment in another medical and <br />dental plan will receive opt-out payments as follows, based on the employee’s status <br />11 <br />San Leandro Confidential Employees Compensation Plan