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Effective January 1, 2016, , the City will contribute the monthly amounts including the
<br />CalPERS Medical Plan “employer minimum share” contribution, towards the election of
<br />medical and dental benefits in the plan, or the actual premiums, whichever is less:
<br />
<br />City of San Leandro
<br />Medical/Dental Premium Contributions
<br />2016 Active Employees
<br />Bay Area
<br />
<br />Medical Plan Coverage Level Monthly
<br />Premium City Pays Employee
<br />Pays
<br />Anthem Select Employee only $ 721.79 $ 674.36 $ 47.43
<br />HMO Employee + 1 $ 1,443.58 $ 1,348.72 $ 94.86
<br /> Employee + 2 or more $ 1,876.65 $ 1,763.34 $ 113.31
<br />Anthem Traditional Employee only $ 855.42 $ 674.36 $ 181.06
<br />HMO Employee + 1 $ 1,710.84 $ 1,348.72 $ 362.12
<br /> Employee + 2 or more $ 2,224.09 $ 1,763.34 $ 460.75
<br />Blue Shield Access + Employee only $ 1,016.18 $ 674.36 $ 341.82
<br />HMO Employee + 1 $ 2,032.36 $ 1,348.72 $ 683.64
<br /> Employee + 2 or more $ 2,642.07 $ 1,763.34 $ 878.73
<br />Blue Shield NetValue* Employee only $ 1,033.86 $ 674.36 $ 359.50
<br />HMO Employee + 1 $ 2,067.72 $ 1,348.72 $ 719.00
<br /> Employee + 2 or more $ 2,688.04 $ 1,763.34 $ 924.70
<br />Health Net SmartCare Employee only $ 808.44 $ 674.36 $ 134.08
<br />HMO Employee + 1 $ 1,616.88 $ 1,348.72 $ 268.16
<br /> Employee + 2 or more $ 2,101.94 $ 1,763.34 $ 338.60
<br />Kaiser (CA) Employee only $ 746.47 $ 674.36 $ 72.11
<br />HMO Employee + 1 $ 1,492.94 $ 1,348.72 $ 144.22
<br /> Employee + 2 or more $ 1,940.82 $ 1,763.34 $ 177.48
<br />United Healthcare Employee only $ 955.44 $ 674.36 $ 281.08
<br />HMO Employee + 1 $ 1,910.88 $ 1,348.72 $ 562.16
<br /> Employee + 2 or more $ 2,484.14 $ 1,763.34 $ 720.80
<br />PERS Choice Employee only $ 798.36 $ 674.36 $ 124.00
<br />PPO Employee + 1 $ 1,596.72 $ 1,348.72 $ 248.00
<br /> Employee + 2 or more $ 2,075.74 $ 1,763.34 $ 312.40
<br />PERS Select** Employee only $ 730.07 $ 674.36 $ 55.71
<br />PPO Employee + 1 $ 1,460.14 $ 1,348.72 $ 111.42
<br /> Employee + 2 or more $ 1,898.18 $ 1,763.34 $ 134.84
<br />PERSCare Employee only $ 889.27 $ 674.36 $ 214.91
<br />PPO Employee + 1 $ 1,778.54 $ 1,348.72 $ 429.82
<br /> Employee + 2 or more $ 2,312.10 $ 1,763.34 $ 548.76
<br />PORAC Employee only $ 699.00 $ 674.36 $ 24.64
<br /> Employee + 1 $ 1,399.00 $ 1,348.72 $ 50.28
<br /> Employee + 2 or more $ 1,789.00 $ 1,763.34 $ 25.66
<br />Dental Plan Coverage Level Monthly
<br />Premium City Pays Employee
<br />Pays
<br />SLPMA 2
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