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<br /> <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 <br />Monthly <br />Premium City Pays <br />Employee <br />Pays <br />Delta Dental Employee only $ 46.70 $ 48.15 $ . <br />Basic Plan Employee + 1 $ 88.70 $ 91.45 $ - <br /> Employee + 2 or more $ 138.30 $ 142.55 $ - <br /> <br /> <br />Employee only $ 73.80 $ 48.15 $ 25.65 <br /> Employee + 1 $ 143.00 $ 91.45 $ 51.55 <br /> Employee + 2 or more $ 238.20 $ 142.55 $ 95.65 <br /> <br /> <br />Employee only $ 67.20 $ 48.15 $ 19.05 <br /> Employee + 1 $ 131.80 $ 91.45 $ 40.35 <br /> Employee + 2 or more $ 218.60 $ 142.55 $ 76.05 <br />Vision Plan Coverage Level <br />Monthly <br />Premium City Pays <br />Employee <br />Pays <br />EyeMed Low Employee only $ 5.88 $ - $ 5.88 <br />Plan Employee + 1 $ 11.12 $ - $ 11.12 <br /> Employee + 2 or more $ 16.36 $ - $ 16.36 <br /> <br /> <br />Employee only $ 11.28 $ - $ 11.28 <br />13 <br />SL Confidential EE Comp Plan 15-20 final