Loading...
HomeMy WebLinkAbout5.a. Receive update on employee benefits for calendar year 2022 Page 1 of 10 Item 5.a. CENTRAL SAN September 20, 2021 TO: ADMINISTRATION COMMITTEE FROM: TEJI O'MALLEY, HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT MANAGER REVIEWED BY: ROGER S. BAILEY, GENERAL MANAGER SUBJECT: RECEIVE UPDATE ON EMPLOYEE BENEFITS FOR CALENDAR YEAR 2022 Please see the attached memo and Health Rates Sheets for 2021 and 2022. Strategic Plan Tie-In GOAL THREE: Fiscal Responsibility Strategy 2—Ensure integrity and transparency in financial management ATTACHMENTS: 1. Memo 2. CalPERS 2021 Regional Health Premiums 3. CalPERS 2022 Regional Health Premiums September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 32 of 46 Page 2 of 10 I Attachment 1 CENTRAL CONTRA COSTA SANITARY DISTRICT September 20, 2021 TO: ADMINISTRATION COMMITTEE VIA: ROGER S. BAILEY, GENERAL MANAGER FROM: TEJI O'MALLEY, HUMAN RESOURCES AND ORGANIZATIONAL DEVELOPMENT MANAGER SUBJECT: RECEIVE UPDATE ON EMPLOYEE BENEFITS FOR CALENDAR YEAR 2022 This memo is to provide information to the Administration Committee and Board of Directors regarding the changes to employee benefits due to the completion of benefit renewal negotiations as well as the annual changes to the CalPERS premium rates. All updated rates for Medical, Dental, and ancillary benefit coverage will go into effect on January 1, 2022. MEDICAL COVERAGE Employees and retirees are eligible to choose any plan that is offered by CalPERS; however, Central San will only pay 100 percent of the premium cost, up to the family rate, of the "core plans". Retirees contribute towards any premium costs if required based upon their tier at the time of retirement. For active employees and non-Medicare eligible retirees, the core plans are Kaiser Permanente and HealthNet SmartCare. For Medicare-eligible retirees, the core plans are Kaiser Senior Advantage and United Healthcare. If a more expensive plan is chosen, the employee or retiree is required to pay the District the difference between the highest cost core plan and the chosen plan. In July of 2021 , CalPERS adopted the final rate adjustments to be effective January 2022, as well as any other plan changes. The rate adjustments, both increases and decreases, will result in an overall average premium increase of 4.86% for all of their plans in all three regions of the state. On average, the health maintenance organization (HMO) plans will increase by an average of 4.69%, the preferred provider organization (PPO) plans will increase by an average of 8.67%, and the Medicare HMO and PPO plans will decrease by an average of 0.36%. For reference, the Bay Area region (Region 1) premiums for 2021 and 2022 are enclosed. Central San's rate adjustments may result in an overall average premium decrease of approximately 1.9% from the current premium level. The District had assumed a premium increase of 7.00% in the fiscal year (FY) 2021-22 budget for the period of January — June 2022. As a result, these improved rates may result in annual cost savings of about $328,000 compared to the budgeted amount. This cost savings is mainly driven by the decreases of the core Medicare supplemental plans as well September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 33 of 46 Page 3 of 10 Administration Committee September 20, 2021 Page 2 of 4 as the required migration of approximately 57 subscribers who will have to select other comparable and potentially cheaper plans due to the elimination of three CalPERS plans (PERS Care, PERS Choice, and PERS Select). The full extent of potential cost savings will not be known until after the end of the open enrollment period in October. The following chart shows current (up to December 31, 2021) medical monthly premium rates, the rate adjustments, and future (calendar year 2022) monthly premium rates for the core plans for active employees and retirees within the Bay Area region: Kaiser Health Net SmartCare 2022 Current Actives Current Monthly Monthly 2022 Monthly Adj. premium Premium Adj. Monthly Premium Rates Rates Rates Premium Rates Single $813.64 5.34% $857.06 $1,120.21 2.92% $1,153.00 2-Party $1,627.28 5.34% $1,714.12 $2,240.42 2.92% $2,306.00 Family $2, 115.46 5.34% $2,228.36 $2,912.55 2.92% $2,997.80 Kaiser Senior Advantage United Healthcare Current 2022 Current Monthly MonthlyMonthly 2022 Retirees premium Add' Premium Premium 'Qd�' Monthly Rates Rates Rates Premium Rates Sin le $324.48 -6.76% $302.53 $311.56 -5.43% $294.65 2-Party $648.96 -6.76% $605.06 $623.12 -5.43% $589.30 Family $973.44 -6.76% $907.59 $934.68 -5.43% $883.95 For reference, I have also included a current census of our active employees and retirees based on their plan selection in calendar year 2021 . 2% 0% 18% 6% 4% ppp— ills ■Anthem Blue Cross ■ Health Net Smart Care ■ Kaiser ■ Kaiser Senior Adv ■ PERS Care ■ PERS Choice ■ PERS Select ■ United Healthcare September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 34 of 46 Page 4 of 10 Administration Committee September 20, 2021 Page 3 of 4 ALL OTHER BENEFITS (NON-MEDICAL) Dental Coverage Dental coverage is provided through Delta Dental at no cost to the employees and their dependents, and retirees may pay a portion based upon their tier at the time of retirement. The premium rates will increase by 3.80%, resulting in an annual cost increase of approximately $32,964 The District had assumed a premium increase of 3.75% in the FY 2021-22 budget. Active Employees Retirees Current 2022 Current 2022 Monthly Adj. Monthly Monthly Adj Monthly Premium Premium Premium Rates Premium Rates Rates Rates Single $67.20 3.80% $69.80 $65.70 3.80% $68.20 Dual $118.30 3.80% $122.80 $115.40 3.80% $119.80 Family $1 ��_t 88 .00--t3.80% $195.10 $184 .20 3.80% $191.10 Vision Plan A vision plan is provided through VSP at no cost to the employees and their dependents, and retirees may pay a portion based upon their tier at the time of retirement. The premium rates reflect no rate increase. The District had assumed a premium increase of 3.75% in the FY 2021-22 budget. Active Employees Retirees Current 2022 Current 2022 Monthly Adj. Monthly Monthly Adj. Monthly Premium Premium Rates Premium Rates Premium Rates Rates Single $6.70 0% $6.70 $7.70 0% $7.70 Dual $11.60 0% $11.60 $13.60 0% $13.60 Family $17.70 0% $17.70 $15 .70 0% $15.70 Basic Life, Accidental Death & Dismemberment (AD&D) and Long-Term Disability (LTD) Coverage Basic Life, AD&D, and LTD coverage is provided through Voya at no cost to Local One and MS/CG members, as well as the Secretary of the District and the General Manager. The Management Group and Unrepresented members pay for their Long-Term Disability insurance premium. The premium rates reflect no rate increase. The District had assumed no premium increase in the FY 2021-22 budget. September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 35 of 46 Page 5 of 10 Administration Committee September 20, 2021 Page 4 of 4 Voya Basic Life Voya AD&D Voya Dependent Life Current 2022 Current 2022 Current 2022 Monthly Monthly Monthly Monthly Monthly Monthly Premium Add'* Premium Premium Add' Premium Premium Add' Premium Rate Rate Rate Rate Rate Rate $0.315 per 0% $0.315 per $0.026 per 0% $0.026 per $0.370 0% $0.370 per $1,000 $1,000 $1,000 $1,000 per unit unit *Adjustment Voya LTD Current Monthly Adj. 2022 Monthly Premium RatePremium Rate $0.287 per$100 0% $0.287 per $100 Employee Assistance Program (EAP) EAP coverage is provided through Managed Health Network (MHN) at no cost to the employees and their dependents. The premium rates reflect no rate increase. The District had assumed a premium increase of 2.0% in the FY 2021-22 budget. EAP Current Monthly Adj 2022 Monthly Premium Rate Premium Rate $3.72 0% $3.72 Open Enrollment will begin on September 20, 2021 to October 15, 2021. Staff will be available to answer any questions or provide clarification during the meeting. September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 36 of 46 Updated: August 25,2021 Attacwmeni 2 CalPERS 2021 Regional Health Premiums (Actives and Annuitants) Effective Date: January 1,2021 IS lameda,Alpine,Amador,Butte,Calaveras,Colusa,Contra Costa,Del Norte,EI Dorado,Glenn,Humboldt,Lake,Lassen,Marin,Mariposa, endocino,Merced,Modoc,Mono,Monterey,Napa,Nevada,Placer,Plumas,Sacramento,San Benito,San Francisco,San Joaquin, an Mateo,Santa Clara,Santa Cruz,Shasta,Sierra,Siskiyou,Solano,Sonoma,Stanislaus,Sutter,Tehama,Trinity,Tuolumne,Yolo,Yuba Basic Monthly Premiums(13) Plan Party Subscriber& Plan Party Subscriber& Plan Party Plan Subscriber Code Code 1 Dependent Code Code 2+Dependents Code Code Anthem Blue Cross Del Norte $935.84 504 1 $1,871.68 504 2 $2,433.18 504 3 Anthem Blue Cross Select 925.60 506 1 1,851.20 506 2 2,406.56 506 3 Anthem Blue Cross Traditional 1,307.86 509 1 2,615.72 509 2 3,400.44 509 3 Blue Shield Access+ 1,170.08 525 1 2,340.16 525 2 3,042.21 525 3 Blue Shield Access+EPO 1,170.08 524 1 2,340.16 524 2 3,042.21 524 3 Blue Shield Trio* 880.50 451 1 1,761.00 451 2 2,289.30 451 3 Health NetSmartCare 1,120.21 528 1 2,240.42 528 2 2,912.55 528 3 Kaiser Permanente 813.64 533 1 1,627.28 533 2 2,115.46 533 3 PIERS Choice 935.84 548 1 1,871.68 548 2 2,433.18 548 3 PIERS Select 566.67 557 1 1,133.34 557 2 1,473.34 557 3 PIERS Care 1,294.69 566 1 2,589.38 566 2 3,366.19 566 3 Peace Officers Research Assoc of CA 799.00 592 1 1,725.00 592 2 2,199.00 592 3 UnitedHealthcare 941.17 576 1 1,882.34 576 2 2,447.04 576 3 Western Health Advantage 757.02 591 1 1,514.04 591 2 1,968.25 591 3 �Supplement/Managed Plan Party Subscriber& Plan Party Subscriber& Plan Party Plan Subscriber Code Code 1 Dependent Code Code 2+Dependents Code Code Anthem Blue Cross Select Medicare $383.37 455 1 $766.74 455 2 $1,150.11 455 3 Preferred Anthem Blue Cross Select Medicare 383.37 459 1 766.74 459 2 1,150.11 459 3 Preferred with Dental' Anthem Blue Cross Medicare Preferred 383.37 515 1 766.74 515 2 1,150.11 515 3 Anthem Blue Cross Medicare Preferred with 383.37 512 1 766.74 512 2 1,150.11 512 3 Dental[Vision' Kaiser Permanente Senior Advantage 324.48 536 1 648.96 536 2 973.44 536 3 Kaiser Permanents Senior Advantage with 324.48 542 1 648.96 542 2 973.44 542 3 Dental' PIERS Choice Medicare Supplement 349.97 551 1 699.94 551 2 1,049.91 551 3 PIERS Select Medicare Supplement 349.97 560 1 699.94 560 2 1,049.91 560 3 PIERS Care Medicare Supplement 381.25 569 1 762.50 569 2 1,143.75 569 3 Peace Officers Research Assoc of CA 513.00 595 1 1,022.00 595 2 1,635.00 595 3 Medicare Supplement UnitedHealthcare Medicare Advantage 311.56 579 1 623.12 579 2 934.68 579 3 UnitedHealthcare Medicare Advantage with 311.56 585 1 623.12 585 2 934.68 585 3 Dental/Vision3 *Blue Shield Trio is only available in El Dorado,Nevada,Placer,Sacramento,and Yolo. 'Dental and Vision coverage is an additional$38.00 per member per month premium.You will be billed directly for this amount. 2Dental benefit is an additional$15.05 per member per month premium.You will be billed directly for this amount. 3Dental and Vision coverage is an additional$25.55 per member per month premium.You will be billed directly for this amount. 1 September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 37 of 46 Page 7 of 10 Updated: August 25,2021 CalPERS 2021 Regional Health Premiums (Actives and Annuitants) Effective Date: January 1,2021 Alameda,Alpine,Amador,Butte,Calaveras,Colusa,Contra Costa,Del Norte, El Dorado,Glenn,Humboldt,Lake,Lassen,Marin,Mariposa, Mendocino,Merced,Modoc,Mono,Monterey,Napa,Nevada,Placer,Plumas,Sacramento,San Benito,San Francisco,San Joaquin, San Mateo,Santa Clara,Santa Cruz,Shasta,Sierra,Siskiyou,Solano,Sonoma,Stanislaus,Sutter,Tehama,Trinity,Tuolumne,Yolo,Yuba Combination Monthly Premiums Subscriber in M, Subscriber in M,& Plan Party Subscriber in M,& Plan Party 1 Dependent in M,& Plan Party Plan 1 Dependent in B Code Code 2+Dependents in B Code Code 1+Dependent in B Code Code Anthem Blue Cross Del Norte and Medicare $1,285.81 505 4 $1,847.31 505 5 $1,261.44 505 6 Supplement Anthem Blue Cross Select and Medicare 1,308.97 457 4 1,864.33 457 5 1,322.10 457 6 Preferred Anthem Blue Cross Select and Medicare 1,308.97 460 4 1,864.33 460 5 1,322.10 460 6 Preferred with Dental' Anthem Blue Cross Traditional HMO and 1,691.23 518 4 2,475.95 518 5 1,551.46 518 6 Medicare Preferred Anthem Blue Cross Traditional HMO and 1,691.23 521 4 2,475.95 521 5 1,551.46 521 6 Medicare Preferred DentalNision' Kaiser Permanente and Senior Advantage 1,138.12 539 4 1,626.30 539 5 1,137.14 539 6 Kaiser Permanente Senior Advantage 1,138.12 545 4 1,626.30 545 5 1,137.14 545 6 with Dental2 PERS Choice and Medicare Supplement 1,285.81 554 4 1,847.31 554 5 1,261.44 554 6 PERS Select and Medicare Supplement 916.64 563 4 1,256.64 563 5 1,039.94 563 6 PERS Care and Medicare Supplement 1,675.94 572 4 2,452.75 572 5 1,539.31 572 6 Peace Officers Research Assoc of CA and 1,439.00 598 4 1,913.00 598 5 1,496.00 598 6 Medicare Supplement UnitedHealthcare and Medicare Advantage 1,252.73 582 4 1,817.43 582 5 1,187.82 582 6 UnitedHealthcare and Medicare Advantage 1,252.73 588 4 1,817.43 588 5 1,187.82 588 6 with Dental/Vision' �Combination Monthly Premiums(Continued) Subscriber in B, Subscriber in B,& Plan Party Subscriber in B,& Plan Party 1 Dependent in M,& Plan Party Plan 1 Dependent in M Code Code 2+Dependents in M Code Code 1+Dependent in B Code Code Anthem Blue Cross Del Norte and Medicare $1,285.81 505 7 $1,635.78 505 8 $1,847.31 505 9 Supplement Anthem Blue Cross Select and Medicare 1,308.97 457 7 1,692.34 457 8 1,864.33 457 9 Preferred Anthem Blue Cross Select and Medicare 1,308.97 460 7 1,692.34 460 8 1,864.33 460 9 Preferred with Dental' Anthem Blue Cross Traditional HMO and 1,691.23 518 7 2,074.60 518 8 2,475.95 518 9 Medicare Preferred Anthem Blue Cross Traditional HMO and 1,691.23 521 7 2,074.60 521 8 2,475.95 521 9 Medicare Preferred DentalNision' Kaiser Permanente and Senior Advantage 1,138.12 539 7 1,462.60 539 8 1,626.30 539 9 Kaiser Permanente and Senior Advantage 1,138.12 545 7 1,462.60 545 8 1,626.30 545 9 with Dental' PERS Choice and Medicare Supplement 1,285.81 554 7 1,635.78 554 8 1,847.31 554 9 PERS Select and Medicare Supplement 916.64 563 7 1,266.61 563 8 1,256.64 563 9 PERS Care and Medicare Supplement 1,675.94 572 7 2,057.19 572 8 2,452.75 572 9 Peace Officers Research Assoc of CA and 1,308.00 598 7 1,825.00 598 8 1,782.00 598 9 Medicare Supplement UnitedHealthcare and Medicare Advantage 1,252.73 582 7 1,564.29 582 8 1,817.43 582 9 UnitedHealthcare and Medicare Advantage 1,252.73 588 7 1,564.29 588 8 1,817.43 588 9 with DentalNision' 'Dental and Vision coverage is an additional$38.00 per member per month premium.You will be billed directly for this amount. 'Dental benefit is an additional$15.05 per member per month premium.You will be billed directly for this amount. 'Dental and Vision coverage is an additional$25.55 per member per month premium.You will be billed directly for this amount. 2 September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 38 of 46 Page 8 of 10 Updated: August 5,2021 Attachment 3 CalPERS 2022 Regional Health Premiums (Actives and Annuitants) Effective Date: January 1,2022 Alameda,Alpine,Amador,Butte,Calaveras,Colusa,Contra Costa,Del Norte,El Dorado,Glenn,Humboldt,Lake,Lassen,Marin,Mariposa, Mendocino,Merced,Modoc,Mono,Monterey,Napa,Nevada,Placer,Plumas,Sacramento,San Benito,San Francisco,San Joaquin, San Mateo,Santa Clara,Santa Cruz,Shasta,Sierra,Siskiyou,Solano,Sonoma,Stanislaus,Sutter,Tehama,Trinity,Tuolumne,Yolo,Yuba Plan Party Subscriber& Plan Party Subscriber& Plan Party Plan Subscriber Code Rate 1 Dependent Code Rate 2-Dependents Code Rate Anthem Blue Cross Del Norte $1,057.01 504 1 $2,114.02 504 2 $2,748.23 504 3 Anthem Blue Cross Select 1,015.81 506 1 2,031.62 506 2 2,641.11 506 3 Anthem Blue Cross Traditional 1,304.00 509 1 2,608.00 509 2 3,390.40 509 3 Blue Shield Access+ 1,116.01 525 1 2,232.02 525 2 2,901.63 525 3 Blue Shield Access+EPO 1,116.01 524 1 2,232.02 524 2 2,901.63 524 3 Blue Shield Trio* 898.54 451 1 1,797.08 451 2 2,336.20 451 3 Health Net SmartCare 1,153.00 528 1 2,306.00 528 2 2,997.80 528 3 Kaiser Permanente 857.06 533 1 1,714.12 533 2 2,228.36 533 3 PERS Gold 701.23 613 1 1,402.46 613 2 1,823.20 613 3 PERS Platinum 1,057.01 601 1 2,114.02 601 2 2,748.23 601 3 Peace Officers Research Assoc of CA 799.00 592 1 1,725.00 592 2 2,219.00 592 3 UnitedHealthcare 1,020.28 576 1 2,040.56 576 21 2,652.73 576 3 Western Health Advantage 741.26 591 1 1,482.52 591 2 1,927.28 591 3 Plan Party Subscriber& Plan Party Subscriber& Plan Party Plan Subscriber Code Rate t Dependent Code Rate 2+Dependents Code Rate Anthem Blue Cross Select Medicare $360.19 455 1 $720.38 455 2 $1,080.57 455 3 Preferred Anthem Blue Cross Select Medicare 360.19 459 1 720.38 459 2 1,080.57 459 3 Preferred with Dental' Anthem Blue Cross Medicare Preferred 360.19 515 1 720.38 515 2 1,080.57 515 3 Anthem Blue Cross Medicare Preferred with 360.19 512 1 720.38 512 2 1,080.57 512 3 Dental/Vision' Blue Shield Medicare 353.11 011 1 706.22 011 2 1,059.33 011 3 Blue Shield Medicare with Dental/Visionz 353.11 016 1 706.22 016 2 1,059.33 016 3 Kaiser Permanente Senior Advantage 302.53 5361 1 605.06 536 2 907.59 536 3 Kaiser Permanente Senior Advantage with Dental' 302.53 542 1 605.06 542 2 907.59 542 3 PERS Gold Medicare Supplement 377.41 616 1 754.82 616 2 1,132.23 616 3 PERS Platinum Medicare Supplement 381.94 605 1 763.88 605 2 1,145.82 605 3 Peace Officers Research Assoc of CA 461.00 595 1 919.00 595 2 1,471.00 595 3 Medicare Supplement UnitedHealthcare Medicare Advantage Edge 347.21 476 1 694.42 476 2 1,041.63 476 3 UnitedHealthcare Medicare Advantage 294.65 579 1 589.30 579 2 883.95 579 3 UnitedHealthcare Medicare Advantage with 294.65 585 1 589.30 585 2 883.95 585 3 Dental/Vision° Western Health Advantage Medicare 314.94 035 1 629.88 035 2 944.82 035 3 Advantage *Blue Shield Trio is only available in El Dorado,Nevada,Placer,Sacramento,Santa Cruz,Stanislaus,and Yolo(partial county served) 'Dental and Vision coverage is an additional$38.00 per member per month premium.You will be billed directly for this amount. 2Dental and Vision coverage is an additional$38.00 per member per month premium.You will be billed directly for this amount. 313ental benefit is an additional$15.05 per member per month premium.You will be billed directly for this amount. °Dental and Vision coverage is an additional$25.55 per member per month premium.You will be billed directly for this amount. 1 September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 39 of 46 Page 9 of 10 Updated: August 5,2021 CalPERS 2022 Regional Health Premiums (Actives and Annuitants) Effective Date: January 1,2022 Alameda,Alpine,Amador,Butte,Calaveras,Colusa,Contra Costa,Del Norte,El Dorado,Glenn,Humboldt,Lake,Lassen,Marin,Mariposa, Mendocino,Merced,Modoc,Mono,Monterey,Napa,Nevada,Placer,Plumas,Sacramento,San Benito,San Francisco,San Joaquin, San Mateo,Santa Clara,Santa Cruz,Shasta,Sierra,Siskiyou,Solano,Sonoma,Stanislaus,Sutter,Tehama,Trinity,Tuolumne,Yolo,Yuba Combination Monthly Premiums Subscriber in M, Subscriber in M,& Plan Party Subscriber in M,& Plan Party 1 Dependent in M,& Plan Party Plan 1 Dependent in B Code Rate 2+Dependents in B Code Rate 1+Dependent in B Code Rate Anthem Blue Cross Del Norte and Medicare $1,438.95 021 4 $2,073.16 021 5 $1,398.09 021 6 Supplement Anthem Blue Cross Select and Medicare 1,376.00 457 4 1,985.49 457 5 1,329.87 457 6 Preferred Anthem Blue Cross Select and Medicare 1,376.00 460 4 1,985.49 460 5 1,329.87 460 6 Preferred with Dental' Anthem Blue Cross Traditional HMO and 1,664.19 518 4 2,446.59 518 5 1,502.78 518 6 Medicare Preferred Anthem Blue Cross Traditional HMO and 1,664.19 521 4 2,446.59 521 5 1,502.78 521 6 Medicare Preferred Dental/Vision' Blue Shield Access+and Medicare 1,469.12 049 4 2,138.73 049 5 1,375.83 049 6 Blue Shield Access+and Medicare with 1,469.12 089 4 2,138.73 089 5 1,375.83 089 6 Dental/VisionZ Blue Shield Access+EPO and Medicare 1,469.12 092 4 2,138.73 092 5 1,375.83 092 6 Blue Shield Access+EPO and Medicare with 1,469.12 093 4 2,138.73 093 5 1,375.83 093 6 Dental/Vision3 Blue Shield Trio and Medicare 1,251.65 094 4 1,790.77 094 5 1,245.34 094 6 Blue Shield Trio and Medicare with 1,251.65 097 4 1,790.77 097 5 1,245.34 097 6 Dental/Vision° Kaiser Permanente and Senior Advantage 1,159.59 539 4 1,673.83 539 5 1,119.30 539 6 Kaiser Permanente Senior Advantage with 1,159.59 545 4 1,673.83 545 5 1,119.30 545 6 Dentals PIERS Gold and Medicare Supplement 1,078.64 619 4 1,499.38 619 5 1,175.56 619 6 PIERS Platinum and Medicare Supplement 1,438.95 609 4 2,073.16 609 5 1,398.09 609 6 Peace Officers Research Assoc of CA and 1,439.00 598 4 1,913.00 598 5 1,496.00 598 6 Medicare Supplement UnitedHealthcare and Medicare Advantage 1,367.49 627 4 1,979.66 627 5 1,306.59 627 6 Edge UnitedHealthcare and Medicare Advantage 1,314.93 582 4 1,927.10 582 5 1,201.47 582 6 UnitedHealthcare and Medicare Advantage 1,314.93 588 4 1,927.10 588 5 1,201.47 588 6 with Dental[Visionb Western Health Advantage and Medicare Advantage 1,056.20 036 4 1,500.96 036 5 1,074.64 036 6 Combination Monthly Premiums(Continued) Subscriber in B, Subscriber in B,& Plan Party Subscriber in B,& Plan Party 1 Dependent in M,& Plan Party Plan 1 Dependent in M Code Rate 2+Dependents in M Code Rate 1+Dependent in B Code Rate Anthem Blue Cross Del Norte and Medicare $1,438.95 021 7 $1,820.89 021 8 $2,073.16 021 9 Supplement Anthem Blue Cross Select and Medicare 1,376.00 457 7 1,736.19 457 8 1,985.49 457 9 Preferred Anthem Blue Cross Select and Medicare 1,376.00 460 7 1,736.19 460 8 1,985.49 460 9 Preferred with Dental' Anthem Blue Cross Traditional HMO and 1,664.19 518 7 2,024.38 518 8 2,446.59 518 9 Medicare Preferred Anthem Blue Cross Traditional HMO and 1,664.19 521 7 2,024.38 521 8 2,446.59 521 9 Medicare Preferred Dental/Vision' Blue Shield Access+and Medicare 1,469.12 049 7 1,822.23 049 8 2,138.73 049 9 Blue Shield Access+and Medicare with 1,469.12 089 7 1,822.23 089 8 2,138.73 089 9 Dental/Vision' 2 September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 40 of 46 Page 10 of 10 Updated: August 5,2021 CalPERS 2022 Regional Health Premiums (Actives and Annuitants) Effective Date: January 1,2022 Alameda,Alpine,Amador,Butte,Calaveras,Colusa,Contra Costa,Del Norte,El Dorado,Glenn,Humboldt,Lake,Lassen,Marin,Mariposa, Mendocino,Merced,Modoc,Mono,Monterey,Napa,Nevada,Placer,Plumas,Sacramento,San Benito,San Francisco,San Joaquin, San Mateo,Santa Clara,Santa Cruz,Shasta,Sierra,Siskiyou,Solano,Sonoma,Stanislaus,Sutter,Tehama,Trinity,Tuolumne,Yolo,Yuba tio Subscriber in B, Subscriber in B,& Plan Party Subscriber in B,& Plan Party 1 Dependent in M,& Plan Party Plan 1 Dependent in M Code Rate 2+Dependents in M Code Rate 1+Dependent in B Code Rate Blue Shield Access+EPO and Medicare $1,469.12 092 7 $1,822.23 092 8 $2,138.73 092 9 Blue Shield Access+EPO and Medicare with 1,469.12 093 7 1,822.23 093 8 2,138.73 093 9 Dental/Vision' Blue Shield Trio and Medicare 1,251.65 094 7 1,604.76 094 8 1,790.77 094 9 Blue Shield Trio and Medicare with Dental/Vision4 1,251.65 097 7 1,604.76 097 8 1,790.77 097 9 Kaiser Permanente and Senior Advantage 1,159.59 539 7 1,462.12 539 8 1,673.83 539 9 Kaiser Permanente and Senior Advantage 1,159.59 545 7 1,462.12 545 8 1,673.83 545 9 with Dentals PIERS Gold and Medicare Supplement 1,078.64 619 7 1,456.05 619 8 1,499.38 619 9 PIERS Platinum and Medicare Supplement 1,438.95 609 7 1,820.89 609 8 2,073.16 609 9 Peace Officers Research Assoc of CA and 1,308.00 598 7 1,825.00 598 8 1,782.00 598 9 Medicare Supplement UnitedHealthcare and Medicare Advantage Edge 1,367.49 627 7 1,714.70 627 8 1,979.66 627 9 UnitedHealthcare and Medicare Advantage 1,314.93 582 7 1,609.58 582 8 1,927.10 582 9 UnitedHealthcare and Medicare Advantage 1,314.93 588 7 1,609.58 588 8 1,927.10 588 9 with Dental/Vision Western Health Advantage and Medicare 1,056.20 036 7 1,371.14 036 8 1,500.96 036 9 Advantage 'Dental and Vision coverage is an additional$38.00 per member per month premium.You will be billed directly for this amount. 2Dental and Vision coverage is an additional$38.00 per member per month premium.You will be billed directly for this amount. 'Dental and Vision coverage is an additional$38.00 per member per month premium.You will be billed directly for this amount. °Dental and Vision coverage is an additional$38.00 per member per month premium.You will be billed directly for this amount. 'Dental benefit is an additional$15.05 per member per month premium.You will be billed directly for this amount. 'Dental and Vision coverage is an additional$25.55 per member per month premium.You will be billed directly for this amount. 3 September 20, 2021 Special ADMIN Committee Meeting Agenda Packet- Page 41 of 46