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Item 18.a.
LCENTRAL SAN
September 21, 2023
FROM: ROGER S. BAILEY, GENERAL MANAGER
SUBJECT: ANNOUNCEMENTS - SEPTEMBER 21, 2023
Attached are the announcements for the above meeting.
ATTACHMENTS:
1. General Manager Written Announcements
2. Health Rates 2023
3. Health Rates 2024
September 21, 2023 Special Board Meeting Agenda Packet - Page 148 of 174
Page 2 of 13
Attachment 1
Board Meeting of September 21, 2023
General Manager Written Announcements
EMPLOYEE APPRECIATION
1) Reminder: Annual Employee Appreciation Celebration Scheduled for
October 18, 2023
The Annual Employee Appreciation Event will be held on Wednesday, October 18 from
11:00 a.m. to 2:00 p.m. in "Flushing Meadow" (the garden/lawn area next to the
Household Hazardous Waste Collection Facility). Central San will be serving lunch,
dessert, and cold drinks. The event will also include the Innovation Fair to showcase
employee optimizations and innovations. There will also be an employee car show.
Board Members, current employees, temporary employees, summer students, and interns
are all invited to attend. The event is not open to family members or retirees.
2)
OUT-OF-STATE CONFERENCE TRAVEL
Staff to Attend Water Environment Federation Technical Exhibition and
Conference in Chicago, Illinois — September 30—October 4
The 96th Annual Water Environmental Federation Technical Exhibition and Conference
(WEFTEC) will take place in Chicago, Illinois from Saturday, September 30, 2023 through
Wednesday, October 4, 2023.
Associate Engineer Amanda Cauble and Senior Engineer Craig Mizutani will join those
employees previously announced as attending the conference. WEFTEC is the premier
water quality conference which shares current industry information about leading trends in
scientific and technology development. The conference provides attendees with the
opportunity to participate in workshops, technical sessions, facility tours, and exhibit
viewing.
Staff attendance at this conference is included in the Fiscal Year 2023-24 Technical
Training, Conference and Meetings Budget.
3) Staff to attend the 37th International Maintenance Conference (IMC -2023) on
December 4-7, 2023, in Marco Island, Florida
The IMC -2023 is a premier industry conference with reliability and asset management
professionals from the world's best -run companies. IMC -2023 allows attendees to learn
about the latest in technology such as artificial intelligence, machine learning, and the
September 21, 2023 Special Board Meeting Agenda Packet - Page 149 of 174
Page 3 of 13
Written Announcements
September 21, 2023
Page 2 of 6
best practices for reliability and asset management. The conference forums include
Strategic Asset Management; Asset Lifecycle Management; Reliability Leadership;
Maintenance, Repair, & Operations Spare Parts Management; and Work Execution
Management / Maintenance Engineering.
Neil Meyer, Jon Nicolaus. Matthew Mahoney, and Nitin Goel will speak at the conference.
Central San will use seven complimentary registrations for the event: four for speakers
and three for members of the Reliability Leadership Institute community.
Operations Department attendees are:
Neil Meyer — Plant Maintenance Division Manager
Nitin Goel — Operations Optimization Manager
Jon Nicolaus — Superintendent — Operations and Maintenance
Matthew Mahoney — Mechanical Shop Maintenance Supervisor
Sean Sullivan — Electrical Shop Supervisor
Steve Borelli — Instrumentation Shop Supervisor
Joey Gois — Maintenance Technician I
Staff participation at this conference is included in the Fiscal Year 2023-24 Technical
Training, Conferences, and Meetings budget.
EMPLOYEE BENEFITS UPDATE FOR CALENDAR YEAR 2024
4) Information regarding the chancres to employee benefits due to the
completion of benefit renewal negotiations and annual chancres to the
CaIPERS premium rates
All updated rates for Medical, Dental, and ancillary benefit coverage will go into effect
on January 1, 2024.
MEDICAL COVERAGE
Employees, Board Members, and retirees are eligible to choose any plan that is offered
by CaIPERS; however, Central San will only pay 100% 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 Anthem Blue Cross Traditional HMO. 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 2023, CalPERS adopted the final rate adjustments to be effective January
2024, as well as any other plan changes. The rate adjustments, both increases and
decreases, will result in an overall average premium increase of 10.77% for all plans.
September 21, 2023 Special Board Meeting Agenda Packet - Page 150 of 174
Page 4 of 13
Written Announcements
September 21, 2023
Page 3 of 6
The health maintenance organization (HMO) plans will increase by an average of
10.50%, the preferred provider organization (PPO) plans will increase by an average of
12.17%, and the Medicare supplemental plans will increase by an average of 9.55%.
For reference, the Bay Area region (Region 1) premiums for 2023 and 2024 are
enclosed as Attachments 2 and 3. For any retirees that live in a geographical area outside
of Region 1, they may pick a plan available in that region, but the District will only pay
100% of the premium cost of the highest cost core plan in Region 1.
Central San's rate adjustments will result in an overall average premium increase of
approximately 9% resulting in an annual cost increase of $869,491. During FY 2023-
24, only 6 months of these higher rates will be in effect, so the cost impact on January -
July 2024 is $434,745 compared to the 2023 rates now in effect. The District assumed a
premium increase of 6.5% in the second half of FY 2023-24, which would have resulted
in $313,851 of additional cost over the six-month period from January -June 2024.
However, the actual variance will vary dependent on staff turnover or active
employees/retirees switching plans during open enrollment this fall.
The following chart shows current (up to December 31, 2023) medical monthly
premium rates, the rate adjustments, and future (calendar year 2024) monthly premium
rates for the core plans for active employees and retirees within the Bay Area region:
September 21, 2023 Special Board Meeting Agenda Packet - Page 151 of 174
Kaiser
Anthem Blue Cross Traditional HMO
Actives
Current
Monthly
Premium
Rates
Adj.
2024
Monthly
Premium
Rates
Current
Monthly
Premium
Rates
Adj.
2024
Monthly
Premium
Rates
Single
$913.74
11.78%
$1,021.41
$1,210.71
10.65%
$1,339.70
Dual
$1,827.48
11.78%
$2,042.82
$2,421.42
10.65%
$2,679.40
Family
$2,375.72
11.78%
$2,655.87
$3,147.85
10.65%
$3,483.22
September 21, 2023 Special Board Meeting Agenda Packet - Page 151 of 174
Kaiser Senior Advanta a
United Healthcare
Retirees
Current
Monthly
Premium
Rates
Adj.
2024
Monthly
Premium
Rates
Current
Monthly
Premium
Rates
Adj.
2024
Monthly
Premium
Rates
Single
$283.25
14.67%
$324.79
$299.68
14.03%
$341.72
Dual
$566.50
14.67%
$649.58
$599.36
14.03%
$683.44
Family
$849.75
14.67%
$974.37
$899.04
14.03%
$1,025.16
September 21, 2023 Special Board Meeting Agenda Packet - Page 151 of 174
Page 5 of 13
Written Announcements
September 21, 2023
Page 4 of 6
For reference, also included is a current census of Central San active employees and
retirees based on their plan selection in calendar year 2023.
Employed: PEF
Gold/Platinum,
4%
Healthcare Plan Census:
271 Active Employees
Employed:
27%
ALL OTHER BENEFITS (NON-MEDICAL)
Dental Coverage
Retired:
Anthem/Bluecros Healthcare Plan Census:
Medicare, 3, 2% 268 Retirees Retired:
Anthem/Bluer,.
4,2%
Retired: Healthnet
Smartcare, 9, S%
Retired:
UrRetired: Kaiser, 29,
United Healthcare
17%
Medicare, 66,40%-
qF r
6,40%
Retired: PERS
Gold/Platinum, 16,
Retired: PERS 10%
Medicare
Supplement, 40,
24%
Dental coverage is provided through Delta Dental at no cost to the employees. Board
Members, and their dependents, and retirees may pay a portion based upon their tier
at the time of retirement. The premium rates will decrease by 3.30%, resulting in an
annual cost savings of approximately $18,827. The District assumed a premium
increase of 3.80% in the
FY 2023-24 budget.
The District is a part of PRISM, a Joint Powers Authority (JPA), and we currently
purchase our Delta Dental insurance through them. As part of that participation, the
District is eligible to receive dividends. These dividends are as a result of surplus for
those participants that participate in the self-funded dental insurance, and to date we
have received a total of $224,471.40 from the surplus fund for calendar year 2021 and
2022. It is unknown at this time if we will be eligible for further dividends but will provide
that information to the Board every year as part of the benefits renewal process.
September 21, 2023 Special Board Meeting Agenda Packet - Page 152 of 174
Active Employees
Retirees
Current
2024
Current
2024
Monthly
Ad.
Monthly
Monthly
Ad.
Monthly
Premium
Premium
Premium
Premium
Rates
Rates
Rates
Rates
Single
$69.00
-3.30%
$66.70
$67.40
-3.30%
$65.20
Dual
$121.40
-3.30%
$117.40
$118.40
-3.30%
$114.50
Family
$192.80
-3.30%
$186.40
$188.90
-3.30%
$182.60
September 21, 2023 Special Board Meeting Agenda Packet - Page 152 of 174
Page 6 of 13
Written Announcements
September 21, 2023
Page 5of6
Vision Plan
A vision plan is provided through VSP at no cost to the employees, Board Members,
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 assumed no
premium increase in the FY 2023-24 budget.
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, Unrepresented employees, and Board Members
also receive Basic Life and AD&D coverage at no cost. M a n a g e m e n t a n d
Unrepresented employees pay for their Long -Term Disability insurance premium.
The premium rates reflect no changes to Life, AD&D, and Dependent Life insurance and
a 3.8% reduction to Long -Term Disability rates. The District had assumed no premium
increase in the FY 2023-24 budget.
Voya Basic Life
Active Employees
Retirees
Current
Current
2024
2024
Current
2024
2024
Monthly
Add
Monthly
Monthly
Adj.Monthly
Monthly
Premium
Premium
PremiumPremium
Add'
Premium
Premium
Rates
Premium
Rates
Rates
Premium
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, Unrepresented employees, and Board Members
also receive Basic Life and AD&D coverage at no cost. M a n a g e m e n t a n d
Unrepresented employees pay for their Long -Term Disability insurance premium.
The premium rates reflect no changes to Life, AD&D, and Dependent Life insurance and
a 3.8% reduction to Long -Term Disability rates. The District had assumed no premium
increase in the FY 2023-24 budget.
Voya Basic Life
Voya AD&D
Voya Dependent Life
Current
Premium RatePremium
2024
Current
$0.287 per $100
2024
Current
2024
Monthly
Monthly
Monthly
Monthly
Monthly
Monthly
Premium
Add'
Premium
Premium
Add'
Premium
Premium
Add'
Premium
Rate
Rate
Rate
Rate
Rate
Rate
$0.315 per
$0.315 per
$0.026 per
$0.026 per
$0.370
$0.370
$1,000
°
0 �°
$1,000
$1,000
0°�°
$1,000
per unit
°
0 �°
per unit
Voya LTD
Current Monthly
Adj.2024
Monthly
Premium RatePremium
Rate
$0.287 per $100
-3.80%
$0.276 per $100
September 21, 2023 Special Board Meeting Agenda Packet - Page 153 of 174
Page 7 of 13
Written Announcements
September 21, 2023
Page 6 of 6
Employee Assistance Program (EAP)
EAP coverage (mental health services, legal assistance/consultation, financial coaching,
dependent care resources, etc.) is provided through Concern at no cost to the
employees and their dependents. The premium rates reflect no rate increase. The
District had assumed no premium increase in the FY 2023-24 budget.
EAP
Current Monthly
2024 Monthly
Premium Rate
Add
Premium Rate
$3.72
0%
$3.72
Open Enrollment began on September 18, 2023 and will end on October 13, 2023.
September 21, 2023 Special Board Meeting Agenda Packet - Page 154 of 174
Updated: September 30, 2022
Attachment 2
CalPERS 2023 Regional Health Premiums (Actives and Annuitants)
Effective Date: January 1, 2023
*For health plan availability by county, please refer to the 2023 Health Benefit Summary or myCalPERS.
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.
3Dental benefit is an additional $15.35 per member per month premium. You will be billed directly for this amount.
4Dental and Vision coverage is an additional $26.03 per member per month premium. You will be billed directly for this amount.
76tmeda', Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, EI Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Mariposa,
docio, 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
Subscriber
Plan
Code
Party
Code
Party
Rate
Subscriber &
1 Dependent
Plan
Code
Party
Code
Party
Rate
Subscriber &
2+ Dependents
Plan
Code
Party
Code
Party
Rate
Anthem Blue Cross Del Norte EPO
$1,200.12
504
1
1
$2,400.24
504
2
2
$3,120.31
504
3
3
Anthem Blue Cross Select HMO
1,128.83
506
1
1
2,257.66
506
2
2
2,934.96
506
3
3
Anthem Blue Cross Traditional HMO
1,210.71
509
1
1
2,421.42
509
2
2
3,147.85
509
3
3
Blue Shield Access+ HMO
1,035.21
525
1
1
2,070.42
525
2
2
2,691.55
525
3
3
Blue Shield Access+ EPO
1,035.21
524
1
1
2,070.42
524
2
2
2,691.55
524
3
3
Blue Shield Trio HMO
888.94
451
1
1
1,777.88
451
2
2
2,311.24
451
3
3
Health Net SmartCare
1,174.50
528
1
1
2,349.00
528
2
2
3,053.70
528
3
3
Kaiser Permanente
913.74
533
1
1
1,827.48
533
2
2
2,375.72
533
3
3
Peace Officers Research Assoc of CA
825.00
592
1
1
1,875.00
592
2
2
2,300.00
592
3
3
PERS Gold
825.61
613
1
1
1,651.22
613
2
2
2,146.59
613
3
3
PERS Platinum
11200.12
601
1
1
2,400.24
601
2
2
3,120.31
601
3
3
UnitedHealthcare SignatureValue Alliance
1,044.07
576
1
1
2,088.14
576
2
2
2,714.58
576
3
3
Western Health Advantage HMO
760.17
5911
1
11
1,520.341
591
21
21
1,976.441
5911
31
3
Plan
Subscriber
Plan
Code
Party
Code
Party
Rate
Subscriber &
1
Plan
3 Code
Party
Code
Party
Rate
Subscriber &
2+ Dependents
Plan
Code
Party
Code
Party
Rate
Anthem Medicare Preferred PPO
$413.59
515
1
4
$827.18
515
2
5
$1,240.77
515
3
6
Anthem Medicare Preferred PPO with
Dental/Vision'
413.59
512
1
4
827.18
512
2
5
1,240.77
512
3
6
Anthem Medicare Preferred PPO
413.59
455
1
4
827.18
455
2
5
1,240.77
455
3
6
Anthem Medicare Preferred PPO with Dental'
413.59
459
1
4
827.18
459
2
5
1,240.77
459
3
6
Blue Shield Medicare PPO
361.90
011
1
4
723.80
011
2
5
1,085.70
011
3
6
Blue Shield Medicare PPO with Dental/Vision2
361.90
016
1
4
723.80
016
2
5
1,085.70
016
3
6
Kaiser Permanente Senior Advantage
283.25
536
1
4
566.50
536
2
5
849.75
536
3
6
Kaiser Permanente Senior Advantage with
Dental3
283.25
542
1
4
566.50
542
2
5
849.75
542
3
6
Kaiser Permanente Senior Advantage Summit
336.29
630
1
4
672.58
630
2
5
1,008.87
630
3
6
Kaiser Permanente Senior Advantage Summit
with Denta13
336.29
636
1
4
672.58
636
2
5
1,008.87
636
3
6
Peace Officers Research Assoc of CA Medicare
Supplement
465.00
595
1
4
1,030.00
595
2
5
1,395.00
595
3
6
PERS Gold Medicare Supplement
392.71
616
1
4
785.42
616
2
5
1,178.13
616
3
6
PERS Platinum Medicare Supplement
420.02
605
1
4
840.04
605
2
5
1,260.06
605
3
6
UnitedHealthcare Group Medicare Advantage
PPO
299.68
579
1
4
599.36
579
2
5
899.04
579
3
6
UnitedHealthcare Group Medicare Advantage
Edge PPO
357.70
476
1
4
715.40
476
2
5
1,073.10
476
3
6
UnitedHealthcare Group Medicare Advantage
PPO with Dental/Vision4
299 68
585
1
4
599.36
585
2
5
899.04
585
3
6
Western Health Advantage MyCare Select HMO
331.11
035
1
4
662.22
035
2
5
993.33
035
3
6
*For health plan availability by county, please refer to the 2023 Health Benefit Summary or myCalPERS.
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.
3Dental benefit is an additional $15.35 per member per month premium. You will be billed directly for this amount.
4Dental and Vision coverage is an additional $26.03 per member per month premium. You will be billed directly for this amount.
Updated: September 26, 2022
CalPERS 2023 Regional Health Premiums (Actives and Annuitants)
CTTeGilve Da -Le: Januar/ I, LULS
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, EI 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
Anthem Blue Cross Del Norte EPO and
Medicare Supplement
Anthem Blue Cross Select HMO and Medicare
Preferred
Anthem Blue Cross Select HMO and Medicare
Preferred with Dental/Vision'
Anthem Blue Cross Traditional HMO and
Medicare Preferred
Anthem Blue Cross Traditional HMO and
Medicare Preferred with Dental/Vision'
Blue Shield Access+ HMO and Medicare
Blue Shield Access+ HMO and Medicare with
Dental/Vision2
Blue Shield Access+ EPO and Medicare
Blue Shield Access+ EPO and Medicare with
Dental/Vision3
Blue Shield Trio HMO and Medicare
Blue Shield Trio HMO and Medicare with
Dental/Vision4
Kaiser Permanente and Senior Advantage
Kaiser Permanente and Senior Advantage with
Dentals
Kaiser Permanente and Senior Advantage
Summit
Kaiser Permanente and Senior Advantage
Summit with Dentals
Peace Officers Research Assoc of CA and
Medicare Supplement
PERS Gold and Medicare Supplement
PERS Platinum and Medicare Supplement
UnitedHealthcare SignatureValue Alliance and
Group Medicare Advantage PPO
UnitedHealthcare SignatureValue Alliance and
Group Medicare Advantage Edge PPO
UnitedHealthcare SignatureValue Alliance and
Group Medicare Advantage PPO with
Dental/Visions
Western Health Advantage HMO and MyCare
Select HMO
Subscriber in M, &
1 Dependent in B
$1,620.14
1,542.42
1,542.42
1,624.30
1,624.30
1,397.11
1,397.11
1,397.11
1,397.11
1,250.84
1,250.84
1,196.99
1,196.99
1,250.03
1,250.03
1,525.00
1,218.32
1,620.14
1,343.75
1,401.77
PlanI PartyI Party Subscriber in M, &
Code Codel Rate 2+ Dependents in B
021
4
7
$2,340.21
457
4
7
2,219.72
460
4
7
2,219.72
518
4
7
2,350.73
521
4
7
2,350.73
049
4
7
2,018.24
089
4
7
2,018.24
092
4
7
2,018.24
093
4
7
2,018.24
094
4
7
1,784.20
097
4
7
1a�.°01
539
4
7
1,745.23
545
4
7
1,745.23
633
4
7
1,798.27
639
4
7
1,798.27
598
4
7
1,999.00
619
4
7
1,713.69
609
4
7
2,340.21
582
4
7
1,970.19
627
4
7
2,028.21
Plan
Code
Party
Code
Party
Rate
Subscriber in M,
1 Dependent in M, &
1+ Dependent in B
021
5
8
$1,560.11
457
5
8
1,504.48
460
5
8
1,504.48
518
5
8
1,553.61
521
5
8
1,553.61
049
51
8
1,344.93
089
5
8
1,344.93
092
5
8
1,344.93
093
5
8
1,344.93
094
5
8
1,257.16
097
5
8
1,257.16
539
5
8
1,114.74
545
5
8
1,114.74
633
5
8
1,220.82
639
5
8
1,220.82
598
5
8
1,582.00
619
5
8
1,280.79
609
5
81
1,560.11
582
5
8
1,225.80
627
5
8
1,341.84
1,343.751 5881 41 71 1,970.191 5881 51 8
1,091.281 0361 41 71 1,547.38 0361 51 8
'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.
3Dental and Vision coverage is an additional $38.00 per member per month premium. You will be billed directly for this amount.
4Dental and Vision coverage is an additional $38.00 per member per month premium. You will be billed directly for this amount.
SDental benefit is an additional $15.35 per member per month premium. You will be billed directly for this amount.
6Dental and Vision coverage is an additional $26.03 per member per month premium. You will be billed directly for this amount.
1,225.80
Plan Party Party
Codel Codel Rate
omm
®EE
OEM
OEM
®EM
MEE
SEE
MEE
®EM
®EM
OEM
1,118.321 0361 61 9
2
Updated: September 26, 2022
CalPERS 2023 Regional Health Premiums (Actives and Annuitants)
Effective Date: January 1, 2023
'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.
3Dental and Vision coverage is an additional $38.00 per member per month premium. You will be billed directly for this amount.
4Dental and Vision coverage is an additional $38.00 per member per month premium. You will be billed directly for this amount.
5Dental benefit is an additional $15.35 per member per month premium. You will be billed directly for this amount.
6Dental and Vision coverage is an additional $26.03 per member per month premium. You will be billed directly for this amount.
3
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, EI 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
Subscriber in B,
Subscriber in B, &
Plan
Party
Party
Subscriber in B, &
Plan
Party
Party
1 Dependent in M, &
Plan
Party
Party
Plan
1 Dependent in M
Code
Code
Rate
2+ Dependents in M
Code
Code
Rate
1+ Dependent in B
Code
Code
Rate
Anthem Blue Cross Del Norte EPO and
$1,620.14
021
7
10
$2,040.16
021
8
11
$2,340.21
021
9
12
Medicare Supplement
Anthem Blue Cross Select HMO and Medicare
1,542.42
457
7
10
1,956.01
457
8
11
2,219.72
457
9
12
Preferred
Anthem Blue Cross Select HMO and Medicare
1,542.42
460
7
10
1,956.01
460
8
11
2,219.72
460
9
12
Preferred with Dental/Vision'
Anthem Blue Cross Traditional HMO and
1,624.30
518
7
10
2,037.89
518
8
11
2,350.73
518
9
12
Medicare Preferred
Anthem Blue Cross Traditional HMO and
1,624.30
521
7
10
2,037.89
521
8
11
2,350.73
521
9
12
Medicare Preferred with Dental/Vision
Blue Shield Access+ HMO and Medicare
1,397.11
049
7
10
1,759.01
049
8
11
2,018.24
049
9
12
Blue Shield Access+ HMO and Medicare with
1,397.11
089
7
10
1,759.01
089
8
11
2,018.24
089
9
12
Dental/Vision2
Blue Shield Access+ EPO and Medicare
1,397.11
092
7
10
1,759.01
092
8
11
2,018.24
092
9
12
Blue Shield Access+ EPO and Medicare with
1,397.11
093
7
10
1,759.01
093
8
11
2,018.24
093
9
12
Dental/Vision3
Blue Shield Trio HMO and Medicare
1,250.84
094
7
10
1,612.74
094
8
11
1,784.20
094
9
12
Blue Shield Trio HMO and Medicare with
1,250.84
097
7
10
Pae 0
1, 1
13
097
8
11
1,784.20
097
9
12
Dental/Vision4
.7°
Kaiser Permanente and Senior Advantage
1,196.99
539
7
10
1,480.24
539
8
11
1,745.23
539
9
12
Kaiser Permanente and Senior Advantage with
1,196.99
545
7
10
1,480.24
545
8
11
1,745.23
545
9
12
Dentals
Kaiser Permanente and Senior Advantage
1,250.03
633
7
10
1,586.32
633
8
11
1,798.27
633
9
12
Summit
Kaiser Permanente and Senior Advantage
1,250.03
639
7
10
1,586.32
639
8
11
1,798.27
639
9
12
Summit with Dentals
Peace Officers Research Assoc of CA and
1,392.00
598
7
10
1,854.00
598
8
11
1,868.00
598
9
12
Medicare Supplement
PERS Gold and Medicare Supplement
1,218.32
619
7
10
1,611.03
619
8
11
1,713.69
619
9
12
PERS Platinum and Medicare Supplement
1,620.14
609
7
101
2,040.16
609
8
111
2,340.21
609
9
12
UnitedHealthcare SignatureValue Alliance and
1,343.75
582
7
10
1,643.43
582
8
11
1,970.19
582
9
12
Group Medicare Advantage PPO
UnitedHealthcare SignatureValue Alliance and
1,401.77
627
7
10
1,759.47
627
8
11
2,028.21
627
9
12
Group Medicare Advantage Edge PPO
UnitedHealthcare SignatureValue Alliance and
Group Medicare Advantage PPO with
1,343.75
588
7
10
1,643.43
588
8
11
1,970.19
588
9
12
Dental/Visions
Western Health Advantage HMO and MyCare
1,091.28
036
7
10
1,422.39
036
8
11
1,547.38
036
9
12
Select HMO
'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.
3Dental and Vision coverage is an additional $38.00 per member per month premium. You will be billed directly for this amount.
4Dental and Vision coverage is an additional $38.00 per member per month premium. You will be billed directly for this amount.
5Dental benefit is an additional $15.35 per member per month premium. You will be billed directly for this amount.
6Dental and Vision coverage is an additional $26.03 per member per month premium. You will be billed directly for this amount.
3
Page 11 of 13
CalPERS 2024 Regional Health Premiums (Actives and Annuitants) Attachment 3
Effective Date: January 1, 2024
`For health plan availability by county, please refer to the 2024 Health Benefit Summary or myCalPERS.
'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 $39.14 per member per month premium. You will be billed directly for this amount.
'Dental benefit is an additional $15.66 per member per month premium. You will be billed directly for this amount.
°Dental and Vision coverage is an additional $27.04 per member per month premium. You will be billed directly for this amount.
September 21, 2023 Special Board Meeting Agenda Packet - Page 158 of 174
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa, Del Norte, EI Dorado, Glenn, Humboldt, Lake, Lassen, Marin, Mariposa,
Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumes, Sacramento, San Benito, San Francisca, San Joaquin,
San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus, Sutter, Tehama, Trinity, Tuolumne, Yolo, Yuba
It U11FAUMOMM-MVII
Plan
Subscriber
Plan
Code
Party
Code
Party
Rate
Subscriber &
1 Dependent
Plan Party Party
Code Code Rate
Subscriber &
2- Dependents
Plan
Code
Party Party
Code Rate
Anthem Blue Cross Del Norte EPO
$1,314.27
504
1
1
$2,628.54
504
2
2
$3,417.10
504
3 3
Anthem Blue Cross Select HMO
1,138.86
506
1
1
2,277.72
506
2
2
2,961.04
506
3 3
Anthem Blue Cross Traditional HMO
1,339.70
509
1
1
2,679.40
509
2
2
3,483.22
509
3 3
Blue Shield Access+HMO
1,076.84
525
1
1
2,153.68
525
2
2
2,799.78
525
3 3
Blue Shield Access+ EPO
1,076.84
524
1
1
2,153.68
524
2
2
2,799.78
524
3 3
Blue Shield Trio HMO
946.84
451
1
1
1,893.68
4511
2
2
2,461.78
4511
3 3
Kaiser Permanente
1,021.41
533
1
1
2,042.82
533
2
2
2,655.67
533
3 3
Peace Officers Research Assoc of CA
931.00
592
1
1
2,117.00
592
2
2
2,651.00
592
3 3
PERS Gold
914.82
613
1
1
1,829.64
613
2
2
2,378.53
613
3 3
PERS Platinum
1,314.27
601
1
1
2,628.54
601
2
2
3,417.10
601
3 3
UnitedHealthcare SignatureValue Alliance
1,091.13
576
1
1
2,182.26
576
2
2
2,836.94
576
3 3
UnitedHealthcare SignatureValue Harmony
937.39
495
1
1
1,874.78
495
2
2
2,437.21
495
3 3
Western Health Advantage HMO
807.23
591
1
1
1,614.46
591
2
2
2,098.80
591
3 3
• • •
Plan
Subscriber
Plan
Code
Party
Code
Party
Rate
Subscriber &
1 Dependent
Plan Party Party
Code Code Rate
Subscriber &
2+ Dependents
Plan
Code
Party Party
Code Rate
Anthem Select Medicare Preferred PPO
$405.83
455
1
4
$811.66
455
2
5
$1,217.49
455
3 6
Anthem Select Medicare Preferred PPO with Dental/Vision'
405.83
459
1
4
811.66
459
2
5
1,217.49
459
3 6
Anthem Medicare Preferred PPO
405.83
515
1
4
811.66
515
2
5
1,217.49
515
3 6
Anthem Medicare Preferred PPO with Dental/Vision'
405.83
512
1
4
811.66
512
2
5
1,217.49
512
3 6
Blue Shield Medicare PPO
392.68
011
1
4
785.36
011
2
5
1,178.04
011
3 6
Blue Shield Medicare PPO with Dental/Vision2
392.68
016
1
4
785.36
016
2
5
1,178.04
016
3 6
Kaiser Permanente Senior Advantage
324.79
536
1
4
649.58
536
2
5
974.37
536
3 6
Kaiser Permanente Senior Advantage with Dental'
324.79
542
1
4
649.58
542
2
51
974.37
5421
3 6
Kaiser Permanente Senior AdvantageSummit
386.55
630
1
4
773.10
630
2
5
1,159.65
630
3 6
Kaiser Permanente Senior Advantage Summit with Dental'
386.55
636
1
4
773.10
636
2
5
1,159.65
636
3 6
Peace Officers Research Assoc of CA Medicare Supplement
465.00
595
1
4
1,030.00
595
2
5
1,395.00
595
3 6
PERS Gold Medicare Supplement
406.60
616
1
4
813.20
616
2
5
1,219.80
616
3 6
PERS Platinum Medicare Supplement
448.15
605
1
4
896.30
605
2
5
1,344.45
605
3 6
UnitedHealthcare Group Medicare Advantage PPO
341.72
579
1
4
683.44
579
2
5
1,025.16
579
3 6
UnitedHealthcare Group Medicare Advantage Edge PPO
366.01
476
1
4
732.02
476
2
5
1,098.03
476
3 6
UnitedHealthcare Group Medicare Advantage PPO with
DentalNision°
341.72
585
1
4
683.44
585
2
5
1,025.16
585
3 6
Western Health Advantage MyCare Select HMO
268.621
0351
1
41
537.24
0351
21
51
805.861
035
3 6
`For health plan availability by county, please refer to the 2024 Health Benefit Summary or myCalPERS.
'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 $39.14 per member per month premium. You will be billed directly for this amount.
'Dental benefit is an additional $15.66 per member per month premium. You will be billed directly for this amount.
°Dental and Vision coverage is an additional $27.04 per member per month premium. You will be billed directly for this amount.
September 21, 2023 Special Board Meeting Agenda Packet - Page 158 of 174
Page 12 of 13
CalPERS 2024 Regional Health Premiums (Actives and Annuitants)
Effective Date: January 1, 2024
September 21, 2023 Special Board Meeting Agenda Packet - Page 159 of 174
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa,
Del Norte, EI Dorado,
Glenn,
Humboldt, Lake,
Lassen, Marin, Mariposa,
Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumes, Sacramento, San
Benito,
San Francisca,
San Joaquin,
San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Solano, Sonoma, Stanislaus,
Sutter, Tehama, Trinity, Tuolumne, Yolo,
Yuba
• .
Subscriber in M,
Subscriber in M, &
Plan
Party
Party
Subscriber in M, &
Plan
Party
Party
1 Dependent in M, &
Plan
Party Party
Plan
1 Dependent in B
Code
Code
Rate
2+ Dependents in B
Code
Code
Rate
1+ Dependent in B
Code
Code Rate
Anthem Blue Cross Del Norte EPO and Medicare Supplement
$1,762.42
021
4
7
$2,550.98
021
5
8
$1,684.86
021
6 9
Anthem Blue Cross Select HMO and Medicare Preferred
1,544.69
457
4
7
2,228.01
457
5
8
1,494.98
457
6 9
Anthem Blue Cross Select HMO and Medicare Preferred with
1,544.69
460
4
7
2,228.01
460
5
8
1,494.98
460
6 9
DentalNision'
Anthem Blue Cross Traditional HMO and Medicare Preferred
1,745.53
518
4
7
2,549.35
518
5
8
1,615.48
518
6 9
Anthem Blue Cross Traditional HMO and Medicare Preferred with
1,745.53
521
4
7
2,549.35
521
5
8
1,615.48
521
6 9
DentalNision'
Blue Shield Access+ HMO and Medicare
1,469.52
049
4
7
2,115.62
049
5
8
1,431.46
049
6 9
Blue Shield Access+HMO and Medicare with Dental/Vision2
1,469.52
089
4
7
2,115.62
089
5
8
1,431.46
089
6 9
Blue Shield Access+ EPO and Medicare
1,469.52
092
4
7
2,115.62
092
5
8
1,431.46
092
6 9
Blue Shield Access+EPO and Medicare with Dental/Vision'
1,469.52
093
4
7
2,115.62
093
5
8
1,431.46
093
6 9
Blue Shield Trio HMO and Medicare
1,339.52
094
41
71
1,907.62
0941
5
81
1,353.46
0941
6 9
Blue Shield Trio HMO and Medicare with Dental/Vision°
1,339.52
097
4
7
1,907.62
097
5
8
1,353.46
097
6 9
Kaiser Permanente and Senior Advantage
1,346.20
539
4
7
1,959.05
539
5
8
1,262.43
539
6 9
Kaiser Permanente and Senior Advantage with Dentals
1,346.20
545
4
7
1,959.05
545
5
8
1,262.43
545
6 9
Kaiser Permanente and Senior Advantage Summit
1,407.96
633
4
7
2,020.81
633
5
8
1,385.95
633
6 9
Kaiser Permanente and Senior Advantage Summit with Dentals
1,407.96
639
4
7
2,020.81
639
5
8
1,385.95
639
6 9
Peace Officers Research Assoc of CA and Medicare Supplement
1,651.00
598
4
7
2,185.00
598
5
8
1,564.00
598
6 9
PERS Gold and Medicare Supplement
1,321.42
619
4
7
1,870.31
619
5
8
1,362.09
619
6 9
PERS Platinum and Medicare Supplement
1,762.42
609
4
7
2,550.98
609
5
8
1,684.86
609
6 9
UnitedHealthcare SignatureValue Alliance and Group Medicare
1,432.85
582
4
7
2,087.53
582
5
8
1,338.12
582
6 9
Advantage PPO
UnitedHealthcare SignatureValue Alliance and Group Medicare
1,457.14
627
4
7
2,111.82
627
5
8
1,386.70
627
6 9
Advantage Edge PPO
UnitedHealthcare SignatureValue Alliance and Group Medicare
1,432.85
588
4
7
2,087.53
588
5
8
1,338.12
588
6 9
Advantage PPO with Dental/Visions
UnitedHealthcare SignatureValue Harmony and Group Medicare
1,279.11
497
4
7
1,841.54
497
5
8
1,245.87
497
6 9
Advantage PPO
UnitedHealthcare SignatureValue Harmony and Group Medicare
1,303.40
496
4
7
1,865.83
496
5
8
1,294.45
496
6 9
Advantage Edge PPO
UnitedHealthcare SignatureValue Harmony and Group Medicare
1,279.11
498
4
7
1,841.54
498
5
8
1,245.87
498
6 9
with Dental/Visions
Advanta a PPOw
Western Health Advantage HMO and MyCare Select HMO
1,075.85
036
4
7
1,560.19
036
5
8
1,021.58
036
6 9
September 21, 2023 Special Board Meeting Agenda Packet - Page 159 of 174
Page 13 of 13
CalPERS 2024 Regional Health Premiums (Actives and Annuitants)
Effective Date: January 1, 2024
'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 $39.14 per member per month premium. You will be billed directly for this amount.
'Dental and Vision coverage is an additional $39.14 per member per month premium. You will be billed directly for this amount.
"Dental and Vision coverage is an additional $39.14 per member per month premium. You will be billed directly for this amount.
'Dental benefit is an additional $15.66 per member per month premium. You will be billed directly for this amount.
'Dental and Vision coverage is an additional $27.04 per member per month premium. You will be billed directly for this amount.
September 21, 2023 Special Board Meeting Agenda Packet - Page 160 of 174
Alameda, Alpine, Amador, Butte, Calaveras, Colusa, Contra Costa,
Del Norte, EI Dorado,
Glenn,
Humboldt, Lake, Lassen, Marin, Mariposa,
Mendocino, Merced, Modoc, Mono, Monterey, Napa, Nevada, Placer, Plumes, Sacramento, San
Benito,
San Francisca,
San Joaquin,
San Mateo, Santa Clara, Santa Cruz, Shasta, Sierra, Siski ou, Solano,
Sonoma, Stanislaus,
Sutter, Tehama, Trinity, Tuolumne, Yolo,
Yuba
Subscriber in B,
Subscriber in B, &
Plan
Party
Party
Subscriber in B, &
Plan
Party
Party
1 Dependent in M, &
Plan
Party Party
Plan
1 Dependent in M
Code
Code
Rate
2+ Dependents in M
Code
Code
Rate
1+ Dependent in B
Code
Code
Rate
Anthem Blue Cross Del Norte EPO and Medicare Supplement
$1,762.42
021
7
10
$2,210.57
021
8
11
$2,550.98
021
9
12
Anthem Blue Cross Select HMO and Medicare Preferred
1,544.69
457
7
10
1,950.52
457
8
11
2,228.01
457
9
12
Anthem Blue Cross Select HMO and Medicare Preferred with
1,544.69
460
7
10
1,950.52
460
8
11
2,228.01
460
9
12
DentalNision'
Anthem Blue Cross Traditional HMO and Medicare Preferred
1,745.53
518
7
10
2,151.36
518
8
11
2,549.35
518
9
12
Anthem Blue Cross Traditional HMO and Medicare Preferred with
1,745.53
521
7
10
2,151.36
521
8
11
2,549.35
521
9
12
DentalNision'
Blue Shield Access+ HMO and Medicare
1,469.52
049
7
10
1,862.20
049
81
111
2,115.62
049
91
12
Blue Shield Access+HMO and Medicare with Dental/Vision2
1,469.52
089
7
10
1,862.20
089
8
11
2,115.62
089
9
12
Blue Shield Access+ EPO and Medicare
1,469.52
092
7
10
1,862.20
092
8
11
2,115.62
092
9
12
Blue Shield Access+EPO and Medicare with Dental/Vision'
1,469.52
093
7
10
1,862.20
093
8
11
2,115.62
093
9
12
Blue Shield Trio HMO and Medicare
1,339.52
094
7
101
1,732.20
094
8
11
1,907.62
094
9
12
Blue Shield Trio HMO and Medicare with Dental/Vision°
1,339.52
097
7
10
1,732.20
097
8
11
1,907.62
097
9
12
Kaiser Permanente and Senior Advantage
1,346.20
539
7
10
1,670.99
539
8
11
1,959.05
539
9
12
Kaiser Permanente and Senior Advantage with Dentals
1,346.20
545
7
10
1,670.99
545
8
11
1,959.05
545
9
12
Kaiser Permanente and Senior Advantage Summit
1,407.96
633
7
10
1,794.51
633
8
11
2,020.81
6331
9
12
Kaiser Permanente and Senior Advantage Summit with Dentals
1,407.96
639
7
10
1,794.51
639
8
11
2,020.81
639
9
12
Peace Officers Research Assoc of CA and Medicare Supplement
1,396.00
598
7
10
1,961.00
598
8
11
2,185.00
598
9
12
PERS Gold and Medicare Supplement
1,321.42
619
7
10
1,728.02
619
8
11
1,870.31
619
9
12
PERS Platinum and Medicare Supplement
1,762.42
609
7
10
2,210.57
609
8
11
2,550.98
609
9
12
UnitedHealthcare SignatureValue Alliance and Group Medicare
1,432.85
582
7
10
1,774.57
582
8
11
2,087.53
582
9
12
Advantage PPO
UnitedHealthcare SignatureValue Alliance and Group Medicare
1,457.14
627
7
10
1,823.15
627
8
11
2,111.82
627
9
12
Advantage Edge PPO
UnitedHealthcare SignatureValue Alliance and Group Medicare
1,432.85
588
7
10
1,774.57
588
8
11
2,087.53
588
9
12
Advantage PPO with Dental/Vision'
UnitedHealthcare SignatureValue Harmony and Group Medicare
1,279.11
497
7
10
1,620.83
497
8
11
1,841.54
497
9
12
Advantage PPO
UnitedHealthcare SignatureValue Harmony and Group Medicare
1,303.40
496
7
10
1,669.41
496
8
11
1,865.83
496
9
12
Advantage Edge PPO
UnitedHealthcare SignatureValue Harmony and Group Medicare
1,279.11
498
7
10
1,620.83
498
8
11
1,841.54
498
9
12
Advantage PPO with Dental/Vision'
Western Health Advantage HMO and MyCare Select HMO 1
1,075.85
036
7
10
1,344.47
036
81
ill
1,560.191
0361
9
12
'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 $39.14 per member per month premium. You will be billed directly for this amount.
'Dental and Vision coverage is an additional $39.14 per member per month premium. You will be billed directly for this amount.
"Dental and Vision coverage is an additional $39.14 per member per month premium. You will be billed directly for this amount.
'Dental benefit is an additional $15.66 per member per month premium. You will be billed directly for this amount.
'Dental and Vision coverage is an additional $27.04 per member per month premium. You will be billed directly for this amount.
September 21, 2023 Special Board Meeting Agenda Packet - Page 160 of 174