Health Plans	1 PARTY (Employee only)	2 PARTY (Employee + 1 dependent)	3 PARTY (Employee + 2 or more dependents)
Blue Shield HMO	$479.47	$958.94	$1,246.62
Blue Shield NetValue	$430.25	$860.50	$1,118.65
Kaiser	$436.25	$872.50	$1134.25
Kaiser Out-of-State	$625.52	$1,251.04	$1,626.35
PERSChoice (PPO)	$477.70	$955.40	$1,242.02
PERSCare (PPO)	$742.41	$1,484.82	$1,930.27
PERS Select	$462.55	$925.10	$1,202.63
PORAC	$452.00	$847.00	$1076.00
CAHP	$602.71	$1,170.07	$1,530.35
CCPOA (unsubsidized)
(Regional No. Cal.-HMO)	$426.30	$853.08	$1,151.29
(Regional So. Cal.-HMO)	$351.75	$703.97	$950.78

Dental Plans	1 PARTY (Employee only)	2 PARTY (Employee + 1 dependent)	3 PARTY (Employee + 2 or more dependents)
Delta Dental Plans
Delta Dental Premier (Basic)*	$48.07	$85.12	$123.75
Delta Dental Premier (Enhanced)**	$50.06	$100.08	$141.22
Delta PPO	$40.87	$80.65	$121.98
Pre-Paid Dental Plans
SafeGuard (Standard)*	$15.11	$24.48	$34.29
SafeGuard (Enhanced)**	$14.78	$25.02	$30.82
DeltaCare USA	$17.35	$28.47	$39.38

* Available to represented employees.
** Available to excluded employees.

Vision Plan	1 PARTY (Employee only)	2 PARTY (Employee + 1 dependent)	3 PARTY (Employee + 2 or more dependents)
Vision Service Plan	$9.19	$9.19	$9.19

Return to Consolidated Benefits