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Region 3 Rates

	Anthem HMO Select	Anthem HMO Traditional	Blue Shield Access +HMO	Kaiser	UHC HMO	PERS Platinum	PERS Gold
Employee Only
Base	$926.68	$1,128.53	$917.91	$969.05	$870.76	$1,431.81	$960.03
Admin Fee	$0.77	$0.90	$0.73	$0.78	$0.70	$1.15	$0.77
Vision	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00
Dental	$49.76	$49.76	$49.76	$49.76	$49.76	$49.76	$49.76
Total	$1,013.21	$1,179.19	$968.40	$1,019.59	$921.22	$1,482.72	$1,010.56

	Anthem HMO Select	Anthem HMO Traditional	Blue Shield Access +HMO	Kaiser	UHC HMO	PERS Platinum	PERS Gold
Employee + 1
Base	$1,925.35	$2,257.06	$1,835.82	$1,938.10	$1,741.52	$2,863.62	$1,920.06
Admin Fee	$1.54	$1.81	$1.47	$1.55	$1.39	$2.29	.$1.54
Vision	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00
Dental	$99.49	$99.49	$99.49	$99.49	$99.49	$99.49	$99.49
Total	$2,026.39	$2,358.36	$1,936.78	$2,039.14	$1,842.40	$2,965.40	$2,021.09

	Anthem HMO Select	Anthem HMO Traditional	Blue Shield Access +HMO	Kaiser	UHC HMO	PERS Platinum	PERS Gold
Employee + Family
Base	$2,502.97	$2,934.18	$2,386.57	$2,519.53	$2,263.98	$3,722.71	$2,496.08
Admin Fee	$2.00	$2.35	$1.91	$2.02	$1.81	$2.98	$2.00
Vision	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00
Dental	$135.13	$135.13	$135.13	$135.13	$135.13	$135.13	$135.13
Total	$2,640.10	$3,071.66	$2,523.61	$2,656.68	$2,400.92	$3,860.82	$2,633.21

Monthly Cafeteria Allowance:

$2,085 for employees with 2 or more dependents (health, dental and vision)
$1,600 for employees with 1 dependent (health, dental and vision)
$800 for employees with employee only (health, dental and vision)
$550.00 for employees:
- who waive health, dental and vision, or
- who waive health, but keep dental & vision

*Included within this amount is the designated minimum health contribution of $162.00.