PLAN COSTS
The following chart shows the amounts you will pay for coverage under each plan this year.
Benefit
You Pay Per Month
You Pay Per Pay Period
Value HMO (CA Care Network) Employee
$158.68
$73.24
$793.40
$366.18
Employee + Spouse
$581.85
$268.54
Employee + Child(ren)
$1,269.46
$585.90
Employee + Family
Classic HMO (Select HMO Network) Employee
$155.21
$71.63
$776.05
$358.18
Employee + Spouse
$569.13
$262.67
Employee + Child(ren)
$1,241.71
$573.10
Employee + Family
Classic PPO Employee
$314.41
$145.11
$1,392.42
$642.65
Employee + Spouse
$1,033.09 $2,200.77
$476.81
Employee + Child(ren)
$1,015.74
Employee + Family
Solution PPO Employee
$246.21
$113.64
$1,231.10
$568.20
Employee + Spouse
$902.81
$416.68
Employee + Child(ren)
$1,969.62
$909.06
Employee + Family
Solution HDHP (HSA) Employee
$191.45
$88.36
$957.29
$441.83
Employee + Spouse
$702.02
$324.01
Employee + Child(ren)
$1,531.56
$706.88
Employee + Family
Dental PPO Employee
$9.62
$4.44
$41.71
$19.25
Employee + Spouse
$44.70 $80.04
$20.63 $36.94
Employee + Child(ren)
Employee + Family
Blue View Vision Employee
$7.25
$3.35
$14.50
$6.69
Employee + Spouse
$14.86
$6.86
Employee + Child(ren)
$22.12
$10.21
Employee + Family
Behavior Frontiers Benefits Guide | 12
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