2024 CalPERS HEALTH BENEFITS PROGRAM BASIC PLAN RATES Monthly Employee Cost All Employee Groups Unit 6 Enrolled 2024 (except Unit 6) HEALTH PLAN Employee Total 2024 2024 2023 2024 2024 2023 & Eligible Monthly Amount Amount Amount Amount Amount Amount Dependents Premium Paid by Paid by Paid by Paid by Paid by Paid by CSU Employee Employee CSU Employee Employee ANTHEM BLUE CROSS Employee Only $925.57 $925.57 $0.00 $20.85 $925.57 $0.00 $15.85 SELECT HMO CALIFORNIA Employee + 1 $1,851.14 $1,851.14 $0.00 $108.70 $1,851.14 $0.00 $98.70 Employee + 2 or more $2,406.48 $2,366.00 $40.48 $226.01 $2,386.00 $20.48 $206.01 ANTHEM BLUE CROSS Employee Only $1,197.94 $983.00 $214.94 $233.65 $988.00 $209.94 $228.65 TRADITIONAL HMO Employee + 1 $2,395.88 $1,890.00 $505.88 $534.30 $1,900.00 $495.88 $524.30 CALIFORNIA Employee + 2 or more $3,114.64 $2,366.00 $748.64 $779.29 $2,386.00 $728.64 $759.29 ANTHEM BLUE CROSS EPO Employee Only $1,215.87 $983.00 $232.87 $200.89 $988.00 $227.87 $195.89 CALIFORNIA Employee + 1 $2,431.74 $1,890.00 $541.74 $468.78 $1,900.00 $531.74 $458.78 (Restricted to Del Norte County) Employee + 2 or more $3,161.26 $2,366.00 $795.26 $694.11 $2,386.00 $775.26 $674.11 BLUE SHIELD ACCESS+ Employee Only $892.49 $892.49 $0.00 $0.00 $892.49 $0.00 $0.00 CALIFORNIA Employee + 1 $1,784.98 $1,784.98 $0.00 $0.00 $1,784.98 $0.00 $0.00 Employee + 2 or more $2,320.47 $2,320.47 $0.00 $66.79 $2,320.47 $0.00 $46.79 BLUE SHIELD ACCESS+ Employee Only $892.49 $892.49 $0.00 $0.00 $892.49 $0.00 $0.00 EPO CALIFORNIA Employee + 1 $1,784.98 $1,784.98 $0.00 $0.00 $1,784.98 $0.00 $0.00 (Restricted to certain counties) Employee + 2 or more $2,320.47 $2,320.47 $0.00 $66.79 $2,320.47 $0.00 $46.79 BLUE SHIELD TRIO Employee Only $810.24 $810.24 $0.00 $0.00 $810.24 $0.00 $0.00 (Restricted to certain counties) Employee + 1 $1,620.48 $1,620.48 $0.00 $0.00 $1,620.48 $0.00 $0.00 Employee + 2 or more $2,106.62 $2,106.62 $0.00 $0.00 $2,106.62 $0.00 $0.00 HEALTH NET SALUD Y MAS Employee Only $656.96 $656.96 $0.00 $0.00 $656.96 $0.00 $0.00 CALIFORNIA Employee + 1 $1,313.92 $1,313.92 $0.00 $0.00 $1,313.92 $0.00 $0.00 Employee + 2 or more $1,708.10 $1,708.10 $0.00 $0.00 $1,708.10 $0.00 $0.00 KAISER PERMANENTE Employee Only $964.15 $964.15 $0.00 $0.00 $964.15 $0.00 $0.00 CALIFORNIA Employee + 1 $1,928.30 $1,890.00 $38.30 $6.36 $1,900.00 $28.30 $0.00 Employee + 2 or more $2,506.79 $2,366.00 $140.79 $92.97 $2,386.00 $120.79 $72.97 STATE EMPLOYER MONTHLY CONTRIBUTION RATE The employer contribution rates below are what the CSU contributes toward your monthly health premium. The employee cost shown above is any amount above the employer contribution. Coverage Level All Employees Unit 6 (except Unit 6) Employee Only $983 $988 Employee + One $1,890 $1,900 Employee + Family $2,366 $2,386 9