2017-2018 Cost for Coverage

Click on a links below to see your cost of coverage for your 2017-2018 benefits for medical, dental and vision.

  • Click here for Supplemental Benefits rates.
  • Click here for Supplemental Life and AD&D rates.
  • Covering a domestic partner?  Click here.

Medical Non-Tobacco User

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $57.46 $44.30 $27.56 $34.52 $28.00
TM + 1 $124.15 $95.72 $59.54 $80.19 $56.00
Family $190.86 $147.14 $91.52 $123.63 $84.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $1,494 $1,152 $717 $898 $728
TM + 1 $3,228 $2,489 $1,548 $2,085 $1,456
Family $4,962 $3,826 $2,380 $3,214 $2,184

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $61.91 $47.26 $29.65 $40.10 $28.00
TM + 1 $133.77 $102.13 $64.07 $92.44 $56.00
Family $205.63 $156.99 $98.48 $140.33 $84.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $1,610 $1,229 $771 $1,043 $728
TM + 1 $3,478 $2,655 $1,666 $2,403 $1,456
Family $5,346 $4,082 $2,561 $3,649 $2,184

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

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Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $81.28 $60.91 $38.26 $53.47 $37.00
TM + 1 $173.85 $130.28 $81.84 $124.73 $79.00
Family $270.95 $203.03 $127.53 $189.35 $117.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $2,113 $1,584 $995 $1,390 $962
TM + 1 $4,520 $3,387 $2,128 $3,243 $2,054
Family $7,045 $5,279 $3,316 $4,923 $3,042

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $98.65 $72.50 $45.44 $67.95 $45.00
TM + 1 $207.72 $152.64 $95.66 $144.78 $92.00
Family $321.95 $236.58 $148.27 $210.48 $140.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $2,565 $1,885 $1,182 $1,767 $1,170
TM + 1 $5,401 $3,969 $2,487 $3,764 $2,392
Family $8,371 $6,151 $3,855 $5,473 $3,640

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $102.22 $75.01 $46.89 $69.69 $47.00
TM + 1 $215.22 $157.90 $98.72 $148.45 $96.00
Family $333.58 $244.76 $153.01 $216.25 $145.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $2,658 $1,950 $1,219 $1,812 $1,222
TM + 1 $5,596 $4,105 $2,567 $3,860 $2,496
Family $8,673 $6,364 $3,978 $5,623 $3,770

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Medical - Tobacco User

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $77.46 $64.30 $47.56 $54.52 $48.00
TM + 1 $144.15 $115.72 $79.54 $100.19 $76.00
Family $210.86 $167.14 $111.52 $143.63 $104.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $2,014 $1,672 $1,237 $1,418 $1,248
TM + 1 $3,748 $3,009 $2,068 $2,605 $1,976
Family $5,482 $4,346 $2,900 $3,734 $2,704

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $81.91 $67.26 $49.65 $60.10 $48.00
TM + 1 $153.77 $122.13 $84.07 $112.44 $76.00
Family $225.63 $176.99 $118.48 $160.33 $104.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $2,130 $1,749 $1,291 $1,563 $1,248
TM + 1 $3,998 $3,175 $2,186 $2,923 $1,976
Family $5,866 $4,602 $3,081 $4,169 $2,704

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $101.28 $80.91 $58.26 $73.47 $57.00
TM + 1 $193.85 $150.28 $101.84 $144.73 $99.00
Family $290.95 $223.03 $147.53 $209.35 $137.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $2,633 $2,104 $1,515 $1,910 $1,482
TM + 1 $5,040 $3,907 $2,648 $3,763 $2,574
Family $7,565 $5,799 $3,836 $5,443 $3,562

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $118.65 $92.50 $65.44 $87.95 $65.00
TM + 1 $227.72 $172.64 $115.66 $164.78 $112.00
Family $341.95 $256.58 $168.27 $230.48 $160.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $3,085 $2,405 $1,702 $2,287 $1,690
TM + 1 $5,921 $4,489 $3,007 $4,284 $2,912
Family $8,891 $6,671 $4,375 $5,993 $4,160

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Bi-Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $122.22 $95.01 $66.89 $89.69 $67.00
TM + 1 $235.22 $177.90 $118.72 $168.45 $116.00
Family $353.58 $264.76 $173.01 $236.25 $165.00
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP BronzeKaiser CA CDHPTriple S Salud
TM Only $3,178 $2,470 $1,739 $2,332 $1,742
TM + 1 $6,116 $4,625 $3,087 $4,380 $3,016
Family $9,193 $6,884 $4,498 $6,143 $4,290

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Medical - DC Hourly - Non-Tobacco User

Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP Bronze
TM Only $28.73 $22.15 $13.78
TM + 1 $62.08 $47.86 $29.77
Family $95.43 $73.57 $45.76
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP Bronze
TM Only $1,494 $1,151 $717
TM + 1 $3,228 $2,488 $1,548
Family $4,962 $3,862 $2,380

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Kaiser CA CDHP - Weekly
Salary0 to $25,000$25,000.01 - $55,000$55,000.01 - $100,000$100,000.01 - $150,000> $150,000
TM Only $17.26 $20.05 $26.73 $33.97 $34.85
TM + 1 $40.10 $46.22 $62.37 $72.39 $74.23
Family $61.81 $70.17 $94.67 $105.24 $108.13
Kaiser CA CDHP - Annual
Salary0 to $25,000$25,000.01 - $55,000$55,000.01 - $100,000$100,000.01 - $150,000> $150,000
TM Only $898.00 $1,042.56 $1,390.20 $1,766.64 $1,812.00
TM + 1 $2,085.00 $2,403.36  $3,243.00 $3,764.40 $3,859.80
Family $3,214.36 $3,648.60 $4,923.00 $5,472.60 $5,622.60

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Medical - DC Hourly - Tobacco User

Weekly
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP Bronze
TM Only $38.73 $32.15 $23.78
TM + 1 $72.08 $57.86 $39.77
Family $105.43 $83.57 $55.76
Annual
 Aetna "R" CDHP GoldAetna "R" CDHP SilverAetna "R" CDHP Bronze
TM Only $2,014 $1,672 $1,236
TM + 1 $3,748 $3,009 $2,068
Family $5,482 $4,345 $2,900

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Kaiser CA CDHP - Weekly
Salary0 to $25,000$25,000.01 - $55,000$55,000.01 - $100,000$100,000.01 - $150,000> $150,000
TM Only $27.26 $30.05 $36.73 $43.97 $44.85
TM + 1 $50.10 $56.22 $72.37 $82.39 $84.23
Family $71.81 $80.17 $104.67 $115.24 $118.13
Kaiser CA CDHP - Annual
Salary0 to $25,000$25,000.01 - $55,000$55,000.01 - $100,000$100,000.01 - $150,000> $150,000
TM Only $1,418 $1,563 $1,910 $2,286 $2,332
TM + 1 $2,605 $2,923  $3,763 $4,284 $4,380
Family $3,734 $4,169 $5,443 $5,992 $6,143

The rates above do not include the spousal surcharge of $25 weekly/$50 biweekly if you are covering a spouse or domestic partner who has coverage at his/her employer. Click here for more information

Dental Cost of Coverage

Weekly
 Dental PPODental DMO
TM Only $3.04 $2.44
TM + 1 $6.09 $4.55
Family $9.13 $7.83
Bi-Weekly
 Dental PPODental DMO
TM Only $6.21 $4.97
TM + 1 $12.41 $9.27
Family $18.61 $15.97

Vision Cost of Coverage

Weekly
 Base PlanBuy Up Plan
TM Only $1.44 $1.96
TM + 1 $2.08 $2.83
Family $3.72 $5.07
Bi-Weekly
 Base PlanBuy Up Plan
TM Only $2.93 $3.99
TM + 1 $4.23 $5.77
Family $7.59 $10.34

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