LAW ENFORCEMENT & SHERIFF'S SUPERVISORY UNIT 2024 MONTHLY COUNTY CONTRIBUTIONS

MONTHLY PREMIUMS & COUNTY CONTRIBUTIONS PEMHCA FHA

FOR CALENDAR YEAR 2024 EE 157.00 704.47
County contribution based on 80/80/80 of the 2024 premium for EE + 1 157.00 1,565.94
Blue Shield Access+ HMO EE + 2 157.00 2,082.82
MONTHLY CONTRIBUTIONS EE MONTHLY COSTS
AVAILABLE FOR MEDICAL PREMIUMS EE EE Total
Cost Cost EE EE
Monthly TOTAL* = PEMHCA + FHA For Plan Admin Cost PAY PERIOD
Premium Contribution Contribution Contribution 0.32% of premium COST

BLUE SHIELD ACCESS+ HMO (Palo Alto Medical Foundation and Dignity Health Medical Network)
EE 1,076.84 861.47 157.00 704.47 215.37 3.45 218.82 109.41
EE +1 2,153.68 1,722.94 157.00 1,565.94 430.74 6.89 437.63 218.82
EE +2 2,799.78 2,239.82 157.00 2,082.82 559.96 8.96 568.92 284.46
BLUE SHIELD TRIO HMO (Dignity Health Medical Network)
EE 946.84 861.47 157.00 704.47 85.37 3.03 88.40 44.20
EE +1 1,893.68 1,722.94 157.00 1,565.94 170.74 6.06 176.80 88.40
EE +2 2,461.78 2,239.82 157.00 2,082.82 221.96 7.88 229.84 114.92
ANTHEM HMO SELECT (Dignity Health Medical Network)
EE 1,138.86 861.47 157.00 704.47 277.39 3.64 281.03 140.52
EE +1 2,277.72 1,722.94 157.00 1,565.94 554.78 7.29 562.07 281.03
EE +2 2,961.04 2,239.82 157.00 2,082.82 721.22 9.48 730.70 365.35
ANTHEM HMO TRADITIONAL (Palo Alto Medical Foundation and Dignity Health Medical Network)
EE 1,339.70 861.47 157.00 704.47 478.23 4.29 482.52 241.26
EE +1 2,679.40 1,722.94 157.00 1,565.94 956.46 8.57 965.03 482.52
EE +2 3,483.22 2,239.82 157.00 2,082.82 1,243.40 11.15 1,254.55 627.27
UNITEDHEALTHCARE SIGNATUREVALUE ALLIANCE HMO (Palo Alto Medical Foundation)
EE 1,091.13 861.47 157.00 704.47 229.66 3.49 233.15 116.58
EE +1 2,182.26 1,722.94 157.00 1,565.94 459.32 6.98 466.30 233.15
EE +2 2,836.94 2,239.82 157.00 2,082.82 597.12 9.08 606.20 303.10
UNITEDHEALTHCARE SIGNATUREVALUE HARMONY HMO (Dignity Health Medical Network)
EE 937.39 861.47 157.00 704.47 75.92 3.00 78.92 39.46
EE +1 1,874.78 1,722.94 157.00 1,565.94 151.84 6.00 157.84 78.92
EE +2 2,437.21 2,239.82 157.00 2,082.82 197.39 7.80 205.19 102.59
KAISER HMO
EE 1,021.41 861.47 157.00 704.47 159.94 3.27 163.21 81.60
EE +1 2,042.82 1,722.94 157.00 1,565.94 319.88 6.54 326.42 163.21
EE +2 2,655.67 2,239.82 157.00 2,082.82 415.85 8.50 424.35 212.17
PERS GOLD PPO (not contracted with PAMF, subject to Non-PPO charges)
EE 914.82 861.47 157.00 704.47 53.35 2.93 56.28 28.14
EE +1 1,829.64 1,722.94 157.00 1,565.94 106.70 5.85 112.55 56.28
EE +2 2,378.53 2,239.82 157.00 2,082.82 138.71 7.61 146.32 73.16
PERS PLATINUM PPO
EE 1,314.27 861.47 157.00 704.47 452.80 4.21 457.01 228.50
EE +1 2,628.54 1,722.94 157.00 1,565.94 905.60 8.41 914.01 457.01
EE +2 3,417.10 2,239.82 157.00 2,082.82 1,177.28 10.93 1,188.21 594.11
PORAC (available to only PORAC Association members)
EE 931.00 861.47 157.00 704.47 69.53 2.98 72.51 36.25
EE +1 2,117.00 1,722.94 157.00 1,565.94 394.06 6.77 400.83 200.42
EE +2 2,651.00 2,239.82 157.00 2,082.82 411.18 8.48 419.66 209.83

DELTA PREFERRED OPTION (DPO+) BUY UP OPTION DENTAL COVERAGE

EE AND DEPENDENTS - ONE FULL YEAR OF ENROLLMENT REQUIRED 48.00 24.00
VISION SERVICE PLAN
EE+1 OR MORE DEPENDENTS -- ONE FULL YEAR OF ENROLLMENT REQUIRED 17.84 8.92
EE = employee only MONTHLY COUNTY CONTRIBUTION
EE+1 = employee plus one dependent RETIREE MEDICAL
EE+2 = employee plus two or more dependents. RETIREE 157.00
* Total County Contribution for each enrollment tier is the Minimum Employer Contribution per the Public Employees' Medical
and Hospital Care Act (PEMHCA) plus the Flexible Health Allowance (FHA) contribution amount for each corresponding enrollment tier.