Common use of Monthly Premium Subsidy Clause in Contracts

Monthly Premium Subsidy. A. The monthly premium subsidy in effect on January 1, 2015, for each medical and/or dental plan, is a set dollar amount and is not a percentage of the premium charged by the plan. The County will pay the following monthly premium subsidy: Health & Dental Plans Employee Employee +1 Dependent Employee +2 or More Dependents Contra Costa Health Plans (CCHP), Plan A $509.92 $1,214.90 $1,214.90 Contra Costa Health Plans (CCHP), Plan B $528.50 $1,255.79 $1,255.79 Xxxxxx Permanente Health Plans $478.91 $1,115.84 $1,115.84 Health Net HMO Plans $627.79 $1,540.02 $1,540.02 Health Net PPO Plans $604.60 $1,436.25 $1,436.25 Kaiser High Deductible Health Plan $478.91 $1,115.84 $1,115.84 Delta Dental with CCHP A or B $41.17 $93.00 $93.00 Delta Dental with Kaiser or Health Net $34.02 $76.77 $76.77 Delta Dental without a Health Plan $43.35 $97.81 $97.81 DeltaCare (PMI) with CCHP A or B $25.41 $54.91 $54.91 DeltaCare (PMI) with Kaiser or Health Net $21.31 $46.05 $46.05 DeltaCare (PMI) without a Health Plan $27.31 $59.03 $59.03

Monthly Premium Subsidy. A. The monthly premium subsidy in effect on January 1, 2015, for each medical and/or dental plan, is a set dollar amount and is not a percentage of the premium charged by the plan. The County will pay the following monthly premium subsidy: Health & Dental Plans Employee Employee +1 Dependent Employee +2 or More Dependents Contra Costa Health Plans (CCHP), Plan A $509.92 $1,214.90 $1,214.90 Contra Costa Health Plans (CCHP), Plan B $528.50 $1,255.79 $1,255.79 Xxxxxx Permanente Health Plans $478.91 $1,115.84 $1,115.84 Health Net HMO Plans $627.79 $1,540.02 $1,540.02 Health Net PPO Plans $604.60 $1,436.25 $1,436.25 Kaiser High Deductible Health Plan $478.91 $1,115.84 $1,115.84 Delta Dental PPO with CCHP A or B $41.17 $93.00 $93.00 Delta Dental PPO with Kaiser or Health Net $34.02 $76.77 $76.77 Delta Dental PPO without a Health Plan $43.35 $97.81 $97.81 DeltaCare (PMI) Delta Care HMO with CCHP A or B $25.41 $54.91 $54.91 DeltaCare (PMI) Delta Care HMO with Kaiser or Health Net $21.31 $46.05 $46.05 DeltaCare (PMI) Delta Care HMO without a Health Plan $27.31 $59.03 $59.03

Monthly Premium Subsidy. A. The monthly premium subsidy in effect on January 1, 2015, for each medical and/or dental plan, is a set dollar amount and is not a percentage of the premium charged by the plan. The County will pay the following monthly premium subsidy: Health & Dental Plans Employee Employee +1 Dependent Employee +2 or More Dependents Contra Costa Health Plans (CCHP), Plan A $509.92 $1,214.90 $1,214.90 Contra Costa Health Plans (CCHP), Plan B $528.50 $1,255.79 $1,255.79 Xxxxxx Permanente Health Plans $478.91 $1,115.84 $1,115.84 Health Net HMO Plans $627.79 $1,540.02 $1,540.02 Health Net PPO Plans $604.60 $1,436.25 $1,436.25 Kaiser County Selected High Deductible Health Plan $478.91 $1,115.84 $1,115.84 Delta Dental with CCHP A or B $41.17 $93.00 $93.00 Delta Dental with Kaiser or Health Net $34.02 $76.77 $76.77 Delta Dental without a Health Plan $43.35 $97.81 $97.81 DeltaCare (PMI) with CCHP A or B $25.41 $54.91 $54.91 DeltaCare (PMI) with Kaiser or Health Net $21.31 $46.05 $46.05 DeltaCare (PMI) without a Health Plan $27.31 $59.03 $59.03

Monthly Premium Subsidy. A. The monthly premium subsidy in effect on January 1, 2015, for each medical and/or dental plan, is a set dollar amount and is not a percentage of the premium charged by the plan. The County will pay the following monthly premium subsidy: Health & Dental Plans Employee Employee +1 Dependent Employee +2 or More Dependents Contra Costa Health Plans (CCHP), Plan A $509.92 $1,214.90 $1,214.90 Contra Costa Health Plans (CCHP), Plan B $528.50 $1,255.79 $1,255.79 Xxxxxx Permanente Health Plans $478.91 $1,115.84 $1,115.84 Health Net HMO Plans $627.79 $1,540.02 $1,540.02 Health Net PPO Plans $604.60 $1,436.25 $1,436.25 Kaiser High Deductible Health Plan $478.91 $1,115.84 $1,115.84 Delta Dental PPO with CCHP A or B $41.17 $93.00 $93.00 Delta Dental PPO with Kaiser or Health Net $34.02 $76.77 $76.77 Delta Dental PPO without a Health Plan $43.35 $97.81 $97.81 DeltaCare (PMI) Delta Care HMO with CCHP A or B $25.41 $54.91 $54.91 DeltaCare (PMI) Delta Care HMO with Kaiser or Health Net $21.31 $46.05 $46.05 DeltaCare (PMI) Delta Care HMO without a Health Plan $27.31 $59.03 $59.0359.03 Deputy District Attorneys’ Assn 00 0000-0000

Monthly Premium Subsidy. A. The monthly premium subsidy in effect on January 1, 2015, for each medical and/or dental plan, is a set dollar amount and is not a percentage of the premium charged by the plan. The County will pay the following monthly premium subsidy: Health & Dental Plans Employee Employee +1 Dependent Employee +2 or More Dependents Contra Costa Health Plans (CCHP), Plan A $509.92 $1,214.90 $1,214.90 Contra Costa Health Plans (CCHP), Plan B $528.50 $1,255.79 $1,255.79 Xxxxxx Permanente Health Plans $478.91 $1,115.84 $1,115.84 SEIU 1021 SLS - 51 - 2022-2026 Health Net HMO Plans $627.79 $1,540.02 $1,540.02 Health Net PPO Plans $604.60 $1,436.25 $1,436.25 Kaiser High Deductible Health Plan $478.91 $1,115.84 $1,115.84 Delta Dental PPO with CCHP A or B $41.17 $93.00 $93.00 Delta Dental PPO with Kaiser or Health Net $34.02 $76.77 $76.77 Delta Dental PPO without a Health Plan $43.35 $97.81 $97.81 DeltaCare (PMI) HMO with CCHP A or B $25.41 $54.91 $54.91 DeltaCare (PMI) HMO with Kaiser or Health Net $21.31 $46.05 $46.05 DeltaCare (PMI) HMO without a Health Plan $27.31 $59.03 $59.03