Medical Plan Premium Comparison Charts for Extra Help Employees

Effective Dates:

June 1, 2020 - May 31, 2021

Level of Coverage: Self

Medical Plan	Semi-Monthly Employee Cost	Semi-Monthly County Contribution	Semi-Monthly Total Premium
Kaiser Permanente HMO	$251.97	$200.00	$451.97
Kaiser Permanente Hospital Services DHMO	$163.92	$200.00	$363.92
Kaiser Permanente Deductible First HDHP	$122.67	$200.00	$322.67
Sutter Health Plus HMO	$137.19	$200.00	$337.19
Sutter Health Plus Hospital Services DHMO	$89.31	$200.00	$289.31
Sutter Health Plus Deductible First HDHP	$68.59	$200.00	$268.59
Western Health Advantage HMO	$149.50	$200.00	$349.50
Western Health Advantage Hospital Services DHMO	$89.72	$200.00	$289.72
Western Health Advantage Deductible First HDHP	$62.74	$200.00	$262.74

Medical Plan	Semi-Monthly Employee Cost	Semi-Monthly County Contribution	Semi-Monthly Total Premium
Kaiser Permanente HMO	$703.94	$200.00	$903.94
Kaiser Permanente Hospital Services DHMO	$527.84	$200.00	$727.84
Kaiser Permanente Deductible First HDHP	$445.34	$200.00	$645.34
Sutter Health Plus HMO	$474.43	$200.00	$674.43
Sutter Health Plus Hospital Services DHMO	$378.65	$200.00	$578.65
Sutter Health Plus Deductible First HDHP	$336.99	$200.00	$536.99
Western Health Advantage HMO	$499.00	$200.00	$699.00
Western Health Advantage Hospital Services DHMO	$379.46	$200.00	$579.46
Western Health Advantage Deductible First HDHP	$325.50	$200.00	$525.50

Medical Plan	Semi-Monthly Employee Cost	Semi-Monthly County Contribution	Semi-Monthly Total Premium
Kaiser Permanente HMO	$1,079.08	$200.00	$1,279.08
Kaiser Permanente Hospital Services DHMO	$829.89	$200.00	$1,029.89
Kaiser Permanente Deductible First HDHP	$713.16	$200.00	$913.16
Sutter Health Plus HMO	$754.41	$200.00	$954.41
Sutter Health Plus Hospital Services DHMO	$618.85	$200.00	$818.85
Sutter Health Plus Deductible First HDHP	$560.23	$200.00	$760.23
Western Health Advantage HMO	$789.08	$200.00	$989.08
Western Health Advantage Hospital Services DHMO	$619.94	$200.00	$819.94
Western Health Advantage Deductible First HDHP	$543.59	$200.00	$743.59

Benefits Unit

Human Resources Department

Business Hours

Address

575 Administration Drive

Room 116 B

Santa Rosa, CA 95403

38.465237, -122.725363

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