ATTACHMENT A
CITY OF ANAHEIM
HEALTH & WELFARE PLAN CARRIERS AND RATES – 2023
LONG TERM DISABILITY INSURANCE (The Hartford) Total Plan Cost/Monthly
• APA (per $100 of covered wages) $0.320 • All other employees (per $100 of covered wages) $0.370
SHORT TERM DISABILITY ADVICE TO PAY WITH CHECK CUTTING SERVICES (The Hartford)
• Per employee $1.82
BASIC TERM LIFE INSURANCE (The Hartford)
• All employees (per $1,000 volume) $0.055 • Dependents (per $10,000 unit) $0.769
GROUP AD&D (The Hartford)
• Basic AD&D (per $1,000 volume) $0.015 • Supplemental AD&D, Management Only (per $1,000 volume) $0.038
SUPPLEMENTAL TERM LIFE INSURANCE (The Hartford)
• Management employees
• IBEW, AMEA, Fire Association & Confidential employees
Age Banded
(Per $1,000 volume)
Under 35 $0.06
35 – 39 $0.08
40 – 44 $0.12
45 – 49 $0.20
50 – 54 $0.30
55 – 59 $0.48
60 – 64 $0.60
65 – 69 $1.10
70 – 74 $1.84
75 + $3.60
2023 Health and Welfare Plan Rates – Attachment A
DENTAL ADMINISTRATIVE SERVICES (Delta Dental PPO) Total Plan Cost/Monthly
• Per employee $6.24
DELTA DENTAL PPO (ACTIVE AND RETIREE)
• Single $58.65
• 2 Party $99.71
• Family $152.47
DELTA DENTAL HMO (ACTIVE AND RETIREE)
• Single $17.55
• 2 Party $29.03
• Family $42.90
FLEXIBLE SPENDING ACCOUNT ADMINISTRATIVE FEE (Igoe Administrative Services)
• Per employee $3.50
HEALTH SAVINGS ACCOUNT (HSA) ADMINISTRATIVE FEE (Igoe Administrative Services)
• Per employee $1.30
COBRA SERVICES ADMINISTRATIVE FEE (Igoe Administrative Services)
• Per employee $0.42
EMPLOYEE ASSISTANCE PROGRAM (REACH)
• Per full-time employee per month $2.25 • Flat monthly fee (all part-time employees) $950.00
VITALITY WELLNESS PROGRAM
• Per benefit-eligible employee per month* $3.79
* Vitality’s fees are paid by medical plan carrier funds and the City does not incur a cost to offer the program.
2023 Health and Welfare Plan Rates – Attachment A
MEDICAL PLANS (ACTIVE)
BLUE SHIELD ACCESS + HMO Total Plan Cost/Monthly
Single $821.59
2 Party $1,646.58
Family $2,328.88
BLUE SHIELD TRIO HMO
Single $669.68
2 Party $1,342.13
Family $1,898.28
BLUE SHIELD PPO SAVINGS WITH HSA OPTION
Single $1,152.80
2 Party $2,305.59
Family $3,262.42
BLUE SHIELD FULL PPO
Single $1,373.59
2 Party $2,747.21
Family $3,887.31
KAISER CALIFORNIA (HMO)
Single $623.13
2 Party $1,246.26
Family $1,763.47
KAISER CALIFORNIA – HMO Part-Time Plan 1
Single $548.85
2 Party $1,097.71
Family $1,553.25
KAISER CALIFORNIA-HMO Part-Time Plan 2
Single $623.69
2 Party $1,247.39
Family $1,765.05
2023 Health and Welfare Plan Rates – Attachment A
MEDICAL PLANS (PRE-65 RETIREE)
BLUE SHIELD ACCESS + HMO Total Plan Cost/Monthly
Single $997.03
Two-Party $1,998.16
Family $2,826.18
BLUE SHIELD TRIO HMO (ACO)
Single $812.35
Two-Party $1,628.02
Family $2,302.69
BLUE SHIELD PPO SAVINGS
Single $1,290.46
Two-Party $2,580.93
Family $3,652.02
BLUE SHIELD FULL PPO
Single $1,774.33
Two-Party $3,548.67
Family $5,021.36
KAISER CA HMO
Single $747.34
Two-Party $1,494.68
Family $2,114.97
KAISER HMO COLORADO
Single $1,500.00
Two-Party $3,000.00
Family $4,335.00
KAISER HMO GEORGIA
Single $1,158.09
Two-Party $2,316.18
Family $3,474.28
2023 Health and Welfare Plan Rates – Attachment A
P age 5 of 7 August 23, 2022
MEDICAL PLANS (PRE-65 RETIREE) CONTINUED
KAISER HMO HAWAII Total Plan Cost/Monthly
Single $975.70
Two-Party $1,951.41
Family $2,927.11
KAISER HMO NORTHWEST LIMITED
Single $1,115.14
$2,230.27
$3,345.41
Two-Party
Family
UNITED HEALTHCARE HMO
Single $3,423.85
Two-Party $6,843.21
Family $9,648.57
2023 Health and Welfare Plan Rates – Attachment A
MEDICAL PLANS (POST-65 RETIREE)
BLUE SHIELD ACCESS + HMO WITH RX PDP Total Plan Cost/Monthly Single $899.23
Two-Party $1,800.88
BLUE SHIELD CMED WITH OR WITHOUT RX PDP
Single $1,336.59
Two-Party $2,673.20
BLUE SHIELD FULL PPO WITH RX PDP
Single $1,165.30
Two-Party $2,330.57
Family $3,348.82
BLUE SHIELD PPO SAVINGS WITH RX PDP
Single $873.03
Two-Party $2,160.50
Family $2,384.05
BLUE SHIELD MEDICARE ADVANTAGE (PPO)
Single $611.64
Two-Party $1,223.28
BLUE SHIELD MEDICARE ADVANTAGE (PPO) EXTENDED SERVICE AREA Single $629.45
Two-Party $1,258.90
BLUE SHIELD MEDICARE ADVANTAGE (HMO)
Single $391.10
Two-Party $782.20
KAISER CALIFORNIA - SENIOR ADVANTAGE (HMO)
Retiree $159.55
Retiree & Spouse, One Medicare $906.89
Retiree & Spouse, One Medicare & Child(ren) $1,527.18
Retiree & Spouse, Two Medicare & Child(ren) $939.39
Retiree, Part B Only $471.55
KAISER CALIFORNIA DOUBLE COVERAGE
Single $141.77
Two-Party $283.54
KAISER SENIOR ADVANTAGE COLORADO
Retiree $235.00
Retiree & Spouse, One Medicare $1,735.00
Retiree & Spouse, Two Medicare $470.00
Retiree & Spouse, One Medicare & Child(ren) $3,070.00
Retiree & Spouse, Two Medicare & Child(ren) $1,970.00
2023 Health and Welfare Plan Rates – Attachment A
MEDICAL PLANS (POST-65 RETIREE) CONTINUED
KAISER SENIOR ADVANTAGE GEORGIA HMO
Retiree $405.55
Retiree & Spouse, One Medicare $1,563.64
Retiree & Spouse, Two Medicare $811.10
Retiree & Spouse, One Medicare & Child(ren) $2,721.75
Retiree & Spouse, Two Medicare & Child(ren) $1,969.20
KAISER SENIOR ADVANTAGE HAWAII HMO
Retiree $405.71
Retiree & Spouse, One Medicare $1,381.41
Retiree & Spouse, Two Medicare $811.42
Retiree & Spouse, One Medicare & Child(ren) $2,357.11
Retiree & Spouse, Two Medicare & Child(ren) $1,787.12
KAISER SENIOR ADVANTAGE NORTHWEST LIMITED HMO
Retiree $317.30
Retiree & Spouse, One Medicare $1,432.44
Retiree & Spouse, Two Medicare $634.60
Retiree & Spouse, One Medicare & Child(ren) $2,547.58
Retiree & Spouse, Two Medicare & Child(ren) $1,749.74
UNITED HEALTHCARE MEDICARE HMO
Retiree $340.07
Retiree & Spouse, One Medicare $3,763.92
Retiree & Spouse, Two Medicare $680.14
Retiree & Spouse, One Medicare & Child(ren) $6,569.28
Retiree & Spouse, Two Medicare & Child(ren) $3,485.50