City Council - Successor Agency - Housing Authority
September 20, 2022

ATTACHMENT 1 – CITY SPONSORED PROGRAM PREMIUMS
Medical Plans
Monthly Premium
Cigna Open Access (PPO)
Single
$1,220.94
Two Party
$2,570.78
Family
$3,676.70
Cigna Full Network (HMO)
Single
$955.46
Two Party
$2,006.49
Family
$2,866.42
Cigna Select Network (HMO)
Single
$773.29
Two Party
$1,623.93
Family
$2,319.87
Cigna Minimum Value Plan
Single
$781.40
Two Party
$1,640.95
Family
$2,344.23
Kaiser
Single
$745.84
Two Party
$1,491.69
Family
$2,110.74
Dental Plans
Monthly Premium
Delta Dental PPO
Single
$51.14
Two Party
$102.28
Family
$127.85
ATTACHMENT 1 – CITY SPONSORED PROGRAM PREMIUM
Delta Dental HMO
Single
$15.52
Two Party
$31.03
Family
$45.78
Vision Plans
Monthly Premium
VSP
Single
$7.99
Two Party
$12.12
Family
$22.15
The Standard - Basic Life/AD&D
Life rate per $1,000
$.09/covered lives
AD&D rate per $1,000
$.02/covered lives
The Standard - Long Term Disability
Rate per $100 of monthly payroll covered
$.58/covered lives
CIGNA Employee Assistance Program (EAP)
5 face to face visits
$2.06/covered lives
Renewals for Group Insurance Programs
September 20, 2022