Cost of Coverage
Full-Time Employees (excluding SPOA members)
Effective 1/1/2026
Kaiser Permanente HMO Plan - Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer
Monthly
Contribution
Employee
Monthly
Contribution
Per Paycheck
Deduction
Employee Only $952.75 $814.00 $138.75 $69.38
Employee + 1 $1,718.73 $1,477.00 $241.73 $120.87
Employee + Family $2,323.75 $1,968.00 $355.75 $177.88
Tier with DPPO Dental Total Monthly
Employer
Monthly
Contribution
Employee
Monthly
Contribution
Per Paycheck
Deduction
Employee Only $989.58 $814.00 $175.58 $87.79
Employee + 1 $1,793.79 $1,477.00 $316.79 $158.40
Employee + Family $2,387.51 $1,968.00 $419.51 $209.76
Kaiser Permanente DEDUCTIBLE HMO Plan - Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer
Monthly
Contribution
Employee
Monthly
Contribution
Per Paycheck
Deduction
Employee Only $819.38 $814.00 $5.38 $2.69
Employee + 1 $1,478.67 $1,477.00 $1.67 $0.84
Employee + Family $2,003.66 $1,968.00 $35.66 $17.83
Tier with DPPO Dental Total Monthly
Employer
Monthly
Contribution
Employee
Monthly
Contribution
Per Paycheck
Deduction
Employee Only $856.21 $814.00 $42.21 $21.11
Employee + 1 $1,553.73 $1,477.00 $76.73 $38.37
Employee + Family $2,067.42 $1,968.00 $99.42 $49.71
Kaiser Permanente HDHP Plan - Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer
Monthly
Contribution
Employee
Monthly
Contribution
Per Paycheck
Deduction
Employee Only $771.12 $771.12 $0.00 $0.00
Employee + 1 $1,391.80 $1,391.80 $0.00 $0.00
Employee + Family $1,887.83 $1,887.83 $0.00 $0.00
Tier with DPPO Dental Total Monthly
Employer
Monthly
Contribution
Employee
Monthly
Contribution
Per Paycheck
Deduction
Employee Only $807.95 $807.95 $0.00 $0.00
Employee + 1 $1,466.86 $1,466.86 $0.00 $0.00
Employee + Family $1,951.59 $1,951.59 $0.00 $0.00
ATTACHMENT B
Cost of Coverage Full-Time Employees (excluding SPOA members) Effective 1/1/2026 Sutter Health Plus HMO Plan LG18- Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $1,269.38 $814.00 $455.38 $227.69
Employee + 1 $2,289.45 $1,477.00 $812.45 $406.23
Employee + Family $3,085.40 $1,968.00 $1,117.40 $558.70 Tier with DPPO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $1,306.21 $814.00 $492.21 $246.11
Employee + 1 $2,364.51 $1,477.00 $887.51 $443.76
Employee + Family $3,149.16 $1,968.00 $1,181.16 $590.58 Sutter Health Plus HMO Plan LG22- Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $1,189.58 $814.00 $375.58 $187.79
Employee + 1 $2,145.85 $1,477.00 $668.85 $334.43
Employee + Family $2,893.90 $1,968.00 $925.90 $462.95
Tier with DPPO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $1,226.41 $814.00 $412.41 $206.21
Employee + 1 $2,220.91 $1,477.00 $743.91 $371.96
Employee + Family $2,957.66 $1,968.00 $989.66 $494.83
Sutter Health Plus Deductible HMO Plan LG24 - Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $1,097.88 $814.00 $283.88 $141.94
Employee + 1 $1,980.75 $1,477.00 $503.75 $251.88
Employee + Family $2,673.90 $1,968.00 $705.90 $352.95
Tier with DPPO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $1,134.71 $814.00 $320.71 $160.36
Employee + 1 $2,055.81 $1,477.00 $578.81 $289.41
Employee + Family $2,737.66 $1,968.00 $769.66 $384.83
ATTACHMENT B
Sutter Health Plus Deductible HMO Plan LG29 - Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $845.88 $814.00 $31.88 $15.94
Employee + 1 $1,527.15 $1,477.00 $50.15 $25.08
Employee + Family $2,069.10 $1,968.00 $101.10 $50.55
Tier with DPPO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $882.71 $814.00 $68.71 $34.36
Employee + 1 $1,602.21 $1,477.00 $125.21 $62.61
Employee + Family $2,132.86 $1,968.00 $164.86 $82.43
Sutter Health Plus HDHP Plan HE08 - Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $1,083.68 $814.00 $269.68 $134.84
Employee + 1 $1,954.35 $1,477.00 $477.35 $238.68
Employee + Family $2,637.90 $1,968.00 $669.90 $334.95
Tier with DPPO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $1,120.51 $814.00 $306.51 $153.26
Employee + 1 $2,029.41 $1,477.00 $552.41 $276.21
Employee + Family $2,701.66 $1,968.00 $733.66 $366.83
Sutter Health Plus HDHP Plan HL12 - Medical, Dental and Vision Tier with DHMO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $835.88 $814.00 $21.88 $10.94
Employee + 1 $1,508.25 $1,477.00 $31.25 $15.63
Employee + Family $2,043.10 $1,968.00 $75.10 $37.55
Tier with DPPO Dental Total Monthly
Employer Monthly
Contribution
Employee Monthly
Contribution
Per Paycheck
Deduction
Employee Only $872.71 $814.00 $58.71 $29.36
Employee + 1 $1,583.31 $1,477.00 $106.31 $53.16
Employee + Family $2,106.86 $1,968.00 $138.86 $69.43
ATTACHMENT B