Rates - Level A

All rates automatically include Life and Accidental Death and Dismemberment coverage

2018 Monthly Premium Rates - Level A

Blue Shield
HMO Access+

$25 office visit co-pay /
$100 + 25% Hospital co-pay
Member
Only
Member
+ 1
Family
Blue Shield HMO Access+
+ Chiropractic / Acupuncture
$200.00 $977.00 $1,689.00
Blue Shield HMO Access+
+ Dental: DeltaCare
+ Vision
+ Chiropractic / Acupuncture
$200.00 $997.00 $1,729.00
Blue Shield HMO Access+
+ Dental: DeltaPPO
+ Vision
+ Chiropractic / Acupuncture
$247.00 $1,085.00 $1,869.00
Blue Shield
HMO Trio ACO

$20 office visit co-pay / $1,500 Deductible
+ 25% Hospital co-pay
Member
Only
Member
+ 1
Family
Blue Shield HMO Trio ACO
+ Chiropractic / Acupuncture
$125.00 $756.00 $1,326.00
Blue Shield HMO Trio ACO
+ Dental: DeltaCare
+ Vision
+ Chiropractic / Acupuncture
$125.00 $777.00 $1,366.00
Blue Shield HMO Trio ACO
+ Dental: DeltaPPO
+ Vision
+ Chiropractic / Acupuncture
$172.00 $865.00 $1,506.00
Kaiser Permanente
Traditional HMO

$30 office visit co-pay /
$500 Hospital co-pay
Member
Only
Member
+ 1
Family
Kaiser Permanente Traditional HMO
+ Chiropractic / Acupuncture
$200.00 $832.00 $1,419.00
Kaiser Permanente Traditional HMO
+ Dental: DeltaCare
+ Vision
+ Chiropractic / Acupuncture
$200.00 $852.00 $1,459.00
Kaiser Permanente Traditional HMO
+ Dental: DeltaPPO
+ Vision
+ Chiropractic / Acupuncture
$247.00 $940.00 $1,599.00
Kaiser Permanente
Deductible HMO

$20 office visit co-pay / $1,500 Deductible
20% of some services
Member
Only
Member
+ 1
Family
Kaiser Permanente Deductible HMO
+ Chiropractic / Acupuncture
$125.00 $653.00 $1,143.00
Kaiser Permanente Deductible HMO
+ Dental: DeltaCare
+ Vision
+ Chiropractic / Acupuncture
$125.00 $673.00 $1,183.00
Kaiser Permanente Deductible HMO
+ Dental: DeltaPPO
+ Vision
+ Chiropractic / Acupuncture
$172.00 $761.00 $1,324.00
Kaiser Permanente
HSA-Qualified Deductible HMO

$30 office visit co-pay / $2,700 Deductible
30% of some services
Member
Only
Member
+ 1
Family
Kaiser Permanente HSA HMO
+ Chiropractic / Acupuncture
$125.00 $519.00 $885.00
Kaiser Permanente HSA HMO
+ Dental: DeltaCare
+ Vision
+ Chiropractic / Acupuncture
$125.00 $539.00 $925.00
Kaiser Permanente HSA HMO
+ Dental: DeltaPPO
+ Vision
+ Chiropractic / Acupuncture
$172.00 $627.00 $1,065.00
Level A Level B Level C contact us