EMPLOYEE RATE SHEET 
BIWEEKLY PREMIUMS 
The County oers a series of health coverage opons. Choosing a health coverage opon is an important decision. To 
help  you  make  an  informed  choice,  your  plan  makes  available  a  Summary  of  Benets  and  Coverage  (SBC),  which 
summarizes important informaon about any health coverage opon in a standard format, to help you compare opons. 
The SBC is available on the web at www.co.fresno.ca.us/summarybenets. A paper copy is also available, free of charge, 
by calling Employee Benets at (559) 600-1810. 
| PLAN YEAR 2017 
On December 6, 2016, the Board of Supervisors approved the biweekly County contribuon toward the full-me biweekly 
health insurance premiums for employees in Bargaining Units 2, 3, 4, 7, 10, 11, 12, 13, 19, 22, 25, 30, 31, 36, 39, 40, 42 
and  43  as  well  as  Management,  Senior  Management,  and  Unrepresented  employees.  The  approved  full-me  biweekly 
contribuon amounts for employees in these bargaining units are $283 per pay period for employee only coverage, $378 
for employee plus spouse or employee plus child(ren) coverage, and $383 for  employee plus  family coverage, eecve 
December 19, 2016.*  
   PLAN 1     PLAN 2     PLAN 3  
Medical/Mental Health 
Kaiser Permanente          
HMO 
  
Anthem Blue Cross           
HMO 
  
Anthem Blue Cross              
PPO $250 
 
Prescripon  Kaiser Permanente    US Script/Envolve    US Script/Envolve  
Vision  Kaiser Permanente    Vision Service Plan (VSP)    Vision Service Plan (VSP)  
Dental Plans  Delta Dental 
DPPO  or 
DeltaCare 
USA DHMO   
Delta Dental 
DPPO  or 
DeltaCare 
USA DHMO    
Delta Dental 
DPPO  or 
DeltaCare 
USA DHMO 
 
  EMPLOYEE COST    EMPLOYEE COST    EMPLOYEE COST  
Employee Only 
$98.64 
    
$86.99 
 
$113.97 
    
$102.32 
 
$210.90 
    
$199.25 
 
Employee + Spouse 
$291.17 
    
$273.99 
 
$317.88 
    
$300.70 
 
$642.17 
    
$624.99 
 
Employee + Child(ren) 
$213.56 
    
$201.28 
 
$237.13 
    
$224.85 
 
$546.06 
    
$533.78 
 
Employee +  Family  $495.56       $477.00    $530.50       $511.94    $1,020.86       $1,002.30  
   PLAN 4     PLAN 5     PLAN 6  
Medical/Mental Health 
Anthem Blue Cross             
PPO $1000 
  
Anthem Blue Cross             
HDPPO $1500 
  
Anthem Blue Cross              
HDPPO $3000 
 
Prescripon  US Script/Envolve    Anthem Blue Cross    Anthem Blue Cross  
Vision  Vision Service Plan (VSP)    Vision Service Plan (VSP)    Vision Service Plan (VSP)  
Dental Plans  Delta Dental 
DPPO  or 
DeltaCare 
USA DHMO   
Delta Dental 
DPPO  or 
DeltaCare 
USA DHMO    
Delta Dental 
DPPO  or 
DeltaCare 
USA DHMO 
 
  EMPLOYEE COST    EMPLOYEE COST    EMPLOYEE COST  
Employee Only 
$91.83 
    
$80.18 
 
$59.74 
    
$48.09 
 
$2.84 
    
$0.00 
 
Employee + Spouse 
$392.22 
    
$375.04 
 
$324.86 
    
$307.68 
 
$210.24 
    
$193.06 
 
Employee + Child(ren) 
$319.61 
    
$307.33 
 
$258.58 
    
$246.30 
 
$149.65 
    
$137.37 
 
Employee +  Family  $675.55       $656.99    $582.49       $563.93    $415.93       $397.37  
How  to  use  this chart:  First, choose your medical/mental health plan. Next, choose your dental plan from the corre-
sponding  plan  column  of  your  choice.  Last,  choose  the  corresponding  level  of  coverage  that  best  meets  your  needs 
(employee only, plus spouse, children, or family) to determine your biweekly premium. 
*These rates do not apply to  part-me employees who are eligible for health insurance. For a copy of part-me rates, please visit the Open Enrollment 
website at www.co.fresno.ca.us/openenrollment or call Employee Benets at (559) 600-1810.