Archive - Benefits and Assessments Rates

2018 Health Plan Cost (Employer)

*2018 UC EMPLOYER RATES*
NON-MEDICARE EMPLOYER RATES - 2018 CORE Major Medical Plan - PPO (AC)	Self	Self + Child(ren)	Self + Adult	Family
All Pay Bands	185.00	333.00	388.50	536.50
NON-MEDICARE EMPLOYER RATES - 2018 UC Health Savings Plan - PPO (AP)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $54,000 or less	443.17	797.70	928.86	1283.41
Pay Band 2 - Employer premium - $54,001 - $107,000	407.12	732.81	846.56	1172.27
Pay Band 3 - Employer premium - $107,001 - $161,000	370.12	666.21	772.80	1068.91
Pay Band 4 - Employer premium - $161,001 or more	331.81	597.25	696.38	961.84
NON-MEDICARE EMPLOYER RATES - 2018 Western Health Advantage (WH)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $54,000 or less	710.95	1279.71	1491.21	2060.00
Pay Band 2 - Employer premium - $54,001 - $107,000	674.90	1214.82	1408.91	1948.86
Pay Band 3 - Employer premium - $107,001 - $161,000	637.90	1148.22	1335.15	1845.50
Pay Band 4 - Employer premium - $161,001 or more	599.59	1079.26	1258.73	1738.43
NON-MEDICARE EMPLOYER RATES - 2018 Kaiser Permanente – CA (KN & KS)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $54,000 or less	521.25	938.25	1092.91	1509.93
Pay Band 2 - Employer premium - $54,001 - $107,000	485.20	873.36	1010.61	1398.79
Pay Band 3 - Employer premium - $107,001 - $161,000	448.20	806.76	936.85	1295.43
Pay Band 4 - Employer premium - $161,001 or more	409.89	737.80	860.43	1188.36
NON-MEDICARE EMPLOYER RATES - 2018 Health Net Blue & Gold (HB)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $54,000 or less	699.29	1258.72	1408.82	1968.26
Pay Band 2 - Employer premium - $54,001 - $107,000	663.24	1193.83	1326.52	1857.12
Pay Band 3 - Employer premium - $107,001 - $161,000	626.24	1127.23	1252.76	1753.76
Pay Band 4 - Employer premium - $161,001 or more	587.93	1058.27	1176.34	1646.69
NON-MEDICARE EMPLOYER RATES - 2018 UC Care (AU)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $54,000 or less	862.73	1552.91	1752.04	2442.22
Pay Band 2 - Employer premium - $54,001 - $107,000	826.67	1488.02	1669.74	2331.08
Pay Band 3 - Employer premium - $107,001 - $161,000	789.68	1421.42	1595.98	2227.72
Pay Band 4 - Employer premium - $161,001 or more	751.37	1352.46	1519.56	2120.65

*EMPLOYER RATES - 2018*	Self	Self + Child(ren)	Self + Adult	Family
DELTA DENTAL PPO (D1)	41.94	86.24	78.58	140.83
DELTACARE USA (D3)	19.30	33.64	33.11	47.47
VISION SERVICE PLAN (V1)	12.75	12.75	12.75	12.75
LEGAL PLAN (ARAG)	0.00	0.00	0.00	0.00

POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP) - 2018	Self	Self + Child(ren)	Self + Adult	Family
PSBP MEDICAL HMO (P1-HN Group # 66700A)	528.16	924.37	1254.76	1,594.57
PSBP MEDICAL PPO (P2-HN Group #N2982A)	479.36	833.89	1158.44	1463.05
PSBP DENTAL DHMO (P3-HN Group #Z0074A)	8.02	15.22	14.12	22.43
PSBP DENTAL PPO (P4-Principal Group #H12843)	23.20	54.00	48.39	86.90
PSBP VISION PPO (P5-HN Group #Z0074A)	4.00	7.45	6.68	11.40
PSBP BROKER/ADMIN FEE	9.83	9.83	9.83	9.83
PSBP LIFE/AD&D ($50,000)	3.05	3.05	3.05	3.05
PSBP SHORT-TERM DISABILITY	9.80	9.80	9.80	9.80
PSBP LONG-TERM DISABILITY	0.00	0.00	0.00	0.00
PSBP WORKERS COMP INS (FELLOWS & PD) PSBP WORKERS CPMP INS (EMPLOYEES)	51.15 Sal. %	51.15 Sal. %	51.15 Sal. %	51.15 Sal. %

2018 Health Plan Cost (Employee)

2018 UC EMPLOYEE RATES
CORE (PPO)	Self	Self + Child(ren)	Self + Adult	Family
All Pay Bands	0.00	0.00	0.00	0.00
UC Health Savings Plan (PPO)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $54,000 or less	19.83	35.70	43.44	59.29
Pay Band 2 - Employee premium - $54,001 - $107,000	55.88	100.59	125.74	170.43
Pay Band 3 - Employee premium - $107,001 - $161,000	92.88	167.19	199.50	273.79
Pay Band 4 - Employee premium - $161,001 or more	131.19	236.15	275.92	380.86
Kaiser Permanente - CA (HMO) Western Health Advantage (HMO)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $54,000 or less	18.97	34.15	41.55	56.71
Pay Band 2 - Employee premium - $54,001 - $107,000	55.02	99.04	123.85	167.85
Pay Band 3 - Employee premium - $107,001 - $161,000	92.02	165.64	197.61	271.21
Pay Band 4 - Employee premium - $161,001 or more	130.33	234.60	274.03	378.28
Health Net Blue & Gold (HMO)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $54,000 or less	39.57	71.22	142.78	174.44
Pay Band 2 - Employee premium - $54,001 - $107,000	75.62	136.11	225.08	285.58
Pay Band 3 - Employee premium - $107,001 - $161,000	112.62	202.71	298.84	388.94
Pay Band 4 - Employee premium - $161,001 or more	150.93	271.67	375.26	496.01
UC CARE (PPO)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $54,000 or less	106.27	191.29	282.86	367.88
Pay Band 2 - Employee premium - $54,001 - $107,000	142.32	256.18	365.16	479.02
Pay Band 3 - Employee premium - $107,001 - $161,000	179.32	322.78	438.92	582.38
Pay Band 4 - Employee premium - $161,001 or more	217.63	391.74	515.34	689.45
	Self	Self + Child(ren)	Self + Adult	Family
DELTA DENTAL PPO	Free	Free	Free	Free
DELTACARE USA (formerly PMI DENTAL)	Free	Free	Free	Free
VISION SERVICE PLAN	Free	Free	Free	Free
LEGAL PLAN (ARAG)	10.87	14.95	14.95	16.31
POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MED HMO	10.78	18.86	38.81	49.32
PSBP MED PPO	20.00	40.00	40.00	60.00
PSBP DENTAL HMO	Free	Free	Free	Free
PSBP DENTAL PPO	Free	Free	Free	Free
PSBP VISION	Free	Free	Free	Free
PSBP LONG-TERM DISABILITY	8.55	8.55	8.55	8.55

UNIVERSITY OF CALIFORNIA RETIREMENT PLAN (UCRP)	Eff. Date	New Rate	Eff. Date	Old Rate
1976 Tier - Members with Social Security 99, A5, BX, CX, IX, K5, LX, and PX EX SX NX HX, RX, TX PA (Safety members)	7/14 7/14 7/14 7/14 7/14 7/14	8.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19	7/13 8/13 10/13 2/14 3/14 7/13	6.5% less $19 6.5% less $19 6.5% less $19 8.0% less $19 8.6% less $19 7.5% less $19
2013 Tier - Members with Social Security 99, A5, BX, CX, IX, K5, LX, and PX EX, HX, NX, RX, SX, TX	07/13 07/14	7.0% (no $19) 9.0% (no $19)	7/13 7/13	7.0% (no $19) 7.0% (no $19)
2016 Tier - Members with Social Security 99, DX, IX, K5, LX CX, EX, HX, NX, PA, RX, SX, TX (not participating)	07/16 07/16	7.0% (no $19) 0.0% (no $19)	7/16 7/16	7.0% (no $19) 7.0% (no $19)

2017 Benefits Rate Table

2017 UCR BENEFIT RATES (R 8/1/2017)
DESCRIPTION

NEW RATE

EFF.
DATE

OLD RATE

EFF.
DATE

PERCENTAGE BASED BENEFITS

Social Security
Gross Limit

6.20%
$127,200

01/91
01/17

6.20%
$118,500

01/91
01/15

Medicare
Gross limit

1.45%
NO LIMIT

01/87
01/94

1.45%
NO LIMIT

01/87
01/94

Workers Compensation Insurance (plus $5,000 per qualified claim)

0.82%

07/17

1.23%

07/16

Employee Support Program

0.28%

07/01

0.24%

07/94

Unemployment Insurance

General Funds
Federal Funds
Other Funds

0.10%
0.60%
0.10%

07/15
07/16
07/16

0.15%
0.55%
0.15%

07/14
07/14
07/15

UC Retirement Plan (UCRP) Employer Contribution

14.00%

07/14

12.00%

07/13

UCRP Supplemental Assessment Rate

1.30%

07/17

1.19%

07/16

Vacation Assessment (Gross salary times rate below)

Effective 10/2014 (old factors in parenthesis effective 07/2012)

LEAVE CODE	NO UCRP	UCRP WITHOUT FICA	UCRP WITH FICA	SAFETY MEMBERS
A & G (STAFF)	.0551 (.0612)	.0739 (.0954)	.0779 (.0998)	.0779 (.0998)
B & H (STAFF)	.0661 (.0734)	.0887 (.1144)	.0935 (.1197)	.0935 (.1197)
C & J (STAFF)	.0772 (.0858)	.1035 (.1336)	.1091 (.1398)	.1091 (.1398)
D & K (STAFF)	.0882 (.0980)	.1183 (.1526)	.1247 (.1597)	.1247 (.1597)
D & E (ACADEMIC)	.0588 (.0980)	.0789 (.1526)	.0831 (.1597)	N/A

Staff Recognition & Development Award Program (SRDP) - formerly Incentive Award Program (IAP)

Description	New Rate	Eff Date	Old Rate	Eff. Date
Staff Appreciation & Recognition (STAR) - Non-represented (99)	0.89%	07/07	0.80%	04/07
Staff Appreciation and Recognition (STAR) - CX	0.89%	07/15	0.00%	07/06
Incentive Award Program (IAP) - FF, K5, RX, SX,	0.00%	07/06	0.50%	01/01
Incentive Award Program (IAP) - TX	0.00%	10/06	0.50%	10/00
Incentive Award Program (IAP) - HX	0.00%	04/07	0.50%	02/01
Incentive Award Program (IAP) - NX	0.00%	03/08	0.50%	02/01
Incentive Award Program (IAP) - EX	0.00%	07/11	0.50%	02/01
Incentive Award Program (IAP) - PA	0.00%	09/11	0.50%	02/01

A10

Other PostEmployment Benefit (OPEB)

2.80%

07/17

2.93%

07/16

A11

Benefits Administration Rate related to OPEB

0.17%

07/10

0.16%

07/08

A12

General Liability - Loc. 5 (UCRFS charge)
General Liability - Loc. N (UCRFS charge)

0.5545%
0.6200%

07/17
07/17

0.5381%
0.5400%

07/16
07/16

A13

Employment Practices - Loc. 5 (UCRFS charge)
Employment Practices - Loc. N (UCRFS charge)

0.3587%
0.2800%

07/17
07/17

0.4452%
0.2300%

07/16
07/16

FLAT RATED (DOLLAR) BENEFITS

NEW AMOUNT

EFF DATE

OLD AMOUNT

EFF DATE

HEALTH INSURANCE - EMPLOYER RATES (separate table)

HEALTH INSURANCE - EMPLOYEE RATES (separate table)

Life Insurance(Flat Rate)

$4.34

01/07

$4.82

01/96

Core Life Insurance (Flat Rate)

$0.47

01/96

$0.52

01/94

U.C. Paid (Basic) Disability (Flat Rate)

$8.04

01/17

$6.71

01/09

Graduate Student (GS) Remission Programs

GS Health Insurance Program (GSHIP) with Admin fee/QTR

$1,188.06

10/17

$1,127.00

10/16

GS Fee Remission - Residents/QTR
GS Fee Remission - Non-Residents/QTR
GS Fee Remission - AGSM/QTR

$4210.00
$4210.00
$4210.00

10/17
10/17
10/17

$4097.00
$4097.00
$4097.00

10/16
10/16
10/16

GS Non-resident Supplemental Tuition Remission/QTR
GS Nonresident Supplemental Tuition/AGSM

$5034.00
$4082.00

10/04
10/17

$5034.00
$4097.00

10/04
10/16

2017 Health Plan Cost (Employer)

*2017 UC EMPLOYER RATES (revised 4/6/2017)*
NON-MEDICARE EMPLOYER RATES - 2017 CORE Major Medical Plan - PPO (AC)	Self	Self + Child(ren)	Self + Adult	Family
All Pay Bands	185.00	333.00	388.50	536.50
NON-MEDICARE EMPLOYER RATES - 2017 UC Health Savings Plan - PPO (AP)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $53,000 or less	557.60	1003.69	1169.43	1615.52
Pay Band 2 - Employer premium - $53,001 - $104,000	521.55	938.80	1087.13	1504.38
Pay Band 3 - Employer premium - $104,001 - $156,000	484.55	872.20	1013.37	1401.02
Pay Band 4 - Employer premium - $156,001 or more	446.24	803.24	936.95	1293.95
NON-MEDICARE EMPLOYER RATES - 2017 Western Health Advantage (WH)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $53,000 or less	571.07	1027.93	1197.65	1654.53
Pay Band 2 - Employer premium - $53,001 - $104,000	535.02	963.04	1115.35	1543.39
Pay Band 3 - Employer premium - $104,001 - $156,000	498.02	896.44	1041.59	1440.03
Pay Band 4 - Employer premium - $156,001 or more	459.71	827.48	965.17	1332.96
NON-MEDICARE EMPLOYER RATES - 2017 Kaiser Permanente – CA (KN & KS)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $53,000 or less	585.75	1054.35	1228.47	1697.10
Pay Band 2 - Employer premium - $53,001 - $104,000	549.70	989.46	1146.17	1585.96
Pay Band 3 - Employer premium - $104,001 - $156,000	512.70	922.86	1072.41	1482.60
Pay Band 4 - Employer premium - $156,001 or more	474.39	853.90	995.99	1375.53
NON-MEDICARE EMPLOYER RATES - 2017 Health Net Blue & Gold (HB)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $53,000 or less	665.25	1197.46	1339.62	1871.82
Pay Band 2 - Employer premium - $53,001 - $104,000	629.20	1132.57	1257.32	1760.68
Pay Band 3 - Employer premium - $104,001 - $156,000	592.20	1065.97	1183.56	1657.32
Pay Band 4 - Employer premium - $156,001 or more	553.89	997.01	1107.14	1550.25
NON-MEDICARE EMPLOYER RATES - 2017 UC Care (AU)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $53,000 or less	665.18	1197.32	1339.44	1871.58
Pay Band 2 - Employer premium - $53,001 - $104,000	629.13	1132.43	1257.14	1760.44
Pay Band 3 - Employer premium - $104,001 - $156,000	592.13	1065.83	1183.38	1657.08
Pay Band 4 - Employer premium - $156,001 or more	553.82	996.87	1106.96	1550.01

*EMPLOYER RATES - 2017*	Self	Self + Child(ren)	Self + Adult	Family
DELTA DENTAL PPO (D1) - r2/24/17	42.75	87.91	80.10	143.56
DELTACARE USA (D3) - r2/24/17	20.03	34.92	34.37	49.27
VISION SERVICE PLAN (V1)	12.75	12.75	12.75	12.75
LEGAL PLAN (ARAG)	0.00	0.00	0.00	0.00

POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP) - 2017	Self	Self + Child(ren)	Self + Adult	Family
PSBP MEDICAL HMO (P1-HN Group # 66700A)	490.90	859.16	1166.24	1,482.08
PSBP MEDICAL PPO (P2-HN Group #N2982A)	501.63	872.87	1211.90	1530.99
PSBP DENTAL DHMO (P3-HN Group #Z0074A)	8.25	15.66	14.84	23.08
PSBP DENTAL PPO (P4-Principal Group #H12843)	23.97	55.79	49.99	89.78
PSBP VISION PPO (P5-HN Group #Z0074A)	4.03	7.50	6.73	11.48
PSBP BROKER/ADMIN FEE	9.83	9.83	9.83	9.83
PSBP LIFE/AD&D ($50,000)	3.05	3.05	3.05	3.05
PSBP SHORT-TERM DISABILITY	9.80	9.80	9.80	9.80
PSBP LONG-TERM DISABILITY	0.00	0.00	0.00	0.00
PSBP WORKERS COMP INS (FELLOWS & PD) PSBP WORKERS CPMP INS (EMPLOYEES)	49.97 Sal. %	49.97 Sal. %	49.97 Sal. %	49.97 Sal. %

2017 Health Plan Cost (Employee)

2017 UC EMPLOYEE RATES (r 4/6/17)
CORE (PPO)	Self	Self + Child(ren)	Self + Adult	Family
All Pay Bands	0.00	0.00	0.00	0.00
UC Health Savings Plan (PPO)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $53,000 or less	16.93	30.47	37.08	50.60
Pay Band 2 - Employee premium - $53,001 - $104,000	52.98	95.36	119.38	161.74
Pay Band 3 - Employee premium - $104,001 - $156,000	89.98	161.96	193.14	265.10
Pay Band 4 - Employee premium - $156,001 or more	128.29	230.92	269.56	372.17
Kaiser Permanente - CA (HMO) Western Health Advantage (HMO)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $53,000 or less	17.78	32.00	38.94	53.14
Pay Band 2 - Employee premium - $53,001 - $104,000	53.83	96.89	121.24	164.28
Pay Band 3 - Employee premium - $104,001 - $156,000	90.83	163.49	195.00	267.64
Pay Band 4 - Employee premium - $156,001 or more	129.14	232.45	271.42	374.71
Health Net Blue & Gold (HMO)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $53,000 or less	37.08	66.74	135.29	164.95
Pay Band 2 - Employee premium - $53,001 - $104,000	73.13	131.63	217.59	276.09
Pay Band 3 - Employee premium - $104,001 - $156,000	110.13	198.23	291.35	379.45
Pay Band 4 - Employee premium - $156,001 or more	148.44	267.19	367.77	486.52
UC CARE (PPO)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $53,000 or less	88.75	159.75	243.81	314.82
Pay Band 2 - Employee premium - $53,001 - $104,000	124.80	224.64	326.11	425.96
Pay Band 3 - Employee premium - $104,001 - $156,000	161.80	291.24	399.87	529.32
Pay Band 4 - Employee premium - $156,001 or more	200.11	360.20	476.29	636.39
	Self	Self + Child(ren)	Self + Adult	Family
DELTA DENTAL PPO	Free	Free	Free	Free
DELTACARE USA (formerly PMI DENTAL)	Free	Free	Free	Free
VISION SERVICE PLAN	Free	Free	Free	Free
LEGAL PLAN (ARAG)	10.41	14.32	14.32	15.62
POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MED HMO	10.02	17.53	36.07	45.84
PSBP MED PPO	20.00	40.00	40.00	60.00
PSBP DENTAL HMO	Free	Free	Free	Free
PSBP DENTAL PPO	Free	Free	Free	Free
PSBP VISION	Free	Free	Free	Free
PSBP LONG-TERM DISABILITY	8.55	8.55	8.55	8.55

UNIVERSITY OF CALIFORNIA RETIREMENT PLAN (UCRP)	Eff. Date	New Rate	Eff. Date	Old Rate
1976 Tier - Members with Social Security 99, A5, BX, CX, IX, K5, LX, and PX EX SX NX HX, RX, TX PA (Safety members)	7/14 7/14 7/14 7/14 7/14 7/14	8.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19	7/13 8/13 10/13 2/14 3/14 7/13	6.5% less $19 6.5% less $19 6.5% less $19 8.0% less $19 8.6% less $19 7.5% less $19
2013 Tier - Members with Social Security 99, A5, BX, CX, IX, K5, LX, and PX EX, HX, NX, RX, SX, TX	07/13 07/14	7.0% (no $19) 9.0% (no $19)	7/13 7/13	7.0% (no $19) 7.0% (no $19)
2016 Tier - Members with Social Security 99, DX, IX, K5, LX CX, EX, HX, NX, PA, RX, SX, TX (not participating)	07/16 07/16	7.0% (no $19) 0.0% (no $19)	7/16 7/16	7.0% (no $19) 7.0% (no $19)

2016 Benefits Rate Table

2016 UCR BENEFIT RATES (R 7/1/2016)
DESCRIPTION

NEW RATE

EFF.
DATE

OLD RATE

EFF.
DATE

PERCENTAGE BASED BENEFITS

Social Security
Gross Limit

6.20%
$118,500

01/91
01/15

6.20%
$117,000

01/91
01/14

Medicare - Gross limit less than or equal to $200,000
Medicare - Gross limit in excess of $200,000

1.45%
2.35%

01/87
01/13

1.45%
NO LIMIT

01/87
01/94

Workers Compensation Insurance (plus $5,000 per qualified claim)

1.23%

07/16

0.87%

07/15

Employee Support Program

0.28%

07/01

0.24%

07/94

Unemployment Insurance

General Funds
Federal Funds
Other Funds

0.10%
0.60%
0.10%

07/15
07/16
07/16

0.15%
0.55%
0.15%

07/14
07/14
07/15

UC Retirement Plan (UCRP) employee Contribution

14.00%

07/14

12.00%

07/13

UCRP Supplemental Assessment Rate

1.19%

07/16

0.60%

07/15

Vacation Assessment (Gross salary times rate below)

Effective 10/2014 (old factors in parenthesis effective 07/2012)

LEAVE CODE	NO UCRP	UCRP WITHOUT FICA	UCRP WITH FICA	SAFETY MEMBERS
A & G (STAFF)	.0551 (.0612)	.0739 (.0954)	.0779 (.0998)	.0779 (.0998)
B & H (STAFF)	.0661 (.0734)	.0887 (.1144)	.0935 (.1197)	.0935 (.1197)
C & J (STAFF)	.0772 (.0858)	.1035 (.1336)	.1091 (.1398)	.1091 (.1398)
D & K (STAFF)	.0882 (.0980)	.1183 (.1526)	.1247 (.1597)	.1247 (.1597)
D & E (ACADEMIC)	.0588 (.0980)	.0789 (.1526)	.0831 (.1597)	N/A

Staff Recognition & Development Award Program (SRDP) - formerly Incentive Award Program (IAP)

Description	New Rate	Eff Date	Old Rate	Eff. Date
Staff Appreciation & Recognition (STAR) - Non-represented (99)	0.89%	07/07	0.80%	04/07
Staff Appreciation and Recognition (STAR) - CX	0.89%	07/15	0.00%	07/06
Incentive Award Program (IAP) - FF, K5, RX, SX,	0.00%	07/06	0.50%	01/01
Incentive Award Program (IAP) - TX	0.00%	10/06	0.50%	10/00
Incentive Award Program (IAP) - HX	0.00%	04/07	0.50%	02/01
Incentive Award Program (IAP) - NX	0.00%	03/08	0.50%	02/01
Incentive Award Program (IAP) - EX	0.00%	07/11	0.50%	02/01
Incentive Award Program (IAP) - PA	0.00%	09/11	0.50%	02/01

A10

Other PostEmployment Benefit (OPEB)

2.93%

07/16

2.98%

07/15

A11

Benefits Administration Rate related to OPEB

0.17%

07/10

0.16%

07/08

A12

General Liability - Loc. 5 (UCRFS charge)
General Liability - Loc. N (UCRFS charge)

0.5381%
0.5400%

07/16
07/16

0.5278%
0.4800%

07/15
07/15

A13

Employment Practices - Loc. 5 (UCRFS charge)
Employment Practices - Loc. N (UCRFS charge)

0.4452%
0.2300%

07/16
07/16

0.4223%
0.1900%

07/15
07/15

FLAT RATED (DOLLAR) BENEFITS

NEW AMOUNT

EFF DATE

OLD AMOUNT

EFF DATE

HEALTH INSURANCE - EMPLOYER RATES (separate table)

HEALTH INSURANCE - EMPLOYEE RATES (separate table)

Life Insurance(Flat Rate)

$4.34

01/07

$4.82

01/96

Core Life Insurance (Flat Rate)

$0.47

01/96

$0.52

01/94

U.C. Paid Disability (Flat Rate)

$6.71

01/09

$6.13

01/00

Graduate Student (GS) Remission Programs

GS Health Insurance Program (GSHIP) with Admin fee/QTR

$1,137.30

10/16

$1,127.00

10/15

GS Fee Remission - Residents/QTR
GS Fee Remission - Non-Residents/QTR
GS Fee Remission - AGSM/QTR

$4097.00
$4097.00
$4097.00

10/16
10/16
10/16

$4080.00
$4080.00
$4080.00

10/15
10/15
10/15

GS Non-Resident Supplemental Tuition Remission/QTR

$5034.00

10/11

$4898.00

10/04

Comm. Infrastructure Fee (CIF) per FTE (UCRFS charge)
CIF for Assistant I (4922) and Assistant II (4921)

$0.00
$0.00

07/16
07/16

$64.14
$32.07

07/15
07/15

2016 Health Plan Cost (Employer)

*2016 UC EMPLOYER RATES (posted 11/17/2015)*
NON-MEDICARE EMPLOYER RATES - 2016 Kaiser Permanente – CA (KN & KS)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - employee premium - $51,000 or less	571.08	1027.94	1197.85	1654.72
Pay Band 2 - employee premium - $51,001 - $102,000	535.03	963.05	1115.55	1543.58
Pay Band 3 - employee premium - $102,001 - $153,000	498.03	896.45	1041.79	1440.22
Pay Band 4 - employee premium - $153,001 or more	459.72	827.49	965.37	1333.15
NON-MEDICARE EMPLOYER RATES - 2016 Health Net Blue & Gold (HB) UC CARE (SU)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - employee premium - $51,000 or less	636.75	1146.15	1282.19	1791.59
Pay Band 2 - employee premium - $51,001 - $102,000	600.70	1081.26	1199.89	1680.45
Pay Band 3 - employee premium - $102,001 - $153,000	563.70	1014.66	1126.13	1577.09
Pay Band 4 - employee premium - $153,001 or more	525.39	945.70	1049.71	1470.02
NON-MEDICARE EMPLOYER RATES - 2016 Blue Shield Health Savings Plan (SP)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - employee premium - $51,000 or less	609.00	1096.19	1277.46	1764.68
Pay Band 2 - employee premium - $51,001 - $102,000	572.95	1031.30	1195.16	1653.54
Pay Band 3 - employee premium - $102,001 - $153,000	535.95	964.70	1121.40	1550.18
Pay Band 4 - employee premium - $153,001 or more	497.64	895.74	1044.98	1443.11

*EMPLOYER RATES - 2016*	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL (CM) - NON-MEDICARE	235.87	424.57	495.33	684.02
DELTA DENTAL PPO (D1)	42.24	86.87	79.15	141.86
DELTACARE USA (D3)	19.88	34.66	34.11	48.90
VISION SERVICE PLAN (V1)	12.75	12.75	12.75	12.75
LEGAL PLAN (ARAG)	0.00	0.00	0.00	0.00

POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP) - 2016	Self	Self + Child(ren)	Self + Adult	Family
PSBP MEDICAL HMO (P1-HN Group # 66700A)	478.42	837.30	1,136.58	1,444.39
PSBP MEDICAL PPO (P2-HN Group #N2982A)	515.33	896.85	1244.79	1572.79
PSBP DENTAL DHMO (P3-HN Group #Z0074A)	9.16	17.40	16.48	25.64
PSBP DENTAL PPO (P4-Principal Group #H12843)	23.97	55.79	49.99	89.78
PSBP VISION PPO (P5-HN Group #Z0074A)	4.10	7.63	6.84	11.67
PSBP BROKER/ADMIN FEE	9.83	9.83	9.83	9.83
PSBP LIFE/AD&D ($50,000)	3.05	3.05	3.05	3.05
PSBP SHORT-TERM DISABILITY	9.80	9.80	9.80	9.80
PSBP LONG-TERM DISABILITY	0.00	0.00	0.00	0.00
PSBP WORKERS COMP INS (FELLOWS & PD) PSBP WORKERS CPMP INS (EMPLOYEES)	46.99 Sal. %	46.99 Sal. %	46.99 Sal. %	46.99 Sal. %

2016 Health Plan Cost (Employee)

2016 UC EMPLOYEE RATES (posted 11/17/15)
Kaiser Permanente - CA Blue Shield Health Savings Plan	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	15.78	28.40	34.56	47.17
Pay Band 2 - Employee premium - $51,001 - $102,000	51.83	93.29	116.86	158.31
Pay Band 3 - Employee premium - $102,001 - $153,000	88.83	159.89	190.62	261.67
Pay Band 4 - Employee premium - $153,001 or more	127.14	228.85	267.04	368.74
Health Net Blue & Gold	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	33.84	60.91	126.05	153.11
Pay Band 2 - Employee premium - $51,001 - $102,000	69.89	125.80	208.35	264.25
Pay Band 3 - Employee premium - $102,001 - $153,000	106.89	192.40	282.11	367.61
Pay Band 4 - Employee premium - $153,001 or more	145.20	261.36	358.53	474.68
UC CARE	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	114.92	206.86	296.33	388.26
Pay Band 2 - Employee premium - $51,001 - $102,000	150.97	271.75	378.63	499.40
Pay Band 3 - Employee premium - $102,001 - $153,000	187.97	338.35	452.39	602.76
Pay Band 4 - Employee premium - $153,001 or more	226.28	407.31	528.81	709.83
	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL – CA	Free	Free	Free	Free
DELTA DENTAL PPO	Free	Free	Free	Free
DELTACARE USA (formerly PMI DENTAL)	Free	Free	Free	Free
VISION SERVICE PLAN	Free	Free	Free	Free
LEGAL PLAN (ARAG)	10.02	13.78	13.78	15.03
POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MED HMO	9.76	17.09	35.15	44.67
PSBP MED PPO	20.00	40.00	40.00	60.00
PSBP DENTAL HMO	Free	Free	Free	Free
PSBP DENTAL PPO	Free	Free	Free	Free
PSBP VISION	Free	Free	Free	Free
PSBP LONG-TERM DISABILITY	9.00	9.00	9.00	9.00

UNIVERSITY OF CALIFORNIA RETIREMENT PLAN (UCRP)	Eff. Date	New Rate	Eff. Date	Old Rate
Members with Social Security (1976 Tier) 99, A5, BX, CX, IX, K5, LX, and PX EX SX NX HX, RX, TX	7/14 7/14 7/14 7/14 7/14	8.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19	7/13 8/13 10/13 2/14 3/14	6.5% less $19 6.5% less $19 6.5% less $19 8.0% less $19 8.6% less $19
Safety Members (PA) (1976 Tier)	7/14	9.0% less $19	7/13	7.5% less $19
Members with Social Security (2013 Tier) 99, A5, BX, CX, IX, K5, LX, and PX EX, HX, NX, RX, SX, TX	07/13 07/14	7.0% (no $19) 9.0% (no $19)	7/13 7/13	7.0% (no $19) 7.0% (no $19)

2015 Benefits Rate Table

2015 UCR BENEFIT RATES (R 7/16/2015)
DESCRIPTION

NEW RATE

EFF.
DATE

OLD RATE

EFF.
DATE

PERCENTAGE BASED BENEFITS

Social Security
Gross Limit

6.20%
$118,500

01/91
01/15

6.20%
$117,000

01/91
01/14

Medicare - Gross limit less than or equal to $200,000
Medicare - Gross limit in excess of $200,000

1.45%
2.35%

01/87
01/13

1.45%
NO LIMIT

01/87
01/94

Workers Compensation Insurance (plus $5,000 per qualified claim)

0.87%

07/15

0.83%

07/14

Employee Support Program

0.28%

07/01

0.24%

07/94

Unemployment Insurance

General Funds
Federal Funds
Other Funds

0.10%
0.55%
0.15%

07/15
07/14
07/15

0.15%
0.60%
0.20%

07/14
07/11
07/14

UC Retirement Plan (UCRP) Employer Contribution

14.00%

07/14

12.00%

07/13

UCRP Supplemental Assessment Rate

0.50%
0.60%

07/14
07/15

0.66%
0.72%

07/13
08/14

Vacation Assessment (Gross salary times rate below)

Effective 10/2014 (old factors in parenthesis effective 07/2012)

LEAVE CODE	NO UCRP	UCRP WITHOUT FICA	UCRP WITH FICA	SAFETY MEMBERS
A & G (STAFF)	.0551 (.0612)	.0739 (.0954)	.0779 (.0998)	.0779 (.0998)
B & H (STAFF)	.0661 (.0734)	.0887 (.1144)	.0935 (.1197)	.0935 (.1197)
C & J (STAFF)	.0772 (.0858)	.1035 (.1336)	.1091 (.1398)	.1091 (.1398)
D & K (STAFF)	.0882 (.0980)	.1183 (.1526)	.1247 (.1597)	.1247 (.1597)
D & E (ACADEMIC)	.0588 (.0980)	.0789 (.1526)	.0831 (.1597)	N/A

Staff Recognition & Development Award Program (SRDP) - formerly Incentive Award Program (IAP)

Description	New Rate	Eff Date	Old Rate	Eff. Date
Staff Appreciation & Recognition (STAR) - Non-represented (99)	0.89%	07/07	0.80%	04/07
Staff Appreciation and Recognition (STAR) - CX	0.89%	07/15	0.00%	07/06
Incentive Award Program (IAP) - FF, K5, RX, SX,	0.00%	07/06	0.50%	01/01
Incentive Award Program (IAP) - TX	0.00%	10/06	0.50%	10/00
Incentive Award Program (IAP) - HX	0.00%	04/07	0.50%	02/01
Incentive Award Program (IAP) - NX	0.00%	03/08	0.50%	02/01
Incentive Award Program (IAP) - EX	0.00%	07/11	0.50%	02/01
Incentive Award Program (IAP) - PA	0.00%	09/11	0.50%	02/01

A10

Other PostEmployment Benefit (OPEB)

2.98%

07/15

2.65%

07/14

A11

Benefits Administration Rate related to OPEB

0.17%

07/10

0.16%

07/08

A12

General Liability - Loc. 5 (UCRFS charge)
General Liability - Loc. N (UCRFS charge)

0.5278%
0.4800%

07/15
07/15

0.6105%
0.3100%

07/14
07/14

A13

Employment Practices - Loc. 5 (UCRFS charge)
Employment Practices - Loc. N (UCRFS charge)

0.4223%
0.1900%

07/15
07/15

0.4412%
0.1100%

07/14
07/14

FLAT RATED (DOLLAR) BENEFITS

NEW AMOUNT

EFF DATE

OLD AMOUNT

EFF DATE

HEALTH INSURANCE - EMPLOYER RATES (separate table)

HEALTH INSURANCE - EMPLOYEE RATES (separate table)

Life Insurance(Flat Rate)

$4.34

01/07

$4.82

01/96

Core Life Insurance (Flat Rate)

$0.47

01/96

$0.52

01/94

U.C. Paid Disability (Flat Rate)

$6.71

01/09

$6.13

01/00

Graduate Student (GS) Remission Programs

GS Health Insurance Program (GSHIP) with Admin fee/QTR

$1,127.00

10/15

$987.00

10/14

GS Partial Fee Remission (PFR) -Residents/QTR
GS Partial Fee Remission (PFR) -NonResidents/QTR
AGSM Graduate Student Fee Remission per QTR

$4064.00
$4064.00
$4064.00

10/11
10/11
10/11

$3708.00
$3708.00
$3404.00

10/10
10/10
10/10

GS Nonresident Suppl. Tuition Remission (NRST)/QTR

$5034.00

10/11

$4898.00

10/04

Comm. Infrastructure Fee (CIF) per FTE (UCRFS charge)
CIF for Assistant I (4922) and Assistant II (4921)

$64.14
$32.07

07/15
07/15

$61.09
$30.55

07/14
07/14

2015 Health Plan Cost (Employer)

*2015 UC EMPLOYER RATES (posted 11/26/2014)*
NON-MEDICARE EMPLOYER RATES - 2015 Kaiser Permanente – CA (KN & KS)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $51,000 or less	546.91	984.45	1147.28	1584.82
Pay Band 2 - Employer premium - $51,001 - $101,000	510.86	919.56	1064.98	1473.68
Pay Band 3 - Employer premium - $101,001 - $152,000	473.86	852.96	991.22	1370.32
Pay Band 4 - Employer premium - $152,001 or more	435.55	784.00	914.80	1263.25
NON-MEDICARE EMPLOYER RATES - 2015 Health Net Blue & Gold (HB) UC CARE (SU)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $51,000 or less	626.90	1128.42	1262.36	1763.88
Pay Band 2 - Employer premium - $51,001 - $101,000	590.85	1063.53	1180.06	1652.74
Pay Band 3 - Employer premium - $101,001 - $152,000	553.85	996.93	1106.30	1549.38
Pay Band 4 - Employer premium - $152,001 or more	515.54	927.97	1029.88	1442.31
NON-MEDICARE EMPLOYER RATES - 2015 Blue Shield Health Savings Plan (SP)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $51,000 or less	557.66	1003.79	1169.83	1615.96
Pay Band 2 - Employer premium - $51,001 - $101,000	521.61	938.90	1087.53	1504.82
Pay Band 3 - Employer premium - $101,001 - $152,000	484.61	872.30	1013.77	1401.46
Pay Band 4 - Employer premium - $152,001 or more	446.30	803.34	937.35	1294.39

	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL (CM) - NON-MEDICARE	108.35	195.03	227.54	314.22
DELTA DENTAL PPO (D1)	43.50	87.91	80.24	142.64
DELTACARE USA (D3)	21.58	37.63	37.04	53.09
VISION SERVICE PLAN (V1)	12.75	12.75	12.75	12.75
LEGAL PLAN (ARAG)	0.00	0.00	0.00	0.00

POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MEDICAL HMO (P1-HN Group # 66700A)	497.94	871.46	1,182.95	1,503.32
PSBP MEDICAL PPO (P2-HN Group #N2982A)	472.21	821.39	1,141.31	1,441.28
PSBP DENTAL DHMO (P3-HN Group #Z0074A)	9.18	17.43	16.51	25.69
PSBP DENTAL PPO (P4-Principal Group #H12843)	23.97	55.79	49.99	89.78
PSBP VISION PPO (P5-HN Group #Z0074A)	4.38	8.15	7.30	12.46
PSBP BROKER/ADMIN FEE	9.83	9.83	9.83	9.83
PSBP LIFE/AD&D ($50,000)	3.15	3.15	3.15	3.15
PSBP SHORT-TERM DISABILITY	9.80	9.80	9.80	9.80
PSBP LONG-TERM DISABILITY	0.00	0.00	0.00	0.00
PSBP WORKERS COMP INS (FELLOWS & PD) PSBP WORKERS CPMP INS (EMPLOYEES)	42.52 Sal. %	42.52 Sal. %	42.52 Sal. %	42.52 Sal. %

2015 Health Plan Cost (Employee)

2015 UC EMPLOYEE RATES (R 11/26/14)
Kaiser Permanente - CA Blue Shield Health Savings Plan	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	13.78	24.80	30.18	41.19
Pay Band 2 - Employee premium - $51,001 - $101,000	49.83	89.69	112.48	152.33
Pay Band 3 - Employee premium - $101,001 - $152,000	86.83	156.29	186.24	255.69
Pay Band 4 - Employee premium - $152,001 or more	125.14	225.25	262.66	362.76
Health Net Blue & Gold	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	35.19	63.34	128.02	156.18
Pay Band 2 - Employee premium - $51,001 - $101,000	71.24	128.23	210.32	267.32
Pay Band 3 - Employee premium - $101,001 - $152,000	108.24	194.83	284.08	370.68
Pay Band 4 - Employee premium - $152,001 or more	146.55	263.79	360.50	477.75
UC CARE	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	96.91	174.44	257.64	335.17
Pay Band 2 - Employee premium - $51,001 - $101,000	132.96	239.33	339.94	446.31
Pay Band 3 - Employee premium - $101,001 - $152,000	169.96	305.93	413.70	549.67
Pay Band 4 - Employee premium - $152,001 or more	208.27	374.89	490.12	656.74
	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL – CA	Free	Free	Free	Free
DELTA DENTAL PPO	Free	Free	Free	Free
DELTACARE USA (formerly PMI DENTAL)	Free	Free	Free	Free
VISION SERVICE PLAN	Free	Free	Free	Free
LEGAL PLAN (ARAG)	10.02	13.78	13.78	15.03
POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MED HMO	10.16	17.79	36.59	46.49
PSBP MED PPO	20.00	40.00	40.00	60.00
PSBP DENTAL HMO	Free	Free	Free	Free
PSBP DENTAL PPO	Free	Free	Free	Free
PSBP VISION	Free	Free	Free	Free
PSBP LONG-TERM DISABILITY	9.00	9.00	9.00	9.00

UNIVERSITY OF CALIFORNIA RETIREMENT PLAN (UCRP)	Eff. Date	New Rate	Eff. Date	Old Rate
Members with Social Security (1976 Tier) 99, A5, BX, CX, IX, K5, LX, and PX EX SX NX HX, RX, TX	7/14 7/14 7/14 7/14 7/14	8.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19	7/13 8/13 10/13 2/14 3/14	6.5% less $19 6.5% less $19 6.5% less $19 8.0% less $19 8.6% less $19
Safety Members (PA) (1976 Tier)	7/14	9.0% less $19	7/13	7.5% less $19
Members with Social Security (2013 Tier) 99, A5, BX, CX, IX, K5, LX, and PX EX, HX, NX, RX, SX, TX	07/13 07/14	7.0% (no $19) 9.0% (no $19)	7/13 7/13	7.0% (no $19) 7.0% (no $19)

2014 Benefits Rate Table

DESCRIPTION
(revised November 10, 2014)

NEW RATE

EFF.
DATE

OLD RATE

EFF.
DATE

PERCENTAGE BASED BENEFITS

Social Security
Gross Limit

6.20%
$117,000

01/91
01/14

6.20%
$113,700

01/91
01/13

Medicare - Gross limit less than or equal to $200,000
Medicare - Gross limit in excess of $200,000

1.45%
2.35%

01/87
01/13

1.45%
NO LIMIT

01/87
01/94

Workers Compensation Insurance (plus $5,000 per qualified claim)

0.83%

07/14

0.65%

07/13

Employee Support Program

0.28%

07/01

0.24%

07/94

Unemployment Insurance

General Funds
Federal Funds
Other Funds

0.15%
0.55%
0.20%

07/14
07/14
07/14

0.30%
0.60%
0.40%

07/13
07/11
07/13

UC Retirement Plan (UCRP) Employer Contribution

14.00%

07/14

12.00%

07/13

UCRP Supplemental Assessment Rate

0.50%
0.72%

07/14
08/14

0.66%
0.50%

07/13
07/14

Vacation Assessment (Gross salary times rate below)

Effective 10/2014 (old factors in parenthesis effective 07/2012)

LEAVE CODE	NO UCRP	UCRP WITHOUT FICA	UCRP WITH FICA	SAFETY MEMBERS
A & G (STAFF)	.0551 (.0612)	.0739 (.0954)	.0779 (.0998)	.0779 (.0998)
B & H (STAFF)	.0661 (.0734)	.0887 (.1144)	.0935 (.1197)	.0935 (.1197)
C & J (STAFF)	.0772 (.0858)	.1035 (.1336)	.1091 (.1398)	.1091 (.1398)
D & K (STAFF)	.0882 (.0980)	.1183 (.1526)	.1247 (.1597)	.1247 (.1597)
D & E (ACADEMIC)	.0588 (.0980)	.0789 (.1526)	.0831 (.1597)	N/A

Staff Recognition & Development Award Program (SRDP) - formerly Incentive Award Program (IAP)

Description	New Rate	Eff Date	Old Rate	Eff. Date
SRDP - Non-represented (99)	0.89%	07/07	0.80%	04/07
Incentive Award Program (IAP) - CX, FF, K5, RX, SX	0.00%	07/06	0.50%	01/01
Incentive Award Program (IAP) - TX	0.00%	10/06	0.50%	10/00
Incentive Award Program (IAP) - HX	0.00%	04/07	0.50%	02/01
Incentive Award Program (IAP) - NX	0.00%	03/08	0.50%	02/01
Incentive Award Program (IAP) - EX	0.00%	07/11	0.50%	02/01
Incentive Award Program (IAP) - PA	0.00%	09/11	0.50%	02/01

A10

Other PostEmployment Benefit (OPEB)

2.65%

07/14

3.24%

07/13

A11

Benefits Administration Rate related to OPEB

0.17%

07/10

0.16%

07/08

A12

General Liability - Loc. 5 (UCRFS charge)
General Liability - Loc. N (UCRFS charge)

0.6105%
0.3100%

07/14
07/14

0.7893%
0.3200%

07/13
07/13

A13

Employment Practices - Loc. 5 (UCRFS charge)
Employment Practices - Loc. N (UCRFS charge)

0.4412%
0.1100%

07/14
07/14

0.2805%
0.0700%

07/13
07/12

FLAT RATED (DOLLAR) BENEFITS

NEW AMOUNT

EFF DATE

OLD AMOUNT

EFF DATE

HEALTH INSURANCE - EMPLOYER RATES (separate table)

HEALTH INSURANCE - EMPLOYEE RATES (separate table)

Life Insurance(Flat Rate)

$4.34

01/07

$4.82

01/96

Core Life Insurance (Flat Rate)

$0.47

01/96

$0.52

01/94

U.C. Paid Disability (Flat Rate)

$6.71

01/09

$6.13

01/00

Graduate Student (GS) Remission Programs

GS Health Insurance Program (GSHIP) with Admin fee/QTR

$869.00

10/13

$619.00

10/12

GS Partial Fee Remission (PFR) -Residents/QTR
GS Partial Fee Remission (PFR) -NonResidents/QTR
AGSM Graduate Student Fee Remission per QTR

$4064.00
$4064.00
$4064.00

10/11
10/11
10/11

$3708.00
$3708.00
$3404.00

10/10
10/10
10/10

GS Nonresident Suppl. Tuition Remission (NRST)/QTR

$5034.00

10/11

$4898.00

10/04

Comm. Infrastructure Fee (CIF) per FTE (UCRFS charge)
CIF for Assistant I (4922) and Assistant II (4921)

$61.09
$30.55

07/14
07/14

$58.18
$29.09

07/13
07/13

2014 Health Plan Cost (Employer)

*Revised 1/14/2014*
(NON-MEDICARE) - 2014 Kaiser Permanente – CA (KN & KS)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $51,000 or less	533.24	957.71	1115.81	1540.29
Pay Band 2 - Employer premium - $51,001 - $101,000	497.19	892.82	1033.51	1429.51
Pay Band 3 - Employer premium - $101,001 - $151,000	460.19	826.22	959.75	1325.79
Pay Band 4 - Employer premium - $151,001 or more	421.88	757.26	883.33	1218.72
(NON-MEDICARE) - 2014 Health Net Blue & Gold (HB) UC CARE (SU)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $51,000 or less	581.51	1046.72	1170.97	1636.18
Pay Band 2 - Employer premium - $51,001 - $101,000	545.46	981.83	1088.67	1525.04
Pay Band 3 - Employer premium - $101,001 - $151,000	508.46	915.23	1014.91	1421.68
Pay Band 4 - Employer premium - $151,001 or more	470.15	846.27	938.49	1314.61
(NON-MEDICARE) - 2014 Blue Shield Health Savings Plan (SP)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $51,000 or less	505.90	908.27	1058.28	1460.66
Pay Band 2 - Employer premium - $51,001 - $101,000	469.85	843.38	975.98	1349.52
Pay Band 3 - Employer premium - $101,001 - $151,000	432.85	776.78	902.22	1246.16
Pay Band 4 - Employer premium - $151,001 or more	394.54	707.82	825.80	1139.09

	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL (CM) - NON-MEDICARE	113.19	203.74	237.70	328.25
DELTA DENTAL PPO (D1)	43.87	89.28	81.44	145.24
DELTACARE USA (D3)	22.27	38.83	38.22	54.79
VISION SERVICE PLAN (V1)	12.53	12.53	12.53	12.53
LEGAL PLAN (ARAG)	0.00	0.00	0.00	0.00

POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MEDICAL HMO (P1-HN Group # 66700A)	463.20	810.67	1,100.43	1,398.43
PSBP MEDICAL PPO (P2-HN Group #N2982A)	444.79	773.40	1,075.50	1,357.64
PSBP DENTAL DHMO (P3-HN Group #Z0074A)	9.46	17.97	17.02	26.48
PSBP DENTAL PPO (P4-Principal Group #H12843)	24.36	56.70	50.81	91.24
PSBP VISION PPO (P5-HN Group #Z0074A)	4.27	7.95	7.12	12.16
PSBP BROKER/ADMIN FEE	9.83	9.83	9.83	9.83
PSBP LIFE/AD&D ($50,000)	3.15	3.15	3.15	3.15
PSBP SHORT-TERM DISABILITY	9.80	9.80	9.80	9.80
PSBP WORKERS COMP INS (FELLOWS & PD) PSBP WORKERS CPMP INS (EMPLOYEES)	24.20 Sal. %	24.20 Sal. %	24.20 Sal. %	24.20 Sal. %

2014 Health Plan Cost (Employee)

2014 HEALTH PLAN COST - EMPLOYEE (R 5/9/14)
Kaiser Permanente - CA	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	11.78	21.20	25.80	35.21
Pay Band 2 - Employee premium - $51,001 - $101,000	47.83	86.09	108.10	146.35
Pay Band 3 - Employee premium - $101,001 - $151,000	84.83	152.69	181.86	249.71
Pay Band 4 - Employee premium - $151,001 or more	123.14	221.65	258.28	356.78
Health Net Blue & Gold	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	29.49	51.17	109.50	131.18
Pay Band 2 - Employee premium - $51,001 - $101,000	65.54	116.06	191.80	242.32
Pay Band 3 - Employee premium - $101,001 - $151,000	102.54	182.66	265.56	345.68
Pay Band 4 - Employee premium - $151,001 or more	140.85	251.62	341.98	452.75
UC CARE	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	71.96	127.83	198.99	254.87
Pay Band 2 - Employee premium - $51,001 - $101,000	108.01	192.72	281.29	366.01
Pay Band 3 - Employee premium - $101,001 - $151,000	145.01	259.32	355.05	469.37
Pay Band 4 - Employee premium - $151,001 or more	183.32	328.28	431.47	576.44
Blue Shield Health Savings Plan	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $51,000 or less	9.67	17.41	21.19	28.92
Pay Band 2 - Employee premium - $51,001 - $101,000	45.72	82.30	103.49	140.06
Pay Band 3 - Employee premium - $101,001 - $151,000	82.72	148.90	177.25	243.42
Pay Band 4 - Employee premium - $151,001 or more	121.03	217.86	253.67	350.49
	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL – CA	Free	Free	Free	Free
DELTA DENTAL PPO	Free	Free	Free	Free
DELTACARE USA (formerly PMI DENTAL)	Free	Free	Free	Free
VISION SERVICE PLAN	Free	Free	Free	Free
LEGAL PLAN (ARAG)
POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MED HMO	9.45	16.54	34.03	43.25
PSBP MED PPO	20.00	40.00	40.00	60.00
PSBP DENTAL HMO	Free	Free	Free	Free
PSBP DENTAL PPO	Free	Free	Free	Free
PSBP VISION	Free	Free	Free	Free
PSBP LONG-TERM DISABILITY	7.95	7.95	7.95	7.95

UNIVERSITY OF CALIFORNIA RETIREMENT PLAN (UCRP)	Eff. Date	New Rate	Eff. Date	Old Rate
Members with Social Security (1976 Tier) 99, A5, BX, CX, IX, K5, LX, and PX EX SX NX HX, RX, TX	7/14 7/14 7/14 7/14 7/14	8.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19 9.0% less $19	7/13 8/13 10/13 2/14 3/14	6.5% less $19 6.5% less $19 6.5% less $19 8.0% less $19 8.6% less $19
Safety Members (PA) (1976 Tier)	7/14	9.0% less $19	7/13	7.5% less $19
Members with Social Security (2013 Tier) 99, A5, BX, CX, IX, K5, LX, and PX EX, HX, NX, RX, SX, TX	7/13 07/14	7.0% (no $19) 9.0% (no $19)	7/13 7/13	7.0% (no $19) 7.0% (no $19)

2013 Benefits Rate Table

DESCRIPTION
(revised November 22, 2013)

NEW RATE

EFF.
DATE

OLD RATE

EFF.
DATE

PERCENTAGE BASED BENEFITS

Social Security
Gross Limit

6.20%
$113,700

01/91
01/13

6.20%
$110,100

01/91
01/12

Medicare - Gross limit less than or equal to $200,000
Medicare - Gross limit in excess of $200,000

1.45%
2.35%

01/87
01/13

1.45%
NO LIMIT

01/87
01/94

Workers Compensation Insurance (plus $5,000 per qualified claim)

0.65%

07/13

0.58%

07/12

Employee Support Program

0.28%

07/01

0.24%

07/94

Unemployment Insurance

General Funds
Federal Funds
Other Funds

0.30%
0.60%
0.40%

07/13
07/11
07/13

0.45%
0.54%
0.45%

07/12
07/10
07/11

UC Retirement Plan (UCRP) Employer Contribution

12.00%

07/13

10.00%

07/12

UCRP Supplemental Assessment Rate

0.66%

07/13

0.63%

08/12

Vacation Assessment (Gross salary times rate below)

Effective 07/2012 (old factors in parenthesis effective 12/2011)

LEAVE CODE	CASUAL/ STUDENTS	RETIREMENT WITHOUT FICA	RETIREMENT WITH FICA	SAFETY MEMBERS
A and G	.0612 (.0612)	.0954 (.0793)	.0998 (.0837)	.0998 (.0837)
B and H	.0734 (.0734)	.1144 (.0950)	.1197 (.1003)	.1197 (.1003)
C and J	.0858 (.0858)	.1336 (.1110)	.1398 (.1172)	.1398 (.1172)
D and K	.0980 (.0980)	.1526 (.1268)	.1597 (.1338)	.1597 (.1338)
E	.0980 (.0980)	.1526 (.1268)	.1597 (.1338)	.1597 (.1338)
F	.0000	.0000	.0000	.0000

Staff Recognition & Development Award Program (SRDP) - formerly Incentive Award Program (IAP)

Description	New Rate	Eff Date	Old Rate	Eff. Date
SRDP - Non-represented (99)	0.89%	07/07	0.80%	04/07
Incentive Award Program (IAP) - CX, FF, K5, RX, SX	0.00%	07/06	0.50%	01/01
Incentive Award Program (IAP) - TX	0.00%	10/06	0.50%	10/00
Incentive Award Program (IAP) - HX	0.00%	04/07	0.50%	02/01
Incentive Award Program (IAP) - NX	0.00%	03/08	0.50%	02/01
Incentive Award Program (IAP) - EX	0.00%	07/11	0.50%	02/01
Incentive Award Program (IAP) - PA	0.00%	09/11	0.50%	02/01

A10

Other PostEmployment Benefit (OPEB)

3.24%

07/13

1.80%

12/12

A11

Benefits Administration Rate related to OPEB

0.17%

07/10

0.16%

07/08

A12

General Liability - Loc. 5 (UCRFS charge)
General Liability - Loc. N (UCRFS charge)

0.7893%0.3200%

07/13
07/13

0.8263%0.2100%

07/12
07/12

A13

Employment Practices - Loc. 5 (UCRFS charge)
Employment Practices - Loc. N (UCRFS charge)

0.2805%0.0700%

07/13
07/12

0.1966%0.0800%

07/12
09/11

FLAT RATED (DOLLAR) BENEFITS

NEW AMOUNT

EFF DATE

OLD AMOUNT

EFF DATE

HEALTH INSURANCE - EMPLOYER RATES (separate table)

HEALTH INSURANCE - EMPLOYEE RATES (separate table)

Life Insurance(Flat Rate)

$4.34

01/07

$4.82

01/96

Core Life Insurance (Flat Rate)

$0.47

01/96

$0.52

01/94

U.C. Paid Disability (Flat Rate)

$6.71

01/09

$6.13

01/00

Graduate Student (GS) Remission Programs

GS Health Insurance Program (GSHIP) with Admin fee/QTR

$869.00

10/13

$619.00

10/12

GS Partial Fee Remission (PFR) -Residents/QTR
GS Partial Fee Remission (PFR) -NonResidents/QTR
AGSM Graduate Student Fee Remission per QTR

$4064.00$4064.00
$4064.00

10/11
10/11
10/11

$3708.00$3708.00
$3404.00

10/10
10/10
10/10

GS Nonresident Suppl. Tuition Remission (NRST)/QTR

$5034.00

10/11

$4898.00

10/04

Comm. Infrastructure Fee (CIF) per FTE (UCRFS charge)
CIF for Assistant I (4922) and Assistant II (4921)

$58.18
$29.09

07/13
07/13

$55.41
$27.71

07/12
07/12

2013 Health Plan Cost (Employer)

Click to view and print in PDF

(NON-MEDICARE) - 2013 Health Net Blue & Gold HMO (HB) Health Net HMO (HN) Anthem Blue Cross PLUS (BC) Anthem Blue Cross PPO (BP) Kaiser Umbrella (KU)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $50,000 or less	558.21	1004.78	1124.04	1570.61
Pay Band 2 - Employer premium - $50,001 - $98,000	522.16	939.89	1041.74	1459.47
Pay Band 3 - Employer premium - $98,001 - $147,000	485.16	873.29	967.98	1356.11
Pay Band 4 - Employer premium - $147,001 or more	446.85	804.33	891.56	1249.04
(NON-MEDICARE) - 2013 Kaiser Permanente – CA (KN & KS)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $50,000 or less	503.23	905.81	1056.79	1459.38
Pay Band 2 - Employer premium - $50,001 - $98,000	467.18	840.92	974.49	1348.24
Pay Band 3 - Employer premium - $98,001 - $147,000	430.18	774.32	900.73	1244.88
Pay Band 4 - Employer premium - $147,001 or more	391.87	705.36	824.31	1137.81
(NON-MEDICARE) - 2013 Anthem Lumenos PPO with HRA (BL)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $50,000 or less	478.51	861.31	1004.87	1387.68
Pay Band 2 - Employer premium - $50,001 - $98,000	442.46	796.42	922.57	1276.54
Pay Band 3 - Employer premium - $98,001 - $147,000	405.46	729.82	848.81	1173.18
Pay Band 4 - Employer premium - $147,001 or more	367.15	660.86	772.39	1066.11
(NON-MEDICARE) - 2013 WESTERN HEALTH ADVANTAGE (WH)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $50,000 or less	523.36	942.05	1099.06	1517.74
Pay Band 2 - Employer premium - $50,001 - $98,000	487.31	877.16	1016.76	1406.60
Pay Band 3 - Employer premium - $98,001 - $147,000	450.31	810.56	943.00	1303.24
Pay Band 4 - Employer premium - $147,001 or more	412.00	741.60	866.58	1196.17

2013 RATES	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL (NON-MEDICARE)	112.21	201.98	235.64	325.41
DELTA DENTAL PPO	43.66	90.00	82.00	147.11
DELTACARE USA	22.16	38.64	38.03	54.52
VISION SERVICE PLAN	12.11	12.11	12.11	12.11
LEGAL PLAN (ARAG)	0.00	0.00	0.00	0.00

POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MEDICAL HMO (Health Net, Group # 66700A)	424.82	743.49	1019.65	1295.78
PSBP MEDICAL PPO (Health Net, Group #N2982A)	409.29	716.27	982.30	1248.36
PSBP DENTAL DHMO (Health Net, Group #Z0074A)	9.18	17.45	16.52	25.71
PSBP DENTAL PPO (Principal, Group #H12843)	24.36	56.70	50.81	91.24
PSBP VISION PPO (Health Net, Group #Z0074A)	4.29	7.99	7.16	12.23
PSBP BROKER/ADMIN FEE	9.83	9.83	9.83	9.83
PSBP LIFE/AD&D ($50,000)	3.15	3.15	3.15	3.15
PSBP SHORT-TERM DISABILITY	8.82	8.82	8.82	8.82
PSBP WORKERS COMP INSURANCE	32.65	32.65	32.65	32.65

2013 Health Plan Cost (Employee)

Click to view and print in PDF

2013 HEALTH PLAN COST - EMPLOYEE (R 10/18/13)
Kaiser Permanente - CA (KN & KS) Anthem Lumenos PPO with HRA (BL)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $50,000 or less	9.67	17.41	20.31	28.04
Pay Band 2 - Employee premium - $50,001 - $98,000	45.72	82.30	102.61	139.18
Pay Band 3 - Employee premium - $98,001 - $147,000	82.72	148.90	176.37	242.54
Pay Band 4 - Employee premium - $147,001 or more	121.03	217.86	252.79	349.61
Health Net Blue & Gold HMO (HB)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $50,000 or less	25.26	45.47	101.25	121.45
Pay Band 2 - Employee premium - $50,001 - $98,000	61.31	110.36	183.55	232.59
Pay Band 3 - Employee premium - $98,001 - $147,000	98.31	176.96	257.31	335.95
Pay Band 4 - Employee premium - $147,001 or more	136.62	245.92	333.73	443.02
Health Net HMO (HN)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $50,000 or less	108.28	194.91	275.59	362.21
Pay Band 2 - Employee premium - $50,001 - $98,000	144.33	259.80	357.89	473.35
Pay Band 3 - Employee premium - $98,001 - $147,000	181.33	326.40	431.65	576.71
Pay Band 4 - Employee premium - $147,001 or more	219.64	395.36	508.07	683.78
Anthem Blue Cross PLUS (BC)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $50,000 or less	75.43	135.77	206.61	266.94
Pay Band 2 - Employee premium - $50,001 - $98,000	111.48	200.66	288.91	378.08
Pay Band 3 - Employee premium - $98,001 - $147,000	148.48	267.26	362.67	481.44
Pay Band 4 - Employee premium - $147,001 or more	186.79	336.22	439.09	588.51
Anthem Blue Cross PPO (BP)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $50,000 or less	106.76	192.17	272.40	357.80
Pay Band 2 - Employee premium - $50,001 - $98,000	142.81	257.06	354.70	468.94
Pay Band 3 - Employee premium - $98,001 - $147,000	179.81	323.66	424.46	572.30
Pay Band 4 - Employee premium - $147,001 or more	218.12	392.62	504.88	679.37
Kaiser Umbrella (KU)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $50,000 or less	137.54	247.57	337.04	447.07
Pay Band 2 - Employee premium - $50,001 - $98,000	173.59	312.46	419.34	558.21
Pay Band 3 - Employee premium - $98,001 - $147,000	210.59	379.06	493.10	661.57
Pay Band 4 - Employee premium - $147,001 or more	248.90	448.02	569.52	768.64
	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL – CA	Free	Free	Free	Free
DELTA DENTAL PPO	Free	Free	Free	Free
DELTACARE USA (formerly PMI DENTAL)	Free	Free	Free	Free
VISION SERVICE PLAN	Free	Free	Free	Free
LEGAL PLAN (ARAG)	10.02	13.78	13.78	15.03
POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MED HMO	8.50	14.87	30.59	38.87
PSBP MED PPO	20.00	40.00	40.00	60.00
PSBP DENTAL HMO	Free	Free	Free	Free
PSBP DENTAL PPO	Free	Free	Free	Free
PSBP VISION	Free	Free	Free	Free
PSBP LONG-TERM DISABILITY	7.95	7.95	7.95	7.95

UNIVERSITY OF CALIFORNIA RETIREMENT PLAN (UCRP)	Eff. Date	New Rate	Eff. Date	Old Rate
Members with Social Security (1976 Tier) 99, CX, IX, LX, BX, and PX EX SX	7/13 8/13 10/13	6.5% less $19 6.5% less $19 6.5% less $19	7/12 7/12 7/12	5.0% less $19 5.0% less $19 5.0% less $19
Members with Social Security (1976 Tier) NX, RX, TX	7/12	5.0% less ($19)	7/11	3.5% less $19
Members with Social Security (1976 Tier) HX	7/11	3.5% less ($19)	7/11	3.5% less $19
Safety Members (PA) (1976 Tier)	7/13	7.5% less ($19)	7/12	6.0% less $19
Members with Social Security (2013 Tier)	7/13	7.0% (no $19 offset)

2012 Benefits Rate Table

DESCRIPTION
(revised August 3, 2012)

NEW RATE

EFF.
DATE

OLD RATE

EFF.
DATE

PERCENTAGE BASED BENEFITS

Social Security
Gross Limit

6.20%
$110,100

01/91
01/12

6.20%
$106,800

01/91
01/09

Medicare
Gross Limit

1.45%
NO LIMIT

01/87
01/94

1.45%
NO LIMIT

01/87
01/94

Workers Compensation Insurance (plus $5,000 per qualified claim)

0.58%

07/12

0.56%

07/11

Employee Support Program

0.28%

07/01

0.24%

07/94

Unemployment Insurance

General Funds
Federal Funds
Other Funds

0.45%
0.60%
0.45%

07/12
07/11
07/11

0.60%
0.54%
0.54%

07/11
07/10
07/10

UC Retirement Plan (UCRP) Employer Contribution

10.00%

07/12

7.00%

07/11

UCRP Supplemental Assessment Rate

0.63%

08/12

0.68%

08/11

Vacation Assessment (Gross salary times rate below)

Effective 07/2012 (old factors in parenthesis effective 12/2011)

LEAVE CODE	CASUAL/ STUDENTS	RETIREMENT WITHOUT FICA	RETIREMENT WITH FICA	SAFETY MEMBERS
A and G	.0612 (.0612)	.0954 (.0793)	.0998 (.0837)	.0998 (.0837)
B and H	.0734 (.0734)	.1144 (.0950)	.1197 (.1003)	.1197 (.1003)
C and J	.0858 (.0858)	.1336 (.1110)	.1398 (.1172)	.1398 (.1172)
D and K	.0980 (.0980)	.1526 (.1268)	.1597 (.1338)	.1597 (.1338)
E	.0980 (.0980)	.1526 (.1268)	.1597 (.1338)	.1597 (.1338)
F	.0000	.0000	.0000	.0000

Staff Recognition & Development Award Program (SRDP) - formerly Incentive Award Program (IAP)

Description	New Rate	Eff Date	Old Rate	Eff. Date
SRDP - Non-represented (99)	0.89%	07/07	0.80%	04/07
Incentive Award Program (IAP) - CX, FF, K5, RX, SX	0.00%	07/06	0.50%	01/01
Incentive Award Program (IAP) - TX	0.00%	10/06	0.50%	10/00
Incentive Award Program (IAP) - HX	0.00%	04/07	0.50%	02/01
Incentive Award Program (IAP) - NX	0.00%	03/08	0.50%	02/01
Incentive Award Program (IAP) - EX	0.00%	07/11	0.50%	02/01
Incentive Award Program (IAP) - PA	0.00%	09/11	0.50%	02/01

A10

Other PostEmployment Benefit (OPEB)

3.72%

07/12

3.51%

07/11

A11

Benefits Administration Rate related to OPEB

0.17%

07/10

0.16%

07/08

A12

General Liability - Loc. 5 (UCRFS charge)
General Liability - Loc. N (UCRFS charge)

0.8263%0.2100%

07/12
07/12

0.7900%0.0900%

07/11
09/11

A13

Employment Practices - Loc. 5 (UCRFS charge)
Employment Practices - Loc. N (UCRFS charge)

0.1966%0.0700%

07/12
07/12

0.1250%0.0800%

07/11
09/11

FLAT RATED (DOLLAR) BENEFITS

NEW AMOUNT

EFF DATE

OLD AMOUNT

EFF DATE

HEALTH INSURANCE - EMPLOYER RATES (separate table)

HEALTH INSURANCE - EMPLOYEE RATES (separate table)

Life Insurance(Flat Rate)

$4.34

01/07

$4.82

01/96

Core Life Insurance (Flat Rate)

$0.47

01/96

$0.52

01/94

U.C. Paid Disability (Flat Rate)

$6.71

01/09

$6.13

01/00

Graduate Student (GS) Remission Programs

GS Health Insurance Program (GSHIP) with Admin fee/QTR

$619.00

10/12

$588.00

10/11

GS Partial Fee Remission (PFR) -Residents/QTR
GS Partial Fee Remission (PFR) -NonResidents/QTR
AGSM Graduate Student Fee Remission per QTR

$4064.00$4064.00
$4064.00

10/11
10/11
10/11

$3708.00$3708.00
$3404.00

10/10
10/10
10/10

GS Nonresident Suppl. Tuition Remission (NRST)/QTR

$5034.00

10/11

$4898.00

10/04

Comm. Worker Fee (CWF) per FTE (UCRFS charge)
CWF for Assistant I (4922) and Assistant II (4921)

$55.41
$27.71

07/12
07/12

$53.02
$26.51

08/11
08/11

2012 Health Plan Cost (Employer)

Health Net Blue & Gold HMO (HB & HE) Health Net HMO (HN & HC) Anthem PLUS (BC) Anthem PPO (BP) Kaiser Umbrella (KU)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $48,000 or less	539.99	971.98	1087.35	1519.34
Pay Band 2 - Employer premium - $48,001 - $96,000	503.94	907.09	1005.05	1408.20
Pay Band 3 - Employer premium - $96,001 - $144,000	466.94	840.49	931.29	1304.84
Pay Band 4 - Employer premium - $144,001 or more	428.63	771.53	854.87	1197.77
Kaiser Permanente – CA (KN & KS)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $48,000 or less	496.32	893.37	1042.27	1439.33
Pay Band 2 - Employer premium - $48,001 - $96,000	460.27	828.48	959.97	1328.19
Pay Band 3 - Employer premium - $96,001 - $144,000	423.27	761.88	886.21	1224.83
Pay Band 4 - Employer premium - $144,001 or more	384.96	692.92	809.79	1117.76
Anthem Lumenos PPO with HRA (BL)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $48,000 or less	513.02	923.43	1077.34	1487.76
Pay Band 2 - Employer premium - $48,001 - $96,000	476.97	858.54	995.04	1376.62
Pay Band 3 - Employer premium - $96,001 - $144,000	439.97	791.94	921.28	1273.26
Pay Band 4 - Employer premium - $144,001 or more	401.66	722.98	844.86	1166.19
WESTERN HEALTH ADVANTAGE (WH)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employer premium - $48,000 or less	505.32	909.57	1061.17	1465.43
Pay Band 2 - Employer premium - $48,001 - $96,000	469.27	844.68	978.87	1354.29
Pay Band 3 - Employer premium - $96,001 - $144,000	432.27	778.08	905.11	1250.93
Pay Band 4 - Employer premium - $144,001 or more	393.96	709.12	828.69	1143.86

	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL	98.05	176.49	205.91	284.35
DELTA DENTAL PPO	43.96	90.65	82.59	148.19
DELTACARE USA	22.38	39.03	38.41	55.07
VISION SERVICE PLAN	11.76	11.76	11.76	11.76
LEGAL PLAN (ARAG)	0.00	0.00	0.00	0.00

POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MEDICAL HMO (Health Net, Group # 66700A)	385.71	675.02	916.30	1164.45
PSBP MEDICAL PPO (Health Net, Group #N2982A)	368.14	636.76	895.54	1124.36
PSBP DENTAL DHMO (Health Net, Group #Z0074A)	9.18	17.45	16.52	25.71
PSBP DENTAL PPO (Principal, Group #H12843)	26.41	60.76	54.50	97.44
PSBP VISION PPO (Health Net, Group #Z0074A)	4.09	7.61	6.82	11.65
PSBP BROKER/ADMIN FEE	8.08	8.08	8.08	8.08
PSBP LIFE/AD&D ($50,000)	3.15	3.15	3.15	3.15
PSBP SHORT-TERM DISABILITY	8.82	8.82	8.82	8.82
PSBP WORKERS COMP INSURANCE	23.83	23.83	23.83	23.83

2012 Health Plan Cost (Employee)

2012 HEALTH PLAN COST - EMPLOYEE (revised July 2012)
Kaiser Permanente - CA (KN & KS) Anthem Lumenos PPO with HRA (BL) Western Health Advantage (WH)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $48,000 or less	8.07	14.53	16.95	23.40
Pay Band 2 - Employee premium - $48,001 - $96,000	44.12	79.42	99.25	134.54
Pay Band 3 - Employee premium - $96,001 - $144,000	81.12	146.02	173.01	237.90
Pay Band 4 - Employee premium - $144,001 or more	119.43	214.98	249.43	344.97
Health Net Blue & Gold HMO (HB & HE)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $48,000 or less	23.08	41.55	95.10	113.56
Pay Band 2 - Employee premium - $48,001 - $96,000	59.13	106.44	177.40	224.70
Pay Band 3 - Employee premium - $96,001 - $144,000	96.13	173.04	251.16	328.06
Pay Band 4 - Employee premium - $144,001 or more	134.44	242.00	327.58	435.13
Health Net HMO (HN & HC)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $48,000 or less	79.27	142.69	213.10	276.52
Pay Band 2 - Employee premium - $48,001 - $96,000	115.32	207.58	295.40	387.66
Pay Band 3 - Employee premium - $96,001 - $144,000	152.32	274.18	369.16	491.02
Pay Band 4 - Employee premium - $144,001 or more	190.63	343.14	445.58	598.09
Anthem PLUS (BC)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $48,000 or less	75.24	135.43	204.63	264.83
Pay Band 2 - Employee premium - $48,001 - $96,000	111.29	200.32	286.93	375.97
Pay Band 3 - Employee premium - $96,001 - $144,000	148.29	266.92	360.69	479.33
Pay Band 4 - Employee premium - $144,001 or more	186.60	335.88	437.11	586.40
Anthem PPO (BP)	Self	Self + Child(ren)	Self + Adult	Family
Pay Band 1 - Employee premium - $48,000 or less	52.57	94.63	157.02	199.09
Pay Band 2 - Employee premium - $48,001 - $96,000	88.62	159.52	239.32	310.23
Pay Band 3 - Employee premium - $96,001 - $144,000	125.62	226.12	313.08	413.59
Pay Band 4 - Employee premium - $144,001 or more	163.93	295.08	389.50	520.66
	Self	Self + Child(ren)	Self + Adult	Family
CORE MEDICAL – CA	Free	Free	Free	Free
DELTA DENTAL PPO	Free	Free	Free	Free
DELTACARE USA (formerly PMI DENTAL)	Free	Free	Free	Free
VISION SERVICE PLAN	Free	Free	Free	Free
LEGAL PLAN (ARAG)	10.02	13.78	13.78	15.03
POST DOCTORAL SCHOLAR BENEFIT PLANS (PSBP)	Self	Self + Child(ren)	Self + Adult	Family
PSBP MED HMO	7.87	13.78	28.34	36.01
PSBP MED PPO	30.00	60.00	60.00	90.00
PSBP DENTAL HMO	Free	Free	Free	Free
PSBP DENTAL PPO	Free	Free	Free	Free
PSBP VISION	Free	Free	Free	Free
PSBP LONG-TERM DISABILITY	7.95	7.95	7.95	7.95

UNIVERSITY OF CALIFORNIA RETIREMENT PLAN (UCRP)	Eff. Date	New Rate	Eff. Date	Old Rate
Members with Social Security (below FICA max) EX and SX deductions effective 12/1/2011 check date CX deduction effective 3/1/2012 check date	7/12	5.0% less ($19)	7/11	3.5% less $19
Members with Social Security (above FICA max)	7/12	5.0% less ($19)	7/11	3.5% less $19
Members Uncoordinated with Social Security	7/12	5.0% less ($19)	7/11	3.5% less $19
Safety Members	7/12	6.0% less ($19)	7/11	4.5% less $19

Accounting Office

Archive - Benefits and Assessments Rates

2018 Health Plan Cost (Employer)

2018 Health Plan Cost (Employee)

2017 Benefits Rate Table

2017 Health Plan Cost (Employer)

2017 Health Plan Cost (Employee)

2016 Benefits Rate Table

2016 Health Plan Cost (Employer)

2016 Health Plan Cost (Employee)

2015 Benefits Rate Table

2015 Health Plan Cost (Employer)

2015 Health Plan Cost (Employee)

2014 Benefits Rate Table

2014 Health Plan Cost (Employer)

2014 Health Plan Cost (Employee)

2013 Benefits Rate Table

2013 Health Plan Cost (Employer)

2013 Health Plan Cost (Employee)

2012 Benefits Rate Table

2012 Health Plan Cost (Employer)

2012 Health Plan Cost (Employee)

Accounting Office