2022 Anthem Health Plan Rates

Public Agencies

  Employee Only Employee and 1 Dependent Employee and 2 or more Dependents
Region 1 $799.00 $1,725.00 $2,219.00
Region 2 $775.00 $1,550.00 $2,010.00
Region 3 $775.00 $1,475.00 $1,894.00
Out of State $899.00 $1,899.00 $2,223.00
Supplemental Plan to Medicare $461.00 $919.00 $1,471.00

Region 1: Northern California
Region 2: Central California
Region 3: LA, Riverside & San Bernardino

State Agencies

  Employee Only Employee and 1 Dependent Employee and 2 or more Dependents
California $750.00 $1,499.00 $1,927.00
Out of State $899.00 $1,899.00 $2,223.00
Supplemental Plan to Medicare $461.00 $919.00 $1,471.00

Maximum Out-of-Pocket Expense is $2,000 per person / $4,000 per a family.

Prescription Drugs

Retail
Generic $10.00 copay
Brand Formulary $25.00 copay
Brand Non-Formulary $45.00 copay
Mail Order
Generic $20.00 copay
Brand Formulary $40.00 copay
Brand Non-Formulary $75.00 copay

Body Scans are subject to a maximum $1,000 coverage limit every 36 months.