2023 NonPERS Active Employees' Medical & Dental Plan Rates 

Plan Rates in effect from January 1, 2023 through December 31, 2023

Quick Links:

2023 Active Open Enrollment Guide (PDF)

2023 Active Dental Comparison Guide (PDF)

2023 Active Medical Comparison Guide (PDF)

2023 Plan Highlights and Summary of Benefits (SBC's)

Dependent Verification Form (PDF)

Union/Association or Management
Resolution
 Full Time/Part Time more than 20 hours per week Part Time Less than 20
hours per week
 Permanent
Intermittent (PI)
 Temporary COBRA
AFSCME, LOCAL 512
 Full Time/Part Time more than 20 hours (PDF) Part Time less than 20 hrs (PDF) PI (PDF) Temp (PDF)
 COBRA (PDF)
AFSCME, LOCAL 2700 Full Time/Part Time more than 20 hours (PDF) Part Time less than 20 hrs (PDF) PI (PDF)
 Temp (PDF)
 COBRA (PDF)
CALIFORNIA NURSES
ASSOCIATION
 Full Time/Part Time more than 16 hours (PDF)

 N/A PI (PDF)
 L3 & LT (PDF)

 L3 & LT COBRA (PDF)
CCC DEFENDERS ASSOCIATION
 Full Time/Part Time more than 20 hours (PDF)

 Part Time less than 20 hours (PDF) PI (PDF)
 Temp (PDF)

 COBRA (PDF)
DEPUTY DISTRICT ATTORNEYS'
ASSOCIATION		 Full Time/Part Time more than 20 hours (PDF) Part Time more than 20 hours (PDF) PI (PDF)
 Temp (PDF)

 COBRA (PDF)
DSA Probation
 Full Time/Part Time more than 20 hours (PDF)
 Part Time less than 20 hours (PDF)
 PI (PDF)
 Temp (PDF)
 COBRA (PDF)
FIRST 5

Part Time less than 20 hours (PDF)
 PI (PDF)

 N/A

 COBRA (PDF)
IN HOME SUPPORTIVE
SERVICES
 Full Time/Part Time more than 20 hours (PDF)

 Part Time less than 20 hours (PDF)
 PI (PDF)
 Temp (PDF)

 COBRA (PDF)
LAFCO Full Time/Part Time more than 20 hours (PDF)

 N/A N/A N/A

 COBRA (PDF)
MANAGEMENT RESOLUTION/
ELECTED OFFICIALS		 Full Time/Part Time more than 20 hours (PDF) Part Time less than 20 hours (PDF) PI (PDF)
 Temp (PDF)
 COBRA (PDF)
PEU LOCAL 1
 Full Time/Part Time more than 20 hours (PDF) Part Time less than 20 hours (PDF) PI (PDF)
 Temp (PDF)
 COBRA (PDF)
PHYSICIAN AND DENTIST'S
ORGANIZATION
 Full Time/Part Time more than 20 hours (PDF)

 Part Time less than 20 hours (PDF) PI (PDF)
 Temp (PDF)

 COBRA (PDF)
PROFESSIONAL & TECHNICAL
ENGINEERS (LOCAL 21, AFL-CIO)		 Full Time/Part Time more than 20 hours (PDF)
 Part Time less than 20 hours (PDF) PI (PDF)
 Temp (PDF)
 COBRA (PDF)
SEIU, LOCAL 1021 Full Time/Part Time more than 20 hours (PDF) Part Time less than 20 hours (PDF) PI (PDF)
 Temp (PDF)
 COBRA (PDF)
TEAMSTERS LOCAL UNION
NO 856		 Full Time/Part Time more than 20 hours (PDF) Part Time less than 20 hours (PDF) PI (PDF)
 Temp (PDF)
 COBRA (PDF)
WESTERN COUNCIL OF
ENGINEERS
 Full Time/Part Time more than 20 hours (PDF)

 Part Time less than 20 hours (PDF) PI (PDF)
 Temp (PDF)

 COBRA (PDF)