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<br />
<br />
<br />
<br />October 13, 2022 7
<br />BENEFIT SUMMARY
<br />35 40 45 50 55 60 64
<br />Cost by Age 957 1,030 1,185 1,449 1,803 2,229 2,671
<br />Retiree Version 1 Premium 1,794 1,794 1,794 1,794 1,794 1,794 1,794
<br />Retiree Version 2 Premium 1,745 1,745 1,745 1,745 1,745 1,745 1,745
<br /> $-
<br /> $500
<br /> $1,000
<br /> $1,500
<br /> $2,000
<br /> $2,500
<br /> $3,000
<br />$C
<br />o
<br />s
<br />t
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<br />P
<br />r
<br />e
<br />m
<br />i
<br />u
<br />m
<br />Age
<br />2022/23 Health Net HMO Plan - Single Coverage
<br />
<br />
<br />
<br />
<br />October 13, 2022 8
<br />BENEFIT SUMMARY
<br />
<br />35 40 45 50 55 60 64
<br />Cost by Age 1,102 1,236 1,443 1,723 2,014 2,372 2,790
<br />Retiree Version 1 Premium 1,815 1,815 1,815 1,815 1,815 1,815 1,815
<br />Retiree Version 2 Premium 1,800 1,800 1,800 1,800 1,800 1,800 1,800
<br /> $-
<br /> $500
<br /> $1,000
<br /> $1,500
<br /> $2,000
<br /> $2,500
<br /> $3,000
<br />$C
<br />o
<br />s
<br />t
<br />/
<br />P
<br />r
<br />e
<br />m
<br />i
<br />u
<br />m
<br />Age
<br />2022/23 Health Net PPO Plan - Single Coverage
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