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<br /> <br /> <br /> <br /> October 13, 2022 5 <br />BENEFIT SUMMARY <br /> <br />35 40 45 50 55 60 64 <br />Cost by Age 485 522 601 735 914 1,130 1,354 <br />Retiree Version 1 Premium 788 788 788 788 788 788 788 <br />Retiree Version 2 Premium 767 767 767 767 767 767 767 <br /> $- <br /> $200 <br /> $400 <br /> $600 <br /> $800 <br /> $1,000 <br /> $1,200 <br /> $1,400 <br /> $1,600 <br />$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 Kaiser Plan - Single Coverage <br /> <br /> <br /> <br /> <br /> October 13, 2022 6 <br />BENEFIT SUMMARY <br /> <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 <br />/ <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