Burbank City Employees Association, AFSCME Local 3143 Sponsored
Public Employees Benefit Trust

Plan
2011 RATES
New Rates Effective 1/1/2011 		2012 RATES
New Rates Effective 1/1/2012 		Percent
Increase
1 Party 2 Party 3 Party 1 Party 2 Party 3 Party  
Health Net/United Healthcare (UHC) PPO 704.00 1,375.00 2,191.00 724.00 1,414.00 2,254.00 2.9%
Health Net HMO 540.00 1088.00 1,629.00 607.00 1,226.00 1,836.00 12.6%
Kaiser HMO 430.00 840.00 1,158.00 465.00 926.00 1,269.00 9.6
Pacificare/UHC - HMO 450.00 922.00 1,289.00 476.00 977.00 1,367.00 6.0%
Health Net - HMO "Salud Network" 380.00 739.00 1,106.00 401.00 781.00 1,171.00 5.8%
DHS Dental HMO (Part-Time Employees) 21.50 39.50 59.50 21.50 39.50 59.50 0.0%
DHS Dental PPO (Part-Time Employees) 42.50 82.50 123.50 42.50 82.50 123.50 0.0%
MES Vision Plan (Part-Time Employees) 12.00 23.00 31.00 12.00 23.00 31.00 0.0%

BCEA's CITY Paid Contributions as of 12/1/09 as of 12/1/10 as of 12/1/11
1 Party up to   425.00   450.00   486.00
2 Party up to 830.00 900.0 972.00
3 Party up 1080.00 1250.00 1350.00

CITY OF BURBANK HEALTH INSURANCE RATGE COMPARISON
New Rates Effective January 1, 2012
Plan - Los Angeles Area
2011 Rates 2012 Rates Percent
Increase
1 Party 2 Party 3 Party 1 Party 2 Party 3 Party  
Blue Shield CA 496.93 993.86 1292.02 510.72 1021.44 1327.87 2.8%
Blue Shield HPN 427.58 855.16 1111.71 439.25 878.50 1142.05 2.7%
Kaiser 434.00 868.00 1128.40 465.63 931.26 1,210.64 7.3%
Pers Choice PPO 496.15 992.30 1289.99 505.63 1011.26 1314.64 1.9%
Pers Select PPO 433.87 867.74 1128.06 429.22 858.44 1115.97 -1.1%
Pers Care PPO 787.24 1574.48 2046.82 906.39 1812.78 2356.78 15.1%
PORAC 527.00 987.00 1254.00 556.00 1041.00 1323.00 5.5%

2011 Enrollment for January 1, 2012 - October 10, 2011 through November 4, 2011

Pac Fed
Benefit Administrators, Inc.
1000 N. Central Ave., Suite 400
Glendale, CA 91202
818-243-0222 - Fax 818-549-0610
800-753-0222