Table: cy_2023_two_plan_model_rates , health_plan_name like all*

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rating_period	calendar_year	model	county	health_plan_name	category_of_aid	lower_bound	midpoint	upper_bound
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	Child - UIS Federal	$31.98	$33.88	$35.91
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	Adult - UIS Federal	$159.56	$165.24	$171.19
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	ACA Optional Expansion - UIS Federal	$262.52	$271.24	$280.36
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	SPD - UIS Federal	$777.28	$801.25	$826.24
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	SPD/Full-Dual - UIS Federal	$121.65	$126.08	$130.73
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	LTC - UIS Federal	$1,530.17	$1,565.44	$1,602.07
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	LTC/Full-Dual - UIS Federal	$108.61	$111.90	$115.35
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	Child - SIS	$101.97	$107.07	$112.47
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	Adult - SIS	$246.98	$256.10	$265.67
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	ACA Optional Expansion - SIS	$317.31	$328.57	$340.37
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	SPD - SIS	$885.32	$914.60	$945.13
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	SPD/Full-Dual - SIS	$245.62	$252.53	$259.79
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	LTC - SIS	$10,296.01	$10,435.04	$10,578.00
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	LTC/Full-Dual - SIS	$7,796.32	$7,885.98	$7,977.85
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	Maternity - UIS Federal	$9,507.77	$9,715.00	$9,929.01
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	Maternity - SIS	$9,507.77	$9,715.00	$9,929.01
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	Child - UIS State-Only	$69.58	$72.46	$75.50
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	Adult - UIS State-Only	$128.25	$132.87	$137.71
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	ACA Optional Expansion - UIS State-Only	$226.09	$233.16	$240.56
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	SPD - UIS State-Only	$564.38	$580.71	$597.73
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	SPD/Full-Dual - UIS State-Only	$230.83	$236.62	$242.66
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	LTC - UIS State-Only	$8,774.99	$8,879.01	$8,985.63
1/23-12/23	2023	Two Plan	Alameda	Alameda Alliance for Health	LTC/Full-Dual - UIS State-Only	$7,687.71	$7,774.09	$7,862.50
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	Child - UIS Federal	$22.68	$24.22	$25.86
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	Adult - UIS Federal	$172.99	$179.14	$185.58
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	ACA Optional Expansion - UIS Federal	$194.13	$200.93	$208.04
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	SPD - UIS Federal	$663.33	$684.54	$706.66
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	SPD/Full-Dual - UIS Federal	$112.88	$117.07	$121.46
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	LTC - UIS Federal	$1,535.89	$1,572.27	$1,610.08
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	LTC/Full-Dual - UIS Federal	$108.46	$111.70	$115.10
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	Child - SIS	$86.91	$91.47	$96.31
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	Adult - SIS	$207.44	$215.30	$223.55
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	ACA Optional Expansion - SIS	$272.06	$281.93	$292.29
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	SPD - SIS	$777.51	$804.67	$832.99
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	SPD/Full-Dual - SIS	$350.48	$358.02	$365.89
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	LTC - SIS	$10,305.10	$10,446.19	$10,591.34
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	LTC/Full-Dual - SIS	$7,798.11	$7,888.25	$7,980.62
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	Maternity - UIS Federal	$9,507.77	$9,715.00	$9,929.01
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	Maternity - SIS	$9,507.77	$9,715.00	$9,929.01
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	Child - UIS State-Only	$56.10	$58.68	$61.39
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	Adult - UIS State-Only	$142.47	$147.65	$153.07
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	ACA Optional Expansion - UIS State-Only	$199.33	$205.84	$212.66
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	SPD - UIS State-Only	$500.59	$515.30	$530.64
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	SPD/Full-Dual - UIS State-Only	$206.86	$212.11	$217.59
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	LTC - UIS State-Only	$8,778.40	$8,883.39	$8,991.02
1/23-12/23	2023	Two Plan	Alameda	Anthem Blue Cross	LTC/Full-Dual - UIS State-Only	$7,689.65	$7,776.55	$7,865.51
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	Child - UIS Federal	$20.52	$21.87	$23.30
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	Adult - UIS Federal	$216.42	$223.66	$231.23
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	ACA Optional Expansion - UIS Federal	$205.61	$212.52	$219.74
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	SPD - UIS Federal	$585.84	$604.20	$623.33
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	SPD/Full-Dual - UIS Federal	$108.12	$111.96	$115.98
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	LTC - UIS Federal	$1,959.67	$2,008.17	$2,058.56
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	LTC/Full-Dual - UIS Federal	$116.34	$119.63	$123.08
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	Child - SIS	$84.80	$89.12	$93.70
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	Adult - SIS	$215.28	$223.08	$231.26
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	ACA Optional Expansion - SIS	$245.75	$254.39	$263.43
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	SPD - SIS	$718.96	$743.45	$768.98
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	SPD/Full-Dual - SIS	$311.40	$318.40	$325.70
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	LTC - SIS	$10,857.53	$11,014.17	$11,175.47
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	LTC/Full-Dual - SIS	$8,226.37	$8,321.55	$8,419.07
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	Maternity - UIS Federal	$10,716.42	$10,949.95	$11,191.13
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	Maternity - SIS	$10,716.42	$10,949.95	$11,191.13
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	Child - UIS State-Only	$52.06	$54.32	$56.70
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	Adult - UIS State-Only	$171.91	$177.69	$183.74
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	ACA Optional Expansion - UIS State-Only	$200.26	$206.81	$213.66
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	SPD - UIS State-Only	$420.10	$432.67	$445.78
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	SPD/Full-Dual - UIS State-Only	$257.96	$263.39	$269.03
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	LTC - UIS State-Only	$8,909.81	$9,018.31	$9,129.59
1/23-12/23	2023	Two Plan	Contra Costa	Anthem Blue Cross	LTC/Full-Dual - UIS State-Only	$8,110.03	$8,201.92	$8,295.99
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	Child - UIS Federal	$36.68	$38.79	$41.05
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	Adult - UIS Federal	$229.23	$237.01	$245.15
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	ACA Optional Expansion - UIS Federal	$345.65	$356.85	$368.55
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	SPD - UIS Federal	$940.89	$969.62	$999.56
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	SPD/Full-Dual - UIS Federal	$109.37	$113.44	$117.72
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	LTC - UIS Federal	$1,961.47	$2,009.41	$2,059.21
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	LTC/Full-Dual - UIS Federal	$118.92	$122.55	$126.37
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	Child - SIS	$90.08	$94.73	$99.65
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	Adult - SIS	$258.35	$267.71	$277.54
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	ACA Optional Expansion - SIS	$342.22	$354.01	$366.36
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	SPD - SIS	$953.50	$984.09	$1,015.99
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	SPD/Full-Dual - SIS	$207.25	$213.41	$219.88
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	LTC - SIS	$10,857.37	$11,012.83	$11,172.88
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	LTC/Full-Dual - SIS	$8,228.10	$8,323.33	$8,420.92
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	Maternity - UIS Federal	$10,716.42	$10,949.95	$11,191.13
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	Maternity - SIS	$10,716.42	$10,949.95	$11,191.13
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	Child - UIS State-Only	$69.48	$72.26	$75.19
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	Adult - UIS State-Only	$159.91	$165.28	$170.90
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	ACA Optional Expansion - UIS State-Only	$237.33	$244.76	$252.53
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	SPD - UIS State-Only	$600.84	$617.98	$635.83
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	SPD/Full-Dual - UIS State-Only	$250.97	$256.17	$261.58
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	LTC - UIS State-Only	$8,907.82	$9,015.69	$9,126.30
1/23-12/23	2023	Two Plan	Contra Costa	Contra Costa Health Plan	LTC/Full-Dual - UIS State-Only	$8,109.19	$8,200.78	$8,294.55
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	Child - UIS Federal	$27.08	$28.49	$29.99
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	Adult - UIS Federal	$191.46	$197.65	$204.10
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	ACA Optional Expansion - UIS Federal	$235.31	$242.76	$250.54
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	SPD - UIS Federal	$685.99	$706.54	$727.94
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	SPD/Full-Dual - UIS Federal	$103.82	$107.32	$110.99
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	LTC - UIS Federal	$1,048.13	$1,071.17	$1,095.07
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	LTC/Full-Dual - UIS Federal	$70.74	$72.80	$74.96
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	Child - SIS	$66.49	$69.68	$73.06
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	Adult - SIS	$219.88	$227.53	$235.54
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	ACA Optional Expansion - SIS	$266.36	$275.37	$284.79
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	SPD - SIS	$720.14	$743.75	$768.38
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	SPD/Full-Dual - SIS	$211.62	$217.68	$224.01
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	LTC - SIS	$7,905.22	$8,013.15	$8,124.16
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	LTC/Full-Dual - SIS	$5,912.04	$5,984.14	$6,058.12
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	Maternity - UIS Federal	$8,019.68	$8,194.49	$8,375.03
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	Maternity - SIS	$8,034.63	$8,209.76	$8,390.64
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	Child - UIS State-Only	$36.69	$38.26	$39.92
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	Adult - UIS State-Only	$137.07	$141.54	$146.21
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	ACA Optional Expansion - UIS State-Only	$198.87	$204.82	$211.03
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	SPD - UIS State-Only	$548.43	$563.99	$580.17
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	SPD/Full-Dual - UIS State-Only	$199.49	$204.51	$209.74
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	LTC - UIS State-Only	$6,857.02	$6,941.67	$7,028.51
1/23-12/23	2023	Two Plan	Fresno	CalViva Health	LTC/Full-Dual - UIS State-Only	$5,890.52	$5,959.84	$6,030.86
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	Child - UIS Federal	$19.87	$21.07	$22.35
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	Adult - UIS Federal	$166.41	$171.92	$177.69
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	ACA Optional Expansion - UIS Federal	$221.74	$228.88	$236.34
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	SPD - UIS Federal	$528.09	$544.27	$561.13
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	SPD/Full-Dual - UIS Federal	$101.80	$105.26	$108.88
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	LTC - UIS Federal	$1,022.66	$1,045.43	$1,069.06
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	LTC/Full-Dual - UIS Federal	$70.60	$72.63	$74.76
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	Child - SIS	$63.63	$66.67	$69.90
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	Adult - SIS	$174.27	$180.33	$186.68
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	ACA Optional Expansion - SIS	$223.47	$231.02	$238.93
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	SPD - SIS	$575.36	$594.23	$613.92
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	SPD/Full-Dual - SIS	$228.28	$234.45	$240.90
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	LTC - SIS	$7,851.79	$7,959.42	$8,070.13
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	LTC/Full-Dual - SIS	$5,885.01	$5,957.19	$6,031.26
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	Maternity - UIS Federal	$8,078.38	$8,254.46	$8,436.32
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	Maternity - SIS	$8,095.84	$8,272.31	$8,454.56
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	Child - UIS State-Only	$44.57	$46.48	$48.48
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	Adult - UIS State-Only	$138.57	$143.22	$148.09
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	ACA Optional Expansion - UIS State-Only	$229.31	$236.36	$243.71
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	SPD - UIS State-Only	$401.15	$412.87	$425.09
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	SPD/Full-Dual - UIS State-Only	$189.53	$194.44	$199.56
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	LTC - UIS State-Only	$6,692.33	$6,775.56	$6,860.96
1/23-12/23	2023	Two Plan	Fresno	Anthem Blue Cross	LTC/Full-Dual - UIS State-Only	$5,891.69	$5,961.29	$6,032.63
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	Child - UIS Federal	$23.28	$24.66	$26.12
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	Adult - UIS Federal	$223.00	$230.17	$237.66
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	ACA Optional Expansion - UIS Federal	$259.26	$267.48	$276.06
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	SPD - UIS Federal	$798.27	$822.15	$847.02
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	SPD/Full-Dual - UIS Federal	$123.23	$127.39	$131.75
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	LTC - UIS Federal	$1,425.16	$1,457.99	$1,492.06
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	LTC/Full-Dual - UIS Federal	$76.16	$78.40	$80.75
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	Child - SIS	$73.83	$77.33	$81.03
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	Adult - SIS	$235.74	$243.87	$252.38
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	ACA Optional Expansion - SIS	$299.01	$308.90	$319.25
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	SPD - SIS	$855.93	$882.52	$910.24
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	SPD/Full-Dual - SIS	$221.56	$227.82	$234.39
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	LTC - SIS	$9,145.91	$9,271.62	$9,400.93
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	LTC/Full-Dual - SIS	$6,966.73	$7,057.70	$7,151.17
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	Maternity - UIS Federal	$7,520.55	$7,684.47	$7,853.76
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	Maternity - SIS	$7,520.55	$7,684.47	$7,853.76
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	Child - UIS State-Only	$37.24	$38.90	$40.65
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	Adult - UIS State-Only	$165.96	$171.30	$176.88
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	ACA Optional Expansion - UIS State-Only	$226.06	$233.05	$240.35
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	SPD - UIS State-Only	$634.71	$652.58	$671.19
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	SPD/Full-Dual - UIS State-Only	$205.62	$211.22	$217.07
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	LTC - UIS State-Only	$7,748.02	$7,841.70	$7,937.75
1/23-12/23	2023	Two Plan	Kern	Kern Health Systems	LTC/Full-Dual - UIS State-Only	$6,890.56	$6,979.30	$7,070.42
1/23-12/23	2023	Two Plan	Kern	Health Net of California	Child - UIS Federal	$20.94	$22.16	$23.46
1/23-12/23	2023	Two Plan	Kern	Health Net of California	Adult - UIS Federal	$146.48	$151.37	$156.48
1/23-12/23	2023	Two Plan	Kern	Health Net of California	ACA Optional Expansion - UIS Federal	$212.46	$219.28	$226.40
1/23-12/23	2023	Two Plan	Kern	Health Net of California	SPD - UIS Federal	$633.21	$652.34	$672.27
1/23-12/23	2023	Two Plan	Kern	Health Net of California	SPD/Full-Dual - UIS Federal	$116.08	$119.97	$124.05
1/23-12/23	2023	Two Plan	Kern	Health Net of California	LTC - UIS Federal	$1,425.24	$1,458.18	$1,492.36
1/23-12/23	2023	Two Plan	Kern	Health Net of California	LTC/Full-Dual - UIS Federal	$75.54	$77.67	$79.91
1/23-12/23	2023	Two Plan	Kern	Health Net of California	Child - SIS	$60.95	$63.93	$67.08
1/23-12/23	2023	Two Plan	Kern	Health Net of California	Adult - SIS	$206.23	$213.35	$220.82
1/23-12/23	2023	Two Plan	Kern	Health Net of California	ACA Optional Expansion - SIS	$248.80	$257.09	$265.76
1/23-12/23	2023	Two Plan	Kern	Health Net of California	SPD - SIS	$695.98	$717.72	$740.39
1/23-12/23	2023	Two Plan	Kern	Health Net of California	SPD/Full-Dual - SIS	$211.75	$217.61	$223.75
1/23-12/23	2023	Two Plan	Kern	Health Net of California	LTC - SIS	$9,146.30	$9,272.25	$9,401.81
1/23-12/23	2023	Two Plan	Kern	Health Net of California	LTC/Full-Dual - SIS	$6,966.59	$7,057.64	$7,151.19
1/23-12/23	2023	Two Plan	Kern	Health Net of California	Maternity - UIS Federal	$7,520.55	$7,684.47	$7,853.76
1/23-12/23	2023	Two Plan	Kern	Health Net of California	Maternity - SIS	$7,520.55	$7,684.47	$7,853.76
1/23-12/23	2023	Two Plan	Kern	Health Net of California	Child - UIS State-Only	$29.59	$30.98	$32.46
1/23-12/23	2023	Two Plan	Kern	Health Net of California	Adult - UIS State-Only	$120.14	$124.17	$128.38
1/23-12/23	2023	Two Plan	Kern	Health Net of California	ACA Optional Expansion - UIS State-Only	$189.82	$195.71	$201.86
1/23-12/23	2023	Two Plan	Kern	Health Net of California	SPD - UIS State-Only	$496.21	$510.38	$525.12
1/23-12/23	2023	Two Plan	Kern	Health Net of California	SPD/Full-Dual - UIS State-Only	$197.09	$202.39	$207.92
1/23-12/23	2023	Two Plan	Kern	Health Net of California	LTC - UIS State-Only	$7,748.36	$7,842.17	$7,938.37
1/23-12/23	2023	Two Plan	Kern	Health Net of California	LTC/Full-Dual - UIS State-Only	$6,891.05	$6,979.97	$7,071.29
1/23-12/23	2023	Two Plan	Kings	CalViva Health	Child - UIS Federal	$27.08	$28.49	$29.99
1/23-12/23	2023	Two Plan	Kings	CalViva Health	Adult - UIS Federal	$191.46	$197.65	$204.10
1/23-12/23	2023	Two Plan	Kings	CalViva Health	ACA Optional Expansion - UIS Federal	$235.31	$242.76	$250.54
1/23-12/23	2023	Two Plan	Kings	CalViva Health	SPD - UIS Federal	$685.99	$706.54	$727.94
1/23-12/23	2023	Two Plan	Kings	CalViva Health	SPD/Full-Dual - UIS Federal	$103.82	$107.32	$110.99
1/23-12/23	2023	Two Plan	Kings	CalViva Health	LTC - UIS Federal	$1,048.13	$1,071.17	$1,095.07
1/23-12/23	2023	Two Plan	Kings	CalViva Health	LTC/Full-Dual - UIS Federal	$70.74	$72.80	$74.96
1/23-12/23	2023	Two Plan	Kings	CalViva Health	Child - SIS	$66.49	$69.68	$73.06
1/23-12/23	2023	Two Plan	Kings	CalViva Health	Adult - SIS	$219.88	$227.53	$235.54
1/23-12/23	2023	Two Plan	Kings	CalViva Health	ACA Optional Expansion - SIS	$266.36	$275.37	$284.79
1/23-12/23	2023	Two Plan	Kings	CalViva Health	SPD - SIS	$720.14	$743.75	$768.38
1/23-12/23	2023	Two Plan	Kings	CalViva Health	SPD/Full-Dual - SIS	$211.62	$217.68	$224.01
1/23-12/23	2023	Two Plan	Kings	CalViva Health	LTC - SIS	$7,905.22	$8,013.15	$8,124.16
1/23-12/23	2023	Two Plan	Kings	CalViva Health	LTC/Full-Dual - SIS	$5,912.04	$5,984.14	$6,058.12
1/23-12/23	2023	Two Plan	Kings	CalViva Health	Maternity - UIS Federal	$8,019.68	$8,194.49	$8,375.03
1/23-12/23	2023	Two Plan	Kings	CalViva Health	Maternity - SIS	$8,034.63	$8,209.76	$8,390.64
1/23-12/23	2023	Two Plan	Kings	CalViva Health	Child - UIS State-Only	$36.69	$38.26	$39.92
1/23-12/23	2023	Two Plan	Kings	CalViva Health	Adult - UIS State-Only	$137.07	$141.54	$146.21
1/23-12/23	2023	Two Plan	Kings	CalViva Health	ACA Optional Expansion - UIS State-Only	$198.87	$204.82	$211.03
1/23-12/23	2023	Two Plan	Kings	CalViva Health	SPD - UIS State-Only	$548.43	$563.99	$580.17
1/23-12/23	2023	Two Plan	Kings	CalViva Health	SPD/Full-Dual - UIS State-Only	$199.49	$204.51	$209.74
1/23-12/23	2023	Two Plan	Kings	CalViva Health	LTC - UIS State-Only	$6,857.02	$6,941.67	$7,028.51
1/23-12/23	2023	Two Plan	Kings	CalViva Health	LTC/Full-Dual - UIS State-Only	$5,890.52	$5,959.84	$6,030.86
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	Child - UIS Federal	$19.87	$21.07	$22.35
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	Adult - UIS Federal	$166.41	$171.92	$177.69
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	ACA Optional Expansion - UIS Federal	$221.74	$228.88	$236.34
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	SPD - UIS Federal	$528.09	$544.27	$561.13
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	SPD/Full-Dual - UIS Federal	$101.80	$105.26	$108.88
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	LTC - UIS Federal	$1,022.66	$1,045.43	$1,069.06
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	LTC/Full-Dual - UIS Federal	$70.60	$72.63	$74.76
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	Child - SIS	$63.63	$66.67	$69.90
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	Adult - SIS	$174.27	$180.33	$186.68
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	ACA Optional Expansion - SIS	$223.47	$231.02	$238.93
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	SPD - SIS	$575.36	$594.23	$613.92
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	SPD/Full-Dual - SIS	$228.28	$234.45	$240.90
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	LTC - SIS	$7,851.79	$7,959.42	$8,070.13
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	LTC/Full-Dual - SIS	$5,885.01	$5,957.19	$6,031.26
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	Maternity - UIS Federal	$8,078.38	$8,254.46	$8,436.32
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	Maternity - SIS	$8,095.84	$8,272.31	$8,454.56
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	Child - UIS State-Only	$44.57	$46.48	$48.48
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	Adult - UIS State-Only	$138.57	$143.22	$148.09
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	ACA Optional Expansion - UIS State-Only	$229.31	$236.36	$243.71
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	SPD - UIS State-Only	$401.15	$412.87	$425.09
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	SPD/Full-Dual - UIS State-Only	$189.53	$194.44	$199.56
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	LTC - UIS State-Only	$6,692.33	$6,775.56	$6,860.96
1/23-12/23	2023	Two Plan	Kings	Anthem Blue Cross	LTC/Full-Dual - UIS State-Only	$5,891.69	$5,961.29	$6,032.63
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	Child - UIS Federal	$27.15	$28.68	$30.31
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	Adult - UIS Federal	$130.23	$134.85	$139.69
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	ACA Optional Expansion - UIS Federal	$228.14	$235.69	$243.59
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	SPD - UIS Federal	$640.05	$659.97	$680.73
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	SPD/Full-Dual - UIS Federal	$60.50	$62.96	$65.56
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	LTC - UIS Federal	$1,589.49	$1,637.85	$1,688.21
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	LTC/Full-Dual - UIS Federal	$153.39	$158.04	$162.91
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	Child - SIS	$88.40	$92.78	$97.41
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	Adult - SIS	$188.27	$195.52	$203.13
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	ACA Optional Expansion - SIS	$266.77	$276.48	$286.65
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	SPD - SIS	$652.08	$675.77	$700.51
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	SPD/Full-Dual - SIS	$345.29	$354.08	$363.27
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	LTC - SIS	$11,620.92	$11,790.19	$11,964.53
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	LTC/Full-Dual - SIS	$8,051.53	$8,147.20	$8,245.30
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	Maternity - UIS Federal	$6,926.63	$7,077.68	$7,233.68
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	Maternity - SIS	$6,926.63	$7,077.68	$7,233.68
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	Child - UIS State-Only	$46.31	$48.56	$50.94
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	Adult - UIS State-Only	$122.42	$126.74	$131.28
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	ACA Optional Expansion - UIS State-Only	$267.18	$275.03	$283.22
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	SPD - UIS State-Only	$798.71	$819.53	$841.19
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	SPD/Full-Dual - UIS State-Only	$310.62	$317.33	$324.32
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	LTC - UIS State-Only	$9,558.93	$9,674.64	$9,793.31
1/23-12/23	2023	Two Plan	Los Angeles	LA Care Health Plan	LTC/Full-Dual - UIS State-Only	$7,896.53	$7,987.51	$8,080.69
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	Child - UIS Federal	$22.26	$23.57	$24.98
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	Adult - UIS Federal	$122.97	$127.35	$131.95
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	ACA Optional Expansion - UIS Federal	$208.83	$215.84	$223.16
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	SPD - UIS Federal	$398.31	$411.10	$424.45
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	SPD/Full-Dual - UIS Federal	$85.60	$88.75	$92.05
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	LTC - UIS Federal	$1,500.06	$1,546.41	$1,594.70
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	LTC/Full-Dual - UIS Federal	$119.50	$123.22	$127.12
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	Child - SIS	$75.22	$79.11	$83.23
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	Adult - SIS	$171.18	$177.84	$184.82
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	ACA Optional Expansion - SIS	$247.66	$256.72	$266.22
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	SPD - SIS	$519.13	$538.71	$559.15
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	SPD/Full-Dual - SIS	$386.49	$396.43	$406.81
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	LTC - SIS	$12,280.50	$12,453.50	$12,631.56
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	LTC/Full-Dual - SIS	$7,535.81	$7,622.04	$7,710.38
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	Maternity - UIS Federal	$6,926.63	$7,077.68	$7,233.68
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	Maternity - SIS	$6,926.63	$7,077.68	$7,233.68
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	Child - UIS State-Only	$34.06	$35.90	$37.84
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	Adult - UIS State-Only	$122.25	$126.49	$130.93
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	ACA Optional Expansion - UIS State-Only	$240.95	$247.95	$255.25
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	SPD - UIS State-Only	$626.04	$642.37	$659.37
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	SPD/Full-Dual - UIS State-Only	$317.47	$324.73	$332.28
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	LTC - UIS State-Only	$10,637.43	$10,762.69	$10,891.06
1/23-12/23	2023	Two Plan	Los Angeles	Health Net of California	LTC/Full-Dual - UIS State-Only	$7,415.70	$7,498.19	$7,582.61
1/23-12/23	2023	Two Plan	Madera	CalViva Health	Child - UIS Federal	$27.08	$28.49	$29.99
1/23-12/23	2023	Two Plan	Madera	CalViva Health	Adult - UIS Federal	$191.46	$197.65	$204.10
1/23-12/23	2023	Two Plan	Madera	CalViva Health	ACA Optional Expansion - UIS Federal	$235.31	$242.76	$250.54
1/23-12/23	2023	Two Plan	Madera	CalViva Health	SPD - UIS Federal	$685.99	$706.54	$727.94
1/23-12/23	2023	Two Plan	Madera	CalViva Health	SPD/Full-Dual - UIS Federal	$103.82	$107.32	$110.99
1/23-12/23	2023	Two Plan	Madera	CalViva Health	LTC - UIS Federal	$1,048.13	$1,071.17	$1,095.07
1/23-12/23	2023	Two Plan	Madera	CalViva Health	LTC/Full-Dual - UIS Federal	$70.74	$72.80	$74.96
1/23-12/23	2023	Two Plan	Madera	CalViva Health	Child - SIS	$66.49	$69.68	$73.06
1/23-12/23	2023	Two Plan	Madera	CalViva Health	Adult - SIS	$219.88	$227.53	$235.54
1/23-12/23	2023	Two Plan	Madera	CalViva Health	ACA Optional Expansion - SIS	$266.36	$275.37	$284.79
1/23-12/23	2023	Two Plan	Madera	CalViva Health	SPD - SIS	$720.14	$743.75	$768.38
1/23-12/23	2023	Two Plan	Madera	CalViva Health	SPD/Full-Dual - SIS	$211.62	$217.68	$224.01
1/23-12/23	2023	Two Plan	Madera	CalViva Health	LTC - SIS	$7,905.22	$8,013.15	$8,124.16
1/23-12/23	2023	Two Plan	Madera	CalViva Health	LTC/Full-Dual - SIS	$5,912.04	$5,984.14	$6,058.12
1/23-12/23	2023	Two Plan	Madera	CalViva Health	Maternity - UIS Federal	$8,019.68	$8,194.49	$8,375.03
1/23-12/23	2023	Two Plan	Madera	CalViva Health	Maternity - SIS	$8,034.63	$8,209.76	$8,390.64
1/23-12/23	2023	Two Plan	Madera	CalViva Health	Child - UIS State-Only	$36.69	$38.26	$39.92
1/23-12/23	2023	Two Plan	Madera	CalViva Health	Adult - UIS State-Only	$137.07	$141.54	$146.21
1/23-12/23	2023	Two Plan	Madera	CalViva Health	ACA Optional Expansion - UIS State-Only	$198.87	$204.82	$211.03
1/23-12/23	2023	Two Plan	Madera	CalViva Health	SPD - UIS State-Only	$548.43	$563.99	$580.17
1/23-12/23	2023	Two Plan	Madera	CalViva Health	SPD/Full-Dual - UIS State-Only	$199.49	$204.51	$209.74
1/23-12/23	2023	Two Plan	Madera	CalViva Health	LTC - UIS State-Only	$6,857.02	$6,941.67	$7,028.51
1/23-12/23	2023	Two Plan	Madera	CalViva Health	LTC/Full-Dual - UIS State-Only	$5,890.52	$5,959.84	$6,030.86
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	Child - UIS Federal	$19.87	$21.07	$22.35
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	Adult - UIS Federal	$166.41	$171.92	$177.69
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	ACA Optional Expansion - UIS Federal	$221.74	$228.88	$236.34
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	SPD - UIS Federal	$528.09	$544.27	$561.13
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	SPD/Full-Dual - UIS Federal	$101.80	$105.26	$108.88
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	LTC - UIS Federal	$1,022.66	$1,045.43	$1,069.06
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	LTC/Full-Dual - UIS Federal	$70.60	$72.63	$74.76
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	Child - SIS	$63.63	$66.67	$69.90
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	Adult - SIS	$174.27	$180.33	$186.68
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	ACA Optional Expansion - SIS	$223.47	$231.02	$238.93
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	SPD - SIS	$575.36	$594.23	$613.92
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	SPD/Full-Dual - SIS	$228.28	$234.45	$240.90
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	LTC - SIS	$7,851.79	$7,959.42	$8,070.13
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	LTC/Full-Dual - SIS	$5,885.01	$5,957.19	$6,031.26
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	Maternity - UIS Federal	$8,078.38	$8,254.46	$8,436.32
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	Maternity - SIS	$8,095.84	$8,272.31	$8,454.56
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	Child - UIS State-Only	$44.57	$46.48	$48.48
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	Adult - UIS State-Only	$138.57	$143.22	$148.09
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	ACA Optional Expansion - UIS State-Only	$229.31	$236.36	$243.71
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	SPD - UIS State-Only	$401.15	$412.87	$425.09
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	SPD/Full-Dual - UIS State-Only	$189.53	$194.44	$199.56
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	LTC - UIS State-Only	$6,692.33	$6,775.56	$6,860.96
1/23-12/23	2023	Two Plan	Madera	Anthem Blue Cross	LTC/Full-Dual - UIS State-Only	$5,891.69	$5,961.29	$6,032.63
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	Child - UIS Federal	$24.03	$25.39	$26.83
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	Adult - UIS Federal	$164.09	$169.56	$175.28
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	ACA Optional Expansion - UIS Federal	$266.72	$275.19	$284.04
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	SPD - UIS Federal	$673.61	$694.03	$715.31
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	SPD/Full-Dual - UIS Federal	$160.08	$165.25	$170.65
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	LTC - UIS Federal	$1,423.00	$1,465.37	$1,509.47
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	LTC/Full-Dual - UIS Federal	$94.35	$97.43	$100.66
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	Child - SIS	$88.68	$92.93	$97.42
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	Adult - SIS	$244.24	$252.88	$261.93
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	ACA Optional Expansion - SIS	$300.61	$310.99	$321.86
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	SPD - SIS	$846.10	$874.15	$903.40
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	SPD/Full-Dual - SIS	$294.60	$302.60	$310.97
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	LTC - SIS	$11,081.36	$11,248.90	$11,421.57
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	LTC/Full-Dual - SIS	$7,408.04	$7,496.11	$7,586.43
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	Maternity - UIS Federal	$7,673.68	$7,840.96	$8,013.72
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	Maternity - SIS	$7,688.64	$7,856.25	$8,029.35
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	Child - UIS State-Only	$51.38	$53.69	$56.12
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	Adult - UIS State-Only	$168.80	$174.32	$180.09
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	ACA Optional Expansion - UIS State-Only	$314.73	$323.45	$332.55
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	SPD - UIS State-Only	$812.99	$833.96	$855.76
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	SPD/Full-Dual - UIS State-Only	$310.24	$317.90	$325.88
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	LTC - UIS State-Only	$9,201.44	$9,315.73	$9,433.00
1/23-12/23	2023	Two Plan	Riverside	Inland Empire Health Plan	LTC/Full-Dual - UIS State-Only	$7,290.53	$7,375.34	$7,462.23
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	Child - UIS Federal	$19.79	$20.83	$21.95
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	Adult - UIS Federal	$99.47	$102.88	$106.46
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	ACA Optional Expansion - UIS Federal	$165.48	$170.84	$176.45
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	SPD - UIS Federal	$377.70	$389.36	$401.50
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	SPD/Full-Dual - UIS Federal	$92.49	$95.59	$98.84
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	LTC - UIS Federal	$1,153.27	$1,187.83	$1,223.82
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	LTC/Full-Dual - UIS Federal	$120.69	$124.25	$127.97
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	Child - SIS	$73.72	$77.17	$80.82
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	Adult - SIS	$149.09	$154.41	$159.98
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	ACA Optional Expansion - SIS	$191.58	$198.20	$205.13
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	SPD - SIS	$550.25	$568.55	$587.64
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	SPD/Full-Dual - SIS	$285.08	$292.60	$300.46
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	LTC - SIS	$8,638.94	$8,762.18	$8,889.04
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	LTC/Full-Dual - SIS	$6,609.25	$6,692.49	$6,777.94
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	Maternity - UIS Federal	$7,682.77	$7,850.25	$8,023.22
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	Maternity - SIS	$7,664.82	$7,831.91	$8,004.47
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	Child - UIS State-Only	$36.70	$38.34	$40.08
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	Adult - UIS State-Only	$102.99	$106.43	$110.03
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	ACA Optional Expansion - UIS State-Only	$182.65	$188.39	$194.38
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	SPD - UIS State-Only	$549.28	$563.22	$577.71
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	SPD/Full-Dual - UIS State-Only	$309.65	$317.39	$325.44
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	LTC - UIS State-Only	$7,480.69	$7,569.52	$7,660.57
1/23-12/23	2023	Two Plan	Riverside	Molina Healthcare	LTC/Full-Dual - UIS State-Only	$6,531.34	$6,611.39	$6,693.50
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	Child - UIS Federal	$24.03	$25.39	$26.83
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	Adult - UIS Federal	$164.09	$169.56	$175.28
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	ACA Optional Expansion - UIS Federal	$266.72	$275.19	$284.04
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	SPD - UIS Federal	$673.61	$694.03	$715.31
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	SPD/Full-Dual - UIS Federal	$160.08	$165.25	$170.65
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	LTC - UIS Federal	$1,423.00	$1,465.37	$1,509.47
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	LTC/Full-Dual - UIS Federal	$94.35	$97.43	$100.66
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	Child - SIS	$88.68	$92.93	$97.42
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	Adult - SIS	$244.24	$252.88	$261.93
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	ACA Optional Expansion - SIS	$300.61	$310.99	$321.86
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	SPD - SIS	$846.10	$874.15	$903.40
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	SPD/Full-Dual - SIS	$294.60	$302.60	$310.97
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	LTC - SIS	$11,081.36	$11,248.90	$11,421.57
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	LTC/Full-Dual - SIS	$7,408.04	$7,496.11	$7,586.43
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	Maternity - UIS Federal	$7,673.68	$7,840.96	$8,013.72
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	Maternity - SIS	$7,688.64	$7,856.25	$8,029.35
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	Child - UIS State-Only	$51.38	$53.69	$56.12
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	Adult - UIS State-Only	$168.80	$174.32	$180.09
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	ACA Optional Expansion - UIS State-Only	$314.73	$323.45	$332.55
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	SPD - UIS State-Only	$812.99	$833.96	$855.76
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	SPD/Full-Dual - UIS State-Only	$310.24	$317.90	$325.88
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	LTC - UIS State-Only	$9,201.44	$9,315.73	$9,433.00
1/23-12/23	2023	Two Plan	San Bernardino	Inland Empire Health Plan	LTC/Full-Dual - UIS State-Only	$7,290.53	$7,375.34	$7,462.23
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	Child - UIS Federal	$19.79	$20.83	$21.95
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	Adult - UIS Federal	$99.47	$102.88	$106.46
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	ACA Optional Expansion - UIS Federal	$165.48	$170.84	$176.45
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	SPD - UIS Federal	$377.70	$389.36	$401.50
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	SPD/Full-Dual - UIS Federal	$92.49	$95.59	$98.84
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	LTC - UIS Federal	$1,153.27	$1,187.83	$1,223.82
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	LTC/Full-Dual - UIS Federal	$120.69	$124.25	$127.97
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	Child - SIS	$73.72	$77.17	$80.82
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	Adult - SIS	$149.09	$154.41	$159.98
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	ACA Optional Expansion - SIS	$191.58	$198.20	$205.13
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	SPD - SIS	$550.25	$568.55	$587.64
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	SPD/Full-Dual - SIS	$285.08	$292.60	$300.46
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	LTC - SIS	$8,638.94	$8,762.18	$8,889.04
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	LTC/Full-Dual - SIS	$6,609.25	$6,692.49	$6,777.94
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	Maternity - UIS Federal	$7,682.77	$7,850.25	$8,023.22
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	Maternity - SIS	$7,664.82	$7,831.91	$8,004.47
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	Child - UIS State-Only	$36.70	$38.34	$40.08
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	Adult - UIS State-Only	$102.99	$106.43	$110.03
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	ACA Optional Expansion - UIS State-Only	$182.65	$188.39	$194.38
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	SPD - UIS State-Only	$549.28	$563.22	$577.71
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	SPD/Full-Dual - UIS State-Only	$309.65	$317.39	$325.44
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	LTC - UIS State-Only	$7,480.69	$7,569.52	$7,660.57
1/23-12/23	2023	Two Plan	San Bernardino	Molina Healthcare	LTC/Full-Dual - UIS State-Only	$6,531.34	$6,611.39	$6,693.50
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	Child - UIS Federal	$29.18	$31.13	$33.22
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	Adult - UIS Federal	$201.74	$208.91	$216.42
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	ACA Optional Expansion - UIS Federal	$310.93	$321.39	$332.34
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	SPD - UIS Federal	$895.68	$923.85	$953.21
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	SPD/Full-Dual - UIS Federal	$95.89	$99.77	$103.85
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	LTC - UIS Federal	$2,275.68	$2,324.25	$2,374.64
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	LTC/Full-Dual - UIS Federal	$211.50	$217.29	$223.35
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	Child - SIS	$102.48	$107.99	$113.84
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	Adult - SIS	$273.90	$284.45	$295.54
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	ACA Optional Expansion - SIS	$387.08	$401.15	$415.89
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	SPD - SIS	$1,101.04	$1,139.02	$1,178.61
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	SPD/Full-Dual - SIS	$252.52	$259.81	$267.47
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	LTC - SIS	$17,759.22	$17,976.70	$18,199.82
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	LTC/Full-Dual - SIS	$13,666.73	$13,816.86	$13,970.48
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	Maternity - UIS Federal	$9,692.93	$9,904.23	$10,122.46
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	Maternity - SIS	$9,692.93	$9,904.23	$10,122.46
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	Child - UIS State-Only	$56.04	$58.87	$61.87
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	Adult - UIS State-Only	$179.44	$185.92	$192.71
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	ACA Optional Expansion - UIS State-Only	$336.05	$345.94	$356.26
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	SPD - UIS State-Only	$828.67	$850.77	$873.79
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	SPD/Full-Dual - UIS State-Only	$169.56	$174.58	$179.84
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	LTC - UIS State-Only	$15,495.01	$15,664.25	$15,837.35
1/23-12/23	2023	Two Plan	San Francisco	San Francisco Health Plan	LTC/Full-Dual - UIS State-Only	$13,455.23	$13,599.57	$13,747.13
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	Child - UIS Federal	$26.96	$29.04	$31.26
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	Adult - UIS Federal	$251.79	$260.95	$270.56
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	ACA Optional Expansion - UIS Federal	$305.41	$316.27	$327.63
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	SPD - UIS Federal	$871.10	$899.81	$929.78
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	SPD/Full-Dual - UIS Federal	$100.79	$105.09	$109.62
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	LTC - UIS Federal	$2,280.67	$2,331.11	$2,383.48
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	LTC/Full-Dual - UIS Federal	$212.73	$218.89	$225.35
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	Child - SIS	$82.30	$87.13	$92.24
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	Adult - SIS	$280.07	$290.96	$302.39
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	ACA Optional Expansion - SIS	$317.29	$329.26	$341.81
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	SPD - SIS	$992.83	$1,028.28	$1,065.25
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	SPD/Full-Dual - SIS	$362.84	$372.14	$381.88
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	LTC - SIS	$17,765.37	$17,985.15	$18,210.72
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	LTC/Full-Dual - SIS	$13,668.42	$13,819.15	$13,973.39
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	Maternity - UIS Federal	$9,692.93	$9,904.23	$10,122.46
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	Maternity - SIS	$9,692.93	$9,904.23	$10,122.46
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	Child - UIS State-Only	$37.05	$39.23	$41.54
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	Adult - UIS State-Only	$173.46	$179.86	$186.56
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	ACA Optional Expansion - UIS State-Only	$265.78	$273.83	$282.24
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	SPD - UIS State-Only	$678.02	$696.55	$715.87
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	SPD/Full-Dual - UIS State-Only	$229.34	$236.18	$243.33
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	LTC - UIS State-Only	$15,496.22	$15,665.92	$15,839.50
1/23-12/23	2023	Two Plan	San Francisco	Anthem Blue Cross	LTC/Full-Dual - UIS State-Only	$13,455.69	$13,600.26	$13,748.04
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	Child - UIS Federal	$24.02	$25.48	$27.03
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	Adult - UIS Federal	$193.09	$199.48	$206.16
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	ACA Optional Expansion - UIS Federal	$288.80	$297.97	$307.55
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	SPD - UIS Federal	$760.84	$783.80	$807.71
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	SPD/Full-Dual - UIS Federal	$95.24	$98.68	$102.29
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	LTC - UIS Federal	$1,847.46	$1,892.17	$1,938.60
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	LTC/Full-Dual - UIS Federal	$81.44	$83.81	$86.30
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	Child - SIS	$78.31	$82.16	$86.23
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	Adult - SIS	$247.00	$255.66	$264.74
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	ACA Optional Expansion - SIS	$323.84	$334.78	$346.23
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	SPD - SIS	$809.43	$835.66	$863.00
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	SPD/Full-Dual - SIS	$195.50	$200.99	$206.76
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	LTC - SIS	$10,118.75	$10,262.77	$10,411.02
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	LTC/Full-Dual - SIS	$7,406.62	$7,493.47	$7,582.49
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	Maternity - UIS Federal	$7,542.96	$7,707.39	$7,877.22
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	Maternity - SIS	$7,505.95	$7,669.59	$7,838.58
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	Child - UIS State-Only	$46.48	$48.48	$50.60
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	Adult - UIS State-Only	$161.59	$166.89	$172.44
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	ACA Optional Expansion - UIS State-Only	$247.66	$255.29	$263.26
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	SPD - UIS State-Only	$569.59	$586.13	$603.36
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	SPD/Full-Dual - UIS State-Only	$253.08	$258.43	$263.99
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	LTC - UIS State-Only	$8,365.39	$8,467.40	$8,572.02
1/23-12/23	2023	Two Plan	San Joaquin	Health Plan of San Joaquin	LTC/Full-Dual - UIS State-Only	$7,363.04	$7,447.98	$7,534.98
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	Child - UIS Federal	$22.94	$24.48	$26.11
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	Adult - UIS Federal	$161.20	$166.90	$172.86
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	ACA Optional Expansion - UIS Federal	$309.56	$319.72	$330.34
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	SPD - UIS Federal	$785.21	$809.90	$835.64
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	SPD/Full-Dual - UIS Federal	$114.03	$118.18	$122.55
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	LTC - UIS Federal	$1,812.75	$1,857.84	$1,904.70
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	LTC/Full-Dual - UIS Federal	$82.44	$84.98	$87.66
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	Child - SIS	$64.36	$67.66	$71.17
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	Adult - SIS	$186.23	$192.90	$199.89
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	ACA Optional Expansion - SIS	$280.64	$290.17	$300.14
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	SPD - SIS	$729.52	$753.45	$778.40
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	SPD/Full-Dual - SIS	$243.63	$249.94	$256.55
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	LTC - SIS	$10,142.31	$10,290.31	$10,442.75
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	LTC/Full-Dual - SIS	$7,444.87	$7,533.07	$7,623.50
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	Maternity - UIS Federal	$7,764.25	$7,933.51	$8,108.32
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	Maternity - SIS	$7,824.08	$7,994.65	$8,170.80
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	Child - UIS State-Only	$34.53	$36.18	$37.93
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	Adult - UIS State-Only	$118.76	$122.89	$127.20
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	ACA Optional Expansion - UIS State-Only	$209.93	$216.64	$223.66
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	SPD - UIS State-Only	$456.50	$470.35	$484.78
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	SPD/Full-Dual - UIS State-Only	$284.41	$290.43	$296.68
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	LTC - UIS State-Only	$8,391.19	$8,495.09	$8,601.70
1/23-12/23	2023	Two Plan	San Joaquin	Health Net of California	LTC/Full-Dual - UIS State-Only	$7,365.61	$7,451.30	$7,539.08
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	Child - UIS Federal	$38.34	$40.35	$42.47
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	Adult - UIS Federal	$214.12	$221.38	$228.98
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	ACA Optional Expansion - UIS Federal	$270.31	$279.25	$288.59
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	SPD - UIS Federal	$636.22	$656.13	$676.88
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	SPD/Full-Dual - UIS Federal	$122.96	$127.37	$132.00
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	LTC - UIS Federal	$2,243.44	$2,311.43	$2,382.22
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	LTC/Full-Dual - UIS Federal	$77.98	$80.90	$83.98
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	Child - SIS	$95.18	$99.97	$105.03
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	Adult - SIS	$234.69	$243.35	$252.45
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	ACA Optional Expansion - SIS	$272.16	$282.03	$292.38
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	SPD - SIS	$615.64	$637.55	$660.43
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	SPD/Full-Dual - SIS	$287.21	$294.71	$302.55
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	LTC - SIS	$12,735.98	$12,936.90	$13,144.15
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	LTC/Full-Dual - SIS	$8,672.93	$8,774.22	$8,878.02
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	Maternity - UIS Federal	$8,777.00	$8,968.29	$9,165.85
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	Maternity - SIS	$8,777.00	$8,968.29	$9,165.85
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	Child - UIS State-Only	$66.17	$68.94	$71.86
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	Adult - UIS State-Only	$195.51	$201.57	$207.91
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	ACA Optional Expansion - UIS State-Only	$252.74	$260.03	$267.64
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	SPD - UIS State-Only	$530.28	$543.83	$557.94
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	SPD/Full-Dual - UIS State-Only	$251.75	$257.67	$263.84
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	LTC - UIS State-Only	$10,513.02	$10,646.50	$10,783.53
1/23-12/23	2023	Two Plan	Santa Clara	Santa Clara Family Health Plan	LTC/Full-Dual - UIS State-Only	$8,594.15	$8,692.50	$8,793.22
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	Child - UIS Federal	$23.40	$24.74	$26.16
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	Adult - UIS Federal	$136.95	$141.78	$146.83
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	ACA Optional Expansion - UIS Federal	$200.58	$207.36	$214.45
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	SPD - UIS Federal	$443.24	$457.49	$472.35
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	SPD/Full-Dual - UIS Federal	$82.20	$85.27	$88.49
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	LTC - UIS Federal	$2,135.26	$2,201.48	$2,270.45
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	LTC/Full-Dual - UIS Federal	$59.28	$61.55	$63.94
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	Child - SIS	$70.90	$74.63	$78.58
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	Adult - SIS	$185.30	$192.24	$199.53
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	ACA Optional Expansion - SIS	$228.47	$236.79	$245.50
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	SPD - SIS	$538.22	$556.84	$576.27
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	SPD/Full-Dual - SIS	$228.06	$233.71	$239.63
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	LTC - SIS	$12,064.52	$12,257.52	$12,456.69
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	LTC/Full-Dual - SIS	$8,305.86	$8,401.60	$8,499.67
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	Maternity - UIS Federal	$8,777.00	$8,968.29	$9,165.85
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	Maternity - SIS	$8,777.00	$8,968.29	$9,165.85
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	Child - UIS State-Only	$33.50	$35.13	$36.86
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	Adult - UIS State-Only	$111.91	$115.88	$120.03
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	ACA Optional Expansion - UIS State-Only	$185.57	$191.19	$197.05
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	SPD - UIS State-Only	$492.70	$504.70	$517.18
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	SPD/Full-Dual - UIS State-Only	$202.97	$207.44	$212.09
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	LTC - UIS State-Only	$9,939.36	$10,066.55	$10,197.15
1/23-12/23	2023	Two Plan	Santa Clara	Anthem Blue Cross	LTC/Full-Dual - UIS State-Only	$8,246.59	$8,340.05	$8,435.73
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	Child - UIS Federal	$24.02	$25.48	$27.03
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	Adult - UIS Federal	$193.09	$199.48	$206.16
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	ACA Optional Expansion - UIS Federal	$288.80	$297.97	$307.55
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	SPD - UIS Federal	$760.84	$783.80	$807.71
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	SPD/Full-Dual - UIS Federal	$95.24	$98.68	$102.29
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	LTC - UIS Federal	$1,847.46	$1,892.17	$1,938.60
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	LTC/Full-Dual - UIS Federal	$81.44	$83.81	$86.30
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	Child - SIS	$78.31	$82.16	$86.23
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	Adult - SIS	$247.00	$255.66	$264.74
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	ACA Optional Expansion - SIS	$323.84	$334.78	$346.23
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	SPD - SIS	$809.43	$835.66	$863.00
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	SPD/Full-Dual - SIS	$195.50	$200.99	$206.76
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	LTC - SIS	$10,118.75	$10,262.77	$10,411.02
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	LTC/Full-Dual - SIS	$7,406.62	$7,493.47	$7,582.49
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	Maternity - UIS Federal	$7,542.96	$7,707.39	$7,877.22
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	Maternity - SIS	$7,505.95	$7,669.59	$7,838.58
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	Child - UIS State-Only	$46.48	$48.48	$50.60
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	Adult - UIS State-Only	$161.59	$166.89	$172.44
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	ACA Optional Expansion - UIS State-Only	$247.66	$255.29	$263.26
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	SPD - UIS State-Only	$569.59	$586.13	$603.36
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	SPD/Full-Dual - UIS State-Only	$253.08	$258.43	$263.99
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	LTC - UIS State-Only	$8,365.39	$8,467.40	$8,572.02
1/23-12/23	2023	Two Plan	Stanislaus	Health Plan of San Joaquin	LTC/Full-Dual - UIS State-Only	$7,363.04	$7,447.98	$7,534.98
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	Child - UIS Federal	$22.94	$24.48	$26.11
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	Adult - UIS Federal	$161.20	$166.90	$172.86
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	ACA Optional Expansion - UIS Federal	$309.56	$319.72	$330.34
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	SPD - UIS Federal	$785.21	$809.90	$835.64
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	SPD/Full-Dual - UIS Federal	$114.03	$118.18	$122.55
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	LTC - UIS Federal	$1,812.75	$1,857.84	$1,904.70
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	LTC/Full-Dual - UIS Federal	$82.44	$84.98	$87.66
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	Child - SIS	$64.36	$67.66	$71.17
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	Adult - SIS	$186.23	$192.90	$199.89
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	ACA Optional Expansion - SIS	$280.64	$290.17	$300.14
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	SPD - SIS	$729.52	$753.45	$778.40
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	SPD/Full-Dual - SIS	$243.63	$249.94	$256.55
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	LTC - SIS	$10,142.31	$10,290.31	$10,442.75
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	LTC/Full-Dual - SIS	$7,444.87	$7,533.07	$7,623.50
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	Maternity - UIS Federal	$7,764.25	$7,933.51	$8,108.32
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	Maternity - SIS	$7,824.08	$7,994.65	$8,170.80
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	Child - UIS State-Only	$34.53	$36.18	$37.93
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	Adult - UIS State-Only	$118.76	$122.89	$127.20
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	ACA Optional Expansion - UIS State-Only	$209.93	$216.64	$223.66
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	SPD - UIS State-Only	$456.50	$470.35	$484.78
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	SPD/Full-Dual - UIS State-Only	$284.41	$290.43	$296.68
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	LTC - UIS State-Only	$8,391.19	$8,495.09	$8,601.70
1/23-12/23	2023	Two Plan	Stanislaus	Health Net of California	LTC/Full-Dual - UIS State-Only	$7,365.61	$7,451.30	$7,539.08
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	Child - UIS Federal	$16.73	$17.72	$18.77
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	Adult - UIS Federal	$128.89	$133.17	$137.64
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	ACA Optional Expansion - UIS Federal	$227.80	$234.98	$242.46
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	SPD - UIS Federal	$498.53	$513.65	$529.40
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	SPD/Full-Dual - UIS Federal	$94.04	$97.20	$100.51
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	LTC - UIS Federal	$1,617.88	$1,657.37	$1,698.38
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	LTC/Full-Dual - UIS Federal	$60.49	$62.21	$64.03
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	Child - SIS	$53.84	$56.46	$59.24
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	Adult - SIS	$169.39	$175.34	$181.57
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	ACA Optional Expansion - SIS	$227.33	$234.97	$242.96
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	SPD - SIS	$613.04	$632.63	$653.05
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	SPD/Full-Dual - SIS	$158.03	$162.79	$167.77
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	LTC - SIS	$8,830.23	$8,960.02	$9,093.69
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	LTC/Full-Dual - SIS	$5,192.77	$5,255.60	$5,320.06
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	Maternity - UIS Federal	$6,496.92	$6,638.53	$6,784.78
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	Maternity - SIS	$6,496.92	$6,638.53	$6,784.78
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	Child - UIS State-Only	$38.62	$40.29	$42.04
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	Adult - UIS State-Only	$132.30	$136.67	$141.24
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	ACA Optional Expansion - UIS State-Only	$255.13	$262.85	$270.89
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	SPD - UIS State-Only	$405.92	$417.71	$429.99
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	SPD/Full-Dual - UIS State-Only	$134.11	$138.09	$142.25
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	LTC - UIS State-Only	$7,224.79	$7,315.45	$7,408.49
1/23-12/23	2023	Two Plan	Tulare	Anthem Blue Cross	LTC/Full-Dual - UIS State-Only	$5,132.28	$5,193.39	$5,256.03
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	Child - UIS Federal	$21.60	$22.78	$24.04
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	Adult - UIS Federal	$169.47	$174.96	$180.69
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	ACA Optional Expansion - UIS Federal	$236.80	$244.25	$252.03
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	SPD - UIS Federal	$657.94	$677.68	$698.24
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	SPD/Full-Dual - UIS Federal	$110.43	$114.08	$117.91
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	LTC - UIS Federal	$1,617.57	$1,656.92	$1,697.78
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	LTC/Full-Dual - UIS Federal	$60.84	$62.62	$64.50
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	Child - SIS	$54.30	$56.94	$59.74
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	Adult - SIS	$178.88	$185.16	$191.73
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	ACA Optional Expansion - SIS	$243.80	$251.99	$260.56
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	SPD - SIS	$636.95	$657.31	$678.53
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	SPD/Full-Dual - SIS	$172.43	$177.52	$182.84
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	LTC - SIS	$8,828.79	$8,958.18	$9,091.42
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	LTC/Full-Dual - SIS	$5,192.24	$5,254.95	$5,319.27
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	Maternity - UIS Federal	$6,496.92	$6,638.53	$6,784.78
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	Maternity - SIS	$6,496.92	$6,638.53	$6,784.78
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	Child - UIS State-Only	$30.56	$31.90	$33.31
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	Adult - UIS State-Only	$121.54	$125.50	$129.64
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	ACA Optional Expansion - UIS State-Only	$209.69	$215.94	$222.45
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	SPD - UIS State-Only	$455.14	$468.00	$481.40
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	SPD/Full-Dual - UIS State-Only	$151.35	$155.66	$160.16
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	LTC - UIS State-Only	$7,223.65	$7,314.04	$7,406.80
1/23-12/23	2023	Two Plan	Tulare	Health Net of California	LTC/Full-Dual - UIS State-Only	$5,131.40	$5,192.33	$5,254.77