PEBB Continuation Coverage premiums (non-Medicare)

Find out the monthly cost of your non-Medicare continuation coverage insurance plans.

Medical plan premiums

Members not eligible for Medicare (or enrolled in Part A only)

Subscriber

Subscriber and spouse1 Subscriber and child(ren) Subscriber spouse1, and child(ren)

Kaiser Permanente NW2 Classic

$715.66

$1,426.25 $1,248.60 $1,959.20

Kaiser Permanente NW2 CDHP

$608.85

$1,206.99 $1,072.04 $1,611.85
Kaiser Permanente WA Classic

$752.15

$1,499.24

$1,312.47

$2,059.55

Kaiser Permanente WA CDHP $610.16

$1,210.10

$1,074.70

$1,616.32

Kaiser Permanente WA SoundChoice $618.49 $1,231.92

$1,078.57

$1,692.00

Kaiser Permanente WA Value

$675.71

$1,346.36

$1,178.70

$1,849.35

Uniform Medical Plan (UMP) Classic $679.72 $1,354.37 $1,185.71 $1,860.37
UMP CDHP $608.35 $1,206.48 $1,071.53 $1,611.34
UMP Plus–Puget Sound High Value Network $644.97 $1,284.88 $1,124.91 $1,764.82
UMP Plus–UW Medicine Accountable Care Network $644.97 $1,284.88 $1,124.91 $1,764.82

1or state-registered domestic partner
2Kaiser Foundation Health Plan of the Northwest offers plans in Clark and Cowlitz counties in Washington, and select counties in Oregon.  

Members not eligible for Medicare (or enrolled in Part A only)

Subscriber only

Subscriber and spouse1

Subscriber and child(ren)

Subscriber, spouse1, and child(ren)

Kaiser Permanente NW Classic2

$710.65

$1,415.33 $1,239.16 $1,943.84

Kaiser Permanente NW CDHP2

$604.16

$1,196.38 $1,062.91 $1,596.81

Kaiser Permanente WA Classic

$733.39

$1,460.80 $1,278.95 $2,006.37

Kaiser Permanente WA CDHP

$600.44

$1,189.46 $1,056.79 $1,587.47

Kaiser Permanente WA SoundChoice

$603.21 $1,200.44 $1,051.13 $1,648.37

Kaiser Permanente WA Value

$656.25

$1,306.54 $1,143.96 $1,794.25

UMP Classic

$674.85

$1,343.72 $1,176.50

$1,845.38

UMP CDHP

$600.54

$1,189.65 $1,056.96 $1,587.74

UMP Plus-Puget Sound High Value Network

$618.07

$1,230.18 $1,077.15 $1,689.25
UMP Plus-UW Medicine ACN $618.07 $1,230.18 $1,077.15 $1,689.25

1or state-registered domestic partner
2Kaiser Foundation Health Plan of the Northwest offers plans in Clark and Cowlitz counties in Washington, and select counties in Oregon.  

Dental plan premiums (with medical plan)

 

DeltaCare

 Uniform Dental Plan

 Willamette Dental Group 

 Subscriber

$39.53

$47.01

$44.45

Subscriber and spouse 1

$79.06

$94.02

$88.90

 Subscriber and child(ren)

$79.06

$94.02

$88.90

Subscriber, spouse1, and child(ren)

$118.59

$141.03

$133.35

1or state-registered domestic partner

 

DeltaCare

Uniform Dental Plan Willamette Dental Group

Subscriber only

$39.53

$45.87 $44.45

Subscriber and spouse1

$79.06

$91.74 $88.90

Subscriber and child(ren)

$79.06

$91.74 $88.90

Subscriber, spouse1, and child(ren)

$118.59

$137.61 $133.35

1or state-registered domestic partner 

Dental plan premiums (dental only)

 

DeltaCare

 Uniform Dental Plan

 Willamette Dental Group 

 Subscriber

$39.53

$47.01

$44.45

Subscriber and spouse 1

$79.06

$94.02

$88.90

 Subscriber and child(ren)

$79.06

$94.02

$88.90

Subscriber, spouse1, and child(ren)

$118.59

$141.03

$133.35

1or state-registered domestic partner

 

DeltaCare

Uniform Dental Plan Willamette Dental Group

Subscriber only

$45.50

$51.84 $50.42

Subscriber and spouse1

$85.03

$97.71 $94.87

Subscriber and child(ren)

$85.03 $97.71 $94.87

Subscriber, spouse1, and child(ren)

$124.56

$143.58 $139.32

1or state-registered domestic partner

Before you enroll

  1. Make sure you live in the plan's service area.
  2. Contact the plan or check the plan's provider directory to make sure your providers are in the plan's network.

Surcharges in addition to medical plan premiums

You will pay the following surcharges in addition to your medical plan premium if they apply to you.

  • A monthly $25-per-account premium surcharge will apply if you or any dependent (age 13 and older) enrolled in PEBB medical uses tobacco products.
  • A monthly $50 premium surcharge will apply if you enroll your spouse or state-registered domestic partner in PEBB medical and your spouse or state-registered domestic partner has chosen not to enroll in other employer-based group medical that is comparable to Uniform Medical Plan (UMP) Classic.

For more details, visit Surcharges.