SEBB Continuation Coverage premiums

Learn how much your SEBB Continuation Coverage plans cost.

2020 medical plans

Plans  Subscriber  Subscriber and spouse1 Subscriber and child(ren)  Subscriber, spouse1 and child(ren)
Kaiser Permanente NW Plan 1 $588.52 $1,171.27 $1,025.58 $1,754.02
Kaiser Permanente NW Plan 2 $601.31 $1,196.85 $1,047.97 $1,792.39
Kaiser Permanente NW Plan 3 $666.54 $1,327.31 $1,162.12 $1,988.08
Kaiser Permanente WA Core 1 $573.46 $1,141.15 $999.23 $1,708.84
Kaiser Permanente WA Core 2 $579.50 $1,153.23 $1,009.80 $1,726.96
Kaiser Permanente WA Core 3 $650.01 $1,294.25 $1,133.19 $1,938.49
Kaiser Permanente WA SoundChoice $609.28 $1,212.79 $1,061.91 $1,816.30
Kaiser Permanente WA Options Access PPO 1 $599.71 $1,193.65 $1,045.17 $1,787.59
Kaiser Permanente WA Options Access PPO 2 $629.44 $1,253.11 $1,097.19 $1,876.78
Kaiser Permanente WA Options Access PPO 3 $676.78 $1,347.79 $1,180.04 $2,018.80
Premera High PPO $630.34 $1,254.90 $1,098.76 $1,879.47
Premera Peak Care EPO $591.39 $1,177.01 $1,030.60 $1,762.63
Premera Standard PPO $582.51 $1,159.24 $1,015.06 $1,735.98
Uniform Medical Plan (UMP) Achieve 12 $593.56 $1,181.35 $1,034.40 $1,769.13
UMP Achieve 22 $658.42 $1,311.06 $1,147.90 $1,963.71
UMP High Deductible2
(with a health savings account)
$591.24 $1,172.88 $1,035.28 $1,723.27
UMP Plus–Puget Sound High Value Network2 $628.88 $1,252.00 $1,096.22 $1,875.11
UMP Plus–UW Medicine Accountable Care Network2 $628.88 $1,252.00 $1,096.22 $1,875.11

1or state-registered domestic partner
2UMP is administered by Regence BlueShield and Washington State Rx Services (WSRxS).

2020 dental plans

Plan Subscriber Subscriber and spouse1 Subscriber and child(ren) Subscriber, spouse1 and child(ren)
DeltaCare $41.33 $82.66 $82.66 $123.99
Uniform Dental Plan $48.67 $97.34 $97.34 $146.01
Willamette Dental Group $49.90 $99.80 $99.80 $149.70

2020 vision plans

Plans  Subscriber  Subscriber and spouse1  Subscriber and child(ren)  Subscriber, spouse1, and child(ren)
Davis Vision $4.36 $8.72 $7.63 $13.08
EyeMed Vision Care $5.96 $11.92 $10.43 $17.88
MetLife Vision $6.66 $13.32 $11.66 $19.98

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.

Premium surcharges in addition to medical plan premiums

You will pay the following premium surcharges in addition to your monthly 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 SEBB medical uses tobacco products.
  • A monthly $50 premium surcharge will apply if you enroll your spouse or state-registered domestic partner in SEBB medical and they have chosen not to enroll in other employer-based group medical that is comparable to the PEBB Program's Uniform Medical Plan (UMP) Classic.

For more details, visit Surcharges.