Medical plan premiums
2024
- Kaiser Permanente NW
-
Plan |
Employee |
Employee and spouse/SRDP |
Employee and children |
Employee, spouse/SRDP, and children |
---|
Kaiser Permanente NW 1 |
$67 |
$134 |
$117 |
$201 |
---|
Kaiser Permanente NW 2 |
$105 |
$210 |
$184 |
$315 |
---|
Kaiser Permanente NW 3 |
$196 |
$392 |
$343 |
$588 |
---|
- Kaiser Permanente WA
-
Plan |
Employee |
Employee and spouse/SRDP |
Employee and children |
Employee, spouse/SRDP, and children |
---|
Kaiser Permanente WA Core 1 |
$48 |
$96 |
$84 |
$144 |
---|
Kaiser Permanente WA Core 2 |
$98 |
$196 |
$172 |
$294 |
---|
Kaiser Permanente WA Core 3 |
$149 |
$298 |
$261 |
$447 |
---|
Kaiser Permanente WA SoundChoice |
$115 |
$230 |
$201 |
$345 |
---|
Kaiser Permanente WA Options Summit PPO 1 |
$100 |
$200 |
$175 |
$300 |
---|
Kaiser Permanente WA Options Summit PPO 2 |
$143 |
$286 |
$250 |
$429 |
---|
Kaiser Permanente WA Options Summit PPO 3 |
$237 |
$474 |
$415 |
$711 |
---|
- Premera Blue Cross
-
Plan |
Employee |
Employee and spouse/SRDP |
Employee and children |
Employee, spouse/SRDP, and children |
---|
Premera High PPO |
$115 |
$230 |
$201 |
$345 |
---|
Premera HMO |
$20 |
$40 |
$35 |
$60 |
---|
Premera Standard PPO |
$64 |
$128 |
$112 |
$192 |
---|
- Uniform Medical Plan (UMP)
-
Plan |
Employee |
Employee and spouse/SRDP |
Employee and children |
Employee, spouse/SRDP, and children |
---|
UMP Achieve 1 |
$44 |
$88 |
$77 |
$132 |
---|
UMP Achieve 2 |
$113 |
$226 |
$198 |
$339 |
---|
UMP High Deductible |
$21 |
$42 |
$37 |
$63 |
---|
UMP Plus–PSHVN |
$86 |
$172 |
$151 |
$258 |
---|
UMP Plus–UW Medicine ACN |
$86 |
$172 |
$151 |
$258 |
---|
2023
- Kaiser Permanente NW
-
Plan |
Employee |
Employee and spouse/SRDP |
Employee and children |
Employee, spouse/SRDP, and children |
---|
Kaiser Permanente NW 1 |
$31 |
$62 |
$54 |
$93 |
---|
Kaiser Permanente NW 2 |
$57 |
$114 |
$100 |
$171 |
---|
Kaiser Permanente NW 3 |
$89 |
$178 |
$156 |
$267 |
---|
- Kaiser Permanente WA
-
Plan |
Employee |
Employee and spouse/SRDP |
Employee and children |
Employee, spouse/SRDP, and children |
---|
Kaiser Permanente WA Core 1 |
$38 |
$76 |
$67 |
$114 |
---|
Kaiser Permanente WA Core 2 |
$43 |
$86 |
$75 |
$129 |
---|
Kaiser Permanente WA Core 3 |
$120 |
$240 |
$210 |
$360 |
---|
Kaiser Permanente WA SoundChoice |
$74 |
$148 |
$130 |
$222 |
---|
Kaiser Permanente WA Options Summit PPO 1 |
$77 |
$154 |
$135 |
$231 |
---|
Kaiser Permanente WA Options Summit PPO 2 |
$106 |
$212 |
$186 |
$318 |
---|
Kaiser Permanente WA Options Summit PPO 3 |
$142 |
$284 |
$249 |
$426 |
---|
- Premera Blue Cross
-
Plan |
Employee |
Employee and spouse/SRDP |
Employee and children |
Employee, spouse/SRDP, and children |
---|
Premera Blue Cross High PPO |
$97 |
$194 |
$170 |
$291 |
---|
Premera Blue Cross HMO |
$25 |
$50 |
$44 |
$75 |
---|
Premera Blue Cross Standard PPO |
$49 |
$98 |
$86 |
$147 |
---|
- Uniform Medical Plan (UMP)
-
Plan |
Employee |
Employee and spouse/SRDP |
Employee and children |
Employee, spouse/SRDP, and children |
---|
UMP Achieve 1 |
$42 |
$84 |
$74 |
$126 |
---|
UMP Achieve 2 |
$105 |
$210 |
$184 |
$315 |
---|
UMP High Deductible |
$28 |
$56 |
$49 |
$84 |
---|
UMP Plus–PSHVN |
$83 |
$166 |
$145 |
$249 |
---|
UMP Plus–UW Medicine ACN |
$83 |
$166 |
$145 |
$249 |
---|
Before you enroll
- Make sure you live in the plan's service area.
- Contact the plan or check the plan's provider director 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 monthly medical premium if they apply to you. For more details, visit Surcharges.
- A $25-per-account surcharge will apply if you or any dependent enrolled in SEBB medical coverage uses tobacco products.
- A $50 surcharge will apply if you enroll your spouse or state-registered domestic partner in SEBB medical coverage and your spouse or domestic partner has chosen not to enroll in other employer-based group medical insurance that is comparable to the PEBB Program's Uniform Medical Plan (UMP) Classic.
Premiums for other benefits
There are no employee premiums for dental, vision, basic life, basic accidental death and dismemberment (AD&D) insurance, and employer-paid long-term (LTD) disability insurance benefits.
How to pay
You pay for coverage with pretax dollars from your paycheck under the state's premium payment plan.
For details and contact information, see How do I pay? on the Paying for benefits page.