Core Network Plans
Your health care plan with Kaiser Permanente is a partnership in health. It connects you to a group of providers, services, and tools that help you live your healthy best.
The Core Plans listed below are available to PEBB members Benton, Columbia, Franklin, Island, King, Kitsap, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, and Yakima counties.
Here are some plan highlights:
- No deductible applied to Telehealth (telemedicine or virtual care)
- No deductible for prescription drugs and cost saving for mail-order
- No deductible for preventive care and covered in full
SEBB members in King, Kitsap, Pierce, Snohomish, Spokane, and Thurston counties also have the option to choose a SoundChoice or Summit PPO plan.
PEBB members in Clark and Cowlitz counties can choose from among 3 plan options in SW Washington.
2025 Plan options
In Benton, Columbia, Franklin, Island, Lewis, Mason, Skagit, Walla Walla, Whatcom, Whitman, and Yakima counties
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $1,250 individual $3,750 family |
$0 | $30, then 20% |
| Employee | $23 |
| Employee & spouse/SRDP* | $46 |
| Employee & children | $40 |
| Employee, spouse/SRDP*, and child(ren) | $69 |
*state-registered domestic partner (SRDP)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $750 individual $2,250 family |
$0 | $25, then 20% |
| Employee | $55 |
| Employee & spouse/SRDP* | $110 |
| Employee & children | $96 |
| Employee, spouse/SRDP*, and children | $165 |
*state-registered domestic partner (SRDP)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $250 individual $750 family |
$0 | $20, then 20% |
| Employee | $208 |
| Employee & spouse/SRDP* | $416 |
| Employee & children | $364 |
| Employee, spouse/SRDP*, and children | $624 |
*state-registered domestic partner (SRDP)
In King, Kitsap, Pierce, Snohomish, Spokane, and Thurston counties
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $1,250 individual $3,750 family |
$0 | $30, then 20% |
| Employee | $23 |
| Employee & spouse/SRDP* | $46 |
| Employee & children | $40 |
| Employee, spouse/SRDP*, and child(ren) | $69 |
*state-registered domestic partner (SRDP)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $750 individual $2,250 family |
$0 | $25, then 20% |
| Employee | $55 |
| Employee & spouse/SRDP* | $110 |
| Employee & children | $96 |
| Employee, spouse/SRDP*, and children | $165 |
*state-registered domestic partner (SRDP)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $125 individual $375 family |
$0 | $20, then 15% |
| Employee | $122 |
| Employee & spouse/SRDP* | $244 |
| Employee & children | $214 |
| Employee, spouse/SRDP*, and children | $366 |
*state-registered domestic partner (SRDP)
Note: Monthly premiums are for school employees. If you are a SEBB Continuation Coverage subscriber, visit HCA's website to see your premiums.
New for 2025
- A member will pay no more than $35, not subject to deductible for a 30-day supply of one inhaled corticosteroid, or one inhaled corticosteroid combination
- Human Immunodeficiency Virus Post-Exposure Prophylaxis (PEP) Drugs or Therapies: No cost share or preauthorization required for at least one of each PEP drug
- Dialysis patients: Members who are undergoing end stage renal dialysis treatment and qualify for Medicare coverage will be reimbursed for their cost of the standard Medicare Part B monthly premium
- Advance care at Home (home care in lieu of inpatient hospital care) will now apply to deductible, copayment, and coinsurance
- For the SoundChoice plan only: benefits for urgent care visits will now apply to deductible, copayment, and coinsurance
2024 Plan documents
In Clark and Cowlitz counties
In Benton, Columbia, Franklin, Island, Lewis, Mason, Skagit, Walla Walla, Whatcom, Whitman, and Yakima counties
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $1,250 individual $3,750 family |
$0 | $30, then 20% |
| Employee | $48 |
| Employee & spouse/SRDP* | $96 |
| Employee & children | $84 |
| Employee, spouse/SRDP*, and child(ren) | $144 |
*(SRDP) state-registered domestic partner
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $750 individual $2,250 family |
$0 | $25, then 20% |
| Employee | $98 |
| Employee & spouse/SRDP* | $196 |
| Employee & children | $172 |
| Employee, spouse/SRDP*, and children | $294 |
*(SRDP) state-registered domestic partner
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $250 individual $750 family |
$0 | $20, then 20% |
| Employee | $149 |
| Employee & spouse/SRDP* | $298 |
| Employee & children | $261 |
| Employee, spouse/SRDP*, and children | $447 |
*state-registered domestic partner (SRDP)
In King, Kitsap, Pierce, Snohomish, Spokane, and Thurston counties
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $750 individual $2,250 family |
$0 | $25, then 20% |
| Employee | $48 |
| Employee & spouse/SRDP* | $96 |
| Employee & children | $84 |
| Employee, spouse/SRDP*, and child(ren) | $144 |
*state-registered domestic partner (SRDP)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $750 individual $2,250 family |
$0 | $25, then 20% |
| Employee | $98 |
| Employee & spouse/SRDP* | $196 |
| Employee & children | $172 |
| Employee, spouse/SRDP*, and children | $294 |
*state-registered domestic partner (SRDP)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| $125 individual $375 family |
$0 | $20, then 15% |
| Employee | $115 |
| Employee & spouse/SRDP* | $230 |
| Employee & children | $201 |
| Employee, spouse/SRDP*, and children | $345 |
*state-registered domestic partner (SRDP)
Premium surcharges
You (the subscriber) may be charged a premium surcharge in addition to your monthly medical premium:
If you or a dependent age 13 or older enrolled on your SEBB medical coverage uses a tobacco product. To avoid the premium surcharge, you and your dependents — ages 18 and older — who use tobacco products can enroll in the Quit for Life Program. Dependents ages 13 to 17 can use the resources at teen.smokefree.gov/.
Spouse or state-registered domestic partner coverage premium surcharge
If your spouse or state-registered domestic partner is enrolled on your SEBB medical coverage and they have elected not to enroll in their employer-based group medical insurance that is comparable to the PEBB Program’s Uniform Medical Plan (UMP) Classic. The comparison must be to the PEBB Program’s UMP Classic, even if you are not enrolled in that plan.
*Source: School Employees Benefits Board (SEBB) Program
Note: Monthly premiums are for school employees. If you are a SEBB Continuation Coverage subscriber, visit HCA's website to see your premiums.
Open Enrollment Webinars
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Plan Options
Different plans are available to you depending on where you live and work.
Questions?
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For eligibility and enrollment questions visit the Washington State HCA website.