Plans that give you peace of mind
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.
Different plans are available to you depending on where you live and work. SEBB members in King, Kitsap, Pierce, Snohomish, Spokane, and Thurston counties can choose Core Plan 1 or Core Plan 2 listed below with providers from our Core Network, and SoundChoice with the SoundChoice Network.
About Summit PPO Plans
Summit PPO includes 3 tiers of coverage for different groups of clinicians. You receive the best value when you choose high-quality care from Kaiser Permanente clinicians. When choice is most important, you have access to more than one million in-network health professionals anywhere in the United States.
Tier 1: Preferred in-network
Kaiser Permanente providers and pharmacies, and preferred contracted providers
Available in King, Kitsap, Pierce, Snohomish, Spokane, and Thurston counties.
Tier 2: In-network
Directly contracted in-network providers and First Choice Health network
Available in Alaska, Idaho, Montana, Oregon, and Washington.
First Health network
Available anywhere else in the United States.
Tier 3: Out-of-network
Includes all providers throughout the United States that are not contracted with Kaiser Permanente, First Choice Health network, or First Health network.
Pharmacy options for Summit PPO Plans
Summit PPO also includes Kaiser Permanente Washington pharmacies, as well as the OptumRx network of pharmacies throughout the nation. Note: You’ll have lower copays for office visits and most prescriptions if you use Kaiser Permanente Washington providers and pharmacies.
2025 Plan options
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)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| Tier 1 & 2: $1,250 individual $2,500 family |
$0 | Tier 1: $20, then 10% Tier 2: $40, then 30% |
| Employee | $40 |
| Employee & spouse/SRDP* | $80 |
| Employee & children | $70 |
| Employee, spouse/SRDP*, and children | $120 |
*state-registered domestic partner (SRDP)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| Tier 1 & 2: $750 individual $1,500 family |
$0 | Tier 1: $10, then 10% Tier 2: $20, then 30% |
| Employee | $114 |
| Employee & spouse/SRDP* | $228 |
| Employee & children | $200 |
| Employee, spouse/SRDP*, and children | $342 |
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| Tier 1 & 2: $250 individual $500 family |
$0 | Tier 1: $10, then 10% Tier 2: $20, then 30% |
| Employee | $270 |
| Employee & spouse/SRDP* | $540 |
| Employee & children | $473 |
| Employee, spouse/SRDP*, and children | $810 |
*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
| 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)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| Tier 1 & 2: $1,250 individual $2,500 family |
$0 | Tier 1: $20, then 10% Tier 2: $40, then 30% |
| Employee | $100 |
| Employee & spouse/SRDP* | $200 |
| Employee & children | $175 |
| Employee, spouse/SRDP*, and children | $300 |
*state-registered domestic partner (SRDP)
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| Tier 1 & 2: $750 individual $1,500 family |
$0 | Tier 1: $10, then 10% Tier 2: $20, then 30% |
| Employee | $143 |
| Employee & spouse/SRDP* | $286 |
| Employee & children | $250 |
| Employee, spouse/SRDP*, and children | $429 |
*(SRDP) state-registered domestic partner
| Annual Deductible | Rx Deductible | Primary Care Office Visit |
|---|---|---|
| Tier 1 & 2: $250 individual $500 family |
$0 | Tier 1: $10, then 10% Tier 2: $20, then 30% |
| Employee | $237 |
| Employee & spouse/SRDP* | $474 |
| Employee & children | $415 |
| Employee, spouse/SRDP*, and children | $711 |
*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.
Open Enrollment Webinars
Learn more about Kaiser Permanente's convenient care options, healthy resources, and your SEBB plan options. You do not need to be a Kaiser Permanente member to attend.
Register for an upcoming webinar
Plan Options
Different plans are available to you depending on where you live and work.
Questions?
We're here to help. Visit our Contact Us page to learn how you can connect with us.
For eligibility and enrollment questions visit the Washington State HCA website.