2014 Medical Plan Premium Rates

Click here to download a PDF showing all 2014 employee benefit rates. 

Employee

 
Employee
Employee & Spouse/Partner
Employee & Children
Employee & Family
PEBB Statewide PPO1
$1,059.82
$1,420.01
$1,218.71
$1,451.80
Providence Choice2
934.14
1,251.70
1,074.26
1,279.75
Kaiser3
1,052.01
1,409.69
1,209.83
1,441.25
Kaiser Deductible3
967.26
1,296.11
1,112.36
1,325.16
PEBB Statewide Part-time PPO4
850.37
1,139.39
977.89
1,164.92
Providence Choice Part-time5
746.46
1,000.21
858.44
1,022.62
Kaiser Part-time6
890.59
1,193.38
1,024.17
1,220.09
Kaiser Deductible Part-Time6
841.14
1,127.11
967.31
1,152.34

 

Click here to download a PDF showing 2014 rates for retirees.

Retiree

 
Retiree
Retiree & Spouse/Partner
Retiree & Children
Retiree & Family
PEBB Statewide PPO1
$1,066.16
$1,428.49
$1,225.99
$1,460.48
Providence Choice2
939.72
1,259.17
1,080.68
1,287.40
Kaiser3
1,058.30
1,418.11
1,217.06
1,449.87
Kaiser Deductible3
973.04
1,303.86
1,119.01
1,333.08
PEBB Statewide Part-time PPO4
855.45
1,146.20
983.73
1,171.88
Providence Choice Part-time5
750.92
1,006.19
863.57
1,028.74
Kaiser Part-time6
895.91
1,200.52
1,030.29
1,227.38
Kaiser Deductible Part-Time6
846.17
1,133.85
973.09
1,159.23
VSP Vision In Part Time Plans
11.97
23.93
23.93
28.10

 

Click here to download a PDF showing 2014 rates for COBRA participants.

COBRA
 
Self
Self & Spouse/Partner
Self & Children
Self & Family
Child
Only
PEBB Statewide PPO1
$1,080.93
$1,448.30
$1,242.98
$1,480.73
$552.65
Providence Choice2
952.75
1,276.63
1,095.66
1,305.24
492.40
Kaiser3
1,072.97
1,437.77
1,233.93
1,469.96
547.18
Kaiser Deductible3
986.53
1,321.93
1,134.52
1,351.56
503.10
PEBB Statewide Part-time PPO4
867.31
1,162.09
997.37
1,188.13
446.48
Providence Choice Part-time5
761.33
1,020.14
875.54
1,043.00
388.27
Kaiser Part-time6
908.33
1,217.16
1,044.57
1,244.40
463.23
Kaiser Deductible Part-Time6
857.90
1,149.56
986.58
1,175.30
437.50
 

 Click here to download a PDF showing 2014 rates for self-pay participants.

Self-Pay Participants
 
Self
Self & Spouse/Partner
Self & Children
Self & Family
PEBB Statewide PPO1
$1,070.12
$1,430.31
$1,229.01
$1,462.10
Providence Choice2
944.44
1,262.00
1,084.56
1,290.05
Kaiser3
1,062.31
1,419.99
1,220.13
1,451.55
Kaiser Deductible3
977.56
1,306.41
1,122.66
1,335.46

 

1 Available to PEBB eligible full-time and part-time employees. VSP routine vision services.

2 Available to PEBB eligible full-time and part-time employees in plan service area.

3 Available to PEBB eligible full-time and part-time employees in plan service area. Kaiser routine vision services.

4 Additional option available to eligible part-time employees. No vision benefit.

5 Additional option available to eligible part-time employees in plan service area.

6 Additional option available to eligible part-time employees in plan service area. Vision exam only.