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Public Employees' Benefit Board

2013 Medical Premium Rates

 

Employee Medical Plans Monthly Premium Rates

 
Employee
Employee & Spouse/Partner
Employee & Children
Employee & Family
PEBB Statewide PPO1
$1,064.82
$1,426.70
$1,224.45
$1,458.64
Providence Choice2
938.76
1,257.90
1,079.58
1,286.08
Kaiser3
1,016.10
1,361.57
1,168.54
1,392.06
Kaiser Deductible3
934.25
1,251.87
1,074.38
1,279.92
PEBB Statewide Part-time PPO4
852.86
1,142.72
980.73
1,168.33
Providence Choice Part-time5
748.63
1,003.13
860.94
1,025.61
Kaiser Part-time6
860.18
1,152.65
989.22
1,178.45
Kaiser Deductible Part-Time6
812.42
1,088.64
934.30
1,113.01
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. VSP routine vision services.
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. No vision benefit.
6 Additional option available to eligible part-time employees in plan service area. Vision exam only.

 

Retiree Medical Plans Monthly Premium Rates

 
Retiree
Retiree & Spouse/Partner
Retiree & Children
Retiree & Family
PEBB Statewide PPO1
$1,066.89
$1,429.49
$1,226.84
$1,461.50
Providence Choice2
940.59
1,260.36
1,081.70
1,288.59
Kaiser3
1,018.11
1,364.26
1,170.84
1,394.81
Kaiser Deductible3
936.09
1,254.34
1,076.51
1,282.45
PEBB Statewide Part-time PPO4
854.53
1,144.96
982.65
1,170.62
Providence Choice Part-time5
750.09
1,005.09
862.63
1,027.61
Kaiser Part-time6
861.88
1,154.92
991.16
1,180.77
Kaiser Deductible Part-Time6
814.03
1,090.79
936.14
1,115.20
VSP Vision In Part Time Plans
13.69
27.36
27.36
32.15
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. VSP routine vision services.
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. No vision benefit.
6 Additional option available to eligible part-time employees in plan service area. Vision exam only.
 

Self-pay Participant Medical Plans Monthly Premium Rates

 
Self
Self & Spouse/Partner
Self & Children
Self & Family
PEBB Statewide PPO1
$1,075.12
$1,437.00
$1,234.75
$1,468.94
Providence Choice2
949.06
1,268.20
1,089.88
1,296.38
Kaiser3
1,026.40
1,371.87
1,178.84
1,402.36
Kaiser Deductible3
944.55
1,262.17
1,084.68
1,290.22
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. VSP routine vision services.
3 Available to PEBB eligible full-time and part-time employees in plan service area. Kaiser routine vision services.
 

 

COBRA Medical Plans Monthly Premium Rates

 
Self
Self & Spouse/Partner
Self & Children
Self & Family
Child
Only
PEBB Statewide PPO1
$1,081.54
$1,449.11
$1,243.68
$1,481.57
$553.91
Providence Choice2
953.51
1,277.66
1,096.55
1,306.29
493.74
Kaiser3
1,032.22
1,383.17
1,187.07
1,414.14
526.41
Kaiser Deductible3
949.06
1,271.73
1,091.43
1,300.22
484.00
PEBB Statewide Part-time PPO4
866.26
1,160.67
996.14
1,186.68
445.93
Providence Choice Part-time5
760.39
1,018.89
874.47
1,041.72
387.79
Kaiser Part-time6
873.83
1,170.93
1,004.90
1,197.14
445.64
Kaiser Deductible Part-Time6
825.31
1,105.91
949.11
1,130.66
420.89
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. VSP routine vision services.
 
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. No vision benefit.
 
6 Additional option available to eligible part-time employees in plan service area. Vision exam only.