Employee monthly premiums (2024)

2024 PEBB Employee Monthly Premiums For state agency and higher-education employees Below are the 2024 premiums for PEBB medical plans. There are no employee premiums for dental coverage, basic life insurance, basic accidental death and dismemberment insurance, and employer-paid long-term disability insurance. Note: Employees who work for a city, county, port, tribal government, water district, hospital, etc., need to contact their payroll or bene昀椀ts o昀昀ice to get their monthly premiums. • Kaiser Foundation Health Plan of the Northwest (KFHPNW) o昀昀ers plans in Clark and Cowlitz counties in Washington and select counties in Oregon. • UMP is administered by Regence Blue Shield and Washington State Rx Services. • UMP Plus includes UMP Plus–Puget Sound High Value Network and UMP Plus–UW Medicine Accountable Care Network. The premium is the same for both. • The term "spouse" is interchangeable with "state-registered domestic partner" (SRDP). Preferred Provider Managed Care Plans Organization (PPO) Plans E昀昀ective Kaiser Foundation January 1, 2024 Health Plan of Kaiser Foundation Health Plan of Washington Uniform Medical Plan the Northwest Classic CDHP Classic CDHP SoundChoice Value Classic CDHP Select UMP Plus Monthly premiums Subscriber only $331 $195 $226 $26 $69 $211 $124 $35 $59 $109 Subscriber $662 $390 $452 $52 $138 $422 $248 $70 $118 $218 & spouse Subscriber & $579 $341 $396 $46 $121 $369 $217 $61 $103 $191 children Subscriber, spouse, $910 $536 $622 $72 $190 $580 $341 $96 $162 $300 & children Medical premium surcharges Two premium surcharges may apply in addition to your monthly medical premium. You will be charged for them if the conditions described below apply, or if you do not attest to the surcharges when required. Visit Surcharges on HCA’s website at hca.wa.gov/pebb-employee for more information. • A monthly $25-per-account medical premium surcharge will apply if you or any dependent (age 13 and older) enrolled in PEBB medical coverage uses tobacco products. • A monthly $50 medical premium surcharge will apply if you enroll a spouse or state-registered domestic partner in PEBB medical coverage, and they have chosen not to enroll in another employer-based group medical plan that is comparable to PEBB’s UMP Classic. HCA 50-0626 (9/23)

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