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Monthly Medical Premiums for Retirees with Medicare

Effective Dates:
June 1, 2022 - May 31, 2023

Retiree - Medicare

Medical Plan Monthly Retiree Cost Monthly County Contribution Monthly Total Premium
County Health Plan EPO $33.63 $500.00 $533.63
County Health Plan PPO $146.52 $500.00 $646.52
Kaiser Senior Advantage $0.00 $298.96 $298.96
Kaiser Northwest $0.00 $318.62 $318.62
Kaiser Hawaii $0.00 $422.68 $422.68
Western Health Advantage Traditional HMO $0.00 $367.50 $367.50

Medicare retirees and dependents enrolled in a Kaiser plan will be enrolled in the Kaiser Senior Advantage. Medicare Retirees and dependents enrolled in a Western Health Advantage plan will be enrolled in the or Western Health Advantage Medicare Advantage plan.

Retiree + 1 - Both Medicare

Medical Plan Monthly Retiree Cost Monthly County Contribution Monthly Total Premium
County Health Plan EPO $567.26 $500.00 $1,067.26
County Health Plan PPO $793.04 $500.00 $1,293.04
Kaiser Senior Advantage $97.92 $500.00 $597.92
Kaiser Northwest $137.24 $500.00 $637.24
Kaiser Hawaii $345.36 $500.00 $845.36
Western Health Advantage Traditional HMO $235.00 $500.00 $735.00

Medicare retirees and dependents enrolled in a Kaiser plan will be enrolled in the Kaiser Senior Advantage. Medicare Retirees and dependents enrolled in a Western Health Advantage plan will be enrolled in the or Western Health Advantage Medicare Advantage plan.

Retiree + 2 or more - All Medicare

Medical Plan Monthly Retiree Cost Monthly County Contribution Monthly Total Premium
County Health Plan EPO $1,100.89 $500.00 $1,600.89
County Health Plan PPO $1,439.56 $500.00 $1,939.56
Kaiser Senior Advantage $396.88 $500.00 $896.88
Kaiser Northwest $455.86 $500.00 $955.86
Kaiser Hawaii $768.04 $500.00 $1,268.04
Western Health Advantage Traditional HMO $602.50 $500.00 $1,102.50

Medicare retirees and dependents enrolled in a Kaiser plan will be enrolled in the Kaiser Senior Advantage. Medicare Retirees and dependents enrolled in a Western Health Advantage plan will be enrolled in the or Western Health Advantage Medicare Advantage plan.

1 Medicare + 1 Non-Medicare

Medical Plan Monthly Retiree Cost Monthly County Contribution Monthly Total Premium
County Health Plan EPO $1,025.49 $500.00 $1,525.49
County Health Plan PPO $1,348.26 $500.00 $1,848.26
Kaiser Permanente Traditional HMO $737.86 $500.00 $1,237.86
Kaiser Permanente Hospital Services DHMO $554.96 $500.00 $1,054.96
Kaiser Permanente Deductible First HDHP $500.46 $500.00 $1,000.46
Kaiser Northwest $970.37 $500.00 $1,470.37
Kaiser Hawaii $907.92 $500.00 $1,407.92
Western Health Advantage Traditional HMO $593.60 $500.00 $1,093.60
Western Health Advantage Hospital Services DHMO $469.44 $500.00 $969.44
Western Health Advantage Deductible First HDHP $413.38 $500.00 $913.38

Medicare retirees and dependents enrolled in a Kaiser Permanente plan will be enrolled in the Kaiser Senior Advantage. Non-Medicare dependents will continue to be enrolled in standard Kaiser Permanente plans.

Medicare Retirees and dependents enrolled in a Western Health Advantage plan will be enrolled in the or Western Health Advantage Medicare Advantage plan. Non-Medicare dependents will continue to be enrolled in standard Western Health Advantage plans.

The benefit rates in this table list the combined rates for Medicare and non-Medicare recipients.

1 Medicare + 2 or more Non-Medicare

Medical Plan Monthly Retiree Cost Monthly County Contribution Monthly Total Premium
County Health Plan EPO $1,971.19 $500.00 $2,471.19
County Health Plan PPO $2,508.78 $500.00 $3,008.78
Kaiser Permanente Traditional HMO $1,517.16 $500.00 $2,017.16
Kaiser Permanente Hospital Services DHMO $1,182.44 $500.00 $1,682.44
Kaiser Permanente Deductible First HDHP $1,082.70 $500.00 $1,582.70
Kaiser Northwest $2,122.12 $500.00 $2,622.12
Kaiser Hawaii $1,893.16 $500.00 $2,393.16
Western Health Advantage Traditional HMO $1,196.26 $500.00 $1,696.26
Western Health Advantage Hospital Services DHMO $969.04 $500.00 $1,469.04
Western Health Advantage Deductible First HDHP $866.46 $500.00 $1,366.46

Medicare retirees and dependents enrolled in a Kaiser Permanente plan will be enrolled in the Kaiser Senior Advantage. Non-Medicare dependents will continue to be enrolled in standard Kaiser Permanente plans.

Medicare Retirees and dependents enrolled in a Western Health Advantage plan will be enrolled in the or Western Health Advantage Medicare Advantage plan. Non-Medicare dependents will continue to be enrolled in standard Western Health Advantage plans.

The benefit rates in this table list the combined rates for Medicare and non-Medicare recipients.

Retiree and Spouse Medicare + 1 or more Non-Medicare

Medical Plan Monthly Retiree Cost Monthly County Contribution Monthly Total Premium
County Health Plan EPO $1,559.12 $500.00 $2,059.12
County Health Plan PPO $1,994.78 $500.00 $2,494.78
Kaiser Permanente Traditional HMO $877.22 $500.00 $1,377.22
Kaiser Permanente Hospital Services DHMO $725.40 $500.00 $1,225.40
Kaiser Permanente Deductible First HDHP $680.16 $500.00 $1,180.16
Kaiser Northwest $1,288.99 $500.00 $1,788.99
Kaiser Hawaii $1,330.60 $500.00 $1,830.60
Western Health Advantage Traditional HMO $837.66 $500.00 $1,337.66
Western Health Advantage Hospital Services DHMO $734.60 $500.00 $1,234.60
Western Health Advantage Deductible First HDHP $688.08 $500.00 $1,188.08

Medicare retirees and dependents enrolled in a Kaiser Permanente plan will be enrolled in the Kaiser Senior Advantage. Non-Medicare dependents will continue to be enrolled in standard Kaiser Permanente plans.

Medicare Retirees and dependents enrolled in a Western Health Advantage plan will be enrolled in the or Western Health Advantage Medicare Advantage plan. Non-Medicare dependents will continue to be enrolled in standard Western Health Advantage plans.

The benefit rates in this table list the combined rates for Medicare and non-Medicare recipients.

Retiree and Child Medicare + Spouse Non-Medicare

Medical Plan Monthly Retiree Cost Monthly County Contribution Monthly Total Premium
County Health Plan EPO $1,559.12 $500.00 $2,059.12
County Health Plan PPO $1,994.78 $500.00 $2,494.78
Kaiser Permanente Traditional HMO $1,036.82 $500.00 $1,536.82
Kaiser Permanente Hospital Services DHMO $853.92 $500.00 $1,353.92
Kaiser Permanente Deductible First HDHP $799.42 $500.00 $1,299.42
Kaiser Northwest $1,288.99 $500.00 $1,788.99
Kaiser Hawaii $1,330.60 $500.00 $1,830.60
Western Health Advantage Traditional HMO $837.66 $500.00 $1,337.66
Western Health Advantage Hospital Services DHMO $734.60 $500.00 $1,234.60
Western Health Advantage Deductible First HDHP $688.08 $500.00 $1,188.08

Medicare retirees and dependents enrolled in a Kaiser Permanente plan will be enrolled in the Kaiser Senior Advantage. Non-Medicare dependents will continue to be enrolled in standard Kaiser Permanente plans.

Medicare Retirees and dependents enrolled in a Western Health Advantage plan will be enrolled in the or Western Health Advantage Medicare Advantage plan. Non-Medicare dependents will continue to be enrolled in standard Western Health Advantage plans.

The benefit rates in this table list the combined rates for Medicare and non-Medicare recipients.