Individual and family plans
Our plans offer great coverage, high-quality providers, and value all along the cost and coverage spectrum. Everything your clients are looking for in a health plan is right here.
Get quotes, process online enrollments, and track enrollment status with our Agent Quoting Tool
Get Sales Packets
E-mail us with your request and you should receive packets within 5 to 8 business days.
1. Learn about our plans
Your clients can choose from an updated portfolio of individual health plans for 2021, including plans direct from Kaiser Permanente, as well as plans through Washington Healthplanfinder. Our plans offer great benefit coverage, value for the money, and a choice of high-quality providers. View our plans
2. Review our provider network
Washington Permanente Medical Group offers nearly 1,300 care providers practicing at over 30 medical facilities and community hospitals in Washington state.1 We are one of the largest multispecialty groups in the state with more than 60 specialties, including 17 surgical specialties. Our individual and family plans offer care through 2 networks. Virtual Plus plan members access care through our Connect network, and all other individual and family plan members access care through our CoreSelect network. These networks also offer care from contracted specialty providers. See the doctors and clinicians in each network Our doctors and other health care providers have been recognized for the quality of care we offer:
- Washington Permanente Medical Group has been one of the top-ranked medical groups in Washington state for more than a decade.2
- Local magazines named 76 Washington Permanente Medical Group physicians "top docs" in 2020; more than 300 of our doctors have been named "top docs" since 2011.3
3. Choose the right coverage level
About our Plans
Our plans offer individual and family benefits delivered in an environment that puts preventive care and overall wellness first. That’s why our plans cover routine appointments, preventive screenings, wellness programs, and more to help prevent our members from getting sick in the first place. And when our members need additional care, they have access to care for over 60 specialties. Our plans also include virtual care through video, phone, online chat, and more so our members can get care 24/7, at home or on the go in Washington.1
Virtual Plus plans: Offer low premiums and start most care with a virtual visit. A Kaiser Permanente doctor or clinician provides care, prescriptions, and referrals for in-person care when needed. First in-person primary care visit and annual in-person preventive visits are covered at no charge. Self-referred in-person care is usually a higher out-of-pocket cost. Fill the first prescription for a new medication at a pharmacy in our network or use our convenient mail-order pharmacy. Then get most refills through mail order. Learn more.
Catastrophic plan (not a metal plan): Offers 3 primary care visits covered in full before deductible, in addition to preventive care visits. All other services are subject to the annual deductible. This plan is only for applicants younger than 29, or applicants age 30 and older who provide a certificate from Health and Human Services demonstrating hardship or lack of affordable coverage.
Flex plans: Offer a great value with access to the CoreSelect network of specially selected providers. Flex plans include a specific number of office visits ("upfront visits") for just a copay as well as upfront coverage for some medications; the deductible doesn't apply to either.
HSA-compatible plans: Members can open their own health savings account (HSA) to use for eligible medical expenses.
Many of our individual and family plans are available in the following counties: Benton, Columbia, Franklin, Island, King, Kitsap, Kittitas, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, and Yakima.
2021 Open Enrollment Deadlines
|Cost to members when they get care2||$$$$||$$$||$$||$|
1 When appropriate and available.
2 Copays, deductible, coinsurance
2020 Open Enrollment Deadlines
November 1, 2020–January 15, 2021
|For coverage beginning||Off-exchange with Kaiser Permanente||Through Washington Healthplanfinder|
|Jan. 1, 2021||Dec. 15, 2020||Dec. 15, 2020|
|Feb. 1, 2021||Jan. 15, 2021||Jan. 15, 2021|
Optional Dental Coverage
We work with Delta Dental of Washington to offer your clients dental coverage when paired with one of our 2021 direct individual plans. Both of the following options fulfill the federal mandate to provide pediatric dental coverage to anyone under age 19. In Washington state, everyone 18 and younger is required to be enrolled in a qualified dental plan. If mutual clients do not enroll in one of our plans, then we are required at initial enrollment and yearly to collect a signed Pediatric Dental Attestation and proof of dental coverage within 60 days of enrollment effective date. If this requirement is not met, medical coverage for everyone on the medical policy will be canceled as of the 61st day. Members will be re-enrolled once requirements are fulfilled. .
Option 1. An adult/family plan that includes dental coverage for members over and under age 19. This plan is available for adults and families who purchase their medical plan direct from Kaiser Permanente. These dental options cannot be purchased separately.
For clients who enroll through the Washington Healthplanfinder, they are able to purchase pediatric dental or adult/family dental along with their medical plan through Healthplanfinder.
Option 2. A pediatric-only plan that includes dental coverage for only those under age 19.
- This plan is only available if your clients purchase their medical plan direct from Kaiser Permanente.
- If your clients purchase their medical plan through Washington Healthplanfinder and are under age 19 or have dependents under age 19, they must purchase pediatric dental coverage through Washington Healthplanfinder, too.
Also see: Using Your Dental Benefits
For members enrolling direct with Kaiser Permanente
Dental coverage can be elected when enrolling in a medical plan online or by using the Individual & Family application. If your clients prefer their current medical plans and are not making any changes during open enrollment, they must complete, print, sign, and send the Account Change Form (PDF) if they want to add one of our dental plans.
If your clients plan to enroll, or have already enrolled, in dental plans through an employer or another dental carrier, they must complete and submit an attestation of pediatric dental coverage form (PDF). They'll also need to submit proof of coverage with the coverage effective date, such as a copy of a dental ID card, billing statement, or benefit booklet. This is a requirement to attest and provide proof of coverage annually to Kaiser Permanente within 60 days of your medical coverage effective date.
Kaiser Permanente Individual and Family Sales support
Kaiser Permanente Individual and Family Sales support is available to answer questions regarding the following topics:
- Book of business questions
- Client eligibility
- Client enrollment status
- Plan quotes and benefits
- Sales kit requests
- Producer of record changes
- Online quoting tool
Sales and Producer support team can be reached at 1-800-474-1079 or via email at firstname.lastname@example.org. Note: Please do not send Individual and Family applications to this email address.
Kaiser Permanente Individual and Family Quotes and Enrolling
Individual and Family enrollment can be submitted either online or via a paper application or member Account Change Form. Enrollment cutoff date for the first of the month coverage is the 15th of the month.
- Online enrollment through the Agent Quote ToolThis is the preferred method of submission for both timeliness and accuracy. You can either assist your clients in completing their enrollment online through our Agent Quote Tool, or by sending them your individual sales URL, where they complete their enrollment.
- Paper application and member Account Change FormsYou can submit a paper application or member Account Change Form to Kaiser Permanente Washington:
- By mail to Kaiser Permanente Individual and Family Membership Administration P.O. Box 34750 Seattle, WA 98124-1750
For 2020 Individual and Family forms please visit our Forms and Resources page.
2021 Individual and Family
2021 Account Change Form (PDF)
2021 Enrollment Guide (PDF)