Individual and Family

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 and apply for coverage

Tools and resources to help you advise your clients on the right Kaiser Permanente for Individuals and Families (KPIF) plan, whether you're selling through the exchange or directly from Kaiser Permanente.

Get sales packets

Email us with your request and you should receive packets within 5 to 8 business days.

Email us

1. Learn about our plans

Your clients can choose from a portfolio of individual health plans for 2024, including plans direct from Kaiser Permanente, as well as plans through Washington Healthplanfinder. Our plans offer great benefit coverage, great value for the money, and a choice of high-quality providers.

You can view our plans and compare up to 3 off-exchange plans at a time on the Sign Me Up online quoting and enrollment tool. To view both on and off-exchange plans together and compare, visit buykp.org.

To compare plans:

Click the Compare box below every plan that is being considered.
Scroll down toward the bottom of the page to see a list of all selected plans.
Click the Compare plans button to see the results.
All selected plans for comparison are shown side-by-side. Scroll down to see additional information.
When Plan details is clicked, the complete information about the selected plan will show. To print the plan details, click Print.

2. Review our provider network

Washington Permanente Medical Group offers more than 1,300 clinicians practicing at 35 medical facilities and at community hospitals in Washington state.* We are one of the largest multispecialty groups in the state with more than 60 specialties, including 17 surgical specialties. In addition, we have a broad network of contracted primary care providers, specialists, and hospitals.

View providers within our provider networks.

Our individual and family plans offer care through 2 networks:

Starting January 1, 2024, the Core network is the provider network for all non-Kaiser Permanente Virtual Plus™ individual and family plans.
The Connect network is the provider network for the Kaiser Permanente Virtual Plus™ individual and family plans.

^*OIC Provider Network Form A

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 care, wellness programs, and more to help prevent our members from getting sick in the first place.

Our plans also have virtual care options that include 24/7 online chat, 24/7 advice line, video and phone visits, e-visits, and email for nonurgent questions.*

To learn more about our plans, view the enrollment guide.

Plan availability
Many of our individual and family plans are available in the following counties: Benton, Columbia, Franklin, Island, King, Kitsap, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, and Yakima. Refer to the Individual and Family Service Area Map for details on where plans are offered.

^*Virtual care is offered when appropriate and available. If you travel out of state, virtual care could be limited due to state laws that may prevent doctors from providing care across state lines. Laws differ by state.

Open enrollment deadlines for the 2024 plan year

November 1, 2023–January 15, 2024

For coverage beginning	Off exchange with Kaiser Permanente	Through Washington Healthplanfinder
Jan. 1, 2024	Dec. 15, 2023	Dec. 15, 2023
Feb. 1, 2024	Jan. 15, 2024	Jan. 15, 2024

Optional dental coverage

We work with Delta Dental of Washington to offer your clients dental coverage when paired with one of our off-exchange individual plans. Both dental plan options fulfill the federal mandate to provide pediatric dental coverage to anyone under age 19. Learn more about dental plans.

1. Learn about our plans

Your clients can choose from a portfolio of individual health plans for 2023, including plans direct from Kaiser Permanente, as well as plans through Washington Healthplanfinder. Our plans offer great benefit coverage, great value for the money, and a choice of high-quality providers. View our plans

2. Review our provider network

Washington Permanente Medical Group offers more than 1,300 clinicians practicing at 35 medical facilities and at 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:

The CoreSelect network is the provider network for all non-Kaiser Permanente Virtual Plus™ individual and family plans
- In King, Kitsap, Pierce, Snohomish, Spokane, and Thurston counties, all primary care is provided by Kaiser Permanente doctors and health care professionals at Kaiser Permanente facilities
  - In some areas, additional contracted providers are available to ensure members have adequate access to care
- The CoreSelect specialty network in King, Kitsap, Pierce, Snohomish, Spokane, and Thurston counties consist of:
  - Kaiser Permanente specialists who practice in more than 60 specialties
  - Providence Medical Group (including Spokane practices)
  - Western Washington Medical Group
  - Seattle Children’s Medical Group
  - A subset of the CHI Franciscan Medical Group
- In counties where we do not have Kaiser Permanente facilities, we have a broad network of contracted primary care providers, specialists, and hospitals
The Connect network provides Virtual Plus plan members access to Kaiser Permanente primary care providers and specialists who practice in more than 60 specialties, in addition we have contracted with providers to ensure access to care

Our doctors and other health care professionals 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 more than 90 Washington Permanente Medical Group clinicians "Top Docs" in 2022; more than 340 of our care providers have been named "Top Docs" since 2011.³

¹ OIC Provider Network Form A
² Washington Health Alliance 2008-2022 Community Checkup reports, www.wacommunitycheckup.org. The 2017-2022 year rankings apply to Kaiser Permanente Washington's medical group, Washington Permanente Medical Group, P.C. Rankings for years prior to 2017 apply to the then-named Group Health Cooperative's medical group, formerly named Group Health Permanente, P.C. and now named Washington Permanente Medical Group, P.C.
³ Top docs for 2022 were honored in Seattle Magazine, Seattle Met, and Spokane-Coeur d’Alene Living. Source: Washington Permanente Medical Group records.

3. Choose the right coverage level

Our plans also have virtual care options that include 24/7 online chat, 24/7 advice line, video and phone visits, e-visits, and email for nonurgent questions.¹

Virtual Plus plans: A type of deductible plan. On Virtual Plus plans, members start most care with a virtual visit. Virtual visits are covered at no charge.

At the virtual visit, a Kaiser Permanente doctor or other clinician will provide the care and prescriptions members need or, if clinically needed, refer members to in-person care.

Virtual options include 24/7 online chat, 24/7 advice line, video and phone visits, e-visits, and email for nonurgent questions Learn more

Catastrophic plan (not a metal plan): Offers 3 primary care visits covered in full before the deductible, in addition to preventive care visits. All other services are subject to the annual deductible. This plan is only for applicants 29 and younger or applicants 30 and older who provide a certificate from Health and Human Services demonstrating hardship or lack of affordable coverage.

Deductible plans (Bronze, Flex Bronze, Flex Silver, Flex Silver HD, and Flex Gold): A member’s monthly premium is lower, but they will need to pay the full charges for most covered services until they reach a set amount, known as the deductible. Then they’ll start playing less — a copay or coinsurance. Depending on the plan, some services, such as office visits or prescriptions, may be available at a copay or coinsurance before they reach the deductible.

HSA-compatible plans: Members can open their own health savings account (HSA) to use for eligible medical expenses.

Cascade deductible plans: Cascade plans are offered by every carrier on the health benefit exchange and have the same standard cost-sharing and benefit design at each metal level, meaning they have the same deductible, copays, and coinsurance for medical services. More information can be found on WAHealthplanfinder.org.

Plan availability
Many of our individual and family plans are available in the following counties: Benton, Columbia, Franklin, Island, King, Kitsap, Lewis, Mason, Pierce, Skagit, Snohomish, Spokane, Thurston, Walla Walla, Whatcom, Whitman, and Yakima. Refer to the 2023 Individual and Family Service Area Map for details on where plans are offered.

Levels	Bronze	Silver	Gold	Platinum
Monthly premium	$	$$	$$$	$$$$
Cost to members when they get care²	$$$$	$$$	$$	$

¹ Virtual care is offered when appropriate and available. If you travel out of state, virtual care could be limited due to state laws that may prevent doctors from providing care across state lines. Laws differ by state.
² Copays, deductible, coinsurance

Open enrollment deadlines for the 2023 plan year

November 1, 2022–January 15, 2023

For coverage beginning	Off exchange with Kaiser Permanente	Through Washington Healthplanfinder
Jan. 1, 2023	Dec. 15, 2022	Dec. 15, 2022
Feb. 1, 2023	Jan. 15, 2023	Jan. 15, 2023

Optional dental coverage

We work with Delta Dental of Washington to offer your clients dental coverage when paired with one of our 2023 off-exchange individual plans. Both of the following options fulfill the federal mandate to provide pediatric dental coverage to anyone under age 19.

Option 1: The Adult/Family Basic plan includes dental coverage for members over and under age 19. This plan is available for adults and families who purchase their medical plan off exchange, directly from Kaiser Permanente. These dental options cannot be purchased separately.

Clients who enroll through the Washington Healthplanfinder can purchase pediatric dental or adult/family dental along with their medical plan through Healthplanfinder.

Option 2: The Pediatric dental plan includes dental coverage for only those under age 19.

This plan is only available if your clients purchase their medical plan off exchange, directly 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.

2023 Dental Plans Summary of Benefits (PDF)

Under the Affordable Care Act and Washington state law, pediatric dental coverage is required. If the application or account change form includes children 18 and younger and the applicant doesn’t enroll in either the Pediatric plan or Adult/Family Basic plan, we will reach out at the time of enrollment and yearly to policyholders. They will be asked to submit an Attestation of Pediatric Dental Coverage with proof of other pediatric dental coverage.

Clients won’t meet the minimum necessary health and dental coverage required by state and federal regulations if the signed attestation form and proof of dental coverage are not returned. Kaiser Permanente will send yearly notifications of the requirement.

For members enrolling directly with Kaiser Permanente
Dental coverage can be elected when initially enrolling in a medical plan. If your existing clients want to make a change in their dental coverage or cancel dental coverage during open enrollment, they need to complete, print, sign, and send the Account Change Form (PDF).

If your clients plan to enroll, or have already enrolled, in a dental plan through an employer or directly with another dental carrier, they need to complete, sign, and submit an Attestation of Pediatric Dental Coverage (PDF) within 60 days of their medical coverage effective date. They also need to submit proof of dental coverage showing the effective date of coverage. Proof of dental coverage can include notification from the employer or dental carrier showing each individual covered and the effective date of coverage. This is a requirement to attest and provide proof of coverage at the time of initial enrollment and then yearly thereafter.

Also see: Dental Coverage

2023 Account Change Form (PDF)
2023 Pediatric Dental Attestation (PDF)
2023 Application for Health Coverage (PDF)

Kaiser Permanente Individual and Family Sales and Producer support

Our Kaiser Permanente Individual and Family Sales and Producer support team is available to answer questions regarding the following topics:

Client enrollment and eligibility status
Plan quotes and benefits
Enrollment material requests
Producer of record changes and questions
Sign Me Up (SMU) registration

When to call Sales and Producer support team

The Sales and Producer support team can be reached at 1-800-474-1079 or via email at ifsales@kp.org.

Note: Please do not send Individual and Family applications to this email address.

When to call Kaiser Permanente Member Services

Some inquiries may require member authorization to release information.

Claims and appeals
Identification cards
Member address changes
Billing and payments
Benefits
Primary care physician selection or change

1-800-290-8900

Claims: Claims Processing
Kaiser Permanente
P.O. Box 30766
Salt Lake City, UT 84130-0766

Appeals: Kaiser Permanente Member Appeals
P.O. Box 34593
Seattle, WA 98124-1593

When to call Washington Healthplanfinder

When a mutual client is enrolled with Kaiser Permanente through the Washington Healthplanfinder:

Eligibility
Plan and account changes (including address changes)
Producer of record adds or changes
Termination requests

1-855-923-4633
wahealthplanfinder.org

When to call the New Member Welcome Team

New members can contact the New Member Welcome Team anytime during the first 12 months of their membership for questions related to:

Benefits and coverage
Transition of care and medications
Website support
Help scheduling first visits with a Kaiser Permanente primary care physician

1-888-844-4607

When to call Producer Relations

Appointment updates
Producer or agent name, email, or address change
Producer addition or termination
Merger or acquisition
Commission payment or statement inquiry
Producer Portal access

brokerappt.commission@kp.org
1-800-337-3196
Press 1 for commissions and appointments.
Press 2 for producer website questions.

Kaiser Permanente Individual and Family quotes and enrolling

We offer tools and resources to help you advise your clients on the right individual and family plan, whether you're selling through the exchange or directly from Kaiser Permanente. Visit buykp.org, Kaiser Permanente’s online quoting tool, to compare on- and off-exchange plans, see if your client may be eligible for a subsidy, and get a fast quote.

Once your client is ready, you can submit the application in one of the following ways.

On exchange: Visit the Washington Healthplanfinder website to submit your client’s application.
Off exchange: Use the Sign Me Up (SMU) tool to submit your client’s application.
1. If you're a first-time user, register for a broker account. See training resources below.
2. Sign in to your account, and from your dashboard you can create a new quote, create a personalized landing page to send to your client to start the online application, or download a paper application if your client prefers that method. Your Kaiser Permanente agent number is automatically tied to the downloaded SMU application, and you will be set up as the producer of record.
  - If your client prefers a paper application, fax or mail it to the number or address below. Please return every page of the application, completed, with all the required signatures, and proof of your qualifying life event (if required). To ensure you are set up as the Producer of Record, complete page 8 of the application.
    Kaiser Foundation Health Plan of Washington
    Membership Administration
    P.O. Box 23127
    San Diego, CA 92193-9921
    
    Or send it by secure fax to: 1-855-355-5334.
3. Track your client’s online application status using the SMU tool, which gives you more visibility into the process.

Get to know the Sign Me Up tool

Learn how to use the Kaiser Permanente Washington SMU tool with the training videos and resources below.

Additional Kaiser Permanente resources

Premium payment options:

Online at kp.org/payonline
Pay by phone 1-833-698-1220
By mailing a check with invoice coupon to:

Kaiser Foundation Health Plan of Washington
P.O. Box 7172
Pasadena, CA 91109-7172

Accepted forms of payment when paying online or by phone:

Credit card (Visa, Mastercard, Discover, and American Express)
Debit card (signature debit and PINless debit)
Personal or business savings and checking

KPIF on-exchange binder payment and ongoing premium payment due dates and grace periods

For on-exchange coverage, the binder payment must be received either by the enrollment effective date or 30 calendar days from Kaiser Permanente receiving the application, whichever is later. If the binder payment isn’t received by the due date, the application will be canceled without beginning coverage.

For subsequent premium payments for on-exchange KPIF members, payments are due by the end of the month before the next coverage month. If a member doesn’t pay by the due date, the following delinquency grace periods apply:

1 month for members who don’t receive financial help (Affordable Care Act advance premium tax credits or Washington Cascade Care Savings)
3 months for members and clients who receive financial help

^{Note: Delinquency grace periods don’t apply to the first binder payment and are used when a member is late on monthly premium payments.}

KPIF off-exchange binder payment and ongoing premium payment due dates and grace periods

For off-exchange coverage, the binder payment must be received either by the enrollment effective date or 30 calendar days from Kaiser Permanente receiving the application, whichever is later. If the binder payment isn’t received by the due date, the application will be canceled without beginning coverage.

For subsequent premium payments for off-exchange KPIF members, payments are due before the first of each month. If a member doesn’t pay by the due date, they have a 1-month grace period to pay the account so that it's current.

^{Note: Delinquency grace periods don’t apply to the first binder payment and are used when a member is late on monthly premium payments.}

Mail-order pharmacy
1-800-245-7979
kp.org/wa

Mental Health Access Center Phone
1-888-287-2680

Hospital Notification Line Phone
1-888-457-9516
(contact within 24 hours from admission to a non-Kaiser Permanente hospital)