Providers for Zip Code 96797

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Obamacare Providers, Plans and 2017 Rates for Honolulu County

The health insurance rates listed below are for calendar year 2017.

2017 Rates and Providers

(click here for 2014)

(click here for 2015)

(click here for 2016)

This page gives you an overview of the rates for individual and family health insurance plans available from HealthCare.gov, the marketplace for Honolulu County, Hawaii.

Currently, there are 23 plans offered in Honolulu County.

Below, you’ll find a summary of plans and rates for each of these providers.‡ This chart is designed to give you a preview of your health insurance options. For detailed information on available subsidies to make your coverage affordable, you must complete an application at HealthCare.gov or contact the provider directly.

 

The table below shows premiums for the following scenarios:

  • Individual
  • Couple
  • Couple with 1 2 or 3 children
  • Individual with 1 2 or 3 children
  • A child alone

Each scenario is covered for age

  • Age 21, 30, 40, 50
  • Age 60 (Individual and Couple only)

 

Note: If you are over 65, you qualify for Medicare. Click here to see listings of 2017 Medicare Advantage plans for Honolulu County

 

For each plan, there are links that go to the insurance provider's website in a new window. You can find links to:

  • a summary of plan benefits and costs,
  • a plan brochure, and
  • a "Provider Directory" -- where you can find out which doctors and hospitals in the Waipahu, HI area accept this insurance coverage as within the plan's "network".

‡Source: HealthCare.gov has released sample rates for all counties in those states served by HealthCare.gov. We have integrated that data into our tables and provide you that information for Honolulu County here.

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Hawaii Medical Service Association

Local: 1-808-948-5555 | Toll Free: 1-800-620-4672

Plan: (PPO) HMSA Platinum PPO

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $430.74
$488.90
$550.49
$769.31
$1169.04		 $861.48
$977.80
$1100.98
$1538.62
$2338.08		 $1135.00
$1251.32
$1374.50
$1812.14		 $1408.52
$1524.84
$1648.02
$2085.66		 $1682.04
$1798.36
$1921.54
$2359.18		 $704.26
$762.42
$824.01
$1042.83		 $977.78
$1035.94
$1097.53
$1316.35		 $1251.30
$1309.46
$1371.05
$1589.87		 $273.52

Plan: (PPO) HMSA Catastrophic Plan

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $7,150 : Family: See Plan Brochure
Out of Pocket Maximum per year: Individual: $7,150 : Family: See Plan Brochure

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Catastrophic 21
30
40
50
60		 $203.72
$231.22
$260.35
$363.84
$552.90		 $407.44
$462.44
$520.70
$727.68
$1105.80		 $536.80
$591.80
$650.06
$857.04		 $666.16
$721.16
$779.42
$986.40		 $795.52
$850.52
$908.78
$1115.76		 $333.08
$360.58
$389.71
$493.20		 $462.44
$489.94
$519.07
$622.56		 $591.80
$619.30
$648.43
$751.92		 $129.36

Plan: (PPO) HMSA Gold PPO

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $369.20
$419.04
$471.84
$659.40
$1002.02		 $738.40
$838.08
$943.68
$1318.80
$2004.04		 $972.84
$1072.52
$1178.12
$1553.24		 $1207.28
$1306.96
$1412.56
$1787.68		 $1441.72
$1541.40
$1647.00
$2022.12		 $603.64
$653.48
$706.28
$893.84		 $838.08
$887.92
$940.72
$1128.28		 $1072.52
$1122.36
$1175.16
$1362.72		 $234.44

Plan: (PPO) HMSA Gold PPO 1000

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $350.11
$397.38
$447.44
$625.30
$950.20		 $700.22
$794.76
$894.88
$1250.60
$1900.40		 $922.54
$1017.08
$1117.20
$1472.92		 $1144.86
$1239.40
$1339.52
$1695.24		 $1367.18
$1461.72
$1561.84
$1917.56		 $572.43
$619.70
$669.76
$847.62		 $794.75
$842.02
$892.08
$1069.94		 $1017.07
$1064.34
$1114.40
$1292.26		 $222.32

Plan: (HMO) HMSA Gold HMO

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $341.46
$387.56
$436.38
$609.84
$926.72		 $682.92
$775.12
$872.76
$1219.68
$1853.44		 $899.75
$991.95
$1089.59
$1436.51		 $1116.58
$1208.78
$1306.42
$1653.34		 $1333.41
$1425.61
$1523.25
$1870.17		 $558.29
$604.39
$653.21
$826.67		 $775.12
$821.22
$870.04
$1043.50		 $991.95
$1038.05
$1086.87
$1260.33		 $216.83
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Kaiser Foundation Health Plan, Inc.

Local: 1-800-570-8004 | Toll Free: 1-800-570-8004

TTY: 1-877-447-5990

Plan: (HMO) KP Bronze I $50 - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $214.27
$243.19
$273.83
$382.68
$581.52		 $428.54
$486.38
$547.66
$765.36
$1163.04		 $564.60
$622.44
$683.72
$901.42		 $700.66
$758.50
$819.78
$1037.48		 $836.72
$894.56
$955.84
$1173.54		 $350.33
$379.25
$409.89
$518.74		 $486.39
$515.31
$545.95
$654.80		 $622.45
$651.37
$682.01
$790.86		 $136.06

Plan: (HMO) KP Platinum $10 - ChiroAcuMassage - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $358.74
$407.16
$458.46
$640.70
$973.61		 $717.48
$814.32
$916.92
$1281.40
$1947.22		 $945.28
$1042.12
$1144.72
$1509.20		 $1173.08
$1269.92
$1372.52
$1737.00		 $1400.88
$1497.72
$1600.32
$1964.80		 $586.54
$634.96
$686.26
$868.50		 $814.34
$862.76
$914.06
$1096.30		 $1042.14
$1090.56
$1141.86
$1324.10		 $227.80

Plan: (HMO) KP Gold I $20 - ChiroAcuMassage - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $319.10
$362.18
$407.81
$569.92
$866.04		 $638.20
$724.36
$815.62
$1139.84
$1732.08		 $840.83
$926.99
$1018.25
$1342.47		 $1043.46
$1129.62
$1220.88
$1545.10		 $1246.09
$1332.25
$1423.51
$1747.73		 $521.73
$564.81
$610.44
$772.55		 $724.36
$767.44
$813.07
$975.18		 $926.99
$970.07
$1015.70
$1177.81		 $202.63
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Hawaii Medical Service Association

Local: 1-808-948-5555 | Toll Free: 1-800-620-4672

Plan: (PPO) HMSA Silver PPO 1500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $298.75
$339.08
$381.80
$533.56
$810.80		 $597.50
$678.16
$763.60
$1067.12
$1621.60		 $787.20
$867.86
$953.30
$1256.82		 $976.90
$1057.56
$1143.00
$1446.52		 $1166.60
$1247.26
$1332.70
$1636.22		 $488.45
$528.78
$571.50
$723.26		 $678.15
$718.48
$761.20
$912.96		 $867.85
$908.18
$950.90
$1102.66		 $189.70

Plan: (PPO) HMSA Silver PPO 3500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $3,500 : Family: $7,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $281.12
$319.07
$359.27
$502.08
$762.97		 $562.24
$638.14
$718.54
$1004.16
$1525.94		 $740.75
$816.65
$897.05
$1182.67		 $919.26
$995.16
$1075.56
$1361.18		 $1097.77
$1173.67
$1254.07
$1539.69		 $459.63
$497.58
$537.78
$680.59		 $638.14
$676.09
$716.29
$859.10		 $816.65
$854.60
$894.80
$1037.61		 $178.51

Plan: (PPO) HMSA Silver PPO 2500

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $288.90
$327.91
$369.22
$515.98
$784.08		 $577.80
$655.82
$738.44
$1031.96
$1568.16		 $761.25
$839.27
$921.89
$1215.41		 $944.70
$1022.72
$1105.34
$1398.86		 $1128.15
$1206.17
$1288.79
$1582.31		 $472.35
$511.36
$552.67
$699.43		 $655.80
$694.81
$736.12
$882.88		 $839.25
$878.26
$919.57
$1066.33		 $183.45

Plan: (PPO) HMSA Bronze PPO 7150

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $7,150 : Family: $14,300
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $252.31
$286.37
$322.45
$450.62
$684.76		 $504.62
$572.74
$644.90
$901.24
$1369.52		 $664.84
$732.96
$805.12
$1061.46		 $825.06
$893.18
$965.34
$1221.68		 $985.28
$1053.40
$1125.56
$1381.90		 $412.53
$446.59
$482.67
$610.84		 $572.75
$606.81
$642.89
$771.06		 $732.97
$767.03
$803.11
$931.28		 $160.22

Plan: (HMO) HMSA Platinum HMO

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $422.38
$479.41
$539.81
$754.38
$1146.35		 $844.76
$958.82
$1079.62
$1508.76
$2292.70		 $1112.97
$1227.03
$1347.83
$1776.97		 $1381.18
$1495.24
$1616.04
$2045.18		 $1649.39
$1763.45
$1884.25
$2313.39		 $690.59
$747.62
$808.02
$1022.59		 $958.80
$1015.83
$1076.23
$1290.80		 $1227.01
$1284.04
$1344.44
$1559.01		 $268.21

Plan: (HMO) HMSA Silver HMO

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $279.92
$317.71
$357.74
$499.94
$759.71		 $559.84
$635.42
$715.48
$999.88
$1519.42		 $737.59
$813.17
$893.23
$1177.63		 $915.34
$990.92
$1070.98
$1355.38		 $1093.09
$1168.67
$1248.73
$1533.13		 $457.67
$495.46
$535.49
$677.69		 $635.42
$673.21
$713.24
$855.44		 $813.17
$850.96
$890.99
$1033.19		 $177.75

Plan: (HMO) HMSA Bronze HMO

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-620-4672 - Provider Directory for This Plan: (Hawaii Medical Service Association)

Deductible: Individual: $6,000 : Family: $12,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $232.45
$263.83
$297.07
$415.15
$630.86		 $464.90
$527.66
$594.14
$830.30
$1261.72		 $612.50
$675.26
$741.74
$977.90		 $760.10
$822.86
$889.34
$1125.50		 $907.70
$970.46
$1036.94
$1273.10		 $380.05
$411.43
$444.67
$562.75		 $527.65
$559.03
$592.27
$710.35		 $675.25
$706.63
$739.87
$857.95		 $147.60
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Kaiser Foundation Health Plan, Inc.

Local: 1-800-570-8004 | Toll Free: 1-800-570-8004

TTY: 1-877-447-5990

Plan: (HMO) KP Platinum $10 - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $4,000 : Family: $8,000

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Platinum 21
30
40
50
60		 $355.35
$403.33
$454.14
$634.66
$964.43		 $710.70
$806.66
$908.28
$1269.32
$1928.86		 $936.35
$1032.31
$1133.93
$1494.97		 $1162.00
$1257.96
$1359.58
$1720.62		 $1387.65
$1483.61
$1585.23
$1946.27		 $581.00
$628.98
$679.79
$860.31		 $806.65
$854.63
$905.44
$1085.96		 $1032.30
$1080.28
$1131.09
$1311.61		 $225.65

Plan: (HMO) KP Gold I $20 - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $0 : Family: $0
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $315.72
$358.34
$403.49
$563.87
$856.86		 $631.44
$716.68
$806.98
$1127.74
$1713.72		 $831.92
$917.16
$1007.46
$1328.22		 $1032.40
$1117.64
$1207.94
$1528.70		 $1232.88
$1318.12
$1408.42
$1729.18		 $516.20
$558.82
$603.97
$764.35		 $716.68
$759.30
$804.45
$964.83		 $917.16
$959.78
$1004.93
$1165.31		 $200.48

Plan: (HMO) KP Silver II $30 - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $271.24
$307.86
$346.65
$484.44
$736.15		 $542.48
$615.72
$693.30
$968.88
$1472.30		 $714.72
$787.96
$865.54
$1141.12		 $886.96
$960.20
$1037.78
$1313.36		 $1059.20
$1132.44
$1210.02
$1485.60		 $443.48
$480.10
$518.89
$656.68		 $615.72
$652.34
$691.13
$828.92		 $787.96
$824.58
$863.37
$1001.16		 $172.24

Plan: (HMO) KP Silver II $30 - ChiroAcuMassage - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $1,500 : Family: $3,000
Out of Pocket Maximum per year: Individual: $6,850 : Family: $13,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $274.62
$311.70
$350.97
$490.48
$745.33		 $549.24
$623.40
$701.94
$980.96
$1490.66		 $723.63
$797.79
$876.33
$1155.35		 $898.02
$972.18
$1050.72
$1329.74		 $1072.41
$1146.57
$1225.11
$1504.13		 $449.01
$486.09
$525.36
$664.87		 $623.40
$660.48
$699.75
$839.26		 $797.79
$834.87
$874.14
$1013.65		 $174.39

Plan: (HMO) KP Bronze I $50 - ChiroAcuMassage - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $6,500 : Family: $13,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $217.65
$247.03
$278.16
$388.72
$590.70		 $435.30
$494.06
$556.32
$777.44
$1181.40		 $573.51
$632.27
$694.53
$915.65		 $711.72
$770.48
$832.74
$1053.86		 $849.93
$908.69
$970.95
$1192.07		 $355.86
$385.24
$416.37
$526.93		 $494.07
$523.45
$554.58
$665.14		 $632.28
$661.66
$692.79
$803.35		 $138.21

Plan: (HMO) KP Gold III $20 - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $1,000 : Family: $2,000
Out of Pocket Maximum per year: Individual: $6,350 : Family: $12,700

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Gold 21
30
40
50
60		 $296.81
$336.88
$379.32
$530.10
$805.54		 $593.62
$673.76
$758.64
$1060.20
$1611.08		 $782.09
$862.23
$947.11
$1248.67		 $970.56
$1050.70
$1135.58
$1437.14		 $1159.03
$1239.17
$1324.05
$1625.61		 $485.28
$525.35
$567.79
$718.57		 $673.75
$713.82
$756.26
$907.04		 $862.22
$902.29
$944.73
$1095.51		 $188.47

Plan: (HMO) KP Silver III $30 - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $2,500 : Family: $5,000
Out of Pocket Maximum per year: Individual: $7,150 : Family: $14,300

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Silver 21
30
40
50
60		 $254.51
$288.86
$325.26
$454.55
$690.73		 $509.02
$577.72
$650.52
$909.10
$1381.46		 $670.63
$739.33
$812.13
$1070.71		 $832.24
$900.94
$973.74
$1232.32		 $993.85
$1062.55
$1135.35
$1393.93		 $416.12
$450.47
$486.87
$616.16		 $577.73
$612.08
$648.48
$777.77		 $739.34
$773.69
$810.09
$939.38		 $161.61

Plan: (HMO) KP Bronze II 30% - Fit

Summary of Benefits and Coverage - Plan Brochure - Customer Service Phone: 1-800-570-8004 - Provider Directory for This Plan: (Kaiser Foundation Health Plan, Inc.)

Deductible: Individual: $5,500 : Family: $11,000
Out of Pocket Maximum per year: Individual: $6,550 : Family: $13,100

Monthly Premiums:
Metal level Age Individual
 Couple
Couple
w 1 Kid
 Couple
w 2 Kids
 Couple
w3+Kids
 Single
w 1 Kid
 Single
w 2 Kids
 Single
w3+Kids
 Child
any age
Bronze 21
30
40
50
60		 $191.12
$216.92
$244.25
$341.34
$518.70		 $382.24
$433.84
$488.50
$682.68
$1037.40		 $503.60
$555.20
$609.86
$804.04		 $624.96
$676.56
$731.22
$925.40		 $746.32
$797.92
$852.58
$1046.76		 $312.48
$338.28
$365.61
$462.70		 $433.84
$459.64
$486.97
$584.06		 $555.20
$581.00
$608.33
$705.42		 $121.36

 

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