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CONNECT with the CityKaiser Permanente Traditional (HMO) Information
Kaiser Permanente Traditional HMO Plan Summary of Benefits and Coverage- Kaiser Permanente Traditional HMO Plan Disclosure Form
- Kaiser Permanente Chiropractic Benefits
Kaiser Permanente Traditional (HMO) Premiums
| Coverage Type | Annual | Monthly | Semi-monthly (24 pay periods)* |
||
|---|---|---|---|---|---|
| Post-tax | Pre-tax | ||||
| Employee only | $5,895 | $491.25 | $0.00 | $245.63 | |
| Employee & Spouse | $12,910 | $1,075.85 | $0.00 | $537.93 | |
| Employee & Domestic Partner (non-dependent) | $12,910 | $1,075.85 | $292.30 | $245.63 | |
| Employee & Children | $11,201 | $933.38 | $0.00 | $466.69 | |
| Employee & Spouse & Children | $17,921 | $1,493.41 | $0.00 | $746.71 | |
| Employee & Domestic Partner & Children (non-dependent) | $17,921 | $1,493.41 | $280.02 | $466.69 | |
* Variances Due to Rounding