Kaiser Permanente Washington Options Federal, HDHP: 2027 FEHB premiums and benefits
| Enrollment | Employee, biweekly | Employee, monthly | Annuitant, monthly | Change in your share vs 2026 | Employee, per year (26 periods) |
|---|---|---|---|---|---|
| Self Only code L14 | $95.70 gov $287.09 | $207.34 | $207.34 | +$2.14 biweekly | $2,488 |
| Self Plus One code L16 | $212.44 gov $637.33 | $460.29 | $460.29 | +$4.76 biweekly | $5,523 |
| Self and Family code L15 | $212.44 gov $637.33 | $460.29 | $460.29 | +$4.76 biweekly | $5,523 |
HDHP, PPO network. Offered in Washington (36 counties). The county list is on the comparison page. The government share is the lesser of 72% of the program-wide average premium or 75% of this plan's premium (5 U.S.C. 8906).
Educational information only; StandWatch is not acting for OPM, and the brochure and your agency's benefits office are the final authority. Same code and assumptions as the comparison page: worst year is exact (premiums plus the in-network out-of-pocket maximum, minus an HSA deposit); the other three are estimates under stated usage profiles, each labeled copays only, has coinsurance, or not priced.
Deductibles and limits
| Self Only | Self Plus One | Self and Family | |
|---|---|---|---|
| Deductible | $1,750 out of network $1,750 | $3,500 out of network $3,500 | $3,500 out of network $3,500 |
| Out-of-pocket maximum | $5,000 out of network $5,000 | $10,000 out of network $10,000 | $10,000 out of network $10,000 |
| Health Savings Account contribution | $750 | $1,500 | $1,500 |
| Deductible after the account | $1,000 | $2,000 | $2,000 |
What you pay for care, in and out of network
| Service | In network | Out of network |
|---|---|---|
| VISITS | ||
| Preventive care | Member Pays Nothing | Member Pays All Charges |
| Primary care visit | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Specialist visit | 20% Coinsurance of Plan allowance | $40 Copayment |
| Urgent care | 20% Coinsurance of Plan allowance | 20% Coinsurance of Plan allowance |
| Emergency room | 20% Coinsurance of Plan allowance | 20% Coinsurance of Plan allowance |
| Labs and X-rays | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| CT, MRI, PET | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Hospital stay, per admission | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Hospital room | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Surgeon, inpatient | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Outpatient surgery | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Mental health, office | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Mental health, inpatient | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Physical therapy | 20% Coinsurance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Chiropractic | 20% Coinsurance Up to 20 treatments per calendar year. | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Acupuncture | 20% Coinsurance up to 20 treatments per calendar year when treatment is received from a licensed or certified acupuncture practitioner | 40% Coinsurance |
| Maternity care | Member Pays Nothing | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Maternity hospital stay | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Infertility diagnosis and treatment | 50% Coinsurance of Plan allowance | 50% Coinsurance 50% of Plan allowance and any difference between our allowance and the billed amount Infertility |
| IVF and assisted reproduction | Member Pays All Charges | Member Pays All Charges |
| Hearing aids | Covered All charges in excess of $3,000 for one hearing aid per ear every 36 months | Covered All charges in excess of $3,000 for one hearing aid per ear every 36 months |
| Durable medical equipment | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Home health | 20% Coinsurance of Plan allowance | 40% Coinsurance 40% of Plan allowance and any difference between our allowance and the billed amount |
| Adult dental exams | Covered | Covered |
| Children's dental exams | Covered | Covered |
| Routine eye exam | Covered 20% of Plan allowance | Covered |
| Eyeglasses | Covered One pair of eyeglasses or contact lenses to correct an impairment directly caused by accidental ocular injury or intraocular surgery | Not Covered |
| PRESCRIPTIONS | ||
| Tier 1 (usually generic) | $10 Copayment | 100% Coinsurance |
| Tier 2 | $30 Copayment | 100% Coinsurance |
| Tier 3 | $60 Copayment | 100% Coinsurance |
| Tier 4 | 25% Coinsurance | 100% Coinsurance |
| Mail order | Yes | Yes |
| Prescription out-of-pocket maximum, Self | None | Not listed |
| Prescription out-of-pocket maximum, family | None | Not listed |
| WITH MEDICARE | ||
| Part B premium reimbursement (prescription drug plan) | None | Not listed |
OPM's summary of the plan's cost sharing. The small print under a figure is OPM's own wording and usually carries the real terms: per-day charges, caps, and whether the deductible applies. The brochure is the official statement of benefits.
Official pages
Kaiser Permanente Washington Options Federal plan site · Summary of Benefits and Coverage · OPM plan comparison and brochure RI 73-051 · 888-901-4636
Before you enroll
Not the official statement of benefits. This plan's brochure is the only contractual statement of what it covers, excludes, and limits. Where this page and the brochure disagree, the brochure governs. Read it before you enroll.
Estimates, under published assumptions. Premiums, deductibles, and out-of-pocket maximums are OPM's figures. The year-cost figures are estimates under the usage profiles and assumed charges published on the comparison page, labeled exact, copays only, has coinsurance, or not priced. They are not predictions of what you will spend.
What the model leaves out. Out-of-network care and balance billing, whether your own doctors take this plan, whether your medications are on its formulary and at which tier, referral and prior-authorization rules, mail-order and specialty pharmacy pricing, FEDVIP dental and vision, and Medicare coordination at 65 beyond the rows shown. Postal Service employees and annuitants are in a separate program and are not covered.
No affiliation. StandWatch is not affiliated with, endorsed by, or acting for the Office of Personnel Management or any federal agency. The plan data is OPM's; the arrangement is ours. StandWatch is not a health plan, a broker, or an insurer, and nothing here is a recommendation to select, keep, or drop any plan, or medical, insurance, financial, tax, or legal advice. The full educational-purpose statement.
Source: OPM FEHB Public Use Files, plan year 2027 (rates, plan key, plan benefits, service area), and the OPM premium charts for the change from 2026.
