HomeMy WebLinkAboutContract10/17/2024
Attest:________________________________Jas
Jason A. Seth, City Clerk
CAG-24-288
!Medicare Rates by Tier MedicareAB I $ 493.88
I All plans offered and underwritten by Kaiser Foundation Health Plan of Washington I This health coverage meets or exceeds the minimum essential coverage requirements and the minimum value standard for the benefits it provides. I This outpatient prescription drug coverage meets the Medicare Part D standard for creditable coverage.
Signature ______________________ Date ___________ _
526GG07-0917
10/17/2024
Attest:___________________________________
Jason A. Seth, City Clerk
Rates Confirmation City of Renton �,T� KAISER PERMANENTE ®Effective Date 1/1/2025 to 1/1/2026
The below rates have been quoted for the following plan(s). Please sign below to confirm rates.
Applicant further acknowledges and agrees that payment of any premium due for the coverage shall constitute applicant's acceptance of the coverage agreement issued.
Core HMO
Group Name City of Renton
Group Number 1162600
RQ-198272
EE $ 742.36
EE/S $1,873.52
Rates by Tier EE/1C $1,284.46
EE/2+C $1,757.98
EE/S/1C $2,415.58
EE/S/2+C $2,889.08
All plans offered and underwritten by Kaiser Foundation Health Plan of Washington
This health coverage meets or exceeds the minimum essential coverage requirements and the minimum value standard for the benefits it provides.
This outpatient prescription drug coverage meets the Medicare Part D standard for creditable coverage.
Signature _____________________ Date __________ _
526GG07-0917
10/17/2024
Attest:________________________________
Jason A. Seth, City Clerk